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��- <br /> � r � <br /> � <br /> m� x ' <br /> �aHii� � <br /> H � � Datc .dli13�._23y_199.L—. .. ._....----. ._. . '�s:, . <br /> APPlicatioNPermA�------------��---------- . o w.�NERGY,�C(30E i��k� :.: � <br /> K y � � RISE AFS �OFN71Al I <br /> O� H O� Owncr.Tlental_kicnith_Scrnic¢s-of--SNohomish County II j <br /> 1 � � <br /> � H S�te Address_17ai:desnn...&d.--CS.th-.Avo.--W-.-1 • I 1 <br /> � 132804-2-OOG-0009 ��"" � :.:: � <br /> �;y x �j Assessor's Property Tax_.Account No. '��:�� <br /> --- -----�--.__..---.. ..::.. ::;� <br /> H t7 -__..___--'------- ':::::..:..::: <br /> O H 'PUL� PLAN RCVIEW tv0. . � . . - � ' �'�' �' <br /> I <br /> He�ng : � � . � ! <br /> �" � , � SileAddress .l�l,eltO51Boxo2870rdgson..R�......5.5..th„�,....{Y�.)...d.RB.x.RB......�.7.5..:....5.�....p.G...z.t�.kC.G.��.CC.k�Qno Rdh � <br /> > HzH r . � Builder.. . .................. C4�q.. .. .... . . 5 . . ... . .... <br /> Owner'sAddress..'.:....�......................... ................... ...........C' G.Y.G.X�.S.�...............Zip..4.f�.20.�.....Phone2.5.�-.A�...�.......... , <br /> yy <br /> ` H H � lJalsli Constru...i..�...�n�.:............Address..6...9...N:....�.4.Gh...S.1:............................... ........................................... � � <br /> O y H e <br /> ,Scattle...........................................................................Zip..9.8.].Q3......................Phone5.4.7..-.4.0A8...F.AX...5.4.7...-.].d0.4......... � <br /> C] l7 V1 � City.. ............ <br /> �+ i <br /> 3��' (�i � • ,r�-.=.-..,.-..,�� j <br /> t� • <br /> zHfa . � <br /> H O[n � .. .s�raxx�r.a.,car_�ass��•e�--�a_.>. � <br /> . ;mxxxx;�su�ax;:c::m:«:-�xecs'attsev'sfcsc,.vxe-..�r.xc . � I <br /> � i <br /> • PROJECT�ESCRIPTION: <br /> • ��eW � Addition , O Sinple Family /ot Stories....�.:............ `' - � <br /> . I. Q Remodel G Condflioned Sq.Ft..................... �"Multi-Famiy �ol Unils.....24............. I <br /> fUEL SOURCE: NFATING SYSTEM 1YPE: � <br /> � .�Pf Electric �Pl Baseba�rd O He�t pump HSPF .............................. � <br /> ' O Oil O Wall heater O Qther................................................. � <br /> . Q Gas O Furnace AFUE................... O Total installed tvatls or BTU's............ y i <br /> . � <br /> „ . _-�r_-�-.�^...._._.� . I <br /> • � . . ._..,.. ....�. _ ..,.. � f . - . •-�-�-•- <br /> • I• � � � � � � � � � � � � � � � � � � � • v • � � � � � � � � � � � � � � � � � � � � � � � � � � . � • <br /> ��:asc-��::z- <br /> ;��- � � COtdPONENT , <br /> I ' . :• r�i ni,�• • . � • u r <br /> � FWI Ceiling R....._g.. <br /> �► � � Vauhed Ceilin R............ <br /> Lhetk one ot tl�e Compliance Opticn Boxes below.Insert Ne values iNo baz number 4.Belore completinp this t� � 9 <br /> 1 • � � sedion reler lo the insWchons an back ol form. 3 Wall R...G.�`�... � <br /> � Below Grade PlaIC � <br /> '�'� Eleciric-Harthwesl Energy Lode, Other Fuol Sources• interior R....._... I <br /> �,�� � Cha0ler 6 Washin9lon State Enerqy Code e�erior R............ <br /> ��Well Insulated Floor O Syslems An„��sis, O PrescriptNe ApDroach, I <br /> Oplion Chapler 4 Chapter 6 Floor R............ � <br /> SLb on Gratle R..�.S2... I <br /> �14e11 Insulated VJall O Component Per�ormance, O Component Pertormance Doors 8 Fame U............ <br /> Oplion . Chapter 5 Approach,Chapter 4 <br /> i �e � G4uinq U............ <br /> �J Pass�+e Solar Option O Campe�e.^.t?oint Syslem, O Systems Analysis, �Glazing ...�w��9a <br /> � O Heat Pump Oplion Chap�er 7 Chapier 5 SolarAllowance � <br /> .� <br /> ...........,o <br /> ' 'f LLJ Air Leakage O STO �ADV <br /> raanr....�—a_.-�vx.:..w� <br /> ,s�:ca.cc�r • <br /> �• � � . � � � � � • l <br /> �� \�/ <br /> !�� � FOR�EPAflTMENT 11SE ONLY: " �'' �' ' ° ' � ' '� '� � � ' ' `' � <br /> i <br /> '� Amoum ol Payment 5...................................... I hereby certify tlut the struc�urzl paneLs vnll meei the tJWEL fortnaldehyde reQuirements�eilher Ne � <br /> HUD s�andards or nmked'eztennf or'ecposme 1' _/ � <br /> f`'; � Owner or Aulhoriied Aqenl: �i^^ /" <br /> DatePermillssued......................................... Jesc C. Jamicson „ � . .. �✓�" `�••�••.. <br /> .................................................................... <br /> , ......... <br /> � � PnnlNune naLie <br /> -� Da�e Permit finaled......................................... TAe loa�jurisdK6m/electrK ufiiiry wiu m��e a paymenl Io either the ilder ar ovmer lor newelxtricaly <br /> � hvled iesidences.Permit must be ssued by 17/31A1 and cansimc�an finiled Cy 6A�B2�n o�der 10 <br /> qwliy lor piymenL To laciliule p�ymml,�he lollavnnp inlartmUon must De fiikd out comDklely_ _ <br /> Ihere6ycertilythatthisdwellinpvras6viAin 'M3ilehecklo:(Dle�seprini) (qDD]l']ONS/RLtd017[LS NOT ELIGIBLE) ` <br /> compluncc wrth the NVlEC. 91-1442572 <br /> Mental }Ioa1Ch Scr. ��{ .,......, <br /> tJamc................................................ d.Tax ID or SS/............................................. <br /> .................._............................................_........... I'.0. ISox 2870 <br /> Buildinp Otleial or FuNonted Apeni Address............_................................................................................................................. <br /> Evc,-eCt, [JA 98203 <br /> ......._........................................._.___......__........ City................................................................__.................... Zip.......................................... <br /> Das <br />