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HomeMy WebLinkAboutBLD2015-00261 - MECHANICAL SILDING PERMIT APPLICAT BLD15-00261 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD15-00261 Received Date: 7/29/2015 SITE ADDRESS: 277 SCENIC VIEW PORT LUDLOW, 98365 OWNER: MARY MC ALISTER PHONE: % GENEVA FINANCIAL 1018 E GUADALUPE RD TEMPEAZ 85283 SUBDIVISION: Block: Lot: PARCEL NUMBER: 821334086 Section: 33 Township: 28 N Range: 1E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI New Woodstove Installation in SFR TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION ADD'L: HEAT TYPE: WOD CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: 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 $156.00 HAC 07/29/15 156333 APPROVED Total: $156.00 JUL 292015 Jefferson County DCC 11Hriem,rLlrhlalinrmclG DI n Ann MIA rm. 7190/?I11F �gON e DEP•MENT OF COMMUNITY D`ELOPMENT 4t� °G 021 Sheridan Street,Port Townsend,\\A 9836 4 j Tel: 360.3'9 4450 Fax:3601-9.4451 ■-C \\'eb www.co.ieffersf Hi Ava u..cummunn-ydevel,gm:enr = J E © E N VF-mail dcd4 c rr[ersnn a us �, � k1NG-CO MECHANICAL PERMIT APPLICATIO 1 , JUL 2 7 2Q15 Steps in the Permit Process: L �) -Review required submittal items to ensure all information is completed prior to submitti g applicatiJJrrERSON COUNTY -Mechanical Permits can be mailed into our office-and do not require an appointment. OCPT.OF CO_MMUNIIY DEVrOPMENT -Fees are due at time of submittal, Mechanical permits are generally issued within 5 business da s. For Department Use Only Receipt#: / 5 3 3 Date`. �1127/a gs Related Application#s: Payment#: 06/ Is this application for use in a Mobile/ Manufactured Home? 1 * If Yes: A permit from Washington State Department of Labor and Industries, not Jefferson County, is I 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 JL 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: CA / 33V O 09‘ Site Address and/or Directions to Property: 2 7 7 c.c e, , r� ei,,e w Z9-) pa,. ( G ce o /acv 4Q , 9(fiG.f- Access (name of street(s) from which access will be gained: f 74 7e " 7 a Description of Work: �/e-e/°7 ,'„s T//f 7. �r / / pie - ..i Ptuw, stove Property Owner Name: 1 Io?0,41 141� e4 Jr' ✓ °' Address: 1277 Sc.eh • 'G 0 , `e. . Gti , POr7 Z. �., ��y 4�'jta- 2 Phone #: y5U- 25/., f6G_S j7 E-mail Address: �4 r m 4GS rieD 4 ;y,y, I, 6j,i,, m K Applicant/Contractor: Authorized Agent/Representative 71 Name: a✓7 /1 ,4-/,f X-i Phone #: G p,l 7 S ._ , c- / E-mail Addressorm ria sfna 5-,yicr/ S License #: Expiration Date: Gen, Mechanical Apphcauon 1 Heat Source • • Electric il Heating Oil Propane* Wood IX 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 G,...,-.+:.--.: -rt *Propane tanks over 125 Fireplace Wood Fireplace woo ood 5tov:, or gallons require a minimum Pellet Stove setback of 10 ft. from Electric Furnace Electric Furnace or HP+/- Ducting property line and buildings, and a site plan must be Propane (LP) Gas Furnace Propane Furnace+/- Ducting 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 issuance. Property Ow r Signature`.? Y7J-L e,,. _Print Name: M/a2� ,t/cAi- - Date: 7/?. OFFICE'USE ONLY Building Permit Fees Mechanical Permit fee(tank swap,wood stove,furnace,etc) $156.00 Propane— Lines,tank, and appliance (add'I $78.00) Project Scanning Fee $19.50 Total Fees* �' � E � V � 4P� 75-. *Additional fees may apply. g 1 JUL 272015 ,I1' 1----� : pp catio 2 JEF _ a Tr",�'`f i1 DEPT.OF COMMUNITY DEVELOPMENIr • I JE FFERSON C(�NTY *NO. 1563 3 DATE 7 RECEIVED FROM Catlei e I Aleaikvey DESCRIPTION AMOUNT MOUNT CURRENCY f^ S / 56,47-11 COIN ! T, CHECKS �C 4- /3 CO Mald_p_p- Na 0 a RECEIVED BY A ! TOTAL 1 /_�, S0 • 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 #: BLD15-00261 Received Date 7/29/2015 SITE ADDRESS: 277 SCENIC VIEW Issue Date 7/29/2015 PORT LUDLOW, 98365 APPLICANT: MARY MC ALISTER PHONE: % GENEVA FINANCIAL 1018 E GUADALUPE RD TEMPE AZ 85283 SUBDIVISION: Block: Lot: PARCEL NUMBER: 821334086 Section: 33 Township: 28N Range: 1E CONTRACTOR: OWNER/BUILDER PHONE: OWNER, MARY MC ALISTER PHONE: if different: % GENEVA FINANCIAL 1018 E GUADALUPE RD TEMPE AZ 85283 PROJECT DESCRIPTION: New Woodstove Installation in SFR 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 7/29/2016. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: Tank/Line/Appliance: Final Approval:it_ '-7 15" 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 11tidemark\data\fo rms1F_BLD_Perm it_Propane.rpt 7/29/2015