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HomeMy WebLinkAboutBLD2014-00359 - MECHANICAL UILDING PERMIT APPLICASN BRD14y00pe9 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00359 Received Date: 10/6/2014 SITE ADDRESS: 181 W PIONEER DR PORT LUDLOW, 98365 OWNER: DEBORAH A BROWNING TRSTE PHONE: 503-593-1757 ANDREW H BROWNING TRUSTEE 181 PIONEER DR PORT LUDLOW WA 98365-9620 9906 SUBDIVISION: Block: Lot: 89 PARCEL NUMBER: 990600389 Section: 9 Township: 28 N Range: 1 E CONTRACTOR: PENINSULA HEAT INC PHONE: 360-681-3333 PO BOX 173 CARLSBORG WA 98324 Contractor's License PENINI*044OW Expires 9/7/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP 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: Approved/Date Permit $152.00 SRE 10/03/14 151613 APPROVED Total: $152.00 OCT - 6 2014 Jefferson County DCD \\tidemark\data\forms\F_BLD App_Bld.rpt 10/6/2014 4oSrONE,RSOOU NTY ti DEPARTMENT OF COMMUNITY DEVELOPMENT '� 621 Sheridan Street I Port Townsend,WA 98368 I Web:www.co.iefferson.wa.us/communitvdevelopment 9SHING�� Tel:360.379.4450 I Fax:360.379.4451 I Email:dcd @co.jefferson.wa.us Building Permits&Inspections I Development Consistency Review I Long Range Planning I Watershed Stewardship Resource Center Master Permit Application MLA: Project Description(include separate sheets as necessary): REVSLiAc - >; --4.NS i ALL p)c\A) }-El i ep 0l`LIP ', Aitaff,AND Lck. Tax Parcel Number: g'9 660c)oOO 381 Property Size: (acres/square feet) Site Address and/or Directions to Property: 1 l P l O N E e-f2 I . )30 r t- L_vcl to k..J Property Owner(s)of Record: 1),rc'1+C('I 1 I A- B Rci„)iu/AA TASTE Telephone: 5 0 3 "' S 7 3 - t 1-5 }Fax: email: Mailing Address: 1' l 1/eNEi. DA. P 2jZ-t Li D Lo t.,.)r Lo - 9g 3&S" Applicant/Agent(if different from owner): P> k)I&. UL A, i-E-C AT i C-0 - Telephone: i—4°'/" 3333 Fax: 34-c- (011' 20 lslo email: ✓UwVtj iFen.ivr St La Mailing Address: *'0 - 133 cash LoA- 543 32! 1,,,,,a4 -COWL . What kind of Permit?(Check each box that applies ❑Lot or Road Segregation IlBuilding ❑Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor, Major or Reasonable E•• i MSingle Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d),or C)** , r-- ' 7/'1] � ,, Manufactured Home ❑ Modular ❑Discretionary"D"or Unnamed Use Clas.i oh Y "-` JEFFERSON COUNTY Dc Aps NO. 151613 DATE �©' 11 RECEIVED FROM 9Q�I��V'.D— t0) � DESCRIPTION BARS# AMOUNT CURRENCY (6\e% 3 j 5 iCOIN e � HECK ' 47� O "g R1 13g ' 2 o e.l m 0 it °' . RECEIVED BY TOTAL 11 ' - �� 4,- C0G � JEFFERSON COU 2 DEPARTMENT OF COMMUNITY DEVELOPMENT Date: /jD Time Received: /b i '/ �rr?pm /. Tue. Wed. Thur. Fri. Date: /O//3 BLD: (4 - OO`3S?' Contact Name: Owner: 8f2,49.,,i0to-+6 Contact Number: 360 Address: fiesiiel Mt id Pi6 u6s . P 12-. 206 Notes: 5''9 /757 /7 Foundation Plumbing Framing Propane Tank 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 Ceiline r 0 •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 OR MANUFACTURED HOME INSTALLER: PHONE: FAX: P 04/NSo t.,--hA-T co • (345 6V I- 3 333 (3k 6 r/-aoz. MAILING ADDRESS: P 0 •130)( 113 ael: 1 EMAIL: m�y&�9�`nSc o*-f cam„. CONTRACTOR'S LICENSE ✓V� WAINS i+ (" NUMBER: PeA# ul . a T T° NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type°f eat: i Proposed: ❑ Public i,k'I- P h/4, AM- 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: Underground Tank Above ground tank Size of Propane Tank: Heat Stove Cook Stove Woodstove Fireplace.nsert rehtO i evotS telleP I knaT retaW toH I Is this appliance being installed in a Manufactured/Mobile Home? Yes o 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, including the reserve area. Square Footage Current Proposed For offs*Use Only Li,ft....:,.. Revision Main Floor Heated 7 EH Bid App Review: (�2"tl Floor Heated 7 Consistency Review: p `�+ r Io S� —,. .