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HomeMy WebLinkAboutBLD2014-00445 - MECHANICAL UILDING PERMIT APPLICIJN BLDI4-00443 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00445 Received Date: 11/25/2014 SITE ADDRESS: 11084 RHODY DR PORT HADLOCK, 98339 OWNER: JAMES J GROVES PHONE: 360-385-6282 PO BOX 321 POULSBO WA 98370-0321 9429 SUBDIVISION: Block: Lot: PARCEL NUMBER: 942901701 Section: 3 Township: 29 N Range: 1V\ CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License AMERIPL055LL Expires 8/2/2015 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP MECHANICAL PERMIT 120 GALLON PROPANE TANK FOR HEATER INSTALLATION 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: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $228.00 SRE 11/25/14 153878 APPROVED Total: $228.00 NOV 2 5 2014 Jefferson County DCD • rnculeA yelmA footsck.s S t l� 2 5/ \\tidemark\data\forms\F BLD_A pp_Bld.r P t 11/25/2014 S � DEPARTMENT OF COMMUNITY DEVELOPMENT W4 a 621 Sheridan Street,Port Townsend,WA 98368 ti Tel.360.379.4450 Fax:360.379.4451 Web:www.co.Jefferson.wa.us/communitydevelopment I?.mail:ded t co.jefferson.wa.us �`SN I N G,SO MECHANICAL PERMIT APPLICATION Steps in the Permit Process: -Review required submittal items to ensure all information is completed prior to submitting application. -Mechanical Permits can be mailed into our office-and do not require an appointment. -Fees are due at time of submittal, Mechanical permits are generally issued within 5 business days. iI*WhIrint91 ,..014VW1j'" it, ;141' -11 Is this application for use in a Mobile/Manufactured Home? * If Yes: A permit from Washington State Department of Labor and Industries, not Jefferson County, is required for appliances installed within a mobile/manufactured home. L&I-360-417-2702 * If No: Complete this form and make an appointment to submit to Jefferson County Permit Tech 360-379-4450 )( General Site plan—showing propane tank, lines,and distance from tank to all existing fp 2 4 tti Y t4 o- Complete first page and signature block only of Mechanical Permit Application. I I A complete solar panel supplemental application. Assessor Tax Parcel Number: q 4Zgvi ri Site Address and/or Directions to Property: /10 g4 3horsy by-. 14- ft Lot) L - Access (name of street(s)from which access will be gained: 1-) { ('= Description of Work: -peop ele +4 i P. / -� 1 riS Name: J@Y h3 S. ,rOvta Address: ?.C). • iAb '4. . , f 1. OA- 412-6 Phone#: vlb- 3E5- 1 2 E-mail Address: SroVeS Otc,bl; eed.to _ Please contact Authorized Agent/Representative with p •' 15 Property Owner Signature: Date: ® • ® ✓® k , . � 4 m ! e i e' Name: kyyeri 64A Deb 44 tit owl Min Yopan�. Phone#: 3LO-3es- (o$ 3 E-mail Address:'Ken,rr►ar�►4- License#: (pp/ G/4 QO p Expiration Date: °0/2 / f t� Ce. P L o SS L L Mechanical Application 1 • • Heat Source Electric Heating Oil Propane* X Wood Indicate Quantity and Fixture Types Below *Propane is prohibited in Quantity Fixture Type Description 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+/-Ducting 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: 120 1 over 500 gallons,a site plan is 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 inspectio . Applicant may request notice of the County's intent to enter upon the property for visits related to this applicat and subsequent permit issuance. Signature: ;�.. _' � �A► .. ' • t Name: Date: 2_f-ArAn OFFIC • ONLY Building Permit Fees Mechanical Permit fee (tank swap,woodstove,furnace,etc) $152.00 Propane—Lines, tank, and appliance (add'I $76.00) Project Scanning Fee $19.00 Total Fees* - 7r` �7, cv *Additional fees may apply. - NOV 25 2014 Mecha .J Application 2 J.... • UiVIY� !1''DF FLQPMENT AMERIGAS PROPANE L P Page 1 of 2 • • CiWashington State Department of Labor & industries IAMERIGAS PROPANE L P Owner or tradesperson 2831 74th DR NE Amerigas Propane Inc MARYSVILLE,WA 98270 425-219-9972 Principals SNOHOMISH County Amerigas Propane Inc, PARTNER/MEMBER Samuel, Steven Alan, PARTNER/MEMBER Prentice Hall Corp, AGENT MAUCH, ROBERT C, PARTNER (End: 07/27/2011) GOMEZ, LUIS A, PARTNER (End: 07/27/2011) KNAUSS, ROBERT H, PARTNER (End: 07/27/2011) Doing business as AMERIGAS PROPANE L P WA UBI No, Business type 