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HomeMy WebLinkAboutBLD2015-00166 - 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#: BLD15-00166 Received Date 5/21/2015 SITE ADDRESS: 372 WOODRIDGE DR Issue Date 5/21/2015 PORT LUDLOW, 98365 APPLICANT: ROBERT R MILLSAP PHONE: 360-437-7683 MARJORY JANE MILLSAP 372 WOODRIDGE DR PORT LUDLOW WA 98365-8743 SUBDIVISION: 9997-WOODRIDGE VILLAGE DIV 1 Block: Lot: PARCEL NUMBER: 999700033 Section: 21 Township: 28N Range: 1E 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 R MILLSAP PHONE: 360-437-7683 if different: MARJORY JANE MILLSAP 372 WOODRIDGE DR PORT LUDLOW WA 98365-8743 PROJECT DESCRIPTION: NEW MECHANICAL PERMIT Directions INSTALL HEAT PUMP &AIR HANDLER 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 5/21/2016. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: Tank/Line/Appliance: Final Approval:` (o/i y /r 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 5/21/2015 B LD 15-00166 BUILDING PERMITAPPLICN Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD15-00166 Received Date: 5/21/2015 SITE ADDRESS: 372 WOODRIDGE DR PORT LUDLOW, 98365 OWNER: ROBERT R MILLSAP PHONE: 360-437-7683 MARJORY JANE MILLSAP 372 WOODRIDGE DR PORT LUDLOW WA 98365-8743 9997-WOODRIDGE VILLAGE DIV 1 SUBDIVISION: Block: Lot: PARCEL NUMBER: 999700033 Section: 21 Township: 28 N Range: 1 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 DESCRIPTIOP NEW MECHANICAL PERMIT INSTALL HEAT PUMP & AIR HANDLER TYPE OF WORK NON 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 APPROVED Total: MAY 2 2015 Jefferson Cou!n,', ❑flrlomar4\ri n rrn c RI n Ann PIA rnt cI)1/9111S • _,-.) (----,,, e 0 , arson: WE 1 11 MAY 1 8 2015 JEFFERSOI COUNTY ,, DEPT.OF COMMUNI DEVELOPMENT 1 L___________, -,-, \ ---i, ("....--1 -- :) ct.,i ,__ , .... „ • • This combination qualifies for a Federal Energy Vu.Oi CERTIFIED® Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2014. www.ahridirectory.org Certificate of Product Ratings AHRI Certified Reference Number: 5021416 Date: 5/5/2015 Product: Split System: Heat Pump with Remote Outdoor Unit-Air-Source I C Outdoor Unit Model Number: 4TWR5030G1 [ I Indoor Unit Model Number: `AM7A0630H21 MITY 1 8 2015 Manufacturer: TRANE L H Trade/Brand name: TRANE JEFFERSON COUNIY DEPT.OF COMMUNITY DEVELOPMENT Series name: XR15 WEATHERTRON Manufacturer responsible for the rating of this system combination is TRANE Rated as follows in accordance with AHRI Standard 210/240-2008 for Unitary Air-Conditioning and Air-Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third party testing: Cooling Capacity (Btuh): 31600 EER Rating (Cooling): 12.50 SEER Rating (Cooling): 15.00 Heating Capacity(Btuh) @ 47 F: 30000 Region IV HSPF Rating (Heating): 9.00 Heating Capacity(Btuh) @ 17 F: 18900 • Ratings followed by an asterisk(')indicate a voluntary rerale of previously published data,unless accompanied with a WAS,which indicates an involuntary relate. DISCLAIMER AHRI does not endorse the product(s)listed on this Certificate and makes no representations,warranties or guarantees as to.and assumes no responsibility for, the product(s)listed on this Certificate.AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s),or the unauthorized alteration of data listed on this Certificate.Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. S TERMcD CONDITIONS TERMS AND Certificate and its contents are proprietary products of AHRI.This Certificate shall only be used for individual,personal and confidential reference purposes.The contents of this Certificate may not,in whole or in part,be reproduced;copied;disseminated; entered into a computer database;or otherwise utilized,in any form or manner or by any means,except for the user's individual, personal and confidential reference. AIR-CONDmONING,HEATING, 8 REFRIGERATION INSTITUTE CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahridirectory.org,click on"Verify Certificate"link we make file better' and enter the AHRI Certified Reference Number and the date on which the certificate was issued, which is listed above,and the Certificate No.,which is listed at bottom right. 130753095738324590 ©2014 Air-Conditioning, Heating,and Refrigeration Institute CERTIFICATE NO.: `9'e gs"‘ ` L JEFFERSON COUNTY , DEPARTMENT OF COMMUNITY DEVELOPMENT Date: 0/5 Time Received: 9:so am m Mon. 4150 Wed. Thur. Fri. Date: BLD: Contact Name: Owner: MiLLSAP Contact Number: 360 cf f7- 74.83 Address: 372_ IdoaDgrD6E Dr.. pi_ 206 Notes: 447 77141-I-P 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 • • SON oG DEPARTMENT OF COMMUNITY DE ti IA. 621 Sheridan 5 rcer,Pon �, iacnd,Ak'A 987,68 r), [E C E �1 M E e "< Tel:3bn 3 9.44�U � f �ti 36n ; 1.4.1.51 web ttwuco., Iten,)n.aau cornmunijdevelopment dcdn'.co cffeisonw�t.u� �j ;' MAY 1 8 2015 'ISFi1 NGA i I I MECHANICAL PERMIT APPLICATION JEFFERSCN COUNTY Steps in the Permit Process: —.DFPT Oc COMMUNITY DEVFLriPMENT -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#5: 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: C- 1(-)i L-'( . :j u0 Site Address and/or Directions to Property: ,7 UJ Lootri ol tate ,0( • Y-- (9 O, 1.6,11n1 QS- Access (name of streets) From which access will be gained: Description of Work: v►sht a-tL 1a- tea pump ki r 1-loivict (, ' Property Name: Rolpe,rt d c fl .i�1�2 K\t.,11�"..1? Address: 317- �lc1 C„ (, t PDY UEkt CIW 1/4.1.1 A i:;* (DS Phone #: `1j U)0 "-k61 - 114,3 E-mail Address: m Please contact Authorized A t :-• -sentative with project info. Property Owner Signature: Date: Applicant/Contractor: Authorized Agent/Representative Name: 1 / Phone#: 40$22„ 104 1 E-mail Address: ” A • . 