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;, .1 ` s0, d` •.:4,1r" 7":!:17,143R10?; <br /> Note: All Geothermal Systems will now <br /> require a Site Plan&Review by our Building Official. <br /> IS THIS GEOTHERMAL? El Yes <br /> HATING SYSTEMS <br /> Quantity: <br /> Make: 06n-feint ,Y L f(t fit <br /> Model: <br /> Fuel: � ) 1401 <br /> Flue Size: ,c <br /> Input BTUs: ( �� y,� , -2)�oes <br /> Output BTUs: (�lly <br /> CFM: Aye d <br /> COOLING SYSTEMS V) <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 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 />