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... <br />C_ <br />cirr oF <br />BU/LD/N6 <br />3Z00 CEO�OR 5T. EYERE7T. <br />i <br />r_�- .��.;��-���--`�Ll� <br />C� <br />Ev��rr <br />oivrsioiv <br />//GI �/ZO/ (20i) <br />3 9L� <br />25l.sB/O <br />About thla torm: This fortn isnl es ImroNed as ft boks, beceuse you ony use poAbna oi 41or a partialar <br />condense tlhe reqairements t al applYtt your pro ijed. it la also an exceAe�M tool for leart�inp lhe res et�lal <br />WSEC requlremeMe. <br />Requlrements are prouped by toundatbn,lraminp, lnsulatbn, and final inapectbn phases. Thls not ony !ats <br />the torm t�choose comPl ence options that best suttthe eaoramks and desipn o(�you� projedlremeMs. Use <br />A desipnated depaRmerrt eneryy speciatlst can help you wrih your questiona. This tortn will help you aomply <br />w'.th the WSEC as qukkly and painlessty as possible. <br />Responsibllity for Intormatton: Although statt members will help you wfth qenerai questions about <br />completin9 this tortn, Il (s utttmately your responsb��ftY to provide detalled Inlortnation about headnp syslema, <br />plazirp, insulatbn, and other building spedtications. Be sure to get prbr approval from the Departmerd M you <br />later wish to make changes In your proJect. For more requirement detail, refer to the Washlnpton State <br />Eneryy Code,1991 Edribn. <br />Pape 1, Compliance Optlons: Select one compliance optbn at ihe top of the table. <br />3 • <br />Pages 2 throuph 6, In the shaded boY arees oniv: Provide Inlormalion end checkcircles t t <br />4 RE,OU.IRED• andcHINSPECTIO�ROVEDaorSinnboxes lo� edi nenon' shaded areas (T ese IAar9.lor <br />depaAme�t use). <br />Since this fortn will be evaluated for completeness and aocuracy, you can avoid unecessary pertnR delays <br />by caretully providing ali required Inlormation. You may disregard items that donY address your particuler <br />building or equipment. <br />5 Compllaace responsibltlty: This form wiil ultlmately be usnd tor ali WSEC field inspedions. When ft le <br />chedced by t e�Bui di giDepartmenl. This denotes whkh WSEC equi ements pplylto yourllProleabThe <br />(nspector will inspect your dwellinp against these checked items and, when deemed acceptabie, piace a <br />second chedc In the 'INSPECTION APPROVED" column. ^„�,� n nrt f2 � <br />All Residential <br />APR 19 19�'3 <br />ri1 ,' C <br />���+li• P�fhll� <br />Occupanc�es <br />Electric Heat source �eX��ua�n9 near P�mns� <br />