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Home My WebLink AboutBLD2013-00309 IRUILDING PERMIT APPLICA•N BRLD13-003309 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00309 Received Date: 10/2/2013 SITE ADDRESS: 617 PINECREST DR# PORT TOWNSEND, 98368 OWNER: EUGENE L TENNEY PHONE: 360-379-0209 KAREN B TENNEY 617 PINECREST DR PORT TOWNSEND WA 983682511 KALA POINT#7 SUBDIVISION: Block: Lot: 407 PARCEL NUMBER: 965000265 Section: 27 Township: 30 N Range: 01 W 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 DESCRIPTION INSTALL HEAT PUMP SYSTEM 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 $228.00 MEB 10/02/13 145420 /� PP®®VE® Total: $228.00 /�'i G� OCT 0 3 2013 Jefferson County DCD \\+irlcmarWrle+e\fnrme\G RI n Ann PIA rn+ Iniwn1Q illUILDING PERMIT APPLICA•N BRLD13-003309 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00309 Received Date: 10/2/2013 SITE ADDRESS: 617 PINECREST DR# PORT TOWNSEND, 98368 OWNER: EUGENE L TENNEY PHONE: 360-379-0209 KAREN B TENNEY 617 PINECREST DR PORT TOWNSEND WA 983682511 KALA POINT#7 SUBDIVISION: Block: Lot: 407 PARCEL NUMBER: 965000265 Section: 27 Township: 30 N Range: 01 W 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 DESCRIPTIOI INSTALL HEAT PUMP SYSTEM 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 $228.00 MEB 10/02/13 145420 APPROVED $228.00 OCT 0 3 2013 Jefferson County DCD \\+irlcmerle\rh+o\fnrme\C Rl n Ann PIrt rn+ Innmniz BUILDING PERMIT APPLICA N BLD 09 Reviee w w T Typype: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00309 Received Date: 10/2/2013 SITE ADDRESS: 617 PINECREST DR# PORT TOWNSEND, 98368 OWNER: EUGENE L TENNEY PHONE: 360-379-0209 KAREN B TENNEY 617 PINECREST DR PORT TOWNSEND WA 983682511 KALA POINT#7 SUBDIVISION: Block: Lot: 407 PARCEL NUMBER: 965000265 Section: 27 Township: 30 N Range: 01 W 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 DESCRIPTIOr INSTALL HEAT PUMP SYSTEM 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 $228.00 MEB 10/02/13 145420 Total: $228.00 APPROVED OCT 032013 Jefferson County DCD 1\4irlcmer41rlofo\4nrmc\G RI 11 Ann Rlrl ml 1(1Y2Y)11•1 Contractors or Tradespeople Priier 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 Datel 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 $250.00 https://fortress.wa.gov/lni/bbip/Print.aspx 10/3/2013 0 • CC CO H 07 co C3 LL ,- _o Z LL. � O I-1 O CO H � O O .. .. 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CO -- -- 0 a) 1- I- x cF I- co m 4- x * 1.- JEFFERSON COUNTY No. 4 20 DATE tV`2 13 RECEIVED FROM ir lv f[Z4 ( ) DESCRIPTION BARS# AMOUNT CURRENCY 4fr coo COIN 0 CH CKS C1 0 ic 4,4 c: RECEIVED BY �ti�= ' TOTAL ?/ y , g,4az�r , 611/D1 -2\ ,V lerN 6, JEFFERN COUNTY r�1 DEPARTMENT OF COMQAUNITY DEVELOPMENT *d 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 . 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment I# Master Permit Application MLA: Project Description(include separate sheets as necessary): LKsTA L . bowl- P w M P S'(sTE.M Tax Parcel Number: CI(e,500oaLO 5 Property Size: (acres/square feet) Site Address and/or Directions to Property.: (oil pi n GCre st� Dims. Cbct- Tu—mse.ry ,w f ct d"3( Zr Property Owner(s)of Record: E t)$e , "T42..t\t∎e st..t .7 Telephone: 3161 - OaOCi Fax: J email: Mailing Address: ..0. 1 Pt.n Q.0 re- Dr , PO& �,$3 e Applicant/Agent(if different from owner): Al r F1 o 1-teaar rty Telephone: 3taO-Web"-6°41 Fax: h83- 3arie email:Cite r1ea1r"•'�10be'ak11t.CANy Mailing Address: 2.2.1 Vy• Cedar St• c e.IN , 1:24, cesses What kind of Permit?(Check each box that applies DBuilding ❑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 CI" ❑ 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 0 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)• 0 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 • I r �*ke�"t In- to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE -L`_...AIL... Date: J— 2_6 --15 By signing this application form,the owner/agent attests that the ormation 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 ponsequence 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 er inspections. Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the time of the apron ,e, e = he 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-tra rails ponpility for adhering to and complying with the ESA. The Applicant has read this died • er and igne and dates it below. Signature: `-.,�_� Date: 9ZU 1 /" ll G:\PemiitCenter\###FORMS###\DM)FORMS\Master Permit Application 5-29-08.doc • I z _ m r 1 , t � 0 a 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#: BLD13-00309 Received Date 10/2/2013 SITE ADDRESS: 617 PINECREST DR# Issue Date 10/3/2013 PORT TOWNSEND, 98368 APPLICANT: EUGENE L TENNEY PHONE: 360-379-0209 KAREN B TENNEY 617 PINECREST DR PORT TOWNSEND WA 983682511 407 SUBDIVISION: KALA POINT#7 Block: Lot: PARCEL NUMBER: 965000265 Section: 27 Township: 30N Range: 01W 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, EUGENE L TENNEY PHONE: 360-379-0209 if different: KAREN B TENNEY 617 PINECREST DR PORT TOWNSEND WA 983682511 PROJECT DESCRIPTION: INSTALL HEAT PUMP SYSTEM 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 10/3/2014. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval. It) 1`l1' l 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 10/3/2013 1