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MAY/15/2017/MON 09:09 AM Heating & Cooling 2 FAX No, 7634283677 P, 003 <br /> � <br /> �1::' y{��/��J,(-[ {= r: �ry>� �1 j� �yK� �f'� ��,y,� y1:...i. <br /> 34��'�:��'C�j.���',:1;%� :'�i'�?T:,/�7+!►'�����.�.lY'�1:J.�1�-i/,��.t%���,�,�-'�'717„L'i/•,:•;'C'C��•��' 9ti�r.,�i:i:',.Y,;; ♦ <br /> Note:All Geothermal Systems vvill now rec�uire a Site Plan&Re�vie�w by our Building Of�'icial. �. <br /> YS T�,S GrEOT�ERMAY.7 ❑Yes �J No , <br /> � HEAT�NG S'YST�MS � . <br /> ���,; I � _ . <br /> Nt��: ��� <br /> Madel: q1��� <br /> �el: ��c�" <br /> ��i <br /> Flue Size: <br /> Input BT`(Js: \O�ab� <br /> Output 8'I'�Ts: <br /> CFM: � <br /> COOY,YNG SYSTEA'�S <br /> QuantitY. - <br /> Mnke: <br /> ,Nlodel: � O�_ <br /> ron�: <br /> A.Power ���- <br /> FIR�PLACES ' � <br /> ❑ Gas Factory�'ireplace Brand Name: <br /> ❑ Wood B ino Fireplace <br /> � '�J'ood Stove Model No.: <br /> [� '9Vood Stove with Flue/Nxasanry <br /> . ' VENTILATX�N � <br /> ❑ Na. t XCitchon Exhaust duct recirculating �o DO cfm <br /> ❑ No. � �ath Exhaust(�aust ha�'e duct outside) cfm <br /> � No. p►;A.-X Othrx Fans: L.ocations c'�AO .@�!'� _ cfna <br /> FIJEL STORAGE_(Mrrst be approved by Fite Marshall ifproposing do abanaCori tarilc its place.) <br /> ❑ Installation ❑ Removal <br /> Puel Oil: gallons ❑ Underground ❑Inside ❑Outside <br /> T�C�ss: gallons <br /> Other. <br /> GAS LINE ONY,'Y <br /> T ❑ �utdoar Crrill ❑ Othcr/List What&Where: l��+A_���,��""'qE.������ <br /> . 2 <br />