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t,..: <br /> m <br /> 1; <br /> 1 <br /> ..�.....� <br /> � <br /> , <br /> r�w r°"' <br /> . . . <br /> �.., � � � 2320Ca1ilornia St., Everett, Washington 98201 258-8211 ; <br /> � m i � �:� <br /> Mailing Address: P. O. Box 1 f07, Evereft, Washington 98206 <br /> A x � <br /> a �+ <br /> >'j y Snohomish PUD Reference ONLY <br /> y �M Energy Plan Review q: 02-9Dro DZi_ � � <br /> �< �� � <br /> I 1 <br /> � y� ��NWEC" Plan Raviow and Compliance for Electric Heat Residences I <br /> z oate: 5- 7-90 I <br /> o �� <br /> H �g Plan Check No: <br /> �� � Assessor's Property Tar. Account T7o:��j�(o- OD��QQ1 <br /> M <br /> y y Jurisdiction Basic Plan � : <br /> r� <br /> N <br /> � �nH IIuilder: F_d Ec.ICrnn� -- � !11 �'; l:� ��r �� �=� ��� � <br /> �� dcy� nddress:�_pa' ��N� sr. Q • -� <br /> � l*1�. C1tY: �1'E¢e'Tf� WA 99tOJ I._(ll , . , . � .- . <br /> yy Phone: ZS 6_—'S73 <br /> O V� <br /> Sinqle Family:__._ <br /> h;ulti-Fam.ily: �/_ IIuildings:_j_ u�its:lo [!i�RETT DUILDIN!; DEPT. <br /> site Address: — <br /> compliance: Chapter 4-Systems Analysis_, Chapter 5-Component Performance� <br /> Chapter G-Prescriptive_, Chapter 7-Component Point_ <br /> ��'� t7ote: See attached documentation for energy requirements. <br /> I�� y ' Snohomish County PUD �,'1 Representative:� _ <br /> � Y Signature � <br />► 1 � c��r.. .:eE 2.�.g-�L40 <br /> �" � Print Phone I <br /> — _ i <br /> � � *I'i'FMS REiA�4 ARE TO BE FILLED OUT BY Ttl� APPLI�ANT* <br /> ---------------------------------------------------------------- I <br /> ��� Builder / Cons�mer Payment <br /> Owner or Authorized Aqent:_ <br /> ( �; Signature Print <br /> Mail Chec}: To: Amount $ <br /> ' Name: -- <br /> � � <br /> ��„1 Add re s s:_.__ <br /> City, St. : — <br /> Tax Id. q or SSq: <br /> Note: An IRS Form 1099 will Ue sent at the end of the year. <br /> � 1 <br /> ... .... (Ci00Cl,�' -"1 <br /> NORTHWEST ._ -- <br /> ENERGY CODE � �"°';'�"'��'�"'`'� <br />