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. _ ,71' � <br />'Jate------��---.�...'.�_L_..._......_..._.._.._-�---..___..___.._. /�!}'y`J�p��� <br />(i <br />L <br />Application/Permit/._..._.----.--_..._--_...__.._..-----_____.._._ .. . .;;.: ' . <br />Owner _.___�.. ... _... _. .l�j�l.GR.� _._._..........._........ • 1� �' , .. <br />LOWp�SE pfS10FMTIA <br />� �'�' /Q�) p <br />Site Address __�.,.�_. � z __4 __JJ =.–_..�—.L.t)� <br />Assessor's Property.Tax_Account No. �:: <br />_. .:.. � .:;.: <br />Sue Address ............:....�raTr.�.�................................. <br />Owner's Address ............................................................................. City................................... :Zip .................... Phone <br />Builder.....�!.'.?�.. �.K� �fn. ....................... Address ................................................ .................................... <br />• � .............. i <br />. <br />C iry ................................................................................... <br />. <br />. <br />. ._ esa.wsr..recxacaaxmuarov��•" <br />• PRO CT OESCRIPTION: <br />� New O Addition <br />� Q Remodel �and'Aioned SQ. Ft......�...�..�...... <br />FUE SOURC[: NEATINGSYSTEMTYPE: <br />Eiearic O Basebavd <br />' O Oil �all heater <br />� O Gas O Furnace AFUE ................... <br />Phone <br />O Sinple Famiy <br />�71ufti-Famity <br />/ o� Stories....._Z/'...... <br />/ ot Units........�y.T ............. <br />O Heat pump HSPF .............................. <br />OOther ................................................. <br />O Total installed watts or BTU's ............ <br />. <br />. <br />. .. . . <br />. <br />....••...•......•.••.���� ......••...•...........•....•. <br />Check one ol Ne Campliance Option 8ozes below. Insert Ihe values into boK number 4. 8eloie complelinp Ihi; <br />section reler lo Ihe inslrucEons un b�ck al fortn. <br />Eleclric - Horlhwesl Enerqy Code, <br />Ch�plet 6 <br />Q Well Insu!zted Floor O Systems Anafysis, <br />Option _J Chapter4 <br />Q Well Insulated Wall �1 Component Performance, <br />Option / Chapler 5 <br />p Passive Solar Option O C^mpener.t Point Syslem, <br />O Heat Pump Option Chapter 7 <br />fOR OEPAHTMEHT USE ONLY: <br />Amoum ol Payment <br />Dale Pcrmit Issued . <br />Date Permit Finaled ... <br />I hereby certify that this dwellinp was bui% in <br />compliancc wAh the NWEC. <br />.. . . .:........._...................... ....................._........... <br />Buildinp Otlicul or Autl�onted Rpenl <br />Olher Fuel Sources - <br />Washinqtan Sl�te Enerqy Code <br />p PrescripfNe Approach, <br />Chaptcr 6 <br />� Approach,�Chapter4 nce <br />p Systems Anaysis, <br />Chapter 5 <br />COMPONENT <br />Fla� Ceilinp R..3S• <br />Vaulled Ceiling R...... .... <br />Wall R..,`�.... <br />Below Grade Wall: <br />interior R............ <br />exterior R............ <br />Floor R•���• <br />Slab on Grade R............ <br />Doors d Frame U�:r.�'.. <br />Glazinq U3.T.:.yb <br />%Glazinp ....•'/• <br />SolarAllowance /.........'/a <br />AirLeakagc �fSTD OADV <br />.•.•.•.... <br />I hereby certiy N�I Ne slrucNral panels will meel ihe NWEC Formaldehyde repuitemenls • either Ne <br />HU� standuds or tmrked'extednf or'exposure 1' � <br />Owner ar Aolhori:ed Aqenl: <br />.................... ................................................................... <br />................................................ �Qn�Wre <br />PnntName <br />The Ioral jurisdic6on/eleelrk utiliry v.ill make op�ymenl lo tiU�er Ne 6uilder or ownet ior new elalricaly <br />he�ted residences. Permil musl be asued by 11J31N1 ard eonslivcfion fin�led hy NJOA2 in o�der to <br />Qu�lily lor p�Yment. To 1�cili�te D+Ymeni, Ihe Iollovnnp_nlortn�0on must be filled oul canDktely_ _ <br />Mailchecklo:(D�easepdnq (pDDITIONS/RL�dODf:LS 10T 8LIG16LG) <br />Name................................................ Fed. Tac ID or SS/...................................................... <br />Address................................................................................................................................. <br />Zi p .......................................... <br />NO1F' M Iq5 Po� 10?7 vA M �nl )1 Dt ��E t� Ibe �ear <br />