Loading...
HomeMy WebLinkAboutBLD2013-00357 41113UILDING PERMIT APPLICA•N BRLD1e 0033557 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD1 3-00357 Received Date: 11/8/2013 SITE ADDRESS: 23 SEA BREEZE LN PORT LUDLOW, 98365 OWNER: MICHAEL D OROS TRUSTEE PHONE: (360)437-2670 CARYL A OROS TRUSTEE 23 SEA BREEZE LN PORT LUDLOW WA 983659585 TEAL LAKE VILLAGE SUBDIVISION: Block: Lot: 21 PARCEL NUMBER: 998700021 Section: 21 Township: 28 N Range: 01 E CONTRACTOR: BRENNAN HTG &A/C LLC PHONE: 206-248-7900 4601 S 134TH PL SEATTLE WA 98168 Contractor's License BRENNHA971 R9 Expires 12/29/2013 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP INSTALL 4 TON HEAT PUMP TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION ADD'L: HEAT TYPE: CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $152.00 MEB 11/07/13 145534 Total: $152.00 \\+irlomorlArle+o\+nrme\G P1 Il Ann PIA rn+ 11/R/7(114 , II ...g..! •1; JEFFERSON COUN co r fi ARTMEFFERSOld r OF COMMUNITY DEVELOPMENT 621 Sheridan Street•Port Townsend.Washington 98368 t� !!� 360/379-4450. 380/379-4451 Fax ittr www.co jefferson.wa.ustotnrndevelopment Master Permit Application MLA: P . (I sheets & � - ,t A_ .f Ilk *1 >,` Tax Parcel Number: l t a F�" "i, Property Size; (acres/square feet) Qt 'e.,a..� to i 4 Lo A Vow Property. )of ., .• %it' h, , i Telephone: 4'11 ' L�► '�:. '""►1w�► fax: email: May g : • h �, . ,' `_C .c�.."-t.,. Applicahwagent(if different from owner):. Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies OBul ling 0 Critical Areas Stewardship Plan CI Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Use) Ingle Family 0 Garage Attached/Detached 0 Conditional Use IC(a),C(d),or C]" O Manufactured Home ❑ Modular 0 Discretionary"0"or Unnamed Use Classification O Commercial• ❑Special Use(Essential Public Facilities)" O Change of Use 0 Boundary Line Adjustment C) Address: 0 Road Approach ©Short Pmt'" O Home Business 0 Cottage Industry 0 binding Site Plan" o Propane 0 Long Plat". C)Sign 0 Planned Rural Residential Development(PRRD)/Arnd rents" O Mowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration" O Stoimwater Management 0 Shoreline Master Program Exemption/Penne Revisions" O Site Plan Approval Advance Determination(SPAAD)• ❑Shoreline Management Substantial Development*" C)Temporary Use 0 Shoreline Management Variance O Wireless Telecommunication• 0 Comprehensive Plan/UDC/Land Use District Map Amendment 0 Forest Practices Act Release of Six-Year Moratorium 0 Jefferson County Shoreline Mester Program Amendment *Nay require a Pre Conference 0 Tree Vegetation Request "Requires a PreAppllcation Conference Please identify any other local,state or federal permits required for this proposal,if known: _.LL;l�yi► l�rio�i OF AGENT I hereby designate Jb'.�(1 ' o act as my agent in matters reia(1ng to this application for permit(s). • RSIGNATURE tt+J.. CI. Y r gate: By signing this application form,the owner/mint attests that the Intimation provided herein,and in any attachments,is true and correct to the best of his her cr its knowledge. Any material falsehood or any omission of a material trot made by the owner/agent with respect to this application packet may result in this permit being null and void. I Anther agree to save.Indemnify and hole harmmleea Jefferson County against all liabilities.Judgments,court costs,reasonable attamey's fees and e penees width may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further access and right of entry„a Wesson County and its employees,representatives or agents for the sole purpose of appacatlon review and iced later inspections. Staffs ..., and right of entry will be assumed unless the appkc lint inf mts the County in writing at the tine of• that he 4r she wants odd, M,7•:. s iL A I jA �..__ £*� ■. ...a.— Date: The r-. . Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or species and could lead to a potential"take"of en endangered species as those terms are defined in the federal law known as the 'Endangered Species Act*or"ESA.'Jefferson Cott ;makes no assurances to the applicant that the actions that wit be undertaken because this permit has will not violate the ESA. 4 .WWuai,groin or agency can fib a lawsuit on behalf of an endangered species regarding your action(s) are in compliance with the a, , County development code.The Applicant acknowledges that he she or holds individual and • i poniffiiityr for a dhertn to Mr com complying with - . The Applicant has read this disda nw, nd is it below. At l�/l.