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HomeMy WebLinkAboutBLD2014-00425 - MECHANICAL ILDING PERMIT APPLICATIS BLD14-00425 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00425 Received Date: 11/19/2014 SITE ADDRESS: 71 CAMANO LN PORT LUDLOW, 98365 OWNER: CAROL GALVAN TRUSTEE PHONE: 360-437-9801 KAREN BLOOMER TRUSTEE 71 CAMANO LN PORT LUDLOW WA 98365-9627 9906 SUBDIVISION: Block: Lot: 45 PARCEL NUMBER: 990600245 Section: 9 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 REPLACE EXISTING AIR HANDLER TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION ADD'L: HEAT TYPE: 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: Approved/Date Permit $152.00 SRE 11/17/14 151737 Total: $152.00 JE Cr_Cr, \\tidemark\data\forms\F_BLD_App_Bld.rpt 11/19/2014 JEFFERSON COUNTY S' II O Li• SUN L2 i''' ‘v-c,i DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street•Port Townsend•Washington 98368 A 360/379-4450. 360/379-4451 Fax �g t'zIN www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: �,Project �'� P�-� �e separate is as necessary): C 1 r r 1 a r I-c r- Tax Parcel Number: Q 0)(DOld `0( y 5 Pro Size: Property (acres/square feet)_ Site Address and/or Directions to Property -A-1 C Q%mA-n o L.r. .1 6 • Property Owner(s)of Record: , •c::+ •• - /, . aln' A_ Telephone: .O • • 4 • b F email: Mailing Address: . ,r_ Q 3 '4,: L Appticant/Agent(If d ntnt from owner): . .. .. = —• i Telephone:`0.1.C-40-0 aLoa 00 Fax -.IMPEILMEI 0 email: a ��lil. .• .. Mailing Address: CO m What kind of Permit?(Check each box that applies ❑Building ❑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 0 Long Prat'* ❑Sign 0 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: I hereby designate,: pESIGNATION OF AGENT � _.I�..4 A. /. to act as my agent in matters relating to ' a i for permits) OWNER SIGNATU- _ /. . �.� /� _ Date: 11 /I I 13rsigning this app 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• _.._, 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 whi«. . ay in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit I further-, :=to..• •..-access and right. entry to Jefferson County and is employees,representatives or agents for the sole purpose of application review a any = uired later inspections. •,_ -s access and right of entry will be assumed unless the applicant i urns t County in writing at the time oft -apps'.. .• that he or si a wa =.j r notice. J / Signatu -:/�f� A V• • - r Date: I ! i �{ The actio,r 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 Enda r= -.. :•s«-.Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit h =n ,- _• will not violate the E ' Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s) = =n If are in compliance •. ' e Jefferson County development code.The Applicant acknowledges at he,s or it holds individual and no n = r Pi� - responsibirdy focad =ri t to and comp ;.,with the ESA. The Applicant has read this disda' er and • ns nd dates it below. Signatu : ,1�.A A•a __ i Date: 1 i i anti FORMS\Master Permit Application S-29-08.doc 4 i • • 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 Piled, Signature: Date: ENERAL CONTRACTOR OR UFA RED HOME INSTALLER: PHONE: FAX: r� .♦ .1 ,�► r_ / (a)\r i • DO (gOk0 Qw t1. 5 MAILING ADDRESS: b 3 \._ �C� 1►%f it /_ t l . • .. ..�� 1 L f CONTRACTOR'S LICENSE Npr(, .. I / 4 �J iiNS Conn NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: " EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: O New 0 Wood Existing: 0 Sewer ❑ ddition 0 Steel Proposed: Bank 0 Community System Alteration/Remodel 0 Concrete Total: Height 0 Individual System O .Repair 0 Masonry SEP Permit# ❑ Demolition 0 Other. Bedrooms: Water Supply: Existing: Setback: ❑ Private well 0 Two Party Type of Heat PropOSed: 0 Public E l.p C.. Total: Name of System: If this is a Commercial Protect 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 I No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: I Underground Tank I Above ground Tank Size of Propane Tank: I Heat Stove I Cook Stove I Woodstove i Fireplace Insert I Hot Water