HomeMy WebLinkAboutBLD2014-00426 - MECHANICAL ILDING PERMIT APPLICAT BRLD1e004pe26
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD14-00426 Received Date: 11/19/2014
SITE ADDRESS: 33 E ISLAND VIEW AVE
PORT TOWNSEND, 98368
OWNER: BUZZ TEFFT PHONE: 360-344-2682
33 EAST ISLAND VIEW AVE
PORT TOWNSEND WA 98368-2597
9621
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 962113408 Section: 35 Township: 30 N Range: 1V1
CONTRACTOR: C H S INC PHONE: (360)732-4585
PO BOX 518
AUBURN WA 98071-0518
Contractor's License CHSIN**9790Z Expires 9/7/2016
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP Replace 120 gal propane tank
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP MEC MAIN:
VALUATION ADD'L: HEAT TYPE: PRO
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: • n
n
Permit $152.00 NEW 11/19/14 153863
Total: $152.00
DOE
Jefferson County DOE
\\tidemark\data\forms\F_BLD_App_Bld.rpt 11/19/2014
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tiSON Cb DE TMENT OF COMMUNITY•VELOP1VIENT
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� 4,, 621 Sheridan Street,Port Townsend,WA 98368
ti ' Tel:360379.4450 ( Fax:360.379.4451
Web:www.co.jefferson.wa.us/communitydevelopment
l ` 1« E-mail:dcda,co.jefferson.wa.us
L�YS IN0,c0
41 MECHANICAL PERMIT APPLICATION
Steps in the Permit Process:
-Review required submittal items to ensure all information is completed prior to submitting application.
-Make an appointment to meet with the Permit Technician by calling 360-379-4450.
-Fees will be collected at intake. Additional fees may apply after review and payment is required before permi i i.su-.•.
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Is this application for use in a Mobile/Manufactured Home?
* If Yes: A permit from Washington State Department of Labor and Industries, not Jefferson County; is
required for appliances installed within a mobile/manufactured home. L&I-360-417-2702
* If No: Complete this form and make an appointment to submit to Jefferson County Permit Tech 360-379-4450
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Complete Site plan Please refer to the site plan checklist to ensure all it a .ye - `•
Complete first page and signature block only of Mechanical Permit Applica •17
A complete solar panel supplemental application. r' ,' 1
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Assessor Tax Parcel Number: ` , ,
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Site Address and/or Directions to Property: 33 ,E .L5/#0 (46-a/ 4UE'
Access (name of street(s) from which access will be gained:
Description of Work: 3 £ S/It, LitEet/ 4v
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6 Name: J2a ,
Address: 33 (H to 4tie—
Phone#: 0 - 344 ` 260 Z-- E-mail Addre s: -buzz€ /fiko.Cc44
Please contact Authorized Agent/Representative with p • - «r d
Property Owner Signature: ♦ Date: //--/f /40-- " ' L
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Name:
Phone#: %0— 23 --4 3 E-mail Address:
License#: • I of Expiration Date:
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Mechanical Application 1
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Electric Heating Oil Propane* Wood
%® * , ' � 70 � *Propane is prohibited in
hazardous locations such as
mot ..... ,. .t_
_ Fan _ Bath Fan and/or Exhaust Fan _ basements or pits or
Clothes Dryer Clothes Dryer with Exhaust Vent anywhere "heavier-than-air"
Cook Stove Cook Stove, Range Hood Exhaust gas can unsafely collect.
Fireplace-Gas Fireplace-Gas or Gas Log Insert *Propane tanks over 124
Fireplace-Wood Fireplace-wood,Wood Stove,or gallons require a minimum
Pellet Stove setback of 10 ft.from
Electric Furnace Electric Furnace or HP+/- Ducting property line and buildings,
. Propane(LP)Gas Furnace Propane Furnace+/-Ducting and a site plan must be
submitted with the
Water Heater-Gas Gas WH Vent and Combustion Air _ application showing the
Gas Pipe System Gas Pipe System LPG/Oil _ setbacks: If propane tank is
Propane Tank LP Fuel Tank(#gallons: 120 ) over 500 gallons,a site plan is
Heat Pump required to accompany this . •
Generator application, and a separate
Air Conditioner Fire Code approval is also
required.
Installation manual must be on site at time of inspection or a
re-inspection fee will be charged.
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 making any issued permit null and void.
I further agree to that all activities I intend to undertake or complete associated with this permit will be performed in
compliance with all applicable federal, state and county laws and regulations and I 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. Applicant may request notice of the County's intent to enter upon the property
for visits related to this application and subsequent permit issuance.
Signature: r,.;� f Print Name: -SOZc Fier Date: //-/8 ' ��
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*Additional fees may apply.
