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Date <br />Owner.._LIU. <br />Sfte Address ._� <br />Assessor's <br />• <br />• <br />• <br />• <br />. <br />. <br />' °/ / <br />f....�_.._���.._�_ / <br />�..� �-.�l✓__.,!_��?� <br />� T� <br />3_....�._._�2�..__...._..!_�' <br />'roperty Tax Account <br />_ ... ..........�. ...�......_._..._....._...._.--- <br />,V_IEW_N0. OS�IIO <br />No <br />Site Address ...........:�.:-�. �.......... / <br />. ... ... �;.. .T ..........� <br />Owner's Address ., . � <br />( %� ;�.� ................,5: d......�.................... <br />Builder .... ?.,Qc:L.V... �. ...................................... . Address ..... <br />Ci t y ........................... <br />PHOJECT OESCNIPTION: <br />O New <br />O Remodel <br />FIIEL �DURCE: <br />c�Efectric <br />Addition <br />G Conditianed Sq. FL ..�� �, <br />HEATING SYSTEM TYPE: <br />O B�eboard <br />; O Oil (g'G/all heater <br />• O 6as Q FurnaceAFUE ................... <br />• <br />. <br />. <br />•••••••••.�.•.•�..�•. <br />Zip <br />Zip <br />Phone <br />C7'Sinple Famity <br />O Muki-Famiy <br />OWP19E RESIC�EN�T <br />Phone <br />� of Stories...... I .:........... <br />/ of Unitn ......................... <br />O Heat pump HSPf ......................... .... <br />OOther ...............................:................. <br />O Tatal installed watts or BTU's ........... <br />•••..•.s••.�.••...•••�•.••.•e• <br />Check one of the Compliance Optlon Boxes helow. I�uert the values into 6oz num6er4. Belore completiup tl�is <br />sectian rehr to tlie instrucGo� an back o! fortn. <br />Electrie • Northwest Enaryy Coda, <br />Chaplu B <br />Q Weil Insulated Floor O S stems Anatysis, <br />Option C pter 4 <br />O Well Insulated Wail Component Pedormance, <br />Option Chapter 5 <br />O Passive Sofar Option O Compener.t Point System, <br />O Heat Pump Option Chapter 7 <br />FOfl DEPAHTMENT USE ONLY: <br />AmouM of Px/meM S ......... ........: <br />Date Permit tssued ......... ........ <br />Date Permrt Fnaled .....:.............:...:........::::.::." <br />I hereby certily that thi3 dwellinq waa buift in <br />compliance wrththe NWEC. <br />................. _..:......................,.::..:........:...»...::,...:. <br />BuiWinp Oflicial or Autl�orized Apent <br />................:.............::....................._.._........:.».......:... <br />Date <br />� <br />OGlif fYBI SW(Cit - <br />W�ehlnpton Sttt� Enerpy Code <br />O Preac�iptive Approach, <br />Chapter 6 <br />O Component Pedormance <br />Approach, Chapter 4 <br />O Systems Analysis, <br />Chapter 5 <br />COMPONENT� <br />Fiat Ceilir.p <br />Vaulted Cei!fip <br />Wall <br />Belnw Gr�de Wap: <br />interior <br />euterior <br />R............ <br />R......... .. <br />Floor {�GS, <br />Slab on Grade R............ <br />Dooro 8 Frame U,....—.. <br />Glazinq U�..`��.s <br />%Giazinq ...........y, <br />SolarAllowance ...........X <br />Air Leakape O STD OAOV <br />••••��•�c <br />I Mroby urtiN tlut Ihe,trucNnl panels w.: meet tlie NWE eb re�ui menb • eftha Ihe <br />NUD shndards ornWhed'exterior or'expwuro 1' <br />Ow orAo�orind n • �^QX� F <br />...,?���.Cx. .r...... �..y�,��✓ / --_/ <br />Pnn[ Name ..................... �. , . . ... .. ..... ... . ... ...(.!! �/ <br />�pnaWro . ......... <br />Theloc�ljurisdkdon/electricutllitywi4maReaWym enYtoeilherthebuiiderorownerlornewelectrica;ly <br />he�ted residences. Portnit must be issuedby 17/3191 and conshuc6on finaled by W3W92 in order k� <br />Qualiy for p�yment To hdliGte p�ymen4 tfie lallowinp infoim�tlon must be filled outcanpktely. <br />Mailoheckto:(pleaseprinq (pDDITIONS/REp10DELS NOT i:LIGIBLE) <br />Name................................................ Fed. Taz ID or SSi............................................ <br />.......... <br />Address........................................................................................................ ....................... <br />