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HomeMy WebLinkAboutBLD2015-00209 - MECHANICAL BUILDING PERMIT APPLICOON B Review 0209 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD15-00209 Received Date: 6/24/2015 SITE ADDRESS: 463 MIDDLEPOINT RD PORT TOWNSEND, 98368 OWNER: JAMES E HANES PHONE: ANNE B S HANES PO BOX 1027 PORT TOWNSEND WA 98368 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001052057 Section: 5 Township: 30 N Range: 1' 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 Install one heat pump and air handler (like in kind) TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION ADD'L: HEAT TYPE: HTP 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 06/22/15 156259 APPROVED Total: $156.00 JUN 232015 Jefferson County DCD \\flAcmerLlrinfvlfnrmc\F RI n Gnn Rlrl rn■ AV) /9 iR • • lor,r,1 sON Co G DEPARTMENT OF COMMUNITY DEVELOPMENT � b"1 tinezidac,;`nrrt,P,nt'1�ocrnscndAA.A?' -C "fcl 3(iO3').1d30 I I :?}).445E Iteh ccc <: cc,mmuniyclevclopmcnt �_ t m ul __,j ' us III N GAO 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#: ± 5(to C-, Date: 6/"?. /. C,1 (5 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: C/01Q Site Address and/or Directions to Property: ut,97 114triti �Po04-1 04 . to-l of s��n� 1 ()JA Access (name of street(s) from which access will be gained: Description of Work: A � &A �� IA Property OwneC Name: _ Address: i Li i I. Phone#: • – - E-mail Address: .. (.;. _ Please contact Authorized Agent/ epresentative with project info. -O✓ ' Property Owner Signature: – A PY1 t c� Date: J Applicant/Contractor: Authorized Agent/Represetative Name: Atte- _t-u) 14-014 i ll ` (t plCa-01 _ Phone #: _ i 440 – i vi = .I E-mail Address: air c 14404-ht ,00 License #: �,l(2 FL 4e 2DloDC�, Expirat •mU. &TAW, ' II Mechanical Application ! JUN 2 2 2015 J • I • Heat Source Electric Y Heating Oil Propane* Wood Indicate Quantity and Fixture Types Below *Propane is prohibited in Quantity 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: ) 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 application and subsequent permit Q issuance. Signature: Print Name: 6121Y LI I qr i A Date: o I j of 1 S 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 • - ,— ,—.—,—_—_,-- . ' .. •. ; ...• -..< •-.. )...,,.... ., i ..f: - ....e''' .7 1%.'"•-.-.., . ' k.' :01: ' '-' 0 ..‘`%:••-".'',C..4:"'..' .. ..,..+-''''. ,/ :," .' 't ..'...*'""■ '%. • - .,i ' . :':','".. 1)...;.■■•... • ` "4.' ., '? ... ---‘".....-..------.. I 1 1•4 •■••• -. ..,,i• • ., .... t ' isi t., . ,,.. ..,„ .....„ „ • 1 24 1 ..).,,, .,.... , . i 1011, , ...: 7..41_, . - ID :: . •.;. MEI . , . . . \\ 0 \ : It 1 .. --ir \ • \■ 1 \\ I/ -/> , I \\ •, . , , ill 1 •\ , . . . . : - : . -. ., .,,..., ii• :. . . • r.,..,.:, !... ,. , --..1 . . I, ... ,... s' ;;. -. . , . , :, . L . ' sr ',, "!, , , .. • 1-v.4, '' : r ' 1$1-6 Int _ s R EC-4: ''' '-: :A7----__ • '. a's" N ' ' —— . _. —•••■■■. . ---A ' I < ill .-• ,'' . A\ _v• 3 " I 0 tt / • • . v , • r Al 1 .c <->.,. ... , ;-• — ,.4 1. 1, 1 \ , • . , 1 . .‘\ F.} • , \\ . • • \\ •••• - . . I , •\ , • v-6 1/2'--I /1 /1 0 • o d.t • // \\ N\ . ? , ; lECEOV a-7 0 ' I• • \ \ \ . . t51.•10.1 s.. JEFFV.8p COUNTY \ • a 4- L ' - OF t PWIINITY DEVELOPMENT -.. . \ II / 1 N. . I .... ,.. .. .,.., . • i ,..._ N ..., -_.... • .""••■'-, - A018 FLO NIENTEINO ,‘,., , .. 221 W. Cedar 9,r—ili 3 it l — Sequars•WA 88382-3320 -.imi;> : z. , . crd e,/ c)/ 683-3901 . .., i 385-5354 . •,-. .: m R . -20 . •)--{x11 U ob 561_1-4 Oc,,s5. .� C}.cti }Rskz3-c u� c-a C>✓i i.^� Q ' Z() CJ P -3 6 hz5 a- L- TwV�3b•3 ,o 1 _6 �rcw OPP- l3 lq 1 - G tik �0 1 Cj J A• EECIOVE T))1 JUN 2 2 2015 JEFFERSON COUNTY DEPT OF COMMUNITY DEVJuiP FNT • • . 