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HomeMy WebLinkAboutBLD2014-00416 - MECHANICAL BUILDING PERMIT APPLOTION BRD1e 004p116 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00416 Received Date: 11/6/2014 SITE ADDRESS: 51 CHIMACUM RD OWNER: DEBI GOETZ PHONE: 360-774-6477 P.O. BOX 154 PORT HADLOCK WA 98339 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901024051 Section: 2 Township: 29 N Range: 1V1 CONTRACTOR: OWNER/BUILDER PHONE: (360)385-6883 Contractor's License MOUNTPI983O6 Expires 9/26/2015 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP ROUGH IN PLUMBING & INSTALL CLASS 1 HOOD & 120 PROPANE TANK 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: outing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $228.00 SRE 11/06/14 151718 State Building Code $4.50 SRE 11/06/14 151718 .-,,r . Total: $232.50 Lai ,C _ . Jefferson County DCLi \\tidemark\data\forms\F_BLD_App_Bld.rpt 11/10/2014 i 0 0 1.,\CM PIC IPAW 1\1 fter kl 0 #NGA14FA gip" . 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Cp '4 fi,Arizip WAIL PAP CA pep wJ zz4a - -r- 4,s-� r %-rt DCD a GLASS l l-�DoJ w;a ,a : . :..r..,a T��..� �.. 6.5t1 ,��� O kF-n . ai • AS SUBMITTED ❑ APPROV 0 AS NOTED ❑ REJECTEa Date Reviewer COMMERICAL KITCHEN INSPECTION AND TEST CERTIFICATE Permit Number04,111-14K8 Issued: Date: Job Address: Owner/Proprietor: Nature of Work:(,x w. .Cirr visv Use of Building: Contractorviratrmoym4 Contractor State License Number: REQUIRED INSPECTIONS V System orientation/installation in accordance with mfr's/UL listing and City permit Appliances properly covered with correct nozzle(s)(appliance mfr's listing) 15( Duct and plenum covered with correct nozzle(s) H Positioning of nozzles ur Nozzle covers in place(where required) t( Fusible links within rated temperature requirement e Hood/duct penetrations sealed with weld or UL listed device we Cylinder pressure gauge in proper range(if It uged) --�❑ Hydrostatic test date of cylinder current(CO2 cartridge exempt) 'Inspect cylinder mount(s) --♦ 0 Check travel of cable(s) Cable piping and conduit properly bracketed te Proper separation between fryer(s)and devices with surface flames W Proper surface to filters clearance 0' Exhaust fan in operating order ti' Filters in proper orientation ®' Fuel shut-off in"on"position for operation/test 1 ' Fan warning sign on hood or at fan manual control switch ( Manual release and location proper La' Personnel instructed in manual operation of system iYClass K Fire extinguisher within 30 feet and tagged properly ''; ❑ 40-B:C Portable Fire Extinguisher available and tagged properly tie Fuel/Power disconnect for all hooded appliances/outlets(with manual reset) —fa--Hood protection system monitored by premises automatic fire alarm system —+ 0 Certification/service tag on system -0--Electrical panel properly labeled for shunt-trip function and manual reset,if applicable o Other: Inspector: Date: Inspector: Date: Comm.Kitchen Inspection&Test Checklist 12/16/2014 CITY OF PORT TOWNSEND COMMERICAL KITCHEN INSPECTION AND TEST CERTIFICATE ACCEPTANCE TESTS GI Automatic Trip Test ❑ Manual Trip Test ❑ I.M.C. 506.3.3.1 Grease duct test. ❑ I.M.C. 507.16 Mood Performance test. ❑ I.M.C.507.16.1 Capture and containment test. ❑ Fuel/Power disconnect for all hooded appliances/outlets(with manual reset) ❑ Hood protection system monitored by premises automatic fire alarm system ❑ Certification/service tag on system Inspector: Date: Inspector: Date: Comm.Kitchen Inspection&Test Checklist 12/16/2014 1;i6171 JEFFERSCOUNTY • t y`t{ �,k 4, DEPARTMENT OF COMMUNITY DEVELOPMENT I sC 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 360/379-4450. 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment Cs Master Permit Application ?...4P4 tt i■ 17t'"ftbi"r-6- MLA:. Project Descxip i n crrdu sheets as necessary•): 2,0 A• i s alb . C SS _ P Cr Tax Parcel Number 1 \ —*0 a 0 S 1 Property Size: I 01 )O (acre quare feet), Site Address antic{Directions to Property: 51 C `�w 1 Property Owner(s)of Record: — ►k ,. • ∎G:' r< ° 1 Telephone:_.Q"53 — (5 . F,�`�: email: ,!