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. �� <br />�►-�� <br />... , <br />.:�� -' <br />Building Record <br />se check one) <br />�taw Bullding ❑ dditlon ov r 500 sq. ft. <br />Jurisdiction• ���.�llP�l.�� <br />please chedc one: City ❑ C011�ty <br />A. Site Information _ <br />Address � <br />r�ti. L I r-�A D i Zio _�� <br />ASSesso�'S Pf�O e Tax # orattach le al descn tion _ <br />.J <br />Servicinq Electric Utility � �� <br />C. If Single Family, Zero Lot Line or <br />Planned Unit Developmant <br />Total Conditioned Floor Area 2 sq. ft. <br />Second Duplex Unit /Z3 sq. ft. <br />A. Primary Space Heat Type <br />(cheek one) <br />❑�flectric Baseboard <br />lJG Electric Wall Heater <br />❑ Electric Furnace <br />❑ Electric Heat Pump <br />❑ Other <br />��� <br />(please check one) <br />❑ Single Family Duplex <br />❑ Multifamily ❑ Zeio Lot Line Home <br />❑ Planned Unit Develo ment <br />Permit # / 3 �� % <br />Fil2 ID #(t! tliHeren� trom Parmit A1 <br />B. Owner Infortnetlon <br />: �.:.r�--�� ��:..��� � <br />Owner (awr�erarnmeoroonsm�ctbnrecrWesu�'aavme^0 <br />Compan YI <br />Address <br />�� 7 State / i Z <br />Phane ( 2010 ) /09,�—•�//J,L(� <br />Federal ID# or SSN <br />D. If Multifemlly (R-7) <br />Total # of Buildings <br />Total # of Units <br />Total sq ft (optionap <br />B. Back•U� Spece Heat Type <br />(e eek a fhet epply) <br />None <br />❑ Wood <br />❑ Electric Baseboard <br />❑ Other (specilybelow) <br />��aa.'t&M ,.:'.d a x,+u.:i:#'r� M �i � � f N �'�»+,i�.�'�C� .. <br />s fi?It'-��t3 ��'3�::.sldJl�.i.A�...+—�� �.�.i.4.trt,r.,,. <br />This bu Ing meets the <br />Electric <br />❑ Other Fueis <br />requirements oi the WSEC. <br />WSEC Compllance Method <br />❑ scriptive Path <br />Component �erformance <br />❑ System Anaiysis <br />1 hereby certUy that this <br />by the 1991 Washington <br />wlth ►he WSEC/pn� tha) <br />o� Builtlinp OtfiCial or <br />C. Water Heet Type <br />( eek ons) <br />Electric <br />❑ Gas <br />❑ Other (specirybe�ow) <br />� <br />Date ot Permit Application 7� <br />Date Buildinq Permit Issued ^ <br />Date oi Insulation Inspection /—G'9� <br />Date of Final Inspection S-S-� <br />or addltion has been Inspected �or the measures requi <br />�gy Code (WSEC), that !t !s In su6stantlal compliance <br />ch st tor Ihls bullding Is on /lle. <br />,� �- c C--�' �/ <br />Date <br />Return white copy lo: Kathleen Skaar, Washington State Energy Office, 809 Legion Way SE, FA-11, Olympia, WA 98504-1211 <br />WSEO - Whife Copy Ufility/Owne� - Canary Copy Junsdiclion - Pink Copy <br />7�92 <br />