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� :. <br /> , � <br /> Building Record ��� "�"'"" <br /> ��:�r -,e,- ..Y, r <br /> � ��n� <br /> �„ • �.x . 3 %�:�,, <br /> —(We3e e check one) (plea e check one) <br /> L�New Bulldlnp ,❑Addltlon over 500 sq,ry. OSingle Family ❑Duplez <br /> Jurisdiction: �� �,• ' .�j y • � � ❑Multifamily ❑Zero Lot Lfne Home <br /> --= ❑Planned Unit Devalo�ment <br /> Wease cneck one: 0"CIN ❑COuntv Permlt# ,:/,,��i <br /> FIIB ID N uldlHerenf Irom PermBA <br /> ��: ?a. <br /> . .. " y�''yTf,}a , <br /> A. Sits In}ormatlon B. Owner Informdlon <br /> Address��C� Owner �awr�ererp„ed�nsm�c�,,,�„�,��1 <br /> CI� � ,,,- Zio yi�i ComnanV;1 C :,.),_ < " d-"'•�• ; <br /> Asseasor'sProoemTaxN oranecn� aroesmnnon�: Address /y�/7 �,L,�Y�! <' C� - <br /> w- ^ ' • 7; � / Ciri �`-�;r�.>� lT. State/ii/�Zin �FZ.�� <br /> ServicingElectricUtili � � . ' / Phone ( i/,�� ) 2�� 77�� <br /> Federal ID8 or SSN <br /> C. If Slnple Famlly,Zsro Lot Llns or D. H Multlhmlly(R-1) <br /> Planned Unit Development Total k o1 Buildings <br /> Total Conditioned Floor Area -- <br /> -_�� sq_fl_ Total M ot Units <br /> Second Duplex Unfl sq. R Total sa. tt. (optional) <br /> ��V�'� ^`��• i � ���'. � .y��t! <br /> �.,�.r . x�. .Y <br /> A. Prlm�ry Space Hset Typs B. B�ck•U He�t T <br /> (cMck orN) ���k���� YPs C. W�tsr HNt Typ� <br /> - __ fcMNr on�) <br /> ❑ �leciric BaseLoard ��one [�}�Eleqric <br /> �I��Electric Wall Heater ❑ Wood ❑ Gas <br /> ❑ Elecidc Fumace ❑ Electric Baseboard ❑ Olher/apearyneww/ <br /> ❑ Electric Heat Pump ❑ Other/aE,eciryberow� <br /> ❑ Other <br /> �`�' '��`�`� r"�':�F�'���i�f�I�1�i��A '� <br /> Thle bu inp meets the WS C Compllance Method Date of Permit Applicatlon ,;% �� � <br /> �- --.� '� <br /> EIecU(c LK Prescriptive Path Date Buildinp Permit Issued %-/Z <br /> ❑ Other Fuels ❑ Component Performance Uate of Insulation In�ction (' -i� 3 <br /> requlrertienta ot tM WSEC. ❑ System Analysfs Date of Final Insnection I i-l5-9,j _ <br /> l herobv csrHly fhat fhla bulldlnp or eddltlon has besn lnipscfsd/er fhe mssauroa roqulrod <br /> by the 188f Weshlnpton Sfete Energy Code(WSEC),fhet/f la In aubsfanNal compflenre <br /> wlth fhe WSEC, and thsf fhe WSEC checkliat for fhls bulldlnp la on/lle. <br /> � ' �� , � ..,, / � <br /> � � <br /> Signat e ol Bulkling 011icial or Authodzed Reprasenlative Date ' �c <br /> Return whlte copy to_ Kalhleen Skaar, Washington State Energy Office, 809 Legion Way SE. FA-11, Qlym�,WA 98504-1211 <br /> _ _--- <br /> WSEO•Whife CopY UtilityNwner.Cenary Copy - . . . Junsdicfion-PinX CopY <br /> 7-Bt <br />