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HomeMy WebLinkAboutBLD2014-00419 - MECHANICAL IIPUILDING PERMIT APPLICATION BLD14-00419 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00419 Received Date: 11/13/2014 SITE ADDRESS: 123 GREENVIEW LN PORT LUDLOW, 98365 OWNER: CALVIN WILLIAMS PHONE: 360-473-3320 890 NE MELANIE CT BREMERTON WA 98311-3019 9556 SUBDIVISION: Block: Lot: PARCEL NUMBER: 955600016 Section: 21 Township: 28 N Range: 1E 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 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NEW MECHANICAL PERMIT INSTALL HEAT PUMP TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC VALUATION MAIN: CODE EDITION: 2012 ADD'L: HEAT TYPE: HTP 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: Approved/Date Permit $152.00 SRE 11/12/14 151726 Total: $152.00 ' \\tidemark\data\forms\F_BLD_App_Bld.rpt 11/13/2014 ON f^ eC 0 JEFFERSON C ,�(Fmk �. J FFERSO COUNTY y DEPARTMENT OF COMMUNITY DEVELOPMENT C� )5� 1 621 Sheridan Street• Port Townsend •Washington 98368 � � 4, 4„. 360/379-4450 • 360/379-4451 Fax 1`�d bG l5� UQ 1sg�N 4° www.co.jefferson.wa.us/commdevelopment SCGn -01) Master Permit Application MLA: x`71 'bp Project Description(include separate sh ets as necessary): rc.?f 4 c -C.X i,S-I r -1r- "p-'m4) Tax Parcel Nurnberg 55(p 000 I Lo Property Size: (acres/square feet) Site Address and/or Directions to Property: /93 Gr{.4.r,v1 Ln Property Owner(s)of Record: , l 1 ,♦ •1 II ' ' Telephone: - • • —4'3 • _ II Fax: ��� email: Mailing Address: 't• U 1 O_A i..C- -� '►�.`� • • 6 t Applicant/A.ent(if different from owner): el lif rr t, i Telephone.- - q ie. .4 00 ax:._ - : s g email O. not -00. lrt r►M�nY�to `►�Q Mailing Address: - 0 J 1 , iii�ii `- _ , 1'=f. ': c!_•m What kind of Permit?(Check each box that applies ❑Building O Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor,Major or =-r-or ..� � - L tow f L Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d ,qr` 1 l_ I) 1 ❑ Manufactured Home 0 Modular ❑Discretionary"D"or Unnanjed t e -lassifrcation O Commercial* ❑Special Use(Essential Public Facilities)** 1 1 ❑ Change of Use 0 Boundary Line Adjustment I P i r�, 2 „„ ❑ Address ❑ Road Approach 0 Short Plat** ; 1 1�. '' l' q) ❑Home Business ❑Cottage Industry 0 Binding Site Plan** 1 ; , ❑Propane ❑Long Plat** ii -_� O Sign ❑Planned Rural Residential bevelopment;(PRRO)LAMe rents** g .* ci m"\TNT ❑Allowed"Yes'Use Consistency Analysis 0 Plat Vacation/Alteration i Y[ ❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revlslons** I; ❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** ❑Temporary Use 0 Shoreline Management Variance ❑Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District Map Amendment O Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment May require a Pre-Appllcatlon Conference 0 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 for permit(s). I hereb desi nat _ to act as m a ent in matters relatin lii)]!to t 's application fo Y 9 OWNER SIGNATU• _ L�.A•♦ . �. Date:!j By signing this ap•j ion 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 know edge. 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 a• =e • provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review a,d any required later ins.- tions. Staff's access and right of entry will be assumed unless the applican info the County in writing at the time of e -•• -tion that he o, - wants prior notice. ` ' Signat e: V �►■ Date: I /0 / "l The act'for 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 h. •=en issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action eve, if you are in compliance with the Jefferson County development code.The Applicant acknowledge that e,she or it holds individual and n n-tran ferable responsil ili or adhering to and complying with the ESA. The Applicant has read this disc imer d gns and dates it below. Signat = r`■I•W s1N Date: i' i b I G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc I Y • • • 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: MAILING ADDRESS: \x,, 5 V\ ,t, r-� EMAIL: ! ' ♦i A S A.k.:.I■ A: ,,--ti• ►I CONTRACTOR'S LICENSE h(,e) . .; • l ' Q INS Cc m NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: O New D Wood Existing: ❑ Sewer ❑ Addition 0 Steel Proposed: Bank ❑ Community System IAlteration/Remodel ❑ Concrete Total: Height: ❑ Individual System O Repair 0 Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: Li Private well 0 Two Party Tye of Heat: Proposed: 0 Public y_-- _— — - I,C C-• Total: — .