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Home My WebLink AboutBLD2014-00140 BLD14-00140 • BUILDING PERMIT APPLILION Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00140 Received Date: 4/21/2014 SITE ADDRESS: 154 JOLIE WAY PORT TOWNSEND, 98368 OWNER: THOMAS H THIERSCH PHONE: 360-344-4030 154 JOLIE WAY PORT TOWNSEND WA 98368-9009 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001071020 Section: 7 Township: 30 N Range: 01 W CONTRACTOR: AIR FLO HEATING COMPANY INC PHONE: 360-683-3901 221 W CEDAR SEQUIM WA 98382 Contractor's License AIRFLI*206DG Expires 4/25/2014 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP LIKE IN KIND HEAT PUMP SYSTEM REPLACEMENT TYPE OF WORK NON 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: outing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $152.00 JLA 04/21/14 148574 APPROVED Total: $152.00 Jefferson County DCL \\tidemark\data\forms\F_BLD App_Bld.rpt 4/21/2014 gqN c0 JEFFEON COUNTY • a rl" DEPARTMENT OF COMMUNITY DEVELOPMENT 4 44. '� 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax 0 ) www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: Project Descri tion(include separate sheets s necessary): LI KC 10 ko 0 D I4F T JM.P S`ZS SK Qe kik-c c rkp..A1T- Tax Parcel Number. 00/ 0-7 /0Z2 Property Size: (acres/square feet) Site Address and/or Directions to Property: 749%.s S Avg- -?- o r‘L AI&J Property Owners)of Record: /p 7 1/'e./...s.G 4 / TPRO5 YS Telephone: 3`r'i-`/030 Fax: email: =g' b` ® Y4Yoo.co...., Mailing Address: /S-17' /;L (A/Al - Po'-r-/o sey�e Applicant/Agent(if different from owner): �1 r co 1 v►ev'tt r1•_ Telephone:36.0-Web-be101 Fax t0 B' - aerl r email:e.tte nee a1r-t%o 11c4. ws Mailing Address: 2• •% W. Cedar St• SeQt,MM a w ■ o1$3e1 •- What kind of Permit?(Check each box that applies Building ❑Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use) aSingle Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d),or C)** ❑ Manufactured Home ❑ Modular ❑Discretionary'D'or Unnamed Use Classification ❑ Commercial" ❑Special Use(Essential Public Facilities)*" ❑ Change of Use ❑Boundary Line Adjustment ❑ Address ❑Road Approach 0 Short Plat** ❑ Home Business ❑Cottage Industry 0 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)* 0 Shoreline Management Substantial Development** ❑Temporary Use 0 Shoreline Management Variance ❑Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District MapAmepdment ❑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„�i•r 1- ea"t'(f1- to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE !^/ �^ Date: �/7/ ca 2-t !'CS1 By signing this application form,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 Comity against all liabilities,judgments,court costs,reasonable attorneys 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 any required later inspections. Staffs access and right of entry will be assumed unless the applicant info s the County in writing at the time of the application that he or- wants prior no =_. Signature: - Date: /6( 2 e I V The action or actions Applicant 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 terms are defined in the federal law known as the "Endangered Species Act'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)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable res • ility for adherl to and complying with the ESA. The Applicant has read this disda' r and/ins and dates it below. Signature: Date: G l �f G:\PcnnitCencer\###FORMS##it\DRD FORMS\Master Penmt.Application 5-29-08.doc . . . , • 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 contraotas and that they will be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: PA V L-0 Hs*TW N b- ( ) 31i S- S3S4 ( ) (63-3511 MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: It1 FL 1 '14)k) )c7- NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New 0 Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel 0 Concrete Total: Height: ❑ Individual System ❑ Repair 0_ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: - Existing: Setback: ❑ Private well 0 Two Party Typ f,N ' Proposed: 0 Public Total: Name of System: If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(includes 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 fora 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, includin• the reserve area. S•uare Foota,e Current ° •• •_ed -- _b�-N ,i _, ' :., 1 z . -- Main Floor Heated ,•.