HomeMy WebLinkAboutBLD2014-00042 •UILDING PERMIT APPLICA.N B Review 0042
Review Type;
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD14-00042 Received Date: 1/31/2014
SITE ADDRESS: 102 CASCADE LN
PORT LUDLOW, 98365
OWNER: GLENN L WILLIAMS PHONE: 3604374191
JANET WILLIAMS
102 CASCADE LN
PORT LUDLOW WA 98365-9587 PORT LUDLOW NO. 1
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 990400415 Section: 9 Township: 28 N Range: 01 E
CONTRACTOR: BRENNAN HTG &A/C LLC PHONE: 206-248-7900
4601 S 134TH PL
SEATTLE WA 98168
Contractor's License BRENNHA971 R9 Expires 12/29/2015
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION new ductless heat pump
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP MEC
VALUATION MAIN:
CODE EDITION: 2012 ADD'L: HEAT TYPE:
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 JLA 01/31/14 145821 APPROVED
Total: $152.00 APPROVED
Jefferson County DCL
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JEFFERSON COUNTY
,1 t e 00: . DEPARTMENT OF COMMUNITY DEVELOPMENT
`'" 621 Sheridan Street•Port Townsend•Washington 98368
360/379-4450. 3601379-4451 Fax
is( vAvw.cojefferson.wa.us/commdevelopment
Master Permit ' •Oration MLA:
-inject•. -. i.I f. '■ude :-;.,.: :{I:sheets as '......- );
- _t II _ LS 3 . . .T&_ _ Ai A•
Tax Parcel Num.AtErairECIM Property Sze: (acres/square feet)
Site Address and/or Di =h1•: s • Prope
CI
Property s)of - e�r . =wr�1 1 I L
Telephone: 0' 0 F email:
Mailing Address: ■ O S■1
Applicant! nt(if d from owner): / IL 6' I .41_4141.� . t--'1 1
Telephoned is Qzi Fax. Mt I email: l�.M ,`
Mailing Address: 1 r .tom
What kind of Permit? Check each box that applies
OBuiiding 0 Critical Areas Stewardship Pla _
❑ Demolition Perm ❑Variance(Minor,Major or Rea-• , =.
mingle Family ❑Garage Attached I Detached ❑Conditional Use[C(a),C(d),or V
O Manufactured 0 Modular ❑Discretionary Tr or Unnamed •,
w
• Commercial ❑Specual Use(Essential Public --h ,_.:)••
o Change of Use ❑Boundary Line Adjustment I 1 ; 3�°,."{ ? 1 201..
O Address ❑Road Approach ❑Short Plat".* 1 1
CI Home Business ❑Cottage Industry ❑Binding Site Plan*' • U�_ '% ;
O Propane 0 Long Plat" - J
O Sign 0 Planned Rural Residential •- e i eflts*'
❑Allowed'Yes"Use Consistency Analysis ❑Plat Vacation/Alteration`* ''" }E' , NT
❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions'*
❑Site Plan Approval Advance Determination(SPAAD)' 0 Shoreline Management Substantial Development'! •
❑Temporary Use ❑Shoreline Management Variance
❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment
❑Forest Practices Act/Release of Six-Year Moratorium 0 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:
t ` ■ G TI• • AGENT
I hereby designate vv .1/ ,( .. A . f t .. :-l' y agent matters relating to this application for permit(s).
OWNER SIGNATURE Q- - . L zyc.s.a..... Date:
By signing this application'orm,the owner/agent attests that the i ation 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 at liabilities,Judgments,court costs,reasonable attorney's fees and
expenses which ma in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit.
