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:. - rY. :r;L� .� _. , � <br /> Note: All Geothermal Systems will now require a Site Plan& Review by our Building Official. <br /> IS THIS GEOTHERMAL? ❑ Yes �to <br /> HEATING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Fuel: <br /> Flue Size: <br /> Input BTUs: <br /> Output BTUs: <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <br /> H.Power <br /> FIREPLACES <br /> � Gas Factory Fireplace Brand Name: 5��{-�- <br /> ❑ Wood Burning Fireplace <br /> � Wood Stove Model No.: �I,L.B ��tS�,� �V <br /> ❑ Wood Stove With Flue ��LM �(�•� <br /> VENTILATION <br /> ❑ No. Kitchen Exhaust duct recirculating cfm <br /> ❑ No. Bath Exhaust(must have duct outside) cfrn <br /> � No. Other Fans: Locations cfrn <br /> FUEL STORAGE (Must be app�oved by Fire Marshal!if proposing to abandon tank in p[ace.) <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 />