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,�, <br /> �iC� 1`ro/L,e.�sc� Activity/Permit # i <br /> NWE� Lowris� Residential Compliance Checklist <br /> Electricelly heated dwel��ngs, s 3 stories, Zone 1, Western Weshington <br /> �r� <br /> \c , ,� <br /> a H . . .�. � .,, ,�.w�x ' �> � <br /> C.�h"� �. . U <br /> yyy FORM INSTRUCTIONS. , ' Please read belore completing torm � r'�''`� ,� <br /> g . . . . .. .. ,. . .,...: ., .:.. . � ���`E� �y:;� <br /> H �� � . . . . .. . .. � ...... . <br /> � �z� 1 Fill in all shaded inlormation boxes Ihat apply to your project ➢9�fl1 place marfcs in the two lett side <br /> H xl <br /> columns labeled "COMPLIANCE RE�UIRED" and "INSP E C T I O N A P P R O V E D". S i n c e t h i s f o r m <br /> � H� will be evaluated tor completeness,you can avoid unecessary permit delays by carelully providing all <br /> y �r required iniormatton.You may ignore boxes that don't address your particular building or equipment. <br /> z ;�' <br /> � y d 2 Statt members will help wfth general questions about filling out thts torm. However, it is your <br /> g reponsibilHy to provide specific Infortnation for heating systems, glazing, Insulation materlals, and <br /> ��� � \ \A ; other buildi�q specillcations. For specific requirements, reler to the Northwest Energy Code, 1987 <br /> H �. �s�� Ed(ilon.This form will ulUmately be the basis tor all NWEC tield inspeclions.You can avold problems <br /> r <br /> � y z � ��\� '` by seeking approval tor any substitutions before IncorporaUng ihem inin the projecL The buildiag <br /> H y �;��; o8icfai may require thal you substantiate compliance claims about building products or techniques by ' <br /> g �' ` "' providing documentation trom approved testlng agencies or code authorities such as ICBO. <br /> o r�ti � , <br /> � [�r e`z��� When your permit fs issued, you will recefve a copy of ihis form. Boxes will be checked under <br /> z y t�i� � �':""`R-� "COMPLIANCE REDUIRED" indicating NWEC requirements that must be incorporated into this <br /> i'3 ��' pro�ect. Each checked requirement will be evaluated by lhe building inspecior and ,when deemed <br /> ' acceptable, marked approved in the "INSPECTION APPROVED"column. <br /> r <br /> �, ; 1 q � When using eilher a Chapter 4 or 5 approach, additional documentatfon must accompany ihis form. �' <br /> ��" � Jhapter 5 calcula�ion worksheets are available trom your building department. <br /> � �r.�: <br /> �r <br /> I '"'j .� , �'' <br /> . <br /> ,� , �� .,, <br /> --� <,�� �.., <br /> � � � DATE City � �� County °NflHlS H ` <br /> : <br /> s <br /> ��. �' NAMF BUILDING ADDRESS LOT k_ � �. <br /> : <br /> BUILDING TYPE: �..,( COMPLIANCE PATH: ; <br /> ❑New Residential: W.Sfngle Fam. ❑ Chapter 6 (<5000 Ft2) � <br /> ��� ( ❑ Remodel ❑ Multi Fam. Componenl PeAormance Ch#5 s <br /> � Addilion ❑ # Stories� � Systems Analysis Chq 4 <br /> c:. ,� <br /> ! � : ?4�3?�Y��h?, .. ��A�a�,.`�.. � <br /> NOTE: All non-electrlcally heated <br /> �a'�� Heating System Type: : dwellings must comply wlth the <br /> Electric: ' 1986 Washington State Energy <br /> �Base board orcad air tumace ' Code and other ordlnances of thls <br /> `_�. ❑Heat pump �Zone heaters Jurlsdlctlon. Se9 the WSEC <br /> DOther — Inspectlon C':eck Llst. , <br /> �°` <br /> . 'xa�^:'e>. .xrsc�zxx. ...a sa`r�.� <br /> �a � <br /> WEE9Fd�G0 <br /> Page 1 of 8 <br />