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<br /> LVpAC�' ,�ki ��V,�� �,�._ � - ��:�.•� �". LOW{IiSE FESIOENiIAL �'�:
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<br /> ��� -Assessor's Property Tax Account No. e�.
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<br /> ,��x 'PUD PI.AN RF:VIEl9 NO ��"��"C'/� a � � �
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<br /> Kc'� Owner's Address................ f..xr.1..r..........................................Ciry.................,.................Zip..................Phone..................................
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<br /> � H,�,y Builder..�uct�Y.�,t.�:1:��.`.::'?�........................Address.._..--'`J...�PG....�.V..'!.��^..�c'.��.....L�F:�...................................................
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<br /> HC��7 O � �����
<br />� H V � � , PROJECT DESCflIPTION: _ L
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<br /> y ,.3 , ONe�� �ddition .��0 •OSinpleFamity /olStories..........:........... .
<br /> t'"' H y � t�emadel .(Yi Conditioned SQ.FL.....L............. O h1u%i-Family J at Uniis.........................
<br /> � Fl1EL SOUpCE: HEATINB SYSTEM TYPE: ' �
<br /> � d� O Eleciric O Baseha�rd O Ne�e pump NSPF .............................. �
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<br /> Cgn ['t�' . OOiI l�Wallheater OOther.................................................
<br /> z ,.3[n • O Gas O Furnace AFUE................... O Total installed watls or BTU's............
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<br /> ---r > >• r�� v �• � CDfdPONEN� �7B
<br /> Fiat Ceiling R...✓.........
<br /> .�y Check one of Ne Compliance ODtion Boxes 6eiow.Insetl Ne values inlo box num6er E.Belore complelinp this VaWled Ceiling R...�.:....
<br /> t� sectionrefer�o�heinslmc6onsnn6ackollorm. Wall Rr.?_!:��
<br /> �- � .a.,� Eiectric•Northwesl Enerqy Cade, Olher Fuel Sources• Below Grade Watl:
<br /> � Chapter 6 Waahinqton Slale Enerqy Code ' interior R....^......
<br /> O Well Insulated Floor O Systems Analysis, O P�escriptive Approach, exterior R..._"�....
<br />� ��� Option Chapter 4 Chapter 6 Floor R..�.J
<br /> � SIa6 on Grade R....:.-:.
<br /> . Q Well Insulated Vlall �Componen�Pedormance, O Component Pedormance
<br /> Option r,hapter 5 Approach,Chapter 4 Doars S Frame U..,-'`_...7..
<br />� O Passive Salar Option O Compc�er.t Point System, O Systems AnaNsis, Gluing U=:'.,jS�U
<br /> Chapter 7 Chapter 5 °/Gluinp ..........!/o
<br /> , O Hr�t Pump Option .
<br /> � :,,, SolarAllowance .........../o
<br /> AirLcakage .�JST� OAOV
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<br />� FON OEPAflTMENT USE ONLY: � � ' a � ' � �� � " �
<br /> �� Amount ol Payme�,[5............._.......,.......,....... � I hcre6y unify Na1lhe swcNral DaneB wiil mcel tl�e NWEC Foimaldchyde repuirements-eiUcr Ihe
<br /> HUD slandards or nuikec'exlennr or'exposure 1'
<br /> . . Owner or Aulhonzad Aqenl:
<br />� ( �I Dale Permit Issued......................................... �
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<br /> �nnt Name SipnaWre
<br /> DalePermitFnaled......................................... iheloraljurisdicfion/elmtricuuliywiiimaee�paymentloeitherNebuildetarownerlornewelxiriwiy
<br /> �eated residences.Pertnd mus�6e issued 6y 17J31N1 and eonslmc�on finiled hy 6/30H2 in oNer to
<br /> I herehy certily that Ihis dwell�np was bui%in eualAy lor paYmenl.To lacilitate p�yment,Ne iollovnnp inlortna6on must 6a filled aut complelely_ _
<br /> compliancewnhthe��YlEC. Mailchecklo:�pleuepnnp (ppUI'I']ONS/RCtdODGI.S NU'I' I:LIGIIILC:)
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<br /> Name................................................Fed.Tarz ID or SSI'......................................................
<br /> BuilEir,p Otlicial or FUNon:ed Apent Address......................................................
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<br /> N�iF'M IR'i fn�n 1 fN9 x�A pe unl�I Cn end M^��ver
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