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From:7634974263 02/11/2015 12:03 #533 P.003/004 <br /> „kc l-,A:,! .z xM.a7,1Z:a7 aCa Vr7gp u.pN'e?.`�.ILMYrr.+� i �� a+ <br /> Note:M1 Geothermal Systems will now require a Site Plan&Review by our Building Official. <br /> IS THI$GEOTHERMAL? ElYes ,No <br /> HEATUII G SYSTEMS <br /> Quantity:; <br /> Make: <br /> Model: Nom'5 Fit <br /> Fuel: N CT- <br /> Flue Size <br /> Input BTUs: <br /> Output BTUs: X2,CW ?'-)-1-1,..A <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity: <br /> Make: - <br /> Model: «K.51\;{ Y,A-U@ <br /> Tons: (?. O‘Q <br /> H.Power <br /> FIREPL <br /> It Gas Factory Fireplace Brand Name: <br /> ■I 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. Bath Exhaust(must have duct outside) cfm <br /> • No. Other Fans: Locations cfm <br /> 4 EL T a RAGE (Must be approved by Fire Marshal if proposing to abandon tank in place.) <br /> ■ Installation 0 Removal <br /> Fuel Oil: gallons 0 Underground 0 Inside ❑Outside <br /> LP Gas: gallons <br /> Other: <br /> GAS LINE ONLY <br /> ❑ Outdoor Grill )A Other/List What&Where: {''l lreV1Ct s; <br /> 2 <br /> y <br />