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������ � <br /> � Building Record ,�o��� "`�` B <br /> � <br /> *� ^x �o.vr r .�'��"'r c -+eMe�M e x»s�.:�., � �. <br /> � .��x.1 r�.fty"� x?a�x�E*.3�'$`s e����d��a a, ��1* y ' `:.Ym",� r7" �..a� <br /> :"*'� 3. �"�,1 . �` iZf�.YA:.. ,��.i�...�:, f ��ll��YIIY�R. t' 'i.a�.`�4€:� <br /> �(p/ ase dreck one) (p� ase rheck wieJ � <br /> New Buildfn Addfli o e 500 sq,fl. �Single Family ❑Duplex <br /> Jurisdiction: 0 — e ❑MuHifamily ❑Zero Lot Line Home <br /> ❑Planned Unit Develo ent <br /> n+aess�na�x o,b: CNv O Countv Permft M .�,iyy a <br /> File I D k I n dlnerenr/rom PermR A1 <br /> �Y�'r< <br /> �?��'..�� � ,g����� �� �yar�� .�,'.,� <br /> \YI\ <br /> A. SRe Informatlon B. Owner Infortnatlon <br /> Address /p/o/U � Owner o�.nerarwreorea,smaeeonrxel�e9� peln,,,q <br /> �f <br /> r+�_ ZiD COITID8f1V ¢ A I/' <br /> ASSessor's P�o B T8x M a enach al descd tlon : Add�95S � '�/9 ///��-_� <br /> ��D �12�28.�� Citv –✓.a�o�'f 5tate A zw � <br /> 3ervicino Electric Utilkv /�/l /7 Phone 1 �o� l,4ti/ ' O?S� <br /> C. N Sinple Famlly,Zero Lot Line or D. Duplex E. N Multifamily(R-1) <br /> Plenned UnM Development Frst Duplex Unk sq.fl. Total M of Buildings <br /> Total Conditioned Floor Area /Gi D s .fl. Second Du lex Unit , ft. Total k of UnNs <br /> A. Primaty Spece Heat Type B. SecorMa►y Space Fleat Type C. W�k Hseat Type <br /> (chsck oml (chsek N t/rt• � <br /> ❑ Electric Baseboard ❑ None Electric <br /> � Elactric Wall Heater ❑ Wood ❑ Gas <br /> U Electric Furnace ❑ Electric Baseboard ❑ Other��,edtyberow) <br /> ❑ Electric Heat Pump ❑ Other�apeertye,�ow� <br /> ❑ Olher <br /> na Hwl Pur�p Onl�. . <br /> WSEC Compllance Method Thls bulldlnp meeta the Date of PermR Application _.S- � <br /> �Prescriptfve Path � electric Date Bufldinp Permit Issued (9/e� <br /> Componem PeAormance ❑ other fuels Date of Insulation Insoection �_��— <br /> ❑ System Analysis roquiromeMa of the WSEC. Date of Final Insoection 3�-9s <br /> I hereby cerf!/y fhaf fhls bullding oreddRlon haa been lnspecfed lor fhe meesures requlred <br /> by fhe 1991 Washingfon Sfa e Energy Code(WSEC), thet H Is in aubsfanflal compUance <br /> w8h fhe WSE�haf 4VSE�eckHsf!or fhls bullding Is2 on Iile. <br /> SlgneNre o18ulkAng Om or Authorized Reprasentative Dat� //7 �� <br /> Raturn canary copy to the servlcing electrlc ulility to irlgger WSEC compllance oeymont <br /> _ _ Return white eopy to: Kathleen Skaer Washington Stete Energy 011lce, P.O.Box 43165 O�ympla WA 98504•3165 tt-9z <br /> WSEO�Whi1e Capy UNlity/Owner�Carwry Copy Jw�sdicf.'on�P1N�Copy <br />