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08-02-'16 08:19 FROM- FIRESIDE T-364 P0002/0004 F-897 <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 <br /> odel:Fuel:Flue Size: <br /> Input BTUs: <br /> Output BTUs: <br /> CFM: <br /> COOLING SYSTEMS <br /> i <br /> c <br /> Quantity: { <br /> a <br /> Make: <br /> Model! <br /> Tons: <br /> H.Power <br /> FIREPLACES <br /> Gas Factory Fireplace Brand Name: <br /> O Wood Burning Fireplace 65040 -_Z715 <br /> Wood Stove Model No.: <br /> ❑ Wood Stove with Flue/Masonry <br /> i <br /> VENTILATION <br /> ❑ No. Kitchen Exhaust duct recirculating cfm i <br /> ❑ No. Bath Exhaust(must have duct outside) cfm <br /> ❑ No. Other Pans: Locations cfm <br /> FUEL STORAGE (Must be approved by pyre Marshall ifproposing to abandon tank in place,) <br /> i <br /> ❑ Installation ❑ Removal <br /> Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside <br /> LP Gas: gallons <br /> Other: <br /> GAS CINE ONLY f <br /> ❑ Outdoor Grill ❑ Other/List What&Where: <br /> 2 <br />