-,-.,... . .... . . ' -T EH Bid App Review: Floor Heated Consistency Review: Other Heated Base fee: Mezzanine - Additional Section: Heated Basement Plan Check fee: } Unheated Basement State Surcharge fee: Other �h" -ham ther Unheated Pot Water Review fee: Garage/Carport .h SUBTOTAL y , Decks 911/Rd Approach fee: Other • r A v M MN' u TOTAL: $ SYsi G►� � -p •.� � _. Receipt Number: Cash/Check Number: ESTIMATED COST(REQUIRED) Date: .Fair market value of all labor and materials foundation to finish fk fk'Cj (J„ r5 Initials: • • G:\PermitCenter\###FORMS###\DRD FORMS\Master Nana Application 5-29-08.doc • • .7 fit • cfNi t. 0 a 0, AIR FLO HEATING COMPANY Check Number: 42224 4 2 2 2 4 Jefferson County Building Department Date Description Amount 04/16/2014 Thiersch Permit 171.00 Screen: 01 REAL PROPERTY MASTER Mode: INQUIRY Parcel # 000001071020 eo Cd 300107102110 • Auto Roll : OFF S7 T30N R1W Nbhd Cd 5325 S1/2 E1/2 E1/2 NW NE SUBJ/EASE Loc ID * Taxpayer Cd THIE 3500 THIERSCH, THOMAS H T/P Chg Dt 5/21/2001 * Title Owner T/P Chg Usr JODI Tax Code 0111 Status TX TAXABLE Land Use 1100 RES-SINGLE Affidavit 92108 Vol/Page / C/U Code COMPLETE ADDRESS WINDOW Taxpayer THIE3500 THOMAS H THIERSCH 154 JOLIE WAY PORT TOWNSEND WA 98368-9009 Search Key CMD 6: End Window CMD 7: End of Job AIR FLO HEATING COMPANY INC Page 1 of 3 • • alWashington State Department of Labor & Industries AIR FLO HEATING COMPANY INC Owner or tradesperson 221 W CEDAR BEQUETTE, MARK A SEQUIM,WA 98382 360-683-3901 Principals CLALLAM County BEQUETTE, MARK A BEQUETTE, SANDRA ABERSON,JOEL RFULLAWAY, MICHAEL (End: 04/01/2010) Doing business as AIR FLO HEATING COMPANY INC WA UBI No. Business type 600 347 761 Corporation Governing persons MARK BEQUETTE SANDRA BEQUETTE; License Verify the contractor's active registration/license/certification (depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties Heating/Vent/Air-Conditioning and Refrig (HVAC/R) License no. AIRFLI*206DG Effective—expiration 03/07/1980—04/25/2016 Bond CBIC $6,000.00 Bond account no. SI5215 Received by L&I Effective date 02/05/2010 02/01/2010 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&LIC=AIRFLI*206DG&SAW= 4/21/2014 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#: BLD14-00140 Received Date 4/21/2014 SITE ADDRESS: 154 JOLIE WAY Issue Date 4/21/2014 PORT TOWNSEND, 98368 APPLICANT: THOMAS H THIERSCH PHONE: 360-344-4030 154 JOLIE WAY PORT TOWNSEND WA 98368-9009 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001071020 Section: 7 Township: 30N Range: 01W CONTRACTOR: AIR FLO HEATING COMPANY INC PHONE: 360-683-3901 221 W CEDAR SEQUIM WA 98382 Contractor's License AIRFLI*206DG Expires 4/25/2014 OWNER, THOMAS H THIERSCH PHONE: 360-344-4030 if different: 154 JOLIE WAY PORT TOWNSEND WA 98368-9009 PROJECT DESCRIPTION: LIKE IN KIND HEAT PUMP SYSTEM REPLACEMENT 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 4/21/2015. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: Tank/Line/Appliance: Final Approval: q-( _ /kf 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_Pemiit_Propane.rpt 4/21/2014 t,O\ �, JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT �SN!\G'C°2 Date: Time Received: 02_,(‘2_ am€ Mon. TUT) Wed. Thur. Fri. Date: BLD: )(i- I `lb Contact Name: Owner: Contact Number: 360 3 T T L1O Address: i64 ,(6tk_-w Ny 206 Notes: 1) / H- k- O)tr/ 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 _ _ Ceilin: JEFFERSON COUNTY NO. 148574 DATE d,24-I 7 RECEIVED FROM P'v f1.-- -iAl DESCRIPTION /► BARS# AMOUNT CURRENCY '-cm s2,6 COIN oc. l 1. 11.. riff I 6-1 i° Z.---c, iaiti. K f v -4 0 r ter 73 o k t sus _ : x.14 6 3. 1 4, di RECEIVED BY TOTAL ti k. -c7'()