HomeMy WebLinkAboutBLD2013-00304 BLD13-00304
BUILDING PERMIT APPLICAAN Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD13-00304 Received Date: 10/1/2013
SITE ADDRESS: 472 ROSE POINT DR
QUILCENE, 98376
OWNER: ERIC EVANS PHONE:
JON/JAY EVANS
2636 11TH AVE E
SEATTLE WA 981023903 FISHERMANS POINT
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 951700004 Section: 31 Township: 27 N Range: 01 W
CONTRACTOR: PENINSULA HEAT INC PHONE: 360-681-3333
PO BOX 173
CARLSBORG WA 98324
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOr INSTALL DUCTLESS HEAT PUMP
TYPE OF WORK RES 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 MEB 09/26/13 145401 APPROVED
Total: $152.00
OCT 01 2013
Jefferson County DCD
Wirlomor44\rlefe\forme\F RI 11 Ann PIA rn+ I n/9 iln9 R
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Date /) i 4 time rece _ived .g:OO C) pm Mon. 1 We el, Thur. --Fri.
BLD: , 13 — 00-364- . Date: AOP 5 .
OWNER: E"' 5 - - Contact Name
-
ADDRESS: y7z, Lse 321 VE- 0011-- Contact Number.360 4,g-1-33g3
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Notes: 206-1)wct L.'s 5 S 145./. .
- .
Foundation Plumbing - Framing . Propane Tank Mechanical - •
Setbacks __ Under-ground Framing Undeiground . Furnace
Footing Rough in Alr seal Above ground Gas
—
Stemwall Hydronic Exterior shear Exterior lines Oil
Straps Interior shear Interior lines . Ducts 4"
--.---
Post Hole Ventilation Appliance
Underfloor _ Gas/wood stove
Man-Homes - -
Setbacks - Insulation V Final Inspection
Foundation i.s.s
- - ,,
Block&Tie floor _wall ceiling. . Address Posted
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Contractors or Tradespeople Pi,Friendly Page
• Page 1 of 1
General/Specialty Contractor
A business registered as a construction contractor with L81 to perform construction work within the scope of
its specialty.A General or Specialty construction Contractor must maintain a surety bond or assignment of
account and carry general liability insurance.
Business and Licensing Information
Name PENINSULA HEAT INC UBI No. 601737680
Phone 3606813333 Status Active
Address Po Box 173 License No. PENINI*0440W
Suite/Apt. License Type Construction Contractor
City Carlsborg Effective Date 9/16/1996
State WA Expiration Date 10/18/2014
Zip 98324 Suspend Date
County Clallam Specialty 1 General
Business Type Corporation Specialty 2 Unused
Parent Company
Business Owner Information
Name Role Effective Date Expiration Date
LOFSTROM, KENNETH JOHN President 01/01/1980
LOFSTROM,MARY E Secretary 01/01/1980
Bond Information
Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date.Impaired Date Bond Amount Received Date
2 CBIC SA4812 09/16/2001 Until Cancelled $12,000.0007/02/2001
Assignment of Savings Information No records found for the previous 6 year period
Insurance Information
Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date
17 Ohio Security BKS 55013351 04/26/2013 04/26/2014 $1,000,000.0003/29/2013
Ins Co
16 Ohio Security BKS55013351 04/26/2012 04/26/2013 $1,000,000.0004/20/2012
Ins Co
15 Continental CWP2928683 04/26/2011 04/26/2012 $1,000,000.0004/18/2011
Western Ins Co
14 North Pacific C07163306 04/26/2011 04/26/2012 $1,000,000.0003/24/2011
Ins Co
13 NORTH PACIFIC C06163306 04/26/2010 04/26/2011 $1,000,000.0004/23/2010
INS CO
12 NORTH PACIFIC C05163306 04/26/2007 04/26/2010 x$1,000,000.0003/27/2009
INS CO
Summons/Complaint Information No unsatisfied complaints on file within prior 6 year period
Warrant Information No unsatisfied warrants on file within prior 6 year period
Infractions/Citations Information No records found for the previous 6 year period
https://fortress.wa.gov/lni/bbip/Print.aspx 10/1/2013
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,r JEFFERSo N ( OU T\
r`, DEPARTMENT OF COMMUNITY DEVELOPMENT
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Master Permit Application MLA: __ __
Project Descrtpbon(include separate sheetS as necessary).
