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Home My WebLink AboutBLD2014-00184 • BUILDING PERMIT APPLKIIIION BLD14-00184 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00184 Received Date: 5/29/2014 SITE ADDRESS: 654 PIONEER DR PORT LUDLOW, 98365 OWNER: ROBERT E SOWATSKY PHONE: 360-437-0710 SIENNA L SOWATSKY 654 PIONEER DR PORT LUDLOW WA 98365-9621 PORT LUDLOW NO 2 AREA 3 SUBDIVISION: Block: Lot: PARCEL NUMBER: 990603224 Section: 9 Township: 28 N Range: 01 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 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION REPLACEMENT OF HEAT PUMP 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: 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 Bv: Date: Receipt: , Approved/Date D Permit $152.00 JLA 05/29/14 148719 Total: $152.00 MAY 2 9 2014 Jefferson County DCD \\f irlornnr4\rio4o\fnrmc\C RI fl Ann PIr1 rnf RP-JO/1(11A . 1� 1 19 - ) ( 4g0N c r- 90JEF• ON COUNTY ' \ 3 DEPARTMENT OF COMMUNITY DEVELOPMENT 11 , 621 Sheridan Street • Port Townsend • Washington ":36014 I 360/379-4450 • 360/379-4451 Fax i J wvvw.cojefferson.wa.us/commdevMo *ent i `qS NGtiO 1 -- JEFFERSON COUNTY Master Permit Application ,___ DFPT.OFCOMMUNITYDFVFL PnrEn2 _ Ih. Project Description (include separate sheets as necessary): IILl� Lt t 0.f--\011- 0-\,A ■ ,"6-0U1v211- 04- (\iL -f_kfY\O c .trY, Tax Parcel Number: 9°10 1p 0 3 2-24 Property Size: (acres/square feet) Site Address and/or Directions to Property: (p S Lt Pioneea- Dr-1 vc, Pcxrt 1...t.K6ALAAJ Property Owner(s)of Record: Robert 4- Sienna. SOL.J,1:1s kti Telephone: y31 -0'1 I O Fax: email: Mailing Address: 4arn4,. Applicant/Agent(if different from owner): > 1 r C1 o �1ea't ncA Telephone: 310.0-web—epic)1 Fax: 6 83- 39"i e email:ette..nea\r-Flab tr. In Mailing Address: l2-1 W. Cedar St• seta s-A ,■ QN c i5SeZ, What kind of Permit?(Check each box that applies ❑Building ❑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 C]** ❑ Manufactured Home ❑ Modular ❑Discretionary"D"or Unnamed Use Classification O Commercial* ❑Special Use(Essential Public Facilities)" ❑ Change of Use ❑Boundary Line Adjustment ❑ Address ❑Road Approach ❑Short Plat ❑ Home Business ❑Cottage Industry ❑Binding Site Plan** 0 Propane ❑Long Plat ❑ Sign ❑Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis O Plat Vacation/Alteration** ❑ Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions"* ❑ Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development** O Temporary Use 0 Shoreline Management Variance O Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District Map Amendment O 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: nn DESIGNATION OF AGENT I hereby designate n I('T1 o *real I nq to act as my agent in matters relating to this application for permit(s). OWNER SIr,NATuR.=_ `.sN- Date: $AVt%-4- By signing this application form,the owner/agent attests that the in rmation 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: S — 11 -t"1 The action or actionl 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-tr ferable res ibility for adhering to and complying with the ESA. The Applicant has read this disclaimer a d si ns and dates it below. Signature: Date: S/21114 G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc 1 It • • Q‘ecit* --F- 11-IP 19 5)261/ 6LOPA&e Fre') scatn. — Cvecicztk- r . -r• r' ■ 0 • Ic . , -.. . ---------- .........-.-- ? t CPRiLLY. C =2 1....-J ----------------- C\J CD --7' I-..7 Cr) ggc‘j E .-- \ i 0) CC t.7.- =, 7-7- CD 7.,..7 c,,D -..., 1-7,.. C) 1if_..------- ----1. LLICIL---' _11 ? I I 1 ..... ), \t',.. I k i 1 13 kr 3---) 1 , Cn 0 L 1 -1-.....x .... i , . W 1 ‘ V 13 0 si AIR FLO HEATING COMPANY INC Page 1 of 2 • • illik Washington State Department of ) Labor & Industries AIR FLO HEATING COMPANY INC Owner or tradesperson 221 W CEDAR BEQUETTE, MARK A SEQUIM, WA98382 360-683-3901 Principals CLALLAM County BEQUETTE, MARK A, PRESIDENT BEQUETTE, SANDRA A, VICE PRESIDENT BERSON, JOEL R, SECRETARY FULLAWAY, MICHAEL (End: 04/01/2010) Doing business as AIR FLO HEATING COMPANY INC WA UBI No. Business type 600 347 761 Corporation License 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. Al RFLI*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 Bond history Insurance American Hallmark Ins Co of Te $1,000,000.00 Policy no. 44CL483619 Received by L&I Effective date 04/18/2014 04/25/2014 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&LIC=AIRFLI*206DG&SAW= 5/8/2014 AIR FLO HEATING COMPANY 4 2 4 2 3 Check Number: 42423 Jefferson County Building Department ate Description Amount 7/2014 Sowatsky permit 171.00 • JEFFERSON COUNTY NO. 1 dii 719 DATE 5/aq�I 1 RECEIVED FROM Pcr CIO Nft ( r(t DESCRIPTION BARS# AMOUNT CURRENCY hLD {` sE 1��, 00 COIN SCC.YN. l CI . 0 0 CHECKS/ 43.4 ao c CI ciploGba()-4 co .Y .oi('.ir Or m o t)S RECEIVED BY S D ii-A TOTAL )-1 ) • C v • • 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 #: BLD14-00184 Received Date 5/29/2014 SITE ADDRESS: 654 PIONEER DR Issue Date 5/29/2014 PORT LUDLOW, 98365 APPLICANT: ROBERT E SOWATSKY PHONE: 360-437-0710 SIENNA L SOWATSKY 654 PIONEER DR PORT LUDLOW WA 98365-9621 SUBDIVISION: PORT LUDLOW NO 2 AREA 3 Block: Lot: PARCEL NUMBER: 990603224 Section: 9 Township: 28N Range: 01E 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 OWNER, ROBERT E SOWATSKY PHONE: 360-437-0710 if different: SIENNA L SOWATSKY 654 PIONEER DR • PORT LUDLOW WA 98365-9621 PROJECT DESCRIPTION: REPLACEMENT OF 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 5/29/2015. REQUIRED INSPECTIONS: C O NS: Installation per Manufacturer Specifications/CO2: Tank/Line/Appliance: Final Approval: y A IS -- 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 5/29/2014