HomeMy WebLinkAboutBLD2013-00052 • BUILDING PERMIT APPLIION BLD13-00052
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD13-00052 Received Date: 2/12/2013
SITE ADDRESS: 773 RAINIER LANE
PORT LUDLOW, 98365
OWNER: JAMES H BOURASA PHONE: 360-437-1042
FRANCES L BOURASA
773 RAINIER LN
PORT LUDLOW WA 98365-8711 PORT LUDLOW NO 7
SUBDIVISION: Block: Lot: 11
PARCEL NUMBER: 990100011 Section: 17 Township: 28 N Range: 01 E
CONTRACTOR: FAST WATER HEATER COMPANY PHONE: 425-636-7054
12601 132ND AVE NE
KIRKLAND WA 98034
Contractor's License FASTWWH948BC Expires 1/4/2014
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION REPLACE HOT WATER HEATER
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP MEC
VALUATION MAIN:
CODE EDITION: 2009 ADD'L: HEAT TYPE:
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
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 $222.00 LYK 02/12/13 139994 APPROVED
Total: $222.00
FEB 12 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#: BLD13-00052
SITE ADDRESS: 773 RAINIER LANE Issue Date: 02/12/2013
PORT LUDLOW, 98365 Final Date: 2/26/2013
APPLICANT: JAMES H BOURASA PHONE: 360-437-1042
FRANCES L BOURASA
773 RAINIER LN
PORT LUDLOW WA 98365-8711
SUBDIVISION: PORT LUDLOW NO 7 Block: Lot: 11
PARCEL NUMBER: 990100011 Section: 17 Township: 28 N Range: 01 E
PROJECT DESCRIPTION: REPLACE HOT WATER HEATER
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009
EDITION.
OCCUPANCY GROUP:
TYPE OF CONSTRUCTION:
SPRINKLER SYSTEM yes no
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 2/26/2013
\\tidemark\data\forms\F_BLD_Occupancy.rpt 3/20/2013
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C 02 (-14 6 3
, C06 JEFFERSON COUNTY
4 Alto DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street• Port Townsend•Washington 98368
360/379-4450. 360/379-4451 Fax
wvvw.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA: CCij
Project Descn tion(include separate sheets as necessary):
� v C Kw is t act° w other �'t e- Y
Tax Parcel Number: qqb Q� ( I Property Size: (acres/square feet)
Site Address and/or Directions to Property:
113 Ra,V1A:e/ ioune
Property Owner(s)of Record: "QQV r-f“al 3 adt4i (24
Telephone: . 0 - , — 0 2.. Fax: email:
Mailing Address: 13 P.CtLi t/t.e..,, TLM e PO L' L u C Q � Lc) A • k t
Applicant/Agent(if different from owner): i t� £ 1 �r !A
Telephone:4 2 6 6¢1 D6 y Fax: ! '
email:
i ifikaffer
Mailing Address:
What kind of Permit?(Check each box that applies — L, ��/ r _
❑Building ❑Critical Areas Stewar is RianO I�' O V I G [EV,
❑ Demolition Permit ❑Variance(Minor,Major _ 1
Single Family ❑Garage Attached/Detached ❑Conditional Use[C(0),;001),or C]** i 1
❑ Manufactured Home ❑ Modular ❑Discretionary"D"or Unnamed Use Classiti�t4Q, , ;
❑ Commercial* ❑Special Use(Essential)Public Ftiees)** LU 13 1 '
❑ Change of Use ❑Boundary Line Adjustment `;LI
❑ Address ❑Road Approach ❑Short Plat*" u u i i
❑Home Business ❑Cottage Industry ❑Binding Site Plan**I JEFFERSON COUNTY
❑Propane ❑Long Plat** o OiV P,9 ITY DEVE OPMENT
❑Sign ❑Planned Rural Residential`r'= -'•• - ---.1 't e i men s**
❑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 to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE Date:
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 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 required later inspections. Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the application that he or she wants prior notice.
Signature: Date: fi._71244 3
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-transferable responsibili fok adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: ¶ Date: o2 !g' 13
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
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BUILDER STATEMENT
The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be assuming the responsibility of the General Contractor for the proposed project.
Signature: Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
FAsT-- wit-reR ,QC.(,-Qr 1,0ftwa,41AA mill 6.36 `70 g9
(4U63L� )d CS-
MAILING
ADDRESS: 11) I t b Z �,"Q- EMAL: py @:15/41-G3o k'k.Q (ke'r Lean
CONTRACTOR'S LICENSE Cj O WAINS
NUMBER: Fit T (A)Ej i44 g 6 r
NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: ' EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
❑ New ❑ Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: Bank 0 Community System
X Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System
❑ Repair 0 Masonry SEP Permit#
O Demolition 0 Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well 0 Two Party
Type of Heat: Proposed: ❑ Public
Total: Name of System:
If this is a Commercial Project you must answer the following:
Number of Parking Spaces: Current Proposed: Number of ADA Parking Spaces:
Number of occupants(includes owners,tenants,employees,etc) Current Proposed
IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No
If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply:
i Underground Tank I Above ground Tank Size of Propane Tank:
i Heat Stove i Cook Stove i Woodstove i Fireplace Insert i Hot Water Tank I Pellet Stove 1 Other
Is this appliance being installed in a Manufactured/Mobile Home? Yes / No
When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property
lines,tank location and size,distances from the propane tank to all property lines,buildings and septic system components,
includin• the reserve area.
