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WASHiNGTON <br /> �� Building Record A"�'� B <br /> '' W5E0 CotrUact# <br /> PROGFiF�M � <br /> ;IY . V -` C �. . iI . <br /> (p/ se check oneJ - (please check oneJ I <br /> New Building Additlon over 500 sq.ft. ❑Single Family ❑Dupiex <br /> Jurisdiction: ❑Multifamily ❑Zero Lot Line Home <br /> ❑Planned Unit Develo ment <br /> �ase cneck one: City ❑Countv Permit# <br /> F'tle ID#(ildillerentlrom PermitAl ,�i i <br /> �7'.:,.�_...dea.' , � . _ � . _ . .. --- . �. Ii� :..� .Y. ..� . .. . ,� :_ ... .. .. .. . I <br /> A. Site Information 8. Owner Information II <br /> Address ///�D �J - /(p� ve f . OWfIBr (ownerat6fieolconstructionreceivesufi!'MPaYmentJ I <br /> CitY /l�./ i �ip GLJ�' COmpany _�Q( ' II <br /> �Assessor's Pro erty Tax# crattacn le al descri rion : Address � /�9 / �`�'� �i �L� <br /> /v�'G'p� _ i • CiN 9_ �ti State Zip <br /> Servicing Electric Utilit4 r/�� o , �/� Phone ( ) I <br /> Federal ID#or SSN <br /> C. If Single Family,Zero Lot Line or D. If Multifamily(R-1) I <br /> Planned Unit Development Total#of Bu�ldings / <br /> Total Conditioned Floor Area sq. ft. Total#of Units <br /> Second Duplex Unit sq. ft. Total s . ft. o tional , �� <br /> M.: H �d 0 °�' � <br /> A. Prfmary Space Heat Type B. Back-Up Space Heat Type 'C. Water Heat Type I� <br /> (check one) (check all fhat applyJ (check one) ��. <br /> ❑ Electric Baseboard ❑ None ��Electric �', <br /> ❑ Eiectric Wall Heater ❑ �Nood ❑ Gas I <br /> ❑ Eiectric =umace ❑ Eiectric Baseboard ❑ Other�specitybeiow� <br /> ❑ Eiectric Heat Pump ❑ Other�specirybeiow) <br /> B Other ! <br /> � P,, f . . . . • , � � [_ PECTJ.-- /EN_}0_. C_ MEht � <br /> ..�� .fn - -.3e. "_ c" ��I <br /> This building m2ets the WSEC Compliance Method Date of Permit Application �—,3_9� <br /> �Electric —B�Prescriptive Path Date Buildinq Permit Issued /�/9-9,� <br /> ❑ Other Fuels ❑ Component Performance Date of Insulation Inspection /�—Z�'� ' <br /> requirements of the WSEC. ❑ System Anatysis Date of Final Inspection �—//- 9�O ', <br /> I her by cert!/y that ihls uilding or addition ,has been inspected for the measuies req�lred <br /> b t e�7997 Washi t Stat Energy Code(WSEC), ihat it!s rn su6stantlal c�mpliance , <br /> i he SEC, a t the S C checklist far this bu!ldin n lile. � <br /> , �l�- <br /> Signatu o ui tling Offia or Authorized Representa ive Date �. <br /> Return white copy to: Kalhleen Skaar, 'Nashington State Energy Of(ice, 809 Legion Way SE, FA-11, Olympia, WA 96504-1211 '�, <br /> � WSEO- While Copy Ulilify/Owner-Canary Copy ✓urisdicfion•Pink Copy � <br /> 7-?2 �I <br />