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ges_. ,t17..,..7MR:"Pa . ss.. x - st, ,.ter 'iwr_. <br /> Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official. <br /> IS THIS GEOTHERMAL? El Yes IKNo <br /> HEATING SYSTEMS <br /> Quantity: / <br /> Make: yo-A.12, <br /> Model: Y"-OrdellArl/ <br /> Fuel: /p//¢l <br /> Flue Size: Zr� <br /> Input BTUs: vCe <br /> Output BTUs: 7/2/(, <br /> CFM: /644 <br /> COOLING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: l` <br /> Tons: <br /> H.Power <br /> FIREPLACES <br /> ❑ Gas Factory Fireplace Brand Name: <br /> ❑ Wood Burning Fireplace <br /> ❑ Wood Stove Model No.: <br /> E l Wood Stove with Flue/Masonry <br /> VENTILATION <br /> ❑ No. Kitchen Exhaust duct recirculating cfm <br /> ❑ No. Bath Exhaust(must have duct outside) cfm <br /> ❑ No. Other Fans: Locations cfm <br /> FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.) <br /> El Installation El Removal <br /> Fuel Oil: gallons ❑ Underground ❑Inside El Outside <br /> LP Gas: gallons <br /> Other: <br /> GAS LINE ONLY <br /> ❑ Outdoor Grill ❑ Other/List What&Where: <br /> 2 <br />