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MECHANICAL SYSTEMS BEING INSTALLED <br /> Note: All Geotherinal Systems will now require a Site Plan & Review by our Building Ofticial. <br /> IS THIS GEOTHERMAL? ❑ Yes �No <br /> HEATING SYSTEMS <br /> Quantity: ( <br /> Make: <br /> ModeL �-lo�r /� 6 �Q <br /> Fuel: � <br /> Y <br /> Flue Size: <br /> [nput BTUs: Q �U� <br /> Output BTUs: � Q <br /> CFM: <br /> COOWNG SYSTEMS <br /> Quantity: / <br /> Make: <br /> Model: �f`y f ��� <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 duct recirculating cfm <br /> ❑ No. � Bath Exhaust(must have duct outside) cfm <br /> ❑ No. Other Fans: Locations cfm <br /> FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.) <br /> ❑ Installation ❑ Removal <br /> Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside <br /> LP Gas: gallons <br /> Other: <br /> GAS LINE ONLY <br /> ❑ Outdoor Grill ❑ Other/List What& Where: <br /> 2 <br />