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WASHING�1 (`` i; <br /> �'� Building Record Attachment B <br /> �� �o�t# <br /> �oc�ann <br /> /y �. �q�/� y �- � � _ , ��, �2 r <br /> ' . . , :� , a ,., c : '.��,.: $;�4���fiY�`��...�� .r�:� f�;?,s.>..�. ��- _....; � <br /> i;�/ease check on,�) (please check one) <br /> ❑New Building, f�Addi�ti/on over 500 sq.ft. ❑Single Family ❑Dupler <br /> Jurisdiction: ��,[�/� v� �.(J�l�`�i �'Multifamily ❑Zero Lot Line Home <br /> ❑Pl;nned Unit Develo ment <br /> please cFreck one: C11V ❑CouMv Permit# [i�!J� <br /> FIB ID#(il diNerent lrom Permit J!i <br /> ... r� ) . . +x # d�'l ..,r,.;ns3.fi t '�.y 3 ♦ x : )r '3S mia1.�>>0v^ <br /> �Sm� � )Q-' �L Sf� �� YT J �.�' �..nf aV � <br /> , � � , ,� � � � ♦�UNS�#tUC"fiQH \ r, T � F�� r x� <br /> . : ,.ta� .� ��.��:�._ ���...��... q .�...4. ' <br /> , � �.e i x"�',���4,�. , <br /> A. Site Information �� B. Owner Infortnation <br /> AddreSS J/7/ L /JI OwnB� owneiatemeolconso-uc' nrecei�e unL mern <br /> � r <br /> City �t/�I o_�� Zia , ��� Com an <br /> Assessor's Pro ert Tax# ora ch�e ai sai eo,, : Address <br /> /O , p�j(�� ��C(� �_7- Cit � Stat� , Zi <br /> Servicinq Electric Utilityl�.�(��_/�/l/ Phone ( ��o ) 77�'lI'i�5 i <br /> C. It Single Fam ily,Zero Lot Line or D. Duplex E. If Multifamiiy(R-1) <br /> Planned Unit Development First Duplex Unit sq.ft. Total#of Buildings <br /> � Total Conditioned Fioor Area s .ri. Second Du lex Unit . R. Total#of Units <br /> � . . /i2�s ��cu�,t . <br /> ,, . . :. �� . .... � �� , ;. <br /> ' ��n� �u�c� . '; . . � <br /> � � <br /> . . :: ,�.� ... .... : .. .. . <br /> A. Primary Space Heat Type B. Secendary Space Heat Type C. Water Heat Type - <br /> (check one) (cheek all ffiaf applyJ (check one) <br /> ❑ lectric Baseboard ❑ None Elsctric <br /> �lectric Wall Heater ❑ Wood ❑ Gas <br /> ❑ Electric Furnace ❑ Electric Baseboard ❑ Other�speatyneiow� <br /> ❑ Electric Heat Pump ❑ Other(S�orry taiow� <br /> ❑ Other <br /> i'iA1VIC!LII�IGE � W'� ' � .' :°`�NISP�C'CIONtIp'tFORG�iII�';: i <br /> . .., __ . . <br /> (lor Neal Pump Only) �/ <br /> WSEC Compiiance Method This building meets the Date of Permit Application //-/,t�95� <br /> �Prescriptive Path ❑ eleciric Date Buildinq Permit Issued /2/(p <br /> ❑ Component Perfortnance ❑ other fuels Date of Insulation Inspection L- ►-9 S <br /> ❑ System Analysis requirements of the WSEC. Date ot Final Inspection �l -ZS-9S <br /> 1 hereby certily fhat this building oraddifion has been inspected/or fhe measures reguired <br /> by fhe 1991 Washington Sfate Energy Code(WSEC), tl�at it is in substantial compliance <br /> 'th the WSEC,and fha the W�=C checklist lor this buildirg is on lile. <br /> �-�-yS <br /> Si �ure of Building Of iaal or Amhorized Representative Dato <br /> Retum canary copy to the servicing electric utility ro trigger WSEC compliance payment <br /> Return whlte copy to:Kathleen Skaar,Washington State Energy Office, P.O.8oz 43765,Olympia,WA 98504-3165 �2�9z <br /> lNSEO-Whire Cop•� Utility/Owner-Canary Copy Jurisdicticn-Pink Copy <br />