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�i � ti <br /> � Building Record ��« "`�� <br /> �� <br /> -,. _ ��*� <br /> r r � � ��.4��1'` 'T'�e :. f`r' 7,.%�'q"`�'x, <br /> lplease cnack onel (PI ase cneck orre) <br /> �I New Building ,❑Addillor over 500 sq.fl. �Single Family ❑Duplex <br /> Jurisdictiorr. (;� r/ �T- C,i u a"Y" ❑Multilamily ❑Zero Lot Line Home <br /> ----'—�ri- ❑Planned Unit Developmenl <br /> pieasecheckone: WlCity ❑CouMy PermitA . � '>-� 7 <br /> File ID#Itttl�MerenthomPermit,q <br /> f R, i ��'' :'`a'�,� . �E��'� "r' . .'.��,.�,..+s� :�::.� `i`� <br /> A. Site Inlormetion B. Owner Intormetlon <br /> Address /,�i•- iS��-:ti -.i= _ Owner a.nererrinedmumcaonree�a:esueHvaannerrcl <br /> c-. � .°� i:�/a r <i / <br /> pily �In., 2ip t�..:�/ Com an — <br /> Mssessor'sProp�Tax�r�etta�aroescrroronl: Address �(� 1-O.�c /�-!' <br /> s ,, <br /> �f f��L�" "i; ✓i�v�it ��^i ��i..r�. i � � ��� Ci� '� S`,_ �. / . S10IB <o ti ZiP '��., JJ <br /> �., ._ �j'•'� _Y <br /> � ServicingElecMcUtiliry :2� ' ' ��" '� _ Phone � I J�Y� ),:��_7 - `>(0�'/ <br /> � FederallDkorSSN SJ�-'!.t ' /�'u-", <br /> C. N Single Famlly,2ero Lot Line or 0. If Multllemlly(R•1) <br /> Plenned Unit Development Total k of Buildings <br /> Total Conditioned_Floor Area__�l$jj_sq.it._ Total p of Units <br /> Second Duplez Unit_ sg.IL Total sq.ft.�oplional) <br /> . — r�7„ <br /> . - F • - IEAT SOIIIN�' ' - � , � <br /> A. Prlmary Spece Heet Type B. Back-UP Space Heat Type C. Water Heat Type <br /> (cneckonel ic� (check�l tMlapply) __ (checkon�)_ _ <br /> ❑ Eloctric Baseboard 7-v None � Eledric <br /> � Eleciric Wall Heater ❑ Wood ❑ G�s <br /> ❑ Eleclric Fumace ❑ Electric Baseboard ❑ Oths�(speatyDeiow) <br /> ❑ Electric Heal Pump ❑ Other�speorynerow� , ._ <br /> ❑ Other- ---. _..-- — -. <br /> �A�PIWICE _ -,`V - <br /> This�b/ullding mcets Ihe WSEC Complience Method Date ol Permit Application _.:�. 7 - y,�.� <br /> Ltl Eleclric �'Prescriptive Palh Dale Building Permit Issued__ _ .�; . <br /> ❑ Other Fuels ❑ Component Pedormance Date of Insulation Inspection_ _�`_.�_r3__ <br /> requlrements of the WSEC. ❑ System Analysis Date of Final Inspection 7-L 9-�i 4 <br /> 1 hereby certlty fhaf fhls bullding or addiffon hes been lnspecfed lor fhe measures requlred <br /> by tho 1997 Washington Sfete Energy Code(WSEC),fhat It Is In subsfanllal eompllanre <br /> ;wlfh the WSEC,end fhaf fhe WSEC chockllstlor fhls bulldfngls on llle. <br /> ;�_ /� ,__ _ , r=__-=_ - -- - ----: -=/ ._�- -- <br /> Sµ�naluro ol�JiWing Otlrtial or AulM1ori[eE Ropresaniativo Ddto <br /> Relurn whlle copy to: Kalhlcun Skaar, Washington Stato Enorgy 011ico. B09 Logion Way SE.FA-11, Olympia,WA 98504-1211 <br /> IYSEO�Lt9uroCaPY � � �" ��— � Uliliry�Ownci.CnwryCopY �– � �' — Juristlicfron.PinhCapy-"�— <br /> ]91 <br />