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SW'TATE G� � ', <br /> �� guilding Record WSEOC�ntract# A�� B <br /> ��� <br /> Cl.ASSIFICATIOH <br /> �(F/�ase check one) (p'ease checY oneJ <br /> K�New Buildin�j Addrition over 500 sq.H. ingle Family ❑Duplex <br /> Jurisdiction: �' � pr �vr� Muitifamily ❑Zero Lot Line Home <br /> ❑Flanned Un't Develo ment <br /> please check one: Ci�y ❑Countv Permit# o� 77/ <br /> File ID#(i7dNerent7rom PermiNn <br /> r,oWsr�ucz�oH <br /> A. Site In(ormation B. Owner Infortnation <br /> Addf255 / /� (,C ✓� Own2� owneratoLmeolcon trucnoniece��rsutili e�_ <br /> / r. <br /> � �C7/1/l . h//I,P <br /> CIIY Zlp COfTI an• --7� <br /> 3�Assessor's Pro ert Tax# orattach/e aldesni tionl: Add�BSS ✓2� <br /> - oo3 - poo c�tv F���{ s i�uA z�p 9 ao/ <br /> Servicinq Elenric Utility p o u Phone ( ��(o ) a5a -a�0(� <br /> C. If Single Family,Zero Lot Line or D. Dupiex I E. If Multifamily(R-i) - <br /> Planned Unit Development_ First Duplex Unit sq. R. Total#of Buildings <br /> Total Conditioned Floor Area g, ,� sq.fl. Second D�plex Unit sq. ft. Total #of Units <br /> 'HF4T SOURCE . <br /> A. Primary Space Heat Type 9. Secondan•Space Heat Type C. Water Heat Type <br /> (checkone! (checkall tIa'applyJ (checkonoJ <br /> ❑ Electric Baseboard ❑ None Electric <br /> �Eleciric WaII Heater ❑ Wood ❑ Gas <br /> ❑ Electric Furnace ❑ Electric Baseboard ❑ Other�spea'rybeiow� <br /> ❑ Electric Heat Pump ❑ Other(specirybeiowJ _ <br /> ❑ Other <br /> CONIPLIAN�E ; v � .._: . ' INISPECTIONIENFQI�CEME`N!C �_-�. '- <br /> (lor Heal Pwrp Onhl <br /> WSEC Compiiance Method This buildi�g meets the Date o! Permit Application ��_a-g3 <br /> ❑ Prescriptive Path ❑ electric Uate Building Permit Issued %L'Z(i-Q3 <br /> ❑ Component Perfonnance ❑ other(uels Date of Insulation Inspection �1}-Q� <br /> ❑ System Analysis requirements of the WSEC. Date o( Finai Inspection 5 Z��-{- <br /> I hereby certily that fhis building oraddifiorrhas been �n�pected for the measures required <br /> the 1991 Washingfon Stafe Energy Code(WSEC), that ii is in substantial compliance <br /> / 'h the WSEC, a fh t e 5 chec list L�r this building is on file. <br /> _ �l( � <br /> Si at re ol Building Olfici�l or A thonzed Represenmtive Gate <br /> Retum canary copy to the servicing electric utility to irigger WSEC compliance payment <br /> Retum vehite copy to: Kathleen Skaar,W�shington State Energy Olfice, P.O.Box 431 G5, Oiympia,WA 98504-3165 ���`�Z <br /> LVSEO- lMiite Copy Ulilily,'Owner-Camry Copy Jurisd�cticn-Pin&Copy <br />