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1 • <br />y '�� <br />�� <br />..� .. <br />i <br />Building Record <br />Attacln�d B <br />ws�o co�act a ' ! ' 1 ' ' <br />� cua�F�c�noN . �:�,�.::=; <br />��pl ase theck oneJ <br />lew tluilding ❑ Addltion aver 590 sq. ft. <br />Jurisdictionl � » f� �'% `"` <br />i =���--- <br />pleese cAeck one: � City ❑ COuntY _ <br />Iplense thack onel <br />�Single Family ❑ Duplex <br />❑ Multilamily ❑ Zero Lol line Home <br />❑ Planned Unit Developme� 9t <br />Permit q �--� : y;� �Y -- -- <br />File ID # lil dillerenf from Permif Nj <br />...-. . , . . . _.. �n� -�... � _�'�� � <br />_.- .. ,;" <br />-- ----- --- ,� ..i� <br />A. Slte Intormetlon <br />Address9.:� i, �_ �=� —' �._ ' � - <br />�-- G <br />CitV �-,/ �% � 7'y !i/%�% Zip �', .-)� : <br />Assessor's Property Tax # �orattacn iepaieescnprion�__ __ <br />- � —' J� �� )'[�,.l�� <br />�. - ,. ._. — <br />$ervicina Electric Utlliry_,�,�__, %�_� �_ <br />B. Owner Informatlon <br />Owner (ownererfnneoroonsm�cnonrecenrosuti' pe_Ym�_ <br />ComP�� ' ��! __ � <br />Address _/-��__!',vX__, i1 ,.,--__ <br />City .` V'_' �-� —_ Slatey:� � Zip_%.i _-- <br />Phone ( _ ,✓ % 1 '7i •�h� <br />Federal IDq or SSN_ _ ���_�.�' �/f(�._ __ <br />C. If Singlo Family, Zero Lot Llne or D. II MultNamlly (R-7) <br />Planned UnN Development Total # of Buildings <br />Total Conditioned Floor Area /���'� sq. ft Totel # ol Units __ _ <br />Second Duplex Unit sq. ft. Total sq. fL (op!wnal) _ _ <br />� NEAT SOIIRCE � -.._ y�._..... .,_ ,� <br />A. Primary Spege Heat Type <br />(cheek one) <br />❑ Electric Baseboard <br />�Electric Wall Heater <br />Electric Furnace <br />❑ Electric Heat Pump <br />❑ Other <br />B. Beck-UP Spece Heet Type <br />(ehsek el lhef epply) <br />� None <br />❑ Wood <br />❑ Clectric Baseboard <br />❑ Other (specilybelow) <br />C. Water Heet Type <br />(ehack cns) . <br />� FIBCtfIC <br />❑ Gas <br />❑ OfhBf (specilybelow) <br />���A� ����NF��.� ,�:� <br />----- ------ - <br />This buliding meets the WSEC Compllance Method Date ol Permil Application ?��,.x <br />d Electric L� Prescriptive Path Date Buildir,g Permit Issued J,,�"';_ `i �� <br />❑ Other Fuels � Component Perlormance Date of Insulation Inspection J' � j= y a, __ <br />requirements of the WSEC. ❑ System Analysis Date ot Final Inspecli_on ��_,(o `�-0� <br />I hereby certlly that thls bullding or eddlNon haa been Inspected lor fhe meeaurea requlred <br />by thg 1891 Weahington Stete Energy Code (WSEC), Ihet It Is In aubatantlal compllan�e <br />� , wlth �Ire WSEC, end th� th� WSEC dieckllat for fhls bullding Is on llle. <br />, �, . -, , ., /', ,, ,,;,�� _; � . <br />/ {; ,. :_ i �� - /!- .�„-iti r '' <br />S�pnaSure ol Building O�lidial ur`Autho�izetl Represenla�rve Dale J. <br />Relurn white copy to: Kathleon Skaar, Washinglon State Energy 011ice, 809 Legion Way SE, FA�11. Olympia. WA 98504�1211 <br />WSEO � L5'hite Copy U�dilyiOwner � Canpr�� Capy Junsdichor� � Pinl� Copy <br />7 92 <br />