Laserfiche WebLink
�r� <br />m�x <br />C, H <br />9 H f/� <br />r9x <br />yzH <br />�H� <br />K�9 H �+] <br />V1 H <br />y t" <br />[�yd <br />OH <br />H [�] O <br />�V � <br />zH� <br />'���:z <br />H r3 <br />O � H <br />��� <br />h7 � <br />z H (n <br />HOcn <br />1 <br />' <br />i <br />E <br />� <br />'s <br />Y <br />s <br />' <br />�ate-----�� --�y--�—U------- --' <br />Appli;ation/Permil i --�----------. \---- <br />i <br />O w n e r--------------- --------- <br />SiteAddress �� _.%'�DiSan.l__S�',___Er/9s�3 <br />Assessor's Property Tax Account No. <br />. <br />• <br />• <br />• <br />• <br />. <br />r <br />Site Address <br />C�� S <br />�,—r'v�=Yu� <br />: <br />S I O E <br />�3o r�J�-�/ �.:r�z% 1���� �v �rrC� � � <br />Owner's Address ...............'.�....... .'..1./.................................... Cdy..................�.......... Zip ./..�,�..�,.� Phana ....:a.7..1...":.`7.�...�: <br />Builder.....E�}.4.I..'..7.....�U�C;OC'fL.,s..........Address.....I..:3`.7.Z MN)<IL7�—o BL.V� <br />....... ............. ................................................................................ <br />Ciry .......... ...�..�..�....��.�..�'—..�'�........................................................... Zip ... �'LO-3.............. Phona ......... ZS �I — �BS� <br />.......................................... <br />PpOJECT OESCHIPTION: <br />.� ew <br />Q Remodel <br />FUEL SOUBCE: <br />,jd'�ledric <br />O Addition <br />G Condftianed Sq. Ft. �.�.�..fgr <br />HEATING SYSTEM TYPE: <br />p Basehoard <br />; O Oil p-Wall heater <br />. Q Gas O FurnaceAFUE ................... <br />. <br />• �� <br />. <br />• � � � � � � � � � � � � � � � � � � � • <br />�ingle Famiy <br />O Mufti•Fsmity <br />i of Stories ..........:........... <br />i af Units ......................... <br />O Heat pump HSPF .............................. <br />OOther ................................................. <br />O Tatal installed watls or BTU's ,So oa <br />.............................a <br />Check one of 1he Campliance ^_ptlan Baes 6elow. Inssrt Ne value� into hox number 4. Balore comDlelinp tl�is <br />secCan re`er to Ne instr�c:c-;an hack a! fami. <br />Electric - Narfhwest Eneryy Coda, <br />Chapter 6 <br />Q Well Insulated Floor O S stems Anatysis, <br />Optian C pter 4 <br />p Well Insulated Wall ComFanent Performance, <br />Option Chapter 5 <br />O Passive Solar Oplian O Compenect ?oint System, <br />O Heat Pump Option Chapter 7 <br />FOR OEPARTMEHT USE ONLY: � � � <br />Amourt[ oi �ayment 5 ..................:.�.....:._......... <br />Date Permi; Issued ...:�.. <br />Date Permit Fnaled .....:.. <br />� i hcreby certify ihat ihis dweiling was 6uiY in '. <br />compluncewAhtheNWEC �� �, <br />�. � .................._............................................_........... �. <br />��.�Buildinp0ilidalorAuNarizedAAent.. ��, <br />� ........................................_........__.......__........ �, <br />Oale : � �� . '. <br />Olher Fual Sources - <br />Washinqtan Stale Energy Code <br />O Prescriptive Appraach, <br />Chapter6 <br />Q Component Perfarmance <br />Approach, Chapter 4 <br />O Systems Anatysis, <br />Chapter 5 <br />COMPONENT <br />wall <br />Belo•x Grade Wall: <br />interior <br />exterior <br />Floor <br />Siab an Grade <br />Doors & Frame <br />Glazing <br />°/<Giazing <br />Solar Allotr,�nca <br />AirLeakage �( <br />• <br />• � � • � e • � . <br />ucWral paneis will meet tl�e M4EC Fa(maWehyde <br />'extenot or'exposure 1l . � � <br />ar <br />• eiNer Ne <br />Thaloaljurisdictluvelectricuolirywillmakea Vayment�oeitherthehuilderorovmerforneweleetricaly <br />heated residences. Pertnil must be asued hy 17J31A1 and conn�Koon finaled6y W3052 in aber lo <br />qwlifylorpayment.Tofadlihtepayment,Nefallowinpinformaoanmustbefilkdoutcompktely. _ <br />— — — — — — — — — — — — — — — — — — — — — — <br />Mallehf ck�o:(pleaseprinl (pDDITI0N5/RED10DEL5 NOT ELIGIBLE) L <br />Name�C,�U/,SC �ti!e(G�ed.TazlDorSSF...�-.n...�7..::.�.�..:��9....�'� <br />....... <br />Address��4-.�..�.� �4:�f%�L%�cZ�. ��-�'�n .................................. <br />............ . ...... .................. <br />NOTE: M IFS fartn 1099 rill W sant at Ne!nE ol Eie year. <br />