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Home My WebLink AboutBLD2015-00089 - MECHANICAL 1110 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#: BLD15-00089 Received Date 3/20/2015 SITE ADDRESS: 74 WINDRIDGE RD Issue Date 3/20/2015 CHIMACUM, 98325 APPLICANT: WALLACE L REISLAND PHONE: 360-732-4656 BARBARA WALLACE 74 WINDRIDGE ST CHIMACUM WA 98325-9767 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901275005 Section: 27 Township: 29N Range: 1W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 (3360) 385-5875 Contractor's License SUNSHP*077QP Expires 11/17/2016 OWNER, WALLACE L REISLAND PHONE: 360-732-4656 if different: BARBARA WALLACE 74 WINDRIDGE ST CHIMACUM WA 98325-9767 PROJECT DESCRIPTION: NEW MECHANICAL PERMIT Directions POLY GAS LINE INSTALLATION 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 3/20/2016. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: Tank/Line/Appliance: Final Approval: (21 fS' 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 N -math ( 4 S61.e 3/d/ I C \\tidemark\data\forms\F_B LD_Perm it_Propane.rpt 3/20/2015 II BUILDING PERMIT APPLIATION BLD15-00089 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD15-00089 Received Date: 3/20/2015 SITE ADDRESS: 74 WINDRIDGE RD CHIMACUM, 98325 OWNER: WALLACE L REISLAND PHONE: 360-732-4656 BARBARA WALLACE 74 WINDRIDGE ST CHIMACUM WA 98325-9767 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901275005 Section: 27 Township: 29 N Range: 1V1 CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NEW MECHANICAL PERMIT POLY GAS LINE INSTALLATION TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC VALUATION MAIN: CODE EDITION: 2012 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: 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 $156.00 SRE 03/18/15 154252 Total: $156.00 AppRO MAR 2 0 201'3 Jefferson County L \\tidemark\data\forms\F_BLD_App_Bld.rpt 3/20/2015 ocC pt g 15'7) 2_S-7_(--- t-qt-g( go r,-- co -,,m. 4, UNITY DEVELOPMENT„, W21 Slivh 'an Street,Port Townsend,WA 9'.■i 8 ■ Tel:360.379.4450 I Fax:360.379.4451 1 Bu) (p t, 156 Well: w. c S f° on.,n.is ommuniir_.,: '1 m'n E-mail:dcd @cojefso .wa us C) 9S . �HIN,, , , , _; MECHANICAL PERMIT APPLICATION V-151 50 Steps in the Permit Process: IAA -Review required submittal items to ensure all information is completed I 1 r 1 1(hi 1 ��q -Mechanical Permits can be mailed into our office-and do not require an; 1 L J T F t -Fees are due at time of submittal, Mechanical permits are generally issuE �_ For Department Use Only Rece �,/f Related Application#s: '+° Is this application for use in a Mobile/Manufactured Home? t�` 4 -- "317/-5 * If Yes: A permit from Washington State Department of Labor and I t required for appliances installed within a mobile/manufactured hoi * If No: Complete this form and make an appointment to submit to J Required Submittal Items-for propane tank only General Site plan —showing propane tank, lines,and distance 4 Required Submittal Items—for Solar Panel installation only Complete first page and signature block only of Mechanical Per J A complete solar panel supplemental application. _ l � Site Information U J Assessor Tax Parcel Number: 7 O I - -2 7 5 - O 0S Site Address and/or Directions to Property: "7 / L)//) d 2% / G47 in a c cJ n - q 8'3. 7,5".” Access (name of street(s) from which access will be gained: Description of Work: PO Lg/A-4 P cr., -4-g_ _L 1 Property Owner Name: /4 , f e--(-4-e l m E Address: Ste, Phone #: 73 Z - c, E-mail Address: rn _ Please contact Authorized Agent/Rep sentative with project info. /.. K Property Owner Signature: ?,,diz �� Date: 6 S / Of __, x. .., .,,,a- --.4,,,,,,m'low?ma,, ,_.a�u Vim- ^,rmm',-7,--^ ,,,T.11,1 --:�.,_,. .„�,-,p, Applicant/Contractor:;Authorized Agent/Representative Name: J.(.4.