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[]
["軽微変更該当証明申請書"]
["（新築／増築・改築）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□無"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,"月",null,"日",null,null,"■有"]
[]
[" 日本ＥＲＩ株式会社　殿"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"依頼者の住所又は"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"主たる事務所の所在地"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"依頼者の氏名又は名称"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"代理者の住所又は"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"主たる事務所の所在地"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"代理者の氏名又は名称"]
[]
[null," 下記の住宅について長期優良住宅の普及の促進に関する法律第８条第１項及び長期優良住宅"]
[null,"の普及の促進に関する法律施行規則第７条第４号に規定する軽微な変更に該当していること"]
[null,"を証する書面の交付を申請します。この申請書及び添付図書に記載の事項は、事実に相違あ"]
[null,"りません。"]
[]
[null,"記"]
[]
[null,"【計画を変更する住宅の直前の（確認書・住宅性能評価書）】"]
[null,null,"１. 確認書又は住宅性能評価書交付番号"]
[]
[null,null,"２. 確認書又は住宅性能評価書交付年月日"]
[]
[null,null,"３. 確認書又は住宅性能評価書交付者"]
[]
[null,null,"４. 確認又は住宅性能評価に係る住宅の位置"]
[]
[null,null,"５. 当初確認時又は住宅性能評価時の工事種別"]
[]
[null,null,"６. 変更の概要 （帳簿変更の有無：",null,null,null,null,null,null,null,null,null,null,"・",null,"）"]
[]
[]
[null,"※受付欄",null,null,null,null,null,null,null,null,null,null,null,"※料金欄"]
[]
[null,null,null,null,"年",null,null,"月",null,null,null,null,"日"]
[]
[null,"第",null,null,null,null,null,null,null,null,null,null,"号"]
[]
[null,"依頼受理者"]
[]
[]
[null,"（注意）"]
[null,"１.この様式において、「一戸建ての住宅」は、人の居住の用以外の用途に供する部分を有しないものに\n　"]
[null," 　限り、「共同住宅等」とは、共同住宅、長屋その他の一戸建ての住宅以外の住宅を いいます。"]
[null,"２.【計画を変更する住宅の直前の（確認書・住宅性能評価書）】については、「確認書」又は 「住宅"]
[null,"　 性能評価書」の該当するいずれかを〇で囲んでください。"]
[null,"３.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,"４.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,"５.当機関の交付した確認書又は住宅性能評価書を用いずに認定申請を行った住宅の場合は当機関へ予め"]
[null," 　ご相談ください。"]
[null,"６.竣工前にする変更の内容が帳簿情報※である場合、６.変更の概要における帳簿の変更「有無」へ"]
[null," 　チェックを入れてください。「有」へチェックを入れた場合、住宅の品質確保の促進等に関する"]
[null," 　法律施行規則第4条及び第7条の4の規定により交付された住宅性能評価書又は確認書（以下"]
[null,"　「評価書等」）は、以降の再交付では当該変更後の内容で交付されます。"]
[null," 　（※：評価書等へ記載されている事項のうち、性能表示事項以外の事項のことをいいます。"]
[null,"　　例）申請者の氏名又は名称及び住所、住宅の所在地及び名称、住宅の延べ面積　など）"]
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["日本ERI株式会社 作成"]

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["委 　 任  　状"]
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[null,"　私は下記の者を代理者と定め、登録住宅性能評価機関に対する申請に関する手続き及び"]
[null,"交付される文書の受領の権限を委任します。"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,"記"]
[]
[]
[null,"委任する業務",null,null,null,null,null,"軽微変更該当証明"]
[]
[]
[null,"建築物名称"]
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[null,"住宅の位置"]
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[null,"委　任　先",null,null,null,null,null,"（会 社 名）"]
[null,null,null,null,null,null,null,"（ 氏  名 ）"]
[null,"（代　理　者）",null,null,null,null,null,"住  所"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,"住　所"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,"住　所"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,"氏　名"]