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10/07/2015 09:10 6517722440 STANDARD HEATING PAGE 02/031 <br /> 'i <br /> + + I <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: 1 <br /> Make: �. <br /> Model: LC MP <br /> Fuel: rn`t� <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: <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 of n <br /> FUEL STORAGE (Must be approvedby Flee Marshall ifprgposing 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 X Other/List What&Where: <br /> ( (^ Q I <br /> 2 <br /> I <br />