HomeMy WebLinkAboutBLD2013-00286 .UILDING PERMIT APPLICAtON BR evie3-0w 02p86
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD13-00286 Received Date: 9/17/2013
SITE ADDRESS: 701 SEAL ROCK RD
BRINNON, 98320
OWNER: RONALD S SPENCER PHONE:
SUSAN M SPENCER
701 SEAL ROCK RD
BRINNON WA 983209730
SUBDIVISION: Block: Lot: T 27+
PARCEL NUMBER: 602264022 Section: 26 Township: 26 N Range: 02 W
CONTRACTOR: PENINSULA HEAT INC PHONE: 457-2775
782 KITCHEN-DICK RD
SEQUIM WA 98382
Contractor's License PENINH1005DB Expires 3/2/2010
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION INSTALL NEW DUCTLESS 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: EEE
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 09/17/13 145363 /�
Total: $152.00 APPROVED
SEP 17 2013
Jefferson County DCD
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CERTIFICATE OF OCCUPANCY
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
(360)379-4450 FAX(360)379-4451
Carl Smith, Director/Building Official
PERMIT#: BLD13-00286
SITE ADDRESS: 701 SEAL ROCK RD# Issue Date: 09/17/2013
BRINNON, 98320 Final Date: 9/18/2013
APPLICANT: RONALD S SPENCER PHONE:
SUSAN M SPENCER
701 SEAL ROCK RD
BRINNON WA 983209730
SUBDIVISION: Block: Lot: T 27+
PARCEL NUMBER: 602264022 Section: 26 Township: 26 N Range: 02 W
PROJECT DESCRIPTION: INSTALL NEW DUCTLESS HEAT PUMP
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2012
EDITION.
OCCUPANCY GROUP:
TYPE OF CONSTRUCTION:
SPRINKLER SYSTEM yes no
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 9/18/2013
\\tidemark\data\forms\F_BLD_Occupancy.rpt 10/8/2013
Contractors or Tradespeople Peter Friendly Page • Page 1 of 1
Electrical Contractor
A business licensed by MI 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 PENINSULA HEAT INC UBI No. 601737680
Phone 3606813333 Status Active
Address 782 Kitchen-Dick Rd License No. PENINHI005DB
Suite/Apt. License Type Electrical Contractor
City Sequim Effective Date 3/2/2000
State WA Expiration Date 3/2/2014
Zip 98382 Suspend Date
County Clallam Specialty 1 Hvac/Rfrg
Business Type Corporation Specialty 2 Unused
Parent Company
Electrical Administrator INFORMATION
License LOFSTKJ951 CC
Name LOFSTROM, KENNETH J
Status Active
Business Owner Information
Name I Role Effective Date Expiration Date
LOFSTROM, KENNETH J 01/01/1980
LOFSTROM,MARY 01/01/1980
ANDERSON,CHARLOTTE Agent 01/01/1980
Bond Information
Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date
1 CBIC SC6801 02/28/2000 Until Cancelled $4,000.00
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
EMEHU03252 3/18/2010 19.28.271 RCW ELECTRICAL CITATION Satisfied $250.00
EMITP00298 11/7/2011 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00
https://fortress.wa.gov/lni/bbip/Print.aspx 9/17/2013
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621 Sheridan Steet I Pod Townsend,WA:.; 1.*: I Web .21/12i.61,4§1t9
Tel Wiel 379.4450 1 Fax 360379 4461 1 Emil d4.•,it**,OfferSOR Wa us
= .3$, •■Permits&Inspeditral Developtnere Coniseency Review 1 Lang Range Planning'Waterhed&math*Amaze Center
Master Permit Application MLA:
Project Dedcripeon(include semi**sheiks as ncssary):
kale ilaf Pviy
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T.Parel Numb* O// 0 461416, Atees4ory
Property size: * 7 c (acresietwere feet)
Site Address andror Demeans to Property /
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Property Owner(*) . Record: i: /0 A,— .., .a _. -
Telephone: A!.#- * ". xi . Fax: *nen:
- '
Meeting Address: fl ' 4Ir.., , .,,, i/town I.lotitr'
AppliberdlAgent(If different from owner):
Telephone: Fax: emelt
Medina Addles*
What kind of Pim*?(Check each box that apples 0 Lot or Road Segregation
01:killtdig 0 Cralcal Areas Stewardship Plan
O DemoNtion Permit 0 Veriteice(Mbhx„Major or Reasonable Economic Use)
3 Single Foley 0 Garage Attached i Detached 0 Genetics's'Use[CM).C(d),or q**
3 Menuhictwed Home 0 WWI* 0 Discretionary"D"or Unnamed Use Clasellicedion
O Commercial• fr"Pt ft 0 Spoil:WU.°(Essential Pub( Famed's)**
O Change cf Use 0 Boundary Une**Mine*
