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{ l'1 kd — k Y 4 L `V <br /> *fie-' _* _ _ E77 m 1`�I" e +2o m1VD'1 4t-,,its �a - m' _ ..,. i� ,?�._�. :,, :. <br /> Note: All Geothermal Systems will now require a Site Plan &Review by our Building Official. <br /> IS THIS GEOTHERMAL? ❑ Ye/ Io <br /> HEATING SYSTEMS <br /> Quantity: <br /> Make: C,odeiM li) <br /> Model: 6 KS Ll 0 703WC <br /> Fuel: VC(1111'bc / <br /> tr <br /> Flue Size: Q c-- <br /> Input <br /> Input BTUs: 70 o a c3 <br /> Output BTUs: rs y , e4bd <br /> CFM: /A D <br /> COOLING SYSTEMS <br /> Quantity: //11 <br /> Make: (�d'i0(Mil,i� <br /> Model: YS X 1,3di / <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 cfm <br /> No. S Bath Exhaust(must have duct outside) cfm <br /> No. I Other Fans: Locations y p i%i r s },A (f S O 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 ❑ Inside ❑ Outside <br /> LP Gas: gallons - <br /> Other: • - . • <br /> GAS LINE ONLY <br /> ❑ Outdoor Grill Other/List What&Where: CAS ) in '✓'O fn rtL{/t,r) <br /> 4.. AtYnh <br /> 2 <br />