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\ <br /> � <br /> ��� <br /> m y <br /> C i-� <br /> H �� <br /> re n <br /> '�tl �i�q <br /> y I . <br /> ��� � Buildin Record A� B <br /> � ��� g wsEoca,o-xta <br /> ��g ��n <br /> '�H� r CLASSIFICATION __ <br /> �N <br /> �..�y �plpasc check onc) <br /> p (p�ease check or.e/ <br /> � y� ❑New Bullding ❑Addition over 500 sq.ft. ❑Single Family ❑Duplez --- i <br /> Jurisdiction: ❑Multitamily ❑2ero Lot Line Home <br /> a ❑Planned Unit Development _ <br /> - --- ❑ Ciry ❑Countv _ Permit#___ -- — <br /> piease -` --� ____ <br /> File ID 7!(i�mnemnt l�am Permrt Mj__ _ _. <br /> ;�, <br /> � 'r ,, � rr�� <br /> A. Slte Inlormation B. Owner Inlormetion ____ <br /> AddrBss Owner 1awrnvetnme,almnshucnonrecciwsuGhiyPeY��I <br /> _ _ _ Company _ . 1 <br /> __ Zip ---- — <br /> Ciry ---:- Address -- --- <br /> Assessor's Property_Tax#for attacn�egai descnpnu�): <br /> Ciry State Zip-- <br /> ___ <br /> - ------ -:_—_._ _ - Phone l 1 <br /> '�' Servicing Electric Utiliry _ ,__ -— <br /> -- - Federal ID#or SSN -___ <br /> 1 ' C. If Single Famlly,Zero Lot Line or D. If Multifemlly(R-1) __ <br /> � ' Planned Unll Development Total q o1 Buildings <br /> 1�' Total Conditioned Floor Area sq.tt. Total M of Units - - - - <br /> Second Duplex Unit sq. it. Total sq.ft. (optional) <br /> I I � NEAT 80URCE ..� <br /> 1�' 8. Beck-U S ace Heat TVpe C. Water Heat Type , <br /> �� A. Prlmary Spece Heat Type �opflanelPchePM ell fh�1 apply) (opflonsl, eheek oneJ <br /> (ene�k one) <br /> � ❑ None ❑ Electric I <br /> ' ❑ Electric Baseboard ❑ Gas i <br /> � ❑ Electric Furnace �l Wood <br /> � ❑ Electric Heat Pump <br /> ❑ Electric Baseboard ❑ Other�sp��y berowi i <br /> I ; ❑ Other rspearyoo�ow, ❑ Otherlsa��ryne�ow) --.-_ -------- <br /> I I_I COM'LIANCE _ INSPECflONIENFORCEMENT <br /> �' WSEC Compllance Metbod Date ol Permit Application <br /> Date Building Permit Issued _ __ __ . <br /> ❑ Prescriptive Palh - - <br /> -- _ <br /> Date ol Insulation Inspection__ . ____ _ _ __ . __ <br /> ❑ Component PeAormance Date of Final Inspeclion <br /> ❑ System Analysis <br /> I herehy certlly fhaf fhle bullding or addlflon hae been Inspecfed lor fhe measures requlmd <br /> by fhe 1881 Washington Sfafe Energy Code(WSEC), thet If Is!n aubsfanf/al compllance <br /> wlfh fhe WSEC,and thaf the WSEC checkNst for fhls bullding Is on llle. <br /> Signalurc ol DuAdi�g 011idal or Authorited Representatrvo <br /> Datn <br /> ReWrn whlle capy lo: Kalhleen Skaar, Washinglon State Ener�y Oflice, 809 Lugion Way SE.FA�11. Ol sacaonWi�rn 9Copy ' 6'-g1 <br /> WSL-O-While CopY U(iliry�Owner�Canary CoPY <br />