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Building Record. """'` <br />5(pease check one, LJp,,ease check deal <br />1:WC Building ❑ Addition over 500 sq. ft. ,l, Single Family ❑ Duplex <br />Jurisdiction: 1.L 7 % j, ,; - r Multifamily ❑ Zero Lot Une Home <br />❑ Planned Unit Development <br />lease coed or,e: Ciry ❑ COUnri Permit M <br />File ID # odr m tram Permn,I <br />D n SA <br />A. Site Information <br />Address .r [+1 r`,. n .,(�, ' ✓n <br />city /)�' Zio NC O/ <br />Assessor's Propq Tax Nroraoach kcaldeurwrim): <br />.9251- /J•rip 7b <br />Servicino Electric Utility ]-,, ,, (i,—�i' �+ rj <br />B. Owner Information <br />Owner tmrwatrmeofc <br />Company <br />Address O l- Oti-1 <br />s <br />City Zip 1r;�7 t9�L <br />Phone <br />Federal IDkorSSN <br />C. It Single Family, Zero Lot Line or D. If Multifamily (R-1) <br />Planned Unit Development Total a of Buildings <br />Total Conditioned Floor Area ry-.. — sq. ft. Total # of Units _ <br />Second Duplex Unit sq. ft. Total sq. h. (optional) _ - <br />• <br />A. Primary Space Heat Type <br />B. Beck -Up Space Heat Type <br />C. Water Heat Type <br />(check oratl <br />idwk ae 1h.PI y) <br />(check deal <br />❑ Electric Baseboard <br />None <br />Electric <br />M Electric Wall Heater <br />❑ Wood <br />❑ Gas <br />❑ Electric Furnace <br />❑ Electric Baseboard <br />❑ Other (spedrybebw) <br />❑ Electric Heat Pump <br />❑ Other (specaybelow) <br />_ <br />❑ Other <br />This building meets the WSEC Compliance Method Date of Permit Application- <br />S Electric ❑ Prescriptive Path Date Building Permit Issued <br />❑ Other Fuels �O component Performance Date of Insulation Inspection 5' - ZS - `13 <br />requirements of the WSEC. ❑ System Analysis Date of Final inspection 9 /:, Q 1 r <br />I hereby certify that this building or addition has been Inspected for the measures required <br />by the 1991 Washington State Energy Code (WSEC), that It Is In substantial complienre <br />.with the WSEC, and that the WSEC checklist for this building Is on file. <br />Sig,,aturgO Building Olflgal of Authorized Representative bale <br />Return white copy to: Kathleen Skaar, Washington State Energy Office. 809 Legion Way SE FA-11 Olympia, WA 98504.1211 <br />-__ WSEO - {Mite Copy Maylowmer• Canary copy Junsdcfion - Pink Copy <br />Fez <br />