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11-15-'16 14:14 FROM- T-410 P0002/0004 F-501 <br /> ' ��'.�S�Pf'•i!5h�.:`::�."!���:c..:t3�'. i�.�i "�„+u,,�:�.,' ('r'�': � � '`��v!M.7 �t~ .;� { •" .. <br /> ��tiP:� )'�� �Af :iP' iF'r _Y� .nNti'.:.Y.ci3.5if..{. ��Y ,.�... r ci..�:C <br />' Note:All Greotliermal Systems will now require a Site p11n&Iteview by our Building Official. <br /> YS T�S G�OT�iERMAL? ❑Ye3 �No <br /> H�ATYNG S'YSTEMS <br /> Quat►tity: <br /> Make: <br /> Modet: <br /> Ptiek <br /> Flue Size: <br /> Input BTUs: <br /> Output�TTJs: <br /> GFM: <br /> COO�,TN'G S�'STEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <br /> H.power <br /> Frkt��'X.AC�S <br /> Gas�'actory�ireplace Brand Namc: , <br /> ❑ Wood Burning�ireplace � �^�- <br /> ❑ Wood Stove Model No.: �J�C�' �. c� ! <br /> ❑ Wood Stovo with rlue/Mason�y <br /> 'V'�NTZT,ATYON <br /> ❑ No. Kitchen�xhaust duct reeireulating efm <br /> ❑ No. �A[�l E7CIlAUSS�must have duct putside) cfm <br /> ❑ No. Other�'Ans: T.ocations cfm <br /> �CJE�,SxOXtAG� (Mirst be approved hy 1�pwe,�arshall�fproposi►eg to abandon tank i��pl�ce.) <br /> ❑ Iost�llation ❑ Removal <br /> Fucl Oil: gAlloi�s ❑ Underground ❑�nside ❑Outside <br /> LP Gas: gallons <br /> Other: <br /> GA,S�.lIN1E ONY.'Y � ' � . <br /> ❑ Outdoor Grill ❑ Other/List Nhat&W11ere: <br /> 2 <br />