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<br /> � � Building Record �� ��� "'�" j
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<br /> P' 'li'" � �� �, _,;;,�,� ��;"��€;��l��,� tes��+~����� �
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<br /> � Buildlnp ❑Addltion over 500 sq,ry, �Ingle Family ❑Duplex �
<br /> i Jurlsdiction: �-� � � f- �I n r �-rf' ❑MulNfamily ❑Zero Lot Line Home
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<br /> ❑Planned Unit Development I
<br /> ae cned,one: City ❑Countv Permit N � 77y p I
<br /> Flle ID M(nmflerentfrom PermBA1
<br /> A. Sits Inform�tlon B. Owner Infortn�tlon I
<br /> Address � t __ Owq�r���a� ,�,�ua� �en i
<br /> � � Uf_,?"�' ZiD ' �2 /', --C..7u�//< �/ ,,, ,! , , ,' �
<br /> ' Companv !
<br /> ! A5899801'8 Pf0 T8X N(or attech lepel de fion ; �� / -�a �
<br /> i Address �/ - '"L� 5�;.
<br /> �_`.' r. f 1.f a•I oF 1tr�r/ �L�, f; CI � ,L� ''j`.' Statel.� rI Z_ IP `�e�_� j
<br /> Servicing Electric Utiliry `, nu�� �- ,. ,o��� phone (����� � � .,_ , �
<br /> / �J �.� � s
<br /> I /�//� Federal IDM or SSN��=yi;�_1Y�� ��—
<br /> C. If Sinpl�F�mlly,Zero Lot Llns or D. H Multlhmlly(R-1) i
<br /> Plenn�d Unit D�vNopment Total N of Buildinps — �
<br /> Total onditioned Floor Area !L I � s , ft. Totel N of Units � — �
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<br /> Second Du�lex Unft_ aq R Total sg,R. (optionap —
<br /> t�„*.:�,, : ��S
<br /> A. Prlm�ry Spaw Heat T g` p� '.
<br /> (ch�ck oru) YPe 8. BaCk-� f lN�t TYPQ C. W�tsr Fbtl Typs �
<br /> (eMek fM �pply) (cMck oruJ I
<br /> �Eleciric Baseboard � None ,� Eleciric �
<br /> I ❑ Electric Wall Heater ❑ Wood � GeS �
<br /> � ❑ Eleatric Furnace ❑ Electric Baseboard ❑ Other�sneciybero,,.� I
<br /> j ❑ Electric Heat Pump ❑ Other
<br /> I ❑ Other lSPeeityberow) -- ---- --
<br /> I [ ' �'��P��'�a�a����a R.. '..��`��lk��"*'���t"'� �, :�. �
<br /> I Thls bulldinp mesb the WSEC Compli�nce Msthod YDate ol Permit Application �� � � I
<br /> �Electrfc -- --- ��—' -�— i
<br /> Prescriptive Path Date Bulld(ngPermit Issued -�� -�L i
<br /> � ❑ Other Fuels ❑ Component Performance Date of Insulatlon Inspection__ �,1 � �,
<br /> roqulremertls o1 the WSEC. ❑ System Analysis Date of Final Inspection _?..-� I
<br /> ' I heroby csrH/y th�f fh/a bulldlny or eddlNon h�s bssn lnapsctsd lor fhs meesuroa roqulrod
<br /> � by fhe 188f Washlnpton Sfete Ensigy Code(WSEC), th�Ht It/n sutitenNel compllenro
<br /> wlth fhe WSEC,end fhsf fhe WSEC checkUst/or thlt bulldlny/a on Nle.
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<br /> ! Sipneture ol Buildinp Oflicial or Aulhorizad Representelive Date � �
<br /> ' Return white co to:_ Kathleen Skaar, Washin ton State Energy 011ice, 809 Legion Way SE,PA•11, OI m ia,WA 98504•121' 1
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<br /> WSEo�Whife Cnpy . . _._ . . _-. 8 Ufili rt7wnei. .. .. . . . ---- - ——y..� ---------- �
<br /> � ty Cannry Copy Junadichan•Pink Capy '��
<br /> 7�92
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