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    Building #1   Building #2
Current heating fuel    
Annual heating cost (estimate only)    
Type of furnace (check one)    Forced Air
 Baseboard
 In-Floor
 Wood Stove
 Other
 None
    Forced Air
 Baseboard
 In-Floor
 Wood Stove
 Other
 None
Approximate Square Feet    
Average Ceiling Height    
Insulation (check one)    Excellent
 Average
 Poor
 None
    Excellent
 Average
 Poor
 None
Would you like to heat domestic hot water?    Yes
 No
    Yes
 No
Distance in feet from outdoor furnace to building    
Would you like a quote on installation services also?    Yes
 No
    Yes
 No
         



 



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