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-J��'�ti�!l����� I i.. i����� .��'.�i��. .,�.. , . � ;��^' ., : <br /> Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official. <br /> IS THIS GEOTHERMAL?�Yes ❑No <br /> HEATING SYSTEMS <br /> Quantiry: / 1 <br /> Make: a�.-� r ct�-�' <br /> Model: ?�-�c�-(/�D C.G(ta C�T-?' <br /> Fuel: N• �- f(eL• <br /> Flue Size: ���` — <br /> Input BTUs: /z.o k- (00 � <br /> . <br /> Output BTUs: //4-l� <br /> CFM: 2.fJG� <br /> COOLING SYSTEMS <br /> Quantity: / / <br /> ��c-f�la s5 <br /> Make: �1 r�s v�o%sGl: r a�c� <br /> Model: �•v�g Z �5'NA- C�T-� �� <br /> Tons: /.2S .S Tol�.1 S <br /> H.Power <br /> FIREPLACES <br /> ❑ Gas Factory Fireplace Brand Name: <br /> ❑ Wood Burning Fireplace <br /> � Wood Stove Model No.: <br /> ❑ Wood Stove With Flue <br /> VENTILATION <br /> � Na Kitchen E�chaust duct recirculating cfin <br /> ❑ No. Bath Exhaust(must have duct outside) cfin <br /> � No. Other Fans: Locations cfin <br /> FUEL STORAGE (Must be approved by Fire MarshaU if proposing to abandon tank in p[ac�) <br /> Q 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 />