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� <br />� . . , , � <br />P�� 2320C�ilifornia St., Everett, Washington 98201 258-8211 <br />� � Mailing Address: P. 0. Box 1107, Everett, Wash/ng(on 98206 <br />��� <br />Snohomish PUD Reference ONLY <br />Energy Plan Review ,�: Q.S� 01� % <br />��NWEC" Plan Review and Compliance ior Electric iieat Resi.dences <br />Date: ,Q �� � / � <br />Plan Check No: <br />Assessor's Property Tax Account No: <br />Jurisdiction Basic Plan ;: <br />Builder: (� _ �- • �c�C.L�-j�/�% <br />Address: /�'/ u /C/ <br />City: S'„!o�{p�+-rtSr� /1. <br />Phone: �/�l - Zn� f�"�"'/•'?-nSv (�A=-�,c, <br />Sinqle Family: �,�p�-�)C <br />t+lulti-Family: ��� Buildings: � Units: Z <br />site Address: �/S �� Q M A nisoN , <br />Compliance: Chapter 4-Syste�as Analysis_, Chapter 5-Component PerformanceX <br />Chapter 6-Prescriptive_, Chapter 7-Component Point <br />NotP_ See attached documentation for energy requir/�ments <br />Snohomish County PUD ttl Representative: � l%. 6"='�-�' <br />� ���Sj.�{n3ture <br />ir ��k� ��,s� -�Z7Z <br />Print Phone <br />*ITEMS BELOi4 ARE TO BE FILLED OUT BY THE APPLICANT* <br />-------- ------------------------------------------------------------ <br />Builder / Consumer Payment <br />Owner or Authorized Agent:_ <br />Signature Print. <br />t•iail Check To: Amount $ <br />Name: <br />Address: <br />City, St.: <br />Tax Id.n or. SSn: <br />Note: An IRS FoYm 1099 will be sent at the end of the year. <br />��� �1G� <br />NORTHWEST C��;�� <br />ENERGY COD[ ��.,:,,. ;,�;.�„��...,,,� <br />