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. . • <br /> , .. <br /> J <br /> Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official. <br /> IS THIS GEOTIiERMAL? ❑ Yes �No <br /> HEATING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Fuel: <br /> Flue Size: <br /> Input BTUs: <br /> Output BTUs: <br /> CFM: <br /> COOLING SYSTEMS <br /> �,tiri� 1 <br /> Make: I IT�jc u� 1 <br /> Model: — �s� <br /> Tons: <br /> H.Power <br /> FIItEPLACES <br /> ❑ Gas Factory Fireplace � Brand Name: <br /> ❑ Wood Burning Fireplace <br /> ❑ Wood Stove Model No.: <br /> ❑ Wood Stove With Flue <br /> VENTILATION <br /> ❑ No. Kitchen Exhaust duct recirculating cfin <br /> ❑ No. Bath E�chaust(must have duct outside) cfm <br /> � No. Other Fans: Locations cfm <br /> FUEL STORAGE (Must be opproved by Fire MarshaU ifproposi►ig to abandon tank in place.) <br /> 0 Installation a 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 />