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t <br /> � •n <br /> MECHANICAL SYSTEMS BEING INSTALLED � � <br /> Note: All Geothermal Systems will now re uire a Site Plan&Review by our Building Official. �' � <br /> IS THIS GEOTHERMAL? ❑ Yes o <br /> HEATING SYSTEMS <br /> Quantity: � <br /> Make: (�r��� �v�t,� <br /> Model: <br /> Fuel: ���, �.i �—!�c.� <br /> Flue Size: <br /> -3�; ,� U , � , <br /> Input BTUs: � � ` �' 'J <br /> our�ut BTus: I 1 �� � � � <br /> � <br /> CFM: �C�i? Z� <br /> COOLING SYSTEMS <br /> i <br /> Qu�t��: r J � <br /> Make: <br /> Model: <br /> Tons: <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 /> a Kitchen E�chaust duct recirculating cfin <br /> ❑ No. Bath E�chaust(must have duct outside) �� <br /> ,� No. � Other Fans: Locations lI%'��c t',..t��:��.��` �'��'' i c�.��� �� <br /> FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.) <br /> ❑ Installation ❑ Removal <br /> Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside <br /> LP Gas: gallons <br /> Other: <br /> GAS LINE ONLY <br /> ❑ !�1� _ / ��1 <br /> Outdoor Grill [� Other/List What&Where: ���?-f�/a� l �� �l�'�%'<�' `�`�` <br /> / <br /> 2 <br />