TrYtiiQ.ti. 1)u.e -I ss I 4- k m
ran Parcel Number. q 5 f 'TooQ 01- property Size: iacresractuare feet}
Site Address anq'or Directions to Property
2. RS - 4i rr d.i_Qa-acene.-- :_4£3__x._._Pro Own s of Record: ,TON k A MS
"aiephone: 204-314 l R/21 Fax: . �� email: �t•t.oMh
Mating Address' .203(• Ai/e +4• e NCr.. ,BJ O
ApplicantlA ent(if different from owner): r t
, cv++,
Telephone: &&•••4745 l ' 3 _ =air.3,G_ -"20f00 . email:
Mating Address?.G.(34X 1/5 4 Cascl£Jakan i Ialir.A• elf—if
What kind of Permit?(Check each box that applies 2:Lot or Road Segregation
Bullotng 2 Critical Areas Stewardship Plan
Demoirtion Permit L..Variance Winer.Major or Reasonable Ecanomtc Use)
Single Family -Garage Attached,Detached -Conditional Use pc.CO?.or CI""
m
Manufactured,-lame 7... Modular Discretionary,D_or Lnnamed Use Classification
Commercial' Special use(Essential Public Facilities)"
:= Change of Use 7 Boundary Una Adjustment
_ Address =Roao Approach Z Snort Plat
--home Business L Cottage industry 7:Binding She Plan
^Sign U S ' ''k PiLong ed Rural Residential Development iPRRDifAmendments"
Allowed"Yes'Use ConsitencyAnatysis Plat Vaeation/Atteraticn"
._
Stormwater Management _Shoreline Master Program Exemption/Permit Revisions'"
_Site Plan Approval Advance Ceserm(natton(SP.AAD1" 7 Shoreline Management Substantial Devi opment"
Temporary Use -Shoreline Management Variance
"• .recess Telecommunication' 7 Comprehensive PianrUDCrLand Use District Map Amendment
_: artiest Practices Act:Release of Six-Year Moratorium Jefferson County Shoreline Master Program Amendment
'May require a Pre—Application Conference _Tree Vegetation Request
••pe.LN+esAPnh urarwnConleroMee
Please identify any other local,state or federal permits required for this proposal,if known:
0I Ol ,4 i ESIGNATION OF AGENT
I nereby aesignete I` t�S to act as my agent in matters relating to this pp(Icartivn ter perm tits I.
p.;itc scaly _Ke '�_ Date: 7—� II 3
i s.gi'Mg thtc ap Mat `c-m,the cadet agent attests that the ntrlmation orcvndeo hetei'r,and rr.any Mtacments.is true ano correct to the Pest '
M,< ^or rr 45 kr.cratedjd'_ Any 1aterai'a'-cehcrxi or any ern ss in is a matertat fact mesa o'y the ownei.,'ateent utt'r respect to:his appication packet
may re s:;R in its pe'm t 'ng aN an t Yrntt
t amen atpett to save. n A_;and horn harmless Jefferson Courts aaairtsi at oat:sties,pudgrr+enta coin:casts reasonable atto-ney s lees arKi
-.rt?ds.4 wh'Cr1 ire r anti was accrue son r>st Jefferson County as a result 1 or to cixtsectoence c(the granvno`3t tras perrn4.
1;nhe,agicex to trevide ec r e"i d nghl'I Lrtr(t:0 Jettelson County and is ernuloYee5 retxesentatives or agents for then.yore purpose of appacahcr I
...,..-1e:e and arty P.C.1,No'lir it 4-:a'itns .ah s access and right of entry we be asswttr.r unless the applicant inic,rrrsrecouniy in Ww.mgattt'e
MTe ill Cne appk!atlar,It it he t � ittlti';�;c(
� Date 't
,
l; a!ote _ _
7`•8€Cf.U0 ur alt-ell Acv- ant wri undertake as a res,JC t!the nsuarrce t.!this perm t may neg -ei mpact upon one of more:htealerreu or
ttnyteed spe e e c Id is to a potential table'of an enaargersd species as thOO teats df4 ieft,ee tn the fetletat ail'knOWt as tt,e #
Erdanaered Spec.es Ad E le"er9em CCUnt+ask s no asrutances to the applicant that the actions the at be unic akert besau'e th,s i
cirri has been sst.e.i A it r. i Inc ESA Any indrrtthral Grotto or agency can file a ians:nt cn t,-hart of an en3angeted species•egatd:no sow
act Cris!ever if you area n cmpt,:, 'an the.e4tarson Cot.n:f ieeein(Kn�^�ertt code The Aco4rcaiti ac 'r ntedjes the its she Oct;lints.flCte h,al
and pit=tats' ail.e-e5):C is,te r • • rd in and r. rh the ESA Inc Appin:ar"t has"end this dr;Ciaai of raj.,.g 5 and dates Rte tit�r (
;V G'tn rirs,'F '.MtY'. ‘, � f �_-.}.—... I.
