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HomeMy WebLinkAboutBLD2014-00459 - MECHANICAL ILDING PERMIT APPLICATI BLD14-00459 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD14-00459 Received Date: 12/9/2014 SITE ADDRESS: 71 CHICKADEE LN QUILCENE, 98376 OWNER: CARL F SMITH PHONE: 360-765-3692 PO BOX 868 QUILCENE WA 98376-0868 SUBDIVISION: Block: Lot: 7 PARCEL NUMBER: 701205007 Section: 20 Township: 27 N Range: 1V1 CONTRACTOR: PROPANE NORTHWEST INC PHONE: (503) 678-4305 PO BOX 1162 CANBY OR 97013 Contractor's License PROPAN1948QC Expires 3/6/2015 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NEW MECHANICAL PERMIT SWAP OUT AND MINOR RELOCATION OF 120 GAL PROPANE TANK TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC VALUATION MAIN: CODE EDITION: 2012 ADD'L: HEAT TYPE: PRO OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: 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 $228.00 SRE 12/09/14 153934 Total: $228.00 APPROVED DEC 0 9 2014 Jefferson County DCC \\tidemark\data\forms\F_BLD_App_Bld.rpt 12/9/2014 50N C w6` : o DEP TMENT OF COMMUNITY D!VELOPMENT W� � 621 Sheridan Street,Port Townsend,WA 98368 ti - Tel:360.379.4450 Fax:360.379.4451 Web:www.co.Jefferson.wa.rrs/communitydevelopment ,,'4 , E-mail:dcd(r co.jefferson.wa.us MECHANICAL PERMIT APPLICATION Steps in the Permit Process: -Review required submittal items to ensure all information is completed prior to submitting application. Make an appointment to meet with the Permit Technician by calling 360-379-4450. -Fees will be collected at intake. Additional fees may apply after review and payment is required before permit is issued. For Department Use Only Receipt#: Date: Related Application#s: Payment#: 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 Required Submittal Items—for propane tank only fComplete Site plan - Please refer to the site plan checklist to ensure all items are on the site plan. Required Submittal Items—for Solar Panel installation only ,�` Complete first page and signature block only of Mechanical Permit Application. A complete solar panel supplemental application. Site Information Assessor Tax Parcel Number: w/ 20 5— 00 ? Site Address and/or Directions to Property: 7/ C.hcc%a-4,dee ,e (iriCete e i Gc1Xi r -7 Access (name of street(s) from which access will be gained: Z _/ 71/" ,.e.,' ate ° - -Lzt Description of Work: 5 j�l2 e)J a it m/ktUN-_ir-e.6 Cee " Ole /7-ca r' 4:f 'AG fr Property Owner Name: irl CU r Address: _ fir 0. / &,< 6 b` Qt.(/Gs`u C , /444 l (5-"3 7 6 g Phone #: ">60 765 3' 692._ E-mail Address: („,(14 Syulilt e kr/I”( Cc =,, Please contact Auth ized P /:presentative with project info. =1 - Property Owner Signature: f 1 Date: 12/572,"el 4 Applicant/Contractor: Authorized Agent/Representative Name: sit lr t 4-.) ‘11A-/if ai Ali i-pit ° ►" , /-'h- f24Kc x/orJ ctie.s 1 Phone #: 3ac �"f-0Yelj A14 7c.) - E-mail Address: L License #: Expiration Date: -C. Ri(Op().ite �1 IvO We Mechanical Application 1 V-ii-f&, Mk 1834(0 • Heat Source Electric LZ Heating Oil Propane* _ Wood _ Indicate Quantity and Fixture Types Below _ __ *Propane is prohibited in Quantity 1 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: Plc) ) 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 this . -tion and subsequent permit issuance. �J r1 Signature: �ls'i Print Name: 614/--r 5wt t `l-'( Date: iZ/571 l OFFICE USE ONLY 1 Building Permit Fees Mechanical Permit fee (tank swap,woodstove,furnace,etc) $152.00 Propane— Lines, tank, and appliance (add'I $76.00) - Project Scanning Fee $19.00 Total Fees* k - *Additional fees may apply. Mechanical Application 2 IIW 0 0 \ 0 0 " g n RS_ 9/143 8� 9A43 0 i7 \ 8 \ c^ \ ]3 N � \ 1" l 0981? 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Date: Time Received: &.-4'4; ii a Date: ..0 BLD: 16, i 63 Contact Name: Owner: 1.1i0- a U Mir/ Contact Number: 360 114- /5/7 Address: I 'D , e- Pi"- RD 206 Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted nI-1, 0 T;,,, Ceiling e5°N o°G, JEFFERSON COUNTY 4 �� DEPARTMENT OF COMMUNITY DEVELOPMENT 9`rNI NG.CO Date: L, 24 Time Received: f 0.:.: µ; ,7 am/pull{ Mon. Tue. Wed. Fri. Date: Li 4; ,1 BLD: S ii.