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� �5' l� � , ActlYity/P�'mit N <br /> NWEC Lowrlse Residential Compliance Check Iist <br /> Electrlcall heated dwellln s, s 3 storles, Zone 1, Weatern Weshin ton <br /> .. .. . .. . . . ... • av <br /> FORM INSTRUCTIONS: Pluso re�u belore complatlnp form �yr�,�' �� <br /> 1 FIII In ell shaded Inlortne�lon boxes that epply to your projed.DauGt place marks in the two lelt sitle � <br /> columns labeled'COMPLIANCE RE�UIRED'and 'INSPECTION APPROVED'.Since Ihls form <br /> wlll be evaluated lor complateness,y�u can evold uneceasery pertnit delays by caretully providinp all <br /> requlred Informalion.You may dlsrepard intormatbn requestes that don't address your parlicular <br /> buildirq or equfpmeM. <br /> 2 Staff inembers will help wi�h peneral questlons about Iillinp oul this lorm.h:Hevar,il is your <br /> reponslblli�y to provlde specific Inlormatlon lor heating systems,glazing,Insulation,and othor <br /> buildinp speciilcations.For specilic ruqWrements,reler to the Notlhwosl Energy Code, 1987 Etlilion. � <br /> �. Thls form will ul�imetaly he Ihe basis lor atl NW EC Iield Inspections.You can avoid pmblams hy <br /> � seekinp approval tor any substitutions belore Incorporalinp them Into Ihe pro�ect.Tho buildinp oflicial <br /> . may require thet you subslantiate compllance claims about building products or techniques by ;:,a <br /> provldlnp documentation irom approved testing apencles or cotle authoritles such as ICBO. r'��� <br /> �. 3 ;, When your permit�s icsuod,yuu will recelve a copy�f this lorm. Bozes will be checked under ;� <br /> 'COMPLIANCF REQUIRED'Indicating NWEC requiremenis Ihat must be Incorporated inlo lhis <br /> . proJecl.Each checked requlrement v,�ill be evaluated by Ihe huilding inspector and,when deemed <br /> acceptable,maA ad approved In Ihe 'INSPF:.TION APPROVED'column. <br /> : � : .v'f��'$�.` wa`�,Aa;I:�°nti i$`r �•tb.;� .�L-x£.+?�?;ti°8a"�'+Lfi�`?b <br /> ` <br /> DATE s"23'9� Clly . ..� . ��, ..�COun�y SiJoHnH15il ��.,.V , a. ... .., a w.... <br /> . NAME K.C. (��-/1S.ti _BUILDING AUDRESS /OSOS 3� RU SE �OT N_ � <br /> . BUILDING,�T{YPE: COMPLIANCE PATH: <br /> {a New Rocidenlial: � Single Fam. � Chapter 6(<50(0 Ft2) <br /> [�Remodnl ❑ Mutli Fam. Component Pedc rmance ChaS <br /> ❑Addltlon ❑ p Storles_(s 3) b Syslems Analy��s Chp 4 <br /> [] Points Systom Chs7 <br /> . Y"8`�� T.was'4.e"�" "x,. �`�+�5� f.�,`�cra�`� �l .�Y ' ����� .. 3.1�:.x <br /> ���.��r� <br /> � Heeting System Type: NOTE: AI7 non-elecrrlca�ry neataa � <br /> Electric� dwelllnpa muat camply wlth the <br /> OBase boara �Forced air furnaco 1986 Washlnpfon Stafe Enerpy <br /> �lieat pump Zone hoatars Co.o end oMer ordlnencea o!thla <br /> �JIhOr . . lurltdctlon, <br /> , S, <br /> NEE��PPIL 10 <br /> NN�EC p/e� reV/BW: IDoparlmenl use only) <br /> Approved by_ Dete <br /> _ PepB 1 01 7 <br />