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WASHINGTON p�q�� g <br /> �� �uilding Record ���►� <br /> ��� �oG� <br /> ,��x CLASSIFICATION <br /> 4+ H .. __ '_.._. '____.— ._'_.—"_"___._—_ <br /> 9 H fn --------------- <br /> �plrnsr check ane) f0�a.ase check oneJ <br /> � C7 New Building ❑Addltion over 500 sq.ft. U Single Family ❑Duplex <br /> � ''3� Jurisd�:tion: ❑Multifamily ❑Zero Lot Line Home <br /> � H� n Planned Unit Developrtienl__________—__ <br /> !/JH _ _— _ . .. ..—_—___—_ _ . ._. . - . <br /> �,7 z�," iease check one� _ . _� City�COun�y_ _ _ Peimil# - ——_. -.-- --- <br /> � ��i £ -- _ _ <br /> Fde ID #(d adlerent Irom Pcrmrt M� ..._.. ___ _ _ <br /> ° �,g _ CONSTRUCTION _ <br /> �j]V n <br /> x y� A. Site Information B. Owner Information � <br /> y __— -- <br /> �" �,y y Address . .__ _ Ownor �oM,�ar nme o�mnsruran recr.vves un�_paymen0 � <br /> - -- _ _- —._.------- --.. __ � <br /> � y ___.___ .. <br /> ~ C.Offl 8f1 ----.— , <br /> G❑m City Zip P Y — _ - i <br /> � t+f� Assessor's Property Taz k�m:i;ach�egai descnphoql : Address <br /> H y Ciry Stale Zip _ <br /> y �y Servicing Elechic Utility _ . _ . Phone ( ._ ) _ . __ � � <br /> FederallDqorSSN ._._______^ � � <br /> C. N 5ingle Femlly,Zero Lot Line or D. II Multlfamily(R-1) _ <br /> Planned Unit Deve�opment Total 11 ot Buildings _ I <br /> Tolal Conditioned Floor Area sq.fL Total#ol Units _ __ _ _ _--. � <br /> Second Duplea Unit sq.f�. Total sq.N. !optional) _ _ __ ' <br /> ! w' <br /> _ -- _ -__ _ _ _ <br /> HEAT SOURCE <br /> _ _----------------- <br /> �_ j A. P„msry Space Heat Type B. BPco�niP noPk en rne eppY)e C� jop ioneFl,�ch kYo e) <br /> �] Elect���.Baseboaid � ] None ❑ Electric <br /> �' �� I 1 Electric Fumace ( 1 Wood I� Gas <br /> '" �� ❑ Electric Heat Purrp �.] Electric Baseboard ❑ Other�spec�ry beaw� <br /> ❑ Other rcornry eeUwl ❑ Other lweciry beiow� _--- <br /> I� � <br /> COMPLIANCE __ _INSPECTION/ENFORCEMENT <br /> - WSEC Compllance Method Date ol Pem�i�Application <br /> (� Prescripuve Path Dale Building Permit Issued <br /> � � ❑ Component Periormance Date of Insulation Inspection _ _ _ <br /> ` �� System Analysis Da�c of Final InsFection <br /> I hereby corflly fhaf Ih/s 6ullding o�edd/flon has been Inspected lor fhe measures requJred <br /> by fhe 1991 Washingfon Sfate Energy Code(WSEC), fhaf!t Is In substantlal compl/ance <br /> wifh fhe WSEC,and thaf fhe WSEC checkllsf!or fhis bullding is on llle. <br /> Sq�n;pure oi Owii7ing 016aa1 or AuO�onteA Ropresenlalrvu D.tic <br /> Relurn white copy to: Hnthlr.en Sknar, Washington State Fnorgy Oflice, 809 Lec�ion Wav SE.FA�11. Olympia. WA 9850"-1271 <br /> WS(-0� WhilcCopy UIJAyOwnrr C�lnd�yCopy Jun,��Lihorr-PinACapY fi-91 <br />