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MJD <br />V <br />H <br />q✓Hva <br />y0 <br />K N <br />HW <br />IV y1V <br />o i <br />aw 0 <br />H <br />z� <br />O Ca <br />O C Va <br />H O rrA <br />r are <br />s <br />Iaft I's- <br />Date :_ <br />AppllcaalloonlPPeerrmll: -� <br />Owner .... —���L ri S v 1.,—• <br />SlteAddress.-�Qt�t! �1Q�a��.�N'a <br />Assessor's P:onerty Tax Account No. <br />' She Address <br />`:\l a W R leE RFe IeFN f la <br />owner's A dress ....................................... . city .................................... Zip .................... Phone ................................... <br />Builder..�M.....'.F..:?Y.�.eJv........ ........... Address ................. ............................................... ........................................... ........ ._.. <br />City.......................... ...................... _.................... .......................... Zip ................................... Phone ................. ................ ..... ........................ <br />PR ECT DESCRIPTION: <br />New O Addition 1���/}� <br />O Remodel ondhloned Sq. R.!..V.....-...... <br />ale <br />HEATING SYSTEM TYPE: <br />leeirie O B eboard <br />O 0il "fall healer <br />e O Gu (,) rurnace ARIF.............. <br />�ngle Family / of StoriesL...._:...,. . <br />O Muhl -Family 0 of Unite ............. .. <br />O Heal pump HSPF .............................. <br />OOther ................................................. <br />O Total Installed vane or BTU's ............ <br />ee•aee.eaeeeaae•••••e��, •. •ee•eeeaa••e•a•eeaeeeeeaeeae <br />Check ont or the Compliance Opton Boxes below. Imen Iht valuer Into box numbet 4. bunt complelIng this <br />section refer to the losinxtlom on back of form. <br />Ebclric - Northstul Energy Code, <br />Chapter 6 <br />O Well Insulated floor <br />O Syateme Anatysls, <br />Option <br />Chapter, 4 <br />O Well Insulated Wall <br />O Component Performance, <br />Option <br />Chapter 5 <br />O Passive Solar Option <br />O Component Point System, <br />O Heat Pump Option <br />Chapter 7 <br />FOR DEPARTMENT USE ONLY: <br />Amount of Payment $ .......... _......................... <br />Date Permit Issued ..............._..................... . <br />DatePermit Finaled.....,.................................. <br />I hereby certify Thal this dwelling was built In <br />compliance with ilia NWEC. <br />.................._.....,_................................................ <br />Building 011klal a Authodrtd Agent <br />..i.... ............... ........ <br />...._........... _ ._......_......... Dale <br />other Fuel sourest - <br />Washinglon Blare Energy Code <br />O Prescriptive Approach, <br />Chapter 6 <br />O Component Performance <br />Ap ch, Chapter 4 <br />yslems Analysis, <br />Chapter 6 <br />COMPONENT E7 <br />FlalCeiling R.... <br />Vaulted Ceding R...g.,. <br />Wall <br />Below Gode Wall: <br />Interior PI............ <br />exterior R..ryyy�/ <br />Floor RX... <br />Slab on Grade? <br />Ooora ri Fame U... <br />Glaring U! a 8 <br />%Glazing V. <br />Solar Allowance % <br />.......... <br />Alt Leakage ID OADV <br />a e s e a a e a a <br />I herebyarlih gut the sirucNral rarols will mtel the NWEC Formaldehyde requirements • either the <br />IIUD simdardds or nuaed'exlednr' o('exposale I , <br />owner or Authorized Agent: �,r-- <br />J.A.mF:es...,�,...YlA.z.T..��cr..l.......' .........9`...M..R.[,tarmR............ <br />Print Nuns pnsWn <br />The Coal wrledktlankleehk utility will mats a Vyaymenl to either the builder of owner lot new tledmk4lty <br />healed residences Permit must be Issued by IRAI and construction 6naled M NJ092 In order to <br />quality lot payment. To facilitate paymen4 die following Information mutt be idle oul completely. <br />- -- -------- - - - - -- <br />Mali thetklo:(pleasepdnt) (ADDITIONS/REHOUELS NOT DLIGIBI.C) <br />Name.)io".O... .M. Al.T.lIVAI. Fed. Tax 10 or BSI..".1:'_1.q..`.... !&.1r..3.... <br />Address 8/.0.......ReeASTA...... .ltl.R,,....................................................................... <br />zip........82.7.6............... <br />NOtE: M IRs ran loge MI to atni at via tne d eye year. <br />J <br />