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I � <br /> • ' ��� 2320 California SL, Everert, Washington 98201 258-82 71 <br /> Mailing Address: P. O. 9ox 1107, Everett. Washingron 98206 <br /> Snohomish PUD Reference ONLY <br /> Energy Plan Review N: <br /> ��NWEc�� Plan Review and compliance for electric Heat Residences <br /> Date• ����'I �S -`�0 <br /> Plan Check No: <br /> Assessor's Property Tax Account No: <br /> Jurisdiction oasic Plan @: <br /> Builder• ��CFEc��O �3u�ia�.5 <br /> Address: I�o3 1�� �"' PL. VF <br /> • City: FE�mca� �a n �t�e; .1 <br /> Phone: :dU C, - `19�1- 7 S�l0 <br /> Single Family: ✓ <br /> Multi-Family: _ Buildings:_ Units: <br /> 8ite Address: Lo, 36 F,�ati {��0����v�l �l,nL �S oi PlnnL rn•yc `i8 �)nc�.,•�,,,sl,<�y <br /> 1 <br /> Compliance: Chapter 4-Systems Analysis_, Chapter 5-Component Performance� <br /> Chapter 6-P:escriptive_, Chapter 7-Component Point <br /> Note: See attache.d documentation for energy requirements <br /> Snohomish County PUD ql Representative:�G-�lt` __ <br /> gnatufe <br /> T�+�� H� �,�E z5 c�—�77— <br /> Print Phone <br /> +ITEMS BEIAW ARE TO BE FILLED OU7' PY THE APPLICANT� <br /> _______"'____'____________'_____'____"_'_'_'___'____'_"___'_"_'_'__"_" <br /> Suilder / Consumet Payment - <br /> Owner or Authorized Agent: <br /> Signature Print <br /> Mail Check To: Amount $ _ <br /> Name: TR�n 7�.,,oc�w <br /> Address: I�u�s .:�� � N� NE <br /> City, St. : W-c�monl� wa <br /> Tax id.p or SSN: <br /> o7�t�� An IRS Form 1099 will be sent at tl�e end of the year. <br /> N O R� h+0��� <br /> ENERGY CODE ����'�•�� <br />