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. ` <br /> Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official. <br /> IS THIS GEOTHERMAL? ❑Yes �No <br /> HEATING 5YSTEMS <br /> Quantity: <br /> Make: <br /> Model: �C1�/���U�'Y7��7- ��D <br /> Fuel: _��� <br /> Flue Size: <br /> /� <br /> Input BTLTs: p <br /> Output BTLTs: �Q_(� <br /> CFM: 1 <br /> COOLING SYSTEMS <br /> �tl�,: ( <br /> Make: <br /> Model: ��T�}- '��„ �()��p3 <br /> Tons: p2 �/�- <br /> H.Power <br /> FIREPLACES <br /> ❑ Gas Factory Fireplace Brand Name: <br /> ❑ Wood Burning Fireplace <br /> ❑ Wood Stove Model No.: <br /> ❑ Wood Stove with Flue/Masonry <br /> VENTILATION <br /> ❑ No. Kitchen E�aust duct recirculating cfm <br /> ' ❑ No. Bath E�chaust(must have duct outside) cfm <br /> ❑ No. Other Fans: Locations cfm <br /> FUEL STORAGE (Must b�approved by Fire Marshall if proposing to abandon tank in plac�) <br /> ❑ Installation ❑ Removal <br /> Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside <br /> LP Gas: gallons <br /> Other: <br /> GAS LINE ONLY <br /> ❑ Outdoor Grill ❑ Other/List What&Where: <br /> 2 <br />