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r <br /> • r <br /> MECHANICAL SYSTEMS BEING iNSTALLED ~ <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: 1 <br /> Make: C�✓f i e l� <br /> Model: `�Q T 1'J S �d�U <br /> Fuel: N u.�c.�.rcth�pu5 <br /> Flue Size: <br /> Input BT'Us: �U��L� _ <br /> Output BTUs: �lo ��S�a <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <br /> H.Power <br /> FIREPLACES <br /> ❑ Gas Factory Fireplace Brand Name: <br /> ❑ Wood Buming Fireplace <br /> ❑ Wood Stove Model No.: <br /> ❑ Wood Stove with Flue/Masonry <br /> VENTILATION <br /> ❑ No. Kitchen E�aust duct recirculating cfrn <br /> ❑ No. Bath Exhaust(must have duct outside) cfin <br /> ❑ No. Other Fans: Locations cfrn <br /> FLTEL 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 />