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t ' <br /> Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official. <br /> IS THIS GEOTHERMAL? ❑ Yes P-110 <br /> HEATING SYSTEMS 1 <br /> Quantity: 1 <br /> wv- <br /> Make: �ny , ,Pum�`� I1 T <br /> Model: �(]�/ ll J <br /> Fuel: <br /> Flue Size: <br /> Input BTUs: <br /> Output BTUs: O <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 <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 ijproposing to abandon tank in place.) <br /> 0 Installation 8 Removal <br /> Fuel Oil: gallons ❑ Underground 8 Inside 8 Outside <br /> LP Gas: gallons <br /> Other: <br /> GAS LINE ONLY <br /> ❑ Outdoor Grill ❑ Other/List What&Where: <br /> 2 <br />