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Jan 15 2015 5: 25PM HP LASERJET FAX p. 2 <br /> 1 9 l <br /> • <br /> .1:. • u • - <br /> Note:All Geothermal Systems will now require a Site Plan &Review by our Building Official. <br /> IS THIS GEOTHERMAL? ❑Yes f No <br /> HEATING SYSTEMS �J <br /> Quantity: <br /> Make: YONo . <br /> Model: e- L2_q.(" <br /> Fuel: <br /> Flue Size: Z:,elf L <br /> Input BTUs: r7Or <br /> Output BTUs: 61?2'Oo <br /> CFM: I 24s)� <br /> COOLING SYSTEMS <br /> Quantity: l <br /> Make: Lc-alvw0,4 <br /> Model: <br /> Tons: / <br /> H.Power C-vle.3. <br /> FIREPLACES <br /> ❑ Gas Factory Fireplace Brand Name: <br /> ❑ Wood Burning Fireplace <br /> ❑ Wood Stove Model No.: <br /> ❑ Wood Stove with Flue I 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 /> ❑ Installation ❑ Removal <br /> Fuel Oil: gallons ❑ Underground 0 Inside ❑Outside <br /> LP Gas: gallons <br /> Other: <br /> GAS LINE ONLY <br /> ❑ Outdoor Grill ❑ Other/List What&Where: <br /> 2 <br />