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Y <br />� l N U�� O M i ti N (, O U N T � <br />\_ <br />�� <br />2320Ca1ilornia St., Everett, Washington 96201 258-8211 <br />M3iling Address: P. O. (iox 1 f07, Ev4°ret►, V Vas hing ton 9 8 2 0 6 <br />Snohomish PUD Reference ONLY <br />Energy Plan Review #:_D.$�' 01!s <br />��NWEC�� Plan Review and Compliance for Elec:;ric Heat Residences <br />� <br />Date: I��' `� - pd_ <br />Plan Check No: --�-�3 �5�u3 <br />Assessor's Praperty Tax Account Plo: <br />� <br />, Jurisdiction Bs�ic Plan #: Z, 6 3 <br />IIuilder: F)��nti�ti�¢g, r L7��/�� Ci�,+sT.ec�.-rU. i-�� <br />Addres�: 9dlo Fve.n/-oe�v�� <br />City: Fv�t.,a;� �,a. 9sr�cf <br />Phone: 2 �-a - 7�00 <br />Single Family: ✓ <br />Multi-Family: ildinqs: / Units: _ <br />8ite A3dresa. (;� G.� � �3esi�d �ve�- v.�.2,�Tf 4�A� <br />Compliance: Chapter 4-Systems Analysis _, Chapte- 5-Cumponent Performance� <br />Chapter 6-Prescriptive_, Chapter 7-Compui�ent Point <br />�Iote: See attached documentation for enPrgy re/,-�(uirements <br />Snohomish County PUD #1 Representative: �� /�• I"`"' <br />Signatur.^ <br />�,� 1�=--. 2543-Sz�i <br />Print Phone <br />*ITEM& BEIAW ARE TO BE FILLED OUT SY THE APPLICANT* <br />----------------------------------------------------------------------------- <br />Huilder / Cansuner Payment \ ,l � <br />owner or A�.ithorized A�ent:,_,_, � / ��L .L��4v�n .P• �J ,�,v,v _ <br />Siqnature Print <br />Mail Check To: Aaiount $,_ <br />� Name: _ <br />"" Address: <br />City, St.: .-- <br />7'ax Id. # or SS#: <br />No e: An IRS Form 1099 will be sent at the er.d of <br />...,... <br />::::::::::::.. <br />NORTNWEST <br />ENERGY CUDE <br />the year. <br />'Gooc! Ca�.� <br />e�y�(��,w:•.� <br />