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MF,CHArIICAL SYSTEMS BEING INSTALI.ED <br /> Notc: All Geothenual Svstems��i11 no��require a Site Plan& Review by our Building Offi�ial. <br /> IS THIS GEOTHERMAL? ❑Yes ❑No I <br /> HEATING SYSTEMS <br /> Quantity: � _ <br /> Make: i <br /> Model: I <br /> Fuel: I <br /> Flue Size: <br /> Input BT'Us: <br /> Output BTUs: <br /> --+-- <br /> CFM: <br /> �--- <br /> COOLING SYSTEMS i <br /> Quantity: I <br /> Make: <br /> Model: <br /> Tons: <br /> , <br /> H.Power <br /> � <br /> FIREPLACES I <br /> � Gas Factory Fireplace Brand Name: /�'��' <br /> Wood Buming Fireplace r <br /> ❑ Wood Stove Model No.: �,Z'7�T�S '����''� <br /> ❑ Wood Stove with Flue/Masonry ' <br /> VENTILATION � <br /> ❑ No. Kitchen EYhaust duct recirculating �cfin <br /> ❑ No. Bath Exhaust(must have duct outside) _�cfm <br /> ❑ No. Other Fans: Locations �_cfm <br /> FUEL STORAGE (Must be approved by Fire Marsha/l if proposing to aba�edon tank in plaeeJJ <br /> ❑ Installation ❑ Removal I <br /> Fuel Oil: gallons ❑ Underground ❑Inside ❑Clutside <br /> LP Gas: gallons <br /> Other: <br /> GAS I,INE ONI,Y <br /> � <br /> , , <br /> �� �� <br /> I + I p <br /> I �� <br />