1 License #: A l .F i-it, 20( D(en Expiration Date:r1'S)1 s Mechanical Application 1 • Heat urce , ',�� ' Electric J Heating Oil Propane* Wood Indicate Quantity and Fixture Types Below *Propane is prohibited in Quantity Fixture Type Description hazardous Iocatbns 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 1 Electric Furnace Electric Furnace or HP+/-Ducting property line and buildings, Propane(LP)Gas Furnace Propane Furnace+/-Ducting and a site plat 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: ) 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 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 nul, and void. I further agree to that all activities I intend to undertake or complete associated with this permit will be perfo me,d 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 applicatio review and any required later inspections. Applicant may request notice of the County's intent to enter upon the p operty for visits related to this application and subsequent permit issuance. �1 { /1 Signature: ' ` ' Ut. Print Name: 1 c,n-� Date: ' c OFFICE USE ONLY _ Building Permit Fees Mechanical Permit fee(tank swap,woodstove,fcrnace,etc $156.00 Propane—Lines,tank, and appliance (add' $78.00) Project Scanning Fee $19.50 Total Fees* ,,,, \ .`► c"j L-,11 *Additional fees may apply Mechanical A lication 2 1?P Parcel Details • • Page 1 of 2 :� Jefferson ounty -3RPa1�er on , --,%...€a,3 Theis- F'1 Ma05 ,,-:-±44. 04 Niebcarn. .: s -- Home County Info Departments Search Parcel Number: 999700033 i = SEARCH Parcel Number: 999700033 Printer Friendly Owner Mailing Address: ROBERT R MILLSAP MARJORY JANE MILLSAP 372 WOODRIDGE DR PORT LUDLOW WA98365-8743 Site Address: 372 WOODRIDGE DR PORT LUDLOW 98365 Section: 21 School District: Chi macum (49) Qtr Section: NE1/4 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-SF-4 - Master Planned Resort - Single Family Zoning 2: Zoning 3: Sub Division: 9997 - WOODRIDGE VILLAGE DIV 1 Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: WOODRIDGE VILLAGE DIV 1 LOT 33 Tax, A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel Plats&Surveys Se tic Monitorin Info „W '„�r '. iiii: Jefferson my HOME I COUNTY INFO I DEPARTMENTS I SEARCH _..:.. - ,.._< .. ............ . .. Nom- .-_ -...a_......... i Best viewed with Microsoft Internet Explorer 6.0 or later Windows - Mac http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?value=999700033 5/21/2015 AIR FLO HEATING COMPANY I • Page 1 of 3 Home Inicio en Espanol Contact !Search L&I A-Z Index Safety Claims & Insurance Workplace Rights killikk Washington State Department of Labor & industries AIR FLO HEATING COMPANY INC Owner or tradesperson 221 WEST CEDAR Principals SEQUIM, WA 98382 p 360-683-3901 BEQUETTE, MARK A, PRESIDENT CLALLAM County 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 Governing persons MARK BEQUETTE SANDRA BEQUETTE; License Verify the contractor's active registration/license/certification (depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties Heating/Vent/Air-Conditioning and Refrig (HVAC/R) License no. AIRFLI"206DG Effective—expiration 03/07/1980—04/25/2016 Bond CBIC $6,000.00 htt s://secure.lni.wa. ov/veri /Detail.as x?UBI=600347761&LIC=AIRFLI*206DG&SAW= 5/21/2015 P g �' P AIR FLO HEATING COMPANY I • Page 2 of 3 Bond account no. SI5215 Received by L&I Effective date 02/05/2010 02/01/2010 Expiration date Until Canceled Bond history Insurance American Hallmark Ins Co of Te $1,000,000.00 Policy no. 44CL483619 Received by L&I Effective date 04/21/2015 04/25/2014 Expiration date 04/25/2016 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. 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. 351,432-00 ......................... Doing business as AIR FLO HEATING COMPANY INC. Estimated workers reported Quarter 1 of Year 2015 "21 to 30 Workers" L&I account representative T1 / FEARAED FEROZE (360)902-4797- Email: FERH235 @lni.wa.gov Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. Citation issue date 07/24/2012 Violations Inspection no. 315954529 Location 125 Horizon View Dr. Sequim,WA 98382 https://secure.lni.wa.gov/verify/Detail.aspx?UB1=600347761&LIC=AIRFLI*206DG&SAW= 5/21/2015