Loading...
HomeMy WebLinkAboutBLD2014-00441 - MECHANICAL BUILDING PERMIT APPLICOON BLD14-00441 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00441 Received Date: 11/24/2014 SITE ADDRESS: 333 BAYCLIFF DR PORT TOWNSEND, 98368 OWNER: MARK KLEINMAN PHONE: 360-609-1963 PILAR KLEINMAN 12409 NW 48TH CT VANCOUVER WA 98685-3317 9650 SUBDIVISION: Block: Lot: 276 PARCEL NUMBER: 965000161 Section: 27 Township: 30 N Range: 1V\ 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 DESCRIPTIOP NEW MECHANICAL PERMIT- 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: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit SRE 11/19/14 153871 Total: $152.00 APPROVED Nov 2 4 2014 Jefferson County DCD \\tidemark\data\forms\F_BLD_App_Bld.rpt 11/24/2014 • • ____., i I I r ■ 1 . S i I i i . i 167' c r- _._ „, .. „_, II V fEr-. '- AV) 4, ,‘„v 7 9 ;:'n,..', ii i 1..I DL,RI ._______ Fr:--------7:1111)/'li 4, JEi-FERSON COUNTY DEPT.OF COPNONITY DFVFI OPMENT 7,,..4' O�j. JEFFER•COUNTY • --c-;ON \,,�`f DEPARTMENT OF COMMUNITY DEVELOPMENT �y = 621 Sheridan Street• Port Townsend •Washington 98368 ,„q www.co.jefferson.wa.us/commdevelopnient dev�pnletE (� \`. s �}� Master Permit Application ,. , M : 1 9 Project Description(include separate sheets as necessary): L . Tax Parcel Number q(OS MD I t0 1 i �OUIVIY ' �r qs �r� 1,1 i�('4RpN ANT (ac /stivare feet) Site Address and/or Directions to Property: �,�✓ ' 6tvHcuri 'Nervg Port low i k.1 (, t44 gldgioc Property Owner(s)of Record: NA-ni �xJ rI VV ail Telephone: S(PO - (OCI (0S Fax: email: Mailing Address: Applicant/Agent(if different from owner): f r clO %-ea%(l, Telephone: Slob'tWeb-6210 I Fax: (033- 3a1-1r email:ette nesoritaheatlrca.com Mailing Address: 22•% W. Cedar S"t" Secat,urn ,ANA cte3ea- W at 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 0 Modular ❑Discretionary 13"or Unnamed Use Classification ❑ Commercial* ❑Special Use(Essential Public Facilities)" ❑ Change of Use ❑Boundary Line Adjustment ❑ Address ❑Road Approach 0 Short Plat" ❑ Home Business ❑Cottage Industry ❑Binding Site Plan" ❑Propane ❑Long Plat" ❑Sign ❑Planned Rural Residential Development(PRRD)>Amendrnents" ❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration" ❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions"" 0 Site Plan Approval Advance Determination(SPAAD)" ❑Shoreline Management Substantial Development-- ❑Temporary Use ❑Shoreline Management Variance ❑Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District MapAmepdment ❑Forest Practices Act/Release of Six-Year Moratorium ❑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: DESIGNATION OF AGENT I hereby designate fl•r-.1-to +treat t nq to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE r'/L""�f ): `J Date: ////Z-// 1/ 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 Courtly against all liabilities,judgments,court costs,reasonable attorneys 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. Staffs 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 responsibIity for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: Date: G:\Pere itCenter\FORMS###\DRD FORMS\Master Peanit.Appficaaon 5-29-084oc BUILDER STATEMENT The signer of this statement does here ify that they are the Owners of the parcel referenced ft that they are not licensed contractors and that they will be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: Fax: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: ❑ Sewer .cY Addition ❑ Steel Proposed: Bank ❑ Community System Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Time of Heat: Proposed: 0 Public 9 t) let l Total: Name of System: If this is a Commercial Prolect.you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: 4 '`Nihmber of occupants(includes owners,tenants,employees,etc) Current Proposed ry IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: 1 Underground Tank I Above ground Tank ,4 r Size of Propane Tank: i Heat Stove i Cook Stove I Woodstove Fireplace Insert i Hot Water Tank I Pellet Stove i Other Is this appliance being installed in a Manufactured/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, including the reserve area. S•uare Foo'.!e Current . • ed' Main Floor Heated EH Ski .. ` APP Review: 2"0 Floor Heated Consistency Review: • Other Heated Base fee: Mezzanine Additional Section: Heated Basement _ Plan Check fee: Unheated Basement "' ' State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd . . ._ � _. Approach fee: Other TOTAL: $ - Receipt Number: Cash/Check Number: iYY r5 7+ ESTIMATED COST(REQUIRED) Date: .Fair market value of all labor and materials foundation to finish )S2'0. 