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HomeMy WebLinkAboutBLD2014-00453 - MECHANICAL 'BUILDING PERMIT APPLIC BLD14-00453 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00453 Received Date: 12/4/2014 SITE ADDRESS: 181 SOUTH BAY LN PORT LUDLOW, 98365 OWNER: DAVID N AHO TRUSTEE PHONE: 360-437-9888 LINDAAAHO TRUSTEE 181 S BAY LN PORT LUDLOW WA 98365-8784 9694 SUBDIVISION: Block: Lot: PARCEL NUMBER: 969400034 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 DESCRIPTION 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: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: A Apprroo / Permit $152.00 SRE 12/04/14 153925 !1 Total: $152.00 DEC 0 4 2014 Jefferson County` =D \\tidemark\data\forms\F_BLD_App_Bld.rpt 12/4/2014 AIR FLO HEATING COMPANY Jefferson County Dept of Community Dev. Check Number: 43270 3 0 bate Description 11/26/2014 permit forAho Job#69177 Amount 171.00 kf °a JEFFERSON COUNTY °„` " DEPARTMENT OF COMMUNITY DEVELOPMENT 4 9.51E .G0 Date: t Z 119 Time Received: //''''�� a/pm Mon. Tue. 'Ved. Thur. Fri. f V 3---3 Date: 12-' I7 BLD: Owner: Contact Name: Address: G Contact Number: 360 y37 g iO I cS' 847 t A) 206 Notes: *VP Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Footing g Under ground Furance g Rough In Air Seal Above ground Stemwall Hydronic Gas Y Exterior shear Exterior lines Straps Hot Water Htr Interior shear Oil Post Hole Interior lines Ducts Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Setbacks Final Inspection Floor Foundation Wall Address Posted 1 Block&Tile Ceiling „sON C,O ti`s L. DEPARTMENT OF COMMUNITY VEL(1P IE J ' �� '4 A 621 Sheridan Street,Port Townsend,WA 98368 . ti ►C Fe!:360.379.4450 Fax:360.379.4451 Web:www.co_jeffcrson.wa.us/cammunity<lcvclopmcnt I�;mtil:dcd(2 co.jefferson.wa.us yS--N O,Cp�' h�T MECHANICAL PERMIT APPLICATION Steps in the Permit Process: -Review required submittal items to ensure all information is completed prior to submitting application. -Mechanical Permits can be mailed into our office-and do not require an appointment. -Fees are due at time of submittal,Mechanical permits are generally issued within 5 business days. t s a r dL k rr -i' xri4T�' i '' F 3�,�'F �' r�ri�,i E ,, rt sw ;rru = i w � r`. i am a s r�,3n n- ,r4�`1 3 ::,J wt,:pt i'; '�#:,as @ ``$� � '� r a �a a fi� ”' " � . - a 4 _ �.: "� � �, Is this application for use in a Mobile/Manufactured Home? * If Yes: A permit from Washington State Department of Labor and Industries,not Jefferson County,is required for appliances installed within a mobile/manufactured home. L&I-360-417-2702 * If No: Complete this form and make an appointment to submit to Jefferson County Permit Tech 360-379-4450 r firs General Site plan—showing propane tank, lines,and distance from tank to all existing structures. C '� - t 4 Ir Z5 rIO 7 & r ,9 . .W5, Complete first page and signature block only of Mechanical Permit Application. — — A complete solar panel supplemental application. — Assessor Tax Parcel Number: Ci(j4 Site Address and/or Directions to Property: Access (name of street(s)from which access will be gained: Description of Work: Name: \r` A\JL1D 4 lANUA A4V Address: Lr l `JQ U1-41 KAkt4 E FO r+- W d bf (It`I`7 r Phone#: � j 9j E-mail Address: Please contact Authorized Agent/Representative with project info. — — ILA Property Owner Signature: Date: 71,„, s� w:A f r Name: �. �� . Phone#: � �0, ( eb�D,- E-mail Address:p. � I r License#: 1.. Re 2ou p Expiration Date: Mechanical Application 1 0411- ,:-''''' ' • '' ' '---- } s , '''i dY Yy t id4 �* L r k Fes= "-:,. -F r k �I 3,iS i w .. , w,y 0L� rua,..,.. t 4 C,'''''.._ z > t`,"{,• - r- I _..... .;,r y Electric J Heating Oil Propane* Wood �(i� ` --� � ";P£$ay al��,e °a� �3, t 1 ufi�r lb.,-, �h�1 x U .L l � ���� *Propane is prohibited in "§� 4 1, ... k ass s, 'l'�i !rl�P _ _ 0 �, � _ hazardous locations such as Fan Bath Fan and/or Exhaust Fan basements or pits or Clothes Dryer Clothes Dryer with Exhaust Vent anywhere"heavier-than-air" Cook Stove Cook Stove, Range Hood Exhaust gas can unsafely collect. Fireplace-Gas Fireplace-Gas or Gas Log Insert *Propane tanks over 125 Fireplace-Wood Fireplace wood,Wood Stove,or gallons