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Home My WebLink AboutBLD2014-00358 - MECHANICAL 4UILDING PERMIT APPLICA S N Review Type: Jefferson County Department of Community Development BLDI4-00358 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00358 Received Date: 10/6/2014 SITE ADDRESS: 91 SHORE DR PORT LUDLOW, 98365 OWNER: CRAIG R SMITH PHONE: 360-286-4286 STARLA SMITH 91 SHORE DR PORT LUDLOW WA 98365-9258 9834 SUBDIVISION: Block: Lot: PARCEL NUMBER: 983401305 Section: 23 Township: 28 N Range: 1E CONTRACTOR: BRENNAN HEATING &NC LLC PHONE: 206-248-7900 4601 S 134TH PL SEATTLE WA 98168 Contractor's License BRENNHA971 R9 Expires 7/13/2015 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: r E Permit $152.00 SRE 10/03/14 151611 Total: $152.00 OCT - 6 2014 Jefferson County DCD \\tidemark\data\forms\F_BLD_App_Bld.rpt 10/6/2014 0 e I 04 ehtthios heat pomp too:titan .4,:-./A in w 1 143 Z eco Di cr. 0, ch Crai1/49 Smilil 11 Shore.br ibi4 Ludlow LOA q8345 \ r----- I (---- r--- iii 11-1-7 ' .:;-•r-c------;--n Fr ,.,,, , . oc_r _ , „di , , , , j li — ,? „ — !,A1,71, ,I V ,,_----,) .----------„I'_:,_,N■ ,r);_- opmrwr ,f,,,,,,,,..„`0e) .- JEFFERSON COUNTY \ A` DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend•Washington 98368 A itip,cre;,,,) , 360/379-4450. 3601379-4451 Fax www.cojefferson.wa.us/cornmdevelopment uslcanmdevelopment Master Permit Application MLA: Project • •p r.• include -: :to sheets • n ry): • I - < 1 ,_ t ot3 a • --k. I. S OoU 116 Tax Parcel Number. 4 B2 b (6 0,5 Property Size: (acres/square feet) Site Address Ind/or Directions to P • . • Q I r •Dr )r-k- Lvci\oLLD QI '3105 Property Owner(s)of Record: e.f 0.h q S r\-Ilk Telephone:' O 0 • $to • s a Q Fax: email: Mailing Address: 4D✓W\r as S t 3rC_ ApplicaA nt(if different from owner):il M/ A 1A .. .�-,.∎-mad A f (� �, Telephone-: Oki) o�4 Ob Fa b -( l $email:\a 1 ryt1 L• a <NI 'r�u"''� . Mairutg Address:y OA S 13 ' �. S �PAt►�Ct �J 11A What kind of Permit?(Check each box that applies ❑Building 0 Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Use) mingle Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d),or Cl" ❑ Manufactured Home ❑ Modular 0 Discretionary"D"or Unnamed • --,1_,-,.,-,.,,•.; L ,, - -- ❑ Commercial• ❑Special Use(Essential Public F •.r =- .' J C-, _ ❑ Change of Use 0 Boundary Line Adjustment ❑ Address O Road Approach ❑Short Plat" ❑Home Business ❑Cottage industry ❑Binding Site Plan" F _. n 0 Propane 0 Long Plat" QG� ' 1 t O Sign 0 Planned Rural Residential Deve (PRRD)/Amendments" O Allowed'Yes'Use Consistency Analysis 0 Plat Vacation/Alteration" i---- ____ . _ 11-1 O Stormwater Management 0 Shoreline Master Program Exemption/Per mill lltrff Ty O Site Plan Approval Advance Determination(SPAAD)• ❑Shoreline Management Subsfaotial E Igdttifitll LAITY DEVELOPMEN- - O Temporary Use 0 Shoreline Management Variance O Wireless Telecommunication• ❑Comprehensive Plan/UDC/Land.Use District Map Amendment O 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: I hereby designat •4► .A i 4. !/* - a D EA S I! NATION a s O F m y A GageENnt T in matters relating.V to/is'a icat for permit(s). OWNER SIGNATUR' L1� �_ I Date: I / By signing this app erform,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 kn• 77,-. 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 •. access and right of entry to Jefferson County and Its employees,representatives or agents for the sole purpose of application review and a = uired later inspections. -s access and right of entry will be assured unless the applicant o t Coun in writing at the 1 time of the .. . that hor she wants . notice. 