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�,,,�.:-, <br /> ... ,, �._, <br /> a p <br /> a M <br /> ; S .�. <br /> .� � .. •.xi� <br /> ����/ <br /> � f... <br /> � � ��� � 2320 Calilornia St., E��eretl, Washinrt�n 98?01 25A-8211 � <br /> o�� ��� Mailinq Add�ess: P. O. Ftox 110J, Fvemt�, Washi,�g;nn 98206 <br /> r � ,�,� � Snohamish PUD Reference ONLY <br /> � � Enery} Plan Review #: !ZD�} v03(o� <br /> O �O <br /> 4t 'tl Jurisdiction: i y Or E .=.?E7Y <br /> y .�L _�— <br /> � �o ��NWEC�� Plan Iteview and Compliance for Electric Heat Residences <br /> HC <br /> � � oat�:1„_ y- �'o - <br /> �Y Plan Check t7o:,��ZS�S'z_ <br /> . ! H Assessor's Property Tax Arcount No: ____ _ <br /> C� <br /> y Jurisdiction Basic Plar, $: <br /> M -- <br /> �N <br /> Builder: d � �«J7���nrr-l' _ <br /> Address: �Z . <br /> H c`� city: (=ntN. �flL! [.✓i_ 9+is'� <br /> - Inone: �/- v/Oi -- —. <br /> Single Pamily: .� <br /> Multi-Family: _ t3uildinqs:_ Units: __ <br /> 81te Address: � 3 s�.l7Yit.v L��__ <br /> �� � <br /> ... � Compliance: Chapter 4-Systemy Analy,is_�, Chapter 5-Component Performanc , <br /> Chapter 6-PrOscriptive_, j2tapter 7-Component Point <br /> Jote• see attached documentat�6n Por en ry equirements <br /> ("` `� / <br /> � ! Snohomish County PUD pl Representative: �� <br /> S ' ture <br /> ... � r sr - 9- 'l7� <br /> � 1 P int Phone <br /> (` �� *ITEMS 'BELOW ARE TO BE FILLED OUT UY T8E APPLICANT* <br /> � ' ----------------------------------------'--------------------------------- <br /> Duilder / Consumer Payment � <br /> �M + 1 /, <br /> 1 Owner or Authorized Agent:_ ��c C7"/� �SP <br /> Slgnat � Prin <br /> � �' Mail Check To: � Amount $ _ <br /> Name• 1c�� <br /> Address: Q'�L <br /> � City, St. : Ni �/ �,J�.r • Sd2S�- <br /> Tax Id. # or SSq : 5',��_�G -u9y3 <br /> ote: An IRS I'orm 1099 will be sent at the end of the year. <br /> � r <br /> NORTHWEST (�?ppa'�) � <br /> ENERGY CODE ��„„�,,�:,c,w�;.,.��� <br />