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<br /> ��� , Activity/Pe pit #
<br /> ��� NWEC Lowrfse Residential Compliance Check list
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<br /> �y� Electricetl heated dwellin s, s 3 storlea, Zone 1, Weatern Wash ngton
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<br /> g�y FORM INSTRUCTIONS: Plaase read before completln0 lorm „
<br /> ��� � FIII In ell shaded In1ortnetion boxes that apply to your pro�ecl.Dollot��a�e marks In Ihe two lett elde
<br /> columna lebeled'COMPLIANCE REOUIRED' and "INSPEC'� ON APPROVED'. Since thls�orm
<br /> wlll be evaluated tor completenesa, you can evold unecessary permit delays by carelWly provldi�q all
<br /> required Inlormation.You may disregard Imormatbn roquestea that don't address your panicular
<br /> buildlnp or equipment.
<br /> � 2 Stafl members wlll help with peneral questlona about fillinp out this torm. However, it Is your
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<br /> ' reponslbility to provide specftic Inlormetlon lor heeting systems, glazing, Insulation, and other
<br /> � buildinp apecificallons. For specilic requirements, reter to the Northwest Energy Code, 1987 Editlon.
<br /> �, ' 7his form wlll ultimately be ihe basis tor all NWEC Ileld Inspeclions.You ca� avoid problems by
<br /> ��,� soekinp approval tor any substitutlons belore incorporating them i�to the pro�ect.The building otticlal
<br /> � f � '" may require that you substamlate compllance claims about bulldlnp products or IechNques by �.:
<br /> � " providing documenlatWn Irom approved tosting apencles or code authoritles such as ICBO. �
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<br /> '�t �'rr 3 W h e n y o u r p e rmlt Is issued, you will recelvo a copy ol this form. Boxes will be checked under �
<br /> n�` "COMPLIANCE RE�UIRED" Indicating NWEC requiremenls that must be incorporaled into thls
<br /> '�' ���". ` pro�ecL Each checked requlrement wlll be evalualed by the building Inspector and ,when deemed �
<br /> ;�� : , ` ar,ceptable, marked approved in Ihe "INSPECTION APPROVED"column. �,
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<br /> 1jDATE - - a Clty_ ✓P _County_ � a � �3 .
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<br /> ' NAME�/1k �C �N BIawI� BUILDID3 ADDRESS__.—. �uel�P`/ �
<br /> � BUIIDING TYP ,_.,/ COMPLIANCE PATH: �'
<br /> � ResldentiaC LrJ Single Fam. ❑ �C pter 6 (c 5000 Ft2)
<br /> � ❑ Remodel ❑ Multi Fam. [1�'Gomponent Pertormance ChqS `
<br /> 1= � Addltlon ❑ # Storie 3_.__(•. ��) ❑ Syslems Analysis Chq 4
<br /> � PoIMs System Chp7
<br /> 1 , g�p .�+i.� A ::��� PLl ET'�`�M:' . '.*�� . �� �
<br /> � �,E :.,-��::, k'�£ ' ..��'M��iLi�i�i�'�.'� s. ,�. Y:..•, . ., .., :
<br /> Heating System Type `' NOTE: 41► non•ateculca►ty heered
<br /> ' '"' dwe111npa muat comply wlrh the
<br /> Electric: ��' 18B6 Washlnpfon State Energy
<br /> �Base board (�Forced air lumace r - Code and ofher ordlnencea ol fhls ���:�
<br /> � C]Hoat pump �neheaters am&�s'.. Ju���R :y���`,,
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<br /> (NWEC plan revlew: loepann,em use oniy� p q
<br /> Approvod by Date 7�/ � pege i ot �
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