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Home My WebLink AboutBLD2015-00171 - 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#: BLD15-00171 Received Date 5/26/2015 SITE ADDRESS: 41-A S KEEL WAY Issue Date 5/26/2015 PORT LUDLOW, 98365 APPLICANT: WILLIAM BLACK PHONE: 603-677-2357 41 A SOUTH KEEL WAY PORT LUDLOW WA 98365 SUBDIVISION: 9616- INNER HARBOR VILLAGE CO Block: Lot: PARCEL NUMBER: 961601502 Section: 17 Township: 28N Range: 1 E CONTRACTOR: SHAUN WINSLOW CONSTRUCTION INC PHONE: 360-620-8386 3619 NOKOMIS RD SOUTHWORTH WA 98386 Contractor's License SHAUNWC904JT Expires 4/30/2016 OWNER, WILLIAM BLACK PHONE: 603-677-2357 if different: 41 A SOUTH KEEL WAY PORT LUDLOW WA 98365 PROJECT DESCRIPTION: NEW MECHANICAL PERMIT Directions INSTALL 120 GALLON PROPANE TANK FOR FIREPLACE AND GAS To Site: STOVE 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 5/26/2016. REQUIRED INSPECTIONS: // Installation per Manufacturer Specifications/CO2: Apf I'IREPLAeE L k 5/294S -1-oyi, Di/ s/igrr5 Tank/Line/Appliance: , ,e 75 Final Approval: )/2/)g— 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 5/26/2015 BLD15-00171 • •BUILDING PERMIT APPLICA1N Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD15-00171 Received Date: 5/26/2015 SITE ADDRESS: 41-A S KEEL WAY PORT LUDLOW, 98365 OWNER: WILLIAM BLACK PHONE: 603-677-2357 41 A SOUTH KEEL WAY PORT LUDLOW WA 98365 9616- INNER HARBOR VILLAGE CO SUBDIVISION: Block: Lot: PARCEL NUMBER: 961601502 Section: 17 Township: 28 N Range: 1E CONTRACTOR: SHAUN WINSLOW CONSTRUCTION INC PHONE: 360-620-8386 3619 NOKOMIS RD SOUTHWORTH WA 98386 Contractor's License SHAUNWC904JT Expires 4/30/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NEW MECHANICAL PERMIT INSTALL 120 GALLON PROPANE TANK FOR FIREPLACE AND GAS STOVE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION ADD'L: HEAT TYPE: EEE CODE EDITION: 2012 HEAT BASE: HEAT TYPE: PRO 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 05/26/15 156112 Permit $78.00 SRE 05/26/15 156112 .P OVED Total: $234.00 MAY Z 6 2015 Jefferson County DCD \\firlomark\, fo\fnrrne\F RI fl on', Rlrl rnf cP,A01-11c. 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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 v 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 rA- Assessor Tax Parcel Number: C l i0 1 ( D I o-) Site Address and/or Directions to Property: L}—[ j\ 'ou-t-[4 k&E I wiz( i -(. L7jC oct� c.0 A ct 3G5 / V) Access (name of street(s)from which access will be gained: S oL't 14 -1 LL_ k\! `- Description of Work: W1L7iJ€_. L-EV O 04 Li rz(6v& -I 24 PL A6 L- L IUST>411 pi it-s p 12`c. PL./V.k___- 6_- A-5 Li Iti L--S Tc) -r I P 1J LiTG L - A ili(Te—__ Property Owner Name: (i;I l l l ►n\ BLA J _ w Address: L4( A- S 7 VT 1+ l J 6 L Lc, Ate-{ t T 1.0 0L 2 co w0. cCSS31 6 Phone#: (0 b3 -(077 -,),-3 S-7 E-mail Address: L - P LI C-9a.SO7 e -mi rm 9m41L . EC YY") = Applicant/Contractor: Authorized Agent/Representative -a Name: i ti j/1 arc C2=4s'f Phone#: 3ec- e -_ ., s'S b E-mail Address: ,Cc Lor4544: ;f cam.. License#: f f� 4/ /c qC y .J'r Expiration Date: 4 p l Mechanical Application 1 1 • S Heat Source rk Electric Heating Oil Propane* ;� t� � � V1 Indicate Quantity and Fixture Types Below *Propane is bited 1 Quantity Fixture Type Description 1-14 rdtous,l ogt1 as d_ � acfi Fan Bath Fan and/or Exhaust Fan -7 n' basements or pits or Clothes Dryer Clothes Dryer with Exhaust Vent anywhere "heavier-than-air" .1 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 1 Gas Pipe System Gas Pipe System LPG/Oil setbacks. If propane tank is ..L Propane Tank LP Fuel Tank(#gallons: / • . 