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5,���---t m�-�.�/ u�o,�,� d ivl� . . � <br /> v�o v'E o n E >'•Pu n K l ,'n� 6ELi,'�+c� Gt/ta�� �n q� � <br /> SYSTEM DESCRIPTION ��oa k �/� ��p��� FS <br /> HEATING SYSTEMS �� ,5 l,�n — �0�„ �y ��N y'•y,q �NR��{�� <br /> i l � 1 <br /> Quantity: <br /> Make: <br /> Model: <br /> Fuel: <br /> Flue Size: <br /> Input BTUs: <br /> Output BTUs: <br /> CFM: <br /> COOLING SYSTEMS � s�/� � o� A���� {y, ` �/� <br /> � � J <br /> �� c. � <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <br /> H.Power <br /> FIREPLACES GAS LINE ONLY <br /> � ❑ Gas facto�ry ifeplace nl ❑ Installing a Gas Line Only <br /> ❑ Wood burning factory fireplace with flue /V �- <br /> ❑ Wood Stove <br /> ❑ Wood stove with flue <br />�,:, <br /> Brand Name Model No. <br /> VENTILATION <br /> No. Kitchen Exhaust duct recalculating cfm <br /> N � No. Bath Exhaust(must have duct outside) cfm <br /> - No. Other Fans: Locations cfm <br /> FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL) <br /> � ❑ Installation or ❑ Removal <br /> � ❑ Fuel oil: gallons ❑ underground ❑ inside ❑outside <br /> ❑ LP Gas: gallons <br /> ❑ Other Gas opening <br /> 2 <br /> . ,: <br /> . <br /> : . -, . <br /> : . -. <br />�. �_ ;. ...__ . , _ � _ .. a. . . _ ...._. <br />