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�V�FiIN�TON <br /> �� Building Record "`�"t B <br /> � <br /> �o�t# <br /> " ��� CUISSIflCAtION °.. � <br /> ;_ <br /> (p! se check oneJ /nle�se chack oneJ <br /> New Building AddNlon ov r 500 s tt. rvt <br /> �' Q• .��i Single Family ❑Duplex <br /> Jurisdiction: ❑Multitamily ❑Zero Lot Line Home <br /> ❑Planned Unit Develo ment <br /> p�aesa cnecx orre: Cflv ❑Countv Permit# ,�9 lD <br /> FIIB ID il(IldiNerentlrom Porm1fM <br /> � � <br /> ., � :.�� : ::: �x �n>, s F�4c,.�' .:x� ..� <br /> � x �= r�"�� � M� `� C�NS1'�i�ION f.; < � _�M���� ���, <br /> ` z A3.i^�ti i� .r� <br /> A. Site Informetion B. Owner Inlormatlon <br /> Address /n —�/� �� � � Owner (owneiareineolconsavcoonre�ei�esurdhvnv�,nerrtl <br /> �n Z�o Comoan <br /> Assessor's Pro ert Tax q oranecnb e�oasat aon : Address <br /> � �� - -�� � Cit State Zi 7 <br /> Servicino Eledric Utilitv�,si�� �i_ L� Phone 1�r 9n�4 ��/„ - $�)�' <br /> C. If Sinple Family,Zero Lot Llne or D. Duplex E. If Multllamlly(R•1) <br /> Planned Unft Development First Duplex UnR sq. N. Total k of Buildings <br /> Total Conditioned Floor Area � s . N. Second Du lex Unit sq. fl. Total q of Units <br /> � M�' ;.z (s z�:F'"�c C •� y�y......y....� y��y/�.., 3 �r:: c-;c c <br /> # `- v.', i .��R,��Y��{i� �a'-r <br /> a <br /> A. Primary Space Heat Type B. Secondary Space Heat Type C. Water Heat T e <br /> (ehsek ons) (ehsek sll tfief apply) (ehxk oneJ yp <br /> ❑ Electric Baseboard ❑ None Electric <br /> � Electric Wall Heater ❑ Wood ❑ Gas <br /> Electric Furnace ❑ Electric Baseboarcl ❑ Other/s�d�yaebw� <br /> ❑ Electric Heat Pump ❑ Olher�spearrybe�ow/ <br /> ❑ Other <br /> £ .. , ��i1Mp�IpN� �' st� <br /> � ��EC'�IdNlENF����i�'�.= __� <br /> ryor H..�VuvO OnNI <br /> WSEC ompliance Mefhod Thls building meets the Date ol Permit Application 3//�3 <br /> Prescriptive Path ❑ electric Date Building Permit Issued - - " <br /> ❑ Component Pertormance ❑ other fuels Date o1 Insulation Inspection <br /> ❑ System Analysis requirements of the WSEC. Date o1 Final Inspection ,�-?_sr <br /> I hereby cert/ly fhaf fhis bulldJng or add/f/on has been Inspecfed lor fhe measures requlred <br />' by fhe 1991 Washington Sfafe Energy Code(WSEC), thaf It is In subsfanNal compl/ance <br /> w/tb fhe WSEC, and fhaf Ihe WSEC checkllst lor fh/s bullding Is on/11 . <br /> / -� <br /> '�✓ i'�'� / // ' - <br /> SlgneWre of Bullding Omcial ar AuModzed Rapresantative Daie <br /> Retum cenary oopy to the sarvicing electric ulility to tdgge�WSEC compliance payment <br /> _ Return white copy to:Kathleen Skaar Washinglon State Energy 011ice P.O. Boz 43165,Olympia WA 98504-3165 tt�52 <br /> WSEO� YYhue Copy UNlity/Owner�Canary Copy Jurisdicfion�Pink Copy <br />