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��G10N <br /> �� Building Record ,,,��� "`�'�° <br /> : <br /> �fpl ese eheek one) , <br /> New Bulldln � Addltlon o r 500 sq ry, Ip�ease cneckone/ <br /> Jurisdiction: i , �Single Family ❑Duplex <br /> — 97 /a�p� ❑Multifamily ❑Zero Lot Line Home <br /> ❑Planned Unft Development <br /> lease check one: C( ❑COUntV y��/� <br /> ---�_. Permit It <br /> FIIB ID#(ll d�Nerenflrom Permlf At <br /> A. Site Informetlon 8. Owner Information <br /> Address .�/Z � <br /> Owner �ax�erarwneucrosmictt�,�n,�suognaevmemi <br /> CifV ZID ,�j� • <br /> �Assessor s Pr�a p�Tax q or attacn ie�des rion ; Com an <br /> / ,,.� � 5�-- Address ,�(y� _ <br /> -�y"—' � " Gty ��ee o 1� State / A Zin 4 .�� <br /> Servicinp Electric Utllitv n ,� �,( Phone � }� � �,�_ �'T <br /> Federal IDq or SSN <br /> C. Ii Slnple Femlly,2ero Lot Llne or D. If Multitamily(R-1) <br /> Planned Unit Development Total q ol Bulldfngs <br /> Total Conditioned Floor Area /�5/� Total#of Un(ts <br /> Second Duplex Unit sq ft Total sq. ft. (op8onap <br /> A. Prlmety Space Heat Type B. Back-U S ece Heat T e <br /> (eheck one) (ehsek slPfhef epp/yJ yp �• Water Heat Type <br /> ❑ Electric 8aseboard (�nkkons� <br /> � None Electric <br /> ` Electric Wall Heater ❑ Wood <br /> ❑ !leciric Furnace � Gas <br /> ❑ Eleciric Baseboard ❑ Other�spedty berow� <br /> ❑ Electrfc Heat Pump ❑ Other�specirybeiow� <br /> ❑ Other <br /> This building meets the WSEC Corr,pllance Method Date ol Permit Application <br /> � eioc��ic .t� 'ao- 9sl <br /> � Prescriptive Path Date Bulldinq Permit Issued / -�'o-�S <br /> ❑ Other Fuels ❑ Component Perlormance Date of Insulation Ins�ection />-�-��_ <br /> requlremenis of the WSEC. ❑ System Analysis Date ot Final Insoection <br /> — �J-iy/-4� <br /> I ereby cer7//y that thfs bu!ld/ng or addlt/on has been Inspected!or the measures requlred <br /> the 1991 WashJngton fate Energy Code(WSEC), that It Is!n substanf/al compllan�e <br /> t he WS C, and th fhe WSEC checkllsf/or fh/s bu//ding Is n 0/ . <br /> Signat ol Building 011icial or Aulhorized Represe�e Date / � <br /> Return white copy to: Katlileen Skaar, Washington State Ener y Olfice, 809 Le3ion Way SE,FA-11, Olympia,WA 98504-1211 <br /> WS[O- While Copy Utilily/Owner-Canary Copy — <br /> ✓urisdicfion•Pink Copy <br /> . 7 92 <br />