� .9 Other Heated Base fee: I ; /,' r 1 t) Mezzanine Additional Section: a Heated Basement Plan Check fee: _N-p7, J£ ..,,, "°-4=1-,04,,..,/, / Unheated Basement State Surcharge fee: 4Tpk� .a f V F /pP 1647- Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL: $ Receipt Number: 15`L9`3 Cash/Check Number: i 2 V ESTIMATED COST(REQUIRED) Date: 7 •Fair market value of all labor and materials foundation to finish 10-510 Initials: 07/24/2013 w T'o.� tit ( r • t \\N. --'.---------------..., , Cie 1....z 1:11 HPAs e: i 41. caret t q,e .i- n ------!____.7- 177, �� D���FCONFNr 1 Parcel Details Page 1 of 2 • • if:e4 I: Jefferson County Home county Info z Departments w Search q, Parcel Number: 990600389 SEARCH Parcel Number: 990600389 Printer Friendly Owner Mailing Address: DEBORAH A BROWNING TRSTE ANDREW H BROWNING TRUSTEE D&A BROWNING REV LIV TRST 181 PIONEER DR PORT LUDLOW WA98365-9620 Site Address: 181 PIONEER DR PORT LUDLOW 98365 Section: 9 School District:Chimacum (49) Qtr Section: NW1/4 Fire Dist: Port Ludlow (3) Township: 28N Tax Status: Taxable Range: 1E Tax Code: 0231 Planning area: Port Ludlow (7) Sub Division: 9906 - PORT LUDLOW NO. 2 Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: PORT LUDLOW NO. 2 AREA 3 LOT 89 Tax,A/V, Sales, Photos, and Permit Data Bldg Data Mao Parcel Plats&Survey Septic Monitoring Info Jefferson County HOME I COUNTY INFO I DEPARTMENTS I SEARCH Best viewed with Microsoft Internet Explorer 6.0 or later Windows- Mac http://www.co.j efferson.wa.us/assessors/parcel/parceldetail.asp?Parcel_NO=9906003 89 10/6/2014 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 WA UBI No. Business type 601 737 680 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 GENERAL License no. PENINI*044OW 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 No current insurance account.See the insurance history. Insurance history Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601737680&LIC=PENINI*0440W&SAW= 10/6/2014 PENINSULA HEAT INC Page 2 of 2 No L&I tax debts are recorded for takontractor license during the previous 6110r period, but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. 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&I account representative T4/CARIE PICKETT(360)902-5592-Email: PICC235 @lni.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. F, ACC IM https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601737680&LIC=PENINI*044OW&SAW= 10/6/2014 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 WA UBI No. Business type 601 737 680 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 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 No current insurance account.See the insurance history. Insurance history Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts 1 I https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601737680&LIC=PENINI*0440W&SAW= 10/6/2014 PENINSULA HEAT INC Page 2 of 2 No L&I tax debts are recorded for teontractor license during the previous 610r period, but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. 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&I 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. p 9 P ©Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. Access Washi ngtctn* https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601737680&LIC=PENINI*0440W&SAW= 10/6/2014 • Jefferson County Building Division Permit Number: BLD14-00359 Applicant: BROWNING TRSTE 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 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) ANAL INSPECTION /O"��/_ `t 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#: BLD14-00359 Received Date: 10/6/2014 SITE ADDRESS: 181 W PIONEER DR Issue Date 10/6/2014 PORT LUDLOW, 98365 Expiration Date 10/6/2015 OWNER: DEBORAH A BROWNING TRSTE PHONE: 503-593-1757 ANDREW H BROWNING TRUSTEE 181 PIONEER DR PORT LUDLOW WA 98365-9620 9906 SUBDIVISION: Block: Lot: 89 PARCEL NUMBER: 990600389 Section: 9 Township: 28 N Range: 1 E 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 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: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $152.00 SRE 10/03/14 151613 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