I further agree t• ;Ilk access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application
review and a required =ter inspections. Staffs. _._ and right of entry will be assumed unless the applicant- the in writing at the
time of the ication he or the wants prior r
Signature: ,i. A &A A . / t� t_k Date:
..i
The action or=«7:77'. ••licant 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 taw known as the
'Endangered S ,.'=-Act'x"ESA.'Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this
pemllt has • issu •will not violate the ESA. An individual,group or agency can file a lawsuit on behalf of an endangered species regarding your
action(s) : if you= -incompliance with the -iiii.n County development code.The Applicant acknowledges he, or it holds individual
and non-tra,sfera•le --- s bility for adhering to- • :.lying with the ESA. The Appicant has read this displa aped . and dates it below.
Signature ' �.. A A AA i '\i _ Date: J �j
G PerrnihCsnter\###FORMS# #wxn i7ORMS\Master Permit Application 5-29-08 a«
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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 UFACTURED HOME INSTALLER: PHOt, : FAX:
M
l4. .A0 / 1 i. 1 ( D) r • x ( 0b q35 i 5
MAILING ADDREss: k o b 3 - 1timM lli a. i., `
CONTRACTOR'S LICENSE 'C ( • • `a.A. f d • "4.1 kir&NS CO m
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE( ) FAX:( )
HARING ADDRESS: • EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
❑ New ❑ Wood Existing: ❑Sewer
❑ n ❑ Steel Proposed: Bank ❑Community System
a.'Aiteration/Remodel ❑ Concrete Total: Height ❑ Individual System
O Repair ❑ Masonry SEP Permit#
❑ Demolition ❑ Other Bedrooms: Water Supply:
Existing: Setback: p Private well ❑ Two Party
T I e L ms ProTotal: Name of System:
If this is a Commercial Protect you must answer the following:
Number of Parking Spaioes: Current Proposed: Number of Parking Spaces:
Number of occupants(Includes owners,tenants,employees,etc) Current Proposed
IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No
if this is a Propane Ta andlor Appliance Installation permit.mark all items below that apply:
I Underground Tank 1 Above ground Tank Size of Propane Tank:
I Heat Stove I Cook I Woodstove I Fireplace Insert I Hot Water Tank I Pellet Stove I Other
is this annliance bet installed in a Manufactured 1 Mobile Home? Yes / No
When applying fora it to install a propane tank you must also submit a site plan showing all of the buildings,all property
lines,tank location d size,distances from the propane tank to all property lines,buildings and septic system components,
includin• the reserve area.
•f are •• r. ♦,: - ___ :fit• • _...,,.m..�*-4-4,1Z,;
Main Floor Heated • -r EH Bid App Review:
•
2"0 Floor Heated Consistency Review
Other Heated «�
Mezzanine Additional Section:
Heated 77'7- 1►- f ' {' r f `- Plan Check fee:
Unheat-• := - eat k ° State Surcharge fee:
Other U
L'.. ' r
iiiii Pot Water Review fee:
Garag ___ . SUBTOTAL
IFFI E'isuN COON
Decks DEPt r ', '\.DV Df-VE OPMENT 911IRd Approach fee:
Other k �_
3 TOTAL $
,,,:r. Receipt Number.
R ;V.fi
. Cash/Check Number:
ESTIMATED COST(REQUIRE II ill` Date:
.Fair market value of all labor and matenals • •_,• to wish
Initials: •
G:\PmrieC«,cer\###FO> \DRD FORMS\Masster Permit Applieauon 5-29-08.doc
• . .
• •
4601 South 134th Place
B RE N NA N 62 766 •( 06)64
(206).362-7665•FAX 248-7905
HEATING & AIR CONDITIONING '-877-BLc#BRENNHA971R9
www.brennanheating.com
NAME HOME PHONE DATE
&knr) Ilnef Wilhiams 40• x;37-��9r , zz-ze,y
ADDRESS WORK PHONE REP
101 Carcc L,,, off
CITY Z CODE C 3 TCO STORE#
, FM Gud lot, `j 4.
