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��H <br /> Qy <br /> r�� <br /> � � <br /> ��i� �� (/3i b' f �f�•,,.i. .Lo� <br /> ��� a ' ,.. , <br /> OH <br /> ��g ' � � 2320 Calilornia St., Everett, N/ashington 98201 258-8211 <br /> �H� Mailing Address: P. O. Box 1 f07, Eveiett, Washing�on 38206 <br /> H <br /> �j� Snohomish PUD Reference ONLY <br /> cQit,��+ Energy Plan Rr.view q: O Q _ <br /> ��� Juriadi^tion: .f a ��e <br /> � <br /> "NWEC�� Plan Review and Compliance for Elec:ric Heat Residences <br /> Date• 9-� /� _ <br /> Plan Check IJo: .-� <br /> Assessor's Property Tax Account No:���LC i,�o ��GC- �/ /.5���'� <br /> Jurisdiction Dasic Plan '� : <br /> Duilder: I � K � _ � L IU�aNK � <br /> Address• Z <br /> City: �( �0 3 <br /> Phone: .2 2 - 1 Z1- <br /> '�1 .� Sinqle Family: ✓ �2 •'� 7� . <br /> 1_' Multi-I'amily: ___ Buildings:_ Units:_ <br /> site }lddreas: _ a iNa�"�� GveiY� <br /> �' ' Compliance: Chapter 4-Systems Analysis_, Chapter 5-Component Performanc v <br /> �' Cl:apter 6-Prescriptive_, Chapter 7-Component Point <br /> f�' Note: See attached documentat' for e y requirements <br /> ' ' Snohomish County PUD #1 :tepresentative: <br /> � nature <br /> 1 --6 e r/ ��cN - 7 Y7/11•S' <br /> �int Phone <br /> � <br /> �.' ____________*ITEMS BELOW �1RE TO BE rILL?'D OUT DY THE APPLICANT* <br /> -------•---�-------------------------------------------- <br /> 1� Builder / Consumer Payment <br /> � ' � Owner rr Authorized Agent: ' � C �yLr C g�'+''+��� <br /> ��� Signature Print <br /> Mail Check To: Amount $�.��la �� <br /> Name: �Y[r C N�� <br /> Address: Pd oX R <br /> city, st. : Ever�e tr cvr► 4�ao� <br /> Tax Id. q or SSH: Sm�'--/oo - o,tGn <br /> ote: An IRS Form 10?9 will be cent at L-he end of the year. <br /> N O R� i 1��i <br /> ENERGY CODE C�' <br /> � ,..�� .,:�,�•�-- <br />