Laserfiche WebLink
SW'1'�A7H' �ENGIDN <br />�� <br />��� <br />� <br />Building Record <br />��S,��as�o� , . , : <br />�(plea� check oneJ <br />L�'New Buildi �❑ Addition over 500 sq. ft. <br />Jurisdiction� � �B�i <br />please check one• CitY ❑ CoufltY <br />C. It Singie Family. Zero Lot Line or <br />Planned Unit Deva <br />A. Primary Space Heat Type <br />(chxk one) <br />�❑ lectric Baseboard <br />lectric Wall Heater <br />❑ Electric Furnace <br />❑ Eleciric Heat Pump <br />❑ Other <br />� <br />First <br />Unit <br />0` L--�-I� <br />Attachment B <br />(ple e check oneJ <br />Single Family ❑ Duplex <br />❑ Multi(amily ❑ Zero Lot Line Home <br />❑ Planned Unit Develo ment <br />Permit# �lo��% <br />File ID # (ildiNerentlrom Peimitll� <br />B. Owner Infortnation <br />Owner (owneratomeo)constructlonreceiwsutiliryEaymerrt) <br />COmpany ,n2 � <br />Address �� ZY %7 o n <br />;,itv �tP/�1.�Xi Statel.[J%i- Zip %rf2GL3 <br />Phone ( 2U�o ) �j ��i7�v^— <br />B. Secondar�/ Space Heat Type <br />(check all f tat app7yJ <br />❑ None <br />❑ Wood <br />❑ Electric Baseboard <br />❑ Other(specilybelow) <br />.. . . . . ... ... .. .. <br />CD�IPLIANC� . ' _ <br />, <br />... .� Qar Heal P�rrp Onh) <br />WSEC ompliance Method <br />Prescriptive Path <br />❑ Component Pertormance <br />❑ System Anaiysis <br />This building meets the <br />❑ electric� <br />❑ other fuels <br />requirements o( the WSEC. <br />ft. <br />E. li Multifamily (R-1 <br />Total # ot <br />C. Water Heat Type <br />(check one) <br />-��Electric <br />❑ Gas <br />❑ Other�SPecrryberow) <br />? INSP�CiNqNIEN�QRC�AlI�N1T <br />� - - <br />Date ot Permit Application �7 /(o -%� <br />Date Buildinq Permit Issued �'S / � <br />Date o( Insulation Inspection -� 23'r7S� <br />Date of Final Inspection /r� — ti—Q,S <br />1 hereby certi/y that this building or addition has been inspected for the measures required <br />by fhe 1991 Washington Sfate Energy Code (WSEC), thaf it is in substantial compliance <br />wiffythe WSEC, and jt;af ihe WSEC checklist for this building is on /ile. <br />of Building O�ficial or <br />Da!e <br />� Return canary copy lo the servicing eleciric utility to irigger WSEC compliance payment <br />Return white copy to: Kathleen Skaar, Washington Stale Energy Olfice, P.O. Box 43165, Olympia, WA 985043165 ��-°'-J <br />WSEO - Whits Copy Utility'Owner - Canary Ccp}� Jurisdiction - Pink Capy <br />