require a minimum Pellet Stove setback of 10 ft.from Electric Furnace Electric Furnace or HP+/- property line and buildings, Propane(LP)Gas Furnace Propane Furnace+/-Ducting and a site plan must be submitted with the Water Heater-Gas Gas WH Vent and Combustion Air application showing the Gas Pipe System Gas Pipe System LPG/Oil setbacks. If propane tank is Propane Tank LP Fuel Tank(#gallons: ) over 500 gallons,a site plan is I Heat Pump required to accompany this Generator application,and a separate Air Conditioner Fire Code approval is also required. Installation manual must be on site at time of inspection or a re-inspection fee will be charged. 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 making any issued permit null and void. I further agree to that all activities I intend to undertake or complete associated with this permit will be performed in compliance with all applicable federal, state and county laws and regulations and I 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 required later inspections. Applicant may request notice of the County's intent to enter upon the property for visits related to this application and subsequent permit issuance. Signature: Print Name: Date: � 9 ,:# .rs s j ail —s* o �� a r t do , r sir ��t, € ,� , . a sI` �.i _, ,ata � ._ ,art "4i t�n-'"t i € ' �,a k ,a��; ; € , '. =' I Nor F = -i j 4~m li`� = 3'0 ' , �, = �,Hy 4 a - ! �j itV1 r #takiip ._ •',. ‘',',:-.0:;.', ' d E+ s°s , .'its u y ., t �� ,,_ ; It # k t 4 Y &„I I� ItlI 4 q l a ' TI a6"b, fir.-W�' 1i r f � j ar l�r. � I "ii € 1 'fid X74 a o-s b �rid� A �� i w- �'�. (+� n 1 ,`�b r a ?� Ipa ny. it t- Id a tr - rl s 't 4 ', i r ti t!' 4�I i - :, spa ' t r wl . c r r I 5 ,n�(Ir Iii. 1 �� �� i. Ii iil _ �. s + viii is n -1 s1 �i 4,0 t p; t r,l`'+E a'sus, ,A-2," r:. s z-. n a �� ' �...�4 a � ,..- _ t9E': � — .. , ,'a� .. ., *Additional fees may apply. Mechanical Application 2 4 ■ 4 v. i cOb JEFF COUNTY _ _ —- , ',, '\ orerNik DEPARTMENT OF COMMUNITY DEVELOPMENT -~ , { " 621 Sheridan Street• Port Townsend •Washington 98308;�, '---_ -- ;1 A 1 licstp 360/379-4450 • 360/379-4451 Fax 1 ,1 www.co.jefferson.wa.us/commdevelopment ,,i Master Permit Application ;MLA: Project Description(include separate sheets as necessary): Tax Parcel Number. Property Size: (acres/square feet) Site Address and/or Directions to Property: Property Owner(s)of Record: Telephone: Fax email: Mailing Address: Applicant/Agent(if different from owner): f'1 r c10 1-tea t;ncl Telephone: 3taO-toe•3-tea 1 Fax: (083' & ,1 email:ette.n(e1writOr1e^atj .Gorr Mailing Address: 2.21 W W. Cec r Si.' SeC� rn 4 wA 412)%e " v 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 ) ❑ Address 0 Boundary Line Adjustment ❑Home Business p Road ❑Short Plat"* .. ❑Home Business g Industry ❑Binding Site Plan ❑Sign ❑Long Plat'"` ❑Allowed"Yes"Use Consistency Analysis ❑Planned Rural Residential Development(PRRDyAmendments** ncY ysi ❑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 Confekence ❑Tree Vegetation Request **Requires a Pre-ApplicationConference Please identify any other local,state or federal permits required for this proposal,if known: I hereby designate t C'�r1 }1e -A.- SIGNATION OF AGENT - • , to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE I Date: /'/z//ZO 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 required later inspections. Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application that he or she wants prior notice. Signature: Date: The action or 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 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 compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: Date: G:\PemutCenter\###FORMS###\DRD FORMS\Master Permit.Application 5-29-08.doc M N 6i4aIti s f This combination qualifies for a Federal Energy All ..1 CERTIFIED' Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31,2013. www.ahridirectory.org Certificate of Product Ratings AHRI Certified Reference Number: 6749945 Date: 11/24/2014 Product: Split System: Heat Pump with Remote Outdoor Unit-Air-Source Outdoor Unit Model Number:4TVVV0060A1 i !, Indoor Unit Model Number:*AM8C0C60V51 Manufacturer: TRANE