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. <br /> . <br /> � [,. �4 <br /> • � , <br /> :�t..«»�Z`�,,v. �c'tats,+£�`.'z� '���������y'�' ,�j[:����t��� »,� A3 ��� �*���`� �'� ; � ��'": <br /> w a.. �?. <br /> Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official. <br /> IS TffiS GEOTHERMAL? ❑Yes �10 <br /> HEATING SYSTEMS <br /> ���,; t <br /> Make: <br /> Model: ri4 (�lr� <br /> Fuel: �j� ��� <br /> �� <br /> Flue Size: `L. <br /> Input BTUs: (D�'�- <br /> Output BTiJs: �� t� <br /> CFM: 12�� <br /> COOLING 5YSTEMS <br /> Qua.ntitY: <br /> Make: 'D�-�` <br /> Model: "�"/` ����'�3�1 <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 With Flue <br /> VENTII.ATION <br /> ❑ No. Kitchen Exhaust duct recirculating cfm <br /> ❑ No. Bath Exhaust(must have duct outside) cfm <br /> ❑ No. Other Fans: Locations cfm <br /> FiJEL STORAGE (Must be approved by Fire Marshall if proposi�g to abandon tank in plac�) <br /> ❑ 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 />