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, , , ,, �<.. .,, . <br /> ��: <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 /> 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 /> 0 Gas Factory Fireplace (�) Brand Name: HEAT&GLO <br /> ❑ Wood Burning Fireplace <br /> B Wood Stove Model No.: 6000CLX-IPI-S (2) <br /> ❑ Wood Stove With Flue a ��• --�— <br /> VENTILATION <br /> ❑ Na Kitchen Exhaust duct recirculating cfm <br /> ❑ No. Bath Eachaust(must have duct outside) cfm <br /> ❑ No. Other Fans: Locations �� <br /> FUEL STORAGE (Must be approved by Fire Marshall ijproposing 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: DONE BY OTHERS <br /> 2 <br />