� Mailing Address: 62027 WI ; NC( �'�t • p• # • , w,4 q 3 Applicant/Agent(if differe from owner): _ •NO • 1� Telephone: -- . Fax: _ -mail: 0 v•A— �4 6 -- Mailing Address: - Wiu11irra% `1 • What kind of Permit?(Check each box that applies 0 Lot or Road Segregation OBuilding 0 Critical Areas Stewardship Plan O Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Use) G Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C]** O Manufactured Home _0 Modular - 0 Discretionary"D"or Unnamed Use Classification O Commercial* 0 Special Use(Essential Public Facilities)** O Change of Use 0 Boundary Line Adjustment O Address 0 Road Approach 0 Short Plat** O Home Business 0 Cottage Industry 0 Binding Site Plan** 0 Propane 0 Long Plat** Sign - - 0 Planned aural Residential Development(PRRD)/Amendments** 0 Allowed`Yes"Use Consistency Analysis 0 Plat Vacation/Atteration** 0 Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** 0 Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** G Temporary Use 0 Shoreline Management Variance 0 Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment 0 Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment *May requite a Pre—Application Conference 0 Tree Vegetation Request **Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal,if known: DESIGNATION OF AGENT I hereby designat• 1' • •. . to act as my agent in matters relating to this application for permit(s). SIGNATURE L l 6. 1- Date: /V� 5 Sr By signing this application form,the ownedagent 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. _ ignature: I_i (_ r— 7N:P.l\ ' Date: g i 026 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 •compliance ',+t the - - •• County development code.The Applicant acknowledges that he,she or it holds individual and n• )1 ibllity f o r •1 ng t o .•. .• •lying with the ESA. The Applicant has read this d' a- and sig and dates it below. Signatu . ` _ • .' ,^ tel i .r► Date: t L Jl-- 1 L G_\PermitCenter\###FORMS###\DRD FORMS\Current DRD Foams\Master Permit Application 5-29-O8.doc • 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. ignature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: Ric NE: Fax: oU• ' 4 ,& 9° r, . b / (30) ( ) MAILING ADDRESS: EMAii: I CONTRACTOR'S LICENSE ( WAINS NUMBER: v' s',0- ..)-A-lik, 41104LakoplABER ARCHITECT/ENGINEER: HONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: " Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: New Wood Existing: r. Sewer 0 Addition o Steel Proposed: Bank 0 Community System Alteration/Remodel D Concrete Total: Height: 0 Individual System Repair 0 Masonry SEP Permit# 5e 0,z-ooatiq 0 Demolition 0 Other: Bedrooms: Water Supply: Existing: Setback: o Private well 0 Two Party Type of Heat: Proposed: 0 Public Total: Name of System: I If this is a Commercial Project you must answer the following: - Number of Parking Spaces: Current Proposed: Number of ADA Parking S « Number of occupants(includes owners,tenants,employees,etc) Current , Proposed - :BC Occupancy: IBC Type of construction: Will you have Food Service.In/ No s If this is a Propane Tank and/or Aooliance Installation permit,mark all items below that apply: —ow i Underground Tank CAbove ground Tank Size of Propane Tank: I,2,B I Heat Stove I Cook Stove I Woodstove 1 Fireplace Insert I Hot Water T.r I Pellet Stove i Other l l o°C ��JJ . Is this appliance being installed in a Manufactured/Mobile Home? Yes 4 . When applying for a permit to install a propane tank you must also submit a e 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, including the reserve area. Square Footage _ Current Proposed For Office Use Only. Amount Revision Main Floor Heated EH Bit App Review: 2htl Floor Heated Consistency Review: Other Heated Base fee: - _ axe .al Mezzanine Additional Section: I,C '''''° Heated Basement Plan Check fee: 1 Unheated Basement State Surcharge fee: `�t 1 5 Other Unheated- Pot Water Review fee: Garage/Carport SUBTOTAL a s'S-(2' I 51 Decks 911/Rd Approach fee: Other ! TOTAL• $ 25(. S'O i Receipt Number: l l '3 I Q Cash/Check Number. 