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HomeMy WebLinkAboutBLD2014-00291 - MECHANICAL •BUILDING PERMIT APPLIC•ON BLD14-00291 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00291 Received Date: 8/11/2014 SITE ADDRESS: 102 OLYMPIC LN PORT LUDLOW, 98365 OWNER: BYRON E ENDSLEY PHONE: 360-437-2538 I DARLENE R ENDSLEY 102 OLYMPIC LN PORT LUDLOW WA 98365-8219 9904 SUBDIVISION: Block: Lot: PARCEL NUMBER: 990400429 Section: 9 Township: 28 N Range: 1E CONTRACTOR: AIR FLO HEATING COMPANY INC PHONE: 360-683-3901 221 W CEDAR SEQUIM WA 98382 Contractor's License AIRFLI"206DG Expires 4/25/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION Install a New Heat Pump System 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: IRouting Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $152.00 SRE 08/11/14 151350 AppROVED Total: $152.00 AUG 11 2014 Jefferson County DCD \\tidemark\data\forms\F_BLD_App_Bid.rpt 8/11/2014 •g cO6) JEFFE•N COUNTY • 3u: LL1 - '2-9 I i ® DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend •Washington 98368 4 � 360/379-4450 • 360/379-4451 Fax t� www.co.jefferson.wa.us/commdeveiopment Master Permit Application MLA: • Project Description(include separate sheets as necessary): `' ll 767_4.1 — 1--,ke. ! . R v.4 i P - sitsr„ ,ti, R.ep1,ke/k,eu_ - Tax Parcel Number: 9 91)4 0 d Zia G7 Property Size: (acres/square feet) Site Address and/or Directions to Property: / /O o 4 ,11 • % 4 4-n Property Owner(s)of Record: ... �. E. ijt r ,_� Telephone: 3 (O-4/37-as- 7 Fax: email: Mailing Address: --a- Applicant/Agent(if different from owner): {}1 r Flo He i n c Telephone:,3 1 e 4-'o b-$AO 1 Fax: to BB- acne email:h OK r t i e.-r e As r' i b tit.44T7,t. . Mailing Address: 221 1n1. Cedar Si.• Se,avautls t 3 - Q.ova. ' What kind of Permit?(Check each box that applies ❑Building 0 Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use) Ingle Family ❑Garage Attached/Detached 0 Conditional Use[C(a),C • • ❑ Manufactured Home 0 Modular ❑Discretionary'D”or Unn. a ' • • V,i fE ❑ Commercial- 0 Special Use(Essential P li '--' v❑ Change of Use ❑Boundary Line Adjustme ❑ Address ❑Road Approach ❑Short Plat-- ❑ Home Business ❑Cottage Industry ❑Binding Site Plan-- AUG 1 1 2014 ❑ Propane ❑Long Plat** ❑Sign ❑Planned Rural Residenti: s =lopment(PRRD)/Amend n> * ❑Allowed`Yes'Use Consistency Analysis 0 Plat Vacation/Alteration ❑Stormwater Management - ❑Shoreline Master Prog - Ex,mil&+1_ t -,III 1r��`il j RIZ, ❑ Site Plan Approval Advance Determination(SPAAD) ❑Shoreline Management -.•.-.. ❑Temporary Use ❑Shoreline Management Variance ❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map.Amepdment ❑Forest Practices Act/Release of Six-Year Moratorium 0 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 Jour"4-1 -0 eat't f`e• to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE % ../ a :_ �"..' L,' �� �r�%fd r - '.i ce By signing this appl .•'form,the owner/agent attests that the information provid=• herein,and in an :chments,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 • . •gent 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 Coufityy 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. Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the time of the ap icati n at he or she waits rice E. Signature: l�C-� Date: r, ` / / -7 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 a in compliance with the fferso County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable sibil(pr f ad a plying a with the ESA. The Applicant has read this disclaimer signs a cites it below. Signature: / Date: G:\PamitCenter\###FORMS###\DRD FORMS\Master Perinit.Appliation 5-29-08.doe • 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 coritraotots 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: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: O New ❑ Wood Existing: ❑ Sewer ❑ 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: ❑ Private well 0 Two Party Type of Heat: Proposed: ❑ Public Total: Name of System: If this is a Commercial Prolectyou 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 1 Fireplace Insert I Hot Water Tank 1 Pellet Stove I Other Is this appliance being installed in a Manufactured 1 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 S•uare Foota•e Current ° •••sed 'ivry : ='p■ ` ,_. _,, ...,,t,tt! Lti__ .,, _<.._c.',F ... .. _ .,. Main Floor Heated EH Bid App Review: 2 °Floor Heated Consistency Review: rt Other Heated , Base fee: 152 .00 Mezzanine " Additional Section: Heated Basement ` Plan Check fee: Unheated Basement .- # � State Surcharge fee: Other Unheated Pot Water Review fee:• Garage/Carport SUBTOTAL x4 N Decks --, _,,,,,, 911/Rd Approach fee: �y - Other ,�t TOTAL: $ ) 1 I X00 L :.- Receipt Number: 15 3 50 Cash/Check Number: n I ESTIMATED COST(REQUIRED) Date: r OM .Fair market value of all labor and materials foundation to finish l MOM Initials: I OF • G:\PemritCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc This combination qualifies for a Federal Energy AI •.i CERTIFIED``' Efficiency Tax Credit when placed in service between Feb 17,2009 and Dec 31,2013. wW W.aliririirPf,to,v.Ory Certificate of Product Ratings AHRI Certified Reference Number: 4655313 Date: 8/4/2014 Product: Split System: Heat Pump with Remote Outdoor Unit-Air-Source Outdoor Unit Model Number: 4TWX5036B1 D t� Indoor Unit Model Number: *AM7A0C36H31 AUG Manufacturer: TRANE J i Trade/Brand name: TRANE JEFEERSOr:!COUNTY } DEPT OF COMMUNITY DEVELOPMENT Series name: XL151 WEATHERTRON Manufacturer responsible for the rating of this system combination is TRANE Rated as follows in accordance with AHRI Standard 210/240-2008 for Unitary Air-Conditioning and Air-Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent,third party testing: Cooling Capacity(Btuh): 37600 EER Rating (Cooling): 12.50 SEER Rating(Cooling): 15.00 Heating Capacity(Btuh)@ 47 F: 34600 Region IV HSPF Rating(Heating): 9.25 Heating Capacity(Btuh)@ 17 F: 21800 *Ratings followed by an asterisk(")indicate a voluntary rerate of previously published data,unless accompanied with a WAS,which indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the product(s)listed on this Certificate and makes no representations,warranties or guarantees as to,and assumes no responsibility for, the product(s)listed on this Certificate.AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s),or the unauthorized alteration of data listed on this Certificate.Certified ratings are valid only for models and configurations listed in the directory at www.ahrldlrectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI.This Certificate shall only be used for Individual,personal and confidential reference purposes.The contents of this Certificate may not,in whole or in part,be reproduced;copied;disseminated; entered into a computer database;or otherwise utilized,in any form or manner or by any means,except for the user's