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� <br /> Building Record � � ��« "`�"'"` � <br /> . <br /> -(pe3a e check one) (pleeae check one) ,.,,� <br /> L�ew Buildinp/��O�'AddNlon over 500 eq.tt. ❑Single Family ll�Duplex <br /> Jurisdiction: (�ut[ 0��AX/U�"� ❑Multifamily ❑Zero Lot Line Home <br /> ❑Planned Unit Develo ment <br /> Weaae eneck one: CItV ❑County Permlt k � <br /> Flle ID k Ind�nsrentnomrermaA <br /> A. Slte Informdlon B. Owner Inform�tlon <br /> Address /oJO�n G � Owner o»,iererdmea recanea <br /> �tfi <br /> Citv �y� ZI 7Q� Com an . �— <br /> Assesaor'sPro Taxk aettaenienaideeerivnonl: Address /22Z ll/M <br /> �? �p /� CftV �TJ�/.Y1S Ste GJ ZID 9i��S� <br /> Servic�ip Electric Utllfri Q (i ^ Phone � <br /> Federal IDM or SSN — <br /> C. If Slnpls F�mlly,Z�ro Lot Lirn or D. N MuHlfamlly(R•i) <br /> Plann�d UnN DevNopment Total k of Buildinps <br /> Total Conditioned Floor Area 1 7 sq.fl. Total M of Units _ <br /> Second Du;'�x Unit 15�3 aq.lt. Total sq.f1. (oationall <br /> A. PHm�ry Sp�c�He�t Typs B. B�ck•U� S��cs Hsd Typs C. W�ter FN�t Typ� <br /> (CMCkOM� (CINCkI IIN 1�1)'f (CINCkOMf <br /> ❑ �Flectric Baseboard ❑ None ���� <br /> �Electric Wall Heater ❑ Wood ❑ Gas <br /> ❑ Electric Fumece ❑ Eledric Baseboard ❑ Olher�apedr,�eeawl <br /> ❑ Electrfc Heat Pump ❑ Other�apecirybeaw) _ <br /> ❑ Other <br /> This bul Inp mesis ths WSEC Compliancs AAsthod. Date o(Permit Application ��—Q3 <br /> Electric ❑ �rescriptive Path 'Date BuildinA Permit Issued Le'�/- 93 <br /> ❑ Other Fuels ���Component PeAormance Date ot Insulation Inspection 7 1�,�_ <br /> roqulremsnte of the W3EC. ❑ System Analysis Date of Final Insoectfon /-7-5�5 _ <br /> I heroby certl/y that fhle bulldlnp or eddltlon hss besn Inspsctsd/or fhe meaauros reyulrsd <br /> by fhs 1981 Washingfon Sfafs Energy Cods(WSEC), thet It Is In subsfenHal compllanre <br /> Ith f WSEC d thet the WSEC checkllst lor thla bulldlny I�on llle. <br /> -�-� _ ,������ — <br /> naWre o18ulMing Olficiel or Authodzetl epresenlative �. Dale • <br /> Return whlle coPy to: Kethleen Skaar, Washington State Energ�Oflice, 809 Legion Way SE,FA•11, Olympia,WA 98504-1211 <br /> WSEO- Whife Copy UfilityA7wner-Canary Copy Jurlsdictian-Fh'nk Copy <br /> 7�92 <br />