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Jul 06 1711:28a Twin City Fireplace 9529422093 p.2 <br /> �-IA7.vTCA�SYSTE1�+iS�BE�NG INST�:TjLLED.` ° . <br /> � <br /> Note:A91 Geothermal Systems will now require a Site Plan&Review by our Building 4fficial. <br /> IS'TAIS GEOTHERMAL? ❑Yes [�No <br /> HEATING SYSTEM,.S <br /> Quantity: <br /> Make: <br /> Model: <br /> FueL• <br /> Flue Size: <br /> Input BTUs: <br /> Output BTUs: <br /> CFl�1: <br /> COOLING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <br /> H.Power <br /> F[REPLACES <br /> ❑ Gas Factory Fireplace Brand Name: <br /> ❑ Wood Buming Fireplace <br /> ❑ Wood Stove Model No.: <br /> ❑ Wood Stove with Flue/Masonry <br /> V�NTR,ATION <br /> ❑ No_ Kitchen Exhaust duct recirculating cfin <br /> ❑ No. Bath Bxhaust(must have duct outside} cfm <br /> ❑ No. Other Fans: Locations cfm <br /> FUEL STORAGE (Must be apprnved by Fire Marshall rf proposing to abQndou tank is place} <br /> ❑ Installation ❑ �temoval <br /> Fuel�il: gallo�s ❑ Ur�'ground ❑Inside ❑Outside <br /> LP Gas: gallons <br /> Other: <br /> GAS LINE ONLY <br /> ❑ Outdoor Grill �X Other/List wnac&whe�e: Gas log set instal�ation, Nat. Gas ' <br /> 2 <br />