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HomeMy WebLinkAboutBLD2014-00384 - MECHANICAL Ali A BLD14-00384 LDING PERMIT APPLICATI Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00384 Received Date: 10/20/2014 SITE ADDRESS: 201 E HORTON ST PORT HADLOCK, 98339 OWNER: JANE ERICKSON PHONE: 360-710-4676 201 E HORTON ST PORT HADLOCK WA 98339 9618 SUBDIVISION: Block: Lot: PARCEL NUMBER: 961801411 Section: 35 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 REPRESENTATIVE: PHONE: 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: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: IRouting Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $152.00 SRE 10/20/14 151641 Total: $152.00 PROVED OCT 20 2014 Jefferson County DCD Etvtanect 400 11401 @ (An'ItStLia. Recd nc - t 0/241` \\tidemark\data\forms\F_BLD_App_Bld.rpt 10/20/2014 ggON kO 2434 G�� JEFF SON COUNTY , - DEPARTMENT OF COMMUNITY DEVELOPMENT '" 621 Sheridan Street I Port Townsend,WA 98368 I Web:www.co.iefferson.wa.us/communitvdevelopment 4.14WI NOS Tel:360.379.4450 I Fax:360.379.4451 I Email:dcd(a,co.jefferson.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 sep rate sheets as necessary 'f p Project 4. (e $'o, a f sil �ebcf )ucttas 4�.t Posit° Tax Parcel Number: q 6 Leo,"J-L I Property Size: (acres/square feet) Site Address and/or Directions to Property: aZo I I--f o l h g-f Tar f ci I a c , W/� ( o 4- S-f ti A-w%I Y = kncid1 Property Owner(s)of Record: :rare- e.r r do s o h Telephone: 33 0- 1-10- 4-6 q-b Fax: email: Mailing Address: to I E err 51-• Pori- H-441.lock, wA gg3 Applicant/Agent(If different f r o m owner): j&riihStt-la- Or-4a- C v - Telephone: 3(0o "(D 8( - 33 3 3 Fax: 3(2,/-(o 6 7- ao g4 email:ft ry p IoG+drlStc(ah2 Mailing Address: P•o B oiC i11-3 r Cr-rdslooei,!.J/4- i S 3 2y-- CO'~ WIjat kind of Permit?(Check each box that applies ❑Lot or Road Segregation Building ❑Critical Areas Stewardship Plan ❑ Demolition Permit tot ..1./ ❑Variance(Minor,Major or Reasonable Economic Use) ❑Single Family OE Garage Attached/Detached ❑Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home ❑ Modular ❑Discretionary"D"or U.•-••-• --- 1wu.r ❑ Commercial* ❑Special Use(Essentia icf cco)E I v E 1 ❑ Change of Use ❑ Boundary Line Adjus 1 t t� ❑ Address ❑Road Approach ❑Short Plat** ❑Home Business ❑Cottage Industry ❑Binding Site Plan*" 1 ❑Propane ❑ Long Plat** 10 CT 2 0 2014❑Sign ❑Planned Rural Reside teal elopment(PRRD) /Amend 11: ❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteratio 4& ❑Stormwater Management ❑Shoreline Master Prog=m Exemp •r • -gni)at@pli ions** ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Managemen Sub i ._ ( OP(NENT El Temporary Use ❑Shoreline Managemen Varianos— --- ❑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: r La, DESIGNATION OF AGENT I hereby designate V-O I to act as my agent in matters relating to this application for permit(s). 10/i, /�/y OWNER SIGNATURE , , Date: 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 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 re•uired later ins•.-ctions. Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the time of the appli 4: that he o l�, nts prior notice. Signature: L 1� Date: /a/i /ae(y The action or actions '. cant 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 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 Tian with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfeg9 9 respons' •" or adhering to and complying with the ESA. The Applicant has read this disdai er d sign and dates it below. Signature: K�.(,L`j _• Date: 2 7.' / ( ( 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: p E N WSu LA- ttEfi--r' c& (36o) /4/ -3333 (34o) Gtr -Le 0 MAILING ADDRESS: p•a. ' /X Carl ,e, (,J/, EMAIL: $14f r, td,lie. ; „cpti,, CONTRACTOR'S LICENSE WAINS NUMBER: PEN in i ,d Li-OW NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project T yp e: Frame T yp e: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: ❑Sewer • Addition ❑ Steel Proposed: Bank Li Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well Li Two Party Type of Heat:u Proposed: ❑ Public 'uket'ifs 11 P Total: Name of System: If this is a Commercial Proiect 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 h- - es. -• ' - -- ∎ - If this is a Propane Tank and/or Appliance Installation permit,mark all items below that plF C _ � [ Underground Tank Above ground tank Size of Propane Tank: I I —-- I Heat Stove Cook Stove Woodstove Fireplace.nsert rehtO i e*t telleP i knaT retaWtoH i 1 ,11 ` Is this appliance being installed in a Manufactured/Mobile Home? Yes / No i1 OCT 2 a 2014 ;� When applying for a permit to install a propane tank you must also submit a site plan spowing all of the buildings,a goperty lines, tank location and size,distances from the propane tank to all property lines,buildiMMOs and septic system co hents, including the reserve area. ,:,C, COI NTY [r-°T OF CL 'li T"hF 71 71V FNT Square Footage