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Note:All Geothermal Systems will zaaw req ' e a Site &Review by our Building Official, <br /> IS THIS GEOTHERMAL? yes <br /> o <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.- <br /> Wood <br /> apoe:Wood Buxning Fireplace <br /> ❑ Wood Stove Model No,: <br /> ❑ Wood Stove with Flue/Masonry <br /> Yom' NTILATI;ON <br /> ❑❑.. No. Kitchen Exhaust duct_ recirculating cfrn <br /> No' Bath Exhaust(must have duct outside) cfm <br /> [] No. Other Fans: Locations cf n <br /> FUEL STORAGE (Must he approved by Fire Marshall if proposing to abandon tank in place.) <br /> ❑ Installation ❑ RemovaI <br /> Fuel Oil: gallons E] Underground ❑Inside ❑Outside <br /> LP Gas: gallons <br /> Other: <br /> GAS LINE ONLY /�++ <br /> ❑ Outdoor Grill Other/List What&Where: l�As P1P6 � "rr <br /> 2 <br />