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INGTON i`1 i^.. <br /> � Building Record ��# "`�°"` B <br /> �� <br /> (please chedc one) (please check one) <br /> �lew Bullding�pddiflon ov�r 500 sq.ft ��gle Family ❑Duplex <br /> Jurisdiction•. l��,,T_�i�/i}p�� ❑MuNifamily ❑Zero Lot Line Home <br /> ❑Planned Unit Develo ment <br /> � please checic ona: CIt4 ❑COUO�V P9ffTllf# �p �� <br /> FI IB I D#(il diHerenf from Permit M <br /> A. Site Iniormation B. Owner Informatlon <br /> Address Q - Owner avneraffimeo7ttxu6uchbnreceivasuh, � <br /> Cit Zi <br /> Com an <br /> ASSBSSOr'S Pr0 ert T2X# o�att hl aldesai tian : AddreSS <br /> LD 2 ._S' .,rf /,� �i oa>� State Zi �� <br /> Servicina Eiectric Utiiitv � �� !J �d1Z Phone (ZQ�� � _� qq <br /> C. It Single Famlly,Zero Lot Line or D. Duplez E. If Multifamily(R-1) <br /> Plenned Unit Development First Duplex Unit sq.ft. Total#of Buildings <br /> Total Conditioned Floor Area s .ft. Second Du lex Unit s . R. Total#of Units <br /> A� P�ti.mcrer o s Pace Heat Type B. Secondar�r gpece He�t Type C. Weter Heet Type <br /> (chxk d/t et�PP�YI (ehsck one) <br /> ❑�Electric Baseboard ❑ None Electric <br /> ✓U Electric Wall Heater ❑ Wood ❑ Gas <br /> ❑ Electric Furnace ❑ Electric Baseboard ❑ Other�specrrybe�ow� <br /> ❑ Electric Heat Pump ❑ Other�speciry beiow� <br /> ❑ Other <br /> Qor Hset Pump Ony) <br /> WSEC Compliance Method This building meets ihe Date of Permit Application /Z-7-9t� <br /> �Prescriptive Path ❑ electric Date Buildinq Permit Issued /-�- � <br /> ❑ Component Pertormance ❑ other fuels Date of Insulation Inspection Z,-(o -9 S <br /> ❑ System Analysis requirements of the WSEC. Date of Final Inspection 4- ��_ 9 S <br /> I hereby cerilly that th►s bullding or addlt has been lnspected/or the measures requ/red <br /> by fhe 1991 Washl ton S Energy e(WSEC, that!t Is!n substantlal compUance <br /> �wlth t WSEC, t WSEC c llst/ s bulld/ng Is llle. <br /> ' ���j�- <br /> S nature ot Building Oflicial or Authorized Representati Date <br /> Return canary copy to the servicing electric utility to trigger WSEC compliance paymont <br /> Return white copy to:Kathleen Skaar,Washington State Energy Otfice, P.O. Boz 43765,Olympia,WA 98504-3165 <br /> WSEO-White Copy Ufility/Owner-Canary Copy Jurisdiclian-Pink Copy <br /> 12�92 <br />