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W_ ASFiINGTON <br />�E1rER4'Y <br />�� <br />._ <br />Building Record <br />�rv� aeu cnecx one) <br />New Buildji �g n Additlon over 500 sq. tt. <br />Jurisdiction: `Y� ��i a-� Je f�_ <br />please check one: CIfV ❑ C011�ly <br />AtfaclmeM B <br />�o�� <br />(please checF one) <br />� Single Family ❑ Duplex <br />❑ Multifamily ❑ Zero Lot Lina Home <br />0 Planned Unit DeveloQment <br />Permit # �02/S <br />FIIB ID il (Ildiflerenf from Permif M <br />�"'`�a"^+ w'h"�P`�.��lfv�..��W�Y �P";11 .?jr <br />� <br />A. Site Informatlon 8. Owner Informetion <br />Address 3i3 � S' Owner lameretn'meolconsb�iccaireeeivesutilirypaymenp <br />Cit .Pi1D ziD 9�3 �p pm � `- � � -- <br />Assessor's Pron Tax # or anacn i aidesrn =r�on�:�— Address 1J X__� _ <br />�.a a� n ����/'�/0-90 City ,�u Statef� zi 7� <br />Servicin Electric Utilit v Cb_�� _ Phone (�O[a )�� -� <br />Federal ID# or SSN <br />C. If Single Femlly, 2ero Lot Line or <br />Plenned Unit Development <br />Total Conditioned Floor Area I Ij Z__ sq._ ft_ <br />Second Duplex Unit Sq �� <br />D. If Multifamliy (R-1) <br />Total N oi Buildinas <br />Total # oi Units <br />Total sq. ft, (optionap <br />-: t� �tT���� . <br />: P.�� . i ,,-^f:e�'�.M31. ' F�^n �a'�'1.•�: ' I ' ,` Xr+. .Y N " j''�'"'4t ��.: � T .1 ..� �.it (� . <br />— V���t��i a.�� <br />A. Primery Spoce Heat Type <br />(check one) _ _ <br />❑ Etectric Baseboard <br />�. Electric Wall Heater <br />❑ Electric Furnace <br />❑ Eleclric Heat Pump <br />❑ Othor <br />B. Beck•Up Spece HeatType <br />(eheck ell thet epply) <br />None <br />❑ Wood <br />U Eleclric Baseboard <br />❑ Other(specilybelow) <br />C. Water Heat Type <br />(eheck oneJ <br />� Eledric <br />C Gas <br />❑ Other (specilybelow/ <br />�-,�" ��-:,':':�bMpLIAt(CE-;--•--" ^...-x-,;;.� � �' ... � INSP�'CTIO��iN <br />M �m� � �\e � :��y Inv � �� � A A/� � , .1��. .a i <br />Thls bullding meets the WSEC Compllance Method Date ol Permit Application��a�'�__ <br />Electric ❑� rescriplive Path Date Building Permit Issued �}=7- Q3 <br />Other Fuels lIs Componont Performance Date of Insulation Inspection___�3_�j' j___ <br />requlrements of the WSEC. ❑ System Analysis Date of Final Ins ection 1�—� g—q3 <br />I hereby cerilly that fhts bul/ding or eddltlon has 6een lnspected lor the measures requlred <br />�y � e 1991 WAsh� �on Sfatp Energy Code (WSEC), fhat If Is !n subsfant/ul complianre <br />w!f fhe WS��, � at�S�VSECFh�kl/st lor fh�ulldln� !s on IUe. <br />or Auihorized Fnpresentativo <br />Return whlte copy to: Kalhloon Skaar, Washington State Energy 011ico, 809 Legion Way SE, FA-11, Olympia, WA 98504�1211 <br />-- - - - ---- - — — - <br />WSEO - Whilo Copy ----- �---�_ Ulility/Owner - Canary Copy � - � -�--_-�-- - -Juri:tditlion � Pink CoPY <br />7.nz <br />