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Home My WebLink AboutBLD2015-00165 - MECHANICAL • 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 #: BLD15-00165 Received Date 5/20/2015 SITE ADDRESS: 33 GOLDFINCH Issue Date 5/20/2015 PORT LUDLOW, 98365 APPLICANT: CLAUDIA WICKS PHONE: 33 GOLDFINCH LN PORT LUDLOW WA 98365-9764 SUBDIVISION: 9905 - PORT LUDLOW NO. 4 Block: Lot: PARCEL NUMBER: 990500035 Section: 17 Township: 28N Range: 1 E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 1 1 367/0 01 38x5-5875 OWNER, CLAUDIA WICKS PHONE: if different: 33 GOLDFINCH LN PORT LUDLOW WA 98365-9764 PROJECT DESCRIPTION: NEW PROPANE COOK STOVE 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 5/20/2016. REQUIRED INSPECTIONS: art Installation per Manufacturer Specifications/CO2: (o/t(7//l `hgn (4w Tank/Line/Appliance: L"/A- Final Approval: L// 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 5/20/2015 ItUILDING PERMIT APPLICAC BLD15-00165 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD15-00165 Received Date: 5/20/2015 SITE ADDRESS: 33 GOLDFINCH PORT LUDLOW, 98365 OWNER: CLAUDIA WICKS PHONE: 33 GOLDFINCH LN PORT LUDLOW WA 98365-9764 9905- PORT LUDLOW NO. 4 SUBDIVISION: Block: Lot: PARCEL NUMBER: 990500035 Section: 17 Township: 28 N Range: 1E 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 DESCRIPTIOI■ NEW PROPANE COOK STOVE TYPE OF WORK STV SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION ADD'L: HEAT TYPE: CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: 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 $156.00 SRE 05/20/15 156106 APPROVED Total: $156.00 MAY 2 0 2015 Jefferson County DCD NfiilomnrlArfafalfnrmc\F RI 11 Ann Rlrf rnf S onmi 5� t 5-(,.... 5- ON co DEO RT. MENT OF COMMUNITY OMM UNI TY•VELOPME T C $Sii-ING 621 Sheridan inert Port 1<wnsend.\\.19836 Tel:36( 3-9 4 1 3 6 0 ■:C Well , ,w c . r« ,■Ir wla ilS d annunindc e) pnr:r E-mail:dcd(ir;cur Cffer,■ n wa.us f MECHANICAL PERMIT APPLICATION Steps in the Permit Process: -Review required submittal items to ensure all information is completed prior to submitting application. -Mechanical Permits can be mailed into our office-and do not require an appointment. -Fees are due at time of submittal, Mechanical permits are generally issued within 5 business days. 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 General Site plan —showing propane tank, lines, and distance from tank to all existing structures. 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: /9 O5o'. 5-" Site Address and/or Directions to Property: 33 60L Fi tf t-A---- -)6_- , - i l Ls wt3 , LD. A 6 Sacs Access (name of street(s) from which access will be gained: 60 e-i_ F-i,j,- )-{ Description of Work: tbPu cif& O -6 7 c) E t.0 rnt. ik3&j P2vPfk ti,C- 5-rUJ Property Owner Name: (') LA l'I)sv.. / t- .vt31 CSC 5 co r Address: 33 C(OLSFI/UC(f LJ'citJC c Phone #: apG - 3 f . Z crr41 E-mail Address: rn zi Applicant/Contractor: Authorized Agent/Representative , -+ It Name: _S-ft7 )c T2.ePi-xJC- - Pc z f ff71"ALC%C( Phone #: E-mail Address: License#: Expiration Date: lfechanical Application 1 1 I • • Heat Source Electric E Heating Oil Propane* X1 Wood Indicate Quantity and Fixture Types Below *Propane is c rohibited in Quantity Fixture Type Description hazardous locations such as Fan Bath Fan and/or Exhaust Fan basement, or pits or Clothes Dryer Clothes Dryer with Exhaust Vent anywhere "he.vier-than-air" X- Cook Stove Cook Stove, Range Hood Exhaust gas can uns:felycollect. Fireplace -Gas Fireplace-Gas or Gas Log Insert *Propane t.nks over 125 Fireplace-Wood Fireplace-wood, Wood Stove, or gallons requi e a minimum Pellet Stove setback o'10 ft. from Electric Furnace Electric Furnace or HP+/- Ducting property line and buildings, Propane (LP)Gas Furnace Propane Furnace+/- Ducting and a site elan must be submitte' with the Water Heater-Gas Gas WH Vent and Combustion Air application showing the Gas Pipe System Gas Pipe System LPG/Oil setbacks. If •ropane tank is Propane Tank LP Fuel Tank(#gallons: ) over 500 gallo s, a site plan is Heat Pump required to accompany this Generator application, :nd a separate Air Conditioner Fire Code a cproval is also req fired. 