The URL can be used to link to this page

Home My WebLink AboutBLD2014-00179 •BUILDING PERMIT APPLICIION BLD14-00179 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00179 Received Date: 5/21/2014 SITE ADDRESS: 282 CRESTVIEW DR PORT LUDLOW, 98365 OWNER: CURTIS W WEBER PHONE: 360-316-9373 AMELIA E WEBER 282 CRESTVIEW DR PORT LUDLOW WA 98365-8003 TEAL LAKE VILLAGE SUBDIVISION: Block: Lot: PARCEL NUMBER: 998700017 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 12/29/2015 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION INSTALL HEAT PUMP TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION 2,500.00 ADD'L: HEAT TYPE: HTP CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: 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 05/20/14 148681 Total: $152.00 APPROVED MAY 21 2014 Jefferson County DCD • \\4irlcmor1Ari.+0 forme\F RI Il Gnn PIA rnf A/11 Ml1 A Vic, JEFFERSON COUNTY 4 DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend•Washington 98368 360/379.11450. 360/379-4451 Fax 421"' )114 ):),.? -- www.cojefferson.wa.us/commdevelopment PMastter Permit Application MLA: 1 9\ \` M\sheets v necessary): Tax Parcel Number.(\Q(2j-4()t)C)l Property Size: (acres/square feet)_ Site Address and/or Directions to Property: es-a.). ot.01/4) Dr . 12 YA- Lk)A low a e3lio6 Property Owner(s)of Record: (I V r -V\ `S • {.r Telephone:3b0. 31(. • Q 3--4-''S Far email: Mailing Address: N\A- A g St -- 11 Applicant/ ent(if different from owner): ' t .-1 v,_t f , Telephone::,/Cis tg b� Fax �0 pp t email) 1 YY1'i t 0.�br unwa ►� UL-1 i)t4 . Mailing Address: Lk CP b� es V.14 1A-% t_ S a 0.4I.c... Q 1 to t3 Co rti) What kind of Permit?(Check each box that applies ❑Building ❑Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use) mingle Family ❑Garage Attached/Detached ❑Conditional Use[C(a).C(d),or CI** ❑ Manufactured Home ❑ Modular ❑Discretionary"D'or Unnamed Use Classification ❑ Commercial* ❑Special Use(Essential Public Facilties)** ❑ Change of Use ❑Boundary Line Accustment ❑ Address ❑Road Approach ❑Short Plat"* ❑Home Business ❑Cottage Industry ❑Binding Site Plan" ❑Propane ❑Long Plat''* ❑Sign ❑Planned Rural Residential Development(PRRD)(Amendments** ❑Allowed'Yes"Use Consistency Analysis ❑Plat Vacation/Alteration** ❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions" ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development** . ❑Temporary Use ❑Shoreline Management Variance ❑Wireless Telecommunication• ❑Comprehensive Plan/UDC/Land Use District Map Amendment ❑Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment *May require a Pre Application Conference ❑Tree Vegetation Request **Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal,if known: DESIGNATION OF AGENT I hereby designate "A • , is • to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE �-- > Date: 5 J i ) I `I By signing this app t-,•• •Rn,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or its knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,Indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and, • required later Inspections. Stairs access and right of entry will be assumed unless the applicant informs the County in writing at the time of ••n that he pr she is prior notice. l Signatu > !- - - ...... T Date: 1-41)I LI . The-.•'• actiOns.Appli:ant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those tens are defined in the federal law known as the 'Endangered Species Ad"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)_ : you are in compliance with the Jefferson County development code.The Applicant ack — an Sig no t-.. sp my ;. adhering i�complying with the ESA. The Applicant has read the I l i Nu ! ;,via', Date. rat ri/I ' G:\PeamnC«uec\###FORMS###\DRD FORMS\Master Permit Appliation 5-2"84' I 1 I MAY 2 0 2014 i JEFFERSON COUNTY DEPT.OF COMMUNITY DEVELOPMENT • • BUILDER STATEMENT The signer of this statement does hereby certify that they are the Bwnsrs of the parcel referenced herein,that they are not licensed contractors and that they wit be assuming the responsibiiiy of the General Contractor far the proposed prr�Ct. Signature Date: ENERAL CONTRACTOR OR UFACTURED HOME INSTALLER: PHONE: FAx: �: !�s <_ . . (20', • DO (�lO�c q`35 r MAILING ADDRESS: B 1 � !_ a i _ • t ... . Imo mil, f"�! l CONTRACTOR'S LICENSE bs(, e, • "�� • i �� s "` NS c. NUMBER: NUMBER ARCHITECT/ENGINEER: ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: o New ❑ Wood Existing: 0 Sewer r3 Addition ❑ Steel Proposed: Bank o Community System Er-Alteration/Remodel p Concrete Total: Height ❑ individual System i3 .Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type Heat: Proposed: ❑ Public .1 t.(.., Total: Name of System: • if this is a Commercial Proiect you must answer the foliowina: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(urdudes owners,tenants,err loyees,etc) Cun�ent Proposed IBC Occupancy: IBC Type of co nstrue ion: Will you have Food Service? Yes / No if this Is a Propane Tank and/or Appliance Installation eennit,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 1 Pellet Stove i Other Is this aaaiiance belne installed in a Manufactured/Mobile Horne? Yes I No When applying fora permit to Install a propane tank you must also submit a site plan showing all of the buildings,al!property lines,tank location and sins,distances from the propane tank to all property lines,buildings 77,s.: ptic system components,. .. including the reserve area. Square Footage Current Proposed �.T ,_._ Main Floor Heated ;4 EH Bid App Review: 2"°Floor Heated Consistency Review: Other Heated Base fee: . . .o U Mezzanine 1 Additional Section: 1 ci ' 13° Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Catport SUBTOTAL Decks -A-4,04,T4 911/Rd Approach fee: other her * TOTAL: $ li .---) 1 • Lii) 5 � Receipt Number. i IC i d U " Cash/Check Number. H1D`4L4 ESTIMATED COST(REQUIRED) '"' iL, Date: v t •r�rmarket value of all labor and me,_. -,c� to �ish i Initials: i \_i.' ` MAY 2 0 2014 G:\PeanitCcuc\###FORMS###\DRD FORMS\Master Pcimzt Application 5-29-08.doc 4""' JEFFERSON COUNTY DEPT.OF COMMUNITY DEVELOPMENT • MAY 2 0 2014 JEFFERSON COUNTY OPT OF COMMUNITY DEVELOPMENT (L- \ 6,4 it A-6-e- 6Y'rse,D6- 146/4-7- PL.1/-"P ! 5 c' (c 4-1 BRENNAN HEATING & A/C LLC Page 1 of 2 • • 0 Washington State Department of Labor & Industries BRENNAN HEATING & A/C LLC Owner or tradesperson 4601 S 134TH PL ERDAHL, DARRIN PAUL SEATTLE, WA98168 206-248-7900 Principals KING County ERDAHL, DARRIN PAUL, PARTNER/MEMBER Doing business as BRENNAN HEATING&A/C LLC WA UBI No. Business type 602 346 866 Limited Liability Company License Verify the contractor's active registration/license/certification (depending on trade) and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. BRENNHA971R9 Effective—expiration 12/29/2003—12/29/2015 Bond FEDERATED MUTUAL INS CO $12,000.00 Bond account no. 9127230 Received by L&I Effective date 11/04/2004 12/22/2004 Insurance Federated Mutual Ins Co $1,000,000.00 Policy no. 9820726 Received by L&I Effective date 06/10/2013 07/13/2007 Expiration date 07/13/2014 Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. Tax debts https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602346866&LIC=BRENNHA971R9&SAW= 5/8/2014 • JEFFERSON COUNT IDCD NO. 14 6 $1 DATE G JXJ 4. ® ' a , T c a RECEIVED FROM .� * d ��►�� 1 f At t. _sill 1�� , _ _7 DESCRIPTION ' BBAARRSS##j AMO yT CURRENCY I��""+' ` /St ,t COIN JL 'I, /1• CHECKS 4 1, � a *406 2 -I /nom , ) K • �> ��/. Ls ( 111 7 i O v. ovvvi RECEIVED BY _�.!A/ �Lr , .� i� TOTAL /�1/, °I) i r t 4¢SON C ;Q �Ga JEFFERSON COUNTY �J_1 /c9 DEPARTMENT OF COMMUNITY DEVELOPMENT 9,pyr NO1.O} �. Date: c4 7 Time Received: 97 7 arr 'pm Mon. Tue. ed. Thur. Fri. l Date: j BLD: /V /79 Contact Name: Owner: Contact Number: 360 (137 ?' 9 Address: -2.22, Cr-c.S7VitAi 206 Notes: J ed P91411 Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance 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 • • 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#: BLD14-00179 Received Date 5/21/2014 SITE ADDRESS: 282 CRESTVIEW DR Issue Date 5/21/2014 PORT LUDLOW, 98365 APPLICANT: CURTIS W WEBER PHONE: 360-316-9373 AMELIA E WEBER 282 CRESTVIEW DR PORT LUDLOW WA 98365-8003 SUBDIVISION: TEAL LAKE VILLAGE Block: Lot: PARCEL NUMBER: 998700017 Section: 21 Township: 28N Range: 01E CONTRACTOR: BRENNAN HTG &NC LLC PHONE: 206-248-7900 4601 S 134TH PL SEATTLE WA 98168 Contractor's License BRENNHA971 R9 Expires 12/29/2015 OWNER, CURTIS W WEBER PHONE: 360-316-9373 if different: AMELIA E WEBER 282 CRESTVIEW DR PORT LUDLOW WA 98365-8003 PROJECT DESCRIPTION: INSTALL 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 5/21/2015. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: Tank/Line/Appliance: =1?l TLfIMP 1 ,s-r& ,Qr/Ok) DR" .56.01 Final Approval: OK -C 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 5/21/2014