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Date ,�......_...._.-------��-f--/S,FS,�___-r.,__ ,� . <br /> ApplicationlPermN�.--------/--'----------- `��•, �o w e i e c II E 3 I 0 F N T I A L �•• <br /> 6Qs�.u7.wa C.6�!t.C_-------- . . , � <br /> �YYIIlf'_'_"'_" • � � <br /> 1 <br /> Site Addrese•--/8L�__�.f���+��-----• "'. , ;,+'� <br /> Assessor's Property_Tax Account_No_ ��''�!:�:. e ..;;'� <br /> � 'PUD PLAN REVIEW �V� �-� .,��'''... <br /> • �.�w*.e-a::...................................................................................... ................................................................. <br /> � Site Addreae ..... ................................... . .. • <br /> � Phone................................... <br /> Owner's Addrosa....................................................................... ....Cily.......................,.............2ip.................... <br /> .. g ... ......1. <br /> � Builder...........�.eitf.S!!.M.s.......-.��..r.!,kf...............Addreas...........!�.y...../... J".......V.....� .../:�?..............;................................ <br /> �.. � ... . <br /> �} — <br /> • s P....................................Phone.........�3�....Q`.1.� ........................ <br /> � Clly......................l..�P./.1R.C.!t..i..I.f...........................................Zi <br /> • <br /> . <br /> • <br /> • PROJECT DESC8IPTION: inple Famiy /oi Stories..........:........... <br /> ' O New AdZition <br /> � i ot Units......................... <br /> Q Remodel G Cond'Afoned SQ.Fl.....�1.�•••• O Mulli•Famiy <br /> � � UHCE: HFATING SYSTEM TYPE: p Heat pump HSPF .............................. <br /> Ekctrie OBaseboard p0ther................................................. <br /> • O 01 ��Nall heater <br /> � � �s Q Furnace AFUE................... O Tatal fnslalled watts or BTU's............ <br /> . � <br /> .� <br /> . � <br /> . • . . • • • . . • • • • . . . . • • . • v • . . • • • . • • . • • • . . • • . • . . . . • . • . . . <br /> ' COMPONENT <br /> • �i � • � �• � Flat Ccilinq R 3 g• <br /> Vaulir.d Ceilinq R••.••••••••• <br /> CMck aro of Ne ComVrW�ODtion Bmin 6ebw.I�ert the v�lues into box number 1.Betore compbtinp this Wail R�.�.AQ✓ <br /> section nhr to the insuucdo�xan 6rk al laim. Below Grade Wall: <br /> EI�NrIe-NoAhw�d En�roY Cod�, Olh�r FuH Sourc�:• interior R............ <br /> Ch�pl�r 6 W�thinqlan SI�U EnepY Cod� �erior R............ <br /> O Prescriplive ApP��h, Floor R..�S. <br /> p Well Insulated Floar O S�ele�er 4�alysis, �ry�p�er 6 Slab on Grade R............ <br /> Optbn y�„ <br /> p Well Innulaled Wall �Component PeAormance, O ApPf o�ach Chaptar��E Doors 8 F2me U...'�..g.. <br /> Optan Chapter5 Glazinq �•���•� <br /> p PaseNe Salar Option O C^mpener.t Point System, O Systems Analysis, �f,GWzinq •••••••%` <br /> Chapter 7 Chapter 5 ga�r Allowance . ........�6 <br /> O Heat Pump Option Air Lwkaqe SiD OAUV <br /> . <br /> o . . . . . . . . . . <br /> , . , . . , . , , , <br /> FOfl UEPAHTMENT USE ONLY: <br /> � AmoutrtolPaymenlS..............�............._......... IAercM'uA'�y tluttheswcadWnelswdlmeettheNWECPomN�dehYAereOuircments-eitherlhe <br /> HUD shnd�rds or motked'ezlerinf or'apusare 1� <br /> Owner or Aulhorizad Ilqenl: <br /> Date Permit Issued..._......................_...........: ................................................................... <br /> . � .................................................................... SipmWre <br /> � � �� � PrintN�me p� <br /> , Date Permit Fnaled......................................... hai�res�d�enas Pomi t m rilbe issued p�y 17/31mA1 ind w�n�,ruco n finikd b,%�A2�'m�oNer io�N <br /> _ � .. . . � . . awl'Ay lor WymenL To lauli�te WYmenl tfie fopovnn0��an^�Uon muri be NMd oul canDNtdy- — <br /> — — — — — — — — — <br /> — — — — — — — — <br /> IhereDycertifythatthiedwellinqwasbuiftin Moilcheeklo:�pkaseprint) (ADDITIONS/REPIODELS NOT ELIGIBLE) <br /> compl'ance wrth the NWEC. <br /> ................................._........... <br /> Name................................................Fed.Taz ID or SS/...................................................... <br /> _......._......._........ . ........................................... <br /> .. <br /> Buildln0��I or/wtl�onnd Apent <br /> Address...................................................................................... <br /> ......:..........................._ .. . ._....... Ciry................................................................... <br /> .................... Zip.......................................... <br /> ...:...... <br /> ». ._._.._.. <br /> D�k <br /> � NO1E:M INS Faim 1099.A1 M s�nt�t m��nE d IM y�u. <br />