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. _ , <br /> . <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 /> Quantity: <br /> Make: <br /> Model: <br /> Fuel: <br /> Flue Size: <br /> Input BTUs: <br /> Output BTUs: <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <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 /> � No. � Kitchen Exhaust � <br /> No. Bath E � duct recirculating d c� <br /> xhaust(must have duct outside) <br /> ❑ No. Other Fans: Locations �� <br /> cfin <br /> FUELSTORAGE � <br /> (Must be approved by Fire Marshall if proposing to abandon tank in place.) � <br /> ❑ Installation ❑ Removal <br /> Fuel Oil: gallons ❑ Under ound <br /> LP Gas: gallons � ❑Inside ❑Outside <br /> Other: <br /> GAS LINE ONLY <br /> ❑ Outdoor Grill ❑ Other/List What&Where: � � � `�n <br /> 2 <br />