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HomeMy WebLinkAboutBLD2014-00139 • BUILDING PERMIT APPLIION BLD14-00139 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00139 Received Date: 4/21/2014 SITE ADDRESS: 142 CRESTVIEW DR PORT LUDLOW, 98365 OWNER: ALVIN N PRESTON PHONE: 360-437-5188 142 CRESTVIEW DR PORT LUDLOW WA 98365-9200 TEAL LAKE VILLAGE SUBDIVISION: Block: Lot: PARCEL NUMBER: 998700006 Section: 21 Township: 28 N Range: 01 E 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: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $152.00 JLA 04/21/14 148575 Y ����,j�� Total: $152.00 Jefferson County DCL I \tidemark\data\forms\F_BLD_App_BId.rpt 4/21/2014 .FS°N cc, JEFFERSON COOP F Gam. DEPARTMENT OF COMMUNITY DEVELOPMENT �`S��r\G�°2 Date: iv/Time Received: .l,z- r r:arr dia Tue. Wed. Thur. Fri. Date: 7/2I BLD: /1(-137 Contact Name: Owner: Contact Number: 360 4437 5-/ Address: / 64 -i t-V)e- 206 Notes: 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 ,X, Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling V c--4-e) • NO. 1 i...4f,8 21-1__ t JEFFERS. COUNTY DATE p,c;\/ BARS# RECEIVED FROM I 2- DESCRIPTION AMOUNT CURRENCY 0117 COIN 411L4. . , . 423/13 cni ro / 4(1 m ,i'l Ar . , 33 0 0 -r, t7 /- O _... f4-- TOTAL RECEIVED BY Apr 12 14 01:31p John and Marth3Fort •372268 p.1 QIo cD JEFFERSON COUNTY /L°\ I °)140:-f.3` DEPARTMENT OF COMMUNITY DEVELOPMENT *0441 621 Sheridan Street• Port Townsend •Washington 98366 \� ` �• 360/379-4450 • 3601379-4451 Fax (�� www.co.jaefferson.wa.usfcommdevelopment Master Permit Application - MLA: • Project Description include separate sheets as necessary): Late t xi,Jt, ik ettfr Pi Pk 1) 464 sTI M Re PPuA:c gke al- Tax Pared Number: Act I '1 G o C o !o Property Size: (acxesfssuare feet) Site Address and/or Directions to Property: ' S1-' ► 1 qe PO " - w ► 1...00.4)Property Owner(s)of Record: L % $,-r o Telephone: - x; Fax email; Mailing Address: l IA. R, ` t 1 )bt_bvJ - (n T , Applicant/Agent(if different from owner): ;e r -►o - In` Telephone:3tto^tD$ ~boot Pa,c d - ' email:Bite neaai►r-ttohtatila.cann • Malting Address: 2• •1 . Cedar - rn - =N -- What kind of Permit?(Check each box that applies , bBuitding ;', El Critical Areas Stewardship Plan 0 SingDemolition ammily� 0 Garage Attached/Detached El Variance(Minor.�[CM)Major CCM Economic Use) • 0 Manufactured Horne 0 Modular i' 0 Discretionary"p or Unnamed Use Classilcafion • El Commercial" 0 Special Use(Essential Public Facilities)" 0 Change of Use ©Boundary Line Ad ►ent 0 Address 0 Road Approach 0 Short Plat'" 0 Home Business 0 Cottage Industry ❑Binding Site Plan" 0 Propane D Long Plat" 0 Sign ❑Planned Rural Residential Development(PRRD►/Amendments" D Allowed ryes"Use Consistency Analysis ❑Plat Vacation/Alteration" 0 Sto nevater Management 0 Shoreline Master Program Exemption/Permit Revisions" Site Plan Approval Advance Determination(SPAAD)` ❑Shoreline Management Substantial Development•" '` • emporary Use • 0 Shoreline Management Variance s Wireless Telecommunication• D Comprehensive Plan/UDC/Lend Use District Map Amm dme t q Forest Practices Act/Release of Six Year Moratorium 0 Jefferson County Shoreline Master Program Amendment 1fipy cquhs s Pia-Application Conference ❑Tree Vegetation Request , • . "Rege1res a Pra-A teaeon Conference, identity any other local,state or federal permits required for this proposal,if knows: . D a: c • 0 OF AGENT by•esigrrate,' p E 1 4 o lea' 14%3 to act as my agent in mailers relating to this application for�mtt(s). „. StGaxi RE 1. /P.«��`l�- -. XIIK Date: ' / 011 y g this application fora:the ownerfagent attests that the information provided herein,and in any attachment%is true and correct to the best of oc its knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application padtet 1 ln.t(mis perm*being nue and void. • 'to save,indemnity and hold harmless Jefferson ��, �!