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` � . <br /> . ;����I�.t�;�'�'�����I��'��'��:�;��} <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 /> Quantiry: <br /> Make: <br /> Model: <br /> Fuel: <br /> Flue Size: <br /> Input BTUs: <br /> Output BT[Js: <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantiry. <br /> Ma1ce: � <br /> Model: <br /> Tons: <br /> H.Power <br /> FIREPLACES ,. <br /> � Gas Factory Fireplace BFand Name: tX/1,�� � � <br /> ❑ Wood Burning Fireplace <br /> ❑ Wood Stove Model No.: <br /> � ❑ Wood Stove with Flue/Masonry <br /> �t��l 5��t�- �1�1-�, <br /> VENTILATION <br /> ❑ No. Kitchen Exhaust duct recirculating cfin <br /> ❑ No. Bath Eachaust(must have duct outside) cfm <br /> ❑ No. Other Fans: Loca6ons cfin <br /> FUEL STORAGE (Must be approved by Fire MarshaU if proposing to abandon tank in plae�) <br /> ❑ Installation ❑ Removal <br /> Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside <br /> LP Gas: gallons <br /> Other. <br /> GAS LINE ONLY <br /> , ❑ Outdoor Grill ❑ Other 1 List What&Where: <br /> 2 <br />