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_______,
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BUILDER STATEMENT
-.e;tom./of!it..t41emeir does hcreLvv cctitt Mat:ne4 3J0tfeOwners d:NI t a(J !t#ar it,:. herein teat tneq arc^rot k:e,,DNS",contr o5 an Ma/
'le.tmo t a5s4n t:;trn respon5ld:R:of 'Tara'C7n:facto(fot,op piuts,*a:dc ct
E.gnatur- -- �' owe 9 2-8 I0
3Ettt.. LC)t' uROR MAN JFAt;L.tI Hpr'aIr.$TA1LER- P a,E: FkY.
t'!.�S}�L_` OA t Ch. ( ) bfs 1-3335 5.4)b_ (-? 3.
,.i4 .rrA `� pc.kkigii3 4Lr{5Lw t o EFJ.w{.. ttl titsttia 4.4.0 e.
,,:`.T^...1','s , �e �= _ _ WANNS
A4C.,-Tt r E'{i_.s EEG._ P,Otit I , Fes-( I
rr;AJD■E9S: 1=L4AIL
Project Type: Frame Type: i Bathrooms: Shoreline: Type of Sewago Disposal:
New Wooc Existing Sewer
Adeition Steel Proposed' Bank Community System
Alteratlon;Rernodei Concrete Total Heigra individual System
Repair Masonry SEP Permit*
Bedrooms:
Demalifian Other ; Water Supply:
Existing: Setback Private well Two Party
p
r� •of Heat: Proposed. Public
Vtie-'T LE ti.5 H P. ' Toter Name of System:
delis Is a Commercial Protect you must answer the toltr fnq:
Number of Parking Spaces Current: Proposed: Ntsnber of ADA Parking Spaces:
Number of occupants tinciudes owners.tenan s,employees,etc) Current Proposed
IBC Occupancy. IBC Type of construction: Will you have Food Service? Yes . Np j
If , i is _ .u.• ne Tank and/or - i - •a:tion ILL 1 I.a, c it. .:.ow >_i
unoerground Tank Above ground tank Size of Propane Tern
Heat Stove Cook Stove JVoodstove Fireplace nse►t __rehtO r evotS teileP i kna a retaW toH + I
Is thls appliance being Installed yt a Manufactured t Mobile noire? Yes i No
When applying for a permit to install a propene tank you must also submit a site plan showing all of the buildings,at property
lines, tank location and size,distances from the propane tank to at property lines,buildings and septic system components,
including the reserve area.
Square Footage Current Proposed i For Office Use Only Amount Revision
main Glaor Heated f EH Bid App Review.
2"'Flow Ideated , Consistency Review
Other Heated ,._
9ase fee;
Mezzanine Additional Section: I
Heated Basement Plan Check fee
I _
Jnheated Basement 1 State Surcharge fee: -
Omer Unheated Pot Water Review fee' _
Garage'Carport SUBTOTAL . _______L■
Decks 91 limb Approach fee: -
Other
TOTAL: g
' Receipt.Number; z —1 (,��1
I Gaeh/Check Number: 'A —'
i ! ��vl
ESTIMATEA COST(REQUIRED) Doti:
Y1��
0:4.r;Tal#:va'kr, I BY Wy-and ?elevols foundaro r�Arrsh
Initials:
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#: BLD13-00304 Received Date 10/1/2013
SITE ADDRESS: 472 ROSE POINT DR Issue Date 10/1/2013
QUILCENE, 98376
APPLICANT: ERIC EVANS PHONE:
JON/JAY EVANS
2636 11TH AVE E
SEATTLE WA 981023903
SUBDIVISION: FISHERMANS POINT Block: Lot:
PARCEL NUMBER: 951700004 Section: 31 Township: 27N Range: 01W
CONTRACTOR: PENINSULA HEAT INC PHONE: 360-681-3333
PO BOX 173
CARLSBORG WA 98324
OWNER, ERIC EVANS PHONE:
if different: JON/JAY EVANS
2636 11TH AVE E
SEATTLE WA 981023903
PROJECT DESCRIPTION: INSTALL DUCTLESS HEAT PUMP
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 10/1/2014.
REQUIRED INSPECTIONS:
Tank/Line/Appliance:
FinalApproval: 10-I V
r
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 10/1/2013