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SW'1'�A7E G� <br /> �� Building Record W$EOCaitract# A�� B <br /> ��� <br /> CI.ASSIfICATiON <br /> (please check one) (please check one) <br /> ❑New Building �Addition over 500 sq.ft. ❑Single Family �Duplex <br /> Jurisdiction: �+ ',P� ❑Multi(amily ❑Zero Lot Line Home <br /> ❑Planned Unit Develo me t <br /> pleasecheckone: � CitV ❑Cou�ty PerfTtit# >Zp< <br /> Fi le I D#{i!di(lerent Iram Permit 1!� <br /> ' CDlISTRUCTiON <br /> A. Site In(ormation B. Owner Iniormation <br /> Address �(p � n P/+Flzc„ (/�- Owner owne�albmeolconsVucNonrec i�sutili errt <br /> � -f/t J <br /> Citv :e Zip �.��0� Com an ' <br /> AsS05S0�s PropBrtV Tax#(or arcach leqal desniption): Add�esS !� %� cc L`-�� <br /> ��'�i. '0 � -O ) - l 7 _ Cit .v_ Stat Zi D. <br /> Servicing Eledric Utilitv , C< {� Phone ( a0/� ) �J�� - S�Jp <br /> C. It Single Family,Zero Lot Line or D. Duplex E. It Multifamily(R-1) <br /> Planned Unit Development First Duplex Unit sq. N. Total#of Buildings <br /> Total Conditioned Floor Area sq.ft. Second Duplex Unit sq.ri. Total#of Units <br /> t <, , ,:. <br /> < :- ��{�Y�Q��C� <br /> A. Primary Space Heat Type B. Secondarv Space Heat Type C. Water Heat Type <br /> (checkone) (checkall tbafapply) (checkoneJ <br /> ❑ Electric Baseboard ❑ None � Electric <br /> ❑ Electric Wall Heater ❑ �Vood ❑ Gas <br /> ❑ Electric Furnace ❑ Electric Baseboard ❑ Other�speci�y be�ow� <br /> ❑ Electric Heat Pump ❑ OIIIEf(specily below) <br /> ❑ Other <br /> CtlMPL1ANC� , ; !NlS��CTIp�1/�t�O�C�II�T . . <br /> (Ior Hea�Portp Only)� <br /> WSEC Compliance Method This building meets the Date of Permit Application �/�- ��� <br /> �Prescriptive Path �, eleciric Date Buiidinq Permit Issued //-9-�� <br /> ❑ Component Per(ormance ❑ other fuels Date of Insulation Inspection <br /> ❑ System Analysis requirer�ients of ihe WSEC. Date oi Final insqection <br /> I hereby certi/y that this building or addition has been inspected for the measures required <br /> by the 1991 Washington Stafe Energy Code(WSEC), that it is in substantial compliance <br /> with the WSEC, and that the WSEC checklist for this building is on/ile. <br /> Signature of Building OHicial or Authorized fiepreseniative Date <br /> Return canary copy to the servicing electric utility to trigger WSEC compliance payment <br /> Reiurn white copy to:Kathleen Skaar,Washington State Energy Otfice, P.O.Boz 43165, Olympia,WA S8504-3165 �Z�9Z <br /> WSEO� White Copy Ut�4ty/Owne�-Canary Copy Jurisoiction-Pink Copy <br />