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�7 <br />��� <br />C H <br />9Hy <br />H�� <br />k � <br />H�H <br />C+1 Q � <br />ON <br />n <br />4��0 <br />t"y� <br />Hy <br />y <br />g�y <br />�O� <br />�� <br />i I - 1_-.. �-!_ -�---- _-,,. <br />o���-_--.__..-------- r� �w__ <br />pppliwtion/Permd / _.__.__.._....-.---.-.----._.- �.--- <br />�p. r - <br />�AN,�__ N----3�R��`-. � y« <br />Owner ---.._---..R _._.__. <br />Site Address ---...___T..1:�-_.Ly�!?i�_P_c.�.-._---.._._. <br />Assessor's Property_Tax_Account.No_ <br />• <br />. <br />• <br />. <br />. <br />�� T7. � ; <br />15`g�k �, .. <br />/ � <br />ISE NESIOEN <br />: � <br />SiteAddress .........................�..w.z:..-.:.w...................................................---__._,.. <br />ZiPhone ................................... <br />....................... .... .. . .. .... C' .. P .................... <br />Owner'sAd^d-r�ee; .................................. . .... rty.................................. <br />• bl�Mic.:.....:.. ..... ... ............................................................... <br />Bwlder........�...... I" �r.4A.:"�.I� .....................Address..._�R....g�X............�.�li ia <br />, .... <br />�-e/ . Phone ....:3.55..�..'4� �-15 ........................ <br />C'rty ...........C...S.�.%:!r�?� •••• .......................................................... Zip .................................... <br />PHO DESCpIPTION: <br />New <br />Q Remodel <br />� FIl SOUflCE: <br />Eleclric <br />O Addition �v2 � <br />�6onditioned Sq. Ft ..................... <br />HEATING SYSTEM TYPE: <br />p Ba board <br />' O Oil all heater <br />t O Gas O furnace AFUE ................... <br />�ngle Famiy <br />O Multi-Famiy <br />i of Siories.........�......... <br />► of Units ......................... <br />O Heat Pump HSPF .............................. <br />OOther ................................................. <br />Q Tatal installed watls ar BTU's ............ <br />. <br />• <br />• ••..•....•.•.....•........•••. <br />• � � � � a � � � � � � � � � � � � � � • v <br />�'..,.» <br />� COMPONENT — <br />' � � � ' � � � Flat Ceiling R�•�!��� <br />�� .� Vaulted Ceiling R............ <br />Check one ol ihe Campliance Op6on Boxes 6elaw. Inseri Ihe values into box numher 4. Belore comDletinp ihis W,II R Ic��. <br />section refer to �he instmcfians an hack of form. Below Grade Wall: <br />Elnclric - Horthwest Energy Cade, <br />Chapter 6 <br />p Well Insulated Floor O Systems Analysis, <br />Opnon C oter 4 <br />p WeII Insulated Wall Camponent Pertormance, <br />Option Chapter5 <br />p PassNe Saiar Option O C^mpener.t Poirt System, <br />Chapier7 <br />O Heat Pump Option <br />FOflUEPAHTMENTUSEONLY: � . � <br />Amount of Payment 5 ...................................... <br />Dale Permit Issucd ........:............................... <br />. Date Pcrmit fina�ed ........................:.:.............. <br />� I hcreby certify ihat this dwelling was buiR in <br />campliancc wdh ihe NWEC. <br />.................._........................... Q.............:._'....... .. <br />� � Buildin0alkular{wNoritedA ent <br />............................... <br />......................_...__......_........ <br />Datc <br />Olher Fuel Saurces - <br />Washington Stale Enerqy Code <br />Q Prescriptive Approach, <br />Chapter 6 <br />�Appmach Chapter4ance <br />O Systems Anaysis, <br />Chapler 5 <br />interior R............ <br />exterior R.......... <br />Floor p, 3-O , <br />Slab an Grad° R <br />Doors 8 Fr�me U 1Z j/�33 <br />Glazing U..��W.. <br />°/,Glazing .......... °�� <br />SolarAllowance ..........°/a <br />AirLeakage STD OAOV <br />.......... <br />I here6y certiy Ihal Ihe sirucNral panels will meet ihe NWEC Formatdehyde repuirements - either tl�e <br />HUD standards or marked'extednf or'exC�ure 17 <br />Owner orAulhorixed Aqanl: <br />G /Et', Bi/�itir . . ...... .. .i. :,l.rr.��.:s� ....................... <br />,�.% ................................................ �i aWre <br />Pnnt Narnc <br />The Iawl Nrisdictlon/elalric uuliry wiii maKe � paym 1 to eilher Ne 6uilder or ovmer lor new eledriwlly <br />heatcd residences. Permit must be r.sued by 1�131 1 a� constmcuan finaled hy W30N2 in order lo <br />qualiy lar payment. To lacili�ale Daymen�, Ne �ollovnnp inlaimatian must bo filled ou� completely_ _ <br />Mailcheck�o:(plr.asePnnq (AUD11'IONS/RL�IOUGI.S NOT C:L1GIIlLG) <br />Name�YU: r.......�t?.���/..f/�... Fed. Tax ID or SS�:.S4���.�..-_�'��.`.:' ............. <br />• ................................. <br />Address ���'... .F.��'%.,�.zrl.��c .:......................................... .......... . <br />.. .. <br />c�r.��2<r.e.� ...............11..�/f��....................... z�P.....✓.L�.'.�G.:°.................... _ <br />NOTE: M Ifl5 Fortn 1 P39 M+II De ttni al me enE ot Pc )ei�. <br />