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Home My WebLink AboutBLD2013-00288 416 UILDING PERMIT APPLIC AVID N BLDI3-00288 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00288 Received Date: 9/17/2013 SITE ADDRESS: 6 HERON RD PORT LUDLOW, 98365 OWNER: PETER A JOSEPH PHONE: JEANNE M JOSEPH 6 HERON RD PORT LUDLOW WA 983659300 LUDLOW BAY VILLAGE SUBDIVISION: Block: Lot: TH3 PARCEL NUMBER: 968600016 Section: 16 Township: 28 N Range: 01 E CONTRACTOR: AIR FLO HEATING COMPANY INC PHONE: 360-683-3901 221 W CEDAR SEQUIM WA 98382 Contractor's License AIRFLI*206DG Expires 4/25/2014 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP REPLACEMENT OF GAS FURNACE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION ADD'L: HEAT TYPE: GAS 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 MEB 09/17/13 145356 APPROVED PPROVED Total: $228.00 +( SEP 17 2013 Jefferson County DCD \\tidemark\data\forms\F_BLD_App_Bld.rpt 9/17/2013 4 °°�\ JEFFER4 COUNTY eA) IS .— 94? 4' . ® \N 3 DEPARTMENT OF COMMUNITY DEVELOPMENT *d 621 Sheridan Street• Port Townsend •Washington 98368 eta _ _. 360/379-4450 • 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: Proj Des ption(include separate sheets as necessary): I—In LN KHJ D R.E PI. N∎ENT 0 F GPcs F u RJi t-G Tax Parcel Number: -1U2 ap(-0O IO Property Size: (acres/square feet) Site Address and/or Directions to Property: b u.4 0...0 aal Property Owner(s)of Record: ' • "AA Telephone: 3oO - 4131- B21 g Fax: email: Mailing Address: le li Gran Pd(k (. ,ka� W,er Applicant/Agent(if different from owner): Al C CI 0 Heat t n Telephone: 31.10•°1021,ib -3A®1 Fax. to B3- acne email:t~tt�.ntat\t�-Fla aria.c.zv t ' Mailing Address: 22-% W. Cedar Si.• Sit✓Q%JLL n ,WQ 883$ ° What kind of Permit?(Check each box that applies OBuilding 0 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 ❑ Modular ❑Discretionary"D°or Unnamed Use Classification ❑ Commercial* ❑Special Use(Essential Public Facilities)** ❑ Change of Use ❑Boundary Line Adjustment ❑ Address ❑Road Approach ❑Short Plat** ❑ Home Business ❑Cottage Industry ❑Binding Site Plan** ❑ Propane ❑Long Plat** ❑Sign ❑Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration** ❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions'•"• ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development** ❑Temporary Use ❑Shoreline Management Variance ❑Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District Map Amendment ❑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 %Ir"Ft 0 }teat 1 IN3 • -. as my agent in matters relating to this application for permit(s). OW UER SIGNATURE ��J�r ' ' Date: ?--? 2.0/3 I. By signing this application form,the owner/agent aligiA 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 re• -• later inspections. Staff's access nd right of en will be assumed unless the applicant informs the County in writing at the time of the app'.- • that , or she wants .•or notice. Signature: ��i.� +w Date: • The action or actions Applicant will undertake as a ult•1 the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take'• 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 J' rson County de • ••. ••e.The Applicant acknowledges that he,she or it holds individual and non-tra r le fi= ponsibility for-,haring t• a • complying The Applicant has read this disclaimer and signs and dates it below. I Signature: - _ ■' ,1: �1r_.all! Date: -,.