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02-07-'17 15:02 FROM- T-802 P0002/0004 F-973 <br /> � � "'�" � '�. <br /> ' Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official. <br /> � IS THYS GEOT�I�RMAL? ❑Yos ❑N'o <br /> HEATyN'G SYSTEIVIS <br /> �uantity: <br /> Make: <br /> ModeL <br /> Fuel: <br /> �'Iue S;zc: <br /> Input BTUs: <br /> Output BTY.Ts: <br /> CFM: <br /> COOLINC SYS'�'�MS <br /> Quantiry: <br /> Matce: <br /> Model: <br /> Tons: <br /> H.Power <br /> �YC�PLACES � <br /> ,� C3as Factory Fireglace Brand Name: <br /> " u Waod$uming Fireplace �/`, �� �/ <br /> ❑ Wood Stove Model No.: �p_�0�(�f� ,� ��C..t�`, <br /> ❑ Wood Sto�ve with Fluc/Masonry <br /> 'V'�NTILATION <br /> No. Kitchen fixhaust duet reeireulating cfin <br /> �] No. Bath Exhaust(must have duct outsidc) cfm <br /> ❑ No. 08�er Fans: I.ocauons cfm <br /> �'C7EL STORAGE (�rrsr be npproved by Fire MarsJ�all if proposing to abandon eank in p!'nc�) <br /> [� Tnstallation ❑ Removal <br /> �uei Oil: gallons ❑ �l'nderground ❑Ynside ❑Outside <br /> LP Gas: gallons <br /> Other: <br /> (CA,S Y.TNE ONLY <br /> ❑ Outdoor drill ❑ Other/�,ist'VVhat&V►rhere: � <br /> � <br />