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• • <br /> , ��5' � � �;;'���T�iVC,���EIN�G"i1�(�T�"��°� �'�.,� '��'�' �� <br /> Note: All Geothermal Systems will now require a Site Plan & Review by our Building Official. <br /> IS THIS GF,OTHF,RMAL? ❑ Yes [�� <br /> I1F,ATINC SYSTF.MS <br /> Quantity: __� <br /> Make: C c.�r r-��� <br /> Modcl: S�i Sc.SAt�ys ------ <br /> f'uel: _._c�ls.x��� <br /> f'lue Size: <br /> Input B"1'Us: __...`_l_D���_ <br /> Output f3TUs: _�� D�� — -------- -- <br /> Cf M: <br /> ------r-- ----- -- <br /> COOI,INC SYSTEMS <br /> Quantity: l <br /> Make: �a tr .er --- <br /> Model: 2'tA�3 13 3 l$ -----.-------- ---- <br /> Tons: _�_Cj <br /> H. f'ower <br /> FIREPLACES <br /> Op c�S r'actory Fireplace Brand Name: _ _ <br /> Wood [3urning Fireplace <br /> ❑ Wood Stove Model No.: <br /> ❑ Waod Stove with Flue/Masonry <br /> VENTILATION <br /> ❑ Na. _ Kitchen Exhaust duct recirculating cfm <br /> � No. � Bath Exhaust(must have duct outside) ��cfm <br /> ❑ No. __ �Jther Pans: Locations_ cfm <br /> FUEL STORAGE (Mu,sl be np,�roved hy/'ire Mnr,chnl/if prnposing tn nbandnn tank in place.) <br /> ❑ Installation � ❑ Removal <br /> Fuel Oil: _ __gallons ❑ Underground ❑ Inside ❑Outside <br /> I_.P Gas: _—I-- gallons <br /> Other: <br /> ----t---- — <br /> GAS LINE ONLY i <br /> ❑ Outdoor Grill ! ❑ Other/List What&Where: <br /> 2 <br />