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 .:ttachments, is true and correct to the best of his, her or its knowledge. Any material falsehood or any omission of a aterial fact made by the owner/agent with respect to this application packet may result in making any issued permit ull and void. I further agree to that all activities I intend to undertake or complete associated with this permit will be pe ormed in compliance with all applicable federal, state and county laws and regulations and I agree to provide acce.s and right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of applica ion 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 application and subsequent permit issuance. Property Owner /9, e6/4-1-)3 i� "�-ICS Date: Signature`.' �l��(z%�`� Print Name: 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 Details • • Page 1 of 2 _ fersn Count Weather:Station s- ' Database Tools : Mapsm ,a fit« " =. 1 Home County info Departments 1 Search Parcel Number: 990500035 SEARCH Parcel Number: 990500035 Printer Friendly Owner Mailing Address: CLAUDIA WICKS 33 GOLDFINCH LN PORT LUDLOW WA98365-9764 Site Address: 33 GOLDFINCH LN PORT LUDLOW 98365 Section: 17 School District: Chimacum (49) Qtr Section: NE1/4 Fire Dist: Port Ludlow (3) Township: 28N Tax Status: SNR/DSBL Range: 1E Tax Code: 0231 Planning area: Port Ludlow (7) Sewer: PLSEWER - Connected(No Drainage: PLDD YES CWF) Bank: View 1: View 2: Zoning 1: MPR-SF-4 - Master Planned Resort - Single Family Zoning 2: Zoning 3: Sub Division: 9905 - PORT LUDLOW NO. 4 Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: PORT LUDLOW NO. 4 LOT 35 Tax,A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel Plats&Surveys l Monitoring Info l.' Jefferson County HOME I COUNTY INFO I 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?value=990500035 5/20/2015 SUNSHINE PROPANE Page 1 of 2 Home Inicio en Espanol Contact Search L&I 5LARCH A-Z Index Help My Secure L&I Safety Claims&Insurance Workplace Rights Trades&Licensing 0 Washington State Department of Labor & Industries SUNSHINE PROPANE Owner or tradesperson 10853 RHODY DR PORT HADLOCK,WA 98339-9745 Principals 360-385-5797 CHAWES,RICHARD HENRY,PRESIDENT JEFFERSON County 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 Governing persons ENVIRONMENTAL HOUSING INC BILL BISHOP DAVE LEMLEY; JO YOUNT; LAURA SIMPSON; LEVI KENT ROSS; MICHAEL EWING; PACO TEED; RICHARD CHAWES; ROBERT YOURISH; RON BISHOP; License Verify the contractor's active registration/license I certification(depending on trade)and any past violations. Construction Contractor Active. ...................................................... Meets current requirements. License specialties GENERAL License no. SUNSHP*077QP Effective—expiration 11/17/1993-11/1712016 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600342368&LIC=SUNSHP*077QP&SAW= 5/20/2015 SUNSHINE PROPANE • Page 2 of 2 Bond . No current bond account.See the bond histo 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. 506478572-6 Received by L&I Effective date 11/13(2014 11/17/2014 Expiration date 1 111 7/2 01 5 Insurance history Savings (in lieu of bond) $12,000.00 Received by L&I Effective date 09/16/2014 09110/2014 Release date Impaired date N/A N/A Savings account ID 0770001033 Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L8,1 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 ................. . Doing business as SUNSHINE PROPANE Estimated workers reported Quarter 1 of Year 2015"11 to 20 Workers" L&I account representative T1/JAN BENTLEY(360)902-4652-Email:STR0235@lnl.wa.gov Workplace safety and health No inspections during the previous 6 year period. O 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= 5/20/2015