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HomeMy WebLinkAboutBLD2013-00080 - MECHANICAL• BUILDING PERMIT APPLICIION BRLD1e 00080 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD13-00080 Received Date: 3/12/2013 SITE ADDRESS: 1921 SWANSONVILLE RD PORT LUDLOW, 98365 OWNER: DANIEL S TOEPPER PHONE: 360-643-3230 1921 SWANSONVILLE RD PORT LUDLOW WA 98365-8716 SUBDIVISION: Block: Lot: PARCEL NUMBER: 821053021 Section: 5 Township: 28 N Range: 01 E CONTRACTOR: ALL WEATHER HTG & COOLING PHONE: 302 KEMP STREET PORT ANGELES WA 98362 Contractor's License ALLWEWH934MU Expires 8/3/2013 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr 2 TON HEAT PUMP SYSTEM INC. INDOOR AIR HANDLER 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 $228.00 JLA 03/12/13 140085 CD Total: $228.00 APPROVED MAR 12 2013 Jefferson County DCD \\firlomorlr\rinfn\forme\G RI fl Ann RId rn+ 1/19/1!114 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 #: BLD13-00080 SITE ADDRESS: 1921 SWANSONVILLE RD Issue Date: 03/12/2013 PORT LUDLOW, 98365 Final Date: 4/16/2013 APPLICANT: DANIEL S TOEPPER PHONE: 360-643-3230 1921 SWANSONVILLE RD PORT LUDLOW WA 98365-8716 SUBDIVISION: Block: Lot: PARCEL NUMBER: 821053021 Section: 5 Township: 28 N Range: 01 E PROJECT DESCRIPTION: 2 TON HEAT PUMP SYSTEM INC. INDOOR AIR HANDLER 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 4/16/2013 \\tidemark\data\forms\F_BLD_Occu pa ncy.rpt 5/22/2013 NM 1 .;F:4YNDERIE 1110 Date 3/re Mime received 2-5'1 am / 0 410 Tues. .Wed Thur. --Fri. Date: .3 -r&1 OWNER: Contact Name: ADDRESS: /c ,–/-4011N ✓I fie Contact Number:360 t-Frz 9g,3 Notes: 206 r sx Foundation Plumbing - Framing Propane Tank • Mechanical Setbacks — Under-ground Framing Underground Furnace _ Footing Rough in Air seal — Above ground _ Gas Stemwall _ Hydronic Exterior shear Exterior lines Oil Straps Interior shear Interior lines Ducts Post Hole Ventilation ____ Appliance _ Underfloor Gas/wood stove Man-Homes Setbacks - Insulation. Final Inspection Foundation — •' Block&Tie _ floor wall ceiling. . Address Posted 1 4+v" ©4. JEFFERA COUNTY • r`, DEPARTMENT OF COMMUNITY DEVELOPMENT �' "4 621 Sheridan Street C Port Townsend • Washington 98368 3601379-4450 • 360/379-4451 Fax k�S N�,o www.co.jefferson.wa.us/commdeveiopment Master Permit Application MLA: Project Description(include separate sheets as necessary): Install 2 ton heat pump system including indoor air handler Tax Parcel Number: 521053021 Property Size: 1680 (acres/square feet) Site Address and/or Directions to Property: 1921 Swansonville Road Property Owner(s)of Record: Daniel&Robin l oepper Telephone: 360-643-3230 Fax: email: Mailing Address: 1632 Swansonville Road Applicant/Agent(if different from owner): All Weather Heating&Cooling,Inc. Telephone: 360-452-9813 Fax: 360-452-5177 email: kmckeown(aiallweathencc.com Mailing Address: 302 Kemp Street Port Angeles,WA 98362 What kind of Permit?(Check each box that applies OBuilding ❑ Critical Areas Stewardship Plan El 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 ❑ Commercial* El Special Use(Essential Public Facilities)** ❑ Change of Use ❑Boundary Line Adjustment ❑ Address ❑ Road Approach ❑ Short Plat** ❑Home Business ❑ Cottage Industry El Binding Site Plan** ❑ Propane ❑ Long Plat** ❑ Sign ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑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 El 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 All Weather Heating&Cooling to act as my agent in matters relating to this application for permit(s). -� - /3 OWNER SIGNATURE ` i,���_ 01- �s�.ri." Date: 3 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 regq fired later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the appli `i n thaLhe shexants Dr r notice. Signature: G �" Date: 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-transferabl esponeibili�y'j for dherin• • and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: On/L.3 L3 IJI JI �1(/ n .. �� � Date: 3- 7 - G:\PermitCenter\###FORMS###\DRD FORMS\Master Pent Application 5-29-O8.doc i • 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 as, ming thtre onsibilit of the General Contractor for the proposed project. Signature: Q Al-usd Date: 3- 9 '/3 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE. FAX. ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAx:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: I Shoreline: Type of Sewage Disposal: ❑ New 9 Wood Existing: Sewer 9 Addition I Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel El Concrete Total: ( Height: ❑ Individual System • Repair c Masonry SEP Permit# • Demolition I Other: Bedrooms: Water Supply: Existing. Setback: Private well 9 Two Party Type of Heat: Proposed: 11 Public Total: Name of System: If this is a Commercial Protect 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 1 Fireplace Insert 1 Hot Water Tank I Pellet Stove i 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, including the reserve area. . Square Footage Current Proposed For Office Use Only Amount Revision i Main Floor Heated EH Bid App Review: 2na Floor Heated Consistency Review: I Other Heated Base fee: Mezzanine Additional Section: Heated Basement Plan Check fee: I Unheated Basement State Surcharge fee: 1 l Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee. Other TOTAL: $ ' Receipt Number: Cash/Check Number: ESTIMATED COST(REQUIRED) , Date: .Fair market value of all labor and materials foundation to finish Initials: i G.\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc Contractors or Tradespeopleonter Friendly Page • Page 1 of 1 Electrical Contractor A business licensed by LEH to contract electrical work within the scope of its specialty. Electrical Contractors must maintain a surety bond or assignment of savings account.They also must have a designated Electrical Administrator or Master Electrician who is a member of the firm or a full-time supervisory employee. Business and Licensing Information Name ALL WEATHER HTG e COOLING INC UBI No. 600485640 Phone 3604529813 Status Active Address 302 Kemp St License No. ALLWEWH934MU Suite/Apt. License Type Electrical Contractor City Port Angeles Effective Date 7/30/2007 State WA Expiration Date 8/3/2013 Zip 98362 Suspend Date County Clallam Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company Other Associated Licenses Specialty Effective Expiration License Name Type Specialty 1 2 Date Date Status ALLWEHC003DCALL WEATHER HTG Electrical Hvac/Rfrg Ltd Unused 3/3/2000 3/3/2008 Expired e COOLING INC Contractor Energy Electrical Administrator INFORMATION License BIRMID'933MU Name BIRMINGHAM, DAVID Status Active Business Owner Information Name Role Effective Date Expiration Date MCKEOWN,THOMAS J Agent 07/31/2007 MCKEOWN,THOMAS J President 07/31/2007 MCKEOWN, IDA L Treasurer 07/31/2007 Bond Information Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 1 CBIC SC6847 02/28/2000 Until Cancelled $4,000.00 02/28/2000 Assignment of Savings Information No records found for the previous 6 year period Insurance Information No records found for the previous 6 year period Summons/Complaint Information Summons and Complaints are not filed with the department for this contractor type Warrant Information Warrants are not filed with the department for this contractor type Infractions/Citations Information No records found for the previous 6 year period https://fortress.wa.gov/lni/bbip/Print.aspx 3/12/2013 • • 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 #: BLD13-00080 Received Date 3/12/2013 SITE ADDRESS: 1921 SWANSONVILLE RD Issue Date 3/12/2013 PORT LUDLOW, 98365 APPLICANT: DANIEL S TOEPPER PHONE: 360-643-3230 1921 SWANSONVILLE RD PORT LUDLOW WA 98365-8716 SUBDIVISION: Block: Lot: PARCEL NUMBER: 821053021 Section: 5 Township: 28N Range: 01E CONTRACTOR: ALL WEATHER HTG & COOLING PHONE: 302 KEMP STREET PORT ANGELES WA 98362 Contractor's License ALLWEWH934MU Expires 8/3/2013 OWNER, DANIEL S TOEPPER PHONE: 360-643-3230 if different: 1921 SWANSONVILLE RD PORT LUDLOW WA 98365-8716 PROJECT DESCRIPTION: 2 TON HEAT PUMP SYSTEM INC. INDOOR AIR HANDLER 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 3/12/2014. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: ( 3/Z 5/S 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 3/12/2013