Tank I Pellet Stove I Other 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 submit a site plan showing all of the buildings,all property //nee,tank location and sire,distances from the propane tank to all property lines,buildings and septic system components, Including the reserve area r ii'4 . Square Footage Current � - Main Floor Heated V:' EH Bid App Review: 2110 Floor Heated Consistency Review: Other Heated Base fee: 15 L l Mezzanine Additional Section: r `` ( 0 ? ` °i Heated Basement ' Plan Check fee: Unheated Basement �r�"�t , • State Surcharge fee: Other Unheated � ' 5 • Pot Water Review fee: a Garage/Carport , SUBTOTAL Decks ' 3 911/Rd Approach fee: VI)Other TOTAL: $ t ' : Receipt Number: y \C-A),I -IT Cash/Check Number ii ESTIMATED COST(REQUIRED) r e.� %lb Date: hh i •Pak market value of all labor and ma= �fr, to Mush \` 9 ■t'si Initials: G:\Pexn Center\###FORMS###WRD FORMS\Master Permit Application S-29-OS.doc Parcel Details Page 1 of 2 • • - 0:41-a: Jefferson s �. Y Home County Info Departments search Parcel Number: 990600245 1 SEARCH Parcel Number: 990600245 Printer Friendly Owner Mailing Address: CAROL GALVAN TRUSTEE KAREN BLOOMER TRUSTEE BLOOMER-GALVAN TRUST 71 CAMANO LN PORT LUDLOW WA98365-9627 Site Address: 71 CAMANO LN PORT LUDLOW 98365 Section: 9 School District:Chimacum (49) Qtr Section: SW1/4 Fre Dist: Port Ludlow (3) Township: 28N Tax Status: Taxable Range: 1E Tax Code: 0231 Planning area: Port Ludlow (7) Sub Division: 9906 - PORT LUDLOW NO. 2 Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: PORT LUDLOW NO 2 AREA 2 LOT 45 Tax, A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel Plats&Surveys Septic Monitoring Info it 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.jefferson.wa.us/assessors/parcel/parceldetail.asp?Parcel_NO=990600245 11/19/2014 BRENNAN HEATING& A/C LLC Page 1 of 2 • • 45 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= 11/19/2014 BRENNAN HEATING& A/C LLC Page 2 of 2 No lawsuits against the bond or saviOaccounts during the previous 6 year per. L&I Tax debts .. ........ ................... No L&l 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. 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. 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 Washingtoe :i i Nye LA,,tee4,1W akn.."n:[8. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602346866&LIC=BRENNHA971R9&SAW= 11/19/2014 0 I • Jefferson County Building Division Permit Number: BLD14-00425 Applicant: GALVAN TRUSTEE 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 /- 5- y L/ LJ Miscellaneous I 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 (2-fj�-� f`-- iv FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# : \\tidemark\data\forms\F_BLD_Permit_BIdg.rpt 11/19/2014 BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD14-00425 Received Date: 11/19/2014 SITE ADDRESS: 71 CAMANO LN Issue Date 11/19/2014 PORT LUDLOW, 98365 Expiration Date 11/19/2015 OWNER: CAROL GALVAN TRUSTEE PHONE: 360-437-9801 KAREN BLOOMER TRUSTEE 71 CAMANO LN PORT LUDLOW WA 98365-9627 9906 SUBDIVISION: Block: Lot: 45 PARCEL NUMBER: 990600245 Section: 9 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 BRENNHA971R9 Expires 7/13/2015 PROJECT DESCRIPTION: NEW MECHANICAL PERMIT REPLACE EXISTING AIR HANDLER TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION ADD'L: HEAT TYPE: 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: Permit $152.00 SRE 11/17/14 151737 BEDROOMS: BATHROOMS: 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 ■ /�N JEFFERSON COUNTY I DEPARTMENT OF COMMUNITY DEVELOPMENT Date: 12_'1, Time Received: q5---L, (9/Pm Mon. Tue. Wed. Thur. Date: 12-5-- BLD: 1 y-1_5--- Contact Name: Owner: Contact Number: 360 (-137980( Address: "1 1 C AvvtArjn L.,J 206 Notes: PULL 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 NCf NO. 151737 DATE NtNIL-1 RECEIVED FROM birtvlirto 4 f)-),„ C �Cit)`q DESCRIPTION BARS# AMOUNT CURRENCY \ck sy I6L (20 'C - COIN 5 CUXY1Y1rs(G Qty l lA„r C •-j e/`V'— t—i CHECKS �J C co p m p � ft 1 . 1RTAL i I . (3 b, BY RECEIVED T i . I