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x C "j <br />lT7 C+1 <br />,��x <br />[ H <br />aNv� <br />yzH <br />"�+J H's7 <br />CA H <br />y t" <br />�O� <br />OH�y <br />H/� L'7 O <br />y, V Ci <br />r H� <br />� <br />H <br />c� �J � <br />� r� r <br />Ch <br />yUfNia <br />�� <br />� 1 � <br />REp�q.c.�s oco �ite�tuus�r <br />. �._�� <br />o�te......._.....L._ _._.L. _:._�..__ ................................_.._ _...._ � <br />_.�., <br />0.pplicalion/Permit P ....__.._.�..------._.._ ............._.........._.......... .:: .. � � - <br />''.. LOWP ISE fl ES IUENT IAL �' <br />Owner _../SiL!`�J�}e�._�._i�Gt.F�Z........._...----�. <br />................. ' � � � . . � � <br />.3'LO�� 7[i..f.��.....:t.l........_ ..............._L�t.�Vi�i� <br />Site Address _�.._._.__........__... z.. '>: Sun: L�e� <br />�.:.: <br />Assessor's Property.Tax,Account .No. —_. .,-:., � ::`.��`' <br />.. ... . --- +' . ' <br />.... . __ .. . �. <br />... ._ � �1 �::�..:'�:: g <br />oc,,.cW ��l1 �i/ toUl%z .__W �"'��� - �:^'?i <br />�.�•m .v �e� ..__.._. •J: <br />� . �_._. �if1 — LV�/'"�-r�/ <br />, Site Address .....3_����...........?:�.....t1'_S.L :..................................................................... .................................................................. <br />� , "�., _ _ � <br />.3Lo 7 � -......5..1.' ................City.......�vCl?��.....Zip..L.'.L'::�...Phone.................. <br />................. . <br />rs�.. Owner's Address ............................................ <br />Builder..... <br />Address <br />; .............. Phone................................................................ <br />C ity ......... ........��a»� ........................................ Zi p .................... <br />............. <br />. _� <br />. <br />. <br />• ��v„:xaus��'� <br />• sxsr�� <br />• PHOJECT OESCPIPTION: �� 1 of Stories ..........:........... <br />� O New CiTAddition ,- � �inple Famity <br />� Y ot Units ......................... <br />�Q Remadel G Conditianed Sq. Ft. .�.'S n.... O MuRi-Famity <br />FUELSOUHCE: NEATINGSYSTEMTYPE: <br />�ctric 9'Baseboard O Haat pump NSPF .............................. <br />• o o�i o w�u n�,i�� O Olher ............................................... <br />� � ��5 Q Furnace AFUE .............. .... O Total iiistalled waBs or BTU's .,/..�.� u <br />• <br />� ..,Ts�,csaaa;vv.mzcw.w-:�':.r.zr_.-� � � � <br />• � <br />• � � � � � � � � � � � � � � � � � � � • ,v • � a � � � � � � � � � � � � � � � � � � e � � � � � � � • <br />.� <br />s COMPONEHT <br />� � �� • � • '' � " Flat Ceiling R.,"�c�, r l.l <br />� � � Vaulted Ceilinp R........... <br />Check one ot Ue Comptiance OO�on Baxes bzlow. Imert Ne vaiues into Gox numLcr i 6:lare coniplxling Ihis v,,ll R� r:i <br />1 <br />� section reler to the inslruchansun 6ack ol lortn. gelow Gtade Wall: <br />Electrio • Northwast Energy Code, <br />Chapter 6 <br />Q Well Insulaled Floor O Systems Anaysis, <br />Option —/ Chapler 4 <br />Q Well Insula�ed Wall t7 Gomponent Pertormance, <br />Oplion Chapter 5 <br />p Passive Soiar Option � Chapter j�� �oint System, <br />O Neat Pump Option <br />FOH �EPAflTMEi;'T USE ONLY: <br />Amount ot Payment <br />Date Permit Issued ................... <br />Date Permfl fina�ed <br />I hereby certify that lhis dwelling vras huil� in <br />compliance w�h ihe NWEC. <br />.................._.................................. I <br />Buildinp Otlkial orAuU�udied Agent <br />Olher Fuel Sourcas - <br />Washinqlon State Enerqy Code <br />Q Prescriptive Approach, <br />Chapter 6 <br />O Companent Pedormance <br />Approach,Chapter4 <br />O Systems Ana�fsis, <br />Chapter 5 <br />interior R............ <br />exlerior R.........1 <br />Floar R�•�y�• <br />Slab on C�de R............ <br />Coors & Frame U_:_�'.`: <br />Glazing U.:.7y.. <br />%Gluing ...�:j% <br />SolarAllowance .........'/o <br />AirLeakage � STD OADV <br />. <br />�.•..����. <br />I here6y cenity Ihal Ihe slructural paneLs will meel tt�e NWfC Fartnaldehyde repuiremenls -eiNer Ihe <br />HUO slandaids ar marked'extednf or'eeposure 1' <br />Owner or Aulhonzed Aqent: <br />. ........................... ............. <br />.......................... <br />.................................................................... SiqnaNre <br />PdniName <br />Thelociljwisdicuon/electricuGlirywillmaNea VaymenitoeiNerNehuilderorownerlornewelectnwM <br />healed residences. Permil must be asued hy 17/31A1 and constmcfion finaled hy N30/92 m oNer to <br />Quatiy lar paymenL To lacilitate D�Yment_Ne followinp inlortnaGon must he filled aW complelely_ _ <br />Mailcheckta:(pleaseD�int) (Al)DI'I'IONS/RI3d0UliI.S �0'1' :i1.IGI6LL) <br />Name................................................ Fed. Tyc ID or SSY...................................................... <br />Address................................................................................................................................. <br />NOTE: N� IRS Fortn 1099 w�ll Oa sent at Na enE oi tlu Kar. <br />yl <br />