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HomeMy WebLinkAboutBLD2014-00344 - MECHANICAL 411t3UILDING PERMIT APPLICA•N BRDI4-003 4 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00344 Received Date: 9/24/2014 SITE ADDRESS: 132 BRUSH PLANT RD QUILCENE, 98376 OWNER: JAMES G BAILEY PHONE: 425-770-7105 BRENDA L BAILEY PO BOX 693 QUILCENE WA 98376 9561 SUBDIVISION: Block: Lot: PARCEL NUMBER: 956100006 Section: 13 Township: 27 N Range: 2111 CONTRACTOR: PENINSULA HEAT INC PHONE: 360-681-3333 PO BOX 173 CARLSBORG WA 98324 Contractor's License PENINI*0440W Expires 9/7/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION New Ductless Single Port 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: Approved/Date Permit $152.00 SRE 09/23/14 151571 Total: $152.00 APPROVED SEP242014 Jefferson County DOD \\tidemark\data\forms\F_BLD_App_Bld.rpt 9/24/2014 (c�SON co�� �,FFERSON COUNTY 1�� - 34L4 ti DEPARTMENT OF COMIANITY DEVELOPMENT 621 Sheridan Street I Port Townsend,WA 98368 Web:www.co.iefferson.wa.us/communitvdevelopment ask j N��o Tel:360.379.4450 I Fax:360.379.4451 I Email:dcdr7a,co.iefferson.wa.us Building Permits&Inspections I Development Consistency Review I Long Range Planning 1 Watershed Stewardship Resource Center Master Permit Application MLA: Project Description(include separate stets as ges s o itM 41 r f�fs *dam Pvmp Tax Parcel Number: 56 loam 6 Property Size: (acres/square feet) Site Address and/or Directions to Property: 1301 F✓rus plea.f- Iva" la- • Property Owner(s)of Record: J-4-114.ES 6 Jtic!!.y Telephone: q2-5---- ?' 710 Fax: email: Mailing Address: P-o- /3o)( b7} vt /c-e4 c-, kiJ'4 9 3 p Applicant/Agent(if different from owner): PeJL>G fltt4-� Co Telephone: 360 460Y -3333 Fax: 6 'f a' / iegte Mailing Address: P'o- 0 3 2 What kind of Permit?(Check each box that ap lies ❑ Lot or Road Segregation ❑Building r ( 14e6/44,44 ❑ Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use) ❑Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C d • ** _. ._ 1��- O Manufactured Home 0 Modular 0 Discretionary"0"or Un d (� �J ❑ Commercial* ❑Special Use(Essential 1 ';.5 ❑ Change of Use ❑ Boundary Line Adjustm•• ❑ Address ❑ Road Approach ❑ Short Plat** ❑Home Business ❑ Cottage Industry ❑ Binding Site Plan** SEP 2 3 2014 ❑Propane ❑Long Plat** ❑Sign ❑ Planned Rural Residen lopment PRRD/ en s* ❑Allowed"Yes"Use Consistency Analysis ❑ Plat Vacation/Alteration JEFFERSON COUNTY ❑Stormwater Management ❑ Shoreline Master Progra ExEmilti9rOgnitlitellitildiAMMT ❑Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management ,+,. . •eve opment** ❑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 **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_�_f�t IIStliC�-!; ce , to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: ✓ /7-2 ZU/ 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 7cation the he wants prior notice. O /'I Signature: Date: l Z/ 0'y 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 ou are in camp ith the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfj respons adhering to and complying with the ESA. The Applicant has read this disclaimer and dales ow. Signature: fr1 a t/ A Date: O' /el f AO 07/24/201: 1 Parcel Details • Page 1 of 2 f ' Jef erson aunty . . ,. „,,,,,,,. ,,,„ - , .1. ----„,:., aw^ 1 i Nome : County Info Departments Search Parcel Number: 956100006 SEARCH Parcel Number: 956100006 Printer Friendly Owner Mailing Address: JAMES G BAILEY BRENDA L BAILEY PO BOX 693 QUILCENE WA98376 Site Address: 132 BRUSH PLANT LOOP RD QUILCENE 98376 Section: 13 School District: Quilcene (48) Qtr Section: SW1/4 Are Dist: Quilcene (2) Township: 27N Tax Status: Taxable Range: 2W Tax Code: 0324 Planning area:Quilcene (10) Sub Division: 9561 - HAMILTON'S 5 ACRE TRACTS Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: HAMILTON'S 5AC TRACTS TAX 150 PTN TR 1&2 Tax,A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel Plats &Surveys Septic Monitoring Info �, Jefferson County I COUNTY INFO DEPARTMENTS SEARCH ,.,,,, HOME ( i Best viewed with Microsoft Internet Explorer 6.0 or later Windows- Mac http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?Parcel N0=956100006 9/24/2014 PENINSULA