� > 1♦ Date: 1 I `` 11 1 411/ C\P -"##irPORMS*##\DRD FORMS\Mauer Permit Application 5 29-0&doc 1 1 r BUILDER STATEMENT The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: ENERAL CONTRACTOR OR NUFACTURED RED HOME INSTALLER: PHONE: FAx: t x■,tom •tr`. \ (dOtr )Lk�r?. I t (a1 O t�_2 '3 0-4-- .5 MAILING ADDRESS: .\\ \ 5 ` \ \I ]!t5?�.-t-R- EMAIN rn Al„ Q'C�xv'v\,�'r` �"tkr)YA CONTRACTOR'S LICENSE ‘0%,(.t Ai\x\ '�... -1 ...� `14 S c NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: 1 ❑ New ❑ Wood Existing: ❑ Sewer oAddition ❑ Steel Proposed: Bank ❑ Community System Aiteration/Remodel 0 Concrete Total: Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# 0 Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: i Private well 0 Two Party Typ f�� Proposed: ❑ Public Heat: Total: Name of System: If this is a Commercial Protect you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(indudes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit.mark all items below that apply:, I Underground Tank I Above ground Tank Size of Propane Tank: I Heat Stove I Cook Stove I Woodstove I Fireplace Insert I Hot Water Tank I Pellet Stove I Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines,tank location and size,distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. S•uare Foote'e Current Pro•osed kf.'i':, 1-..'.Ei t,.. ,.:16`6,,1;_-_,:. t,-'; t' d, :CL$114' ?! 1_ Main Floor Heated .. r, {S EH Bid App Review: k''sl`,t_kcf, 2n°Floor Heated }' I} 'r1 Consistency Review: Other Heated ;. ' ! Base fee: Mezzanine ` 1 Additional Section: tr Heated Basement '' Plan Check fee: roil, tt a Unheated Basement I'e'sZ ! State Surcharge fee: Other Unheated "A s' � Pot Water Review fee: Garage/Carport F 'I ,, SUBTOTAL Decks € `' ', 11 911/Rd Approach fee: y LLI Other in 3 s# TOTAL: $ va � ,W a: r r I'Y ' Receipt Number: 1L{ j t Cash/Check Number: 2l n: ESTIMATED COST(REQUIRED) .- . i IIII Date: � / .Fair market value of all labor and materials • ndation to finish t Initials: G:\PemtitCcntcr\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc w, i..,., ' ,f o'"''* 0*fir "..1 , !m* 1 '1,1,4,. • . .�t I '1 , `'- ,:::4. A tile, esie . $�•. -7•' • 7-'°*« li: 1-877 ;. NAN'FM( .: Hi AIINC, & AIR CONDITIONING wymbrken .': .. I NAM . HO E DA + ON DATE AcDDR s _ WORK PHONE REP x =!"" CITY ZIP COD OQ TORE# + M.°' I ,inllk� . LOCATION imor GAS LINE VENTING "_H ELECTRICAL 's ...ice-Ji✓w .rc� , ` .7' "" IAIIPFMIRF GENERAL :' «�' �, �F WORK .._ . � „�.,��. � a+t ef .�'lwwwt Pr,s..� �.aa .r. -'/I* , CUSTOMER i TO PROVIDE $ $ t $ ilia.M I EXTENDED WARRANTY EMERGENCY EARTHQUAKE SHUT-OFF ELECTRONIC AIR CLEANER $ POWER DUCT CLEANING $ SUB-TOTAL omsamiiNiiiii R AL Propose We tofurnish materials earl laborµcom In ecoordence with above specifications. AP material is guaranteed to be as specified Ali to In a a ASBESTOS a or ortbr ba *ri the ossedusslike manner acterding to the r a r a,Any s s from above r,s a«: 0 • MECHANICAL AND DEMOLITION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD13-00357 Received Date 11/8/2013 SITE ADDRESS: 23 SEA BREEZE LN Issue Date 11/8/2013 PORT LUDLOW, 98365 APPLICANT: MICHAEL D OROS TRUSTEE PHONE: (360)437-2670 CARYL A OROS TRUSTEE 23 SEA BREEZE LN PORT LUDLOW WA 983659585 21 SUBDIVISION: TEAL LAKE VILLAGE Block: Lot: PARCEL NUMBER: 998700021 Section: 21 Township: 28N Range: 01E CONTRACTOR: BRENNAN HTG &A/C LLC PHONE: 206-248-7900 4601 S 134TH PL SEATTLE WA 98168 Contractor's License BRENNHA971 R9 Expires 12/29/2013 OWNER, MICHAEL D OROS TRUSTEE PHONE: (360)437-2670 if different: CARYL A OROS TRUSTEE 23 SEA BREEZE LN PORT LUDLOW WA 983659585 PROJECT DESCRIPTION: INSTALL 4 TON HEAT PUMP Directions To Site: THIS PERMIT IS VALID FOR ONE YEAR AND IS NOT RENEWABLE. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 11/8/2014. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: 5115 ) / BUILDING INSPECTION HOT-LINE 379-4455. REQUESTS MUST BE RECEIVED BY 3 PM THE DAY BEFORE THE INSPECTION IS NEEDED. Office Hours 9:00 a.m. -4:30 p.m. Monday-Thursday HOT LINE AVAILABLE 24 HOURS A DAY \\tidemark\data\forms\F_BLD_Permit_Propane.rpt 11/8/2013 Q,�S CO °?. JEFFERSON COUNTY *v,'"''�{ DEPARTMENT OF COMMUNITY DEVELOPMENT N`ffflNG.CO Date: /Li Time Received: jq am/pm Mon. Tue. Wed. hur. F . Date: s"_ /5 BLD: j'3 -3j'-7 Contact Name: Owner: Contact Number: 360 443 7 24 76 Address: 3 s?QA. br,G.4-r..- 206 Notes: '.- U'u Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance_X_ Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection - Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling