Laserfiche WebLink
��b <br />ro <br />y <br />C M <br />� Htn <br />ti�s <br />K n <br />o m o <br />� N M <br />�.�� <br />o.. <br />z n o <br />�1A� <br />M <br />¢ y <br />� M H <br />N <br />O N <br />� ro � <br />� O y <br />I �� <br />� <br />�,;� _ -.1.�_._ .___ __ _ _. <br />: � <br />1L- _ <br />Appliwlion/PcrmH I _..........._----"---..__.....__..___.....__. <br />O�sner..r'.!�I?'�`•r.._G N,7'• _ <br />Sitc Address _�. � `-_..�`.-�)-!�_L-=�.--....._._......__. <br />Asscssor's Property Tax_Account.No_ <br />. <br />• <br />. <br />• <br />. <br />�'� l 0 W R I 5 E R E 5 I 0 E N i I A l/�y <br />� � <br />1C�1 �..n%L <br />-- `'� ::.. B �,r�. . <br />sncaadr�s5.....1-.'._�.L�.....l::.L��..f.�:.�.:.r" ................................................................................................................................................... <br />Owncr'sAddrcss.z.I..�a...l:....I.��.�.(::.L:h.Yh f}t.;r .....................Ciry....5�:!.lr.(...j_l:.-..........Zip:L..G::S:(....Phone!.::,2..4...:. �.'...-.?..`... <br />.... <br />,� �3 }! �.........��il('h'' '` �' <br />6uilder..(Y_,';? UL?�rt....�..`............�. <br />........................Address... 5 /� (............................................................................................... <br />�i �� � , � ............. Phonc..1..�.. `:..:::J..Y.'' ............................... <br />cay..... ti,:;;.:.i.`.!?:...r..i::tl .........................................................z� <br />p ...:.. ` :. :............ ........ <br />_ __— <br />PROJECT DESCRIPTION: �- <br />AdGition � <br />� New <br />Q Remode� G Condiiioned Sa. FL....e�........�.... <br />FUEL SOUHCE: NEATIHG SYSTEM TYPE: <br />(j'Elcarie O Basehoard <br />' O Oil �-W�II hc�lcr . <br />. U Gas O Furnace ANE ................... <br />inple Famiy / o( Storics ..........:........... <br />O Mu11i-Famiy / al Units ......................... <br />O licat pump HSPF .............................. <br />OO�hcr ................................................. <br />O Tolal installed wans or BTU's............ <br />• sr..-.�:�.s,—. <br />. .. ��-,�� .. . , . . . ..,... . . , � <br />. <br />......•..•........... v .............................. <br />f*YIIL'RPg4TW. v3V..w'�'...K^:.:Y2:�. <br />� COtdPONENT p <br />� �' � � � � �� Flat Cciling p,3� <br />�� Vaulted Ceiling R..... . <br />theck one al Ne ComDliance OO�ion Boxes below.lnsert Ihe values inlo boK numhet 4. &.�ore comGle�inp ihis � �`v,ll R.. 1.�7.. <br />� sectionrelertotheinstmcuonsnnbackollorm. �"�' <br />BclowGrade Vlali: <br />Eleclrio • Ilorlhwesl Enerqy Lade, <br />Chapter6 <br />Q Well Insulated Floor O Systems Anaysis, <br />Option � Gjh�pter4 <br />O Ylell Insulated Wall m'Component Pedormance, <br />Option . Chapter 5 <br />O Passive Solu Option O Cempc�er.t Point Sysicm, <br />ONc�tPumpOption Chaptcr7 <br />FOR DEPARTMEHT USE ONLY: <br />Amount ol Payment 5 ...................................... <br />Oalc Pr.tmit �ssucd ......................................... <br />Da�c Permit Finaled ......................................... <br />I hcrc6y ccrtifythat Ihis dwcllinq was 6uilt in ' <br />comploncc w�h Ihc NWEC. <br />.................._......................................................... <br />Buildinp Otikul or �Wtnartted Apenl <br />Olhar Fual Sourcoc - <br />Washinqton Stata Enorqy Cada <br />Q Prescrip�rve Approach, <br />ChaDter 6 <br />Q Componenl PcAormance <br />Approach, Chaptcr 4 <br />p Systems Anaysis, <br />Chap�er 5 <br />imcrior R............ <br />exlcrior fl......p.... <br />floor R../..J.... <br />Slab cn Grade R............ <br />�oors 8 Frame U...:.'.... <br />Glazinp U. �_'.iC� <br />YGiazing ...�.(...% <br />SolarAllowancc .........°/ <br />AirLwkage TD OA�V <br />..•....... <br />I herchy cc�tih� Uul Ihe s�rucW�al pancls vnll �iecl Ihc NY�EC fomialdchpdc rcQuiicments -eit�er Ne <br />HUD sl.mdaiAs or m��led'erlcnnY or'eapm,ure 1' . , <br />Owncr or Aulhori[ed Agenl: ./�� <br />��� ✓L,� L <br />.Jw/ ............... ...................................... <br />�-�.L�/t1=i..N,:....j{.....L��:.4./,I.1�.5l�... Sipnamrz <br />Pnni Nune <br />TTCIewljudsdic0oa41avkutiiiryv.illmatea pa1'mentloeiNerthebwWerorownerloroewelalriwiry <br />he��ed iesidenus. Pennii musi be iuued 6y 1D31A1 md �onsirucfion �inalcd hy NJON2 in ofder �o <br />Quolity br paymenL To IauliUlc paymrnt, tlic lollowinp inlortn�tion musl �e filled aul comD�elcly_ _ <br />Mailoheckto:(DlcasePiinp (,11)UI'I'IONS/RI:bi011f.LS SU�I� IiI.IGIISI.I�.)— <br />Name......................_........................ Fed. Tac ID or SSr,................_. _._............................ <br />Addr es: ....................................................... <br />Crty ............................... <br />HOtf' A� �q51c� 1h?0 �+�I N irnl a! �e mt c� ^r wa� <br />