Free Legal and Business Form L65 RBP

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Residential Building Application Washington State Energy Code Date: Planning and Building Department (360) 577-3330 Job Type: Classification: o New Hom e o A ti ddi on Construction Site Information o Rem odel o M u lia m iy tf l o Si g l Fa m iy (i cl des Du pl es ) n e l n u ex Site Address: Legal Description: Lot___________________ Block__________ Plat_____________________________ Description of Improvement: Owner Information Owner: Address: City: Contractor: Estimated Valuation of Improvement: $_______________________________________ If New or Addition to Single Family Total Heated/Conditioned Floor Area (interior dimensions): Second Duplex Unit: sq. ft. If New or Addition to Multifamily Total Number of Buildings: Total Heated/Conditioned Floor Area (interior dimensions): Total Number of Units: sq. ft. sq. ft. State: Zip: Phone: Day Phone: Window Schedule Total of Glazed Rough Openings: sq. ft. Percentage of Heated/Conditioned Floor Area: % U – Value of Windows from Table 6-1 or 2: U._________________ Heat Source & Primary Space Heat Type o Electric Zoned Resistance o Electric Forced Air Furnace o Electric Heat Pump o Other (specify) o Prescriptive Path o Sys tem A a l i n ys s o Com pon tPerform en an ce Chapter 6 OR Output: Size: Size: Input: KW KW KW BTU HSPF: AFUE: % WSEA Compliance Option (Method Proposed) o Table 6-1, Option: _________________________________ o Table 6-2, Option: _________________________________ Chapter 5 (Heat Loss Worksheet Attached) Chapter 4 (Computer Model Attached) Ventilation Compliance Option (Method Proposed) Location o W hol Hou s e Fa n e o I t ra ted Forced Ar Fu rna ce Venia ti neg i tl on Rev. 7/99 Size in CFM

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