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. � <br />. <br />�.: . <br />�'�' : � �' I � �.i � �. <br />•� <br />..� .� <br />=`�Pt�`���: ' `'}, �. t � <br />(ple e check one) <br />New Buildin _❑ Additlon over 500 sq. tt. <br />Jurisdiction: � �Jh°.) r� i <br />pleasecheckone: Ciry ❑CountV <br />(plea check one) <br />ingle Family ❑ Duplex <br />❑ Multifamily ❑ Zero Lot Line Home <br />❑ Planned Unit Develo ment <br />Permit # %2 <br />File ID #(i! diHerent !rom Permit N� <br />A. Site Infaffna� n 8. Owner Information <br />Address ( � Owner (ownerarfimeotronswctionreceivesu6Gtyaarmenp <br />Ci ,¢nQ Zi _�� Com an � <br />Assessor'S Pro e T�c # arattach/e a/descn tion : AddreSs " 2 <br />,Lp 3 �, ,�- yL _ Ci . . Stat i� Zi J� <br />Servicina Electric Utility �n ('� [� Phone ( 2G'G� ) 3�_7 �� 7Z9 <br />C. If Single Family, Zero Lot Line or D. Duplex E. If Multifamily <br />Planned Un(t Development First Duplex Unit sq. ft. Totai # of Buil <br />'s, <br />�9n).4 `�y�ef� U k�2] b J�. ` . � 4� . . 5Y� . <br />Z..k�`.tY4+.�4�L+L '` 1. �.Lm La <br />A. Primary Spece Heat Type <br />(cheek one� <br />❑ Electric Baseboard <br />� Electric Waii Heater <br />❑ Electric Furnace <br />❑ Elect�c Heat Pump <br />❑ Other <br />B. Secondark Space Heat Type <br />(eheek all f at apply) <br />❑ None <br />❑ Wood <br />❑ Electric Baseboard <br />❑ OthBf (specilybelow) <br />C. Water Hoat Type <br />(chaek one) <br />,� Eiectric <br />❑ Gas <br />❑ Other (spacilybelow) <br />Qw Heat Pump OnN) <br />WSEC Compliance Method This building meets the Date of Permit Application /a-/(� ->'-y� <br />� Prescriptive Path � electric Date Buildinq Permit Issued �T /-9h <br />❑ Component Periormance ❑ other iuels Date of Insulation Inspection �-IS-RS <br />❑ System Analysis requlrements of the WSEC. Date of Final Inspe�tion !('r-7_S - i5 <br />I hereby cert!/y that thls bu!ld/ng or addltlon has been /nspected lor the measures requlred <br />„/by 1he 1991 Washln on State Energy Code (WSEC), that /t !s ln substantlal compllance <br />�GT� the yNSEC, an�j'�at�WSEC checkllst /or thls bu1ld/ng Is on fll�: � <br />OHicial or Authorized Representatfoe <br />Date <br />Return canary copy to the servicing electric utiliry to trigger WSEC compliance payment <br />Return white copy to: Kathleen Skaar, Washington State Energy ONice, P.O. 8ox 43165, Olympia, WA 98504-3765 <br />WSEO - Whife Copy Utiliq�/Owner • Canary Copy Junsdiction - Pink Capy <br />t2�92 <br />