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i 'w h � :� � � � ���`;MEC� � t �C�� �.���LViS. '� �;���L D�"`��,� �',�'�%'�.���;��� <br /> � <br /> Note: All Geothermal Systems will now require a Site P.lan&Review by our Building Official. <br /> IS THIS GEOTHERMAL? ❑Yes [�,No <br /> HEATING SYSTEMS <br /> Quantity: I <br /> Make: l�hl �� <br /> el: � '�$ �3b� <br /> FueL• <br /> Flue Size: <br /> Input B1'Us: <br /> Output BTUs: <br /> CFM: <br /> I COOLING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: �� �`n <br /> H.Power <br /> FIREPLACES <br /> ❑ Gas Factory Fireplace Brand Name: <br /> ❑ Wood Burning Fireptace <br /> ❑ Wood Stove Model No.: <br /> ❑ Wood Stove with Flue/Masonry <br /> V ENTiLATIOIY <br /> ❑ No. Kitchen Ex�iaust duct recirculating cfm <br /> ❑ No. Bat6 Exhaust(must have duct outside) cfin <br /> ❑ No. Other Fans: Locations cfin <br /> FUEL STORAG E (Must be approved by Flre Marsha!!if proposing to abandon tmik in plac�) <br /> ❑ Installation ❑ Removal ' <br /> Fuei 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 />