1 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 rel d to this application and subsequent permit issuance. Property wne (,� �� b I I 1 Signatur ,� C_ C� 4CY- Print Name: �� LAQ IL Date: c, ��ro J ft 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) 7C""7 n V', Project Scanning Fee $19.50 Total Fees* 2c-5?) • 5 *Additional fees may apply. Mechanical Application 2 SHAUN WINSLOW CONSTRUCT* INC Page 1 of 2 Illi Home Inicio en Espanol Contact Search L&I 1 SEARCH A-Z Index Help My Secure L&I Safety Claims&Insurance Workplace Rights Trades& Licensing 4741 Washington State Department of Labor & Industries SHAUN WINSLOW CONSTRUCTION INC o I _' V ii n 11933 CARRIAGE PL SE Owner or tradesperson I JJ OLALLA,WA 98359-9309 Principals 360-620-8386 ' ^1 ' WINSLOW,SHAUN A,PRESIDENT KITSAP County MAY 1 6 2015 Doing business as I. I SHAUN WINSLOW CONSTRUCTION INC i ` ■ I I I JEFFERSON COUNTY WA UBI No Business type DEFT.OF COMMUNITY DEVELOPMENT 603 006 872 Corporation License I Verify the contractor's active registration/license/certification(depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. SHAUNWC904JT Effective—expiration 0413012010—04/30/2016 Bond Wesco Insurance Co $12,000.00 Bond account no. 46WB060151 Received by L&I Effective date 03/18/2015 04/01/2015 Expiration date Until Canceled Bond history Insurance Western Heritage Ins Co $1,000,000.00 Policy no. SCP-0990852 Received by L&I Effective date 03/31/2015 04/01/2014 Expiration date 04/01/2016 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&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. ; https://secure.lni.wa.gov/verify/Detail.aspx?UBI=603006872&LIC=SHAUNWC904JT&SAW= 5/26/2015 SHAUN WINSLOW CONSTRUC N INC Page 2 of 2 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. 192,199-00.. ...__.......... ..... Doing business as SHAUN WINSLOW CONSTRUCTION INC Estimated workers reported Quarter 1 of Year 2015"1 to 3 Workers" L&I account representative T2!DAN STRATE(360)902-4635-Email:STRE235@lni.wa.gov Workplace safety and health No inspections during the previous 6 year period. to Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the slate of Washington. it https://secure.lni.wa.gov/verify/Detail.aspx?UBI=603006872&LIC=SHAUNWC904JT&SAW= 5/26/2015 Parcel Details Page 1 of 2 ri Jefferson oun I F., ,,__ __. _Fa�nxi . ,,, ea...,..fabon , „54,.....cn bo,,,, 5i±,,w k ? ,:...»:. Home , County Info -Departments Search Parcel Number: L961601502 SEARCH Parcel Number: 961601502 Printer Friendly Owner Mailing Address: WILLIAM BLACK PO BOX 134 BLOCK ISLAND RI02807-0134 Site Address: 41 S KEEL WAY PORT LUDLOW 98365 Section: 17 School District: Chimacum (49) Qtr Section: SW1/4 Fire Dist: Port Ludlow (3) Township: 28N Tax Status: Taxable Range: 1E Tax Code: 0231 Planning area: Port Ludlow (7) Sewer: PLSEWER - Connected(No Drainage: CWF) Bank: View 1: View 2: Zoning 1: MPR-MF-10 - Master Planned Resort - Multiple Family Zoning 2: Zoning 3: Sub Division: 9616 - INNER HARBOR VILLAGE CONDOMINIUM Assessor's Land Use Code: 1400 - Residential Condominiums Property Description: INNER HARBOR VILLAGE CONDO UNIT 15-A Tax, A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel Plats&Surveys Septic Monitoring Info f�� `N<, Jefferson Cooney r HOME I COUNTY INFO I DEPARTMENTS I SEARCH 3 Best viewed with Microsoft Internet Explorer 6.0 or later Windows - Mac http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?value=961601502 5/26/2015 • • Jefferson County DCD Building Division Correction Notice PERMIT NUMBER 15 pQ 1 7 1 OWNER L)i - t p.M $i-ACi< rl JOB LOCATION V/-4 SDl r7 r/ t�I eL Inspection of this structure has found the following violations: (D Cg./)1.4L SVAC.r VEtii-rc L.c)I--I i � �F rJK FL.DL.) e.Fh TO 3E PLU46ED (� �nnoKL-/(,'L7 rECTOZ - 2 You are hereby notified that no more work shall be done upon these premises until the above violations are corrected, unless noted otherwise. When corrections have been made, call for inspection. Date 4)/ ¶//S Inspect BUILDING DIVISION (360)379-4450 SPECTION HOTLINE(360)379-4455 THIS NOTICE MUST BE KEPT WITH APPROVED PLANS ON SITE