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W SFiI�1�T01�1 <br /> � Building Record ,��# "`�"` e <br /> �� <br /> �(p ase check one) (p/ease check one) <br /> New Buildi ❑Additlon over 500 q.tt. �Single Family ❑Duplex <br /> Jurisdiction: �,�, Q-/ �/y�-f� ❑Multifamily ❑Zero Lot Line Home <br /> i <br /> ❑Planned Unit Develo ment <br /> �ase check one: Clty ❑Countv Permit# 53 <br /> File ID#(i�diHerenNrom Permit A1 � <br /> A. Site Informetion B. Owner Informetion <br /> Address �S.rip7 o?S� �p _ Owner avnerattlmeolcons nraaeiv��6/' � <br /> — i D,—/� oe � <br /> Citv /=,LP1:.e ' Zio Com an <br /> Assessor's Pr ert Tax# oranacn�e a�descr� tion : Address G .5" — <br /> �� ��. un— ds � c�ri ,✓-ue,� State N/,4 Zio � Jo <br /> Servicinq Electric Utilitv iir� a `l�u p Phone ( ) J�j/} ' <br /> Ir C. 1f Single Famlly,Zero Lot Line or D. Duplex _ E_If Multliamily(R•1) <br />� Planned Unit Development First Duplex Unit sq. ft. Total#of Bufldings <br /> Total Conditioned Floor Area / U s .ft. Second Du lex Unit s .ft. Total#of Units <br /> ��� <br /> A. Primery Space Heat Type B. Seconda1y Spece Heat Type C. .Water Hea4 Tyµe <br /> (eheck one) (chxka/l t6af epp/y) (check o�) <br /> ❑ Electric Baseboard ❑ None Electric <br /> ❑ Electric Wall Heater ❑ Wood ❑ Gas <br /> l� Electric Furnace � Electric Baseboard ❑ Other(specrtybeiow) <br /> ❑ Electric Heat Pump ❑ Other(specuybe�ow� <br /> ❑ Other ' <br />� <br /> i <br /> (la HaW Pump Ony) � <br /> WSEC Compliance Method This buliding meets the Date of Permit Application �- �j.y� <br /> �Prescriptive Path electric Date Buildinq Permit Issued ��/�� 9 <br /> Component Performance other fuels Date of Insulation Insoection //.3 -9 G� <br /> ❑ System Analysis requlrements of the WSEC. Date of Final Inspection -,�y'�y��— <br /> I hereby certlly that t !s bullding or addlt/on has been lnspected/or the measures requJrad <br />� by e f�9 Washl t n State Energy Code(W9EC), that It Is ln substantlal compllance <br />, w t e SEC,a f at fhe kllsf/or thls bullding Is on flle. <br /> � <br /> i <br /> Signature ot uil ing Official r Authorized Represenlative Date <br /> Return can�ry copy to ihe servicing electric utility to trigger WSEC compliance payment <br /> Return white copy to:Kathieen Sh2ar,Washington State Energy OHice, P.O. Box 43165,Olympia,WA 98504•3165 <br /> WSEO- Whde Copy Utility/Owner-Canary Capy Junsdiction-Pink Copy <br /> 12-92 <br /> I <br /> I <br />� <br /> 1 <br /> \. <br />