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Home My WebLink AboutBLD2014-00440 - MECHANICAL BUILDING PERMIT APPLICSON BLD14-00440 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00440 Received Date: 11/24/2014 SITE ADDRESS: 53 SEAWAY PL PORT LUDLOW, 98365 OWNER: ALICE HAZARD PHONE: 360-437-4114 53 SEAWAY PL PORT LUDLOW WA 98365-8751 9987 SUBDIVISION: Block: Lot: PARCEL NUMBER: 998700060 Section: 21 Township: 28 N Range: 1E 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 DESCRIPTION MECHANICAL PERMIT 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 11/24/14 153872 APPROVED Total: $152.00 NOV 2 4 2014 Jefferson County DCD \\tidemark\data\forms\F_BLD_App_Bld.rpt 11/24/2014 ON . 4�5 Co DEPARTMENT M N�I OF CC)1�1MIJNITY DES'E�:I,OPMEi`v'I' '� (E,,2"; ti- 1 d ;7;rc ° r: Ecz i _h,cAI\ 1.'), iG�s r__:_,) 7_,...„..; (...._. 1 E.;, _ vs\ /.7 Fr_._, \� t '1 a cc w c,. "nt''`c, 1 _ .:eat -- ._.W_ -- 71 NCs I-)i MECHANICAL PERMIT APPLIC it4 - -- --1:---- _ _ FLr; cotrdrY Steps in the Permit Process: -'- fl i 'OMMIJN!TY DEyfr!_OPMENT f -Review required submittal items to ensure all information is completed prior to submitting application. -Mechanical Permits can be mailed into our office-and do not require an appointment. -Fees are due at time of submittal, Mechanical permits are generally issued within 5 business days. -for Department UOnly . iiecelpt It Date 'IkeJat t$A licatiort 'p; ,..,,. aYM Is this application for use in a Mobile/Manufactured Home? * If Yes: A permit from Washington State Department of Labor and Industries, not Jefferson County, is required for appliances installed within a mobile/manufactured home. L&I -360-417-2702 * If No: Complete this form and make an appointment to submit to Jefferson County Permit Tech 360-379-4450 R ed Submiittal lte s.-fc r,p�pane tank only — General Site plan—showing propane tank, lines,and distance from tank to all existing structures. j Require4b iitt i items for solar F,tanei ine40-fion©TI9t .. _ . ... ,..m .,z,. _ Complete first page and signature block only of Mechanical Permit Application. A complete solar panel supplemental application. Site#ttforar _. Assessor Tax Parcel Number: 99 $7 OOO 6 0 Site Address and/or Directions to Property:?J«I.,n.ba1 J0 TT-.A (4,6_24., ow 4,,, �0 Sr+.N+67 Pk ,5-3 S-e j J/e -/ "RD.11.-/oc/%,.v Access (name of street(s)from which access will be gained: 7;4/ /,•dc. 44- -P v (..-e. Ant-, /Lt Description of Work: gaff&Lc_ encs-k_, t4-ea.+ PwAT 00 l kt c•r te-, ,c TT".--e- (4-P Name: l4 I;c L /1a.zacd ; Address: �3 Seucw&c f/a cc "Poe 1-- /ud/ow A.>A- cip Phone #: 360 - `437- //'/ E-mail Address: /u4. zu Please contact Auth. ized A entie resentative with project info. - - Property Owner Signature: / i• p Y g ,lI. _ 1,'/. /"A ,_. Date: g ' r Applicant/Contractor Autho 'iized Agent/Re rase at>ve Name: /9r)- EA /ica74),G, — ems/ ie. 3e0.--5.••J Phone#: 34o- 38.x'-S3Jsy E-mail Address: j/tj/.krFro 1/Je.A License #: i9-I2/ I if Z© 6 VG Expiration Date: y/LS/zo t G Mechanical Application 1 • Heat Source Electric Heating Oil Propane* iNoo,4`''' 1 9 L L �� ni �Iir\," indicate Quantity and Fixture T e5 Be�aaivv � "--41"-repane is Prohibited in ( uantity... •ixct ire Type Scription hazardous locations such as Fan Bath Fan and/or Exhaust Fan basements or pits or Clothes Dryer Clothes Dryer with Exhaust Vent anywhere "heavier-than-air" Cook Stove Cook Stove, Range Hood Exhaust gas can unsafely collect. Fireplace-Gas Fireplace-Gas or Gas Log Insert *Propane tanks over 125 Fireplace-Wood Fireplace-wood,Wood Stove, or gallons require a minimum Pellet Stove setback of 10 ft.from / Electric Furnace Electric Furnace or HP+/-Ducting property line and buildings, Propane(LP)Gas Furnace Propane Furnace+/-Ducting and a site plan must be submitted with the Water Heater-Gas Gas WH Vent and Combustion Air application showing the Gas Pipe System Gas Pipe System LPG/Oil setbacks. If propane tank is Propane Tank LP Fuel Tank(#gallons: ) over 500 gallons,a site plan is / Heat Pump required to accompany this Generator application, and a separate Air Conditioner Fire Code approval is also required. Installation manual must be on site at time of inspection or a re-inspection fee will be charged. By signing this application form, the owner/agent attests 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 making any issued permit null and void. I further agree to that all activities I intend to undertake or complete associated with this permit will be performed in compliance with all applicable federal, state and county laws and regulations and I 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 inspections. Applicant may request notice of the County's intent to enter upon the property for visits relat d to this application and subsequent permit issuance. Signatur: : g_ 1',1 Print Name: 1,Y1 d l./ I &f 10L Date: I 1 Lf. 1 1 OFFICE ONL' y � Methanmca) Permit fee tta i a ,wood ,e; 0* ) 152.4+ 1„ ° Kan LtO�a tanik1 and appliance dd 1 $76 00) IFt7jt Scanning Fee $19.90 ' Total P� *Additional fees may apply. Mechanical Application 2 • • This combination qualifies for a Federal Energy i CERTIFIED® Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2013. www.ahridireetory.org Certificate of Product Ratings AHRI Certified Reference Number: 5021416 Date: 11/17/2014 Product: Split System: Heat Pump with Remote Outdoor Unit-Air-Source,- Outdoor Unit Model Number: 4TWR5030G1 II '.'