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���� Building Record ���« A�� B <br /> �oGRa�n <br /> i�, � <br /> �(p�e e cneck one) (please check oneJ <br /> L�New Bullding ❑ dditlon over 500 sq.tt. �Ingle Famlly ❑Duplex <br /> Jurisdiction: � � ❑Muitifamily ❑Zero Lot Lfne Home <br /> ❑Planned Unll Develo ment <br /> p�eese eheck one: Clry ❑CounN Permlt M �� <br /> FIIO ID#111 dlNerent from PermM A1 . <br /> A. Slte Informetlon B. Owner Infortnetlon ', <br /> Address 5�1,3 /�i�/ Owner owr�er rtlmeaooruaucConre �vesuU� avnem_ <br /> a /�*/� <br /> , �� � <br /> City Zip 2Gi3 Com an <br /> Assossor's Pro�erty 7ax# oranacn ie a��fescn ' n : Address ���O 11 _</ G <br /> y ��ry �',,,o���t- State pl/�-z�p �,PZI.� <br /> ServiGng Electdc Utility O_ Phone ( :20/n 1 .,��S�g �'�_ <br /> Federal ID#or SSN <br /> C. I}Single Famlly,Zero Lot Line or D. IT MultHemlly(R-1) <br /> Plenned Unit Development Total #ot Buildings <br /> Total Conditfoned Floor Area s .ft. Total k of Units <br /> Second Duplex Unit sq, ft. Total sq ft (optionap _ <br /> � <br /> A. Primary Spece Heat Type 8. Back-Up Spece Heet Type C' Whack one�t Type <br /> (ehackons) _ (chwkallthatapply) ( <br /> ❑ EI clric Baseboard ❑ None leciric <br /> Eleciric Wail Heater ❑ Wood ❑ Gas <br /> . ❑ Electric Furnece ❑ Electric Baseboard ❑ Olhe�jspecllyDelow) <br /> ❑ Electric Heat Pump ❑ Other�sperrry be�ow� <br /> ❑ Other - <br /> Thls bullding meets the WS C Compllance Method Date of Permil Application 3/- _ <br /> ❑ Electric Prescriptive Path Date Building Permit Issued� ' <br /> ❑ Other Fuels ❑ Componenl Performance Date of Insulation Ins ection - - <br /> requlrements of the WSEC. ❑ System Analysis Date ot Final Ins ection � -r r-�_ <br /> 1 hereby cert(ly thaf thls bullding or addltion has been Inspected lor fhe meesures requfred <br /> y fhe 1991 Washington State Energy Code(WSEC), thaf It is In substant(al complianre <br /> � he W EC, and at fhe W� SE—C�kllsf for thls bullding Is o��e. �j7� -- <br /> SlgnaWr uilding 011icial or Authorimd Representalive �+��e � y� <br /> Return whlte copy to: Kathieon Skaar, Washingron Stalo Fnergy Office, E709 Legion Wa _SE, FA•11, Oiym�ia,WA_98504-1211 <br /> WSFO-Whifc Copy UfilityA�wner�C.�nary Copy Jurisdic(iorl-Pink Copy <br /> 7 91 <br />