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01/65/2917 08:14 7634987618 COMFORT MATTERS HTGE PAGE 03/04 <br /> Note:All Geothermal Systeno,s wi,l�no�v�uire a Site Plaa&Review by our Buildi�ag O�ic;�al_ <br /> IS THIS G�C17[`�RM,A,.L? ❑Yes �To . <br /> / <br /> �kEA'�iG 3YSTEMS ' <br /> ���- t � � � <br /> Make: ��tiCi rl ---- � <br /> Model: f��Gt���J� , . ' <br /> F�al: � . <br /> Flue Size: <br /> Iu�ut HTUs: __— � , <br /> Output BTUs: . <br /> CFM: . <br /> COOLIl�IG SXS'�J,V�S <br /> Qua�ntity. <br /> Make: <br /> Model: ' <br /> Tons: � � <br /> � H.Porover - <br /> FIREPLACES • ' <br /> Q Qas k'actory Fireplace Bxa�pd Na�aae: <br /> ❑ Wood B�ning Fire�lace • <br /> {] Wood Stove Model No.: <br /> ❑ Wood Stove with Flue/kv�asoxuy , <br /> V'�NTII.A'FION <br /> ❑ No. 'XC�tc�Exhaust duct recizculating c$n <br /> ❑ No. Bath Exhaust(musc bave duct outside) cfim <br /> ❑ No. O�h�'F�as; �.ocations � - <br /> . �IIEL STOItAGE (Muet be a,�proved by Fine,dlsrshall if p%posing to aban�on tank en place.) <br /> ❑ Iastallar3on ❑ Rsmoval , <br /> F1�el 0�i: gallons ❑ x7z�dergroimd ❑Inside ❑Outside <br /> LP Gas: ga�o,as . <br /> Other: • <br /> GA9 LINE ONLY <br /> � ❑ Outdoor Grill ❑ Other/T.i�st Wbat&Where: • <br /> 2 � <br />