10 Signature: IC A AAA.4 . •a�l�m Date: 1 The action lotions 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 •' n 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) - if you are in complian•,with the Jefferson County development code.The Applicant acknowledges th he, or• holds individual and no : bleJesponsibifity j. adhering t• -- •complying with the ESA. The Applicant has read this d' rn r a signs nd dates it below. Signatu i IAA 1 A. .' -,a Date:, G:\Perini .\###FORMS###\DRD FORMS\Master Permit Application S-29.08.doc • • 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: ENERAL CONTRACTOR OR UFA URED HOME INSTALLER: PHONE: FAX: III A& .A. 0-.4111 . 1... a 110- t (od'� r t O (aOki) "I fJ. 0 MAILING ADDRESS: b 3 ‘ ti iiLi �' ,tT:�'ii!l�!� I CONTRACTOR'S LICENSE b3(, \ r, • r • i 11[,VS INS [;preN NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FM:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: 0 New ❑ Wood Existing: 0 Sewer ❑ )ddition ❑ Steel Proposed: Bank 0 Community System e Alteration/Remodel ❑ Concrete Total: Height ❑ Individual System ❑ .Repair 0 Masonry SEP Permit# ❑ Demolition ❑ Other. Bedrooms: Water yxiU Setback: e well ❑ Two Party Typvf1Hea I _ Proposed: ❑ Public C. Total: Name of System: If this is a Commercial Protect you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ACA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: W l 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 1 Above ground Tank Size of Propane Tank: 1 Heat Stove 1 Cook Stove 1 Woodstove 1 Fireplace Insert 1 Hot Water Tank 1 Pellet Stove 1 Other Is this appliance being installed in a Manufactured/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, including the reserve area. �"S•uare Foota•e Current t H ;i` «' L._ . _...__ Main Floor Heated _ M EH Bid App Review: 111 Floor Heated Consistency Review: Other Heated Base fee: IMP--- Mezzanine Additional Section: =Ms/ ' v t Heated Basement fi Plan Check fee: OCT _ J �°� Unheated Basement € State Surcharge fee: i ,r_f.'SO. COUNTY Other Unheated _: Pot Water Review fee: r)�,��/ , ou,' . Garage/Carport SUBTOTAL - ° m' T s_ Decks 911/Rd Approach fee: Other K TOTAL: $ t i z Receipt Number. \k.,:,\ b Cash/Check Number: ESTIMATED COST(REQUIRED) '' 13 II Date: 44 .Fair market value of all labor and materials . . ... to finish Initials: r, G:\PermtCcnter\###FORMS###\DRD FORMS\Master Permit Apptiarion 5-29-08.doc IJEFFERSON COU4k( 1,C7)CE) • 151611 DATE RECEIVED FROM (?)reYNOT-C\ 4-Yr-c) k iNI-r. Cy\a-cl -Pti-t\/\ - BARS# AMOUNT DESCRIPTION CURRENCY 01:;■4=% t'S2-- 5 COIN 2 co E 4:: 47 :' c t'lr-7:111il' m XI 8 --1<3 . ,.,. . . TOTAL 111 --s RECEIVED BY ■;Ner- 0 • 44��soh `o�� JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Date: t 0�Q Time Received: (0 . 41 2_ m Mon. ue Wed. Thur. Fri. Date: `D - l BLD: Contact Name: Owner: (/ Contact Number: 360_ Agi��' e Address: v5 s , 1 206 Notes: .�j_ f Foundation Plumbing Framing Propane ank 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 0 • Jefferson County Building Division Permit Number: BLD14-00358 Applicant: SMITH 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 I Mechanical Systems / j~`I ! ;1 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 11,01-/Z G FINAL INSPECTION MUST E 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#: BLD14-00358 Received Date: 10/6/2014 SITE ADDRESS: 91 SHORE DR Issue Date 10/6/2014 PORT LUDLOW, 98365 Expiration Date 10/6/2015 OWNER: CRAIG R SMITH PHONE: 360-286-4286 STARLA SMITH 91 SHORE DR PORT LUDLOW WA 98365-9258 9834 SUBDIVISION: Block: Lot: PARCEL NUMBER: 983401305 Section: 23 Township: 28 N Range: 1E CONTRACTOR: BRENNAN HEATING &NC LLC PHONE: 206-248-7900 4601 S 134TH PL SEATTLE WA 98168 Contractor's License BRENNHA971 R9 Expires 7/13/2015 PROJECT DESCRIPTION: 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: Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $152.00 SRE 10/03/14 151611 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 1