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HomeMy WebLinkAboutBLD2014-00256 - MECHANICAL IOUILDING PERMIT APPLICAION BLD14-00256 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00256 Received Date: 7/22/2014 SITE ADDRESS: 41 MC ARDLE AVE QUILCENE, 98376 OWNER: DONALD L WARD PHONE: 360-765-3336 LORNA J WARD PO BOX 65 QUILCENE WA 98376-0065 9372 SUBDIVISION: Block: Lot: PARCEL NUMBER: 937200401 Section: 24 Township: 27 N Range: 21/1 CONTRACTOR: GREENWOOD HEATING AND AC PHONE: 206-784-1818 825 S STACY ST SEATTLE WA 98134 Contractor's License GREENHA922D7 Expires 3/27/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOF Install New Heat Pump TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC VALUATION MAIN: CODE EDITION: 2012 ADD'L: HEAT TYPE: HTP OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: 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 at Permit $152.00 SRE 07/22/14 151276 /APPROVED Total: $152.00 JUL 2 2 2014 Jefferson County DOD \\tidemark\data\forms\F_BLD_App_Bld.rpt 7/22/2014 JUL/22/2014/TUE 11 : 08 AM Green* Heating FAX No. 206 462 iiii6 P. 003 W 131-1) LI—25(4P soN cow JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street I Port wwwco,lofferson,wa.us/communitvdevelopment WA 98368 I Web;wwco,lofferson,wa.us/communitvdevelopment Noy° Tel:360.379,4450 I Fax;360.379.4451 I Email;dcdeco.iefferson.wa.us Building Permits&Inspections I Development Consistency Review I Long Range Planning I Watershed Stewardship Resource Center Master Permit Application MLA: w Project Description(include separate sheets as necessary): 1 _duc ec lea- um p . 1'Y�� -s+ub�, h�t. (r\ (Z.'B 2Ll NA Tax Parcel Number. Q572 4C41p/ Property Size: (acres/square feet) Site Address and/or Directions to Property: �►1 m rrdte Aye , Quileene, coA 98A 37/0 Property Owner(s)of Record:, Don llOaicL Telephone: 3(p0•7Co S33Lo Fax: • email: Mailing Address: Po BOX 6:05, Chtilcosve s LcM 4 113—llc Applicant/Agent(if different from owner): 614e,en 000l] Mecall not. frrC. Telephone: 1.0tet litti nit _Fax: WU'4 to , email:QeM31D a +f+tertuaoo e.405. R Mailing Address: i v. ti _ •_., 4� _ . 01 What kind of Permit?(Check each box that applies ❑ Lot or Road Segregation ❑Building ❑Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Use) .Single Family ❑Garage Attached/Detached ❑ Conditional Use[C(a),C(d),or CI ❑ Manufactured Home ❑ Modular ❑ Discretionary"D°or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use CJ Boundary Line Adjustment ❑ Address ❑ Road Approach ❑Short Plat** ❑Home Business 0 Cottage Industry O Binding Site Plan** ❑Propane ❑ Long Plat** ❑Sign ❑ Planned Rural Residential Development(PRRD)/Amendments*" O Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration** ❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions''" O 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 e'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 ór ePi i-- ` arm to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Data: 1! 7.7.• ‘14 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 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 any required I-+=r i p ions. •tafrs access and right of entry will be assumed unless the applicant informs the County In writing at the time of the application " - e • • ,-f''?