Current Proposed For Office Use Only Amouirt Revision Main Floor Heated lb�b EH Bid App Review: 2"d Floor Heated Consistency Review: Other Heated Base fee: 152.: Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL: $ 0 V Receipt Number: & I I (,(4, I Cash/Check Number: 'W ESTIMATED COST(REQUIRED) Date: `0'��/� [Fair market value of all labor rd materials foundation to finish L1'D`T v (gyp Initials: S ) 07/24/201: • • a PENINSULA HEAT INC Page 1 of 3 0 • 0 Washington State Department of Labor & industries IPENINSULA HEAT INC Owner or tradesperson 782 KITCHEN-DICK RD LOFSTROM, KENNETH J SEQUIM,WA 98382 360-681-3333 Principals CLALLAM County LOFSTROM, KENNETH J LOFSTROM, MARY ANDERSON, CHARLOTTE, AGENT Doing business as PENINSULA HEAT INC WA UBI No. Business type 601 737 680 Corporation ILicense 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. PENINHI005DB Effective—expiration 03/02/2000—03/02/2016 Designated administrator Active. LOFSTROM, KENNETH J Meets current requirements. License type License no. Electrical Administrator LOFSTKJ951 CC Bond CBIC $4,000.00 Bond account no. SC6801 Effective date 02/28/2000 Expiration date Until Canceled Savings No savings accounts during the previous 6 year period. License Violations https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601737680&LIC=PENINHI005DB&SAW= 10/20/2014 PENINSULA HEAT INC Page 2 of 3 Infraction no. • • EMITP00298 Satisfied Violation date RCWNVAC 11/07/2011 19.28.101 RCW Violation city Violation amount Sequim $250.00 Type of violation ELECTRICAL CITATION Description Failing to obtain or post an electrical/telecommunications work permit prior to beginning the electrical/telecommunication installation or alteration as referenced in WAC 296-46B-900 (3)(6),effective after 12/30/2008 see WAC 296- 46B-901(3)(6). Infraction no. EMEHU03252 Satisfied .......................... Violation date RCW/WAC 03/18/2010 19.28.271 RCW Violation city Violation amount Sequim $250.00 Type of violation ELECTRICAL CITATION Description Employing an individual for the purposes of chapter 19.28 RCW who does not possess a valid certificate of competency or training certificate to do electrical work.Jefrey Buerer Expired training certificate7/26/2009 Class B label,work date 2/22/2010 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/CARTE PICKETT(360)902-5592-Email: PICC235 @Ini.wa.gov IWorkplace safety and health No inspections during the previous 6 year period. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601737680&LIC=PENINHI005DB&SAW= 10/20/2014 PENINSULA HEAT INC Page 3 of 3 S • ©Washington State Dept.of Labor&industries.Use of this site is subject to the laws of the state of Washington. Access Washington https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601737680&LIC=PENINHI005DB&SAW= 10/20/2014 Parcel Details Page 1 of 2 III • , l'''''' : +t r 61 '4 r ' e e son ounty .,;..',Ii , . ' - _ � -,, Home - County Info 1... epartmer is :, Search Parcel Number: 961801411 SEARCH Parcel Number: 961801411 Printer Friendly Owner Mailing Address: KENNETH R HAMMAR JANE S ERICKSON PO BOX 1760 PORT TOWNSEND WA98368-0180 Site Address: 201 HORTON ST PORT HADLOCK 98339 Section: 35 School District:Chimacum (49) Qtr Section: SW1/4 Fire Dist: Chimacum (1) Township: 30N Tax Status: Taxable Range: 1W Tax Code: 0211 Planning area:Tri-Area (4) Sub Division: 9618 - IRONDALE 1-92 Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: IRONDALE #1 BLK 14 LOTS 5 TO 9 &41 TO 44 Tax,AN, 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.coj efferson.wa.us/assessors/parcel/parceldetail.asp?Parcel_NO=961801411 10/20/2014 • • Jefferson County Building Division Permit Number: BLD14-00384 Applicant: ERICKSON 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 I fsJi I/ )11 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 , / /id gi 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#: BLD14-00384 Received Date: 10/20/2014 SITE ADDRESS: 201 E HORTON ST Issue Date 10/20/2014 PORT HADLOCK, 98339 Expiration Date 10/20/2015 OWNER: JANE ERICKSON PHONE: 360-710-4676 201 E HORTON ST PORT HADLOCK WA 98339 9618 SUBDIVISION: Block: Lot: PARCEL NUMBER: 961801411 Section: 35 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: 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 10/20/14 151641 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 e_s co `` i. i o{ JEFFERSON COUNTY �, DEPARTMENT OF COMMUNITY DEVELOPMENT ' 1 P(' Date: '2. ' Time Received: 2s am/ Mon. Tue. Wed. Thur. Fri. Date: BLD: it-/— �8Y Contact Name: Owner: o Contact Number: 360 7/49 47,4 Address: A01 6 g j,J 206 Notes: f. .i 17ok„n 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 JEFFERSON COUNTY hcO NO. 151641 DATE 1D/ rJ/I4 ,i, a PctF INC RECEIVED FROM �-nSV�`0.- DESCRIPTION BARS# AMOUNT CURRENCY A) ibmte j cx..-) c)a)tal1 �,_;, COIN S C 6 I,.N Ig . vv ' ciI41 '- 1-4 1 I CHECKS IhS �f HerA t' t o P � M �. o fli o-: 4 RECEIVED BY V " t , 6 TOTAL I ` °v • _ i