individual, personal and confidential reference. AIR-CONDITIONING,HEATING, CERTIFICATE VERIFICATION &REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahrldirectory.org,click on"Verify Certificate"link we make life better' and enter the AHRI Certified Reference Number and the date on which the certificate was issued, which is listed above,and the Certificate No.,which is listed at bottom right. ©2014 Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: 130516603004858466 S • (`1) J AUG 1 1 2014 JEFFERSON COUNTY , DEPT.OF COMMUNITY DEVELOPMENT • Parcel Number:990400429 06/19/2014 Owner Maing Address: B'RON E ENC6LEY DART ENE R END6LEY 102 OLYMPIC LN PORT LUDLOW WA 98365-8219 Ste Address: 102 OLYMPIC LN PORT LUDLOW 98365-8219 Section: 9 School District: Chia cum(49) Qtr Section: SW1/4 Fire Dist: Port Ludbw(3) Township: 28N Tax Status: Taxable Range: 1E Tax Code: 0231 Planning area: 98365-8219 Sub Division: 9904 - PORT LUDLOW NO. 1 Land Use Code: 1100 98365-8219 Property Description: 5 V E PORT LUDLOW NO. 1 AREA 4, LOT 29 r G I . JEFFERSON C0O\!TY -,?.OF COMn1 NITV DP Fl oa ng. AIR FLO HEATING COMPANY IN1 Page 1 of 2 Washington State Department of ) Lahor & Industries AIR FLO HEATING COMPANY INC Owner or tradesperson 221 W CEDAR BEQUETTE, MARK A SEQUIM, WA98382 360-683-3901 Principals CLALLAM County BEQUETTE, MARK A, PRESIDENT BEQUETTE, SANDRA A, VICE PRESIDENT BERSON, JOEL R, SECRETARY FULLAWAY, MICHAEL (End: 04/01/2010) Doing business as AIR FLO HEATING COMPANY INC WA UBI No. Business type 600 347 761 Corporation 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 Bond history Insurance American Hallmark Ins Co of Te $1,000,000.00 Policy no. 44CL483619 Received by L&I Effective date 04/18/2014 04/25/2014 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&LIC=AIRFLI*206DG&SAW= 5/8/2014 151350 NO. 151314,Q01 /1 Del") COUNTY AMOUNT coctry\pov\tuir AMC' JEFFERSON C - ,roy 'GO BAR * JEFF-- I „ e,4011 ,, 9,CA NO Ci • RIV C 0 c cn 11014- RECEIVED FR°M ' R._- ry 0 empTIO DES- CU:CRHEECICOCIKYN SC:)ANTOE °C?i Sill 1 4 .271 ..< • AA ...yvAl WA" 55 ' jar 17 tirima,,,,5 Olt I op -e,...,.4",. Iv 1 I 11 ' ,_ TOTA i 1 ; Jit 4 - , . , . ,. A ' ...- RECEIVED BY . 4,, • • "°gN obey JEFFERSON COUNTY W ` DEPARTMENT OF COMMUNITY DEVELOPMENT Date: 9 /i4 Time Received: am/pm Mon. t� Th r. Fri. Date: 9 1 BLD: i / --CV _ , Contact Name: /_ Owner: ( ia1 Sj)A ,;: i�.0 Contact Number: 360 ' 1 ,R 7- S 3 g` Address: r __ ilfr 7 . Notes: Paftra, CI-4-kb'/ Cren1 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 A.. •osted Block&Tile Ceiling 11 • 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#: BLD14-00291 Received Date 8/11/2014 SITE ADDRESS: 102 OLYMPIC LN Issue Date 8/11/2014 PORT LUDLOW, 98365 APPLICANT: BYRON E ENDSLEY PHONE: 360-437-2538 DARLENE R ENDSLEY 102 OLYMPIC LN PORT LUDLOW WA 98365-8219 SUBDIVISION: 9904 Block: Lot: PARCEL NUMBER: 990400429 Section: 9 Township: 28N Range: 1 E CONTRACTOR: AIR FLO HEATING COMPANY INC PHONE: 360-683-3901 221 W CEDAR SEQUIM WA 98382 Contractor's License AIRFLI*206DG Expires 4/25/2016 OWNER, BYRON E ENDSLEY PHONE: 360-437-2538 if different: DARLENE R ENDSLEY 102 OLYMPIC LN PORT LUDLOW WA 98365-8219 PROJECT DESCRIPTION: Install a New Heat Pump System 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 8/11/2015. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: Tank/Line/Appliance: Final Approval: -P-1 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 8/11/2014