HEAT INC • • Page 1 of 2 0 Washington State Department of Labor & industries PENINSULA HEAT INC Owner or tradesperson PO BOX 173 LOFSTROM, KENNETH JOHN CARLSBORG, WA 98324 360-681-3333 Principals CLALLAM County LOFSTROM, KENNETH JOHN, PRESIDENT LOFSTROM, MARY E, SECRETARY Doing business as PENINSULA HEAT INC License Verify the contractor's active registration/license/certification (depending on trade) and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. PENINI*0440W Effective—expiration 09/16/1996—10/18/2016 Bond CBIC $12,000.00 Bond account no. SA4812 Received by L&I Effective date 07/02/2001 09/16/2001 Expiration date Until Canceled Insurance Ohio Security Ins Co $1,000,000.00 Policy no. BKS 55013351 Received by L&1 Effective date 04/04/2014 04/26/2013 Expiration date 04/26/2015 Insurance history Savings No savings accounts during the previous 6 year period. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601737680&LIC=PENINI*0440W&SAW= 9/24/2014 PENINSULA HEAT INC Page 2 of 2 Lawsuits against the bond or savi No lawsuits against the bond or savings accounts during the previous 6 year p od. L&1 Tax debts ...................... ................. 5.1—�_ 1 o 1 a.-- C_ a _..I. 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. 920,088-00 Doing business as PENINSULA HEAT INC Estimated workers reported Quarter 2 of Year 2014"7 to 10 Workers" L&l account representative T4/CARIE PICKETT(360)902-5592-Email: PICC235 @Ini.wa.gov Workplace safety and health No inspections during the previous 6 year period. ©Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. Access • 34ashingt n L5!+ti:y3 hid i4,0t.4%h`Ok we , • https://secure.fni.wa.gov/verify/Detail.aspx?UBI=601737680&LIC=PENINI*0440W&SAW= 9/24/2014 kg. o�0, J EFFERSON COUNTY 6 DEPARTMENT OF COMMUNITY DEVELOPMENT S6,f\G.CO AS- Date: 024' Time Received: //( m Mon. Tue. Wed. Thur. Fri. Date: 9'30 BLD: /4/--- 3 7 V Contact Name: Owner: Contact Number: 360 2115-7 70 ?/OSv Address: / 3 L /9/'c15A /'Lr/ 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 Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling 11! S Jefferson County Building Division Permit Number: BLD14-00344 Applicant: BAILEY BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2012 International Building Codes To schedule inspections, call (360)379-4455 no later than 3:00PM the day before the inspection is needed. Requests received after 3:00 PM will not be scheduled for the next day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Mechanical Systems 7/30,c1 A final inspection will not be scheduled until all of the following are completed and signed off by the applicable Department: • Building Permit Conditions are met • Septic Permit Final/Complete for any building containing plumbing • Land Use Conditions met and signed off • Public Works Permit Final(where applicable) FINAL INSPECTION 61;,/ FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD14-00344 Received Date: 9/24/2014 SITE ADDRESS: 132 BRUSH PLANT RD Issue Date 9/24/2014 QUILCENE, 98376 Expiration Date 9/24/2015 OWNER: JAMES G BAILEY PHONE:425-770-7105 BRENDA L BAILEY PO BOX 693 QUILCENE WA 98376 9561 SUBDIVISION: Block: Lot: PARCEL NUMBER: 956100006 Section: 13 Township: 27 N Range: 2V1 CONTRACTOR: PENINSULA HEAT INC PHONE: 360-681-3333 PO BOX 173 CARLSBORG WA 98324 Contractor's License PENINI*0440W Expires 9/7/2016 PROJECT DESCRIPTION: New Ductless Single Port 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: Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $152.00 SRE 09/23/14 151571 Exist: Exist: Total: $152.00 Prop: Prop: Total: Total: Directions to Site: HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. Request must be received by 3pm the day before the inspection is needed. Office Hours 9:00 am -4:30 pm MONDAY- THURSDAY HOT LINE AVAILABLE 24 HOURS A DAY JEFFERSON COUNTY ba NO. 1 515 7), 4. DATE ‘ RECEIVED FROM P/i))0Cala, //eta' /ft DESCRIPTION BARS# AMOUNT ° CURRENCY iik#tillie /54. CO , -..... ccCall /91a aV CHECKS es "4-tk/3 F0-16. 2 111$ co 0 „,-- ...,.. 1,-,=-4: 4111 i i„ Ar40,74-3747,wfr71.17/Marif , Prkarkartfir 33 0 rririri"ITZ7Z‘l 11 ... , • . A , RECEIVED BY 1.. . ' 4 'XIII 41' ' TOTAL ni IP 9°