601 619 800 Limited Liability Partnership ILicense Verify the contractor's active registration/license/certification (depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL T n License no. r AMERIPL055LL Effective—expiration 06/13/1995—08/02/2015 NOV 2 5 2014 Bond uNrY SAFECO INS CO OF AM $12,000.00 ( !4�I1v N VFLONIFNT Bond account no. 5799215 Received by L&I Effective date 06/27/2002 06/08/2002 Expiration date Until Canceled Insurance https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601619800&LIC=AMERIPL055LL&SAW= 11/25/2014 AMERIGAS PROPANE L P Page 2 of 2 Ace American Insurance Compang) $2,500,000.00 • Policy no. HDOG27335123 Received by L&l Effective date 07/09/2014 07/01/2014 Expiration date 07/01/2015 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&l 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 closed. 537,607-02 Doing business as AMERIGAS PROPANE LP Estimated workers reported N/A L&I account representative T4/CARTE PICKETT(360)902-5592-Email: PICC235©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 <•�,:uti tiFas1;rwxarr„Wai0 14,4, iG± NOV 25 2014 • (� U ,a ly LF'JE{OPMENT https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601619800&LIC=AMERIPL055LL&SAW= 11/25/2014 vvoric uraer summary Work Order# U , -( -\ � (.117 262481 Scheduled Date/Time Notification: Sales Order Planner Group: Plant: 0 Customer:, Assigned to: Grid# Zone: N = _ f' Material: Owner: Subtanks: Equipment ID: Company ID: Manufacturer Serial#: OP# Description Status Work Center Completed Duration Actual ,.. ,-..ems;,,. __ ` Y�..f''`wr Tan, ,Size Recert. Date/ Type(if PFI Performed and DOT ASME Manufacturer Serial# Manuf acturer M R Year/MO app li cable) Docurnentedmomv f l I 75- d /a % 1 0 f f I 20 V 00133/ &/o. h; (,-)4) C3 yes ❑ No .# First Stage . Second Stage Integral Twin t3-7 0 ! It v LVL#64 Appliance Type ex. Heat 1-(ec.4- Quantity Per Type 3 j Total BTU of Type 54,000 SO 0 00 If New Exterior Line is Installed or Replaced Perform If New Interior Line Is Installed or.Replaced Perform New°Customer Safety Assurances Y/N Test for Leakage Pressure Test Tank shut off showed to' ustomesf-? Line Depth Line Material - �° (In inc} es)° -' - , ��' Line material Customer knows tli'e smeilof propane? iNtei` �iiiQr `° : Comments:.., to}thenlskai3e Start Pressure End Pressure Time Held System OK �s rt PSIG PSIG MIN } v, Start Pressure End Pressure Time Held System OK PSIG PSIG _ MIN Start Pressure End Pressure Time Held System OK Flow Pressure Lock-up Pressure J,7 PSIG :a, PSIG * iii s IN WC IN WC MIN f cJ frl IN WC f 2 IN WC tL °'" i70_, Start Pressure , End Pressure Time Held System OK Flow Pressure Lock-up Pressure PSIG PSIG MI PSIG PSIG 4 10 Start Pressure End Pressure Time Held System OK Flow Pressure Lock-up Pressure t ` IN WC IN WC Min IN WC Customer Signature J IN WC 1-11k*. ` _/_ Service Tech / (if required) �Z�� G. �`� I Si:nature , uv_nm_c_n i ` • 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#: BLD14-00445 Received Date 11/25/2014 SITE ADDRESS: 11084 RHODY DR Issue Date 11/25/2014 PORT HADLOCK, 98339 APPLICANT: JAMES J GROVES PHONE: 360-385-6282 PO BOX 321 POULSBO WA 98370-0321 SUBDIVISION: 9429 Block: Lot: PARCEL NUMBER: 942901701 Section: 3 Township: 29N Range: 1W CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License AMERIPL055LL Expires 8/2/2015 OWNER, JAMES J GROVES PHONE: 360-385-6282 if different: PO BOX 321 POULSBO WA 98370-0321 PROJECT DESCRIPTION: MECHANICAL PERMIT 120 GALLON PROPANE TANK FOR Directions HEATER INSTALLATION 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 11/25/2015. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: Tank/Line/Appliance: Final Approval: 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 11/25/2014 MONTECIT0111 New Construction f/8"grid L r • c� NOV 25 2014 NOTES I - ' .., ∎i N ni „ .r0 N2Mr_NT Mil ad 1 .800.milgard • milgard .com WINDOWS$&DOORS" ,4�5oN °o& JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT l'SWI N 019 )ate: tZ•C>Time Received: l ( 5^v apm Mon. a Wed. Thur. Fri. Date: 2-_(6 3LD: 1 U - i-Pf5" Contact Name: Jwner: Contact Number: 360 .5"e5" b2 2 4ddress: i I O$q )y b 206 Notes: / 14,t C-k 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