EXISTING adds
LOCATION l,;vin,Crrtyyl
GAS LINE - t
VENTING
ELECTRICAL Culler&mow 0nF Fut1
Dr1iva artl kc4f/ Lung dude t pump. Brawn pearled dailkian
lo lie ir!th atigvi awl— Awl ecKki rif Ci%t in Mile area . Exfen)r
GENERAL hnerrt Skate fitkoiiilchicitd_ 4i/ lobo and molarQl inclu k co/
DESCRIPTION
fn rckk ,
OF WORK
TO BE DONE(F.rec U 9f e op 12k-9 I Pk)
4 Costa) as1t CGati st 600/ cccibii Cowl pup p rf k 14(1660/Et'a u tiet $/e
CUSTOMER
TO PROVIDE
Leant t1S8-11-//P14 liv Ru Ducikss ikal Lop $ 6!R5.' $
Perrnnt $ 335.0' $ _____.___
$ $ \U/ �,
$ $ , —� .
$ $ l 2014
EXTENDED WARRANTY $ $ f/
EMERGENCY EARTHQUAKE SHUT-OFF $
$$$$
"''r
�t�ra couNry
�'l Gr VI-(OPMENT
ELECTRONIC AIR CLEANER $ $ --
POWER DUCT CLEANING
SUB-TOTAL $ 55-30,"' $
TAX $ 41Q730 $
TOTAL $ (x027.70 , $
We Propose hereby to furnish materials and labor-complete in accordance with above specicadons.
AN material is guaranteed to be as specified.All work is to be completed in a substantial ASBESTOS and ether hexerdow nrahrhely visible or unforeseen,which may be disturbed daring the
workmanlike manner according to the specifications submitted per standard practices.Any purposed scope of our work shall be the sole responsibility of the customer.Execution of proposed work
alteration or deviation from above specifications involving extra costs will be executed only slab not proceed until ALL ASBESTOS,and other hazardous materials are removed In an approved manner.
orders, become over and above the estimate.Thank
you for ,iu ay AC BID VALID FOR 30 DAYS.
Acceptance of Proposal , 1 /I hereby authorize the above work and agree to pay the amount set forth in tlris proposal.I Signature
agree to the terms and conditions of this contract.I reserve the right to cancel ails agree-
ment within(3)three work days of the below unless work has commenced.Customer will
be responsible for any collection andlor attorney fees if payment Is not made. V Date of Acceptance: '-Z2- 70/41 Signature j /l°.
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t-,i l 2014
JEFFERSON COUNTY
L; PT.OF COMMUNITY DEVELOPMENT
Screen: 01 REAL PROPERTY MASTER Mode: INQUIRY
Parcel # 000990400415 Qo Cd 282109307231 Auto Roll : OFF
PORT LUDLOW NO. 1 Nbhd Cd 3332
AREA 4
LOT 15
Loc ID
* Taxpayer Cd WILL 2888 WILLIAMS, GLENN L T/P Chg Dt 8/18/2004
* Title Owner T/P Chg Usr JA
Tax Code 0231 Status TX TAXABLE Land Use 1100 RES-SINGLE
Affidavit 101108 Vol/Page / C/U Code
COMPLETE ADDRESS WINDOW
Taxpayer
WILL2888 GLENN L WILLIAMS
JANET WILLIAMS
102 CASCADE LN
PORT LUDLOW WA 98365-9587
Search Key
CMD 6 : End Window CMD 7: End of Job
BRENNAN HEATING & A/C LLC Page 1 of 2
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OWashington State Department of
Labor & industries
BRENNAN HEATING & A/C LLC
Owner or tradesperson 4601 S 134TH PL
SEA ,
ERDAHL, DARRIN PAUL TTLEWA98168 206-248-7900
Principals KING, County
ERDAHL, DARRIN PAUL
Doing business as
BRENNAN HEATING&A/C LLC
WA UBI No. Business type
602 346 866 Limited Liability Company
Governing persons
DARRINPERDAHL
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.
BRENNHA971R9
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
Insurance
Federated Mutual Ins Co $1,000,000.00
Policy no.
