|
SNOT1oMlst,COUNTY.' Commercial&Industrial Energy Efficiency Services 1 1
<br /> PLOD INCENTIVE&TECHNICAL ASSISTANCE PROGRAM
<br /> PUBLIC UTILITY DISTRICT NO,1 WORK AUTHORIZATION
<br /> Note: Due to limited conservation funds,this form must be signed and returned before August 15,2011
<br /> to be valid. The work identified within this document must be completed and pass P.U.D.inspection on or before '
<br /> November 15,2011 in order to be paid by the Agreement Expiration Date: December 15,2011
<br /> Business/Building Owner-Official Name(for payment) • Tax ID Number Authorization Date
<br /> Facility Name
<br /> vetijlOSAl i�u eFifittea
<br /> i bCY a ks cttlro , ' .t*
<br /> > . 07/13/11
<br /> ma ..a . ra °.SdRt ' amautsaa w ,nGtJ F a �..,. a d ri Facility Address Owner's Mailing Address(for payment)
<br /> t
<br /> PUD
<br /> Staff
<br /> ` n :•V3A! ' `tfe `ah ° s, ;; t c �.0
<br /> V'. 0 4, st " 4 ,"4,91 4 . � a TA' 802blv/; ) , 2t'- ' f* KenSatre
<br /> atr
<br /> e
<br /> ",° . • o & a . r .t fob a --n
<br /> City State Zip City State Zip Project Number
<br /> ct + .z. a � �.+ a s, +� `Vw+] *f�' t' 820x32�Oai< P-3513 C
<br /> �k,:t;y�• -":',,,,4,,-x,
<br /> . .ry� L'O, '3.,, : x0„8:418 °c !L +wy' ? �a Veft9 4 #44Sa. f ,Y.1414'0.*.Ne9012..rte.,ra.2 -
<br /> da<y �i i� g,-...:',,,e, c w., .. ..�.� .1�-' �... _ ..�-, .� e wa„ ,..I. '�,n� L�i�°.t� ��;CS_
<br /> ,,. r x . 1e ` s Cos ° I , n EstFl(nnOal
<br /> r,Val T �. „ r ` Measure Cost;` E jn, iU 5.5 An uaj n
<br /> iCve ed v e ti Iec da
<br /> ` T '� ' e U mouh f=de cal Savin s �n
<br /> Descrfp iQn of N�easure ,....Cos-_,. . ,Vi... ed�nJ . _,a,_'( .. , `=z., g
<br /> T''' 'Whc- ;4 ° - ke l`t- TM
<br /> VT }, ' 1 `' f
<br /> j-
<br /> -,
<br /> ' � 5
<br /> d. x+" fih`h;, a-31 *0, t " . .`
<br /> . } . zinB yi I'
<br /> T • �. .W � �p0 t20w di '4:
<br /> Y 1 -. F1 L 6h 3vE SrroWk
<br /> „ $5,482.00 T $1,370.50 $606.19 3,031 kWh $214
<br /> ° . ",., l. ,,Y 7 ` � � a. .Kr .iA 0,,t rof ,
<br /> , $+ ; 4: itt-tqy4 s" r t.ri. ,, �7 a , d,4*.,,,Ot + v ,,, 4. t'
<br /> £
<br /> k -,
<br /> 5 a� a ° T Li; ti 6. a q
<br /> ",
<br /> , •Gii &..-- "r mgo4, 1,h4�La Fkm
<br /> ° t am3 proaosed Ne Lg tg
<br /> Load, ct 01
<br /> • cipatp.. ig ting ° °u tlo„p ,� O69 e
<br /> Totals11''':4',$5'482e00 :iT�t b "fi �3 03 h orf c 1 :,
<br /> 71,
<br /> . ,,.4.42.1.1:,,l exp .-i• :r . .d r tK a' qq
<br /> k- t !92' �i���AF�ON NP,
<br /> Incentive asYa%of Project Cost►44,!.Y.. '.,�,, �,l iivai *w,
<br /> Savings as a%of Facility Total Annual Electrical Use
<br /> •
<br /> Measure&Verification(M&V)
<br /> n - ar '.z ,�"t m.. ',,"'n.s �as..'"�„ '`�`v y"'I�%R' '11;;A3'_S y a, " .'v. n,7 A { t";}: +`;;
<br /> ��;rsr'-f�:!� �.t,.,r y ��� ti �,� I sr„? V 1, �z , ��ws��t , � x � ��' r`;� ,��
<br /> ',4214-3.#9.7:.,g- i i�N"`����a,'.‘41,-,. �t , '�,tc l i-;kr,. 'uv->t j 5:,1 v s �tri _ ,, y,T{p,r�i j ` :,
<br /> f 1 rz�m 1
<br /> �Ve dy.rl r8 l - g.., / y tr .L x 'x , �; 'y, t w 0; 3 ti a. �..�,,,,4A,4 -4 ._ .... „e F.Z.•al,.: -.,'.
<br /> f � � x � !, a�r.,.�a}�-:�„L>.'a1��.3.,.�hy:s F�.µ.Vi� .
<br /> w
<br /> I,the undersigned,understand the energy cost savings shown are estimates. These estimates are based on standard engineering calculations. I further
<br /> understand that I will not be eligible to receive payment until measures funded by the program have been installed an passed inspection by Public Utility
<br /> District No.1 of Snohomish County(the"PUD"). The actual Incentive shall not exceed 70%of the authorized project costfor existing facilities. For new
<br /> construction project,the incentive shall not exceed 50%of authorized material cost or full incremental cost. I understand that any changes in project
<br /> scope requires prior authorization before proceeding.
<br /> I agree to indemnify and hold harmless the PUD and each and all of its agents or employees from and against any and all losses,liabilities,damages,
<br /> costs,expenses(including reasonable attorneys'fees and expense),claims,judgments arising out of or in connection with participant In this program. I
<br /> understand it Is the sole responsibility of the building owner or agent to obtain building and/or electrical permits,inspections and approvals
<br /> whenever they are required by law and to dispose of existing hazardous waste appropriately(see Lighting Waste Disposal Form).
<br /> I hereby certify that the information contained on this form is,to the best of my knowledge,true and correct. I understand and will comply with the time
<br /> constrained listed.
<br /> Eg
<br /> uuiir9
<br /> Authorized Signature Date
<br /> —(?Mit
<br /> Print Name
<br /> Title PUD Approval
<br /> _ - Version lb-020111
<br /> 63
<br />
|