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04/07/2014 MON 15: 35 FAX 763 473 8565 Sabre Plumbing & Heating �003/008 <br /> Note:All Geothermal Systems will no���require a Site T'lan&Revie�;�by our BuildiTtg Official. <br /> IS THIS GEOTHERMAL? ❑Yes [�No <br /> HEATWG SYSTEMS <br /> Quantity: �� 1 -- ----- , ...._.�.._�._.�_� <br /> Make: ���,_ � . <br /> Model: ,� � � .._I � ' ���,� <br /> Fuef: ���_ 1� �3 ��� <br /> P�UE S17R: <br /> �— <br /> TnputBTUs: _�j�� _ �� <br /> Output BTUs: ��1� __._.__.._.._ -----.. �.._._.._ <br /> GFM: ��D�Q � ���_ <br /> COOLING SYST'EMS <br /> Quantity: �' �--�- ---- - - — <br /> Make: OtN.� <br /> ModeL �,�,�� <br /> Tons: <br /> H.Power ____ <br /> FII�EPLACES <br /> ❑ Gas Factory Fireplace Brand Name: <br /> ❑ Wood Buming Fireplace <br /> ❑ Wood Stove Model No.: <br /> ❑ Wood Stove with Flue/Masonry <br /> VENTJLATION <br /> � No. Kitchen Exhaust duct recirculating efin <br /> No. � Bath Exhaust(must have duct outside) �cfm <br /> ❑ No. Other Fans: Locations_�_._ cfm <br /> FUEL STORAGE (Mus1 be approved hy Fire Marshall if proposing ta abandon tank in plac�) <br /> ❑ installation ❑ Removal <br /> Fuel 0i1; gallons ❑ Underground ❑Tnside ❑Outside <br /> LP Gas: gallons <br /> Other: <br /> GAS LINE ONLY <br /> ❑ Outdoor Grill ❑ Other/List What&Where; <br /> 2 <br />