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HomeMy WebLinkAboutBLD2014-00427 - MECHANICAL ish UILDING PERMIT APPLICAON BLDI4-00427 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00427 Received Date: 11/19/2014 SITE ADDRESS: 184 S BAY LN PORT LUDLOW, 98365 OWNER: CHRIS G HASHAGEN PHONE: 360-437-9095 KAREN L HASHAGEN 184S BAY LN PORT LUDLOW WA 98365-8784 9694 SUBDIVISION: Block: Lot: PARCEL NUMBER: 969400014 Section: 16 Township: 28 N Range: 1E CONTRACTOR: AIR FLO HEATING COMPANY INC PHONE: 360-683-3901 221 W CEDAR SEQUIM WA 98382 Contractor's License AIRFLI*206DG Expires 4/25/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI NEW MECHANICAL TO REPLACE THE 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: outing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $152.00 SRE 11/17/14 151738 0 „w Y Total: $152.00 1' K\ ; ',7-1-soli County DCD \\tidemark\data\forms\F_BLD_App_Bld.rpt 11/19/2014 Nov.12.2014 02:54 PM 110th Bay Community Assoc 3604308 PAGE. 2/ 2 • . -tririliei4 JEFFERSON COUNTY • kiloDEPARTMENT'OP GOMMUMITY DEVf 117 _ 621 Sheridan Street Port Townsend•WashELOPMington 98368 3601379-00. Fax www,ca jatfA5erson3601378-d4Si.wr3.us/onmr:nd evelopment Master Permit Application - MLA: - . Project Descripton dude separate ghee ran n ••): � X s 4 Ill', . .. . A,- . . y�1�. ■..:4' , .. .... Tax Parcel Number. ?6 ,le�Jy r) / Prope+ty Size: - (acres/Ware feet) Site Address and/or Directions to Property: / // ys • Property Owner()of Record: irtm "rJ1/ l ,.--,t Telephone j()- �f i 5'D 2.S Fax: • f email:• . Mailing Address: AppliaanUAgent(if different from owner): :If AO ,. .-_a t l Telephone O� 1 Fax; laBS-i' C"t email: s _ ' A• Mailing Address: 2.2.!, A. . tea. __r ! _ * r - • ,...�0 tom._.../--. .. what kind of Permit?(Check eat box that applies - DBunding a CAtical Areas Stewardship Plan O pemolitlon Permit 0 Variance(Minor.Major or Reasonable Economic Use) O single FamIly ❑Garage Method/Detached ❑Conditional Use[C(a),C(d),or Cj" O Manufactured Hama 0 Modular O Discretionary JD'or Unnamed Use Ciu*itication o Commercial• 0 Special Use(Ea*endal Public Facilities) ❑ Change of Use ❑Boundary Une Adpstment ❑ Address _ ❑Road Approach t3 Short Plat" o Home Business d Cottage industry O•Bitxiklg Site Plan" ID Propane U Long,Plat" 0 Sign Cl Planned Rural Residential Development(PRiRDyArendrnents" • ©Mowed"Yes'Use Consistency Analysis ❑Plat VacalloWAlteration" i.Stornweter Management 0 shoreline Master Program ExemptiotVPermit Revisions*" o Site Plan Approval Advance Determination(SPAA4)" 0 Short+Qns Management Substantial Development" 0 Temporary Use ❑Shoreline Management Valiance CI Wireless Telecommunication• 0 Comprehensive Plan/UDC/Land Use Dia1rtrx Map.Anteltdment 0 Forest Practices Ad/Release of Six-Tear Moratorium 0 Jefferson County Shoreline Master Program Amendment May require a Pre Applrcedon Corrlre wlea C)True Vegetation Request Please identify any other local,state or federal permits required for this proposal,If known: . i i•.A^70 OF Ac ' I hereby designate it i r TI O Al- -f. t - to act as my agent In matters relating to this application permit(s). \` atrm SIGMA •r ��� :. ` _ Date:, �/ /�-/ By signing this application form.the owner/agent attests that the • ,• provided.herein•and in any attachmendi.Is true and r,4rreet to tiro pest et his her or Its knowledge. Any material falsehood er any omission of a material fact made by the owner/agent with roved to this eppioseen pudwl may result In this permk being null and void. •ti I further agree to save,indemnity and hold harmless Jefferson Courtly agaktst all liabltibp,sneers-court mato-reasonable attorney's(Valenti expenses which may in any way accrue against Jefferson County as a mask of or In onto I further agree to provide access and right of entry to Jefferson!:comer and its employees ' review and any maul •toter Inspection. Staffs access and right of entry weber assume ' time of the ,y:- thult'e or ghoul fa,>,'. .,.:• --1t-?' t Signature 4� ',car lit.