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W_ ASHIN�GTDN <br />C�ODE <br />�� <br />Building Record <br />�(plea�s cheek oneJ <br />'L�'fJew Bulldl .❑ Additlo ver 500 sq. ft. <br />Jurisdictlon: —��G� <br />please check one• IN ❑ CountV <br />A. Site Iniormation <br />Address 39 � <br />Citv �/1-O�B Zi ��_ <br />Assessor'S Pro ert Tax q orat ch le al descripNon) : <br />Q 2 . �/201-/-Q5 <br />Servicinq Electr(c Utilitv %,// %� <br />�`�.�-e � J % �� <br />Adachnent B <br />(please chack one) <br />� Single Family ❑ Duplex <br />❑ Muitifamily ❑ Zero Lot Line Home <br />� Planned Unit evelo ment <br />Permit # <br />File ID # flld7nerenf from Permif M <br />B. Owner Informetlon <br />Owner (owneraroineam�sm¢tlon�ecen�es„oWn•qevmen!) <br />Com an <br />Address 2Z <br />C� State Z( <br />Phone , <br />Federal IDk or SSN <br />C. It Single Femlly, Zero Lot Line or D. I} Multlfamily (R-1) <br />Planned Unit Devefopme�t Tolal # of Build(ngs <br />Total Conditioned Floor Area /Z 7 sq. ft. _ Total k of Units <br />Second Duolex Unit sq R Total sq. fl. (optional) <br />� <br />A. Primary Space Heat Type <br />(cheek one) <br />❑�, �EI °tric Baseboard <br />LS Eleciric Walt Heater <br />❑ Electric Furnace <br />❑ Electric Heal Pump <br />❑ Other <br />B. Back-Up Space HeetType <br />(cheek el1 fhet epply) <br />❑ None <br />❑ Wood <br />❑ Electric Baseboard <br />❑ �lh2f (speci/ybelowJ <br />C. Water Heat Type <br />(eha.k one) <br />0'Electdc <br />❑ Gas <br />❑ Other(speeltybe�ow) <br />This bullding meets the WSEC Compllence Method Date of Permit Application �=,p.�i-' <br />❑ Eleciric ,❑�,�escriptive Path Date Buildinp Permit Issued �p 2(Q- <br />❑ Other Fuels 'U' Component PeAormance Date of Insulation Inspection 5 <br />requlrementa of the WSEC. ❑ System Analysis Date of Final Inspection � <br />I her by certl/y fhat thls bulld� ng or addltlon has been lnspecfed Jor the measures requlred <br />by e 1991 Washingfon State FnPrgy Code (WSEC), that /t Is In subsfantfal compllanre <br />f WSEC, nd fhat fh ' C checkllsf !or th/s bullding /s on J/le. <br />l� G�i� <br />Signature o) <br />9etu white <br />ONicial or ANhorized Represonlativo <br />to: <br />WSEO - Whrte Capy <br />Dale <br />Stale Energy 011ice, 809 <br />Ufilityrownar - Canary Copy <br />Olympia, WA 98504•1211 <br />Jurisdiction - Pink Copy <br />7 9P <br />