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["現金取得者向け新築対象住宅証明書審査申請書"]
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[{"$nulls":22},"年",null,"月",null,"日"]
["富士建築センター株式会社 　殿"]
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[{"$nulls":9},"証明申請者の住所又は"]
[{"$nulls":9},"主たる事務所の所在地"]
[{"$nulls":9},"証明申請者の氏名又は名称",{"$nulls":17},"印"]
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[{"$nulls":9},"代理者の住所又は"]
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[null,"現金取得者向け新築対象住宅証明書発行のための適合審査を申請します。"]
[null,"この申請書及び提出図書に記載の事項は、事実に相違ありません。"]
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["【建築物の名称】"]
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["【適用する住宅性能】"]
[null,"住宅の新築\n又は\n新築住宅の取得",{"$nulls":4},"□","断熱等性能等級の等級４"]
[{"$nulls":6},"□","一次エネルギー消費量等級４以上"]
[{"$nulls":6},"□","劣化対策等級３で、かつ、維持管理対策等級２以上"]
[{"$nulls":7},"（共同住宅等については一定の更新対策が必要）"]
[{"$nulls":6},"□","耐震等級（構造躯体の倒壊等防止）の等級２以上"]
[{"$nulls":7},"（耐震等級３に係る適合審査を受けようとする場合",{"$nulls":13},"□","耐震等級３）"]
[{"$nulls":6},"□","免震建築物"]
[{"$nulls":6},"□","高齢者等配慮対策等級３以上の住宅"]
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[null,"※受付欄",{"$nulls":9},"※料金欄"]
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[null,"第","     ",{"$nulls":7},"号"]
[null,"申請受理者印"]

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[null,"担当",{"$nulls":3},"を代理人と定め下記に関する権限を委任致します。"]
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