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- ,� . <br /> z <br /> P � � �320 California St., Everett, Washington 98201 258-8211 <br /> � ' Mailing Address: P. O. Box 1 f07, Everett, Washington 98206 <br /> Snohomish PUD Reference ONLY <br /> Energy Plan Review #: nS - �'oH� <br /> ��NWEC" Plan Review and Complir.nce for Electric Heat Residences <br /> Date: 5 2U �9`� <br /> Plan Check No: <br /> Assessor's Property Tax Account No: 192 uo S -Z - � rS -DaoO <br /> Jurisdiction Basic Plan #: <br /> Builder• KF /��f* sr-, !'v z/ <br /> Address:� 3 / � �r 2 f +� � � <br /> City: � . � I w� e s n � G <br /> Phone: _�� �- ; ��� — <br /> Single Family:�_ Units: <br /> Multi-Family: _ 1�uildings:_ _ <br /> Site Ad3ress: / D . •� ��' �'� � <br /> Compliance: Chapter 4-Systems Analysis,_,, Chapter 7-Component Poinormance� <br /> Chapter 6-Prescriptive�, <br /> Note: See attached documentation for energy requirements. <br /> -��., N. G,�-- <br /> Snohomish County PUD $1 Representative: Signature <br /> �oH•.J H, L,c4-kc 7�s8 8 z.7 z <br /> Print Phone <br /> *ITEMS BEIAW ARE TO B� FILLED oUT BY THE APPLICnNT*_____________ <br /> ------------------------------------------------------- <br /> � SuilBer / Consumer Payment <br /> Owner or Authorized Agent: Siqnature Print <br /> Amount�..$ <br /> Mail Check To: <br /> Name: <br /> Address• <br /> City, St. • -� <br /> 'Cax Id. # or SS#� <br /> 'ote: An IRS Form 1099 will be sent at the end of the year. <br /> � � <br /> .::E•.::EE•: �ioOdC¢� <br /> N O R T H W E S T �y�,�t,w��� <br /> ENER_ G� C� <br />