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SWTA�TE � <br /> �E Building Record WSEOConh�dCt# A��� B <br /> �oG _ <br /> "- �: : _. " 1 ATIOM�.,�,; <br /> (please check oneJ � (please check one) <br /> ❑New Building �$Addition over 500 sq.ft. ❑Single Family �Duplax <br /> Jurisdiction: �,rP:p {-� ❑Multifamily ❑Zero Lot Line Home <br /> ❑Planned Unit Development <br /> �ease cnecAone: � Citv ❑CountY Permit# C y DZ� 6 <br /> FilB I D#1 i!diHerenf Irom Permit 1!I <br /> A. Site Information B. Owner Information <br /> Address � 7dS ��n�n� D� Ow�ef (avnerath'mao/mnstnicoonreceivesutil'MpaymenU <br /> cit�_ F_��,� y �iA Zip �j�,F20_3 Com an ic <br /> ASSe5S0�'S PropBrtY T8X# (or attach lesal descripfioN: Add�BSS 7� 5 �2n��: u,l�r <br /> 343 � DOZ no4 QS �5 Citv f-„o.ofl Statei.u� Zip 9,f r, <br /> Servicinq ElectricUtilit�}.U•� .*I o� Sw..�c.,�� Ga, Phone ( 2G(c 1 �53 —GU� �j <br /> Federal ID#or SSN <br /> C. Ii Sfngle Famiiy,Zero Lot Lfne or D. If Multifamily(R-1) <br /> Planned Unit Development � Total #of Buildings • <br /> Total Conditioned Floor Area sq. R. Total #of Units <br /> Second Duplex Unit �0.38' sq. ft. Total sq. ft. (optionap <br /> , , H -50 CE <br /> A. Primary Space Heat Type B. Back-Up Space Heat Type 'C. Water Heat Type <br /> (eheck one) (cheek all fhat apply) (check one) <br /> ❑ Electric Baseboard ❑ None ❑ Eleciric <br /> � Electric Wall Heater ❑ Wood ❑ Gas <br /> . ❑ Elec;ric Furnace ❑ Electric Baseboard ❑ OthCf(spacilybelow) <br /> ❑ Electric Heat Pump ❑ Other �spec�rybe�ow) <br /> ❑ Other <br /> P.1�fA1���. � r,�,,�.:��u � ON � IiC E <br /> This bullding meets the WSEC Compliance Method Date of Permit Application y_�q_q 3 <br /> �-Electric [� Prescriptive Path Date Buildinq Permit Issued ; .- ��3 <br /> ❑ Olher Fuels ❑ Component Performance Date of Insulation Inspeclion �-z 3-93 L,z- <br /> requirements of the WSEC. ❑ System Analysis Date of Final Inspection �-/7-9 3 n�� <br /> I here6y certify that this building or addition has been inspected for the measures iequired <br /> by the i991 Washington State Ene�gy Code(WSEC), thaf it!s!n substantial compliance <br /> the SEC, a d that the WSEC checklist/or this 6uilding is on fil� <br /> Lf �',LL�� <br /> Signalu ol Building Otticial or Aulhorized Represenlaiive Date <br /> Return white copy to: Kathleen Skaar, Washington State Energy OHice, 809 Legion Way SE, FA-11, Olympia,WA 98504-1211 <br /> ' WSEO- Whi;e Copy Ufility/Owner•Canary Copy Jurisdrelion•Pink Copy <br /> 7-92 <br />