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� � � <br />ay5c� <br />H x� <br />� H� <br />"�� H � <br />yH <br />H <br />xp <br />OHd <br />H�g <br />(j] Y (�i <br />�y� <br />Ny <br />g�y <br />� Hy <br />HOy <br />• • • <br />Pu� 2320 California �SL, Everett, Washingron 982U 1 258-82� 1 <br />� � Mailing Address: P. 0. Box 1107. Evere�t, Washingron 99�06 <br />Snohomish PUD Reference ONLY � <br />Enerqy Plan Review ;: C�.� -CJ/`f'S <br />��NWEC�� Plan Revieti �nd Compliance for Electric Iieat Residenc2s <br />Date: 2�—IqQ�- <br />Plan Check tlo: -L" 7- � a-� � lpa� ��"� �-d� q—� �Q ` <br />Assessor's Proper � Tar Account No: <br />Builde:: �'�� ���1��. �.`^C <br />Address: � b <br />City: a.� Su�\� <br />��hone: S3- o� <br />Single Family:_x <br />t•iulti-Family: _ <br />site Adcress: S � 2 <br />Buildinys: ` <br />51 -e�• 5•W• <br />Jurisdiction Basic Plan ;: <br />Units• _ <br />Y'Vare'ct, �nrF. <br />Compliance: Chapter ,-Systems Analysis_ , Chapter 5-Componen� Perfornance� <br />Chapter G-Prescrip�ive_, Chapter 7-Conponent Point_ <br />t:ote: See attached docunentatior� fo e��gy �e��ements. <br />Snohon�i<_.h County PUD �1 N.enrr_sentative:� _-1 c' i'1 �`� <br />Si�,nature <br />�(c,ff�) /-� ( /�P=�' <br />Yrint Phone <br />*ITE?dS T�EI.047 ARE TO BE FILLED OUT fiY TSiE APPLICANT* <br />-----------------------�------------------------------------------ <br />Duilder / Consumer Payment <br />Owner oi• Authorized Ag nt' �� �'`� � ��� � � � �� ���� <br />Signature Prini <br />hiail Check To: ,` � Amount $ <br />xame: M • P• �'w�'� <br />Address: —�,0� ��cK <br />=�-tY, St.:—ST�r.L�S�zZ� �- �`� ' — <br />Tax Sd.; or SS=:_� _ _ <br />Note: An IRS F'or:�� 1099 will Ue sent at the end of the year. <br />NOR� <br />ENERGY CODE <br />� 1� �1 <br />- - .:,�: ��., _ __. <br />