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FP 2320 California 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 #: <br />1'NWEC" Plan Review and Compliance for Electric Heat Residences <br />Plan Check No: ejol2S`365 <br />Assessor's Property Tax Account No: <br />Date: /r)-3/-`jb <br />Jurisdiction Basic Plan #: <br />Builder: ALL- Wff65'7 DBJr-LohMrFAYT J ryc <br />Address • 1 -� i5 /10 IV-IrL2 faP262&L P Z <br />City: 1.( )A VfSo 7 <br />Phone: <br />.tingle Family: ✓ �+ �� <br />Multi -Family: _3/ / Buildings. _ Units: <br />Site Address: 25 X A :z 5T <br />Compliance: Chapter 4-Systems Analysis_, Chapter 5-Component Performance x_ <br />Chapter 6-Prescriptive_, Chapter 7-Component Point_ <br />Note: See attached documentation for energy requirements. <br />Snohomish County PUD #1 Representative: S mat <br />t re�- <br />_TOH� /f-87.72. <br />Print Phone <br />*ITEMS BELOW ARE TO BE FILLED OUT BY THE APPLICANT* <br />-------------------------------------------- <br />Builder / Consumer Payment <br />�ifx��% �� '� lLf7cr� eL .D lj°Cnorti+cAV <br />Owner or Authorized Agent: Signature Print <br />Mail Check To: <br />N. <br />NORTHWEST <br />ENERGY CODE <br />Name: /` igjE Mc,-L071sc- <br />Address: <br />City, St.: FDM on1.7" <br />Tax Id.# or SS#: <br />Note: An IRS Form 1099 w <br />Amount $ 11 0-� - <br />sent at the end of the year. <br />