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� 952�331869 18 07 45 06 15 2015 3/4 <br /> MECHANICAL SYSTEMS BEING INSTALLED <br /> Note: All Geothercnal Systems will now require a Site Plan&Review by our Building Official. <br /> IS THIS GEO"THERMAL? ❑Yes ❑No <br /> HEATING SYSTEMS <br /> Quantity: <br /> Make: <br /> �fodel: <br /> Puel: <br /> Flue Size: <br /> Input BTUs: � <br /> Output BTUs: <br /> CFM: <br /> COOLING SYST�MS <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <br /> H.Power � <br /> I'IR�PLACES <br /> ❑ Gas Factory Fireplace Brand Name: <br /> ❑ Wood Burning[=ircplace <br /> ❑ Wood Stove Model No.: <br /> --,_._____. <br /> Wood Stove with Flue!Masonry <br /> VENTILA'I'ION <br /> ❑ No. Kitchen Exhaust duct recirculating cfm <br /> ❑ No. Bath Exhaust(must have duct outside) cfm <br /> ❑ No. Other Fans: Locations cfm <br /> FUEL S'TORAGE (�Ylusr be upproved hy Fire Murshu/!ifproposing to ahandoir tmik in placc.) <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&Wllere: <br /> C��s �.��E �..��ov �c���rs� ` <br />