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�� � ._n. <br /> • • • <br /> ' • � � <br /> ;, 2320 Califomia St., Everett, Washington ,98201 258-8211 <br /> � � � Mailing Address: P. O. Box 1107, Everett, Washington 98206 <br /> Snohomish PUD Reference ONLY <br /> Energy Plan Review tt : bs��J_� <br /> ��NWEC�� Plan Review and Compliance for Electric Heat Residences <br /> Date: � - 2 3 --% G <br /> Plan Check No: <br /> Assessor's Property Tax Account No: _ <br /> i <br /> Jurisdiction Basic Plan � : <br /> Builder• O� � 1��5� - <br /> Address: yQ O)C �� L 53 <br /> city: �LJm<< <br /> Phone: �6�- 53ya 1 <br /> Single Family:� <br /> ;lulti-Family: _ Buildinqs:_ Units:_ <br /> Site Address: �` >��� �S� J�' <br /> t Compliance: Chapter 4-Systems Analysis_, Chapter 5-Component Perfornance� <br /> - Chapter 6-Prescriptive_, Chapter 7-Component Point_ <br />;;, Note: See attached documentation for energy rec;uirements. <br />�' Snohomish County PUD ?pl Representative: � r1C�� // ��C <br />' Signature <br /> j: JolfiJ f-� L/akE 25�-8z-7�L <br />�, Print Phone <br />� <br />' __*ITEMS_BEL047-ARE TO BE FILLED OUT BY THE APPLICANT* <br /> ---------- ------------------------------------------------ <br /> f� Builder / Consumer Payment <br /> j; . <br /> Owner or Authorized Agent: _ <br /> Signature Print <br /> " h1ai1 Check To: Amount $_ <br /> Name• <br /> Address: <br /> City, St. : <br /> Tax Id. ; or SS� : <br /> Note: An IRS rorm .1099 will be sent at the end of the year. <br /> `N�E�''�T ,�C�_`�'_'_.�od�_,�t1tS, <br />� 'NERGY CODE � : .:,:-�.��.���.,���= <br />