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���rotv r�: �-, <br /> �� Buildirug Re�ord A�� B <br /> �� <br /> �o�# <br /> '� l � �a���k� Ye i�� `t x... n`r"t w;e>;�...... y e w ..»n. <br /> i .�,' � �.'3p�.. �uTa" � \ �� � � /p ��Yac i <br /> � w1Sl�:r�4'�ia�a;k� �-`i 4�.' �3.�� � �5�.'.���Zc•'�.�'�Y����a� � a� ' s�i � 2�. �ZER vi x � :n � <br /> i ? � C:�j <br /> �(plea�s check wre) ,(,d,e�ase �ck cne) <br /> LNNew Bulldir ❑Addfti aver 500 sq.ft. L�'Single Family ❑Duplex <br /> Jurisdiction: �i � _ ❑Mu%ifamily ❑Zero Lot Line Home <br /> ❑Planned linit Develo ment <br /> dease cnecx o�: ��v ❑Countv Permit H � 3 <br /> Fle I D N 111 di�'erem Irom Permlr�1 <br /> ��,��� ��q��. . �: . — <br /> �°F'�x�` q t p x�. . , . �- _ e.wc z <br /> � &�'�'Sb'\:;. -.�`� �J' Y i ,��g '�\�?� <br /> �J, w. <br /> A. SNe Iniormetion B. Owner Informetion <br /> Address -- Owner oK,oiareineorca,sm,cnonieceo�es erw <br /> 1p <br /> / / !�'/ I <br /> c�tv , zip q 2a� com a� <br /> Asses or's Pro eA Tax q orercach egardesalceon): Address (p <br /> 2 � �7` Citv �ir/A��7i Stat // Zio ,F9/13 <br /> Servicina Electric Utilitv /I �+ � // / Phone ( 10� ���5-</77 5— <br /> C. II Single Famlly,Zero Lot Line or D. Duplez E. i(Multifamily(R•1) <br /> Planned Unit Development Flrst Duplex Unk sq. k. Total N of Buildings <br /> Total CoMitioned Floor Area s . ft. Second Du lez Unit . R. Total M of Units <br /> €s`La ,..,,�}���`��; ��. t' ..:. ,-. . �ku��`h��'�y. a : .: . . � � <br /> '�F •'�`k��le.?�,:�.�`��� �" ����'a��.�.�`��1�L�`� <br /> A. Primery Space Heat Type B. Seconda1y Space Heat Type C. Water Heet Type <br /> (ehxk onel _ (ehsek ell f/ief epp/Yl (eheek oneJ <br /> ❑ E�ectric Baseboard ❑ None Electric <br /> ��'Electric Wall Heater ❑ Wood ❑ Gas <br /> ❑ Electric Furnace ❑ Electric Baseboard ❑ Other�spedtyberow� <br /> ❑ Electric Heat Pump ❑ Olher�s�,e�rrynBkw/ <br /> ❑ Olher <br /> �� y��i � <br /> "R� .��-`�\ 'r.�'�i`S.`. .�a�'�.����IUYG��m xx?..:-� � . ' �,:?...�,�. <br /> �lor H��1 Purrp On1� <br /> WS,E,-C,/Co�npliance Method This buliding meets the Date ol PermA Application �/�'9� <br /> L7 Prescriptive Path ❑ etectric Date Buildinp Permft Issued ��2�-Q <br /> ❑ Component Perlormance ❑ other fuels Date of Insulation Inspection ���-p� <br /> ❑ System Analysis requiremenls of ihe WSEC. Date of Final Insoection �—��q�f <br /> 1 hereby ceri!/y thef fhls bul/ding or addlNon has been/nspecfed lor the measures required <br /> by f 1991 ashingto St e Energy Code(WSEC), thaf R is In substanftel compllance <br /> f W C,and af e WSEC checkl/sf lor thls bullding Is on/lle. <br /> � / �� <br /> SI Nre ol Buil ' dal a� utliorized Heprasentative Dat� <br /> ' Return eanary copy to tha servlcing electrlc u111ity to triggar WSEC compliance payment <br /> Relurn white copy to:Kathleen Skaar, Washington State Energy 011ice P.O Box.t3165 Olympia WA 985043165 ��9� <br /> WSEO� Whire Capy Utiliry/Owi�er�Canery Copy JurisdicNon-Pfnk Copy <br />