01) Initials: ' G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc 11/17/2014 Parcel Print Parcel Number 965000161 08/15/200 Owner Mailing • re,: MARK KLEINMAN PILAR KLEINMAN [E4 C ' 12409 NW 48TH CT VANCOUVER WA 98685-3317 I- Address: A,,14P1 333 BAYCLIFF DR ''F''T f'( ',"; Iry nr)r PORT TOWNSEND 98685-3317 Section: 27 School District: PortTownsend (50) Qtr Section: NW1/4 Fire Dist: Dimacum (1) Township: 30N Tax Status: Taxable Range: 1W Tax Code: 0111 Planning area: 98685-3317 Sub Division: 9650 - KALA POINT 3-8 Land Use Code: 1100 98685-3317 Property Description: KALA POINT #5 LOT 276 http://www.cojefferson.wa.us/assessors/parcel/parcelprint.asp?PARCEL_NO=965000161 1/1 • This combination qualifies for a Federal Energy sik"III I 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: 5021416 Date: 11/12/2014 • Product: Split System: Heat Pump with Remote Outdoor Unit-Air-Source n _ , (r- Outdoor Unit Model Number: 4TR5030G1 W Indoor Unit Model Number: *AM7A0B30H21 Manufacturer: TRANE --_J Trade/Brand name:TRANE � _ r4 6A i;OLINTY Series name: XR15 WEATHERTRON DEPT OF COMiv4UkITY Cl VP'OPMHIT 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): 31600 EER Rating (Cooling): 12.50 SEER Rating(Cooling): 15.00 Heating Capacity(Btuh)la 47 F: 30000 Region IV HSPF Rating(Heating): 9.00 Heating Capacity(Btuh)©17 F: 18900 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 i AND CONDITIONS This Certificate e 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-CONDmONING,HEATING, CERTIFICATE VERIFICATION &REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahrldirectory.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. 130602938205425168 Air-Conditioning,Heating,and Refrigeration institute CERTIFICATE NO.: Parcel Details Page 1 of 2 • lb raJefferson Count Home County Info ; Departments Search Parcel Number: 965000161 SEARCH Parcel Number: 965000161 Printer Friendly Owner Mailing Address: MARK KLEINMAN PILAR KLEINMAN 12409 NW 48TH CT VANCOUVER WA98685-3317 Site Address: 333 BAYCLIFF DR PORT TOWNSEND 98368 Section: 27 School District: Port Townsend (50) Qtr Section: NW1/4 Fire Dist: Chimacum (1) Township: 30N Tax Status: Taxable Range: 1W Tax Code: 0111 Planning area:Tri-Area (4) Sub Division: 9650 - KALA POINT 3-8 Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: KALA POINT #5 LOT 276 Tax,A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel Plats&Surveys Septic Monitoring Info io letion County HOME I COUNTY INFO I DEPARTMENTS I SEARCH Best viewed with Microsoft Internet Explorer 6.0 or later Windows - Mac http://www.coj efferson.wa.us/assessors/parcel/parceldetail.asp?Parcel_NO=965000161 11/24/2014 AIR FLO HEATING COMPANY INC Page 1 of 2 • S Washington 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&1 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= 11/24/2014 AIR FLO HEATING COMPANY INC Page 2 of 2 Received by L&I 111 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 Whinttxt ` ,.V,cnttwrt WO" https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&LIC=AIRFLI*206DG&SAW= 11/24/2014 • Jefferson County Building Division Permit Number: BLD14-00441 Applicant: KLEINMAN 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 Mechanical Systems 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 121 y � 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#: BLD14-00441 Received Date: 11/24/2014 SITE ADDRESS: 333 BAYCLIFF DR Issue Date 11/24/2014 PORT TOWNSEND, 98368 Expiration Date 11/24/2015 OWNER: MARK KLEINMAN PHONE: 360-609-1963 PILAR KLEINMAN 12409 NW 48TH CT VANCOUVER WA 98685-3317 9650 SUBDIVISION: Block: Lot: 276 PARCEL NUMBER: 965000161 Section: 27 Township: 30 N Range: 1■1 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- 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 11/19/14 153871 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 "ON cbcI JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMEN )ate: /4/Z, Time Received: 9/Z s/pm o Tue-. --Wed. Thur. Fri. Date: 3LD: *-4'471/4' / Contact Name: Jwner: Contact Number: 360 4ddress: '2 3'3 6 / c--1---)"1" 20625x,15-2 btL 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 JEFFERSON COUNTY P- NO. 153871 DATE tt^1"1 -4 RECEIVED FROM Air flOw keot'i jn &i,t't'J DESCRIPTION BARS# AMOUNT CURRENCY i