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Nl <br />Building Record WSEOContmet# aro�nmeM B <br />MOGRAM <br />+ rP :f < pyT-y.p... ,��f•�'rV_y�'a3T� IY� I "c'�Ih �-n`�..q+�^''}_I n "3y1"y�rh � "•�i;' V„i,': <br />:'�:w�w:.�t1[?I.7Y'.�11 Y�im,!K�..a „( Y 4 ..e:i-.r�. v.wW,n'1.. �R•�i:�Y.&Li..l�t.R 4�..a _ <br />(please check one) <br />® New Building ❑ Addition over 500 sq. ft. <br />Jurisdiction: t='jPrr>•N <br />please check cne• 0City ❑ County <br />A. Site Information <br />Address <br />251A' - 7 4"A 31 SE <br />City ci-iv t o ii Zip Cta?-V <br />Assessor's Property Tax # (or attach local description): <br />3487 <br />Servicing Electric Utility p V A. 0 1 DIP CtuAnjw i f <br />(please check one) <br />N Single Family ❑ Duplex <br />[]Multifamily ❑ Zero Lot Lin- Home <br />❑ Planned Unit Development <br />Permit # C 34 foS I <br />File ID # (if different from Perm A} <br />B. Owner Information <br />Owner (owner at time or construction receives uk'litypsymen0 <br />Company LAIN F_ Rlpn{ <br />Address 220, <br />City Fverr+F Sae UmFZk= <br />Phone ( ZO& ) -355- 4725 <br />Federal ID# or SSN <br />DevelopmentC. If Single Family, Zero Lot Line or D. if Multifamily (R-11) <br />Planned Unit <br />ConditionedTotal .. <br />Second Duplex Unit sq. ft. 1 otal sq. ft. (optional) <br />„,�., ,y � -m •t- 3t;V6 r t. r wi}�'�# vk•,�7jti� 11' i"�'f1.it�1�r, r ).c krek <br />. il.�.�-, �`' ter.. i...-�': 1-7: n.':y.h.�.i�w'�r,i •w 1 w, � � , �i'.4t �IJie� r.... ': �..V .r <br />A. Primary Space Heat Type <br />(check one) <br />❑ <br />Electric Baseboard <br />9 <br />Electric Wall Heater <br />❑ <br />Electric Furnace <br />❑ <br />Electric Heal Pump <br />❑ <br />Other <br />B. Back -Up Space Heat Type <br />(check all that apply) <br />❑ None <br />❑ Wood <br />❑ Electric Baseboard <br />❑ Other (specilybelow) <br />C. Water Heat Type <br />(check one) <br />❑ Electric <br />❑ Gas <br />❑ Other (specify below) <br />J CIJ .r <br />This building meets the WSEC Compliance Method Date of Permit Application <br />® Electric ❑ Prescriptive Path Date Building Permit Issued <br />❑ Other Fuels K Component Performance Date of Insulation Inspection q - 2q- 6 3 <br />requirements of the WSEC. ❑ System Analysis Date of Final Inspection a - 21- 9 3 I •' <br />1 hereby certify that this building or addition has been Inspected for the measures required <br />bif the 1991 Washington State Energy Code (WSEC), that It Is In substantial compliance <br />e W EC, and th a WSEC checklist for this building is on file. <br />Signature o Building Official or Aulhorized Representative Date <br />Return white copy to: Kathleen Skaar, 'Washington State Enorgy 011ice, 809 Legion Way SE, FA-11, Olympia. WA 98504-1211 <br />WSEO - While Copy Utililyrowner- Canary Copy Jurisdiction - Pink Copy <br />7.92 <br />