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Home My WebLink AboutBLD2014-00414 - MECHANICAL 0BUILDING PERMIT APPLICOON BLD14-00414 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00414 Received Date: 11/7/2014 SITE ADDRESS: 94 COOK AVE PORT TOWNSEND, 98368 OWNER: DANIEL PAU GOLDSTEIN PHONE: 360-774-2651 ELIZABETH R GOLDSTEIN 94 COOK AVENUE EXT PORT TOWNSEND WA 98368-9285 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001043011 Section: 4 Township: 30 N Range: 1111 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 DESCRIPTION MECHANICAL PERMIT 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: IRouting Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $152.00 SRE 11/06/14 151695 Total: $152.00 APPROVED Jefferson County DCL E l k lui Ab jai in I.C. k / 1L[ \\tidemark\data\forms\F_BLD_App_Bld.rpt 11/7/2014 4 , co, JEFFERSON COUNTY < 1DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax $$`r8'TN � www.co.jefferson.wa.us/commdevelopment 6 Master Permit Application t MLA: Project Description(include separate sheets as necessary): r1 311..I A cx)c,-V.-cz S J To "e\--i) Tax Parcel Number:MI O 'ol♦ Property Size: (acres/square feet) Site Address and/or Directions to Property: L1' •. � . • V.--k- 4- Vb r-4- Tow rta.e Property Owner(s)of Record: 1.-.1 % - A Telephoneo D �'44 - o[ 5 1 Fax: _ em 'I: Mailing Address:4 coo■L Qv"-k _ e . or -I-6w r1 —CI B t (0 8 Applicant/Agent(if different from owner): = ■. _ .. Telephone:a02 ' O� F. : _ Ci•o % 1 0- email: •.' ..' a - Mailing Address: . r " WC.. QS 68 a i . CO Yr% What kind of Permit?(Check each box that applies OBuilding ❑Critical Areas Stewardship Plan ❑ Demolition Permit O Variance(Minor,Major or Reasonable Economic Use) Single Family ❑Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home 0 Modular ❑Discretionary"D"or Unnamed - - ❑ Commercial* ❑Special Use(Essential Public ' •ier o I-E (}Q V!I ,-, ❑ Change of Use ❑Boundary Line Adjustment LI ❑ Address ❑Road Approach ❑Short Plat'" ❑Home Business ❑Cottage Industry ❑Binding Site Plan** 0 Propane ❑Long Plat** A�IID�}``'/ ��nn11 �-t- ❑Sign ❑Planned Rural Residential De - p 'nt(tab)/Am�df �s** J ❑Allowed"Yes'Use Consistency Analysis 0 Plat Vacation/Alteration** .-- ❑Stormwater Management ❑Shoreline Master Program Ex= ptio • r- •• ** O Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Subst.ntial DevelorigifieN COUNTY t O Temporary Use ❑Shoreline Management Varian DEPT.OF COMMUNITY DEVELOPMENT O 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 (21**Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal,if known: a SIGNATION OF AGENT I hereby design; - 4,►, ' -∎ �:to act as my agent in matters relating t thi application for permit(s). OWNER SIGNAT - ,ri �J•V ..�,�,_ Date: ( I �� \ 4 By signing this a.. n 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 kn•^1T •e. 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 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 ,rovide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any re•uired later inspections. taffs access and right of entry will be assumed unless the applican info s the County in writing at the time of th,ap•ii.'on that he or she v)an k rior notice. I Signatur• r A A A I .' it `�� Date: h U �i The actin • actions 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 ,,= 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) , en i you are in compliance with he Jefferson County development code.The Applicant acknowledges at he,she or it holds individual and non- ansfe •e responsibility for ad r g to and complying with the ESA. The Applicant has read this dii glai er n}l stile and dates it below. Signature. 0�� . Date: ` G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.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 ANUFACTURED HOME INSTALLER: PHONE: FAx: 14 .A. 0,... 1 ... II t ( o 01 o (�OL CI`6' - 0' MAILING ADDRESS: �t1\ J _ C:l�ir '!lfii'.`� �� . i t• •:�:.� ♦: ,.•�1'1 �! CONTRACTOR'S LICENSE h(.2xv\ 4, • • 0‘ # % LVgINS co NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAx:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: O New ❑ Wood Existing: 0 Sewer ❑ ydition ❑ Steel Proposed: Bank ❑ Community System eAlteration/Remodel ❑ Concrete Total: Height: 0 Individual System O Repair ❑ Masonry SEP Permit# ❑ Demolition 0 Other: Bedrooms: Water Supply: Existing: Setback: t I Private well ❑ Two Party Tyrig.qf Heat: Proposed: ❑ Public 1,CC_ Total: Name of System: If this is a Commercial Prolect you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parkin Q V Number of occupants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? s / No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: 1 Underground Tank .1 Above ground Tank Size of Propane Tank: NOV 6 2014 I Heat Stove I Cook Stove 1 Woodstove I Fireplace Insert I Hot Water Tank 1 Pellet Stove 1 Oi14r L L_� Is this appliance being installed in a Manufactured f Mobile Home? Yes / No JEFFERSON COUNTY When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings Prffk0'MENT lines,tank location and size,distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. 