- Lirti Contact Name: Owner: t Contact Number: 360 Address: °', e.17 GA/Gcce/77. 206 1-1,',„. 7 L / 30/d Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling PROPANE NORTHWEST INC Page 1 of 2 . ill Cil Washington State Department of Labor & Industries PROPANE NORTHWEST INC Owner or tradesperson PO BOX 1162 BANSEN, KEVIN (PAUL) PAUL CANBY, OR 97013 503-678-4305 Principals BANSEN, KEVIN (PAUL) PAUL, PRESIDENT HUTT, DONALD LEE, VICE PRESIDENT Doing business as PROPANE NORTHWEST INC WA UBI No. Business type 602 325 012 Corporation ILicense Verify the contractor's active registration/license/certification (depending on trade) and any past violations. Construction Contractor Active. Meets current requirements. License specialties Tanks and Tank Removal License no. PROPANI948QC Effective—expiration 11/03/2006—03/02/2015 Bond TRAVELERS CAS&SURETY CO $6,000.00 Bond account no. 104835231 Received by L&I Effective date 11/03/2006 10/30/2006 Expiration date Until Canceled In surance United States Fire Insurance C $1,000,000.00 Policy no. 5068761093 Received by L&I Effective date 03/06/2014 03/06/2014 Expiration date 03/06/2015 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602325012&LIC=PROPANI948QC&SAW= 12/9/2014 PROPANE NORTHWEST INC Page 2 of 2 Insurance history Savings ... ... ... . .... No savings accounts during the previous 6 year period. 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&l 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. 899,753-01 Doing business as PROPANE NORTHWEST INC Estimated workers reported Quarter 3 of Year 2014"7 to 10 Workers" L&I account representative T5/MICHAEL MURPHY(360)902-4822 -Email: MURY235 @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. Access %ELI hinzton'T. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602325012&LIC=PROPANI948QC&SAW= 12/9/2014 Parcel Details Page 1 of 2 • • sJ County 5/����/�� -. , . t,. , ,,,, ,,,,,--., 4 . Database To Ma i'lebscarn Home County Info Departments Search 1 Parcel Number: 1701205007 I SEARCH Parcel Number: 701205007 Printer Friendly Owner Mailing Address: CARL F SMITH PO BOX 868 QUILCENE WA98376-0868 Site Address: 71 CHICKADEE LN QUILCENE 98376 Section: 20 School District: Quilcene (48) Qtr Section: NW1/4 Fire Dist: Quilcene (2) Township: 27N Tax Status: Taxable Range: 1W Tax Code: 0321 Planning area: Quilcene (10) Sub Division: Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: QUILCENE BAY VISTA LOT 7 SURVEY V9/P143 Tax,A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel •fats &Surve s I Septic Monitoring Info i °� Jefferson Coi Rty HOME I COUNTY INFO 1 DEPARTMENTS I SEARCH Best viewed with Microsoft Internet Explorer 6.0 or later Windows - Mac http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?Parcel NO=701205007 12/9/2014 Parcel Details Page 2 of 2 • http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?Parcel N0=701205007 12/9/2014 • • 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 #: BLD14-00459 Received Date 12/9/2014 SITE ADDRESS: 71 CHICKADEE LN Issue Date 12/9/2014 QUILCENE, 98376 APPLICANT: CARL F SMITH PHONE: 360-765-3692 PO BOX 868 QUILCENE WA 98376-0868 7 SUBDIVISION: Block: Lot: PARCEL NUMBER: 701205007 Section: 20 Township: 27N Range: 1W CONTRACTOR: PROPANE NORTHWEST INC PHONE: (503) 678-4305 PO BOX 1162 CANBY OR 97013 Contractor's License PROPAN1948QC Expires 3/6/2015 OWNER, CARL F SMITH PHONE: 360-765-3692 if different: PO BOX 868 QUILCENE WA 98376-0868 PROJECT DESCRIPTION: NEW MECHANICAL PERMIT Directions SWAP OUT AND MINOR RELOCATION OF 120 GAL PROPANE To Site: TANK 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 12/9/2015. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: Tank/Line/Appliance: iL Final Approval, 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 12/9/2014