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<br /> WASHINU,TON �_ ' � ; I
<br /> �� Building Record WSEOContraCt# A��� B �
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<br /> � ;`�� ' L ,�; � CLASSIFICATION % , i'' _ ;f.F �`x'�:
<br /> � �. �. ,
<br /> �(plea�check one) (please check one) I
<br /> L'i'New Bufldin ❑AddiNon over 500 sq.ft. ❑Single Family ❑Duplex '
<br /> Jurisdiction: (/ o���jL��'� �family ❑Zero Lot Line Home
<br /> r-�� ❑Planned Unit Develo ment '
<br /> please check one: L7 l:lly ❑Counry Permit# / �
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<br /> FiIB ID#(1/diflerent lrom Permit A1 ' � �
<br /> " °' CONSTR C ION h ' '
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<br /> w. ii�. v � n�'.�,C. .�... :� ..^�'':�SV..T..s.
<br /> A. Site Information B. Owner Information
<br /> Ac�dress 2S(�J�3 �1_I/m,iS-c i' i Owner (amer at tlme al wrutruconn mceiyes ubfiypayment)
<br /> Ciry J Zlp COrtI an
<br /> Assessor'S PfOperty TeX#(or attach legal desaiption): Add�BSs o � Slr Lo
<br /> Ci J�a�.2 State Zi 2fJ(o
<br /> Servicing Electric Utiliri /,/17 Phone (�OL ) 33q- ls79S
<br /> Federal ID#or SSN
<br /> C. If Single Family,Zero Lot Line or D. If Multifamily(R-1)
<br /> Plenned Unit Development Total#of Buildings
<br /> Total Conditioned Floor Area ,390(o sq. ft. Total#of Units �'j ''_
<br /> Second Duplex Unit sq.ft. Total sq. ft. (optional) 39a(y
<br /> i • -L . p n�u. ..,..e,..,.,:...r,.r,.a-. � n r� �r� • - : '
<br /> � ,'k ,��, � �:s;�: - - -"��.,�' .T�=;;,;�:�:HEATSOURCE`��� ��',��� '�� ..���.�.. ::'��. �.'� .'�
<br /> A. PHmary Space Heat Type B. Back-Up Space Heat Type C. Water Heat Type `;;_-_
<br /> (check one) (optlonal,cAeck aU thaf app/y) (optlonal, eheck one) :.. �;Q:��v
<br /> ❑ Electric Baseboard ❑ None Electric i
<br /> ❑ Electric Furnace ❑ Wood ❑ Gas �' �
<br /> ❑ Electric Heat Pump ❑ Electric Baseboard ❑ Other�speciy beiow� _
<br /> � Other �speary oerow) ❑ Other(spec�y be�ow) _ ��` .
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<br /> '�._\ . >� COMPLIA C '�.�C� Y h,.:'� T-y,��,...�..�,.,..._.r,�.,—..Y..,,�.�,.�., .
<br /> � u_, :.:; '= `� '.1NSPECTION/ENFORCEMENT;;�'��; �
<br /> SEC Compliance Method Date of Permit Application rf-a/y- ���
<br /> Prescriptive Path Date Buildin Permit Issued -
<br /> Component Performance Date of Insuiation Inspection ' -9 ��"` ��
<br /> ❑ System Analysis ,5' r�,,�o�ai'S3 Date of Final Inspection Z.- Z 8�9 �
<br /> I hereby certlly that this bul/ding or addlHon has been lnspected ior the measures requ/red
<br /> by the 1991 Washington State Energy Code(WSEC), that!t!s!n subsfantial compllance
<br /> wit WS C,and that the WSEC checklist for this building is on file. �
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<br /> Signature ol ding OHicial or Authorized Represenlative Date �
<br /> Return white copy to: Kathleen Skaar, Washington State Energy Office, 809 Legion Way SE, FA•11, Olympia,WA 98504-1211
<br /> WSEO• lNhite Copy Utility/Owner-Canary Copy Jurisdiction-Pink Copy g.g�
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