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• �- <br /> �' �___ MECHANICAL SYSTEMS BEING INSTALLED <br /> r <br /> Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official. <br /> IS TffiS GEOTHERiVIAL? ❑ Yes �No <br /> HEATING SYSTEMS <br /> Quantity: _ � _ <br /> Make: ��,,y�,�l �'� <br /> Model: V�I�L���D�/�.��I U P�I.�;� <br /> Fuel: <br /> Flue Size: <br /> Input BTUs: �;�� <br /> Output BTUs: <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity: � � <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 /> ❑ W ood Stove with Fiue/Masonry <br /> VENTILATION <br /> ❑ No. _ Kitchen Exhaust_ duct recirculating cfin <br /> ❑ No. Bath Exhaust(must have duct outside) cfm <br /> ❑ No. Other Fans: Locations cfm <br /> FUEL STORAGE (�lust be approved by Fire Ma��shall if proposing to abantlon tank 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 />