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� <br /> � <br /> j <br /> � <br /> _ � <br /> _ � <br /> i <br /> � <br /> _�� � ' <br /> b� � ,$ I <br /> � <br /> � "� <br /> ��� '" . D �'�''�. �-j� �, ( Activityll.7� ?mit # — <br /> � ~ I�JIMEC Lowrise Residential Gompl�ianc:e Check Iist <br /> : <br /> � � e <br /> �� � <br /> �� � ElectNcall heeted dwellin s, s 3 storles, Zore 1, Western Washin ton <br /> H � <br /> �I-� y ��� � � �;:. ' e -. '.... ! <br /> gd� FORM INSTRUCTIONS: .�- Please read�betore completing rorm ��,`�.�,�' � <br /> ,�� �a 1 FIII In all shaded Infortnatlon boxes ihat appty to your project.Ranoi place marks in ihe two leri side I <br /> ''�' � columna labeled" COMPLIANCE RE�UiFiED" and "INSPECTION API'ROVED". Since this lorm <br /> will be evalualed for completeness, you can avoid unecessary permit d3lays by caretully providing all <br /> required inlormation.You may disregard information requeste�that don't eddress your particular <br /> bulldirq or equipment. <br /> I <br /> 2 StaH members will help with general questions about tilling out Ihis form. However, it is your ' <br /> repmeibility to provide specilic Iniormation tor heating syslems, giazing, fnsulation, and olher <br /> building specilications. For specific requirements, refer to the Northwast Energy Code, 1987 Edition. <br /> Thls form will uftimatety be the basis lor all NWEC field fnspections. You can avoid problems by I <br /> BeekinQ approval for any substitutions bflfore incorporating them into tlie project.l"he building oHicial <br /> may require that you substantiate compliance claims about buildinc� products or�echniques by <br /> providing documentaUon irom approved testing agencies or code authorities such as ICBO. <br /> 3 When your permit is issued, you will receive a copy oi this form. Boxes will be checked undor <br /> (��f "COMPLIANCE RE�UIRED" IndicaUng NWEC requiremenis that must be incorporated into this ' <br /> proJect. Each checked requfrement will be evaluated by the buiiding inspector and ,when deemed <br /> � � ; acceptable, marked approved in the INSPECTION APPROVED"column <br /> �_ , i..�a'�xs..� ���.Y�.i�Aa�Vs...,.... h,�&x \�� ' � `�:�.� ��";a` � <br /> ,I ��� <br /> .��. ..�*^�-�.�': .�.�..,.r:� <br /> I .�� ' DATE —�I- O Clry Couniy., �OE�oNISH .,.. , � , <br /> ' NAMEx4�7 EIfLC� BUILDING aDDRESS ��I �'y 7 �k�-7�� LOT i�_ , <br /> I '_ <br /> i, _�� BUILDIN,,,G���...,,,T(((YPE: COMPLIANCE PATN: <br /> �New Residentiat: �Singie Fam. Chapter 6 (< 5000 Ft2) �� <br /> Remodel ❑ Mulli Fam. Component PoAormance ChN5 $ <br /> � ��'_� ❑ Addition ❑ # Stories_(s 3) Systems Analysis Ch#4 <br /> i 0 Points Syslem Chp7 a`: <br /> . - . . .u�.\..'. �m' '�`^�,.'�„ � •'��''. ° \., v:,:.��Y''���tv�`�;�'� �� . ;e � <br /> � �. <br /> ��,► Heating System Type: NOTE All non•electrlcally heated � � <br /> Electria dwellings must compfy w/th the <br /> []Base board Foroed air furnace 1906 Washington State Enerpy <br /> []Heat pump �Zone heaters Code and other ordlnances of thls <br /> �]Other Judndlctlon. <br /> x. <br /> ,.4.,..�,.�, , li°^' � [. `im.� ��^•..�,ra <br /> WEEB APflIL Vo <br /> NWEC plan �evlew: (Department use only) <br /> Approved by Date----�1 Page � of � <br />