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HINGTON <br />At, <br />�Building Record t <br />MEW <br />CLASSIFICATION _ <br />(please check one) <br />L New Building ❑ Addition over 500 sq. ft. <br />Jurisdiction: -I o � I/ - <br />please check one• City ❑ County <br />A. Site Information <br />Address 11-a=L J IV — <br />city er17 Zip '1' <br />Assessor's Property Tax # for anech legal desalpticn) : <br />011 'd - L'),.0 7- -30 <br />Servicing Electric Utility '6-Y1y LJ /J <br />(please check one) <br />Single Family ❑ Duplex <br />Multifamily [:]Zero Lot Line Home <br />❑ Planned Unit Development <br />Permit # <br />File ID # Ill different from Pemtx M <br />B. owner Information <br />Owner towns•atwneotoaatrucNa+rreceAesuMNpamrU <br />Coin am• ' <br />Address/ / ' ✓ o� <br />city f/.i/r-X ✓ Ili! State`// % Zip 41/r� r <br />Phone I ( 7 ) (r_-j - V' X(' <br />Federal ID# or SSN <br />C. If Single Family, Zero Lot Line or D. it Multifamily (R-1) <br />Planned Unit Development Total —# of Buildings <br />Total Conditioned Floor Area 1464 sg it. Total # of Units <br />Second Duplex Unil �sgft. Total m.�optional) <br />NEAT SOMCE -. - -- ---------- - <br />A, Primary Space Heat Type <br />(check one) _ <br />❑ <br />Electric Baseboard <br />Electric Wall Heater <br />❑ <br />Electric Furnace <br />❑ <br />Electric Heat Pump <br />❑ <br />Other _ <br />B. Back -Up Space Heat Type <br />(check all that apply) <br />None <br />7 Wood <br />❑ Electric Baseboard <br />❑ Other (specify below) <br />C. Water Hem Type <br />(check one) <br />❑ "Electric <br />❑ Gas <br />❑ Other (specifyhelow) <br />�pV --- _NI�PECTIONIENFORCE IT 't <br />This building meets the WSEC Compliance Method Dale of Permit Application <br />Electric ❑ rescriptive Path Date Building Permit Issued r r <br />1� Com onent Performance Date of Insulation Ins ectiD <br />❑ Other Fuels p Date of Final Inspection <br />rnnutremenis of the WSEC. ❑ System Analysis <br />I hereby certify that this building or addition has been Inspected for the measures required <br />by the 1991 Washington State Energy Code (WSEC), that It Is in substantial compllanre <br />with the WSEC, and that the, WSEC checklist for this building is on file. <br />/ <br />Ignature of Building Off lial or Authorized Representative Date <br />Return white copy to Kathleen Skeet, Washington State Energy Office Bog Legion Wey 1E FA-11, Olympla, wR sooug- I I <br />WSEO -While Copy Uhldyd)w•oer - Canary Copy Judsdeffion - Pink Copy <br />7.92 <br />