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[{"$nulls":28},"別記様式１号"]
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["低炭素建築物新築等計画に係る技術的審査依頼書"]
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[{"$nulls":22},"年",null,null,"月",null,null,"日"]
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["一般財団法人 福岡県建築住宅センター　殿"]
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[{"$nulls":10},"依頼者の住所又は"]
[{"$nulls":10},"主たる事務所の所在地"]
[{"$nulls":10},"依頼者の氏名又は名称"]
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[{"$nulls":10},"代理者の住所又は"]
[{"$nulls":10},"主たる事務所の所在地"]
[{"$nulls":10},"代理者の氏名又は名称"]
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[null,"　低炭素建築物新築等計画に係る技術的審査業務規程に基づき、都市の低炭素化の促進に関する法律"]
[null,"第５４条第１項の認定基準のうち、以下に掲げる基準への適合性について技術的審査を依頼します。"]
[null,"この依頼書及び添付図書に記載の事項は、事実に相違ありません。"]
[]
["記"]
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[null,"【技術的審査を依頼する認定基準】"]
[{"$nulls":6},"■","法第５４条第１項第１号関係"]
[{"$nulls":7},"■","外壁、窓等を通しての熱の損失の防止に関する基準"]
[{"$nulls":7},"■","一次エネルギー消費量に関する基準"]
[{"$nulls":7},"■","その他の基準"]
[{"$nulls":6},"■","法第５４条第１項第２号関係（基本方針）"]
[{"$nulls":6},"■","法第５４条第１項第３号関係（資金計画）"]
[null,"【建築物の位置】"]
[null,"【建築物の名称】"]
[null,"【市街化区域等】",{"$nulls":4},"□","市街化区域"]
[{"$nulls":6},"□","区域区分が定められていない都市計画区域のうち用途地域が定められている"]
[{"$nulls":7},"土地の区域"]
[null,"【建築物の用途】",{"$nulls":4},"■","一戸建ての住宅",{"$nulls":4},"□","非住宅建築物",null,null,null,"□","共同住宅等",null,null,"□","複合建築物"]
[null,"【建築物の工事種別】　",{"$nulls":5},"■","新築",null,"□","増築",null,"□","改築",null,"□","修繕又は模様替"]
[{"$nulls":7},"□","空気調和設備等の設置",{"$nulls":7},"□","空気調和設備等の改修"]
[null,"【申請の対象とする範囲】",{"$nulls":7},"■","建築物全体"]
[{"$nulls":9},"□","複合建築物の非住宅部分",{"$nulls":6},"□","複合建築物の住宅部分"]
[null,"【認定申請先の所管行政庁名】"]
[null,"【認定申請予定日】",{"$nulls":12},"年",null,null,"月",null,null,"日"]
[]
[null,"※受付欄",{"$nulls":9},"※料金欄"]
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[null,"年　　　　月　　　　日"]
[]
[null,"第",{"$nulls":8},"号"]
[]
[null,"依頼者受理者名"]
[]
[]
[null,"＜登録住宅性能評価機関からのお願い＞"]
[null,"　省エネ技術導入状況等について、個人や個別の住宅が特定されない統計情報として、国土交通省等"]
[null,"に提供することがございますのであらかじめご了承のほどお願い申し上げます。"]
[null,"（注意）"]
[null,"１．依頼者が法人である場合には、代表者の氏名を併せて記載してください。"]
[null,"２．代理者が存しない場合については、代理者の部分は空欄としてください。"]
[null,"３．申請の別において一部の住戸の認定とする場合は、別紙に住戸番号を記載してください。"]
[]
["低炭素建築物新築等計画に係る技術的審査依頼書（複数依頼者）"]
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[null,null,null,"複数依頼者の概要"]
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[null,null,null,"依頼者８",null,null,null,"依頼者の住所又は"]
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[null,null,null,"依頼者10",null,null,null,"依頼者の住所又は"]
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