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"` z . <br /> ? s�. ,yW� �� �5 �,'• � � a . <br /> � �' �� ��.r�� ,;v�< <br /> , 1'Vate:All Geothermal Systertzs will now require a Site Plan&Review by our Buildin�Official. <br /> IS THIS GEOTHERMAL? -(�Yes �No <br /> HEATING SYSTEMS <br /> Quantity: ___ __ ��.�._ <br /> Make: ._._.....__ <br /> Model: <br /> Fuel: <br /> Ftue Size: � <br /> :tnput BTUs: <br /> fJutput B1'Us: � <br /> CFM: <br /> Ct3�I,ING SY'�T�MS <br /> Quantity: <br /> Make: <br /> ModeL � <br /> Tons: <br /> H.Power <br /> FIREPLACES <br /> ❑ Gas F�ctory Fireplace Brand Name: <br /> ❑ Waod Bumin��ireplace _ —_.._., <br /> ❑ W[SOd StOVe Model No.: <br /> �..... <br /> Woo�Stove witl°�Ftue/Masanry <br /> VEN'�;LAT�4N <br /> ❑ No. Kitchen Exhaust duct __recirculating cfm <br /> �.__ <br /> N0. ........____..._. Bath 8xha��st(must have duct autside) 1 Cftri <br /> ❑ No. .._.._____ �ther Fans: Locations_._.... �cfm <br /> k"[JEL STQR,,�G� (Must be approved by,�"ire M�rshall if prapr�xing tn aba�t�lvrr tartk in plac�) <br /> ❑ Installation ❑ R.emoval <br /> Fue(Oil; gat2ans ❑ Undergraund [�lnside ❑Outside <br /> LF Gas: � ..____..�gallons <br /> 4ther: _ ...._.__._.�_._ <br /> GA�LINE 41VLY <br /> ❑ C?utdoor Gril! � f.hher(List What&Where:_/��L�$ ��' � ��"�,� <br /> 2 � � s �.c����� <br />