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HomeMy WebLinkAboutBLD2014-00400 - MECHANICAL • BUILDING PERMIT APPLI( ION BLD14-00400 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00400 Received Date: 10/24/2014 SITE ADDRESS: 5761 CAPE GEORGE RD PORT TOWNSEND, 98368 OWNER: NORA SHAPIRO TRUSTEE PHONE: 360-379-2424 N SHAPIRO REVOCABLE TRUST 5761 CAPE GEORGE RD PORT TOWNSEND WA 98368-9043 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001195006 Section: 19 Township: 30 N Range: 1V1 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 INSTALL NEW 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 $152.00 SRE 10/24/14 151705 APPROVED Total: $152.00 E, 4 OCT Z a 20a54 Jefferson County DOD efie\OLb-Ct 1ACUriUk atA 1011-4/14 \\tidemark\data\forms\F_BLD_App_Bld.rpt 10/24/2014 kin III L[004 -_ , 'd JEFFERSON COUNTY I �� C E O V E era%° DEPARTMENT OF COMMUNITY DEVELOPMENT !i , L; 621 Sheridan Street•Port Townsend•Washington 98368 4''‘ri\N''''' '''. .4' 360/379-4450• 360/379-4451 Fax I OCT 1 4 2014 www.co.jefferson.wa.uslcommdevelopment i 1 i Master Permit Application MLA: JEFl-ERSCt V COUNTY Project Description(include separate heets as n a r t F, l 51-0 ie-� C I ---� Tax Parcel Number:CO 119 Cj 0069 Property Size: Q c '€ S (acreskrquare feet) Site Address and/or Directions to Property: IS-no I a �G- .22 _.-IX,�. .C- Property Owner(s) Record: k it , l.,I t , I Telephone: r I - Fax emati.� .r • . lf t•;,Er f i. . Mailing Address: mr._!. .9 ► !.r - • ir.!-r sr► vi..A, r A #)I! i a; Applicant/Agent(if different from ow er): .aJ - _ . - Telephone: 31.0-(a Y 3-347 0 Fax email: _ " Mailing Address: ,;C'.11*". ' What kind of Permit?(Check each box that applies OBuilding 0 Critical Areas Stewardship Plan - 0 Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Use) ❑Single Family 0 Garage Attached/Detached ❑Conditional Use[C(a).C(d),or C]" ❑ Manufactured Home ❑ Modular ❑Discretionary."D"or Unnamed Use Classification ❑• Change ❑Boundary Special Use(Essential Public Facilities)•* dary tine Adjustment • O Address 0 Road Approach 0 Short Plat** . 0 Home Business 0 Cottage Industry 0 Binding Site Plan" ❑Propane ❑Long Plat" ❑Sign 0 Planned Rural Residential Development(PRRD)/Amendments** O Allowed'Yes'Use Consistency Analysis 0 Plat Vacation/Alteration" . O StOrmwater Management 0 Shoreline Master Program Exemption/Permit Revisions" 0 Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** • 0 Temporary Use 0 Shoreline Management Variance ❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Forest Practices Act/Release of Sbc Year Moratorium 0 Jefferson County Shoreline Master Program Amendment May require a Pre-App!/catFon Conference ❑Tree Vegetation Request "Requires a Pro-Application Conference Please Identify any other local,state or federal permits required for this proposal,If known: ` DESIGNATION OF AGENT I hereby designate 1� � to act as my agent in matters relating to this application for permit(s). Owner SIGNATURE .. /, ul. 4 I� Al Dater 1T:_ By signing this application form,the ownertagent .,,, 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. t further agree to save,indemnity and hold harmless Jefferson County against at 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 inspectionsStaffs access and right of will be ass: ede 1 =applicant informs the County in • at the time of the applan that he or, -wail' , . not•-. - Signature: ht .e ../J_i (Alr0ii ' ,�� : c:,\O Od- The action or actions Applicant will undertake as a result of, 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)_ _nip you are In compliance with the Jefferson Coon, development code. _ •.leant acknowledges that he,she or it holds individual and non-tra = respon .1.1 ,. for adhering to and-• g with the4E f..�-r at has read this ig d it below. Signature: I A..� O. _ .i /I A/ 4 !,7./ // ("MIL.. ` Data: G:\PamilCenter\###FORMS###\DRD FORMS\Mast rPeanicApplication 5-24-08.dac Peel 1014 1`1 '3-b� Ch- k 311 2�eo tL.Ds� .o� 1 G• o0 Scc.n — ill ' • giAstft-Q- 5 .vri re) /----'Th 2 n4 fAcov '...} 01_ ic goS 0 :7\ U--------- , 0 ,_, - r C -71--• OCT 2. 