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[]
["設計住宅性能評価 審査依頼チェックシート"]
[]
["【設計内容の問合せ先】"]
[null,"会社名"]
[null,"担当者氏名"]
[null,"電話番号",{"$nulls":13},"FAX"]
[null,"e-mail"]
[]
["【当機関への申請】"]
[null,"確認申請",{"$nulls":7},"□","予定",null,null,"□","有り",null,"（確愛R",null,null,"第",null,null,"号）",null,"□","無し"]
[null,"長期使用構造等であることの確認",{"$nulls":7},"□","要",{"$nulls":13},"□","否"]
[]
["【添付図書】"]
[null,"正","副","添付図書"]
[null,"□",null," 委任状"]
[null,"□",null," 設計住宅性能評価 審査依頼チェックシート（本紙）"]
[null,"□","□"," 設計住宅性能評価申請書",{"$nulls":10},"□"," 第二面 別紙の添付"]
[null,"□","□"," 自己評価書及び設計内容説明書"]
[null,"□","□"," 付近見取図"]
[null,"□","□"," 配置図"]
[null,"□","□"," 仕様書（仕上表を含む）"]
[null,"□","□"," 各階平面図"]
[null,"□","□"," 床面積求積図"]
[null,"□","□"," 二面以上の立面図"]
[null,"□","□"," 断面図又は矩計図"]
[null,"□","□"," 基礎伏図"]
[null,"□","□"," 各階床伏図"]
[null,"□","□"," 小屋伏図"]
[null,"□","□"," 各部詳細図"]
[null,"□","□"," 各種計算書"]
[null,"□","□"," 機器図 （一次エネのみ）"]
[null,"□","□"," 系統図 （一次エネのみ）"]
[]
["【申請時での基礎着工予定日】"]
[null,"基礎着工予定日　：　",{"$nulls":5},"令和",{"$nulls":3},"年",null,null,"月",null,null,"日頃"]
[]
["【連絡事項等】"]
[null,"領収書宛名",{"$nulls":4},"□","申請者",null,null,"□","代理者",null,null,"□","その他　　（",{"$nulls":10},"）"]
[null,"※連絡事項等"]
[]
[]
[]
[]
[]
[]
[null,"※欄は記入しないでください。"]