1 V ESTIMATED COST(REQUIRED) Date: 1 �� .Fair market value of all labor and materials foundation to finish i Initials: I • I G:\PermitCenterN,##=FORMS:##\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc 51 Chimacum Rd,Port Had lock,WA-Google 11/5/14 5:32 PM • tOmPeelth040.0**M*IklibM4M*3-, GO(Sle Ilat11,),76 • (tie) 116) 016) Valley ern Y Blocked Plug-in 8111's Barter Shop • NJ4)011` \\NN Joy Luck CP X alymi)ic. rfaelA Post c t 4 c(-rjyt r 111,14110 k W4 9 '/ 9 Cot"IL c.ifeck_ kinspecttlyi 1;51.e. EvIvet. 1 kfico-te L.00Aid toe '-- https://maps.google.com/maps?output=classic&dg=brw Page 1 of 2 teN ItCS SCO • 0 . ,.... '= '-.•-tv::-.-.7'.-."-.:i-:-.7.---.-1:'L.;1-, -'--.:.:•t.:';• ':.1.:I-1:- --.-' '-.-.i.-.:-'::-,.'",,':-.- :1:-'*-47-'rr'''. ' JI .....-..... •%-.--i'-v:... •::.=.- :::-... 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PARCEL NO. 901-024-051 MEI Jefferson County Building Division Permit Number:• BLD14-00416 Applicant: GOETZ 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 Rough-in Plumbing rz//06q1 Gas Line:Interior �a Gas Line:Exterior Propane Tank C itoM Pressure Test Mechanical Systems Pt N 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 p. FINAL INSPE TI N 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 11/10/2014 BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD14-00416 Received Date: 11/6/2014 SITE ADDRESS: 51 CHIMACUM RD Issue Date 11/10/2014 Expiration Date 11/10/2015 OWNER: DEBI GOETZ PHONE: 360-774-6477 P.O. BOX 154 PORT HADLOCK WA 98339 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901024051 Section: 2 Township: 29 N Range: 11/1 CONTRACTOR: OWNER/BUILDER PHONE: (360)385-6883 Contractor's License MOUNTPI98306 Expires 9/26/2015 PROJECT DESCRIPTION: ROUGH IN PLUMBING & INSTALL CLASS 1 HOOD & 120 PROPANE TANK 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: BEDROOMS: BATHROOMS: Permit $228.00 SRE 11/06/14 151718 Exist: Exist: State Building Code $4.50 SRE 11/06/14 151718 Prop: Prop: Total: $232.50 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 it °oG JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT )9`rHI 6 9 Date: ia/ i5 1 4 Time Received: /O OD (1pm Mon. Tue ed. Thur. Fri. /��4 ff Date: d , I) 4 BLD: 14— V l ,//V Contact Name: MP Owner: G--o-P T� -/�L _ Contact Number: 360 4f:� s Address: S I ` 4 1 r'Yi:-r JA rYL 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 V\Z-0(.. Fit. • •-ction .i. Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling ,soN `� JEFFERSON COUNTY f �Z. DEPARTMENT OF COMMUNITY DEVELOPMENT �s�,f G.�O Date: 4g2 ,Time Received: 1)3( ama Mon. Tue. 401011. Thur. Fri. Date: ( 2- --17 BLD: /L1— 4//4 Contact Name: Owner: Contact Number: 360 7 lt.t 4,LO? Address: 3---/ C—h i ktitta 206 Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas--51--Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines X Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling • . c, s I I 1 \sz• ‘--c) •(-!If.,- i I .t- i ' 1 7 op i I „ — \\ .\ 7\ 7.7 , \ N \ \ 1 ■-,f— \ 1111 \ \ \ \ N \\\ I- 9 . ottn-fel- [ c 41 ,.... --__ 11 \C \ \ \ \ \, , \ \ \ \ \ \ 2 ..„, \:\ \ \ \ \\\ \ \ \ \ \\:\ I\\*\\\ \Ns\ \ \ \ \ \ \ \ \\\ \\ N \ 0 D I's p lay \ \ N\ N \ , \ \ ■„. \ , , \ ---z, -\, , \ \ , \ i -,„ \ t i „,, „„ \ N , . , :\\\\ , , ...., , o , , ,, , „ •,„ , \ 1 rk 1p. , ,, tr 12 , \ ,\ , \ \ I , 1 5;--j"- '''' 4 \,, ,,, \ , ' , I , "V" lti \ V.,_. 9:— N 's \ ".. ,,. ,\2 .•-■..„... \ (9°,1 1 \\ 0 X - IN r --1 I ki) I ■ • A"'.. . : X ( c '' ;'' \ o ‘r) 1 ' , X . ---- ''''G •-t„ ■ x,,, *CT. 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