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��� <br /> A�x <br /> C M <br /> � H � <br /> H�� . <br /> � M'� ��+� ''� f - i <br /> CA H W/"..7i iW� �-- ' � �B" _... <br /> y �� � 8uilding Record ��� � � � '�� � <br /> OMd <br /> �� g � --_ <br /> H g� ., , - : 1��� ,u ,. <br /> b{.yH <br /> ` �„�� ...x�, . :y J_— � (Please cbeck onel <br /> td�n please cneck oneJ qSingle Family ❑Duplex <br /> ��y �New Buildinq �Addition o•+er 500 sqlft• — ❑Multifamily ❑Zero Lot Line Home -- <br /> �� �+ iunsdiction � i / '� � �` �' � � <br /> �1 ❑Planned Unit Development <br /> zHfn -- !�%y � <br /> H O [n CitY ❑COunty Permit# <br /> P�e File ID M Uldinerentlrom Permtt+ll <br /> ��� . � '�e°&�L^6�4L�Skr <br /> am� s--�iNe�,��-r�' <br /> . - . ' y,�,z��� <br /> B. Owner IMormetion _— <br /> p. Slte Informetion — <br /> V� Owner ownerattimeolconstnicib�r�'�'�il� t <br /> Address_lU�� / � �.0 ; - ,.,,,;�<� n _ <br /> ' ComPanY � � �� u, ,, �" .,�r� -`�- <br /> c�� '.% -" z�a � �'10 � �i r-�✓� N r — <br /> �_��_ Address `d I� I � ;,, �� <br /> Assessor s Property Tax# �or anacn i_ ai desa� i�on : State� h9 Z�P I� <br /> + �. �,� h i . t- City__/1_��J �l2 <br /> I f fd � . �1� , .`f" �� � /�>/� <br /> �ol_1_ �r— J u i� _ Phone ( �o�.. ) .r= � " <br /> Servici�Electric Uliht ���z �- .-- -- Federal ID#or SSN — <br /> '�' D. H Multlfamily(R-1) <br /> C. II Single Famlly,2ero Lot Line or Total t!of Bui�dings <br /> ��� Planned Unit Development ____ ___-- Total�ot_Unils_ <br /> _ — sq.ft. <br /> � Total Conddioned Floor Area �SS_ — �� Tolal sq.it�optional) <br /> � � Second Duplex Unil__ —Sq' ' <br /> ""�` �' � ,. <br /> _T � . <br /> 1_I . - _�►T�---- --- :�t <br /> '�' f B. Beck-U� Spece Heat Type C. Water Heat Type-- <br /> A. Primary Spece Heat Type (�h�k e mai appry) _ __ �cneok o�e/ <br /> '_' �obeokone/ __ _ __ . __ - �� Electric <br /> ❑ ElecUic Baseboard �.None ❑ Gas <br /> '-' � Electric Wall Heater � WOOd <br /> ❑ Other(speci/ybelow) <br /> ' ❑ Eleclric Furnace ❑ Eleciric Baseboard — — <br /> � ❑ Electric Heat Pump ❑ Other(spec�rybeiowl <br /> � ❑ Other _ _ _ _ <br /> � -- __ — -- <br /> _ <br /> � COMPI.IANCE _ �MI�CEMENT <br /> t�' Thls bullding meels the WSEC Compllence Melhod Date ot Permit Application _- ;. _ ,_ <br /> ,�- <br /> Prescriplive Path Date Building Permit Issued /'.3=1�----- <br /> '_' �Eleciric Date o( Insulation Inspection__„����-1�-- <br /> ❑ Other Fuels ❑ Componenf Pertormance Date ot Final Inspection - �q -`� �' <br /> requlrements ot the WSEC. ❑ System Analysis - -- - <br /> 1 hereby certl(y that fhis bulldJng or addition has been fnspected for fhe measures requlred <br /> by fhe 1991 Washington State Energy Code(WSEC), thsf!t 7s in substantial compllanre <br /> ! wltb the WSEC,and fbaf the WSEC checkllsf lor tbls b/u�Iding!s on �ile. <br /> j G <br /> r'� ,. i � % � � '. % `i�:lli�:G� . �-�- <br /> ��, y . .. . - Date .. . ..�___ __ . - —_ _ — _. —_ <br /> Siqnature of BWldmg Oflidal or Authorized Rep�e,entative <br /> to: Kathleen Skaar, Washington State Energy Oflice, 809 Legion Way SE.FA-11. Olympia.WA 98504-7211 <br /> RelUrn wM�e COpy _. . . . -� - ---- � Jwisdiclion-PinN Copy <br /> R5C0-While Copy Ulility/Owner-Ca�ary Copy <br /> �92 <br />