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.., . • Q ,�--( � l$� ActivitylP-•mit # <br /> . NWEC Lowrise Residential Campliance �heck list <br /> • Elactrically heated dwellln s, s 3 stories, Zone 1, We�tern Wash(ngton <br /> � <br /> FORM INSTRUCTIONS: Please read betore completinfl form <br /> ,.. ... . .._.�.,.�_, . , . .. . ., ...., . <br /> 1 FII in all shaded infortnatbn boxes that apply to your pro�ect.�p.n0i place marks in the two le(t sfde <br /> wlumns Iabeied'COMPLIANCE REDUIRED" and 'INSPECTION APPROVED". Since this form <br /> wili be evaluated for completeness,you can avoid unecessary pertnft delays by carefully providing all <br /> required information.You may disregcrd intormation requestes that don't address your particutar <br /> buildirp or equipmem. <br /> 2 StaM members wiil help with general questions about tilling out this torm.However, it is your <br /> reponsibility to provide speciBc iniortnation for heating systems, glazing, insuiation,and other <br /> ��ildinq specifications. For specific requirements, reter to the NoRhwest Enerqy Code, 1987 Edition. <br /> Thfs form will ultimately be the basis for all NWEC field inspections.You can avoid problems by <br /> seekinp approvai for any substitutions before incoiporating them into the proJect.The building offi�ial <br /> may require that you substamfate compliance claims about huilding products or techniques by <br /> providing documentation 1rom approved testing agencies or code authorities such as ICBO. <br /> 3 When your permil is issued,you wili receive a copy of this(orm. Boxes will be checked under <br /> 'C�MPLIANCE REQUIRED" indicating NWEC requiremeMs that must be incorporatEd ir.to this <br /> ' prcject. Each checked reguirement wil�be evaluated by the building inspector and ,when deemed <br /> acr.eplable, marked approved in the "INSPECTION APPROVED"column. <br /> DATE�, , -//-O' � City „County ,�'c/fvtr/Si! <br /> NAME W�/� �1�'nt� BUILDING ADDRES� _.__LOT A�_ <br /> BUILDING TYPE: COMPLIANCE PATH: <br /> �New Residential: � Single Fam. � Chapter 6 (< 5000 Ft2) <br /> Remodel ❑ Multi Fam. Component PeAormance ChN5 <br /> ❑ Addition ❑ N Stories_(s 3) Systems Analysis Ch#4 <br /> � Poinis System Ch#7 <br /> Heating 5ystem Type: NOTE: ar� non•e►ecrrrcar►y nesred <br /> Electric: dwelllnp, must comply wifh fhe <br /> OBaseboard �Forcedairfumace 1886 Wzshlnpton Stafe Enerpy <br /> OHeat pump �]Zone heaters Code and other ordlnances of th/s �� <br /> [�Other h�Kediction. �� <br /> , & � <br /> .� ' .�..�. . ... ... ... .z�u�Xi�b. . h,l� /�� .��r <br /> WEE9 11PNIL�0 <br /> NWEC p18n revlew: (Department use only) <br /> Approved by Date — page s of � <br /> . <br />