� ey aSalast all liabilities,judgments,court costs reasonable attorneys fees and which may in any way accrue against Jefferson County as a result of or in Consequence ether granting of this perma agree to provide access and right of entry to Jefferson County add its employees,representath es or agents for the sole purpose of application and any required later Inspections. Staffs access and right of entry wit be assumed unless the applicant informs the County In writing at the ,of the applica on that he or she wants prior notice. Date:�,: `3 /I�.Llw YrJ f-�'k Dail 44/2_41- • or actions Applicant will undertake as a result of the issuance of this permit may negatively Inspect upon one or more threatened-or -• species and could lead toe potential"take”of an endangered species as those terms are defined in the federal law known as the �,- ;:.Species Acct'or"ESA."Jefferson County makes no assurances to the applicant that the actions that wit be undertaken because this `1 : it been Issued w not violate the ESA. Any fndh+tdual,group or agency can lie a tenet on behalf of an endangered species regatdmg.your even if you are in compliance with the Jefferson County development code.The Applicant adamoeledges that he sheer K holds individual Anil,. tie responsib baring to and complying with the ESA. The Applicant has read this disclaimer and signs and dates t below. Signature: c Date: y/ ,,/, • / "/ Gc\PermiCCcnt r1###FORMS###\DRD FO dater Pean pp&aition 5-29-OS4oc • 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 conbooters 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: F-t.0 tke ft UN h-- ( >MS-S3Si+ ( ) 4g3-3c111 MAILING ADDRESS: %4X‘ • cf k sr F �„L2 v,A\ EMAIL: 4S U w r WAINS LICENSE NUMBER: Al ZL.� --0 g C., —. ., — NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: 0 New ❑ Wood Existing: ❑ Sewer O Addition ❑ Steel Proposed: Bank 0 Community System O Alteration/Remodel ❑ Concrete Total: Height: 0 Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other Bedrooms: Water Supply: Existing: Setback: 0 Private well 0 Two Party Ty f eat • Proposed: ❑ Public ¶) C. 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 Aboveground 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, includin• the reserve area. S•uare Foota t e Current • • .•=ed '° , s fi . Main Floor Heated -^- k}. EH BId App Review: 2"0 Floor Heated _,_ ' Consistency Review: Other Heated Base fee: Mezzanine Additional Section: `i. 3 1` i� +� Heated Basement fi T`` Plan Check fee: Unheated Basement 1 ,- State Surcharge fee: Other Unheated 3 a t Pot Water Review fee: Garage/Carport }° SUBTOTAL Decks 911/Rd Approach fee: Other F pa 1 .A I'`Q Irk i ` � ,' TOTAL: $ ‘(411'k Receipt Number: "" Cash/Check Number: ESTIMATED COST(REQUIRED) Date: .Fair market value of all labor and materials foundation to finish 0 q 4(_�P- Initials: . l G:\PemtitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc • ■ ‘It Per _ In r " ►-X54'°''' PcL' t/ p t\1 AIR FLO HEATING COMPANY 4 2 2 2 3 Check Number: 42223 Jefferson County Building Department Date Description Amount 04/16/2014 - Preston Permit 171.00 III • Screen: 01 REAL PROPERTY MASTER Mode : INQUIRY Parcel # 000998700006 4Peo Cd 282121107231 • Auto Roll : OFF TEAL LAKE VILLAGE Nbhd Cd 3351 LOT 6 (REVISED V6/PG 188-197) Loc ID * Taxpayer Cd PRES 3300 PRESTON, ALVIN N T/P Chg Dt 5/28/2002 * Title Owner T/P Chg Usr JA Tax Code 0231 Status TX TAXABLE Land Use 1100 RES-SINGLE Affidavit 94626 Vol/Page / C/U Code COMPLETE ADDRESS WINDOW Taxpayer PRES3300 ALVIN N PRESTON 142 CRESTVIEW DR PORT LUDLOW WA 98365-9200 Search Key CMD 6: End Window CMD 7: End of Job • AIR FLO HEATING COMPANY INC Page 1 of 3 Chill I tashington.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 HeatingNent/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 S 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#: BLD14-00139 Received Date 4/21/2014 SITE ADDRESS: 142 CRESTVIEW DR Issue Date 4/21/2014 PORT LUDLOW, 98365 APPLICANT: ALVIN N PRESTON PHONE: 360-437-5188 142 CRESTVIEW DR PORT LUDLOW WA 98365-9200 SUBDIVISION: TEAL LAKE VILLAGE Block: Lot: PARCEL NUMBER: 998700006 Section: 21 Township: 28N Range: 01 E 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, ALVIN N PRESTON PHONE: 360-437-5188 if different: 142 CRESTVIEW DR PORT LUDLOW WA 98365-9200 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: -712,// 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 4/21/2014