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MAR/02/2016/WED 08: 29 AM Heating & cooling FAX No, P. 003 <br /> Note:All Geothermal Systems will now require a Site Plar�8r Revietirr by ouz'Building Of�icial. <br /> XS x'�S G�O�'�YtMAY,? ❑Yes (�No <br /> HEATTNG S'YSTEMS <br /> Quantiry: l \ . <br /> Make; ��R,4e'la�� �Oa►ltE� <br /> Model: qo�p rfl�10���� /�b �o <br /> �uel: �� l�ak <br /> Flt1e Size: • <br /> Input B.TUs: _ /00 dO�O �ra ooc7 <br /> Output BTUs: � �~ � . <br /> � <br /> CFM: <br /> COOY,ING SY5TEM5 ' <br /> Quantity: � . <br /> Make: <br /> Model: � �4 <br /> Tons: "� <br /> H.Fowcr , � <br /> FIREPLACES <br /> ❑ Gas Factory Pireplace ��and Nazn�e: <br /> ❑ Wood Burnimg F�replace <br /> Q 4Vood Stove Model No.: � <br /> ❑ 'aVood Stove with�'luc 1 Masonry <br /> VENTTLATION � <br /> ❑ No. � Kitchen Exhaust duct recirculating �j_cfin <br /> ❑ No. r" �ath Exhaust(must have duct outside) �h•:� � <br /> �] No. �� Other Fans: Lacations 'n'�y� c� <br /> �C�T�STORAGE (Must be approved by,Fira Marshall if,proposiir�g w abandori tar�k r�pl'ac�) <br /> ❑ Installation ❑ Removal � <br /> Fuel 0i1: gallons ❑ �LTndcrground ❑Insidc ❑Outside <br /> LP Gas: gallons <br /> Othex: <br /> GAS LINE ONLY <br /> 1 (� � <br /> ❑ Outdoor Grill ❑ Other/�,ist What&Whcre:��`� i �•``�`��`�'��� ����r <br /> 2 <br />