4 2014 L il . -Ierv-I-1A5-2 ,1, 1 L? iTiii'r,S COUN PT TY ! c .O COMMUNITY DEVELOPMENT Ifj ! i „ II ,,,j GE-cri to 0 (.II.) 1 , t oi c) AIR FLO HEATING CO INC Page 1 of 2 • • liniWashington State Depatt„nent of Labor & industries IAIR FLO HEATING CO INC Owner or tradesperson 221 W CEDAR ST BEQUETTE, MICHAEL SEQUIM,WA 98382-3320 360-683-3901 Principals CLALLAM County BEQUETTE, MICHAEL FULLAWAY, MICHAEL BEQUETTE, MARK A, PRESIDENT BEQUETTE, SANDRA A, VICE PRESIDENT BERSON, JOEL R, SECRETARY BERSON, JOEL R, TREASURER LEVINSON, WILLIAM R, AGENT Doing business as AIR FLO HEATING CO INC WA UBI No. Business type 600 347 761 Corporation ILicense I Verify the contractor's active registration/license/certification (depending on trade)and any past violations. Electrical Contractor Active. Meets current requirements. License specialties HVAC/RFRG License no. AIRFLHC009C8 Effective—expiration 02/28/2000—02/28/2016 Designated administrator Active. BERSON,JOEL RAY Meets current requirements. License type License no. Master Electrician BERSOJR975LB Bond CBIC $4,000.00 Bond account no. si6233 Received by L&I Effective date 05/19/2010 07/06/2010 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&LIC=AIRFLHC009C8&SAW= 10/24/2014 AIR FLO HEATING CO INC Page 2 of 2 Expiration date • Until Canceled Bond history Savings No savings accounts during the previous 6 year period. License Violations Infraction no. EDORN00206 Satisfied Violation date RCWMWAC 03/28/2013 19.28.161(6)RCW Violation city Violation amount Sequim $250.00 Type of violation ELECTRICAL CITATION Description Failure of the electrical contractor to accurately verify electrical training hours on an Affidavit of Experience. 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. 351,432-00 Doing business as AIR FLO HEATING COMPANY INC. Estimated workers reported Quarter 2 of Year 2014"21 to 30 Workers" L&I account representative T1 /FEARAED FEROZE(360)902-4797-Email: FERH235 @lni.wa.gov IWorkplace 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 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&LIC=AIRFLHC009C8&SAW= 10/24/2014 Parcel Details Page 1 of 2 410 110 4 C f e s nt e . r o n u y .„, a Home County Info Departments Search Parcel Number: 001195006 SEARCH Parcel Number: 001195006 Printer Friendly Owner Mailing Address: NORA SHAPIRO TRUSTEE N SHAPIRO REVOCABLE TRUST 5761 CAPE GEORGE RD PORT TOWNSEND WA98368-9043 Site Address: 5761 CAPE GEORGE RD PORT TOWNSEND 98368 Section: 19 School District: Port Townsend (50) Qtr Section: SW1/4 Fire Dist: Chimacum (1) Township: 30N Tax Status: Taxable Range: 1W Tax Code: 0111 Planning area: Quimper (2) Sub Division: Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: DISCOVERY RIDGE DIV II PARCEL 6 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.co.j efferson.wa.us/assessors/parcel/parceldetail.asp?Parcel_NO=001195006 10/24/2014 AIR FLO HEATING COMPANY INC Page 1 of 2 • • C)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&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= 10/24/2014 AIR FLO HEATING COMPANY INC Page 2 of 2 Received by L&I 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&l Account ID Account is current. 351,432-00 Doing business as AIR FLO HEATING COMPANY INC. Estimated workers reported Quarter 2 of Year 2014"21 to 30 Workers" L&I account representative T1 /FEARAED FEROZE(360)902-4797-Email: FERH235©Ini.wa.gov IWorkplace 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 isiun ton3 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&LIC=AIRFLI*206DG&SAW= 10/24/2014 ■ esO\ c%, JEFFERSON COUNTY 2 Y;.0' DEPARTMENT OF COMMUNITY DEVELOPMENT Date: Time Received: am/pm Mon. Tue. ed. Thur. Fri. Date: BLD: 6 y - y &O Contact Name: Owner: Contact Number: 360 ?79 2_elZ'1 Address: s"1 G t L ,t„ 206 Notes: h Tt) 1 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 Block&Tile Ceiling , - • • Jefferson County Building Division Permit Number: BLD14-00400 Applicant: SHAPIRO 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 Miscellaneous 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 FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • S BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD14-00400 Received Date: 10/24/2014 SITE ADDRESS: 5761 CAPE GEORGE RD Issue Date 10/24/2014 PORT TOWNSEND, 98368 Expiration Date 10/24/2015 OWNER: NORA SHAPIRO TRUSTEE PHONE: 360-379-2424 N SHAPIRO REVOCABLE TRUST 5761 CAPE GEORGE RD PORT TOWNSEND WA 98368-9043 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001195006 Section: 19 Township: 30 N Range: 1V1 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: INSTALL NEW 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 10/24/14 151705 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 . INDIdOlJnil/Mina.)_.0 :-.171: -- r_________7 ' :• iflhi tiO k: 130 ....._. _J • 00'IL 1 mtuaad agdeqs tIOZ/ZZ/0 I Iunouly uopdp3safj aiga Idoci 2uning *op uosiaf • m Et :Jaciumm patip T T T£9 ANVdWO3 ONI.I.V3H 01A HIV JEFFERSON COUNTY 1 �. NO. 151705 ) acii DATE 101 I L) RECEIVED FROM S f I D `'O ` DESCRIPTION BARS# AMOUNT • , CURRENCY `/� E 152q °°° N'tO h 'I4 Ponet_ C OIN \ � d 0 etti- `� ec ( [ CHECK 13111 2 4 'p,„,yce 0 � `�4 I lei 5-00(0 ° li Fl�'UI(G pt) 0 , , ,..,„., , ,.. ,,,,,,, -, " ., ,, , 4.0„,,,,,,„,,,„ o , :,,,N, ii ,. ,,,,,,,.., ,,,,,v,,,,,,,,t,,,, , ,,, .,„„,,, ,,,,,,,,,:„.,,.,,, RECEIVED BY `> • _ TOTAL I *l ° 0 0 ____