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04-11-'16 14:19 FROM- F I RESIDE T-845 P0002/0004 F-281 <br /> Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official_ <br /> IS THIS GEOTHERMAL? El Yes ❑No <br /> HEATING SYSTEMS <br /> Quantity: <br /> Make: i <br /> Model: <br /> Fuel: <br /> Flue Size: <br /> Input BTUs: <br /> Output BTUs: <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <br /> H.Power <br /> IIRE LACES.' <br /> ;d.s pactory.rireplace;: . ,B ai d Nan1e APP17:: .` : ... <br /> �fl :Wood Burning-Fireplace. ; <br /> Y7 ` jfr <br /> ❑ Wood Stove: c <br /> il�fodel Noy:' ' .. i <br /> ❑ <br /> wood;StOve with,Flue/Masogry.; <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 approver!by Pre Marshall if proposing to abandon tank In place.) <br /> ❑ Installation 0 Removal <br /> Fuel Oil; gallons 0 Underground ❑Inside 0 Outside <br /> LI'Gas: gallons <br /> Other: <br /> GAS LINE ONLY <br /> ❑ Outdoor Grill ❑ Other/List What&Where: <br /> 2 <br />