0 ,fi i `�g ' �N 4 ke'r i �� eA � yi; " 4 Square Footage Current Proposed � � i A ,i �, 1�".� . iiil as . �i t r w iLM G Main Floor Heated ,� '' EH Bld App Review: Floor Heated aita rp p91 Consistency Review: �sa4ra e Base fee: Other Heated Ei i �,+;( Mezzanine :-!':'571r-i=p 4{ Additional Section: ite Heated Basement ,;; 41'44 Plan Check fee: C:eitO'IltLiV"40 Unheated Basements is x-1 State Surcharge fee: Other Unheated 04i ,b ' Pot Water Review fee: 405t4„,... -- Garage/Carport P f �TSUBTOTAL Decks ys '' 911/Rd Approach fee: 1 Other w �Vld l? , i r TOTAL:TAL: $ r , 1 � 4t 44,6 Receipt Number: 1c,/ 6O/5 " r t " Cash/Check Number: 4 f 4 q�I r 111 ESTIMATED COST(REQUIRED) Date: r //� ��4 •Fair market value of all labor and materials foundation to finish ` / ((�� Initials: J • G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc BRENNAN HEATING & A/C LLC Page 1 of 2 • • Washington State Department of Labor & Industries BRENNAN HEATING & A/C LLC Owner or tradesperson 4601 S 134TH PL ERDAHL, DARRIN PAUL SEATTLE,WA 98168 206-248-7900 Principals KING County ERDAHL, DARRIN PAUL, PARTNER/MEMBER Doing business as BRENNAN HEATING &A/C LLC WA UBI No. Business type 602 346 866 Limited Liability Company 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. BRENNHA971 R9 Effective—expiration 12/29/2003-12/29/2015 Bond ................. FEDERATED MUTUAL INS CO $12,000.00 Bond account no. 9127230 Received by L&I Effective date 11/04/2004 12/22/2004 Expiration date Until Canceled Insurance Federated Mutual Ins Co $1,000,000.00 Policy no. 9820726 Received by L&I Effective date 06/13/2014 07/13/2007 Expiration date 07/13/2015 Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602346866&LIC=BRENNHA971R9&SAW= 11/7/2014 BRENNAN HEATING& A/C LLC Page 2 of 2 No lawsuits against the bond or sags accounts during the previous 6 year Sod. L&I 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 Infraction no. PPEJP00330 Satisfied Violation date RCW/WAC 09/14/2012 18.106.020 Violation city Violation amount Seattle $250.00 Type of violation PLUMBER INFRACTION Description Contractor employed a person to engage in the trade of plumbing without a current journeyman,specialty or trainee certificate, temporary permit or medical gas endorsement as required.On 9/11/12, Brennan Heating & A/C LLC employed Levy Malcom Steere to perform plumbing related duties without proper plumbing certification. 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. 803,761-08 Doing business as BRENNAN HEATING&AIR CONDIT Estimated workers reported Quarter 2 of Year 2014"76 to 100 Workers" L&I account representative T4/ALISON WOODWARD(360)902-4629-Email:WOAL235©Ini.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. Access Washington* 4:rc+[i lobe(4,Vf VM https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602346866&LIC=BRENNHA971R9&SAW= 11/7/2014 • • Jefferson County Building Division Permit Number: BLD14-00414 Applicant: GOLDSTEIN 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 ii/z6/0-1 # . Miscellaneous 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 it/Zsllyl 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#: BLD14-00414 Received Date: 11/7/2014 SITE ADDRESS: 94 COOK AVE Issue Date 11/7/2014 PORT TOWNSEND, 98368 Expiration Date 11/7/2015 OWNER: DANIEL PAU GOLDSTEIN PHONE: 360-774-2651 ELIZABETH R GOLDSTEIN 94 COOK AVENUE EXT PORT TOWNSEND WA 98368-9285 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001043011 Section: 4 Township: 30 N Range: 1V1 CONTRACTOR: BRENNAN HEATING &A/C LLC PHONE: 206-248-7900 4601 S 134TH PL SEATTLE WA 98168 Contractor's License BRENNHA971 R9 Expires 7/13/2015 PROJECT DESCRIPTION: MECHANICAL PERMIT 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 11/06/14 151695 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 40- °0o JEFFERSON COUNTY ` DEPARTMENT OF COMMUNITY DEVELOPMENT moos, ` Time Received: 3' 14 a /p Mon. 1 .J . Wed. Thur. Fri. Date: 1 i Date: i//2-c BLD: i4-- c'e4 14 Contact Name: Owner: Ge74..05Y auJ Contact Number: 360 377- pq/ �q- ��vc AJG EATN 206 Address: Notes: /.Ej+." ® 4641t eet-dadf 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 QInrL Q.Tilo Ceiling JEFFERSON COUNTY No. 151695 DATE / - ,DJ) RECEIVED FROM �� ilI 1�ia�� /' ` 4 / "of,/e �1 DESCRIPTION BARS# �j AMOUNT ....1 CURRENCY ��"'�"� 15P,OZ) COIN J3J l /J 6:71E71 4414' 2 ,,, . o ,;,--, u,1 - , , ti s. I � ,,,,, ,14/1a-irrni- , - . -, j04,Anp ill", 1 RECEIVED BY /. .�. ,.�/// TOTAL i 17/4