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11/17/2015 TUE 1Q: 31 FAx 763 a73 8565 Sdbre Hedting & Ai.r Cond �003/OOa <br /> � <br /> i <br /> i <br /> � Note: AlI Geothermal Systems will now requirc a ite Plan 8t Revie by our Duilding Offiaial. <br /> � IS TSIS GrEOTHERMALT ❑Yes �10 . <br /> I HEATING SYSTEMS <br /> Quantity: ' � <br /> Make: <br /> hiodal: ��t''� VU1Q01��, <br /> . .�u�l: --�---�--. . . . . . .. _ .. � --�----�---- <br /> Flue Size; <br /> Input�TUs� _ <br /> Output B1`i1s: ����OD <br /> , CFM� <br /> CAOLTNG SYS�MS <br /> IQuantity: ---- <br /> MSke: <br /> Mndef� <br /> i <br /> Tons: <br /> H,Power <br /> 1�'IREPLACES ' <br /> , ❑ Gaa Factory Pireplace Brand Name; <br /> 0 Wood Burning niroplaco <br /> [] Wood Stova Modal No.: _ <br /> ❑ Wood Stave with Flue/Masoary <br /> VI�'NTIi�AT��N � <br /> . ❑ No. Kitchen�xhaust duct recirculating cfm <br /> � No. Batla Exhaust(must have duct outside) efm <br /> No. Othcr Fans: Locations �� <br /> F[TEL STO il AGIC (Jl�ust be a�roved by I+Fre Marshall ij�xogoseng ta nbando��tai:k an pla�c�) <br /> , ❑ Installntion Q Removal <br /> Puel Oil: gapons ❑ Under�round ❑Insida ❑Outside <br /> LP G�s: gallons <br /> 0 thar: <br /> GAS LIN�ONLY <br /> Q Outdaor GrilI ❑ O�I�cr/List What&Where: <br /> 2 <br />