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Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official. <br /> IS THLS GEOTHERMAL? ❑Yes �No <br /> HEATING SYSTEMS <br /> Quantity: I <br /> Make: ��'1�"T <br /> Model: 3��' l►�v D l b�� � <br /> Fuel: �-�- �S <br /> Flue Size: <br /> :� y <br /> Input BTUs: /�i��b <br /> Output BTUs: �2' �U� <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity; , <br /> Make: l����� <br /> Model: I � 13,\N��3D <br /> Tons: 2• s <br /> H.Powe�! <br /> FIREPL CES <br /> � Gas Factory Fireplace Brand Name: <br /> Wood Burning Fireplace <br /> ❑ Wood Stove Model No.: <br /> ❑ Wood Stove with Flue/Masonry <br /> VENTIL�ATION <br /> No. Kitchen Exhaust duct recirculating cfm <br /> No. Bath Exhaust(must have duct outside) cfm <br /> No. Other Fans: Locations cfm <br /> FUEL S'�ORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.) <br /> ❑ Installation ❑ Removal <br /> Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside <br /> LP Gas: gallons <br /> Other: <br /> GAS LI1�E ONLY <br /> Q Outdoor Griil ❑ Other/List What&Where: <br /> 2 <br />