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May• 0� 2014 3: 22PM HP LRSERJET FRX p. 4 <br /> � ,-,,: <br /> ,.� <br /> Note:All G�therma!Systems wil]now require a Site Plan& Review by our Building Offici�l <br /> ' LS?HIS GEOTHERMAL? ❑ Yes�o <br /> HEATING SYSTEMS <br /> � Qusntity: / <br /> Make: �'��Z�12a <br /> Model: !�- <br /> � FucL• � <br /> Flue Size: �' <br /> . Input STUs: � <br /> Output BTils: �?�� <br /> CFM: (' <br /> ' COOLING SYSTEMS � <br /> , <br /> Qaantity: <br /> Make: <br /> � Model: <br /> Tons: <br /> �" H.Power <br /> FIREPLACES <br /> ❑ Gas Factory Firoplace Brar►d Name: <br /> ❑ Wood Burning Fireplace <br /> ❑ Wood Stove Model IVo.: <br /> ❑ Wood Stove with Fluc/Masonry <br /> VENTlLA770N <br /> � No. � Kitchen Exhaust � duct reciroulating �'� cfm <br /> No. "2-- Bath Exhaust(must have duct outside) �c <br /> ❑ No. Other Fans: Locations cfm <br /> FULL STORAGL (Must be approvad by Flre Marshal�PJ'propos�irg to abandon tank in placG) <br /> ❑ Installation ❑ Remaval <br /> Fuel Oil: gailons ❑ Underground ❑Inside ❑Outside <br /> LP Gas: galions <br /> Othtr: � <br /> GAS LINE ONLY <br /> ❑ Outc}oorGrili � Other/List WhatBt Where: �� <br /> 2 I <br />