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Site Application Survey

To determine the appropriate patio heater selection and placement, please fill in the following information, or download a PDF and fax it to us at (724) 652-0682.

Type of Gas

Natural
Propane

Patio Location

Ground Level
First Floor Roof
Elevated Above Ground
Other

Entire Patio to be Heated?

Yes
No

Patio Floor Construction

Does Patio Overlap City Property?

Yes
No

Does Patio Butt-Up Against a Wall?

Yes - 4 Sides
Yes - 3 Sides
Yes - 2 Sides
Yes - 1 Side
No
Wall Height

Can the Heater be Wall-Mounted?

Yes
No

Is there a Patio Fence?

Yes - 4 Sides
Yes - 3 Sides
Yes - 2 Sides
Yes - 1 Side
No
Fence Height

What seasons will the patio be open?

Spring
Summer
Autumn
Winter

Are there Patio Heaters now?

Yes
If so, what kind?
No

Is there a roof/canopy over the patio?

Yes
If so, where?
...height to bottom of roof?
...what material?
No

Are there other height obstructions?

Yes
Where and how high are the:
Building Overhangs
Trees
Decorative Beams
Signs
Permanent Umbrellas
No

Number of Patrons Patio is Licensed for:

Number of Patrons
Number of Tables
Size of Tables
Number of Chairs
Number of Bar Stools

Your Information

Submitted By
Company
Date

Project Information

Project Name
Project Contact
Address
Phone
Fax
E-mail
Notes

Send Survey