HomeMy WebLinkAboutBLD2013-00275 • 0
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#: BLD13-00275 Received Date 9/5/2013
SITE ADDRESS: 6193 SR20 Issue Date 9/5/2013
PORT TOWNSEND, 98368
APPLICANT: BRUCE M BAKER PHONE:
6193 STATE ROUTE 20
PORT TOWNSEND WA 983689309
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 001333006 Section: 33 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, BRUCE M BAKER PHONE:
if different: 6193 STATE ROUTE 20
PORT TOWNSEND WA 983689309
PROJECT DESCRIPTION: LIKE IN KIND REPLACEMENT OF GAS FURNACE
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 9/5/2014.
REQUIRED INSPECTIONS:
Tank/Line/Appliance:
FinalApproval: 9 - l`t
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 9/5/2013
BUILDING PERMIT APPLICXMON BRLD1e 00275
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD13-00275 Received Date: 9/5/2013
SITE ADDRESS: 6193 SR20
PORT TOWNSEND, 98368
OWNER: BRUCE M BAKER PHONE:
6193 STATE ROUTE 20
PORT TOWNSEND WA 983689309
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 001333006 Section: 33 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 DESCRIPTIOII LIKE IN KIND REPLACEMENT OF GAS FURNACE
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 $228.00 MEB 09/05/13 142462
Total: $228.00
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e, s" COG JEFFERSON COUNTY �� `)Q�`
DEPARTMENT OF COMMUNITY DEVELOPMENT
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Date: Y-27 Time Received: 7 f3 am/ Mon. Tue. ed. Thur. Fri.
Date: ?-Zg
13-,2 7$ Contact Name:
er:Vt J3 ,4 Contact Number: 360 ye.5 5'9OO Neryk
Address: (a/ 53 5x '14) '"- M 116)4,u_ 32g_,,•7 6/
Notes: / ■ 4 -,G !'l a62..
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
en-Homes Insulation
Final Inspection
Setbacks Floor
Foundation Wall Address Posted
Block&Tile Ceiling
.4F�5ON c JEFFERSON COUNTY
jI DEPARTMENT OF COMMUNITY DEVELOPMENT
Date: III 1$Time Received: 9 '[0 mar Mon. Tue. Wed. Thur. Fri.
Date: q-Z 2
13-- ; 7S Contact Name:
er: Contact Number: 360 43*$ I 6,17
Address: b1 ` 3 sr2 -22j 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
on-Homes Insulation
Final Inspection k
Setbacks Floor
Foundation Wall Address Posted
Block&Tile Ceiling
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AIR FLO HEATING COMPANY
Check Number: 41204 412 0 4
Jefferson County Building Department
Date Description Amount
08/30/2013 Permit for Baker 228.00
•
Contractors or Tradespeople liter Friendly Page . Page 1 of 1
Electrical Contractor
A business licensed by L8:1 to contract electrical work within the scope of its specialty. Electrical
Contractors must maintain a surety bond or assignment of savings account.They also must have a
designated Electrical Administrator or Master Electrician who is a member of the firm or a full-time
supervisory employee.
