HomeMy WebLinkAboutBLD2014-00387 - MECHANICAL ILDING PERMIT APPLICATION BLD14-00387
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD14-00387 Received Date: 10/20/2014
SITE ADDRESS: 142 DEER HOLLOW CIR
PORT LUDLOW, 98365
OWNER: JAMES SELBY PHONE: 360-437-1343
PEGGY SELBY
142 DEER HOLLOW CIRCLE
PORT LUDLOW WA 98365-0530 9482
SUBDIVISION: Block: Lot: 21
PARCEL NUMBER: 948200021 Section: 21 Township: 28 N Range: 1 E
CONTRACTOR: EVERWARM INC PHONE: (360)452-3366
257151 HWY 101
PORT ANGELES WA 98362
Contractor's License EVERWI*088NL Expires 8/17/2016
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI INSTALL PROPANE FIRE PLACE
WITH EXISTING 120 GAL. PROPANE TANK
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP MEC MAIN:
VALUATION ADD'L: HEAT TYPE: PRO
CODE EDITION: 2012 HEAT BASE: HEAT TYPE:
OCCUPANCY:
UNHEATED: #OF STORIES:
OCCUPANCY:
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: Approved/Date
Permit $152.00 SRE 10/20/14 151664 APPROVED
Total: $152.00 OCT 2 0 2014
Jefferson County DCD
\\tidemark\data\forms\F_BLD_App_Bld.rpt 10/20/2014
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� o� DEPARTMENT OF COMMUNITY DLOPMENT
, �,a 621 Sheridan Street,Port Townsend,WA 98368 E 0 V 1
ti a°7' h ; Tel:360.379.4450 I Fax:360.379.4451 I� _,
- ? Web:www.co.jeffexson.wa.us/communitydevelopment <E-mail:dcdCa)co.jeffeison.wa.us n
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MECHANICAL PERMIT APPLICATI �-
'JE �ERSOJ COUNTY
Steps in the Permit Process: "PT OF c0"r iUNI?Y D�'ri np��ENT
Review required submittal items to ensure all information is completed prior to submitting application. i
-Make an appointment to meet with the Permit Technician by calling 360-379-4450.
-Fees will be collected at intake. Additional fees may apply after review and payment is re•uired before permit's iss ed.
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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
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Complete Site plan -' Please refer to the site plan checklist to ensure all items are on the site plan.
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Complete first page and signature block only of Mechanical Permit Application.
A complete solar panel supplemental application.
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Access (name of street(s)from which access will be gained:
Description of Work:
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Property Owner Signature: /L �{ Date:
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Mechanical Application 1 � .
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Fan Bath Fan and/or Exhaust Fan basements or pits or
Clothes Dryer Clothes Dry er 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 120
Fireplace-Wood Fireplace-wood,Wood Stove,or gallons require a minimum
Pellet Stove setback of 10 ft.from
Electric Furnace Electric Furnace or HP+1- 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 ) 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 • any attachments,
is true and correct to the best of his, her or its knowledge. Any material falsehood or any omssion 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 regssocins'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 relate o this ap c�/ and subsequent permit issuance.
Signature: /�/ �:,� Print Name: 7 V �i Date: off` <• cur i - ��
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Mechanical Application 2
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Parcel Details Page 1 of 2
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Parcel Number: 948200021 SEARCH
Parcel Number: 948200021 Printer Friendly
Owner Mailing Address:
JAMES SELBY
JAMES SELBY TRUSTEE
PEGGY SELBY
142 DEER HOLLOW CIRCLE
PORT LUDLOW WA98365-0530
Site Address:
142 DEER HOLLOW CIR
PORT LUDLOW 98365
Section: 21 School District:Chimacum (49)
Qtr Section: NW1/4 Fire Dist: Port Ludlow (3)
Township: 28N Tax Status: Taxable
Range: 1E Tax Code: 0231
Planning area: Port Ludlow (7)
Sub Division: 9482 - EDGEWATER VILLAGE
Assessor's Land Use Code: 1100 - Residential - Single Unit
Property Description:
EDGEWOOD VILLAGE LOT 21
Tax,A/V, Sales, Photos, and
Permit Data Bldq Data Map Parcel Plats&Surveys
Septic Monitoring Info
Jefferson County HOME I COUNTY INFO I DEPARTMENTS I SEARCH
Best viewed with Microsoft Internet Explorer 6.0 or later
Windows- Mac
http://www.cojefferson.wa.us/assessors/p—arce
j l/parceldetail.asp?Parcel_NO=948200021 10/20/2014
EVERWARM INC Page 1 of 2
•
Washington State Department of
Labor & industries
EVERWARM INC
Owner or tradesperson 257151 HWY 101
MCCARTNEY, PORT ANGELES, WA 98362
CCARTNEY,TERRENCE J
360-452-3366
Principals CLALLAM County
MCCARTNEY, TERRENCE J, PRESIDENT
MCCARTNEY, VIRGINIA
RIMSTAD, SECRETARY
Doing business as
EVERWARM INC
WA UBI No. Business type
601 361 016 Corporation
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
License no.
EVERWI*088NL
Effective—expiration
08/13/1992—08/17/2016
Bond
TRAVELERS CAS&SURETY CO $12,000.00
Bond account no.
206809004
Received by L&I Effective date
08/09/2001 08/02/2001
Expiration date
Until Canceled
Insurance
..............................
Nautilus Ins Co $1,000,000.00
Policy no.
BN958693
Received by L&l Effective date
01/17/2014 01/20/2014
Expiration date
01/20/2015
https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601361016&LIC=EVERWI*088NL&SAW= 10/20/2014
EVERWARM INC Page 2 of 2
Insurance history 4111 •
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.
IWorkers' 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.
447,103-01
Doing business as
EVERWARM HEARTH &HOME
Estimated workers reported
Quarter 2 of Year 2014"11 to 20 Workers"
L&I account representative
TO/CAROLYN CRAWFORD(360)902-4715-Email: CRAI235 @Ini.wa.gov
IWorkplace 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. rt€` Access
dh.34'2E 41z't i...:q.f C @fiIC9§t wo,..Si#<.
https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601361016&LIC=EVERWI*088NL&SAW= 10/20/2014
Jefferson County Building Division Permit Number: BLD14-00387
Applicant: SELBY
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
Fireplace Insert
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 ).-1--t,5'
FINAL INSPECTION UST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
I
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX(360)379-4451
PERMIT#: BLD14-00387 Received Date: 10/20/2014
SITE ADDRESS: 142 DEER HOLLOW CIR Issue Date 10/20/2014
PORT LUDLOW, 98365 Expiration Date 10/20/2015
OWNER: JAMES SELBY PHONE: 360-437-1343
PEGGY SELBY
142 DEER HOLLOW CIRCLE
PORT LUDLOW WA 98365-0530 9482
SUBDIVISION: Block: Lot: 21
PARCEL NUMBER: 948200021 Section: 21 Township: 28 N Range: 1 E
CONTRACTOR: EVERWARM INC PHONE: (360)452-3366
257151 HWY 101
PORT ANGELES WA 98362
Contractor's License EVERWI*088NL Expires 8/17/2016
PROJECT DESCRIPTION: INSTALL PROPANE FIRE PLACE
WITH EXISTING 120 GAL. PROPANE TANK
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP MEC MAIN:
VALUATION ADD'L: HEAT TYPE: PRO
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 10/20/14 151664
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