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��G"fON <br /> � AtfadNnent B <br /> � Building Record „�o�t* <br /> � <br /> '�ix ,t::�t x t� � :������ � i�>� r^^a� �." , �� �� .5::»� . . <br /> � Cv��. a �i �..i:�a Z.,. �. � .s. � �i3 ��� '-,��, u xx��T.i��: . `��� .< ...�,�•� <br /> p ase eheck oneJ (please cMck oneJ <br /> New Buildin Addi�jon over 500 sq.ft. p Single Family ❑Duplox <br /> Jurisdiction: D'f- .�il.¢7�'}� �uluHifamily ❑Zero Lot Line Home <br /> ❑Planned Unit Develo ment <br /> esecheckone: Citv ❑CoufdV PemfkM L� /� <br /> FIB ID M(NdiHeremlromPornRM <br /> A. Ske Informatlon B. Owner�nformation <br /> Address /.�,'17 Owner oxnerarxmeoreonstectlonrerer�eaN rnenr <br /> ���G�l�+p zin �j' �/ Com an ^,. , ' <br /> Ass s r's Pro 'srtv T8x N Iw anach kaa�des«lanoN: Address //3 /� �_�;e i a <br /> S" � Citv �wood StateWff Zi <br /> ervicinn Electric Utl:it O �— Phone ( GYQ ) nS„� - 9� <br /> C. If Slnple Family,Zero Lat Llne or D. Dupbx E. If MuNltemlly(R-1) <br /> P�anned UnR DevelopmeM Frst Duplex UnA sq.ft. Total N o(Buildings �— <br /> Total Conditioned Floor Area s . R. Second Du lex Unit ,ft. Totai M ol UnNs <br /> \_;.; <br /> A. P�H�k ry.Spece Heat Type B. Secondary Spece Heal Type C. Water Heat Type <br /> 1 (dr�ekW fF�r�pptyl (eheekoMJ . <br /> �Electric Baseboard None Electric <br /> Eiectric Wall Heater ❑ Wood Gas <br /> � Eiectric Fumace ❑ Electric Baseboard ❑ Other�spedrybeww) <br /> ❑ Eiectric Heat Pump ❑ Other/apecnyaeiow� <br /> ❑ Olher <br /> n«w.�w„a o,�M <br /> WSEC Compllance Method This bulldinp meeta the Date of Permk Applicatfon - ��-y,� <br /> � Prescriptfve Path ❑ eiectric Date Buildinn PermR Issued iG,- 9�— <br /> Component PeAomiance ❑ other luels Date ol Insulation Inspection J -I�-Q 6 <br /> ❑ System Analysis requlrementa of the WSEC. Date of Flnal Insoection (p-2 8-9 6 <br /> + hereby certlly that fhla bullding o►addltion has been lnapected/or fhe measurns reyulred <br /> b�•fhe 1991 Washington State Energy Code(WSEC), fhat It!s!n substantlal compllance <br /> w1Rti the WSEC,and fhaf fhe WSEC checkllsf lor fhls bulld/ng is on Ille. <br /> �s- �/Zg�� <br /> Signe ol BuIIdrK OfAdel or AuthoAted Rapresenlative Date <br /> J <br /> Return eanary copy to ihe servicing electrlc utlllly ta trigger WSEC compliance peyment <br /> Return wfilte copy to:Kethleen Skaar Washington Stete Enargy Oflice P O Box 43165 Olympla WA 985D4 3165 � �� <br /> WSEO-YNrlfe CoPY Utlliry/Oxtter�Canary CnpY JurlsdicNan-PliJr Copy . <br /> i <br />