•.e 1 I r::' ISIS If this is a Commercial Protect you must answer the following: Number of Parking Spaces: Current: Proposed: a � Number of occupants(includes owners,tenants,employees,etc) Current Proposed f` f , IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No _____ t',.--- If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: _ - -- .,iy 1 Underground Tank 1 Above ground Tank Size of Propane Tank: •, ,n;,rr1\!T 1 Heat Stove I Cook Stove 1 Woodstove 1 Fireplace Insert 1 Hot Water Tank 1 Pellet Stove l Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a 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. y iF 5 I ro 1 ,.. i€•c $ a IT sat'.t �I , ii ,Ill ,,,.? i o.k Y. j 5; , a , S•uare Foota•e Current Pro•osed . ;, a -� ,�• f., Fm i o C iy k, `;. K:i�ti . ,r`:.' 1 , ,_ ,,y Main Floor Heated F '3r d i ! EH Bld App Review: Floor Heated ' Consistency Review: Other Heated .' Base fee: s Mezzanine }r �: G,, Additional Section: Heated Basement �t . i is Plan Check fee: Unheated Basement is ' :.„ State Surcharge fee: 1)C4.-:dal Other Unheated :411 ;4` Pot Water Review fee: Garage/Carport T rlfi��V.,11',+,'� a SUBTOTAL Decks.. AFC, 911/Rd Approach fee: ale„ 4-w Other ,�:,rj TOTAL: $ iNlakt, VI r Receipt Number: s i. ` Cash/Check Number: ESTIMATED COST(REQUIRED b to 0 Date: •Fair market value of all labor and ma erials foundation to finish Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc Parcel Details Page 1 of 2 • • -tose County E_ Home County Info Departments Search H , Parcel Number: 955600016 SEARCH Parcel Number: 955600016 Printer Friendly Owner Mailing Address: CALVIN WILLIAMS 890 NE MELANIE CT BREMERTON WA98311-3019 Site Address: 123 GREENVIEW LN PORT LUDLOW 98365 Section: 21 School District:Chimacum (49) Qtr Section: NW1/4 Fire Dist: Port Ludlow (3) Township: 28N Tax Status: Taxable Range: 1E Tax Code: 0231 Planning area: Port Ludlow (7) Sub Division: 9556 - GREENVIEW VILLAGE Assessor's Land Use Code: 1100 - Residential Single Unit Property Description: GREENVIEW VILLAGE LOT 16 Tax,A/V, Sales, Photos, and Permit Data Bldg Data Map 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=95 5600016 11/13/2014 BRENNAN HEATING& A/C LLC Page 1 of 2 • Washington State Department of Labor & industries IBRENNAN 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 ILicense 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= 11/13/2014 BRENNAN HEATING&A/C LLC Page 2 of 2 No lawsuits against the bond or saviSaccounts during the previous 6 year pea L&I Tax debts .......................................... No L8d 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 3 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 Wa bi tmt ' https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602346866&LIC=BRENNHA971R9&SAW= 11/13/2014 • • Jefferson County Building Division Permit Number: BLD14-00419 Applicant: WILLIAMS 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 Miscellaneous 2 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 114-2.6‘--14 ce. 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#: BLD14-00419 Received Date: 11/13/2014 SITE ADDRESS: 123 GREENVIEW LN Issue Date 11/13/2014 PORT LUDLOW, 98365 Expiration Date 11/13/2015 OWNER: CALVIN WILLIAMS PHONE: 360-473-3320 890 NE MELANIE CT BREMERTON WA 98311-3019 9556 SUBDIVISION: Block: Lot: PARCEL NUMBER: 955600016 Section: 21 Township: 28 N Range: 1E CONTRACTOR: BRENNAN HEATING 8,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: NEW MECHANICAL PERMIT INSTALL 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 11/12/14 151726 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 60N cOG JEFFERSON COUNTY �° ` DEPARTMENT OF COMMUNITY DEVELOPMENT 4-moo, 9^5',,I N GK' Date: ii LC Time Received: (1'`35 am/pm Mon. Tue. Wed. Thur. 4b) Date: BLD: BLD ii--06111 1 Contact Name: Owner: Contact Number: 360 t7f /4 cog Address: 123 Gtealvie0 Lk 206 '3G- '/73 3370 Notes: 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 RIr,r4 R.Tile Ceiling