- �r notice. (4 • Signature: .!J bate: ` ZZ-1 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 wilt 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 respo dherin d complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: Date; '7• ii- (14 07/24/2013 JUL/22/2014/TUE 11 : 09 AM Greenwd Heating FAX No. 206 462 46 P. 004 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: GENERAL CONTRACTOR Oe MANUFACTURED HOME INSTALLER: PHONE: FAX: Greenwood Heating and AC (206 ) 784-1818 (206 )462-6216 ' MAILING ADDRESS: 825 S Stacy St EMAIL: ashleyb @greenwoodheating_com CONTRACTOR'S LICENSE T WAINS NUMBER: G REE N HA922 U7 NUMBER ARCH TECT/ENGINEER: PHONE (206 ) 7$4.1618 FAX:(206 )462-6216 MAIUNG ADDRESS: 825 S Stacy St EMAIL ashleybegreenwoodheaeng.com Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: ❑ Sewer 0 Addition ❑ Steel Proposed: Bank 0 Community System ,6,_Alteration/Remodel 0 Concrete Total: Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# o Demolition ❑ Other; Bedrooms: Water Supply: . Existing: • Setback: 0 Private well ❑ Two Party Tye of Heat: Proposed: ❑ Public Eltbiric, 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: II3C 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: Underground Tank Above ground tank Size of Propane Tank: Heat Stove Cook Stove Woodstove Fireplace.nsert rehtO I evotS telleP I knaT retaWtoH I Is this appliance bein,p installed in a Manufactured/Mobile Home? Yes / o 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. __ . _ . . , , . Square Footage Current Proposed For Office Use Only . . • Amount Revision .• . Main Floor Heated • • EH Bld App Review: 2'Floor Heated Consistency Review: Other Heated • . : ' Base fee: ' 51 pp Mezzanine . • Additional Section: I .VQ Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated • • •• . Pot Water Review fee: Garage/Carport SUBTOTAL Decks . • 911/Rd Approach fee: Other TOTAL: $ ` -i - 03 • " Receipt Number: C 51'1`-t �} ) • Cash/Check Number: "( C.C. ESTIMATED COST(REQUIRED) to Date: *Fair I .Fair market Value of all labor and materials foundation finish . L o o Initials: 07/24/2013 GREENWOOD HEATING AND AC Page 1 of 4 • • 13 Washington State Department of Labor & Industries GREENWOOD HEATING AND AC Owner or tradesperson 825 S STACY ST PORTER, MICHAEL SEATTLE,WA 98134 206-784-1818 Principals KING County PORTER, MICHAEL, PRESIDENT PORTER, MICHAEL, AGENT Doing business as GREENWOOD HEATING AND AC WA UBI No. Business type 602 259 014 Corporation Parent company SELECT AIR SERVICES INC License Verify the contractor's active registration/license/certification (depending on trade)and any past violations. Electrical Contractor Active. Meets current requirements. License specialties HVAC/RFRG License no. GREENHA922D7 Effective—expiration 03/27/2008—03/27/2016 Designated administrator Active. PORTER, MICHAEL Meets current requirements. License type License no. Master Electrician PORTEM*957BE Bond CBIC $4,000.00 Bond account no. SI5623 Received by L&I Effective date 03/19/2010 04/10/2010 Expiration date Until Canceled Bond history Savings https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602259014&LIC=GREENHA922D7&SAW= 7/22/2014 GREENWOOD HEATING AND AC Page 2 of 4 No savings accounts during the pre.6 year period. • License Violations Infraction no. EHRAL00800 Satisfied Violation date RCW/WAC 09/10/2010 19.28.101 RCW Violation city Violation amount Seattle $250.00 Type of violation ELECTRICAL CITATION Description Energizing electrical equipment without an electrical inspection as referenced in WAC 296-46B-900(10)(a),effective after 12/30/2008 see WAC 296-46B-901(10)(a).WAC 296.46B.901(1). Infraction no. EHRAL00801 Satisfied Violation date RCW/WAC 09/10/2010 19.28.101 RCW Violation city Violation amount Seattle $250.00 Type of violation ELECTRICAL CITATION Description Failing to request an inspection within 3 business days after completion of the installation or 1 business day after energizing, whichever occurs first as referenced in WAC 