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Oate <br />ApplicatiaNPermd / �--__�-------- <br />OW �0f "'V�f�:l—.SitZ/S� � 1L _'_'_'_'__ ,� J <br />Si�_ Address . 2� 1 Z-----���(I G1N,A__�"V_-. C V, � <br />Assessor's Property_Tax_Account No. <br />---�^ q------y <br />b,nn ni n�i o[1lTFW N(1 QJ / � ��� / <br />. <br />• <br />• <br />• <br />. <br />PISE NESIOENTIAL � <br />� � . . � � <br />�•' Jwfnl L.AK <br />��::�. � .:. <br />Site Address .. . . .. . e!.k :... ............................................................... <br />2���......V/.!'alLll.: �t...... ll.�-' ....................../.�..... �.. <br />, .............................. <br />� C� �l',�/.. Phone ..�..,`-.'�..�2.- ��.`.�... <br />OwneYs Address .2�%�....�G�.r].r.:!...�✓� ................. Ciry...�!�T.=i=. ��.......... Zip ...._..r...... <br />. ...... - <br />�� G��'-?- '_ <br />Builder.s:..�'r.?r��/.....� f.�; nt/ ........................... Address ...... ��t.rr.r. �:..............................................._......:.......................................... <br />................ . _ <br />C�ry ................................................................................................. Zip .................................... <br />Phone ... 2..-�?....`�..".�6/.. r .............................. <br />PpOJECT DESCHIPTION: <br />p'New <br />� Remodel <br />(�J Addition Sinple Famiy <br />p^.onditioned Sa. Fl ..................... O Mufli•Famiy <br />/ ot Stories ..........:........... <br />/ of Units ......................... <br />�Fl1EJ�30UHCE: HEA G SYSTEM TYPE: p Heat pump HSPF .............................. <br />p�Eledric se6oard <br />• O Oil O Wall heater O Other ................................................. <br />• � �ag Q Fumace AfUE ................... O Total insUlled watts or BTU's ,.�.QCO <br />• <br />• <br />. <br />• •���������.����.���.�.��.�...• <br />.��.����.�������������l�� <br />se�ctlon roter to Ihe i s�tn�ictl aee Wde ot lormw ��rt �e V��s into boz number 1. &tore completinp Ihis <br />EI�Nrie • Nm1h�w�� Fn�ryr Cod�. <br />Choptx 6 <br />p Well Insulated Floor O S tams Anayeie, <br />Option apter 4 <br />p Weil Ineulated Wall Component PeAarmance, <br />Optian Cbapter 5 <br />Q PaeeNe Solar Option O C:mpeneM Pomt aystem, <br />O Heat Pump Option Chapter 7 <br />FON OEPARTMENT USE ONLY: <br />AmouM o1 Paymerrt 5.......:..._.._.........._......... <br />Date Permit Issued............._....»...._...._...._ <br />Date PermA Finated ..........._........:_.........._..... <br />I herz6y certify that thia dweliinq was buiR in <br />compliance wrth the NWEC. <br />........._......_.. <br />...._ ............................_......_........... <br />Buildinp Otficnl or /wNonted Apenl <br />.................................................._.___...Y»....... <br />Oate <br />Olh�r Po�I Soure�s - <br />Wuhinqtan Sl�b Enxqy Cad� <br />Q Preecriptive Approach, <br />Chapter 6 <br />� ppproach�Chapter 4 �Ce <br />O Systems Analysis, <br />Chapter 5 <br />COMPONENT � <br />FlatCeilinp R.'3.�.. <br />Vaul�ed Ceilinq R••�•.Q <br />Wall R..L�3�J <br />Below Gmde Wall: <br />interior R............ <br />exterior R............ <br />Floor R • ••'— <br />Siab on Grade R•••.••••�••• <br />Doora d Frame U....."-... <br />Gtazinp U..S�o <br />XGIazinO /c• ��.. ro <br />SolarAliawance ..........'� <br />AirLeaka9e CJ�ro OADV <br />••••••..• <br />I here6Y urtiy tlut the stn�cWN D���'�I meel Ihe NWEC Fortnilddryde rt0uircments • either Ihe <br />HUU sWduds or nurked'eateriof or'exDosurc 1! <br />Owna or�ntl�ariz�d Ap�nL• <br />............................................................ <br />PrnitNime ..................................................... SipnzWre <br />7he�oul�uriWkBoNelxtricu6lirywillmaKe� Vrymenitaei�erlAebuilderorownerlornewelxlricaiN <br />he�ted residenas. Pertnit must G osued M 17131A1 ud wnshucuon (�n�kd W 6130A2 n order to <br />Qu�INy tor p�ymenl. To hdlihte prymml, Ihe �ollawinp infoim�don must be fiikd out cdnDk�dY_ _ <br />M�flehettlo:(pk�seD�nt) (ADDITIONS/REt•tODELS NOT ELIGIBLE) <br />Name ... <br />Address <br />Fed. Tax ID ar SSf ...................................................... <br />Zip.......................................... <br />NOTE: M IHS fcim 1099 wiA W s�nt y m� enE ci he �tu. <br />