Business and Licensing Information
Name AIR FLO HEATING CO INC UBI No. 600347761
Phone 3606833901 Status Active
Address 221 W Cedar St License No. AIRFLHC009C8
Suite/Apt. License Type Electrical Contractor
City Sequim Effective Date 2/28/2000
State WA Expiration Date 2/28/2014
Zip 983823320 Suspend Date
County Clallam Specialty 1 Hvac/Rfrg Ltd Energy
Business Type Corporation Specialty 2 Unused
Parent Company
Master Electrician INFORMATION
License BERSOJR975LB
Name BERSON,JOEL RAY
Status Active
Business Owner Information
Name Role Effective Date Expiration Date
BEQUETTE,MICHAEL 01/01/1980
FULLAWAY,MICHAEL 01/01/1980
LEVINSON,WILLIAM R Agent 01/01/1980
BEQUETTE,MARK A President 01/01/1980
BERSON, JOEL R Secretary 02/12/2010
BERSON, JOEL R Treasurer 02/12/2010
BEQUETTE,SANDRA A Vice President 01/01/1980
Bond Information
'Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date'
4 CBIC si6233 07/06/2010 Until Cancelled $4,000.00 05/19/2010
2 COLONIAL AM CAS 8 LPM4054452 07/06/2001 Until Cancelled 08/21/2010 $4,000.00 07/18/2001
SURETY OF MD
Assignment of Savings Information No records found for the previous 6 year period
Insurance Information No records found for the previous 6 year period
Summons/Complaint Information Summons and Complaints are not filed with the department for this contractor type
Warrant Information Warrants are not filed with the department for this contractor type
Infractions/Citations Information
Infraction/Citation Date
IEDORN00206 RCW Code Type
3/28/2013 19.2 Status Violation Amount
19.28.161(6)RCW ELECTRICAL CITATION Satisfied $250.00
https://fortress.wa.gov/lni/bbip/Print.aspx 9/5/2013
gON
+`` B °odd JEFFEOON COUNTY �'1J /
DEPARTMENT OF COMMUNITY DEVELOPMENT
'd 621 Sheridan Street• Port Townsend •Washington 98368
. �y 3601379-4450 je • 7 44ax (V
{� 0, 4 www.co fferson.wa.us/commdevelopment 360/39 51 F
Master Permit Application MLA:
Project Descri tion(include separate sheets as necessary):
1-�KE 1h K1 \) k.Got.IAc.,EMENT OF 6-Rs FUtNtrL -=
Tax Parcel Number: 0 0 155',00 4, Property Size: (acres/square feet)
Site Address and/or Directions to Property:
1 3 Ntc Intern:
llz. � _ � 2�
Property Owner(s)of Record r'uc at ex-
Telephone: S -MLA.t`i Fax: email:
Mailing Address: (c t ci 3 S1'tC..Q.CA.i kt Zc )
Applicant/Agent(if different from owner): Air Pi O }-lead't nc%
Telephone: 3*aO-Web-?AO% Fax: 1a BB- act, e email:etl rlealr-f1oheatit%.corn
Mailing Address: 2.71 W. Cedar $t• QL04M ,WQ GtelieZ,
What kind of Permit?(Check each box that applies
❑Building ❑Critical Areas Stewardship Plan
❑ Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use)
' Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C)**
❑ Manufactured Home 0 Modular 0 Discretionary"D"or Unnamed Use Classification
O Commercial• ❑Special Use(Essential Public Facilities)--
❑ Change of Use ❑Boundary Line Adjustment
❑ Address ❑Road Approach ❑Short Plat**
❑Home Business ❑Cottage Industry 0 Binding Site Plan**
❑Propane ❑Long Plat•"
❑Sign 0 Planned Rural Residential Development(PRRD)/Amendments**
❑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**
O Temporary Use ❑Shoreline Management Variance
❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment
O 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 fl i r A 0 k'1 eat flq to act as my agent in matters relating to this application for permit(s).
Owti SIGNATURE '^� °,r � Date: 8-Ades-LS
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 later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the ap r • that he r she nts notiicce��/ � $��— 13
Signature: 7Ll► 4-/ '_ " Date:
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 , e Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-tran ati -- respo/'•i' )• •to and complying with the ESA. The Applicant has read this disclaimer and ns and dates it below.
Signature: 1�►_ 41 A *,'�� ll_1` Date: CJ
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit.Application 5-29-08.doc
JEFFERSON COUNTY •C/ NO. 146
DATE If c/ 3
RECEIVED FROM ANT r"" I £ ,
DESCRIPTION BARS# AMOUNT
CURRENCY ivib (S6,.5.c. 7 -z-k,'
COIN
CHECK i)
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661 SU0( ' /-1(2,4q
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RECEIVED BY TOTAL , 2 2,:r. `)-1- `