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� �� ,� � �'�`��E+� �:A:L SYSTEM�y�EIItT ���ISTA:I�'� �:. a�� '� q:., `�. <br /> Note: All Geothermal 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: <br /> Model: <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: Montigo <br /> ❑ Wood Burning Fireplace <br /> � Wood Stove Model No.: LS38FSDN a^���v �-�l S <br /> ❑ Wood Stove With Flue . • <br /> .1-.i�r�cL duTaoo� F�2�p�1c� �- J�nnG <br /> VENT[LATION /�DOit- TD ��S �n� ��"� �'� �rn�'�S <br /> ❑ No. Kitchen Exhaust duct recirculating cfm <br /> ❑ No. Bath Exhaust(must have duct outside) cfm <br /> ❑ No. Other Fans: Locations cfm <br /> FUEL STORAGE (Must be approved 6y Fire Mars/iall 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 /> ❑ Outdoor Grill � Other/List What&Where: <br /> 2 <br />