`-"° r j The action or actions Applicant will undertake ae a result of the issuance of Vile permit mery endangered species and could Iced ton potential•take ciao endangered spades es urge c• '"" -9171'1'-t— -- "Endangered Species Ace or'ESA-"Jefferson Courtly makes no assurances to the apples permit has been issued wig not violate the ESA. Any individual,group or agency can file s ectian(s)even"you -in**mellow with the . • County development code,The i and non•tr m-.r responsibility f� ad•,.•. *� f•coptpiying wlth•ehe ESA. The Apps • signature! "'AV.//t- AaIPAI' _ _ • G� dly, G:1PoerlM##POirMSM#1r\1�1t►PD1AM511XPfter l?eoatic.l{rptia+ S?e eb doe /]')/‘�( iU( c4="3.14 Lrl li+ctivi.4;ji BUILDER STATEMENT signer of this statement does hereby that they are the Owners of the parcel referenced her that they are not licensed Contteotors and that The signer Y certify Y they will be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR OR MA, FACTO' D HOME IN LER: PHONE: FAX: C2(%+ yZ' - 360)6f�3-3510 / ( ) MAILING ADDRESS: 2 2 / EMAIL: CONTRACTOR'S LICENSE �6 WAINS NUMBER: i�- �i� ��� NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: • EMAIL `p/ Project Type: Frame Type: Bathrooms: Shoreline: Type f Sewage Oisp I: l O New ❑ Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank 0 Community System Op' •Iteration/Remodel ❑ Concrete Total: Height: ❑ Individual System ❑ Repair 0 Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well 0 Two Party Type of Heat: Proposed: ❑ Public Total: Name of System: If this is a Commercial Project 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 Senrice? Yes / 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 lines,tank location and size,distances from the propane tank to all property lines,buildings and septic system components, includin• the reserve area. S•uare Foota!a Current ° •• .sect` ,r �t{{ ' __. + , _. Main Floor Heated - -' EH Bid App Review 2na Floor Heated 4 Consistency Review: Other Heated = Base fee: t a l,; ' Mezzanine _', Additional Section: i ci , c,; Heated Basement 4 1 - Plan Check fee: Unheated Basement F1r , State Surcharge fee: Other Unheated . Pot Water Review fee: Garage/Carportj SUBTOTAL , l Decks t 911/Rd Approach fee: Other ,' TOTAL: $ Receipt Number. i 5 I Cash/Check Number. Lt, 2 04., t � ESTIMATED COST(REQUIRED) Date: \V(4 -/ i`� .Fair market value of all labor and materials foundation to finish Initials: ' G:\Pem*tCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc • • ---„,...t.........,\ rA r� R Q is t 0 e C) +- v i \n i--- ___--} %..1 AL. 11;....‘. h r \\Ct 7. ) fi V n e 3 G o S C I 1 Parcel Details Page 1 of 2 • • t n e erso County .. Home nun Info Departments Search Parcel Number: [969400014 SEARCH Parcel Number: 969400014 Printer Friendly Owner Mailing Address: CHRIS G HASHAGEN KAREN L HASHAGEN 184 S BAY LN PORT LUDLOW WA98365-8784 Site Address: 184 SOUTH BAY LN PORT LUDLOW 98365 Section: 16 School District:Chimacum (49) Qtr Section: SW1/4 Fire Dist: Port Ludlow (3) Township: 28N Tax Status: Taxable Range: 1E Tax Code: 0231 Planning area: Port Ludlow (7) Sub Division: 9694 - LUDLOW POINT VILLAGE DIV 1 Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: LUDLOW POINT VILLAGE DIV 1 LOT 14 