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p '- � �� T �a �-�'�¢� C.> <br /> Date ._����__L�- .1.+ .�. . <br /> ----•-------• - � �NEROYCODEt�I�;, . <br /> Application/PcrmA/..-------_.----..,-------�-- ",';, „'. <br /> �M /-� ,�'J . "., lOWM13[ pES10FMilAI ! <br /> Owner J-L�.�4�&V.I�:.�......�`G-711.L�.�___.._.._ •• � , � , . . � � . <br /> Site Addross.__�------------------ : <br /> �Assessor's Property Tax Account_No^ , � ..:;:�''�� 4• <br /> ..;:i•.,Ic., ;.,::,' . <br /> �PUD PLAN RE:;I�EW��N�. I�'_���5 � <br /> , Site Address ....................................................................................................................................................................................................... I, <br /> � Owner'�Addres�.............................................................................Ciry.................................,..Zip....................Phone....................,.............. <br /> Buildet.........................................................................Address........................................................................................................... <br /> ............... <br /> . Zip.................................... <br /> Phona................................................................ � <br /> . <br /> C i y................................................................................................. <br /> • � <br /> . <br /> . <br /> • PROJECT DESLRIPTIOH: �Sinple Famiy /ol Stoties.....�..}.._....... , <br /> ; • New O AdCilion !al Unils......................... <br /> Q Remodel G Condi�ianed 5a.FI..(..G?..�`�....�... O Muhi•Family i <br /> � FUEL SOUflCE: HFATIHG SYSTEM TYPE: �heyt pump HSPF ............._..». <br /> • Elzctric O Base6wrd """"' <br /> • O Oil • Wall hvter O Other................................................. <br /> . O Gr.s ' O Furnace AFUE................... O Tatal installed wans or BTU's............ <br /> . <br /> . • I <br /> . �. . . . . . . . . . � . . . . . . . . . . v . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i <br /> C�MPONENT , <br /> : :• r' � �� • ' ' • ' . FIxlCeilinq R.3�.. ' <br /> Vaulted Ceilinq R.�� <br /> i <br /> LAeck one al the Compliinu Option Bo.er.below.Inserl Nc wlues inlo bo:numbet/.Belote r.ompielinp Nis yyall R.r.S.�. <br /> seuion«Ier lo Ilm inslnxfions oi buk ol lorm. Beiow Grade Wali: <br /> EUclrfc•Nodhwesl Enerqy Code, Other Fuel Sourca� • interior 9..I.�.... <br /> Ch�pler 6 W�chlnpton SI�I� Enarqy Coda ���rior R............ <br /> p Well Inculated Flaor O Sy�lemc Anaysis, O PrescripUve Approach, Floor q 3.0„ <br /> Oplion Chapter 4 Chapler 6 <br /> S�bonGnde R..I..�.. <br /> O Well Intulated Wail • Componenl Per�ormance, O ADp D;�h�Lhap er 4��� Doon 6 Fnme U.:'2z•• , <br /> Oplion GAapter S Glatinp U.3�;Y8 <br /> O Pas�He Solar Opt(on rJ C^mpener.t Poinl Syaiem, O Syatema Analysis, y.Glazinp .�����'ti <br /> Ch�pler 7 Chapter 5 SolarAllowance <br /> O Hwt Pump Oplion """"'"�� ` ' <br /> Air Lwlwqe •STO OADV <br /> � <br /> o . . . . . . . . . . <br /> ; - , <br /> ,, . , . , . . , , , <br /> FOR �EPAR'i MENT USE ONLY • <br /> ��- AmouM ol Payment S�......... •••�..� 1 hereby uniry tlul Ne slrucNril 0�^a��^�I meel Ihe lM14EC Foim+WehYd�repuinmenh•eiNer Ih� <br /> � � HUD sund�ids or m�hed'exRdnf or'expasure t: � <br /> Owner ar Aulhorind Aqnnl: <br /> Dale Permil IsLued.................:.....:..:.............. .................. . ................................................................... <br /> .. ............................................. " SOn�Wre <br /> Pdnl Nune <br /> ' .._ �...._:.... p <br /> ........ <br /> Oate PermA Finated.............. . ... ��es ee�es Pe�imilfmusllbe issu d Dy 17/71m/91�nd c�onsl�uco n�Rmkd 6y eNJ0A2 n ober lo <br /> . awlitM lor p�ymenl.To I�citi�te D+Ym�^�_�0�ollovAnp inloim�fion musl be f�IleO oul canDbldy_ _ <br /> - - - - - - - - - <br /> - - - - - - - - _ <br /> I hereby cenily Ihat ihis dweltinp vras built in 'M�il cAeck lo:�nteue D�nq (�l)D 17'I ONS/RG�IODLLS �OT L•L IG I OL[ <br /> coTplunce wnh ihe NWEC. <br /> Name................................................fed.Taz ID or SSI...................................................... <br /> .................._............................... <br /> .........._........... <br /> Buildinp Oflcul or PuNonled A enl ......................................................................... <br /> C AddtesE........................................................ <br /> : Cily........................................................................................ 2ip.......................................... ,; <br /> ....._....._.. <br /> ......................_.........__......�....... <br /> D�le <br /> MO7F'M�AS�e��M7�.'�N on111 I�r r^!d M�en <br />