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� <br />.a�1AeP <br />5 N O H O M I ti H G U U N T\ <br />� _ <br />, . �LeT � � <br />2320Califomia St., Everett, Washington 9820i 258-A211 <br />Mailing Address: P. O. Box 11�%7, Everett, Washington 9B206 <br />Snohomish PUD Reference ONLY <br />Energy Plan Review ,�: bj-���-� <br />��NWEC�� Plan Raview and Compliance for Electric Heat Residences <br />Date• p ��S-/� <br />z��2 c� � 3 o�P%sl <br />Plan Check No: ow� ( L�T / <br />Assessor's Property Tax Account No: 3�3z QOy O�Z. O170% � / <br />Jurisdiction Basic Plan #: <br />Builder: �"R.57/}0 �.�11 T/GyG,Ta�J <br />Address: 2 20 �— ST. S� � <br />City: cv�� Niil�� Zo$ <br />Phone: 337 - 5/65't <br />Single Family: pc.tP�°� <br />Multi-Family: � Buildings:_ Units:_ <br />Site Address: 5 7d �] %h �� �'" �Cw+� N <br />b� . 4 e7 �� <br />Compliance: ChaFter 4-Systems Analysis_, Chapter 5-Component Performance� <br />Chapter G-Prescriptive_, Chapter 7-Component Point <br />Note: See attached documentation for energy requirements <br />�_� /I..G� �- <br />Snohomish County PUD ttl Representative: �-1 �i• <br />�' ,siqnature <br />fOy�J fi, C./}KE 2SS3-SZZZ <br />Print Phone <br />*ITEMS BELOW ARE TO BE FILLED OUT BY THE APPLICANT* <br />Builder / Consumer PaymAnt <br />Owner or Authorized Agent: <br />1•iail Check To: <br />Name: <br />Address: <br />City, St <br />Tax Id.n <br />Note: An <br />NOR� <br />ENERGY CODE <br />ture <br />Amount $ <br />Pr <br />or SSy: <br />IRS Form 1099 will be sent at the end of the year. <br />� <br />- ,':y_:�:�e,4!L;.,r,P,; <br />� <br />