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��� <br />A�x <br />>yC�/� <br />��� <br />� CHp H <br />��d <br />OH <br />��g <br />��� <br />C�i� y <br />H <br />C] C V� <br />��� <br />�3Oti <br />o.« ._._�f..-_.:z_�__�� <br />Application/Permit / .................._._......_._._..__...--.----.---......-- <br />Owner._._!/.....C! L.. �Z_....._ ....................---......_...._......._. <br />S�:enaa«55./Z,:.......5`��.� r...._..�v.y�%_...._.: ; .. <br />Assessor's Procerty Tax Account No. <br />. <br />. <br />. <br />. <br />• <br />C• Z. <br />LOWHISE NESIOEN <br />B .: . <br />�M� C.Hi�f <br />-- -- y ST- �P` S f.✓ <br />rry <br />SiteAddress ......�R..Z.�............�✓ ................................................�...../................................. .............................................................:.................. <br />Owner's Address ....V :. z.l.......5. y..�..S�T� ....�S,V C'rty..�✓�. �'r �.. Zip .L.�L`4R..... Phane ..........:...:...:............:... <br />..QI [1t.�Gt �4i�d'PP3, ��{"�DS.....�roo�s�or PL• <br />Builder..�.t�.......s.5 .......................�............... Address......................... . ................................................................................. <br />City.....�.�......�.��Nis � .............................7.ip...��..Z.S..�.� Phone......33_5^I'y�.�...................... <br />N .............. <br />.... ..................................... <br />PROJEi.T OESCRIPTION: <br />p New <br />Remodel <br />UEI„SOt1RCE: <br />�leqric <br />O Oil <br />������� <br />�Canditianed Sp. ft...� �::..... <br />HEATING SYSTEId TYPE: <br />O Basebaard <br />� � (�y�ll heater <br />. O Gas O FurnaceAFUE ................... <br />� ingle Famiry <br />O hluhi-family <br />0 0� s�orie5......! ...:........... <br />Y af Units ......................... <br />Oh�at pump HSPF .............................. <br />OOther ........................... ..................... <br />� Total instailed watts or BTU's ...�:?..�� ��� <br />. <br />• ,�,y�Gy, cx�za �ra . . ._ . <br />• <br />• � � � � � � � � � � � � � � � s � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � • <br />Check one al Ne Compl�ance Option Boses hxlow. In;en the vaWes inta box number 4 Belore completinp tha <br />section refer ta Ne ins�nx6ons nn 6ar,k ol tortn. <br />Electric • Narthwest Energy Cade, <br />Chapter 6 <br />Q Well Insulated Floor O Systems Anatysis, <br />Option �� Chnpter 4 <br />p Well Insulated Wall C'JGomponenl Pedormance, <br />Optian Chapter 5 <br />p PassNe Solar Option O Cemy:neet °aiN System, <br />O Heat Pump Option Chapter l <br />FOR OEPAHTMEHT USE ONLY: <br />AmoaM ot Payment 5 ....................... i <br />Dale Pcrmit Issued ......................................... ' <br />Date Permit Flnaled ......................................... <br />I here6y certify that ihis dwelling was huiR in <br />compliance w�h the NWEC. <br />..:............... _......................................................... <br />Buildinp Otikul orAuNonied AAent <br />Da1e <br />Olher Fuel Saurces • <br />Washington State Enerqy Cade <br />Q Prescriptive Appraach, <br />Chapter 6 <br />O Component ?erformance <br />Approach, Chapter 4 <br />Q Systems AnaFfsis, <br />Chapter S <br />COMPONENT <br />Flat Ceiling R...J�...� <br />Vaulted Ceiling R............ <br />Wall R..=..�... <br />Below Grade Wall: <br />interior R............ <br />exterior R............ <br />Floar R.2S <br />Slab on Grade R............ <br />Daars 8 Fr�me U.:33,,. <br />Giuing U:z`.4�.?a <br />%Gluing .�...'/o <br />SolarAllowance ..........% <br />AirLeakage �T� OADV <br />.•••••.•�• <br />I hereby ceniy that Ihe slmctunl panels will meellhe N1VEC iormatdehyde repuirements • either Ihe <br />HUDstan�atdsormarked'ezterinfor'exposurel' � <br />Owner br Aothori=ed Aqenl: <br />.. ................. ................................... ................................................................... <br />Print Name SipnaWre <br />The loral judsdicfionlelatric uoliry wiii mate a paymrnl lo either Ihe buiider or owner for new eleclricalN <br />hrated residences. Permit must be issued 6y i�/31�91 and construc6on finaled by fi�70N2 in order Io <br />qualily for paymenL To lacilitale payment, the Ioilamnp inlortnaGan musl bo filled oW eomD�p�eiy_ _ <br />Mailehecklo:(pleaseDrint) (ppUl'1'fONS/RGNODfLS NOT GLIGI6Lfi) <br />Name................................................ Fed. Tax ID or SSY...................................................... <br />Address .................... <br />CBy............................ <br />NOTF: M IFS Faim 1PN w�ll Oa senl aI t�e cnd cl me ycar. <br />