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HomeMy WebLinkAboutBLD2014-00411 - MECHANICAL aUILDING PERMIT APPLICA•N RBLD14. eveview iew00411 R Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00411 Received Date: 11/5/2014 SITE ADDRESS: 204 WOODLAND WAY PORT TOWNSEND, 98368 OWNER: DENNIS E MC DANIEL TRSTE PHONE: 360-385-5847 TRUE HEART TRUSTEE 204 WOODLAND WAY PORT TOWNSEND WA 98368-2818 SUBDIVISION: Block: Lot: 3+ PARCEL NUMBER: 001345006 Section: 34 Township: 30 N Range: 1V1 CONTRACTOR: PENINSULA HEAT INC PHONE: 360-681-3333 PO BOX 173 CARLSBORG WA 98324 Contractor's License PENINI*044OW Expires 3/2/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION MECHANICAL PERMIT REPLACE BOILER- SAME FOR SAME TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC VALUATION MAIN: CODE EDITION: 2012 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: 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: ct Permit $152.00 SRE 11/05/14 151690 /APPROVED ! Approved/Date, D Total: $152.00 2`, Jefferson County DOD 1ff$0N ) 1 1 I oY JEFFWON COUNTY • DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street I Port Townsend,WA 98368 I Web:www.co.iefferson.wa.us/communitvdevelopment SksN01 Tel:360.379.4450 I Fax:360.379.4451 I Email:dcdta7.co.iefferson.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): Re-pl&ce A c f;(cc - ice_ Tax Parcel Number: 0,0 i3`/s-066 Property Size: (acres/square feet) Site Address and/or Directii n to Property: W D0d Cd-n-ce- to Wood Dr • 0c'4 l t. waif Property Owner(s)of Record: _761117 / - G Qd! f 1S , .J Telephone: '3(04 not ot _ 360 - Sais/ email: Mailing Address: . /00,07 !., OOi'f !� ���� WA- - Applicant/Agent(if different from owner): 0 MJcc. Telephone: 7'b—69 -- Fax: �7W'"6g. A i email: m.4cfy?laeivcitr i _ Mailing Address: � O'/3 0" / 13, h%yi Gv • ®3� ' / c What kind of Permit?(Check each box that applies ❑Lot or Road Segregation ErBuilding ❑Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use) "Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home ❑ Modular ❑Discretionary"D"or Unnamed Use Classification ❑ Commercial* ❑Special Use(Essential Public Facilities)** ❑ Change of Use ❑Boundary Line Adjustment ❑ Address ❑ Road Approach ❑Short Plat** ❑Home Business ❑Cottage Industry ❑Binding Site Plan** ❑Propane ❑Long Plat** ❑Sign ❑Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration** ❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions** ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development'`* ❑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: /1 / _ DESIGNATION OF AGENT I hereby designate /'� I' 'P to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE &IL � ..0‘P Date: ��7o'7,/ By signing this application form,the owner/.gent 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 inspection . to s access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application th a or she wa r notice. Signature: i��:✓, Date: l//�T The action or actions Applicant H 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 the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferablei •• sibility fi d� 'ng to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: f/ •✓ I Date: /1/ 0 q /02-0 l y 07/24/2013 • 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: 12 n5I&- Ifeal Co . (3po) (98l- 3333 1 23 (36) 6 1 c4 MAILING ADDRESS: .0 /30( / rl cha ` EMAIL.YO fr /(f /.6,9/7, CONTRACTOR'S LICENSE k3,2 WAINS NUMBER: /) V 7 / '6 W 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 of�Heat: Proposed: ❑ Public 191-T 1/0 -i i2 Total: Name of System: If this is a Commercial Prolect 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 reh • I evotS telleP I knaT retaW toH I Is this appliance being installed in a Manufactured I Mobile Home? Yes / No When applying for a permit to install a propane tank you must also subm • rte 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 Office Use Only Amount Revision Main Floor Heated EH Bld App Review: 2"0 Floor Heated Consistency Review: Other Heated C Base fee: Mezzanine J Additional Section: Heated Basement Plan Check fee: Unheated Basement (b 1 State Surcharge fee: Other Unheated t Pot Water Review fee: Garage/Carport SUBTOTAL c7 