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Date__�=_1-9 L--------- <br /> ---.�-- <br /> ADD�iation/PermA/-------,— � ..A . _.... <br /> �( OWftlf__�.L_��-- �-��`(J�D '., l 0 W R 1�S E R E 71 D�f M T 11� �..:�' � , <br /> SiteAddress.tZ�O�---,�},�(��---��� _ 1 • , '. <br /> �Assessor's Propert�Tax_Apccount,No_ �" o L/1/<� <br /> :, 'PUD PLAN REVIEW N OS /IO I�Z `e .�'''�.� <br /> �''�:::::i% <br /> . �/� ..,. <br /> . . Sde Address ..�T..!7i.DI........._�I'.A�.mS..............TT:�.E....l.................:.................................................... � <br /> ' p� ........................................... <br /> .-�} � �Owner'sAddress..,�,�.���.J........I.'�.D.�.Ip.:.�S........�.l�.�.!.....City...F..��..a�Tr....Zip...M7.��..P�one.�.�,2r...�.r..'$�.1Q <br /> , Builder...H'....MiY,SArS........WSI.Lr3,S!P..IaAddress... ..�...aCZ.I........�'�J...M..'I.S�......,��.�..L................._.._..........:.............. <br /> . . � Ciry....F1r�:�'.�..T..T..........................................................Zip...��..r.��.�..............Phone._�.�...'Jr....'..a�..�.1.�?...................... <br /> , . . <br /> � . <br /> � <br /> � <br /> . <br /> ' • PpOJECT DESCpIPTION: <br /> • <br /> �. - O New dCition Sin le Fami <br /> � O Remodel G Conditioned Sq.Fl.3�.,,, O Muki-Fami � �of Stories.........:.._....... <br /> � . . N J ol Units......................... <br /> FIlE4S0UNCE NFATIHG SYSiEM TYPE: <br /> _: �4Aric� �§�sebaard O Heat pump HSPF .._..........._. <br /> � O Oil ••••�•••••� <br /> �• �4a�1 hwler O Other................................................. <br /> • O Gas Q Furnace AFUE................... <br /> . O iotal insWlled watts or BTU's............ <br /> • <br /> • . <br /> • . • • . . . . . . . . . • . • . . . . • . . . • • . • . • . . . . • . . . . . . . . . • . . . . . . <br /> v o <br /> � �� �� � ' ' �' � �COMPONENi <br /> Flat Ceilinq F_�8 <br /> theck oro ol Ne ComFfunce Opdon Boxes beiow.Insert tl�e v�iues into Eox number 1.Belore eomplelinp Ihis Vaulted Ceilinq R........... <br /> � � seUion mler to the instruetlonson bxk ol lo�m. � Z <br /> wan a.........1.. <br /> Eieclric-Norlhwest Energy Code, Other Fue�Sourees- Beiow Grade Wall: <br /> Chapter 6 � Washinqlan State Energy Code interior R............ <br /> O O�eU�lnsulated floor Systems Analysis, Q Prescriptive Approach, acterior p... <br /> Chapter 4 Chapter 6 Fioor q,_�.Q <br /> O Well Insulated Wail O Component Performance, O Component PeAormance Slab on G2de R...... . <br /> ���� � � Chapter S . Approach,Chapter 4 Doors 6 Frame b.�'�., i <br /> O Passive Salar Option O Compener.t°oint System, O Systems Analysis, Giazinq �,.,.,, ,.� <br /> O Heat Pump Option Chapter 7 Chapter 5 '6Glazinp ..2„,a/e <br /> � SolarAllowance� � ,y, <br /> � Air Lwkaqe �'STp OADV <br /> . <br /> o . . . . .. . . . . <br /> k <br /> 'FORDEPAqTMEHTUSEONLY: � � , <br /> � i � <br /> �AmOunt ol Payment$ ......`. � � i hereb ceAi ihat the slrucNril �nels wili meel Ihe MYEC FofmaWehyde repuiremenls•either the <br /> ._........, y y P <br /> HUD standards or mahed'exterinf or'exposure i' <br /> � :DalePermillssued �- OwoeiorAothorited�Apenl: � � <br /> ; ' �'. ; ..................................................................... .................................................................. <br /> � Print Nune Spn�Wrc <br /> Dale Permrt Fnaled .......: ......_., p.�pv�N�dK�o�/Neciric utlli xill m�ke� � <br /> . , . b Cymenitoeitherlhehuilderorownerbrnewelec�ri�lly <br /> � -� he�led residences Pertnit must Ee issueE by 17/31A1�nd wnslivcdon finokd by KJ092 in order to <br /> .I hero6y tertify that Ihis dwelhnp vras bwR�in � aW��'�or p�ymenl.To laeilime D+Ymm4 Ne lollowinp inlorm�fion must De 61kd out canpkidy_ <br /> compluncewrthlAeNWEC.' Mailcheckta:(pkueD��q (ADDITIONS/REMODELS NOT ELIGIBLE) <br /> ', S Name................................................Fed.Taz ID or SS/...................................................... <br /> . _..... .......: .._....::....: <br /> Bu�lOinp Otl¢:�I orlwthonieE Apent <br /> � Address........................................................... <br /> -: .. . ., . .....................P.......................................... <br /> -. .......:: .......:.� ....._:......:. �. <br /> Oa�e M.................................................................... <br /> . .................... Zi .......................................... <br /> NOIF'M INS Form 1099 w�A pe xnt�I�t mC e1 pr K��. <br />