--,—.4 7"4—t112 Phone #: .3 F S -1-7 5'7 E-mail Address: L4 t & ,_ ccrv..tu,;�; Expiration Date: /1 P ,Cam, License #: �SLJ,y /�, /P �b 7 7 � l° p �i7 h;`) C7 ( Ir--1 n \\/7 C� Mechanical Application ---if r i ij MAH 1 8 2015 ii Li 1' , 1Y • • Heat Source Electric Heating Oil Propane* Wood Indicate Quantity and Fixture Types Below *Propane is prohibited in Quantity Fixture Type Description 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 related to t 's application and subsequent permit issuance. !� �� 1 CM9� <�� ` / /. Signature rint Name. ate: , S�^C/✓ 41i1/-e— .r Atn/Jr✓ OFFICE USE ONLY Building Permit Fees Mechanical Permit fee (tank swap,woodstove,furnace,etc) $156.00 Propane-Lines, tank, and appliance (add'I $78.00) Project Scanning Fee $19.50 Total Fees* *Additional fees may apply. Mechanical Application 2 Parcel Print Page 1 of 1 • • Parcel Number:901275005 08/15/2014 Owner Mailing Address: WALLACE L REISLAND BARBARA WALLACE 74 WINDRIDGE ST CHIMACUM WA 98325-9767 Site Address: 74 WINDRIDGE RD CHIMACUM 98325-9767 Section: 27 School District: Chimacum(49) Qtr Section: NW1/4 Fire Dist: Chimacum(1) Township: 29N Tax Status: SNR/DSBL Range: 1W Tax Code: 0211 Planning area: 98325-9767 Sewer: Drainage: Bank: View 1: View 2: Zoning 1: Zoning 2: Zoning 3: Sub Division: Land Use Code: 1100 98325-9767 Property Description: SHERWOOD FOREST LARGE LOT LOT E (REVISED) http://www.co.j efferson.wa.us/assessors/parcel/parcelprint.asp?PARCEL N0=901275005 3/20/2015 SUNSHINE PROPANE Page 1 of 3 • • Home Inicio en Espanol Contact Search L&I A-Z Index Safety Claims & Insurance Workplace Rights A Washington State Department of IL Labor & Industries SUNSHINE PROPANE Owner or tradesperson 10853 RHODY DR CHAWES, RICHARD HENRY PORT HADLOCK, WA 98339 360-385-5797 Principals JEFFERSON County CHAWES, RICHARD HENRY, PRESIDENT LEMLEY, DAVID BARRY, VICE PRESIDENT SIMPSON, LAURA ANNE, SECRETARY YOURISH, ROBERT B, TREASURER FLANDERS, RONALD LEE, MEMBER EWING, MICHAEL HOYT, MEMBER ROSS, LEVI K (End: 01/01/1980) CHAWES, RICHARD (End: 01/01/1980) YOUNT, JO (End: 01/01/1980) SPRING, PERRY (End: 11/05/2010) PETERSEN,JAMES (End: 11/05/2010) Doing business as SUNSHINE PROPANE WA UBI No. Business type 600 342 368 Corporation Parent company ENVIRONMENTAL HOUSING INC License Verify the contractor's active registration/license/certification (depending on trade) and any past violations. Construction Contractor https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600342368&LIC=SUNSHP*077QP&SAW= 3/20/2015 SUNSHINE PROPANE Page 2 of 3 • Active. Meets current requirements. License specialties GENERAL License no. SUNSHP*077QP Effective—expiration 11/17/1993—11/17/2016 Bond ......... No current bond account. See the bond history. Bond history Insurance FEDERATED SERVICE INS CO $1,000,000.00 Policy no. 633829 Received by L&I Effective date 11/09/2006 11/17/2006 Expiration date Until Canceled United States Fire Insurance C $1,000,000.00 Policy no. 506-878572-6 Received by L&I Effective date 11/13/2014 11/17/2014 Expiration date 11/17/2015 Insurance history Savings (in lieu of bond) $12,000.00 Received by L&I 09/16/2014 Savings account ID Effective date 0770001033 09/10/2014 Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period, but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. 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. 422,171-00 III https://secure.lni.wa.gov/verify/Detail.aspx?UBI_600342368&LIC_SUNSHP*077QP&SAW_ 3/20/2015 SUNSHINE PROPANE Page 3 of 3 Doing business as i SUNSHINE PROPANE Estimated workers reported Quarter 4 of Year 2014"11 to 20 Workers" L&I account representative T1 /JAN BENTLEY(360)902-4652 - Email: STRO235 @Ini.wa.gov Workplace safety and health No inspections during the previous 6 year period. "Washington State Dept.of Labor&Industries. Use of this site is subject to the laws of the state of Washington. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600342368&LIC=SUNSHP*077QP&SAW= 3/20/2015