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Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official. <br /> IS THIS GEOTHERMAL? f1 Ycs GI No <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 /> ynS y (o'� lJ <br /> 0 Gas Factory Fireplace Brand Name: Koz Heat <br /> ❑ Wood Burning Fireplace <br /> 8 Wood Stove Model No.: CSK-335 (?) <br /> ❑ Wood Stove With Flue <br /> InSnru I )r Lr$ Ver rinc,e in MAin -POD . <br /> VENTILATION hSTAu— l nS�T �&nrir)G tr► Loc �L��- <br /> ❑ No. Kitchen Exhaust duct recirculating cfm <br /> ❑ No. Bath Exhaust(must have duct outside) cfm <br /> El 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 />