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1 � <br /> Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official. <br /> IS THIS GEOTHERMAL? ❑ Yes x❑No <br /> HEATING SYSTEMS <br /> Quantity: � <br /> Make: DAIKIN <br /> Model: DM96VE1004CN <br /> Fuel: NATURAL GAS <br /> Flue Size: <br /> Input BTUs: 100,000 <br /> Output BTUs: 96,000 <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity: � <br /> Make: DAIKIN <br /> Model: DX13SA611 <br /> Tons: 5 <br /> H. Power <br /> FIREPLACES <br /> ❑ Gas Factory Fireplace Brand Name: <br /> ❑ Wood Burning Fireplace <br /> ❑ Wood Stove Model No.: <br /> ❑ Wood Stove with Flue/Masonry <br /> VENTILATION <br /> ❑ Na Kitchen Exhaust duct recirculating cfin <br /> ❑ No. Bath E�aust(must have duct outside) cfm <br /> ❑ No. Other Fans: Locations cfin <br /> FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.) <br /> ❑ Installation ❑ Removal <br /> Fuel Oil: gallons ❑ Undergound ❑ Inside ❑ Outside <br /> LP Gas: gallons <br /> Other: <br /> GAS LINE ONLY <br /> ❑ Outdoor Grill ❑ Other/List What&Where: <br /> 2 <br />