608 65TH PL SE 2018-01-02 MF Import

• HINGTON CODE PROGRAM Building Record (please check one) ❑ New Building ❑ Addition over 500 sq. ft. Jurisdiction: please check one: ❑ City ❑ County A. Site Information Address City Zip Assessor's Property Tax # (or asach kraal descdotbn) : Servicing Electric Utility C. If Single Family, Zero Lot Line or Planned Unit Development Total Conditioned Floor Area Second Duplex UrIt -_-, C _-.:- - - A. Primary Space Heat Type (Check one) ❑ Electric Baseboard ❑ Electric Furnace ❑ Electric Heat Pump ❑ Other (specify below) COMPLIANCE WSEC Compliance Method I� Prescriptive Path ❑ Component Performance ❑ System Analysis IM MIFICATION WM Ceotraet # (please check one) ❑ Single Family ❑ Duplex ❑ Multifamily ❑ Zero Lot Line Home ❑ Planned Unit Development Permit # _ Fllo ID # (a wrteram from Permit a) Atfachnfall B B. Owner Information Owner ar nme or axsm aan nx akes uaeY parr err) _ Comoan Address City _' State Zip - Phone ( _ Federal ID# or SSN D. If Multllamily (R-1) Total # of Buildings sq H. Total # of Units sq. ft. Total Sq. . ootlonal NEAT SOURCE B. Back -Up Space Heat Typ@ (optional chock all that apply) ❑ None ❑ Wood ❑ Electric Baseboard ❑ Other (speedy below) C. Water Heat Type (uptlonal, check one) ❑ Electric ❑ Gas ❑ Other (specify bebw) INSPECTM UENFORCEMENT Date of Permit Application_ Date Building Permit Issued Date of Insulation Inspection Date of Final Inspection I hereby certify that this building or addition has been Inspected for the measures required by the 1991 Washington State Energy Co.i,r (WSEC), that It is In substantial compliance with the WSEC, and that the WSEC checklist for this building is on file. Signature of Building Offbal or Authorized Representative Date Return white copy to: Kathleen Skaar, Washington State Energy Office, 809 Legion Way SE, FA-11. Olympia, WA 98504.1211 WSEO - White Copy U10dylowner- Canary Copy — Junsd'ctlort -Pink Copy 6-91