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, N O H O M,I 5 H C 5 V N T V�� <br />o _ <br />I . <br />PUBLIC UTIUTY'DISTRICT No l <br />. •.. - <br />, Fverett, Washington 9820' 258-8211 <br />P. O. Box 1107, Everett, Washinyton 387_06 <br />Snohomish PUD Reference ONLY <br />Energy Plan Review n: O s" � � <br />��NWEC�� Plan Revievr and Compliance for Electiie Heat Residences <br />Plan Check No: <br />Assessor's Prope�ty Tax Account No: <br />Date: O � ! —�� <br />Jurisdiction Basic Plan �: <br />Builder: �LM� �L � <br />Address • U • �c - <br />^_ity: �o S �• A <br />Fhone: 7�z - 07./ .•� - 2.11�� �f�'G�=lt ) <br />Single Family:_� ��`'`��� <br />Multi-r^amily: _ Buildings:_ ?Jnits:_ <br />Site Address: ��Q %%f�/S�^� C� �/ <br />Compliance: Chapter 4-Systems Analysis_, Chapter 5-Component Performance�, <br />Chapter 6-Prascriptive_, Chapter 7-Component Point_ <br />tdote: See attached documentation for enerq,y/ requ/�/r ements. <br />Snohomish County PUD nl Representativer ��^� /I' �"' <br />Si nature <br />'To,lr..1 /-f . L't K� 1i.S8 �8 Z7-L.... <br />Print Phone <br />'�ITEMS BELO'� ARE TO BE FILLED OUT BY THE APPLICAN'P* <br />--------------------------------------------------•---------------- <br />Builder / Consumer Payment <br />Owner or Authorized Agent: <br />Signat;.ire Print <br />Mail Check To: Amount $_ <br />Name• <br />Address• <br />City, St.: <br />Tax Id.r or SStt: <br />Note: An IRS Form 1099 will be sent at the nnd of the year. <br />N O R� �GoOd,C¢�t"`—s% <br />EN�RGYCODE - -. °'�-��- <br />