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WASHING70N �: i ' <br />� Building Record <br />�� <br />(please check ane) <br />C'�New Buildin�p ❑ Additlon over 500 sq. lt. <br />Jurisdiction: / i !' _C✓�'i? 11' <br />r <br />O�easecheckone� �CiIY ❑COUO�y <br />� <br />� <br />I:�.^i ii ::u� 1 <br />CLASSIFICATION � _ _ ; <br />lplease check one) <br />❑ Single Family 0'Duplex <br />� Mullilamily ❑ Zero Lot Line Home <br />❑ Planned Unit Development _ <br />Permit# .i7?(n/ _ <br />FiIB ID # l ildHerenf Imm PermieOl <br />__ . ,.. C0118T�UCTION _. . . q,_,_, . . <br />A. Site Informetlon <br />Add_ress 7ZQ1��0 � <br />City � Zi � C2�/ <br />Assessor's Pmperty Tax # (a.attacn�ega�descnptioN: <br />,Lcf _2 _�Sf� 7- �/ }-�-�— <br />Seryicing EI_e_clnc Utilit ��d. �' U• U. <br />C. Ii Single Famliy, Zero Lot Llne or <br />Planned Unit Development <br />To�al Conditioned FloorArea '"�'�� s .c�ft_ <br />Second.Duplex Unit �� �� �q _ft. <br />B. Owner Inlormetlon <br />OwnBf rnmeralumeafmnstruclu mca'ves +nwt <br />_—�. 119:L ' , 1 {�i'v <br />Com an <br />Address � .jL�(LL'J["ti�l� ,�U <br />city Fitv,2rtt._s� ie[�' zio /r1c�'r- <br />Phone ( 2G/., 1 i ti�-7701 <br />FederallDttorSSN��=�J_��y�� _ <br />D. If MUltitemlly (R•1) <br />Total # of Buildings <br />Total p ol Units � _ <br />Tot_al sg. fl. o tion� <br />_. _._ HBAT SOURCE ` . . --_•,v. <br />A. Primary Space Heat Type B. Beck-U� Spece Heet Type C. Water Heet Type <br />(checkone) (checkel Ihatapply) _ (cbeckone) _ <br />❑ Electric Baseboard ❑ None � � Electric <br />�}'Fleciric Wall Heater ❑ Wood ❑ Gas <br />❑ Electric Fumace ❑ Electric Baseboard ❑ Olher �spenryneiow) <br />❑ Eleclric Heat Pump ❑ Olher �speurybeiaw) <br />❑ Other <br />-- <br />COMPUAlICE ' _ INSPECTION/ENFORCEMENT <br />Thls bullding meels lhe WSEC Complianee Me�hod Date of Permit Application �_, �j -iL <br />---.._.... _. _----.. - - -�---- <br />❑ Eleclric ❑ Prescriplive Palh Date_Building Permit Issued ,� f�-`/fi <br />❑ Other Fuels �Component PeAormance Date ot Insulation_Inspectlon _/I__ J�_L _ <br />requlremeNs ot lhe WSEC. ❑ Syslem Analysis Date of Final Inspection 17 Z-`f � <br />I hereLy certlly thaf fhfs bullding or addltlon has been Inspected lor the measures requlretl <br />by Ihe 7991 Waahington Stafe Energy Code (WSECJ, that it Is !n subsfantlal compllanre <br />wlfh fhe WSEC, and fhef fhe WSEC cheekllsf lor thls bulldlrtg is on flle. <br />/ � <br />_.._-_ _____-____ _.__- _..-_ ___.______=_-__ <br />59mWro ai pu Itl ng 011icial or Aulhorizetl Represenlativo Dalo _ _ _ <br />Relurn whita eopy to: Kathleon Skaar, Washington Stato Energy Oflico. 809 Logion Way SE, FA-11, Olympia, WA 98504-1217 <br />_. .__ __.__ ..__._ -_. _—__ ._— ..__ <br />WSEO-W�rfeCopy Uliliry,Yhvncr-CanaryCapy JuriStliefion�PmkCopy <br />) 93 <br />