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. � <br />� ��� <br />., <br />.-. .. <br />Building Record ��� A"�`"°"` B <br />�:J� t���ilr`n��.wf�._ '�� �.7t,. H��,�'�I�.hA:L.�i.t :co � � .. <br />, si, �9.. �..r �2' � a � � <br />(please eneGc onaJ <br />�New Building ❑ Addition over 500 sq. R. <br />Jurisdiction: � �u,�¢ (f <br />�easecheckone: i,al CIfV ❑COU11tV <br />(please check oneJ <br />❑ Single Famiiy � Duplex <br />❑ Multifamily ❑ Zero Lot Line Home <br />❑ Planned Unit Development <br />Permit # 3 900 � <br />FI le I D q llt dlMerent Irom Parmlt MI <br />, t� `' , �' i�i��:i� I r.l.�. 1 <br />.��..,� �.. �. <br />A. Site Informetlon <br />Address I)�O f�Q /2f s �Q � P j'r- <br />���v �aLerD fn)fi Zip Q� <br />Assessor'9 PfOpertV Ta% # larattach leoal descripfbnl : <br />ServlcinpElectrfcUtflitv P 0111,�- S,no(��,u,�, <br />Ccu wi r, <br />C. If Single Femily, Zero Lot Llne or <br />Planned Unit Development <br />Total Conditioned Floor Area ,� i'� b- sq it <br />Second Duolex Unit sq fl <br />B. Owner Information <br />Owner �owneretMneor�roncm,cuonreceHssupBrypay�,e�rt_L <br />,/3�/1 G�c�evsr�v� <br />Comoanv <br />Address a.. <br />CIN L.,��,�a�� State�;ji� ZiD �;b <br />Ph0—�e ( 2(7fo ) 7��-feQ3.[� _ <br />Federal IDk or SSN <br />D. If Multlfamily (R•7) <br />Total tf of Buildings <br />Total # ol Units <br />Total sq. ft. (optional) <br />..,,y � . o.. ,e;� i i .�: ' � , �t t ' '�+�.j.�vw-eI1lLJ..iI'�B � . • . . � <br />i t <br />A. Primary Space Heat Type <br />(cheek one) <br />❑ Electric Baseboard <br />[2�. Electric Wall Heater <br />❑ Electric Furnace <br />❑ Electric Heat Pump <br />❑ Other <br />B. Back•Up Spece HeatType <br />(ehsck all lhef epplyJ <br />❑ None <br />❑ Wood <br />❑ Eleciric Baseboard <br />❑ Other(specrrybe�ow) <br />C. Water Heet Type <br />(eheck one) <br />❑ Electric <br />❑ Gas <br />❑ Other (speclry ee�ow) <br />t�J�ii' aJ �' ra ' •� ' x ' i� l��i �1.�.� <br />l;_.(�.1.��' ,_ �.�;,:7��i.�,.71.f,�. �,. I ,�r_ <br />Thls bullding meets the WSEC Compllance Method Date ot Permit Applicatlon 1 2-IS-9 2 <br />�' Electric � Prescriptive Path Date Bulidin Permit Issued -I -.3 <br />❑ Other Fuels ❑ Componenl Performance Date ot In.;uiation Ins ectlon --S 3 <br />requirements of the WSEC. ❑ System Analysis Date of Final Inspection i/� �a27��_ <br />that <br />Sipnature o1�Gulldin,, Official or Aulhorized <br />bullding or addltlon has been Inspected lor the measures requlred <br />Sfate Energy Code (WSEC), thaf It Is in substanffal complfanre <br />tI�jWSEC checkllst lor thls.tlulld,�ng Is on llle. <br />Dato <br />Roturn white copy to: Kathleon Skaar, Washington 31ate Enorgy 011ice, 809 Legion Way SE FA-11 Olympia WA 98504-12f 1 <br />YL5E0 • Wftife Copy Ulil;tyA7wner � Canary Copy Jurkdiction • Pink Copy <br />7 92 <br />