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HomeMy WebLinkAboutBLD2014-00381 - MECHANICAL 1 UILDING PERMIT APPLICAN BLD14-00381 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00381 Received Date: 10/16/2014 SITE ADDRESS: 310 FOUR CORNERS RD OWNER: JEFFERSON COUNTY PUD#1 PHONE: PO BOX 929 PORT HADLOCK WA 98339-0929 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001333037 Section: 33 Township: 30 N Range: 1V1 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 DESCRIPTIO1 Install 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: outing Date: Type Amount Paid By: Date: Receipt: Orgye_d_/Date_ Permit $152.00 SRE 10/16/14 151656O'' _ Total: $152.00 OCT 16 2014 ,Jefferson County DOD \\tidemark\data\forms\F_BLD_App_Bld.rpt 10/16/2014 „, O/NT -c L� 0 V 4” cO • n� ,) 6. JEFFEIltN COUNTY /� I ° r4 DEPARTMENT OF COMMUNITY DEVELOPMENT fl� f gl `d 621 Sheridan Street• Port Townsend •Washington 98368 ( OCT 1 2014 360/379-4450 • 360/379-4451 Fax I c www.co.jefferson.wa.us/commdevelopment �'' ...�____ .'APT or rr'r?,4+ii.iTy,_, ,,rf npMEh�7 Master Permit Application - MLA Prot Descri tiLiion(include separate sheets as necessa : � �., Tax Parcel Number.QQ 1 3 33 03 7 Property Size: (a square feet) Site Address and/or Directions to Property: O1-v Alt," - ! fi, Property ��/� i Owner(s)of Record: A_,__ , �.����,. Telephone: Fax: email: Mailing Address: 0 :� 7.; ,a ,i,/A41111-1.50 ; g$ Applicant/Agent(if different from owner): i C F1 O ii, - --_,I t Cl` , 3V,0"web—a°IO 1 Fax: l' ' ' Telephone: —a1"'7 email:rtiClM+i.�c�'� ' e ` Mailing Address: 221 W. Cedar St• seatw M ,W E'► 88382 Ca.(Jyit, What kind of Permit?(Check each box that applies ©Building 0 Critical Areas Stewardship Plan C) O Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use) ❑Single Family 0 Garage Attached/Detached 0 Conditional Use(C(a),C(d),or Cj o �aufactured Home 0 Modular 0 Discretionary`D or Unnamed Use Classification mmercial" ❑Special Use(Essential Public Facilities)" ❑ Change of Use ❑Boundary Line Adjustment ❑ Address 0 Road Approach 0 Short Plat" ❑ Home Business ❑Cottage industry ❑Binding Site Plan" ❑Propane 0 Long Plat"" O Sign 0 Planned Rural Residential Development(PRRD)Amendments"` O Allowed'Yes'Use Consistency Analysis 0 Plat Vacation/Alteration"" ❑Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions"` O Site Plan Approval Advance Determination(SPAAD)` ❑Shoreline Management Substantial Development-- 0 Temporary Use 0 Shoreline Management Variance ❑Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District Map Amendment 0 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 ■ 1 i -%0 A"1eat.t1• to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE L4- - Ili". Date: l) /Pi By signing this application form,the ownerfagent 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 Courtly 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. Staffs a•' ss and right of a will be assumed nless the applicant informs the County in writing at the time of the application that he spe wan - nod:. Signature: �o L..4 ■ J l,w Rate: rC/lo/i y The action or actions Applicant will undertake as a result of the -suanoe 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 y u are in compliance 1 the Jefferson Cou •- lopment code.The Applicant acknowledges that he,she or it holds individual and non-Uansfe le,respgibif fora,,eri, and •• �,rng ' the E •. Th :nt has read this disda' era signs and dates it below. Signature: r ILI., `:.,°i_.�I . ' ( MN � Date: is7J$ l`�or GAP D v Nib mg ,i rub CERTIFIED® OCT n2 www.ahridireetory.org t/•mTY Certificate of Product Ratings AHRI Certified Reference Number: 4385486 Date: 10/13/2014 Product: Variable Speed Mini-Split Air-Conditioner,with Remote Outdoor Unit-Air-Source, Free Delivery Outdoor Unit Model Number: PUY-A24NHA4(BS) Indoor Unit Model Number: PKA-A24KA(L) Manufacturer: MITSUBISHI ELECTRIC COOLING & HEATING Trade/Brand name: MR. SLIM Series name: Manufacturer responsible for the rating of this system combination is MITSUBISHI ELECTRIC COOLING & HEATING 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): 24000 EER Rating(Cooling): 10.60 SEER Rating(Cooling): 17.00 CERTIFIED RATINGS FOR VARIABLE-SPEED,MINI-AND MULTI-SPLIT SYSTEMS ARE VALID FOR ALL COMBINATIONS OF INDOOR UNITS (BASED ON COMBINATION TYPES)WITH THE SPECIFIC OUTDOOR UNIT LISTED ABOVE AND IN THE AHRI DIRECTORY OF CERTIFIED EQUIPMENT.VISIT WWW.AHRIDIRECTORY.ORG TO VERIFY THAT THIS COMBINATION IS AN ACTIVE LISTING AND THE DATA LISTED ON THIS CERTIFICATE IS ACCURATE.SEARCH ON THE AHRI REFERENCE#TO QUICKLY LOCATE THIS COMBINATION IN THE DIRECTORY. •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.ahrldirectory.org. TERMS AND CONDITIONS r 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 ,I The information for the model cited on this certificate can be verified at www.ahrldirectory.org,click on"Verify Certificate"link 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 130577151610728961 001 33303 [H,, C ovin HOCT 1 6 2014 II I I JEFFERSON COUNT`( DEPT OF COMMUNITY DEVFLOPMENT 0 ID 6 R 11fi I I 1-4 2'1 56 n 01 s fir' PIA etef- Parcel Details Page 1 of 2 • • tierterso C n n o u ty „ „„ „ 7p, i** name County Info Departments Search Parcel Number: 001333037 SEARCH Parcel Number: 001333037 Printer Friendly Owner Mailing Address: JEFFERSON COUNTY PUD #1 PO BOX 929 PORT HADLOCK WA98339-0929 Site Address: Section: 33 School District: Port Townsend (50) Qtr Section: SW1/4 Are Dist:Chimacum (1) Township: 30N Tax Status: MISC Range: 1W Tax Code: 0111 Planning area: Quimper (2) Sub Division: Assessor's Land Use Code: 9700 - Exempt Property Property Description: S33 T30 R1W NESW(LS N/HWY&E255' S/HWY) LS PTN TX 2,3,18,26 Tax,A/V, Sales, Photos,and Permit Data Bldg Data Map Parcel Plats&Surveys Septic Monitoring Info kt Jefferson County ' ; -, HOME I COUNTY INFO I DEPARTMENTS I SEARCH 1 Best viewed with Microsoft Internet Explorer 6.0 or later gjWindows- Mac http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?Parcel_NO=001333037 10/16/2014 AIR FLO HEATING CO INC Page 1 of 2 • • 0 Washington State Department of Labor & industries AIR FLO HEATING CO INC Owner or tradesperson 221 W CEDAR ST BEQUETTE, MICHAEL SEQUIM,WA 98382-3320 360-683-3901 Principals CLALLAM County BEQUETTE, MICHAEL FULLAWAY, MICHAEL BEQUETTE, MARK A, PRESIDENT BEQUETTE, SANDRA A, VICE PRESIDENT BERSON, JOEL R, SECRETARY BERSON, JOEL R, TREASURER LEVINSON, WILLIAM R, AGENT Doing business as AIR FLO HEATING CO 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. Electrical Contractor Active. Meets current requirements. License specialties HVAC/RFRG License no. AIRFLHCOO9C8 Effective—expiration 02/28/2000—02/28/2016 Designated administrator Active. BERSON,JOEL RAY Meets current requirements. License type License no. Master Electrician BERSOJR975LB Bond CBIC $4,000.00 Bond account no. si6233 Received by L&I Effective date 05/19/2010 07/06/2010 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&LIC=AIRFLHC009C8&SAW= 10/16/2014 AIR FLO HEATING CO INC Page 2 of 2 • • Expiration date Until Canceled Bond history Savings No savings accounts during the previous 6 year period. License Violations Infraction no. EDORN00206 Satisfied Violation date RCW/WAC 03/28/2013 19.28.161(6) RCW Violation city Violation amount Sequim $250.00 Type of violation ELECTRICAL CITATION Description Failure of the electrical contractor to accurately verify electrical training hours on an Affidavit of Experience. 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. 351,432-00 Doing business as AIR FLO HEATING COMPANY INC. Estimated workers reported Quarter 2 of Year 2014"21 to 30 Workers" L&I account representative T1 /FEARAED FEROZE (360)902-4797-Email: FERH235 @Ini.wa.gov Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. Citation issue date 07/24/2012 Violations Inspection no. 315954529 Location 125 Horizon View Dr. Sequim,WA 98382 ©Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. Access lArashingtoe <'c .;i1S+k k Y K:+kizpY,"K'iy Wth ui4s https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&LIC=AIRFLHC009C8&SAW= 10/16/2014 f 61_ JEFFERSON COUNTY �SffM�,F-.„O DEPARTMENT OF COMMUNITY DEVELOPMENT 2 ,".Y 3O Date: t'—Li Time Received: 1O'12_ im pm Mon. Tue. Wed. Thur. Fri. Date: BLD: 1i{-" 3q I' Contact Name: Owner: PIA,); Contact Number: 360 30Z, 0V7 Address: '[U j,rW 206 Notes: t " ' - 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 1 Jefferson County Building Division Permit Number: BLD14-00381 Applicant: JEFFERSON COUNTY PUD#1 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 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 f L J [427 FINAL INSP CTION 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#: BLD14-00381 Received Date: 10/16/2014 SITE ADDRESS: 310 FOUR CORNERS RD Issue Date 10/16/2014 Expiration Date 10/16/2015 OWNER: JEFFERSON COUNTY PUD#1 PHONE: PO BOX 929 PORT HADLOCK WA 98339-0929 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001333037 Section: 33 Township: 30 N Range: 1V\ 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 PROJECT DESCRIPTION: Install 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 10/16/14 151656 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 • • CONDITIONS for Building Permit# : \\tidemark\data\forms\F_BLD_Permit_BIdg.rpt 10/16/2014 JEFFERSON COUNTY No. 1 6 6 0 cp R DATE 0 RECEIVED FROM ./ �, /� X11// P� ,/4 ■ DESCRIPTION �, BARS# AMOUNT CURRENCY r it r ' r 1, YR„i 1 _ ®r ■ C co O rn o it RECEIVED BY P irir�•.'J/i/, TOTAL /7 ,