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Mechanical Application
Parcel Details • Page 1 of 1
e Jeffer- son County-
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Parcel Number: 962113408 SEARCH
Parcel Number: 962113408 Printer Friendly
Owner Mailing Address:
BUZZ TEFFT
33 EAST ISLAND VIEW AVE
PORT TOWNSEND WA98368-2597
Site Address:
33 E ISLAND VIEW AVE
PORT TOWNSEND 98368
Section: 35 School District:Chimacum (49)
Qtr Section: NW1/4 Fire Dist:Chimacum (1)
Township: 30N Tax Status: Taxable
Range: 1W Tax Code: 0211
Planning area:Tri-Area (4)
Sub Division: 9621 - IRONDALE 100-179
Assessor's Land Use Code: 1100 - Residential - Single Unit
Property Description:
IRONDALE #6 BLK 134 LOTS 20 THRU 24
Tax,A/V,Sales,Photos,and
Permit Data Bldg Data Mao Parcel Plats&Survev
Septic Monitoring Info
eirt )e He-cc1 Cot HOME I COUNTY INFO I DEPARTMENTS I SEARCH
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http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp 11/19/2014
C H S INC Page 1 of 4
• •
Washington State Department of
Labor & Industries
C H S INC
Owner or tradesperson PO BOX 518
CASALE,CARL MARTIN AUBURN,WA 98071-0518
253-833-7220
Principals KING County
CASALE,CARL MARTIN,PRESIDENT
EGAN,THERESA MARIE,VICE PRESIDENT
MCENROE,JOHN DANIEL,VICE
PRESIDENT
LILJA, NANCI LEE,SECRETARY
KASTELIC,DAVID ALLEN,TREASURER
C T CORPORATION SYSTEM,AGENT
ESTENSON,NOEL,PRESIDENT
(End:09/21/2012)
WESTBROCK,LEON,VICE PRESIDENT
(End:09/21/2012)
BAKER,DAVID A,SECRETARY
(End:09/21/2012)
Doing business as
CHS INC
WA UBI No. Business type
600 148 004 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.
CHSIN**9790Z
Effective—expiration
09/09/2003—09/07/2016
Bond
.................
Liberty Mutual Ins Co $12,000.00
Bond account no.
58S203444
Received by L&I Effective date
10/05/2012 11/21/2012
Expiration date
Until Canceled
Bond history
Insurance
...............................
Old Republic Ins Co $1,000,000.00
Policy no.
MWZY302766
Received by L&I Effective date
09/08/2014 09/01/2014
Expiration date
09/01/2015
https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600148004&LIC=CHSIN**9790Z&SAW= 11/19/2014
0 ill
MECHANICAL AND DEMOLITION PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT#: BLD14-00426 Received Date 11/19/2014
SITE ADDRESS: 33 E ISLAND VIEW AVE Issue Date 11/19/2014
PORT TOWNSEND, 98368
APPLICANT: BUZZ TEFFT PHONE: 360-344-2682
33 EAST ISLAND VIEW AVE
PORT TOWNSEND WA 98368-2597
SUBDIVISION: 9621 Block: Lot:
PARCEL NUMBER: 962113408 Section: 35 Township: 30N Range: 1W
CONTRACTOR: C H S INC PHONE: (360)732-4585
PO BOX 518
AUBURN WA 98071-0518
Contractor's License CHSIN**9790Z Expires 9/7/2016
OWNER, BUZZ TEFFT PHONE: 360-344-2682
if different: 33 EAST ISLAND VIEW AVE
PORT TOWNSEND WA 98368-2597
PROJECT DESCRIPTION: Replace 120 gal propane tank
Directions
To Site:
THIS PERMIT IS VALID FOR ONE YEAR AND IS NOT RENEWABLE.
THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR.
THE EXPIRATION DATE IS 11/19/2015.
REQUIRED INSPECTIONS:
Installation per Manufacturer Specifications/CO2:4 '// Z.# I ,
Tank/Line/Appliance:
Final Approval: //zOill
BUILDING INSPECTION HOT-LINE 379-4455.
REQUESTS MUST BE RECEIVED BY 3 PM THE DAY BEFORE THE INSPECTION IS NEEDED.
Office Hours 9:00 a.m. -4:30 p.m. Monday-Thursday
HOT LINE AVAILABLE 24 HOURS A DAY
\\tidemark\data\forms\F_BLD_Permit_Propane.rpt 11/19/2014
�4wgs°N ,06.1.• JEFFERSON COUNTY
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DEPARTMENT OF COMMUNITY DEVELOPMENT
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Date: I I A Time Received: /[,4i) am 111# Mon. Q Wed. Thur. Fri.
Date: __A
BLD: r 474L Contact Name: i
Owner Contact Number: 60 . �m_ 12 Address: i ei-) �b '73 I - 1 / 19
Notes: PO (),01_ 4ark 1 Ct
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/Woos . -
Man-Homes Insulation ."
Final Inspection
Setbacks Floor
Foundation Wall Address Posted
Block&Tile Ceiling