3 Address 0 Road Approach 0 Short Plat**
0 Home&sinew 0 Cottage Industry 0 Bire*ig Site Plan** ,
0 Pmpene 0 Long Plat"
0 Sign 0 Rimed Far*Residential Development(PRRnyAmenchnents
0 Mowed Yes-Use Conehtency Analysts 0 Plat vacetbniAlteration"
3 Slonweeder Management 0 Shored*Wm*Program Exemption/Pernik Fie/dims**
0 Sae Plan Approval Mimeo Detrambetkin(SPAAD)* 0 Shorties***game*Substteithe Development**
0 Temporary Use 0 Shore**Management Viviano)
0 Wireless Talecommuntation* 0 Comprehensive PirmliAt/CA.ond Use Distrtt Map Amendment
0 Forest Practices Act/Release al Stx.Yew Moratorium 0 Jefferson County Shore**Mader Program Amendment
nay swam•Pre–Itaalleadoe CcurAttence 0 Tree Vegetadon Rodent
–Ratimnat a PreApplicartian Canamence
Please identify any other local,stele or federal pentete requked br this proposal,W known:
ClISKRIATION OF AGENT
I hereby ftsignate a , i °, .1., '44.1 to act es my agent WI matters relating to this application for parrot(s). ,
OWNER SIGNATURE r11■40. 1 -A__j -----------
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Debt ear .47 ASP...
By swing the apinication form ■ ownseiment attests that the informenon pronded herein,and in my attachments,e true and correct to the best d
his her or its knowledge, Any'Merin falsehood or are omission ce a material fad made by the ormerragent with respect to the&Widen packet
may resue mitts pemill being nut and void.
I Anther agree to save,indemnity and hold rumness Jefferson County agairst at liabrabes judgments court cons,reasonable Money's tees and
• menses which may ii any way act:Tiresome Jefferson County as a resie of or in consequirice tithe granting ce this point.
I Other agree to proven access and '., of entry to Jefferson County and is eneloyees,represereatves or agents forts sole;expose or applicetion
review and my .... ' ;1,. - vi-.L..i access and night of entry wit be assumed'Mess the applicant informs County in earflap at the
bine ci the. ,. ..., :.07 . cr*le 's for nohow. A -,
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_ . Date: i# ° 4/
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The action or actions Apple:ant;et undertake as a mud d the essumice d this permit may negatively mead upon one or more threatened or
endangered species and could teed to a pobarstre lake'of en endangered species as three teems are denied in the federal law known as the
'EN:Migrated Species ACt.or ESA. Jefferson County makes no assurances to the applicant that the actions that vet be undertaken because tins
PM*has been issued ml riot violate; ,ESA My ndividuat,grow)or agency can fie a lawsuit on behalf of an endangered spades regareng your
'dice(s)even(you = .. .- , .,;-'''' 1 the Jefferson Courts development code The Applicare acknowledges eel he.she and holds mdrvidual
and novt--. -= -. ..„..-.111!. skitey*.-' .to end complying i‘nh the ESA The Appkat has read this ..--.,4, ;0,-77 -:,.. , :Iles 1 below
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signature di / .46-, Dale: rir° a
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The sour of then steeee1Twnt does hereby certify that trey are the Owners d the parcel referenced hewn,that they are not teamed contractors and that
they aria be assurnerg the resporiebity tithe GOWNE11 Contractor fa the proposed pica t
GENERAL*Nurture Date
CONTRACTOR OR MANUF t3RED HOME INSTALLER: NONE; FAX:
I _ �e- � . r (go rd
MuNGA „ 17+ .,,,,- ► LrJ i ri
CONTRACT 'S License
*VANS
NurdiER: PEN 1,, 'I ir elilt9til WIRIER
ARCHITECTIEN R: PHONE ( ) FAX:( )
MAUNG ADDRESS:
Project Type: Promo Type: Shaming,: Two of Sewage :
New Wood Exiting: Sew
Addition Steel Proposed: Banc Carmitmky System
Alteratirmliwnodid Concrete Total: Individual
Repslr Masonry Bedroom: Weber Permit*
Derno hion ': B BeiWeber
Setback: Private will Two Party
Proposed: Attic
%elm. lkifp
wit, Total: Name of System:
Nunew of C Number of AIM Puking Spaces:
Number of occupants(. owners,%omits,employees,etc) Contrail
IBC Occupancy: IBC Type of c cep. WS you haw Food Servicer? ygg 1. !
