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Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official. <br /> IS THIS GE THERMAL? ❑Yes ®No <br /> HEATING SY TEMS <br /> Quantity: <br /> Make: 0'4^/GL E u bL:::' <br /> Model: SOL. I/o <br /> Fuel: A) Co <br /> Flue Size: 3 w Pv_ <br /> Input BTUs: I IU,oov. <br /> Output BTUs: 109,Sao <br /> CFM: N A <br /> COOLING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <br /> H.Power <br /> FIREPLACES <br /> LGas Factory Fireplace Brand Name: <br /> Wood Burning Fireplace <br /> Wood Stove Model No.: <br /> L Wood Stove With Flue <br /> VENTILA-TION <br /> No. Kitchen Exhaust duct recirculating cfm <br /> No. Bath Exhaust(must have duct outside) cfm <br /> No. Other Fans: Locations cfm <br /> FUEL STO E (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: <br /> 2 <br />