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W� <br /> � Buii�i�g Record ��# �� B <br /> �oGRann <br /> � � .F ,� ��,- , � i�fl- � , � ,� <br /> . x <br /> �(ple�e eheck one) (please eheck oneJ <br /> I�New Building�Addition�over 500 sq.tt. �ngie Family ❑Duplex <br /> Jurisdiction: ,I�c� C JIt��G�. ❑Multifamily ❑Zero Lot Line Home <br /> .s �% ❑Planned Unit Develo ment <br /> please check one: City ❑CountV Permit 71 Zz.J <br /> File ID#(!t dinerent Irom Permit X1 <br /> A. Site Iniormation B. Owner Information <br /> Address .� /� O �Cr � U+°�_ �wner �ownerarrmeor�onsm,cnonrecen�esumnyaavmeml <br /> CiN -!1P/�P / ZiP_ . 2�3 _ Com an <br /> Assessor' Pro e Tax# or attach le al descn tian : Add�ess ,/I i <br /> / ` Ci tate Zi 2 <br /> Servicinp Electric Utility �fl��J /1 _ Phone ( 2C//n ) 7 7�i/1/„97 <br /> Federal ID#or SSN <br /> C. If Single Famlly,2ero Lot Line or D. If Multifemlly(R-1) <br /> Planned Unit Development Total#of Buildings <br /> Total Conditioned Floor Area /��/ sq.ft. �otal#of Units <br /> Second Duplex Unit sq. ft. Total sq ft (optional) <br /> A. Primary Spac�a Heat Type B. Back-Up Space Heat Type C. Water Heat Type <br /> (check one) (check eil that applyJ (cheek one) <br /> ❑ Electric Geseboard ❑ None Electric <br /> �Electric Wail Heater ❑ Wood ❑ Gas <br /> ❑ Electric Furnace ❑ Electric Baseboard ❑ Oth@f(specitybelowJ <br /> ❑ Electric Heat Pump ❑ Other�spec�iyneiow� <br /> ❑ Other <br /> I <br /> This bullding meets the WSEC Compl(ance Method Date ot Permit Appiication �S/-9S <br /> Electric Prescriptive Path Date Buildinq Permit Issued (9-2-� <br /> ❑ Other Fuels ❑ Component Pertormance Date of Insulation Inspection �'L4-95 <br /> requirements oi the WSEC. ❑ System Analysis Date of Final Inspecti�n %-/¢9! <br /> I hereby certtly that this building or addlt(on has traen inspected for the measures requlred <br /> by the 1991 Washington State Energy Code(WSEC), that It!s/n substantlal compllance <br /> !th th WSEC, d that the WSEC checkllst for this bu!!di g!s n file. <br /> l3l <br /> Signalur 1 Building Official or Aut orized Represenlative Dale <br /> Retum whita copy to: Kalhleen Skaar, Washi�gton Stale Energy Office, 809 Legior Way SE, FA•71, Olympia,WA 98504-1211 <br /> WSEO-Whife Copy Ulility/Owner-Canary Copy Juncdicfion•Pink Copy <br /> 7�9Y <br />