S•pare Foota•e Current P ••Deed t v r c k��� a • a s a C4 ' 9
,..d�adcFaa-�' :441-3.14,4,4V.4.
.k.,-ne.w .�..�.
Main Floor Heated .0 }•'4•-- EH Bld App Review:
2r°Floor Heated , "'':'14:. Z Consistency Review:
Other Heated - Base fee:,
741 '@
Mezzanine r
�.�g Additional S-.. •a• _
Heated Basement ` z 4c? - =`€,r-� �"_ V will'
Unheated Basement State Surcharge fee:
Other Unheated Iiirir,Mill;Pot 7 r r -evie +-: I //i
Garage/Carport •. y i
JEFFERSON COON
Decks ;.k I-9I'll7RiivTI rr�;l!�;f;��?•vss�aus"'"---
Other } �_Jam, 4
bU(JUC Ems``� 1 1 i ,` TOTAL sc=> 9
k"-At , Receipt Number: 1 -4 /I ' `i
L.1,1.:0-'1'''477,: Cash/Check Number: 1 l G zo
-ll0
ESTIMATED COST(REQUIRED) Date:
.Fair market value of all labor and materials foundation to finish
— Initials: - �).___,..,
G:\PemvtCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
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v........--� „J,,,. F Famala.DTIOCopy
WAllsdF yihn fro JOB CODE PAY CODE DATE NSTALLER VAN# J•L-
{,I Tn�� Il�ll�l if��llllll�ll in rl �' uj ,.
0 20352 57774 6 ;t i
/.�/t 1Y PM LOCAU RENCE
'A` INSTALLED �"~
4�I�W\ 1208245 L �4�sERIAL8-/i_ 1 --fi�t - c .. S�
DELIVERED
n✓ 800•THINK FAST 41IA 6C>VI�r ` t
CLOSED SYSTEM CHECK 240 VOLT COMPATIBILITY CHECK VENT CAPACITY CHECK CLEARANCES WATER PRESSURE CHECK
TE METHOD USED Vembywire d watt tx i5patiblhtywith breaker PASSED tiAT B 'S BEING VENTED 6'C-V_lei MAXIMUM ESSURE OF�
f vRSUAL ,rd m mum FAIL ❑ B s R COMMON VENT_ FAIL f PAS U FAIL[]TESTED AT
PRESSURE OSCILLATION BREAKER -i us
■ APPLIED H T 30 AMP Il 10 W ■l.; •'. PASS IG BTU'S OF WATER HEATER MU pi &VE
TEST RESULT 26 AMP f 1 r III r:h• PASS Vj
❑OPEN CLOSED .20 AMP■12A in 3840 FAIL 0 MAX BTU'S FOR CONNECTOR `M •FAIL iLJ OK s r ED ``��cle
PROPOSED WA rrh C� Q AUTHORIZED
CODE# DESCRIPTION COST
2009 UNIFORM PLUMBING CODE d
313.6 Insulate exposed pipes to R-3 if in an unconditioned space. w _ (F-13) ,, G „
•508.2 , install Earthquake Straps at the top and bottom third. (F-8) (F-9)
508.4 Install a Drip Pan ❑Up to Size 24"(F-1) ❑26"and Larger(F-2) _ . . ,
, 508.4 Install' I feet of drain from Drip Panto! ((0-13)
605.2 Install Water Shut Off,Old valve was:I I (G-2) _,,,,
•608.2. Install Pressure Regulating Valve ;_,(B-1)(B-2)(B-3) -.
608.3 Install Expansion Tank. Previous was:I I(A-1)(A-2)(A-3)(A-4)
608.5 Install P&T Relief Drain to the exterior or approved location. (G-4) 076. N
608.7 Install Vacuum Breaker F-10) •
2009 INTERNATIONAL RESIDENTIAL CODE Gas Pi•e,Vent,and Combustion Air)
G2406.2,, Relocate to an Approved Location, Existing is: t1=® (4) 0
02408.2 Install a Stand,Oct stand was: (F-5)(F-6) `- 0
G2408.3 Install Bollard (F-19) ;2441 f --D� "e
G2411.1 Bond Water and Gas pipes with 6 awg wire and clamps. (H-5) aq- /
G2419.4 Install Sediment Trap.
