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. � <br />��,-� � <br />r� � <br />..� ■� <br />� , , <br />Building Record <br />ase chedc one) <br />New Buildir}g ,❑ Addition over 500 sq. tt. <br />Jurisdiction: (,Ly � �iI�CT% <br />alease check one: City ❑ County <br />.� <br />��# <br />(please check one) <br />❑ Single Family � Duplex <br />❑ Multifamily ❑ Zero Lot Line Home <br />C Planned Unit Development <br />Permit # �D.� h�� <br />FiIB ID #(!f dillerent irom Permtt 41 <br />:�.:����:�� <br />. . yk i .. . . . , , . . . , . <br />.. . ,- �.� , ..' <br />� .,?.� ' .a .:. � . . , <br />A: Site Informatlon <br />Address /� /U - 23� <br />it <br />: CEri JD/e Zip _ a!J/ <br />��Assessor's Pro e Tvt #(or anach �e�al descripNon) : <br />i�0/ ' D�a.. <br />Servicinp Eledric UtiliN , no�fr�— <br />B. Owner Informatlon <br />Federal ID# or SSN <br />C. If Single Famlly, Zero Lot Line or D. If Multifemlly (R-1) <br />Planned Unit Development Total # af Buildings <br />Total Conditioned Floor Area s. ft. Total # of Units <br />Second Duplex Unit � sq. ft. Total sq. ft. (optionap <br />A. Primary Space Heat Type <br />(ch�ck oroJ <br />.�❑/ Electric Baseboard <br />�p. Electric Wall Heater <br />❑ Electric Fumace <br />❑ Electric Heat Pump <br />❑ Other <br />B. Back-Up Space Heat Type <br />(ehsck all fhe(apply) <br />❑ None <br />❑ Wood <br />❑ Electric Baseboard <br />❑ Other (specilybelow) <br />C. Water Heat Type <br />(ehiek orro) - <br />Eledric <br />❑ Gas <br />❑ Other (speGrybelow) <br />r �, � , a � �. � <br />This bullding meets the WSEC Compliance Method Date of Permit Application S-'/p- 9� <br />� Electric � Prescriptive Path Date Buildinq Permit Issued ��� -� j _ <br />❑ Other Fuels Component Performance Date of Insulation Inspection /• Z!?-5 �I <br />requirements of the WSEC. ❑ System Analysis Date of Final Inspection 7- Z fr- q� f <br />1 hereby cerNly that thls bullding or additlon has been lnspected /or the measures requlred <br />by the 1991 Weshington State Energy Code (WSEC), that It Is !n substantlal complfanr.e <br />(�Ith thet�(SEC, an hetthe WSEC checkllst /or thls bullding !s on ffl�. <br />I �---( : 7 � � �--- �% i % ;, �`7 � <br />Building OMicial or Authorized Representative <br />Date <br />Return white copy to: Kathleen Skaar, Washington State Energy Office, 809 Legion Way SE, FA-11, Olympia, +JA 98504-1211 <br />' WSEO - White Copy Ulilify/Owner • Canary Copy � Jurisdicfion - Pink Copy <br />7•92 <br />