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• 'W1312014 13:36 Steinkraus Plumbing fAX)952361590 P.0021004 <br /> y ,.. V_ z < <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 /> Quantity: <br /> Make: <br /> Model: <br /> Fuel: <br /> Flue Size: <br /> Input BTUs: <br /> Output BTUs: <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 /> ❑ Wood Burning Fireplace <br /> ❑ Wood Stove Model No.: <br /> ❑ Wood Stove with Flue/Masonry <br /> VENTILATION <br /> ❑ No. Kitchen Exhaust duct recirculating _.. ...- cftin <br /> ❑ No. Bath Exhaust(must have duct outside) cf n <br /> ❑ No. Other Fans: Locations chn <br /> FUEL STORAGE I(21 fust be approved by.mire Marshall ,proposing to abandon tank in place.) <br /> ❑ Installation ❑ Removal <br /> Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside <br /> LP Gas: gallons <br /> Other: <br /> GAS LINE ONLY <br /> ❑ 1 — <br /> Outdoor Grill � ether!List What&Where: g�`E ►e- 0�1r �-'��'r. <br /> -- <br /> 2 <br />