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' 9529331869 11:52 14 07-13-2015 3/4 <br /> > IVIECHAIVICAL SYSTEIvIS BEING INSTALLED ' <br /> Note:All Geothermal Systems will now require a Site Plan&Review by our Buiiding Official. <br /> IS THIS GEOTHERMAL? ❑Yes [�No <br /> HEATING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Fuel: <br /> Flue Size: <br /> Input BTCJs: <br /> Output BTUs: <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity: � <br /> Make: (�.A�.R�� .R _ <br /> Model: �,�A��„�j r�QQ <br /> Tons: � <br /> H.Power <br /> FIREPLACES <br /> ❑ Gas Factory Fireplace Brand Name: <br /> ❑ Wood Burning Fireplace <br /> ❑ Wood Stove Model No.: <br /> ❑ Wood Stove�vith Flue/Masonry <br /> VENTILATION <br /> ❑ No. Kitchen Exhaust duct recirculating cfm <br /> a No. Bath Exhaust(must liave duct outside) cfm <br /> No. Other Fans: Locations cfm <br /> FUEL STORAGE (Must be approved by Fire Mars/:a//if proposi�rg to aba�rdo��tank irr place.) <br /> ❑ Installation ❑ Removal <br /> Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside <br /> LP Gas: gallons <br /> �ther: <br /> GAS C.INE ONLY <br /> ❑ Outdoor Grill ❑ Other/List What&Where: <br /> � <br />