Decks 911/Rd Approach fee: Other TOTAL: $ f�/ o0 Receipt Number: 151670 Cash/Check Number: /3Y23 ESTIMATED COST(REQUIRED) Date: •Fair market value of all labor and materials foundation to finish ll- S 11/ Initials: 07/24/2013 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&l 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&I Effective date 04/04/2014 04/26/2013 Expiration date 04/26/2015 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601737680&LIC=PENINI*0440W&SAW= 11/5/2014 PENINSULA HEAT INC Page 2 of 2 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&l Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period, but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. IWorkers' 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 IWorkplace 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 Whi "%x%97 it.3 C«„r0.ftl57i Mi9t 1'tt https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601737680&LIC=PENINI*0440W&SAW= 11/5/2014 Parcel Details Page 1 of 2 S • teems �a, ' pi!4 nome Coo, Search Parcel Number: 001345006 SEARCH Parcel Number: 001345006 Printer Friendly Owner Mailing Address: DENNIS E MC DANIEL TRSTE TRUE HEART TRUSTEE 204 WOODLAND WAY PORT TOWNSEND WA98368-2818 Site Address: 204 WOODLAND WAY PORT TOWNSEND 98368 Section: 34 School District: Chimacum (49) Qtr Section: NE1/4 Fire Dist:Chimacum (1) Township: 30N Tax Status: Taxable Range: 1W Tax Code: 0211 Planning area:Tri-Area (4) Sub Division: Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: MARVIN GARDENS LOT 3(TAX 47) BND TGTH THRU BLA#76354 Tax,A/V, Sales, Photos, and Permit Data Bldg Data Mao Parcel Plats&Surveys 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=001345006 11/5/2014 Sally Ellis From: Mary Lofstrom <mary@peninsulaheat.com> Sent: Monday, November 10, 2014 4:09 PM To: Sally Ellis Subject: Inspection date change. Hello Sally. I called in an inspection for customer McDaniel of 204 Woodland Way. The original inspection date was the 13th, now the folks need to have it changed to the 17tH Would you let me know you got this email?? Thanks so much. Mary Lofstrom Peninsula Heat Co Sales& Marketing 360-681-3333 (p)u)lk-1 1 X445°N. cow JEFFERSON COUNTY w` ` DEPARTMENT OF COMMUNITY DEVELOPMENT g moo, l 9SX'NGS �-✓ Date: /� 6 Time Received: ll c irk • pm Mon. Tue. Wed. Thu . �'' ►� V!! - 11 l Date: ..___ I �.1 II Contact Name: BAD: Contact Number: 360 3g5 5E47 Owner: 206 Address: _6 ' 'p = 'a AY Notes: _____ tel4A0YP , Foundation Plumbing Framing Propane Tank Mechanical Framing Under ground Furance Setbacks Under ground g Gas Footing Rough In Air Seal Above ground Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Ventilation Appliance Post Hole Underfloor Gas/Wood stove Insulation Man Homes Final Inspection Floor. Setbacks Wall Address Posted Foundation nr4 R.Ti P Ceiling RI Jefferson County Building Division Permit Num BLD14-00411 Applicant: MC DANIEL 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 M: stems cal Sy I/ 1? /% ? eous 1 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 t-1FINAL INS E TION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • BUILDING PERMIT S Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD14-00411 Received Date: 11/5/2014 SITE ADDRESS: 204 WOODLAND WAY Issue Date 11/5/2014 PORT TOWNSEND, 98368 Expiration Date 11/5/2015 OWNER: DENNIS E MC DANIEL TRSTE PHONE: 360-385-5847 TRUE HEART TRUSTEE 204 WOODLAND WAY PORT TOWNSEND WA 98368-2818 SUBDIVISION: Block: Lot: 3+ PARCEL NUMBER: 001345006 Section: 34 Township: 30 N Range: 1V1 CONTRACTOR: PENINSULA HEAT INC PHONE: 360-681-3333 PO BOX 173 CARLSBORG WA 98324 Contractor's License PENINI*0440W Expires 3/2/2016 PROJECT DESCRIPTION: MECHANICAL PERMIT REPLACE BOILER- SAME FOR SAME TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION CODE EDITION: 2012 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: 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 11/05/14 151690 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 Dr D NO. 151690 DATE 17---5---.2C/1/ RECEIVED FROM i• -tL A Nom, - .0`. t•_ DESCRIPTION BARS# AMOUNT CURRENCY L'\ 1,5-- v0 COIN 070 Ai r ,4:14 C / .3�ic e c) CHECKS 2 o J3gtz3 -1 w C) 0 ciao RECEIVED BY T T J TOTAL 171.