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, w ' <br /> MECHANIGAL SYSTEMS BEI�TC.�TN�TALLE��} ': <br /> Note: All Geotl�ermal Systems will now require a Site Plan& Review by our Building Official. <br /> IS THIS GEOTHERMAL? ❑ Yes �No <br /> HEATING SYSTEMS <br /> Quantity: <br /> Make: l,l��` ' 'ti/1 <br /> Model: �11 `x� <br /> Fuel: (/LJi . <br /> Flue Size: <br /> Input BTUs �VO� � <br /> Output BTUs: � � <br /> CFM: OD <br /> COOLING SYSTEMS � <br /> Quantity: <br /> . <br /> Make: � � <br /> Model: �—t�� <br /> Tons: <br /> H.Power <br /> FIREPLACES <br /> ❑ Gas Factory Fireplace Brand Name: <br /> ❑ Wood Buri�ing Fireplace <br /> ❑ Wood Stove Model No.: <br /> ❑ Wood Stove with Flue/Masonry <br /> VENTILATION <br /> Na Kitchen Exhaust duct recirculating cfin <br /> No. ��- Bath Exhaust(must l�ave duct outside) �cfm <br /> No. Other Fans: Locations cfin <br /> FUEL STORAGE (Must be app��oved by Fire Marsliall if proposi�:g to abandon ta»k in place.) <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 />