Tax,A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel Plats&Surveys Septic Monitoring Info Jefferson County HOME l COUNTY INFO l 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_N0=969400014 11/19/2014 AIR FLO HEATING COMPANY INC Page 1 of 2 • • Washington.State Department of 45 Labor & industries AIR FLO HEATING COMPANY INC Owner or tradesperson 221 W CEDAR BEQUETTE, MARK A S WA 98382 360 0-683--683-3901 Principals CLALLAM County BEQUETTE, MARK A, PRESIDENT BEQUETTE, SANDRA A, VICE PRESIDENT BERSON, JOEL R, SECRETARY FULLAWAY, MICHAEL (End: 04/01/2010) Doing business as AIR FLO HEATING COMPANY INC WA UBI No. Business type 600 347 761 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 Heating/Vent/Air-Conditioning and Refrig (HVAC/R) License no. AIRFLI*206DG Effective—expiration 03/07/1980—04/25/2016 Bond ................. CBIC $6,000.00 Bond account no. SI5215 Received by L&I Effective date 02/05/2010 02/01/2010 Expiration date Until Canceled Bond history Insurance American Hallmark Ins Co of Te $1,000,000.00 Policy no. 44CL483619 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&LIC=AIRFLI*206DG&SAW= 11/19/2014 AIR FLO HEATING COMPANY INC Page 2 of 2 Received by L&I • Effective date 04/18/2014 04/25/2014 Expiration date 04/25/2015 Insurance history Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. 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 No license violations during the previous 6 year period. 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. 351,432-00 Doing business as AIR FLO HEATING COMPANY INC. Estimated workers reported Quarter 3 of Year 2014"21 to 30 Workers" L&I account representative T1 /FEARAED FEROZE(360)902-4797-Email: FERH235©Ini.wa.gov Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. Citation issue date 07/24/2012 Violations Inspection no. 315954529 Location 125 Horizon View Dr. Sequim,WA 98382 ©Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. access Washington's WrNrglil WO''i€1, https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&LIC=AIRFLI*206DG&SAW= 11/19/2014 • • Jerson County Building Division Permit Number: BLD14-00427 Applicant: HASHAGEN 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 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 / 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#: BLD14-00427 Received Date: 11/19/2014 SITE ADDRESS: 184 S BAY LN Issue Date 11/19/2014 PORT LUDLOW, 98365 Expiration Date 11/19/2015 OWNER: CHRIS G HASHAGEN PHONE: 360-437-9095 KAREN L HASHAGEN 184 S BAY LN PORT LUDLOW WA 98365-8784 9694 SUBDIVISION: Block: Lot: PARCEL NUMBER: 969400014 Section: 16 Township: 28 N Range: 1E CONTRACTOR: AIR FLO HEATING COMPANY INC PHONE: 360-683-3901 221 W CEDAR SEQUIM WA 98382 Contractor's License AIRFLI*206DG Expires 4/25/2016 PROJECT DESCRIPTION: NEW MECHANICAL TO REPLACE THE 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 11/17/14 151738 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 AIR FLO HEATING COMPANY 4 3 2 0 4 Check Number: 43204.1 Jefferson Co. Dept. of Comm. Dev. Date Description Amount 11/12/2014 Permit Hashagen 171.00 0-SOi Co,. 4,a JEFFERSON COUNTY 4` DEPARTMENT OF COMMUNITY DEVELOPMENT S`rfJ!N GAO Date: I Z if Time Received: 10 Z (a/pm Mon. Tue. Wed. Thur. Date: C 2_°5- BLD: 1 1 (/27 Contact Name: Owner: Contact Number: 360 Address: (g1"/ S ay I--IS 206 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 Block &Tile Ceiling JEFFERSON COUNTY bC,„f No. 1517 8 DATE ��JtJ1LI RECEIVED FROM Q..tr C C DESCRIPTION BARS# AMOUNT CURRENCY ✓tct brikse L 52:- (}c) G . 0 LP COIN CGt��Li)r 0 .i® -Lim-t CH�CK (� co 434 2 c o C o n o RECEIVED BY �-`�`� TOTAL .