11337 ,t .' q CJ O ��� 2 d'U U P 11571 91 O /- "t- r ( . --' /2-(Q18 6/ (9\ -' , g35. z0 ? '( ( 011S. fa J • This combination qualifies for a Federal Energy 0%11'1 .1 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: 5021598 Date: 6/18/2015 Product: Split System: Heat Pump with Remote Outdoor Unit-Air-Source Outdoor Unit Model Number: 4TWX5030B1 Indoor Unit Model Number: *AM7A0B30H21 Manufacturer: TRANE Trade/Brand name: TRANE Series name: XL151 WEATHERTRON Manufacturer responsible for the rating of this system combination is TRANE Rated as follows in accordance with AHRI Standard 2101240-2008 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): 13.00 SEER Rating (Cooling): 15.25 Heating Capacity(Btuh) @ 47 F: 30000 Region IV HSPF Rating (Heating): 9.20 Heating Capacity(Btuh) @ 17 F: 18900 it) C � 1:11 D JUN 22 L JEFIERSCiN CO OPT OF C0M MUNITY •Ratings followed by an asterisk C)indicate a voluntary rerate of previously published data,unless accompanied with a WAS,which indicates an involuntary rerate. 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. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI.The 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; I I " 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-CONDITIONING,HEATING, CERTIFICATE VERIFICATION Ii REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.org,click on"Verify Certificate"link we make lice 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. ©2014 Air-Conditioning, Heating,and Refrigeration Institute CERTIFICATE NO.: 130791284954162100 AIR FLO HEATING COMPANY• Page 1 of 2 . 411111 Home Inicio en Espanol Contact Search L&I SE nHC.El A-Z Index Help My Secure L&1 Safety Claims& Insurance Workplace Rights Trades&Licensing Washington State Department of ILJ Labor & Industries AIR FLO HEATING COMPANY INC • Owner or tradesperson 221 WEST CEDAR SEQUIM,WA 98382 • Principals 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 contractors active registration/license/certification(depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties HeatingNent/Air-Conditioning and Refrig (HVAC/R) License no. AIRFLI.206DG Effective—expiration 03107/1980—04/25/2016 Bond CBIC $6,000.00 Bond account no. 515215 Received by L&I Effective date 02/0512010 02101/2010 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 04/2112015 04/25/2014 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&LIC=AIRFLI*206DG&SAW= 6/24/2015 AIR FLO HEATING COMPANY, Page 2 of 2 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 T3/NATASHA DRAGOVICH(360)902-4679-Email:DRAG235@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 '.. ®Washington Slate 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=600347761&LIC=AIRFLI*206DG&SAW= 6/24/2015 Parcel Details 0 • Page 1 of 2 0—,,,,, iefferson Counto „ . Weather Station P Database Tools " II ' Maps F 0:4 Webcans Home County Info : Departments Search Parcel Number: 001052057 SEARCH Parcel Number: 001052057 Printer Friendly Owner Mailing Address: JAMES E HANES ANNE B S HANES PO BOX 1027 PORT TOWNSEND WA98368 Site Address: 463 MIDDLEPOINT RD PORT TOWNSEND 98368 Section: 5 School District: Port Townsend (50) Qtr Section: NW1/4 Fire Dist: Chimacum (1) Township: 30N Tax Status: Taxable Range: 1W Tax Code: 0111 Planning area: Quimper (2) Sewer: Drainage: Bank: View 1: View 2: Zoning 1: RR-5 - Rural Residential Zoning 2: Zoning 3: Sub Division: Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: MC CULLOUGH SHORT PLAT LOT 3 Tax, A/VSales, Photos, and Permit Data Bldg Data Map Parcel lats&Surveys l _ _Stic Monitoring Info b =,._ Jerson 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=001052057 6/24/2015 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#: BLD15-00209 Received Date 6/24/2015 SITE ADDRESS: 463 MIDDLEPOINT RD Issue Date 6/24/2015 PORT TOWNSEND, 98368 APPLICANT: JAMES E HANES PHONE: ANNE B S HANES PO BOX 1027 PORT TOWNSEND WA 98368 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001052057 Section: 5 Township: 30N Range: 1W 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, JAMES E HANES PHONE: if different: ANNE B S HANES PO BOX 1027 PORT TOWNSEND WA 98368 PROJECT DESCRIPTION: Install one heat pump and air handler(like in kind) 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 6/24/2016. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: Tank/Line/Appliance: Final Approval: 74>97.2" 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\fo rms\F_BLD_Perm it_Propane.rpt 6/24/2015