i LJ Trade/Brand name: TRANE Series name: XV201 Manufacturer responsible for the rating of this system combination is TRANE Rated as follows in accordance with AHRI Standard 210/240-2008 for Unitary Air-Conditioning and Air-Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent,third party testing: Cooling Capacity(Btuh): 54500 EER Rating (Cooling): 12.70 SEER Rating(Cooling):, 19.40 Heating Capacity(Btuh)@ 47 F: 51500 Region IV HSPF Rating(Heating): 10.00 Heating Capacity(Btuh)@ 17 F: 48000* •Ratings followed by an asterisk(•)indicate a voluntary rerate of previously published data,unless accompanied with a WAS,which indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the product(s)listed on this Certificate and makes no representations,warranties or guarantees as to,and assumes no responsibility for, the product(s)listed on this Certificate.AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s),or the unauthorized alteration of data listed on this Certificate.Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI.This Certificate shall only be used for individual,personal and confidential reference purposes.The contents of this Certificate may not,in whole or in part,be reproduced;copied;disseminated; entered into a computer database;or otherwise utilized,in any form or manner or by any means,except for the user's individual, personal and confidential reference. AIR-CONDITIONING,HEATING, CERTIFICATE VERIFICATION &REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.org,click on"Verify Certificate"link we make life better' and enter the AHRI Certified Reference Number and the date on which the certificate was issued, which is listed above,and the Certificate No.,which is listed at bottom right. 130613423493911575 ©2014 Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: Parcel Details Page 1 of 2 el, lb id je5 County n „-,,.,..., .d. ...,..„„.......„,.... , ......_,............,.....-- "W” . '', ........, 3',....-v-s-=.....,.....— --z. -PF:=--- tic , ,,,...av,,, -.^z,zt." 4 g�� Home County Info a Departments Search Parcel Number: 1969400034 SEARCH Parcel Number: 969400034 Printer Friendly Owner Mailing Address: DAVID N AHO TRUSTEE LINDA A AHO TRUSTEE DAVID & LINDA AHO TRUST 181 S BAY LN PORT LUDLOW WA98365-8784 Site Address: 181 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 34 Tax,A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel Plats&Surveys Septic Monitoring Info Z Je er on County HOME I COUNTY INFO I DEPARTMENTS I SEARCH Best viewed with Microsoft Internet Explorer 6.0 or later ile Windows-Mac http://www.co.j efferson.wa.us/assessors/parcel/parceldetail.asp?Parcel_NO=969400034 12/4/2014 AIR FLO HEATING COMPANY INC Page 1 of 2 SO CiWashington State Department of Labor & Industries AIR FLO HEATING COMPANY INC Owner or tradesperson 221 W CEDAR BEQUETTE, MARK A S WA 98382 3600-683--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 HeatingNent/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= 12/4/2014 AIR FLO HEATING COMPANY INC Page 2 of 2 Received by L&I 410 Effective date SIP 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 @lni.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* https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&LIC=AIRFLI*206DG&SAW= 12/4/2014 (LT -, — s 1 I s 1 I I I r;(711\ (,) • • Jefferson County Building Division Permit Number: BLD14-00453 Applicant: 0 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 ZI/ M fitil6�'-L.� Miscellaneous 1Z'1'r�t4 ''��Sn�:`s`�J� t4 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 I 11161 FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR BUILDING PERMIT S Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD14-00453 Received Date: 12/4/2014 SITE ADDRESS: 181 SOUTH BAY LN Issue Date 12/4/2014 PORT LUDLOW, 98365 Expiration Date 12/4/2015 OWNER: DAVID N AHO TRUSTEE PHONE: 360-437-9888 LINDA AAHO TRUSTEE 181 S BAY LN PORT LUDLOW WA 98365-8784 9694 SUBDIVISION: Block: Lot: PARCEL NUMBER: 969400034 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 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 12/04/14 153925 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