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, <br /> ���INGTON A�� e <br /> Building Record ���#— <br /> ��y �o�� <br /> CLA881FICATION ___ ` ' <br /> C�H —__'—_.__ �. <br /> a y y �piense chech ono) , <br /> �pream cnock onol ❑Sin le Family ❑Duplex <br /> � �� ❑New Bullding ❑Addition over 500 sq.ft. ��Mul�tifamily ❑Zero Lot Line Home <br /> Jurisdiction: _ . _ - - - <br /> H� _ <br /> n Planned_Umt Deyelo�men _ _ -- <br /> -- <br /> � H ro -- <br /> [nr+ --------'—_ Permitp_ - ___ — <br /> H reese check one ❑CoUnt __ <br /> O City Y <br /> � O� P � Fde ID IX(d d�nwent lrom Permit M� . <br /> HC <br /> � �g CONSTRUCTION <br /> (7 Y �] <br /> 8. Owner InformeUon _-- <br /> x �,�-'3� A. Site Informetion _ _ <br /> - - --� Owner_fowna�r emv ot mrsmicnon rece�ws uaMr aarmenq <br /> -- <br /> ra H Addross- - ----- ------ _ --- <br /> �' Company ! <br /> �' Zip <br /> o Cvr Ciry - � Address -.. . .. . ._ _ -. .-- <br /> � t�� Assessor's Property'fax N �o�arcacn iepai descnprnn�: City Stale Zip � <br /> Htn .. _ _. .. . . . _- - - - - �- � Phone (� . ) . . _ - _ ._ <br /> '� �y Servicing Electric Ulility _ -_ — <br /> Federal ID#or SSN � <br /> i, <br /> D. II MultHemily(R•1) �— <br /> C. If Single Famliy.Zero Lot Lfne or Total#of Buildings � <br /> Planned Unll Development —� <br /> Sq ��. Total #of Units __------ <br /> Total Conditioned Floor Area S �� Total sq. fL (optional) _ ..�---- <br /> Second Duplex Unit 4' <br /> 1� 1' ..��;:_,�:�.�, <br /> NEAT SOURCE -.-- ,�:. � <br /> — — -- -- ----- <br /> -- --------- - - _ _ <br /> B. Back•Up Spece Heat Trpe C. Weter Heet Type <br /> �` � A. Primary Spece Heel Typc (opflonal,chxk one) <br /> � (c�eck one) (opllonal,check all fhaf epp y) <br /> ❑ None ❑ Electric <br /> � ❑ Electric Baseboard n y�ood Cl Gas <br /> � ❑ Electric Furnace ❑ Other�spec�ry bebw) <br /> � � ❑ Electric Heat Pump ❑ Electric Baseboard <br /> ❑ Olher (spec�y be�owi <br /> ❑ O�her(specdyoclawl . . _ _. . . ..– --------. <br /> � � � _ . <br /> - COMPLIANCE ___ __ _ _ INBPECTIOIIIENFOi10EMENT __ <br /> ' Dale of Permit Application <br /> - _ WSEC Compilence Method <br /> DateBuildingPermillssued_ ______._ _ _ <br /> ❑ Prescriplive Path Date of Insulation_Inspection _ ___.__ <br /> _ - - <br /> �e� ❑ Component Performanco Dale ol Final Inspection <br /> ❑ Sys�em Analysis <br /> I hereby certlly fhat fhla bulld!ng or addlllon has been Inspected for Ihe mensures requlred <br /> wifh the9WSEC,eand fhaf SherWSEC�heck/!sf oSEhfs bullding!s on/llte.ntlel compllance <br /> oa�e <br /> Signaturo u� f3���lding Olhaal or Authorilod Rop�osonla���o <br /> Retum whlte copy to: Kathleen Skaar, Washin�ton State Enarc�y Olfice, B09 Legion Way SE.FA�11�J�I cd�cPt�onWi'm9Copy ' g g� <br /> WSEO�W���te CoPY UUliry Ownrr Cnnary CopY <br />