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h��CNAIV,ICAL S�'5TEP�(� B�EI�TG tNSTALLED <br /> �ote: �II Geothennz3l Svste�ns ��ill nc7«� reyuire a 5ite Plan �. Re��ie�+� by c�ur I3uil�ir�g(�Yticial. <br /> IS"(�HISGEQTHERMAL? (� Yes [�,.'�o <br /> t <br /> IiE.��TItiG St SI'E:1iS <br /> Qu�ntih: �_______ ___.__.________�____ _. <br /> \111��: <br /> �lodel: <br /> !uel: <br /> t�lue SiTe: <br /> irrput L3 I l.''s: _______ .________�--- � <br /> ()utput E3Tt�: �___.. _ _ _..__.____._.___.____ <br /> C'F�1: <br /> C'UULIVG S}tiTF;�#S <br /> (��R�sntit�w: <br /> �1ak�: <br /> '�lotlel: <br /> Tons: <br /> 1I. Yv���er <br /> FIR�PI:�CES � <br /> �' Gas F��actor}� Fire�lace f3rand �:ame: <br /> �..._._ _T.__._.__.. <br /> ❑ G'�'ac�d Burning �'ireplace <br /> ❑ �a�d 5tove '�tad�1 V��.: <br /> Q \�'ood Stove uith rlue 4lasonn --.___—__.__ __-- <br /> �'E\TI LATIOti <br /> ❑ \ca. h:itchen Exhaust duet recircwlatinp; __ _ �frn <br /> ______._ _. ___._____ _._.._.� <br /> [�" ?�o. � Ba[h Exhaust!must ha�e duct�u�side) ��p___cfm <br /> _--- <br /> ❑ ���. � C>ther Fans: Loc�tions cfm <br /> F1'EL STOR:�GE f:�lust be�erpprored hr f��e 4lnrclrrrtl if pr�t�osing!o rxhn�rdan tr�nk in pluce.) <br /> � In>tallation ❑ (LenzG7�ai <br /> Fuel Uil: _______��g�lluns ❑ t_'�nderr_rc�und ❑ Inside ❑Outside <br /> LP Gas: �aiic�ns <br /> _......_`_____,. <br /> Other: <br /> C:AS l.[ti�O\L.ti <br /> ❑ C}utd�arGrill ❑ Other: List �4�hat& ��'hzre: <br /> �v�rtw a�.k: /�'�� �`�� �.i�t�r c.�eZS 1- �.2-� (2.t"i-€�v�w) �ro Z N D F C.c�o�. <br />