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<br /> ; �� Building Record ��;�# �"` B
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<br /> y � H ', (Please check one) (please check oneJ
<br /> K y � �New Building, ❑AddiHon over 500 sq.fl. �Single Family ❑Duplex
<br /> o� � o� Jurisdiction� � ; '� - ', ';'�' , '�_ ❑Multifamily ❑Zero Lot Line Home
<br /> y y H _ ❑Planned Unit Deveiopmenl
<br /> x� � � , pleasecheckone: ��CitV ❑Countv Permit� ' �';;1 _
<br /> � N .7 � Flle ID#�ff dillerent trom Permit pi _
<br /> H [�i7 �y i `:`?,��m�,'" *ss�..�d,�.",�'.�'� �:�',. . ��j���':n,-- - .-_ t a�gCnfiyy �
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<br /> y y � A. Site Info.matlon B. Owner InformeUon j
<br /> r Fy y � Address 4.'�. =,� G�.c:.�/_ ��CJ,J Owner lavneraftimeolowismictanreceivesuN�ypa�menp I
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<br /> o t7 tn Citv / .�. ,�r' ZiD `7���UJ COmPanY ✓ u P >' G.0 ,./�—�— .
<br /> � [� t' � Assessof S PrOpe�Tax#(arattach legal description/: AddrBSs � _'�' 7 /�`%*f'Cu c•.: �_
<br /> �-3 O V! � i i -1 i. �? � l � /�i Ci11V A�` 1 /�7 � i� ,.� � .5'1818 i ld�I� �%�(: ' /i i
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<br /> i Servicing Electric Utihty��, � i i!,�__ Phone ( 1� % ) �� ;,�'�/,'.
<br /> I Federal IDq or SSN /� - '�i S .� , ' G,
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<br /> � C. If Single Fam�ly,Zero Lot Line or D. If Multlfamlly(R-1)
<br /> � ' Plar.ned Unit Development Totel#of Buildings �
<br /> `���� � Total_Conditioned Floor Area /�S Ia s fL Total#of Units
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<br /> Secord Du lex Unil s .ft. To al s . f o i I
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<br /> j ,�.-. : , :, ,:t. I�ATSOIIRCE
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<br /> � i�� � A. Primary Space iieat Type B. Back-UP Space Heat Type C. Water Heat Type
<br /> I (checkone) (checkel thefapply) (che�kone)
<br /> � ❑ Electric Baseboard ❑ None ❑ Electric
<br /> _- i � Electric Wall Heater � Wood ❑ Gas
<br /> � Electric Furnace ❑ Electric 6aseboard ❑ Other�specirybemw)
<br /> j ❑ Electric Heat Pump ❑ Olh2f(specitybel. .)
<br /> ' ❑ Other
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<br /> � _��CWMPLIANCE � � IMSPECTIOMIENFORCEMENT `>-;� ,�
<br /> -,�I This building meets the WSEC Cumpllence Method Dale o! Permit Application _,_ > >-_-� ;
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<br /> � Eieclric � Prescriptive Palh Date Building Permit Issued ___/�_' � L j
<br /> � ❑ Other Fuels ❑ Component Perlormance Dale of Insulation Inspection - _ ��
<br /> ! requirements of the WSEC. ❑ System Analysis Date of Final Inspection 5 - - s`..> ;
<br /> 1 here6y certlty that fhls bWlding or addit/an has been lnspected for the measures requlred !
<br /> , by fhe 1991 Washington State Energy Code(INSEC), thaf!t!s!n substa�'.'al complian�e !
<br /> wlfh fhe WSEC,and fhat fhe WSEC check!!st/or fhls 6ullding!s on Iile.
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