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� �� <br /> u �x <br /> ay H <br /> t""H�y , <br /> y r~ �� SF�GTON AHadrneid B <br /> � � � �� Building Record ,,,��,�# <br /> y�� ��an� <br /> o �d CLASSIFICATION '� <br /> � �g - -__-- - _-- - - <br /> n• n (p�nase eheck onel �pieuse chncA ono) <br /> 9 y� ❑New Buildinp ❑Addition over 500 aq.ft. ❑Single Fami�y ❑Duplex <br /> t"�i y Jurisdiction: ❑Multifamily ❑Zero Lot Line Home <br /> g y H _ _ __ _____ ____ ____ n Planned Unit Development __ _ <br /> O❑C VJ ploese check one� ❑ Ci�V ❑COUnty Permi�# <br /> � [s7 t" FiIC ID k(Ad�Nerenf lrom Permif,Y� _ _ <br /> M <br /> y o y CONSiiIUCTION ���'�;. <br /> __ .� .�a .,��1�,�,�'.� <br /> A. Sita Informetion B. Owner Inlormation <br /> - --- <br /> Address __ _ Owner_ �ownn at nme ol cnrsmctan ra,-eires�peyrt�err.� <br /> City Zip Company <br /> Assessor's Property Taz#�o�arracn iega�oescnpoon�: Address <br /> City State Zip _ <br /> Servicing Elecfric Ur'nty Phone ( ) <br /> Federal IDN or SSN �- �' <br /> C. If Single Famlly,Zero Lot Line or 0. If Multllamlly(R•1) <br /> P7anned Unit Development Total k ol Buildings <br /> ' ' To:al Conditioned Floor Area sq. R. Total k o� Units <br /> -- -- --- --- <br /> '�` Second Duplex Unit sq. it Total sq.fL (optiona!) I <br /> �–� HEAT SOURCE <br /> ��' A. Primary Space Heat Type 8. Beck-Up Spece Heat TypB C. Weter Heat Type � <br /> /cheek one) (opfronal,check el/fhef s ip/y) (opflonel,check one) <br /> ' ❑ Electric Baseboard � � None ❑ Electric <br /> ' n Electric Furnace � � Wood n Gas <br /> ❑ Electric Heat Pump �_� Electric Baseboard ❑ Other�spacrry be,awl <br /> �1 ❑ ��h9f (SpPtily bPlmvl �� ��hEf�SprcAy belnbt� � <br /> �1 <br /> �_' CaMPLIANCE INSPECfIOMIENFORCEMENT j <br /> -- -- - _ - — --- --- <br /> i <br /> ��' WSEC Complfance Method Date ol Permll Ap�lication I <br /> n Prescriptive P^ih Date Building Permit Issued I <br /> ' �� Componem Pnr�ormance Date ot Insulation Inspection , <br /> _ - ------ <br /> ' �� Syslem Ana' sis Date of Final Inspection I <br /> I hereby cerNly fhef fh/s 6ullding or addlffon has been lnspecfed!or fhe meaeures requlred <br /> by fhe 1991 Washingfon Sfafe Energy Code(WSECJ, fhaf/f/s In subsfanflal compllence <br /> wlfh fhe WSEC,and fhaf fhe WSEC check/!sf for fhls bullding!s on/lle. <br /> Sie�n�lure ol E3und�ng 011ioal or Autlwrved Represenlatrve Datu �I <br /> ReWm whlte copy to: Kathleen Skaar, Washington Slafe Energy OHice. B09 Legion Way SE.FA t 1. Olympia. WA 9850a t2t i � <br /> WSEO WhReCnpY UIrOryOwror Can,�ryCoPY .lun5a�chnn 15nhCo�q 6-91 <br />