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I�\ I'�� <br /> J <br /> P � � 2320 Calilornia St., Everett, Washington 98201 258-8211 <br /> Mailing Address: P. 0. Box 1107, Everett, Washington 98206 <br /> _ Y <br /> Snohomish PUD Reference ONLY <br /> Energy Plan Review q: /Oq��/2 �o <br /> ��NWEC�� Plan Reviev and Compliance for EleaEria Heat Reaidences <br /> Date: � '� �' / � <br /> Plan Check No: <br /> Assessor's Property Tax A^.count No: <br /> Jurisdiction Basic Plan #��:lJ_� <br /> Builder:�i""%" r/ �H'e j <br /> Address: <br /> City: <br /> Phone: ^�' r"° <br /> Single Family:_ <br /> Multi-Fami y: � Builftings•_ Units�2 <br /> dl-st��� DI'P�1FX �/Z Ca�v Rc(1 �'ve � <br /> aite aaresee <br /> Complianoe: Chapter 4-Systems Analysis_, Chapter 5-Component Performance� <br /> Chapter 6-Prescriptive_, Chapter 7-Component Point_ <br /> Note;. See attached documentati for en rgy requirements. <br /> Snohomish County PUD #1 Representative: i ature <br /> �l err1� o�� ' .��f7-/775� <br /> int Phone <br /> *ITEMS BELOW ARE TO BE FILLED OUT BY THE APPLICANT* _____ <br /> ---------------------------------------------- <br /> .� Buileer / Coneumer Payment <br /> l�a � <br /> Owner or Authorized Agent: �`' r` ignature Pr t <br /> Amount $ <br /> Mail Check To: � <br /> Name: C QC ti'��✓ /���E� / n� <br /> Address: ��s S f E.,�wY� �Nnc� ��r S�"� � — <br /> City, St. :��it f-F �.-+. 96'.�05� <br /> Tax Id. # or SS#: G ol • �» - �y� <br /> ote: An IRS Form 1099 will be sent at the end of the year. <br /> ..:... <br /> ............ �v <br /> � ................ <br /> N O R T H W E S T �,.,,g,Ju;�„e,u.,� <br /> ENERGY CODE <br />