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<br /> ; (j New O Addition I�1z U O Single Famiy 1�4 f�1`'�` T of Srories..........:..........
<br /> � Q Remodel G Condi�ianed Sq.Ft..................... O Multi-Famiy Y of Units.........................
<br /> FIIE SOURCE: HEATINGSYSTEMTYPE: ' ,
<br /> Electric O Base6wrd O Heat pump HSPF ..............................
<br /> � O Oil m'Wall heater O Other.................................................
<br /> . O Gas O Furnace AFUE................... O Total installed watts or BTU's....3�?.���'
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<br /> i� � , i , � COMPONENT
<br /> � Flat Ceiling R_3...�.d..
<br /> �� i.heck ane af Ihe Compliance OD�on Bozes below.Insert the values inte 6ox num6er 4.Betare campletinp ihis Vaulted Ceilinp R...........
<br /> seUion relerto the insWctlonsnn back of fortn. Wall R..2.�..
<br /> � Electric•Norlhwest Energy Code, Olher Fuel Sources- Below Grade Wall:
<br /> � Chapler 6 Wa:hfngtan State Enerpy Code interior R............
<br /> O 1Ne��Insulated Floor Q Systems Anatysis, O P�escriptive Appraach, exterior R.•2S.
<br /> � Option C pter4 Chapter6 Floor R..........
<br /> � O Well Insulated Wall Companent Perlormance, O Component Pertormance SIa6 on Grade R.....ZZ
<br /> Optian Chapter 5 Approach,Chapter 4 Doors 6 Frame U..�.,,.....
<br /> � O PassNe Solar Option O Cempener.t Point System, O Systems Anatysis, Giazing U.-.37,yH
<br /> Chapter7 Chapter5 %Glazinp /.`f.:..."/o
<br /> � O Heat Pump Option SolarAllowance ..........%
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<br /> AmountofPayment5............................. � IherebyceMi thaltl�eslmcNralpanelswillmeel�heNWECFortnaldenyderequirements-eiliicrthe "
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<br /> ; HUDstandar sormarked'ezlennfor'exposurel' .
<br /> Date Permit Issued......................................... L P�N,r..dJ...N.:f B�CUJ,:i:J�....l.cL'G:... �:.(fe:�/��-f,fi�::::L..'.:...G,.::c.� .
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<br /> healed residences.Permit must be issued by 17J31N1 and consiruction finaled by''�/3052 in order to
<br /> I here6y certify�hat�his dwelling was 6uilt in �_qualify tor paymenL To facililale Dayment,tl�e lollawinp inlortna6on musT6e filled ou[complelely_ _
<br /> compliancew�hiheNWEC, ' Maile^heekto:(pleaseprinq (pDDITI0N5/RE�fODELS N0. ELIGIBLE)
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