Laserfiche WebLink
WASHINGTON Attachment e <br /> � Building Record ►�o�# <br /> ��� <br /> ,�. <br /> �. . .-, , s , _ ,?ri� ,. <br /> . a,�� . : . . <br /> (please check one) ,(�ple `e check one) <br /> �New Buildin ❑Additlon cver 500 sq.ft. L'7 Single Family ❑Duplex <br /> Jurisdiction• [.tu o��/�V.f 9/�i ❑Multif ,rily ❑Zero Lot Line Home <br /> ❑Planned Unit Development <br /> Prease cnecx one:_ �Citv ❑County Permit# ri � T <br /> FIIe ID#I ildiflerent lrom Permit.'� <br /> �. <br /> A. Site Information B. Owner Information <br /> Address � 7- � �A CLGY ' Owner �ow�,erareRreota,nsw�eo�receNeS�n�evaerme�r� <br /> City J,���'�"i ZiP ComPanY C1/� � /��1 o_n -, <br /> Assessor's Pro e T2X# (oranacn leqal descnptioN: Address �,QO/ ��1�� -��. <br /> .. .� - CI Stat Zi Z ' <br /> Servicinq Electric Utility`�v�/� G . L�1�• Phone ( '� <br /> Federal ID#or SSN <br /> C. If Single Family,Zero Lot Line�� D. If Mullifamily(R-1) _ <br /> Planned Unit Development Total#of Buitdings <br /> Total Conditioned Floor Area �' s . ft. Total#of Units <br /> Second Duplex Unit sq. ft. Totai sq ft (optional) <br /> A. Primary Space Heat Type B' Bne k a Qrna PaP y�Heat Type �' Wn ck o�t Type <br /> (cheek oneJ ( P � <br /> ❑ Electric Baseboard ❑ None Q'Electric <br /> Electric Wall Heater ❑ Wood ❑ Gas <br /> . ❑ Electric Furnace ❑ Electric Baseboard ❑ OtFier(spec;rybe�ow) <br /> ❑ Electric Heat Pump ❑ Other(specitybelow� <br /> ❑ Other <br /> ' C � � � �i��`'�I I�t� C <br /> .r <br /> This buflding meets the WSEC Compliance Method Date of Permit Application _ � �-2.3- <br /> ❑ Electric Frescriptive Path Date Buildinq Permit Isc� �� 9- �-Q-9�/ <br /> ❑ Other Fuels ❑ Component Performance Date of Insulation Inspection /-Zr,- 95 <br /> requirements of the WSEC. ❑ System Analysis Date of Final Inspection S-Z9-�— <br /> 1 hereby certf/y that this bu(Iding or addltion has been lnspected for the measures requlred <br /> by the 1991 Washi gton S te Energy Code(WSEC), that!t!s!n substantia/compliance <br /> w h the E a d th e W checklist/or this bui in�on tile. <br /> . � <br /> SiynaWre ol Building �flicial cr Authorized Hepresentative Dale <br /> Return white copy to: Kalhleen Skaar, Washington State Energy Ottice, 809 Legion Way SE, FA-11, Olympia,WA 9$5D4•1211 <br /> - WSEO- N'hife Copy Ulilily/Owner-Canary Copy ��Jurisdicfion-Pink Cop�( <br /> �-+._.......-..:.,,�..,, 1 7�92 <br />