296-46B-900(10)(a),effective after 12/30/2008 see WAC 296-46B-901(10)(a). Infraction no. EHRAL00799 Satisfied Violation date RCW/WAC 09/10/2010 19.28.101 RCW Violation city Violation amount Seattle $2,000.00 Type of violation ELECTRICAL CITATION Description Failing to obtain or post an electrical/telecommunications work permit prior to beginning the electrical/telecommunication installation or alteration as referenced in WAC 296-46B-900 (3)(6), effective after 12/30/2008 see WAC 296- 46B-901(3)(6). https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602259014&LIC=GREENHA922D7&SAW= 7/22/2014 GREENWOOD HEATING AND AC Page 3 of 4 Infraction no. • • EAARG00317 Satisfied Violation date RCWM(AC 05/11/2010 19.28.101 RCW Violation city Violation amount SEATTLE $1,000.00 Type of violation ELECTRICAL CITATION Description Failing to obtain or post an electrical/telecommunications work permit prior to beginning the electrical/telecommunication installation or alteration as referenced in WAC 296-46B-900 (3)(6),effective after 12/30/2008 see WAC 296- 46B-901(3)(6). For the AC to Furnace control cable. Infraction no. ELEIS00359 Satisfied Violation date RCW/WAC 04/27/2010 19.28.101 RCW Violation city Violation amount Seattle $250.00 Type of violation ELECTRICAL CITATION Description Failing to obtain or post an electrical/telecommunications work permit prior to beginning the electrical/telecommunication installation or alteration as referenced in WAC 296-46B-900 (3)(6),effective after 12/30/2008 see WAC 296- 46B-901(3)(6). Workers' comp Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. L&I Account ID Account is current. 043,142-00 Doing business as GREENWOOD HEATING&AIR CONDIT Estimated workers reported Quarter 1 of Year 2014"Greater than 100 Workers" L&I account representative T3/KRISTI LINN(360)902-4612-Email: LINB235 @Ini.wa.gov Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602259014&LIC=GREENHA922D7&SAW= 7/22/2014 GREENWOOD HEATING AND AC Page 4 of 4 Citation issue date • • 06/12/2013 Violations Inspection no. 316775709 Location 825 S Stacy St Seattle,WA 98134 Citation issue date 10/30/2012 Violations Inspection no. 316535871 Location 3217 Eastlake Ave E Seattle,WA 98102 ©Washington State Dept.of Labor&industries.Use of this site is subject to the laws of the state of Washington. Access imaashiitt amti§k e4GV�r itif os$iG https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602259014&LIC=GREENHA922D7&SAW= 7/22/2014 Parcel Details Page 1 of 2 III • C i - r o 4 I '''1 S-- f'4'. ' ie fe son un y i( :-,,--4-'14 4.°°';'''' ..,,r —"" '„ ''", —"'"''---'''''''— _ .. :- --"s. ---"—:....:;':: - _ '1",,,.'"--°'±',F4% ''. 7; ,,, ''',”,s7',H": . _ x - � : Home County info Departments� - march 1 3p. .0 Parcel Number: 937200401 SEARCH Parcel Number: 937200401 Printer Friendly Owner Mailing Address: DONALD L WARD LORNA J WARD PO BOX 65 QUILCENE WA98376-0065 Site Address: 41 MCARDLE AVE QUILCENE 98376 Section: 24 School District:Quilcene (48) Qtr Section: NE1/4 Are Dist: Quilcene (2) Township: 27N Tax Status: Taxable Range: 2W Tax Code: 0320 Planning area: Quilcene (10) Sub Division: 9372 - CAMPBELL'S H.W. Assessor's Land Use Code: 8300 - Open Space Agricultural (A) Property Description: CAMPBELL'S H.W. ADDITION BLK 4 LOT 9 Tax,A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel Plats&Surveys Septic Monitoring Info Jefferson Co 7r 1}' - HOME l COUNTY INFO I DEPARTMENTS I SEARCH Best viewed with Microsoft Internet Explorer 6.0 or later ie Windows - Mac http://www.co.j efferson.wa.us/assessors/parcel/parceldetail.asp?Parcel_NO=93 7200401 7/22/2014 JEFFERSON COUNTY •r) NO. 151!76 DATE ( 4 RECEIVED FROM J5t ti ed«r- DESCRIPTION BARS# AMOUNT ' at, .