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� .., __.:s, <br /> �`���` <br /> ,. • � <br /> . �� 2320California�St., Ever?tt, Washington9820f 258-8211 <br /> � ' ' Mailin.g Address: P. O. Box 1107, Everett, Washington ��9206 <br /> � <br /> Snohomish PUD Reference ONLY <br /> Energy Plan Review y :�� �� <br /> ��NWEC" Plan Reviea and Cor�pliance for Electric Heat Residences <br /> Date: �ya.�r- � �� lq90 <br /> Plan Chec}: tdo: <br /> Assessor' s Yroperty Tax Acecwit tdo: <br /> Jurisdiction Ba�s-i� Plan ' <br /> � Z�C 8 s8 <br /> �ui:.der: i���n�m.� Cn�,<; n�v �u� <br /> Address: lOon9 - ISI �- PI S �- :=`��'-3 ��(i-.���lG <br /> City: � e 'on � + <br /> Phone: `lA� - µ3�l8 — <br /> Single Family:_ <br /> I•tulti-Family: �C _ Buildings:�_ Units:� <br /> /� CN C coau�'� � �v�����,<rr <br /> Site Address: �-�n aon � f�2o �^ <br /> Chapter 5-Component Perforrance� <br /> Com�liance: Chapter 4-Systems Analysis_, Chapter 7-Component Point_ <br /> Chapter 6-Prescriptive_, <br /> Note: See attached documentation for energy �eauirements. <br /> I 1 0�.(�..,�� <br /> Snohomish County PUD =,'1 Representative:�� �- �-�-� ature <br /> �/ ' �i.�_1�1����rJ �`k��l ����- <br /> Print Phone <br /> *ITEMS BEL04l AFE T('� BE PILLED OUT BY THE APPLICANT*_________ <br /> ------------------------------- ------------ <br /> Nuilder / Consumer Payment <br /> l3a�c�� c. Kor, M::� <br /> 6 ��Y�90 _ <br /> Owner or Authorized Agent: Signature Print <br /> Amount $ <br /> Mail Check To: <br /> Name: ��N���F� C nr.c- q �c✓ � <br /> Address: IOAOA - ISlac F�1 5��-- <br /> City, St. : $ roo�+o.nri�' W/t �192tic) <br /> Tax Id. ,"r or Ssr : �il- IOl31H�i <br /> Note: An IRS Form 1099 wiYl.�be sent at the end oL the year. <br /> � <br /> ................ GCOC�•�Jc�:►s, <br /> � <br /> NORTHWEST _ -. .. . - .- . <br /> ,.: . _, , ...., <br /> ENERGY CODE <br /> � <br /> �,yyy il��� �{ ` . � �4 'V �..w �i^�q�5 <br /> ��s�€qJ�. � �. �` � . :� t y � � � � <br />.._._..._�..._, . . ., 9'�� -. ew� ...�_�__��,...., .. _ � '',.d _ �-�r . ��. _r�.. . �. . _�.'_ :_�.'.�� <br />