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11�16-'15 15:31 FROM- T-438 P0402/0007 F-778 <br /> �,.io!!Ci�.�;4'.rF;'%\lhi;:��!l���:"l.�rr3:�: ;Ih�. ;(:.,sy;�/�;`.�1f}";`,-�`�? , <br /> • <br /> �;�,�.,,;:.:, :,:,.,�,.;.,;,� ;t.�; NTCA �;SY�S•r� � S�'AI:..E, .. ,,.� <br /> . .. <br /> � ... •� � ' . C.�1 L ��' E�N,�'C`�.�.:,IN.. ," <br /> .,, � �<., J,- ��°'-. <br /> Notc: All Qeothermal Systems will now require&Site plan&Review by our Building Official. � <br /> YS THYS G�OTH�CtMAL? ❑Yes ❑No � <br /> HEATIIVG SYST�MS <br /> � <br /> Quantiry: ; <br /> 's <br /> Make: � <br /> � <br /> Modcl: � <br /> -- - s <br /> � <br /> �uel: <br /> Fluc Siz�: <br /> Input�T�Js: <br /> ; <br /> Output BTUs: . <br /> ; <br /> C�M: i <br /> COOY.INC S'l''ST�MS { <br /> Quantity: <br /> Make: <br /> � <br /> Model: <br /> Tons: <br /> �,Power <br /> � <br /> �iREp�,nc�s <br /> � Gas Factory Pirepl�ce Brand N'amz: `�'1 .� �I..V'"' . �(�7 � <br /> [J Wood Buming,Fireplacc �` 1� ; <br /> (] .'VJ�obd Stove Modol No�: S`s��.V>` ��( �, �� E <br /> ❑ �Wood Stoyz with l�lue/Masonry. <br /> VENTILATION ? <br /> r <br /> � <br /> ❑ No. �itchen Exhaust duct rccirculating cfm j <br /> ❑ No. Bath�xhaust(must have duct outsidz) cfrn i <br /> ❑ No. Othcr Fans: Locations cfm j <br /> � <br /> �UL�C.STO�tAG� (M��st be up,proved 6y FYre Mnrshnll fprupos�ng to nbandon tank in p►nce.) � <br /> I <br /> ❑ Inst�tllation ❑ R.emoval i <br /> I <br /> Puel Oil: �gallons ❑ Underground 0 Tnside �Outside <br /> �.P Gas: gallons <br /> Othcr: <br /> GA.S y.,XNE ONLY <br /> ❑ Outdoor Grill ❑ Other/List What&Where: <br /> 2 <br /> � <br /> � <br /> � <br />