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���' <br />p�x <br />9HN~ <br />y � <br />�H� <br />��~pH <br />yx <br />o�d <br />��8 <br />QY (] <br />C"y� <br />gyy <br />C]�N <br />�OW <br />�� <br />�� <br />��HINGIDN � � � <br />Building Record ��� A"�"�"` 6 <br />� <br />PROC'R �fvl <br />�a IXA3�FICATIOU = ��,� m�� <br />(please check one) (please check one) <br />x�lew Building ❑ Addition over 500 sq. ft. � Sino'e Family ❑ Duplex // <br />Jurisdiction: everett ❑ Multifamily ❑ Zero Lot Line Home�J <br />please check one: � Clfy ❑ Countv <br />A. Site Information B. Owner <br />Addres�@l3_�rant nt,_ _ Owner lav <br />CitV Fyexett Z�p 98293 <br />Assessor'S Prop� TaX #(or attach legal descnplioN : <br />SBNicinq EIBCtriC Utility PUD#1 of Sno Co <br />C. If Single Famlly, 2ero Lot Llne or <br />Planned Unit Development <br />A. Primary Space Heat Type <br />(check ane) <br />� Electric Baseboard ` ,,� <br />❑ Electric Wall Heater C�l��� <br />❑ Electric Furnace <br />❑ Electric Heat Pump C� <br />❑ Other <br />itch <br />Federal ID# or SSN <br />D. I( Multifemily (R-t) <br />Total p ot Buildings <br />Total # of Unils <br />Total sg. ft. (oplional _ <br />B. Back-Up Spece HeatType <br />(ehaek ell fhat eppty) <br />❑ None <br />❑ Wood <br />❑ Eleclric Basehoard <br />❑ Other (specily below) <br />C. Weter Heat Type <br />(cheok one) <br />❑ Eiactric <br />❑ Gas <br />❑ OthBf (spxitybelowJ <br />This byllding m s the WSEC Compllence Method Date of Permil Application i1-10-92 _ <br />�Electric ❑ rescriptive Path Date Building Permit Issued �1-_/ � <br />❑ Olher uels �omponent Performance Date of Insulation Io5p2c[ion '=J�� <br />requlreme s of the WSEC. ❑ System Analysis Date of Final Inspection �-2%-�� <br />I here6y certlly that fhls 6ullding or addlflon has been inspecfed /or the measures required <br />by fhe 1991 Washingfon State Energy Code (WSEC), thatlt Is /n substanflal compllanre <br />!th th WS a and t at the WSEC check/!st lor )s 6ullding Js on /Ile. <br />1��1�'j; � ,. %�.� �- �,_�� � <br />or <br />Date <br />Return whita copy to: Kathleen Skaar, Washington State Energy Office, 809 Lr�gion Wav SE, FA-11, Olympia, WA 98504-1217 <br />.. - � -- -- - - � ---- --- ... --- -- -- --�------- --- ----- --. ..---�- — <br />WSEO � Whife Copy UfilityKhvncr - Canary Copy Junsdiclion � Pink Copy <br />7�92 <br />