1 L, t.:_ •Li',', ;1. 1' _.. L'hL:;... _ — si;.a i i :_t{:.I "...AM. (i. L. Li.u, %.l"a« '7.:is ....k.
Underground Twit Above ground tank Size of Propane Tar ic:
Host Stove Cook Stove Woodstove Replace neon i evriSteSeP t knaT re taW toH I
When appiyhtg!bra permit to instal a promote/art yet must also submit a site plan showMg allot the Makings,at propf
Ores,tat* n from the to if o and septic
krokriling the reserve arm
• Current • .. • For Mar Use.. Amara* Reulaker
Mein Floor Herted EH APP Ft.14"7 1111111111111111111111111
tliaiaIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
IIIIIIIIII t]Mwr Base :
k"te
Hexed Basement 11111 Ram Check tee:
Unheated Basement State Surcharge fee:
Other Unheated Few m ru�r�s1 _
SUBTOTAL IMMIIIIIIIIM
Decks III 911/Rd Approach fee
Odtter TOTAL: ; $ i 5- .a i
SWUM • COST( ) Date:
Oliva Immo vOkoo of at tabor tvatonas trunderen to bosh
0-.`24 2013
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Date Ct4# time received am 1 pm Mon. Tues'. . ed- Thur. --Fri.
BED: , , _2... ,(. . Date:
•
OWNER: Contact Namer.
ADDRESS: "1 0 t.. 5.c. . c...." e-- Contact Number.360 .
- - 206
Notes: . k„,\..e.cj
•
Foundation *Plumbing - Framing" • Propane Tank Mechanical -. •
---- . ...
. - .
Setbacks Under-ground Framing Under ground Furnace -
Footing _ Rough in Alr seal • Above ground Gas
Stemwall Hydronic Exterior shear Exterior lines Oil
• _
Straps _____ Interior shear Interior lines . Ducts
Post Hole Ventilation Appliance•Underfloor .. Gas/wood stove
Man-Homes
Setbacks • Insulation. . Final Inspection
• --;r
Foundation- .
Block&1-re • floor _wall ceiling. Address Posted
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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#: BLD13-00286 Received Date 9/17/2013
SITE ADDRESS: 701 SEAL ROCK RD Issue Date 9/17/2013
BRINNON, 98320
APPLICANT: RONALD S SPENCER PHONE:
SUSAN M SPENCER
701 SEAL ROCK RD
BRINNON WA 983209730 T 27+
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 602264022 Section: 26 Township: 26N Range: 02W
CONTRACTOR: PENINSULA HEAT INC PHONE: 457-2775
782 KITCHEN-DICK RD
SEQUIM WA 98382
Contractor's License PENINHI005DB Expires 3/2/2014
OWNER, RONALD S SPENCER PHONE:
if different: SUSAN M SPENCER
701 SEAL ROCK RD
BRINNON WA 983209730
PROJECT DESCRIPTION: INSTALL NEW 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 9/17/2014.
REQUIRED INSPECTIONS:
Tank/Line/Appliance: OFD e/sA5 fr
FinalApproval: a
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