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INGTON (~ `' <br />oil <br />Building Record � #d � <br />RMWink <br />y <br />(please check one) <br />�lew Building,, El Addition over 500 sq. ft. <br />Jurisdiction <br />please check one: [?city ❑ County <br />A. Site Information <br />Address 1J <br />city zit) <br />Assessor's Propedly Tax #/ (or attach legal descr'ution) : <br />[ wa — u Z �' -- <br />Servicina Electric Utility Qw� <br />C. If Single Family, Zero Lot Line or <br />Planned Unit Development <br />Total Conditioned Floor Area _ 2T sq ft <br />Second Duplex Unit_ _ -. — <br />A. Primary Spare Heat Type <br />(check ore) <br />❑�-� <br />Baseboard <br />/Electric <br />LrJ Electric Wall Heater <br />❑ <br />Electric Furnace <br />❑ <br />Electric Heat Pump <br />❑ <br />Other <br />(please check one) <br />13Single Family ❑ Duplex <br />❑ Multifamily ❑ Zero Lot Line Home <br />❑ Planned Unit Development <br />Permit # 73 7 7 <br />File ID # (if different from Permit 0) <br />B. Owner Information <br />Owner(owrwatrimeofwm-waionmwvesyY!kPeY?ren0 <br />4 [l11. ll %ii9)1'Ck� <br />Coma <br />Address :z Z z- - ,i :2.,ii <br />City" 'L a ) 4 ) )/- Stateu 4 zip YZ- <br />Phone ( , r, 1>i 7- % <br />Federal It)* or SSN <br />D. If Multifamily (R-1) <br />Total # of Buildings <br />Total If of Units <br />Total sq. optional <br />B. Back -Up Space Heat Type <br />(check an that.pply) <br />❑ None <br />❑ Wood <br />❑ Electric Baseboard <br />❑ Other (specify below) <br />F ��irwwrrs __ <br />This building meets the <br />El Electric <br />❑ Other Fuels <br />requirements of the WSEC. <br />WSEC Compliance Method <br />❑ Prescriptive Path <br />U3" Component Performance <br />❑ System Analysis <br />C. Water Heat Type <br />(check one) <br />2'Electric <br />❑ Gas <br />❑ Other (specify below) <br />Date of Permit Application " Z <br />Date Building Permit Issued"` <br />Date of Insulation Inspection 1 ? 174 17 <br />Date of Final Inspection <br />1 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 compllanre <br />with the WSEC, and that the WSEC checklist for this building is on file. <br />Signature of Building Official or Authorized Representative Date <br />Return white copy to Kathleen Skaar, Washington State Energy Office, 809 Legion Way SE, FA-11, Olympia, WA 98504.1211 <br />WSEO - White Copy Utility/Owner - Canary Copy Judsdiclion - Pink Copy <br />7-92 <br />