9820726
Received by L&I Effective date
06/10/2013 07/13/2007
Expiration date
07/13/2014
Savings
No savings accounts during the previous 6 year period.
https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602346866&LIC=BRENNHA971R9&SAW= 1/31/2014
PERMIT
EXPIRATION NOTICE
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
December 04, 2014
GLENN L WILLIAMS
JANET WILLIAMS
102 CASCADE LN
PORT LUDLOW WA 98365-9587
RE: SUBJECT: PERMIT TO EXPIRE - NOT RENEWABLE
SITE ADDRESS: 102 CASCADE LN
PERMIT#: BLD14-00042
LEGAL DESCRIPTION: 9904 BLOCK: LOT:
PROJECT DESCRIPTION: new ductless heat pump
DEAR GLENN WILLIAMS
PERMIT# BLD14-00042 WAS ISSUED BY THIS DEPARTMENT ON 1/31/2014 , WAS VALID FOR ONE
YEAR AND IS NOT RENEWABLE. According to our records, a final inspection has either not been
scheduled or has not been passed.
TO SCHEDULE A FINAL INSPECTION, CONTACT THE DEPARTMENT OF COMMUNITY DEVELOPMENT
INSPECTION HOTLINE AT 379-4455 and leave your request after the recorded message.
In the event a final inspection is not passed, the inspector will give you a written notice of required
corrections. You must call for a re-inspection to receive final approval.
A FINAL INSPECTION MUST BE SCHEDULED BY 1/4/2015.
Please contact the Department of Community Development(360) 379-4450 with any questions.
Sincerely,
Permit Technician
cc: file
\\tidemark\data\forms\F_BLD_pro_exp_ntc.rpt 12/4/2014
•
MECHANICAL AND DEMOLITION PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT#: BLD14-00042 Received Date 1/31/2014
SITE ADDRESS: 102 CASCADE LN Issue Date 1/31/2014
PORT LUDLOW, 98365
APPLICANT: GLENN L WILLIAMS PHONE: 3604374191
JANET WILLIAMS
102 CASCADE LN
PORT LUDLOW WA 98365-9587
SUBDIVISION: PORT LUDLOW NO. 1 Block: Lot:
PARCEL NUMBER: 990400415 Section: 9 Township: 28N Range: 01E
CONTRACTOR: BRENNAN HTG &A/C LLC PHONE: 206-248-7900
4601 S 134TH PL
SEATTLE WA 98168
Contractor's License BRENNHA971 R9 Expires 12/29/2015
OWNER, GLENN L WILLIAMS PHONE: 3604374191
if different: JANET WILLIAMS
102 CASCADE LN
PORT LUDLOW WA 98365-9587
PROJECT DESCRIPTION: new ductless heat pump
Directions
To Site:
THIS PERMIT IS VALID FOR ONE YEAR AND IS NOT RENEWABLE.
THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR.
THE EXPIRATION DATE IS 1/31/2015.
REQUIRED INSPECTIONS:
Tank/Line/Appliance: A St ‘211(2/1q
FinalApproval: 1/10k tVil v f
BUILDING INSPECTION HOT-LINE 379-4455.
REQUESTS MUST BE RECEIVED BY 3 PM THE DAY BEFORE THE INSPECTION IS NEEDED.
Office Hours 9:00 a.m. -4:30 p.m. Monday-Thursday
HOT LINE AVAILABLE 24 HOURS A DAY
\\tidemark\data\forms\F_BLD_Permit_Propane.rpt 1/31/2014
,
JEFFERSON COUNTY
r;y 4 " DEPARTMENT OF COMMUNITY_lr-) :1 Ire
,y) Ill/
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Date: Time Received: am/pm Mon. Tue. Wed. Thur. Fri.
� Date: /Z_%Q I
BLD: /6(---("T 2 Contact Name:
Owner: Contact Number: 360 £)7 4//7`
Address: ,1c CAS&WL L, 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
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JEFFERSON COUNTY I NO. 1.736
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DATE 1,r23/l
RECEIVED FROM
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DESCRIPTION B SN AMOUNT
CURRENCY Vo y�.0. _ r
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