}� CURRENCY �j ) 6/v j" . 1 �.00 svf-, COIN `�./ !l`� + _I / ° !) ,I cc' `'CTa ECIC9� CO , ,,,,, 04444 tti, il. rn II ter., n RECEIVED BY �° 1,k' TOTAL 13 ! ` U Point& Pay - Create Order Page 1 of 1 • • Thank you for your payment! This service has been provided by Jefferson County Dept of Community Development, WA and Point& Pay. We value your business. Please keep this receipt for future reference. You have made a payment to Jefferson County Dept of Community Development, WA . Jefferson County Department of Community Development thanks you for your payment. For questions about your account, please call 360-379-4452 Name: Jesse Lehmbecker Address: 825 S Stacy St, Seattle WA, US, 98134 Contact: 2067841818 Comments: Payment ID: 14491349 Date: 07/22/14 11:41 AM Subtotal: $171.00 Fee: $5.00 Total: $176.00 Method: Credit or Debit Card(************7235) Item Purchased Transaction Description Account Amount Residential Applications Jefferson Co C D GOV 937200101 $171.00 Signature: Date: / / By signing this receipt you agree to the terms and conditions of this service. You will see one line item on your credit or debit card statement indicating the amount you paid and will be identified as Jefferson Co C D GOV. If you have any questions about the charges please call 1-888-891-6064. Print Receipt Close Window https://agent.pointandpay.net/pointandpay_counter/viewReceipt.do?method=viewPayment... 7/22/2014 FSO\ � OFF iGi JEFFERSON C Y • DEPARTMENT OF COMMUNITY DEVELOPMENT 9SHtNG o Date: 1 zy Time Received: 01,0 am pm Mon. Tue. Wed. Thur. 4. BLD: _ Date: '7-25- L} -2 Contact Name: Owner: Contact Number: 360 Address: 206 tt% gl./�.- Notes: Foundation Plumbing Framing Propane Tank p Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Straps Oil p Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Setbacks Final Inspection Floor Foundation Wall Block&Tile Address Posted Ceiling z,�,,gGh coo • • 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#: BLD14-00256 Received Date 7/22/2014 SITE ADDRESS: 41 MC ARDLE AVE Issue Date 7/22/2014 QUILCENE, 98376 APPLICANT: DONALD L WARD PHONE: 360-765-3336 LORNA J WARD PO BOX 65 QUILCENE WA 98376-0065 SUBDIVISION: 9372 Block: Lot: PARCEL NUMBER: 937200401 Section: 24 Township: 27N Range: 2W CONTRACTOR: GREENWOOD HEATING AND AC PHONE: 206-784-1818 825 S STACY ST SEATTLE WA 98134 Contractor's License GREENHA922D7 Expires 3/27/2016 OWNER, DONALD L WARD PHONE: 360-765-3336 if different: LORNA J WARD PO BOX 65 QUILCENE WA 98376-0065 PROJECT DESCRIPTION: Install New 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 7/22/2015. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: Tank/Line/Appliance: Final Approval: liL., 1)Z1k 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 7/22/2014 tILDING PERMIT APPLICATION BLD14-00256 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00256 Received Date: 7/22/2014 SITE ADDRESS: 41 MC ARDLE AVE QUILCENE, 98376 OWNER: DONALD L WARD PHONE: 360-765-3336 LORNA J WARD PO BOX 65 QUILCENE WA 98376-0065 9372 SUBDIVISION: Block: Lot: PARCEL NUMBER: 937200401 Section: 24 Township: 27 N Range: 2■A CONTRACTOR: GREENWOOD HEATING AND AC PHONE: 206-784-1818 825 S STACY ST SEATTLE WA 98134 Contractor's License GREENHA922D7 Expires 3/27/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION Install New Heat Pump TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION ADD'L: HEAT TYPE: HTP 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: •- • Permit $152.00 SRE 07/22/14 151276 Total: $152.00 JUL 2 2 2014 Jefferson County DCD \\tidemark\data\forms\F_BLD_App_Bld.rpt 7/22/2014