(M-2) , q." 1' . 8.�
G2420.5.1 Install Gas Shut Off Valve, Old valve was: I (M-1) s•
62427.10.2.2 Install double wall vent. Reason.
I (L-1)
Combustion Air Supply.codes 62407.5.1 through 62407.11 (1-2) Ce
2009 WASHINGTON ENERGY CODE
504.2.1 Install R-10 Insulated Pad if it is an electric tank located on concrete. (F-7)- BEM.
FIR CODE ADDITIONAL ITEMS r vjj-
0131 Vrt� alL� t►
2I 8 &4z l
Z �� ,/" PERMIT "
Work Au orization:I the undersigned am the owner or authorized agent for the premises in which the work listed above is to be done.I authorize Fast Water Heater SUB TOTAL I I —I(j
to perform tie work listed in the authorized cobumn above.I also acknowledge that a survey was performed prior to installation and that all of the above fisted Items
were alned as either required by code,required by the city,required by the mania-adorer,necessary to complete the Job or optional.Customer acknowledges that any
Items listed on this agreement as reqiirad by code or city that are not marked as authorized were not completed.Customer realizes that In the event that these horns am TAX cr.,
deemed necessary by the inspector,t e.price listed will bete cost to perform such services plus any sem II and potential tank removal and reinstallation tees.Customer I 'S?' ,
has also been made aware Ihatui re dicbons may choose to not erdoce scific c codes but j
Fast Water Healer may be required to uphold an the codes to satisfy specific contractual X ' �,.� TOTAL,I! �(,',(Ky./_� •
obligations as well as requirements set by the manufacturer in order to provide a warranty. Jere
Disclaimer:The custemer has been advised prior to starting any work,awl their emoting hs =d and I o poybutelane
piping and that Fast Water Heater Company is not responsible for any leaks,dogged pipes or Wows,or other problems associated
with the existing plumbing,neither prior nor after the installation of the water heater. �Jl/IELar rr,.c,_
TERMS:A'I work is C•r h.•es on oast due amounts a-e1.5%lnorth 06%h Par)Acceptance:I the undersigned find the I
_ service arty materials rendered and installed X
Cade have been corn..:.,:•in a satisfactory manner. ^�j�!. , ..s„�.-- - .
Type■ - CC I D/t I I agre
ed tamatt the customer will call the Inssplecct' •'ulhovtty a dpprovide access for Inspectioon to within aorasoonnaabl@ time.
Type In the event the p@rrnh expires before Inspection, customer will be responsible for any Armes or penalties that may result.
Atxd _.: , WalTayty Any water heaters or related equipment instated by Fast Water Heater Company that cony a manufacturers l
I I .❑.... --. wmrsnty,-wilfbe warranted solely by the manufacturer.Fast Water Heater Company does not provide any additional warranty
POST INSTALLATION CHECKLIST for the equipment unless otherwise slated m writing.Any parts supplied by Fast Water Heater CompanyTor the instelladwm or 1
repair of the water heater or related equipment are warranted for,defects-Mr the period of one year from the original date of
8 Post Install Checidist and Satisfaction Faze Feted Out . Installation or In accordance with the manufactures or other limited warranties.L Is warranted for one year and a.. ,.
Attach Rating g Plate to back°Fast Cagy H WarraolY Rep rent only as It relates w spedac• provided and the slated:.. r�.,. , , r . • •
. •.m @Xdudese tool .fa: co" - ten tea ,TOP COPY•,FASIm ,80TTOM C0 PY-CUSTOMER
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Date 2,-/2-1." time received q31 6 -// pm Mon. CD.Wed: Thur. -Fri. •
BIM: /3 --5-Z- Date: 24'2-S-- • .
OWNER: • Contact Name
ADDRESS: 773 . P410e,- Ad n 4 2-
Contact Number:360 413 2, i- i -
-4
Notes: 206 s) tAl g C_L/CL--- . f
. • -
.Foundation Plumbing - Framing Propane Tank Mechanical ' •
_.
Setbadts Under-ground Framing Uncle!:ground Furnace _____
Footing Rough In Air seal Above ground • Gas
____
Stemwall Hydronic Exterior shear Exterior lines Oil _
Straps Interior shear Interior lines . Ducts
• Post Hole ' S Ventilation Appliance
Underfloor Gas/wood stove
Man-Homes . -
•
.
Setbacks ' Insulation. Final Inspection .1
Foundation. • . '- , ..:1
ty
4•Block&Tie floor wall ceiling Address Posted
. . 1
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#: BLD13-00052 Received Date 2/12/2013
SITE ADDRESS: 773 RAINIER LANE Issue Date 2/12/2013
PORT LUDLOW, 98365
APPLICANT: JAMES H BOURASA PHONE: 360-437-1042
FRANCES L BOURASA
773 RAINIER LN
PORT LUDLOW WA 98365-8711 11
SUBDIVISION: PORT LUDLOW NO 7 Block: Lot:
PARCEL NUMBER: 990100011 Section: 17 Township: 28N Range: 01E
CONTRACTOR: FAST WATER HEATER COMPANY PHONE: 425-636-7054
12601 132ND AVE NE
KIRKLAND WA 98034
Contractor's License FASTWWH948BC Expires 1/4/2014
OWNER, JAMES H BOURASA PHONE: 360-437-1042
if different: FRANCES L BOURASA
773 RAINIER LN
PORT LUDLOW WA 98365-8711
PROJECT DESCRIPTION: REPLACE HOT WATER HEATER
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 2/12/2014.
REQUIRED INSPECTIONS:
t.4ank/Line/Appliance: Zj
FinalApproval: _ 2. ( 13
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 2/12/2013