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Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official. <br /> IS THIS GEOTHERMAL? ❑Yes•:N No <br /> HEATING SYSTEMS ✓` k✓1(Jt i e k— <br /> Quantity: <br /> Make: Lev,ha L.ennox L-P,vl rte_ <br /> Model: EL2-%W407dX✓3W %i. &Q9-VV 1~LM6(Jila90Xv31C Cp,X32ri�Vc <br /> Fuel: 11/0 <br /> Flue Size: <br /> Input BTUs: 6(a o o�_ 9, (go O 0 00 <br /> Output BTUs: <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity: -S- 3 <br /> Make: Le n L P_ny1 n) <br /> Model: X Q a-0l 6 Qx 0 -(�- <br /> Tons: <br /> H.Power <br /> FIREPLACES <br /> ❑ Gas Factory Fireplace Brand Name: <br /> ❑ Wood Burning Fireplace <br /> ❑ Wood Stove Model No.: <br /> ❑ Wood Stove with Flue/Masonry <br /> VENTILATION <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 by Fire Marshall 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 />