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1.. � � <br />,� .... <br />� �_� i <br />, <br />,� _; � <br />.�� <br />: �fr. . <br />Building Record <br />�cnsdr onsJ <br />N�w Bulldl�q ❑ Aa�IUon over 500 �4• ft• <br />�udad�t+on• �",�l 01= E��r�� <br />piws c�Mdc ons: � CitY ❑ CountY <br />A. Slb Intorm�tlon <br />Addrese (e,�0 � <br />Ciri � � zia 9 �v3 <br />U <br />As esa r's Pro e Tex N a rnach k+I drs m n: <br />a O �- ' <br />3ervic;i Electric Utfli o �_� � <br />C. M SInpN Funlly, Z�rc Lot Lin� or D. Dup� <br />Pl�nn�d Unit D�w�opm�nt � First <br />A. Prinu�ry SP�a Ns�t TYP� <br />le►�* onq <br />❑ Electric Baseboard <br />� Electdc Wall Heater <br />❑ Electric Fumace <br />❑ ElecMc Heat Pump <br />❑ Other <br />WSEC Compll�na 11NMod <br />�Prescriptive Path <br />Component Perfortnance <br />❑ System Analysis <br />that <br />by fhs 1DD1 <br />Aldclrw�t ` <br />YME�OCa�tractN <br />ra�s.� �n� a,�� <br />�Single Family ❑ Duplex <br />MulHfamil; ❑ 2ero Lot Line Home <br />❑ Planned Unk Deve ent <br />Permit N a � <br />File ID N tndxlerenrmom PermBM — <br />B. OwnK Inform�tlon <br />. �,,,. � <br />. . !i/��/,�'�11�—'L� • <br />. . �i .��i , ..i � . <br />• , : . / , tC � <br />Unit <br />B. ��t iva�rJ � 7YP� <br />None <br />❑ Wood <br />❑ Elect�ic Baseboard <br />❑ Other (apecirrbelo�') <br />Ror �.w nns �rl <br />Thls bulldlny mests the <br />� electrlc <br />❑ other fuels <br />roqylnm�nb of th� �NSEC. <br />E. M Multlhi <br />R, Total A of <br />C. d�ibro�t TYP� <br />� Electric <br />❑ Gas <br />❑ Other (spedbbsaw! <br />Dete of Pertnit ApplMstion // aa -�l!'� <br />Date Building Pertnit Issued - - <br />Date of InsulaHon Ins ection -�— <br />Date ot Finai Inspect�on ' - � <br />thla bulfdiny a addlNon has bssn �n+Psct�d for m° measuros roqulrod <br />�ton StaN En�ryr Code (WSEC), fhat It Is In +ubshnHal compllancs <br />that tlN YVSEC cMcMl�f lor fhia build�np Is on �. _ <br />of eulklirq Olfidal or AuMorized RepreseMatNe <br />Dete <br />to the servicin electric utiliry to trigger WSEC compliance payment <br />R�tum cen�ry copY 0 <br />R�tum whlt� co to: Kethleen Skaar, Washin on State Ener Olfice, P.O. Box 43165, OI m�un W�8�4^ ��y <br />WSEO - White CnPy UOIiryNwne� • Canary CopY <br />12A2 <br />