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�,. �.��, .:a,�,. .__.� � <br /> ,�. • <br /> SYSTEM DESCRIPTION <br /> HEATING SYSTEMS / / <br /> Quantity: ( , <br /> Make: �/�,Z� C <br /> Model: �1��(/�V���70 V �/��/l Y��d�V <br />�:. Fuel: �7 9Q,S <br /> s . i�i ..� — , <br /> Flue Size: �__ <br />�y /O U v v <br /> Input BTLJs: /�/��V V <br /> Output BTUs: <br /> CFM: <br /> E�= COOLING SYSTEMS <br /> i',_ <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <br /> H.Power <br />�,!'. <br />'` FIREPLACES GAS LINE ONLY <br />�: <br /> ❑ Gas factory fireplace ❑ Installing a Gas Line Only <br /> ❑ Wood burning factory fireplace with flue <br /> ❑ Wood Stove <br /> ❑ Wood stove with flue <br /> Brand Name Model No. <br /> ,, <br /> VENTILATION <br /> u;;.: <br />;�` No. Kitchen Exhaust duct recalculating cfm <br /> sw. <br />�:� 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 � `6 <br /> �,N <br /> a; 2 <br /> a;�, <br /> ir,., <br />. <br /> n .�. . . ; . � .. � . � � . . . . . � . - <br /> ; � � .. . : -�. , . <br /> 4 _ ... . . . . . . . . . ,.. ,. . �. <br /> . . . . . l. . . . , . � � . � , . � - <br /> rf '. � . . .�. - . . . . .. . . � . . . _, x.. <br /> � . . . . �. . . . . . �. . .. ' �. . ,. . � . _ . . .. . .. . . :,: <br /> 6. <br />� — s <br /> , <br /> � <br /> _, . _ <br /> c� , - . . .-..�„±. ,_._. .., ......�__� ._. <br />