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Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official. <br /> IS THIS GEOTHERMAL? ❑Yes C�.No <br /> HEATING SYSTEMS <br /> Quantity: �� 0. <br /> Make: `�,� <br /> Model: �U,1'f�,b��� <br /> Fuel: ��� �J�.J <br /> Flue Size: <br /> Input BTUs: ��� <br /> Output BT[Js: ��_� <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity: � �l� <br /> Make: �0��- <br /> Model: � ���"�Ol.� <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. Bath Exhaust(must have duct outside) cfm <br /> ❑ No. Other Fans: Locations cfin <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: <br /> 2 <br />