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• r , , <br /> y�H ��HINGTON p�� g <br /> Building Record �o�# <br /> ��� ��� <br /> ay <br /> �O�'x CLA881FICATION <br /> 9 H C~n -- ----- _ <br /> rx <br /> y �3 (plee�se cheeF onei Ip���se che�ch onel <br /> '< y� �New Bullding ❑AddlUon over 500 sq.H. ❑Single Family 7buplez <br /> p� H� _ ❑Multitamily ❑2ero Lot Line Home <br /> Jurisdidion_ ._ L_ � <br /> y� J •' ❑Planned Unit Cevelopment <br /> � �� piease checti one: 0"City _ ��County Permi�# , � _ . - <br /> -- _ <br /> _ <br /> y Cy FiIC ID #{i�tl�Nerenilrom PermitAj <br /> _- <br /> � �g ; .�„ CON8TRUCTION ; .:: . : . <br /> n V � . , _ ----- <br /> -- ---- --- - <br /> zy y� A. Slte Inlormatlon 8. Owner Informetion <br /> r HH Address , ._ , _ :l_�/ ;• ' � : Owner �ow�,uarnmeorconsm�cnmrecp�esunirrypnrma�t_�—_ <br /> gy - ; �` <br /> H <br /> o C tn City _ , �t ZiP .�_��� ' Company --- <br /> � �r Assessor s Property Tax p io�anacn�ogaiaescnphonJ' Address � � � �. . ._ _ ; <br /> �-Z3 o vi � ° �/ Ciry ' State : Zip,f1_�L <br /> Servicing Electric Utiliry.__� ,. , ,. . - � Phone _ __(_ � _ ) _. _ . _ _%��� <br /> FederallDaorSSN " • `�� �-I-�t�..___ <br /> ' �� � � , .��.' � /.S/ <br /> C. If Single Famlly,Zero Lot llne or D. II Multltemily(R•1) _ ___ <br /> Planned Unit Development Total k of Buildings __ <br /> Total Conditioned Floor Area sq. It Tatal#ol Unit� _ _ <br /> �� � Second Duplex Unit sq. fl. Tolal sq. It. (op�ional) ._ <br /> _ , HEAT SOURCE _ �__ _� <br /> �– �� A. Prlmery Space Heat Type 0. Back-UP Space Heat Type C. Water Heet Type <br /> � (check one) (checF el Ihel epplyl (checN one) <br /> �_] Electric6aseboard � � None �_� Elechic <br /> � � � U Eledric Wall Heater � � Wood f J Gas <br /> � ❑ Electric Fumac� ❑ Electric Baseboard ❑ Other �spec�ryvemw) <br /> ❑ Eloclric Heat Pump �_� Other Isµrny nniowi <br /> A ❑ O�her _ <br /> COMPLIANCE INSPECTIOIUENFORCEMENT � <br /> Thls bullding meets the WSEC Compllance Method Date ol Permil �pplicahon _ <br /> U Elr.dric �..� Prescrip�rvo Path Da�e Building Permit Issued �,� ;� � ��.� <br /> 1 , � �-_� Other Fuels �_) Componenl Pertormance Dale of InsulaGon Inspection � - �.'� /,j <br /> � ' roqulremenis ol the WSEC. ❑ System Analysis Date ol Final Inspection _ _; i�-. ;�'.�__.__ <br /> 1 hereby cerflly fhaf fh/s bullding or addlflon hae 6een Inspecfed lor fhe measurea requlred <br /> by fhe 1991 Weshingfon Sfafe Energy Code(WSEC), fhef If Is In subsfanflal compllenre <br /> wlfh fhe WSEC,and fhaf fhe WSEC checkllsf lor fh/s bullding Is on llle. <br /> Sign;ilum ol�udtlinfl O�hnnl or Aullm�ved Represun�q�rvn Dale <br /> Rolum whlle Copy to: Kathlcen Skear, Washington Stato Enorgy Olhcu. 009 I rgion Wny 51 ,fA 11, Olympia,WA 98504�1211 <br /> WS�n WhA�CoPY Uhhty'Owrre� Canary Copy Junsdirhon .PinF CopY <br /> 1 92 <br />