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NJILNG IN <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: <br /> Make: <br /> Fuel: <br /> Flue Size: <br /> T....jDD.—T... <br /> ,,,tpA B 1 V <br /> Output BTUs: <br /> CFM: <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <br /> ii.v�JCrr <br /> FIREPLACES <br /> ❑ Gas Factory Fireplace Brand Name: <br /> 1_1 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 /> F1 IA 0 1: gallons ❑ I inrlararnimrl ❑incitiP ❑nLtQ'dp <br /> LP Gas: gallons <br /> Other: <br /> GAS LINE ONLY <br /> I-1 n...a i :ii ",tar r�",41h-. D.\iTl _ �� fL, tti / 110.E K. S�ilbf b. %.. <br /> 2 <br />