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�� � <br />]�_� �� : i i'• I � <br />«. � <br />.� ., <br />�ase cnea� one) 1 <br />New BuIIdInB /� Addltlon over 500 aq. fl. <br />Jurisdiction: i�i A� �){" /�./�er �" <br />yeasernecx«a: CIry ❑Counry <br />�._f�"'�� <br />WS�ContractM <br />(j�eese cnecx aa) <br />w Single Famlly ❑ Duple: <br />❑ Mullitamily ❑ Zero Lot Line Home <br />� Planned Unit Development _ _ <br />Permit M ' ,' `I(.: � <br />File ID # �nanerent riwn rermn Il <br />" "`� �TFT^'�i^�'�T'!!"_1. `r'. YE'R �!�\.'�F�i1lM� � <br />A. Site Inlormallon B. Owner Informetlon <br />Addres5�p j[__i _/'�'_! . - `��! �._ _ Owner fax+�e+erOmec+mvmxiunrecaYesuNlvm�+�`erxl <br />—fi _- <br />CiN �t; � N' �.9 ZiP �t -�d � COmDanY/ G i 6F "i ��J r", �ir �-�.J.�_ <br />AssessorsPropenyTaxp a� rcam�epeipe�___ Address a/i,.yL'-,�i,��'_t-,..,�_1"� <br />-� i �� �. /- or �..y_ City C�y nr�¢ ___3latee:� 4. ) c� � <br />1c_�. _� �11 �.. <br />----- <br />ServicingEleclricUlility__,y, i�_��✓.�^,�__.. __ Phone ( :u�r ) .9.��/-l�u�>;� <br />� Federal IDp or SSN <br />C. II Slnple Family, Zero Lot Lino or <br />Plenned Unit Development <br />TotalConditio_ned_FloorArea_ __�.�.�Z,___ _@g.lt_ <br />SecondDuplezUn' _,. . ______ __sq._IL <br />U. II Multllamlty (Fi-1) <br />Tolal # ol Buildings <br />Total M o( Units <br />To�al sq It,_{ootionap <br />.._,. ..._, � -�.. . �.�;.,. ,c��. � <br />. . ... �,.,. �T� ,.,.� <br />_�.� P F� 1" �n1e:�_- <br />A. Prlmery Space Heat Type B. Baek•UR S��Y�Neet Type C. W��r�� t Type <br />r��ko�.i anKw. fh� 6 <br />__ __— - ___-- <br />❑ Eledric Baseboard � Nono [�� Eledric <br />� Electric Wall Heater ❑ Wood ❑ Gas <br />❑ Electric Furnace ❑ Electric Baseboard ❑ Other �soec�ryeeww� <br />❑ Electric Heal Pump ❑ Other �spec;tyna,bw� _ <br />..__. _._ _____ ._-_- <br />❑ O�her _ . . _ _ <br />. , � ri���iE . . . . .. .',,�,+ <br />Thle bulldinp mxela Ihe WSEC Compllenee Method Date ol Pertni� Application .�� �> f_; __ <br />� Eleclnc Prescriptive Palh Date Building PermR Issued �r � :_ __ <br />❑ Other Fuels Componen� Fedormance Dals ol Insulation Inspection _�(�]' j_ <br />requlmmenls ol lhe WSE0. System Analysis Dale ot rinal Inspection �r,_ �� �� �� <br />1 hereby eertlty rhal fhla bullding or addlflon hae been Inspected !or fhe measures nqulred <br />by fhe 7997 Washingfon Sfefe Energy Code (WSEC), fAat ll la In au6efenflel eompllenre <br />W11h fhe WSEC, and fhaf Ihe WSEC checkUaf for Ihla bulldfng le on llle. <br />� r � .. , <br />,�__ <br />.��l �zt __ -- _ _ _ . <br />sp�awmoloudarpolh:iaiorautnoneeCnepmsonlauvo oate ' '/ <br />Heturn whlla copy to: Kathloon Skaar, Wa,hinqtan Stalo Enorgy 011ir,o. BU9 Legion Way SE. FA41, Ol�mpia, WA 985044211 <br />- . __ . . .. . . _ . _..... . . _ _ _ . . . _._— <br />WSEO-IYmlaCnpY UIJ�fyDxner�Car.aryCopY Junsa�clion.PmFLopY <br />0 <br />