__ Indoor Unit Model Number: *AM7A0B30H21 I r—. !' r nip 0 r Manufacturer: TRANE Trade/Brand name: TRANE ( ;ft,ay Y Series name: XR15 WEATHERTRON Manufacturer responsible for the rating of this system combination is TRANE Rated as follows in accordance with AHRI Standard 210/240-2008 for Unitary Air-Conditioning and Air-Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent,third party testing: Cooling Capacity(Btuh): 31600 EER Rating (Cooling): 12.50 SEER Rating(Cooling): 15.00 Heating Capacity(Btuh)@ 47 F: 30000 Region IV HSPF Rating(Heating): 9.00 Heating Capacity(Btuh)@ 17 F: 18900 •Ratings followed by an asterisk(`)indicate a voluntary rerate of previously published data,unless accompanied with a WAS,which indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the product(s)listed on this Certificate and makes no representations,warranties or guarantees as to,and assumes no responsibility for, the product(s)listed on this Certificate.AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s),or the unauthorized alteration of data listed on this Certificate.Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI.This Certificate shall only be used for individual,personal and 9 •Ufa confidential reference purposes.The contents of this Certificate may not,in whole or in part,be reproduced;copied;disseminated; entered into a computer database;or otherwise utilized,in any form or manner or by any means,except for the user's individual, personal and confidential reference. AIR-CONDITIONING.HEATING, $REFRIGERATION INSTITUTE . CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahridlrectory.org,click on"Verify Certificate"link and enter the AHRI Certified Reference Number and the date on which the certificate was issued, which is listed above,and the Certificate No.,which is listed at bottom right. 130607101598402659 ©2014 Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: AIR FLO HEATING COMPANY INC Page 1 of 2 0 Washington State Department of Labor & industries I AIR FLO HEATING COMPANY INC I Owner or tradesperson 221 W CEDAR BEQUETTE, MARK A SEQUIM,WA 98382 360-683-3901 Principals CLALLAM County BEQUETTE, MARK A, PRESIDENT BEQUETTE, SANDRA A, VICE PRESIDENT ILicense I 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 Workers' 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. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&LIC=AIRFLI*206DG&SAW= 11/24/2014 1 AIR FLO HEATING COMPANY INC Page 2 of 2 Estimated workers reported Quarter 3 of Year 2014"21 to 30 Workers" L&I account representative T1 /FEARAED FEROZE (3601902-4797-Email: FERH2356Ini.wa.aov Workplace 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 I_ncatinn ©Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. ACce "waihrn tr https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&LIC=AIRFLI*206DG&SAW= 11/24/2014 Parcel Details Page 1 of 2 'I' ' , efferson county , i •,,,, 1,. , .4.,f, i _ _ _ _ , 14 ,, .4,44,VA',,, ;r,<,„ " :. '""'.'°a '� zt. F —..gi g. -+. '.»; .: ro '' -°7 & 1" 7t.'":, I: -- il Home County info Departments u„ Search E Parcel Number: 998700060 SEARCH Parcel Number: 998700060 Printer Friendly Owner Mailing Address: ALICE HAZARD 53 SEAWAY PL PORT LUDLOW WA98365-8751 Site Address: 53 SEAWAY PL PORT LUDLOW 98365 Section: 21 School District:Chimacum (49) Qtr Section: NE1/4 Fire Dist: Port Ludlow (3) Township: 28N Tax Status: Taxable Range: 1E Tax Code: 0231 Planning area: Port Ludlow (7) Sub Division: 9987 - TEAL LAKE VILLAGE Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: TEAL LAKE VILLAGE LOT 60 Tax, A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel Plats&Surveys Septic Monitoring Info „a Jefferson County' HOME 1 COUNTY INFO 1 DEPARTMENTS l SEARCH Best viewed with Microsoft Internet Explorer 6.0 or later Windows- Mac http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp 11/24/2014 i JEFFERSON CONY . 153870 DATE 1 L_��-1 RECEIVED FROAi.r o � x DESCRIPTION BARS# AMOUNT CURRENCY , COIN co vti� � � 1 t) ti) oivikaar a � ` o � � 4)(aG� RECEIVED BY TOTAL �(� • Jefferson County Building Division Permit Number: BLD14-00440 Applicant: HAZARD 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 Mechanical Systems Mechanical Systems 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 { '� ( �"� `4( FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR I. BUILDING PERMIT • Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD14-00440 Received Date: 11/24/2014 SITE ADDRESS: 53 SEAWAY PL Issue Date 11/24/2014 PORT LUDLOW, 98365 Expiration Date 11/24/2015 OWNER: ALICE HAZARD PHONE: 360-437-4114 53 SEAWAY PL PORT LUDLOW WA 98365-8751 9987 SUBDIVISION: Block: Lot: PARCEL NUMBER: 998700060 Section: 21 Township: 28 N Range: 1 E CONTRACTOR: AIR FLO HEATING COMPANY INC PHONE: 360-683-3901 221 W CEDAR SEQUIM WA 98382 Contractor's License AIRFLI*206DG Expires 4/25/2016 PROJECT DESCRIPTION: MECHANICAL PERMIT 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 11/24/14 153872 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