„9_. G:\PennitCenter\###FORMS###\DRD FORMS\Master Pemtit.Application 5-29-08.doc Contractors or Tradespeople Printer Friendly Page Page 1 of 1 • Electrical Contractor A business licensed by LEI to contract electrical work within the scope of its specialty. Electrical Contractors must maintain a surety bond or assignment of savings account.They also must have a designated Electrical Administrator or Master Electrician who is a member of the firm or a full-time supervisory employee. Business and Licensing Information Name AIR FLO HEATING CO INC UBI No. 600347761 Phone 3606833901 Status Active Address 221 W Cedar St License No. AIRFLHCOO9C8 Suite/Apt. License Type Electrical Contractor City Sequim Effective Date 2/28/2000 State WA Expiration Date 2/28/2014 Zip 983823320 Suspend Date County Clallam Specialty 1 Hvac/Rfrg Business Type Corporation Specialty 2 Unused Parent Company Master Electrician INFORMATION License BERSOJR975LB Name BERSON,JOEL RAY Status Active Business Owner Information Name Role Effective Date Expiration Date BEQUETTE,MICHAEL 01/01/1980 FULLAWAY,MICHAEL 01/01/1980 LEVINSON,WILLIAM R Agent 01/01/1980 BEQUETTE,MARK A President 01/01/1980 BERSON,JOEL R Secretary 02/12/2010 BERSON, JOEL R Treasurer 02/12/2010 BEQUETTE,SANDRA A Vice President 01/01/1980 Bond Information Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 4 CBIC si6233 07/06/2010 Until Cancelled $4,000.00 05/19/2010 2 COLONIAL AM CAS& LPM4054452 07/06/2001 Until Cancelled 08/21/2010 $4,000.00 07/18/2001 SURETY OF MD Assignment of Savings Information No records found for the previous 6 year period Insurance Information No records found for the previous 6 year period Summons/Complaint Information Summons and Complaints are not filed with the department for this contractor type Warrant Information Warrants are not filed with the department for this contractor type Infractions/Citations Information Infraction/Citation Date RCW Code Type Status Violation Amount EDORN00206 3/28/2013 19.28.161(6)RCW ELECTRICAL CITATION Satisfied $250.00 https://fortress.wa.gov/lni/bbip/Print.aspx 9/17/2013 • a Gas fv4)w - GPI ti-creo OldijeA • C(‘/I Ø14/ ! 70 / AIR FLO HEATING COMPANY CIlk Number: 41248 41248 Jefferson County Building Department Date Description Amount 09/11/2013 Permit for Joseph 228.00 • - .:. - --: :.-. .,-;,ISL'•:."4:-7- ---36.-v.-,Arr.- . Pagelft. t,-.7.44- • . - .-. .,.,44„ -z• ----,.. -,,::: AP " - - . - . t.t:, . -$:i: • pm - Date j_____11/1 ______"2—q -time received .v Mon. Tue .. _Wed; 0- BUD: t _. .1:: Date: OWNER: Contact Name Ole : V ADDRESS: \ - a ' -4-46- Contact Number:300 Z.„--k - 206 . fi- Notes: • ' . .Foundation Plumbing - Framing . Propane Tank Mechanical i,- - Setbacks Under-ground Framing under ground Furnace Footing Rough in Air seal Above ground Gas _ Stemwall _ Hydronic Exterior shear Exterior lines • Oil Straps Interior shear Interior lines , Ducts I , -,--- Post Hole • Ventilation Appliance ••Underfloor _ Gas/wood stove Man-Homes . . Setbacks , Insulation. - Final Inspection >b Foundation- • Block&Tte — " floor wall ceiling Address Posted .0 • 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#: BLD13-00288 Received Date 9/17/2013 SITE ADDRESS: 6 HERON RD Issue Date 9/17/2013 PORT LUDLOW, 98365 APPLICANT: PETER A JOSEPH PHONE: JEANNE M JOSEPH 6 HERON RD PORT LUDLOW WA 983659300 TH3 SUBDIVISION: LUDLOW BAY VILLAGE Block: Lot: PARCEL NUMBER: 968600016 Section: 16 Township: 28N Range: 01E CONTRACTOR: AIR FLO HEATING COMPANY INC PHONE: 360-683-3901 221 W CEDAR SEQUIM WA 98382 Contractor's License AIRFLI*206DG Expires 4/25/2014 OWNER, PETER A JOSEPH PHONE: if different: JEANNE M JOSEPH 6 HERON RD PORT LUDLOW WA 983659300 PROJECT DESCRIPTION: REPLACEMENT OF GAS FURNACE Directions 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 9/17/2014. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: ) D°� 1'5 t 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 9/17/2013 JEFFERSON COUNTY *lb NO. 1356 DATE 11/1"1/((.3 RECEIVED FROM AkNr b-�� 1 DESCRIPTION BARS# AMOUNT CURRENCY i/ i7/tf -r : ' COIN e Li[ 214 aiP , c o RECEIVED BY TOTAL , 2-2-t' `