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Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official. <br /> IS THIS GEOTHERMAL? ❑ Yes i <br /> HEATING SYSTEMS <br /> Quantity: / <br /> Make: S�a�,�j /r) <br /> Model: ._5/0719 <br /> Fuel: <br /> Flue Size: <br /> Input BTUs: /P0/41,1) <br /> Output BTUs: /G;fiSiVG) <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <br /> H.Power <br /> FIREPLACES <br /> ❑ Gas Factory Fireplace Brand Name: <br /> O Wood Burning Fireplace <br /> O Wood Stove Model No.: <br /> ❑ Wood Stove with Flue/Masonry <br /> VENTILATION <br /> O No. Kitchen Exhaust duct recirculating cfm <br /> ❑ No. Bath Exhaust(must have duct outside) cfm <br /> 0 No. Other Fans: Locations cfm <br /> FUEL STORAGE (Must be approved by Fire Marshall i-proposing to abandon tank in place.) <br /> O Installation ❑ Removal <br /> Fuel Oil: gallons 0 Underground ❑Inside 0 Outside <br /> LP Gas: gallons <br /> Other: <br /> GAS LINE ONLY <br /> O Outdoor Grill 0 Other/List What&Where: <br /> 2 <br />