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Home My WebLink AboutBLD2015-00275 - MECHANICAL UILDING PERMIT APPLICA•N BLD15-00275 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD15-00275 Received Date: 8/5/2015 SITE ADDRESS: 68 LAUREL ST PORT HADLOCK, 98339 OWNER: MATTHEW SIMPSON PHONE: 14525 132ND CT NE WOODINVILLE WA 98072-4618 SUBDIVISION: Block: Lot: PARCEL NUMBER: 921063012 Section: 6 Township: 29 N Range: 1E CONTRACTOR: GREENWOOD HEATING AND AC PHONE: 206-784-1818 825 S STACY ST SEATTLE WA 98134 Contractor's License GREENHA922D7 Expires 3/27/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI' Replace electric air handler. Install heat pump. 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: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: 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 08/05/15 156402 APPROVED Total: $156.00 AUG 0 5 2015 Jefferson County DCC 11firle.nnrLl,e/e\fnen,elr RI n Ann P1,4 en/ R/S/9Ric SON C • • �w O DEPARTMENT OF COMMUNITY DEVELOPMENT 4 'L 621 Sheridan Street,Port Townsend,WA 98368 W � 1- C 1 el:360.3 9 4150 I Fax.360.3'9.4 A51 0r- H V I 14cb:wwwco) ffcrson.wa.uslcommunitydcvclopmcut " 114nail:dcd(t4co ieffcrson.wa us ! �G�yN 1 N OHO , i j 1 AUG - R 1015 MECHANICAL PERMIT APPLICATION jU Steps in the Permit Process: i JEFFERSC:1 COUNTY -Review required submittal items to ensure all information is completed prior to submitting a f-•--- Di nF!!r nrnn;nr g per:-- ,",n+-- -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. 1 For Department Use Only Receipt#: ,C�(/f i Date: '1i3f/° '{ Related Application#s: Payment#: f3(",; g 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: 921063012 Site Address and/or Directions to Property: 68 Laurel St, Port Hadlock, WA 98339 Access (name of street(s) from which access will be gained: Description of Work: replace electric air handler, Lennox (:RX40MV048, 15kw Install heat pump_ Pnnox XP21-048 Property Owner Name: Matt Simpson m Address: 68 Laurel St, Port Hadlock, WA 98339 0 Phone #: 425-894-7519 E-mail Address: c) ✓_ Please contact Authorized Agent/Representative with project info. Property Owner Signature: Date: 7/29/15 It r_ Applicant/ Contractor: Authorized Agent/Representative Name: Greenwood Heating and AC 9 ashleyb @greenwoodheatinq.com Phone #: 2067841818 E-mail Address: ashleyb(c�greenwoodtn License #: GREENHA922U7 Expiration Date: 02/03/17 Mechanical Application 1 • • Heat Source Electric 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 _ 1 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 1 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 i"s)ae. " ailiri and subsequent permit issuance. Ashley Bouck 7/29/15 Signature: Print Name: Date: OFFICE USE ONLY Building Permit Fees Mechanical Permit fee (tank swap,woodstove,furnace,etc I $156.00 Propane— Lines, tank, and appliance (add'l $78.00) Project Scanning Fee $195.0 Total Fees* ees may apply w � U J Mechanical Application 2 `IEFFERSON COUNTY P.PT O, COMMUNITY DFVFI.OPMENT JEFFERSON COUNTY • 0 C NO. 1 5,0 2 0 DATE J i if A� � y RECEIVED FROM �uJ114I vd ilahnt ai' �! „ iy DESCRIPTION !/ BARS# AMOUNT CURRENCY By z 6/ 15-c , OD COIN �� //�v.ns�. !!! / q, SO CHECKS) ( lJ PN q. / c)63 4/,2 0 , y y G /r g b c./. A La��f� ma 4 `' ‘ aii ° / /41;?lef RECEIVED BY �'�. TOTAL /7 5, 50 ``� ?45ury RUC. , JEFFERSON COUNTY 9So DEPARTMENT OF COMMUNITY DEVELOPMENT Date: F- 13 Time Received: Sf'/ '7 a at Mon. 40 Wed. Thur. Fri. Date: S-- /g BLD: /5--,-7g- Contact Name: Owner: Contact Number: 360 4/2-S— g 2S-77 Address: & 8- L,40R4-- S-- 206 Notes: frail, /i_e,,, ,i. 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 „...., CTRI jos. • '' diatfft � , I. _._..._ ri(' r, r, , i 7 i 1 l ') - "gig, „- EfIJGBtii:v'r4EP. Why'- i.. it,,,, • e .,r ,our— SQL - `•., A 4S7 ._ tut)-z..; v c, ` k. 1f1 C te. Oa '' - . . - , new■D r-- "4744 _ip.4-4::,,,,,..: is y • E734i (rte .Y - ' � � �''— - N01,\ 46l om. . CC ,..Cheri fir Vr 0* , ) %,j C U ) , udt lnvext»tn , I •3 6'7 4 . (,.. /,‘,....... ,hi,..f J �z . ,.._.c. / /c* is ..� s. . .vY�4:L.. kf..ivi.... .k C"�'::,tiL,..J,•, ...• I', PLEASk ORP'W A OU1 • 2-01S 0 4 j ,. 1 Parcel Print Page 1 of 1 Parcel Number:921063012 05/12/2015 Owner Mailing Address: MATTHEW SIMPSON 14525 132ND CT NE WOODINVILLE WA 98072-4618 Site Address: 68 LAUREL ST PORT HADLOCK 98072-4618 Section: 6 School District: Chimaaim(49) Qtr Section: SW 1/4 Are Dist: Chimacum(1) Township: 29N Tax Status: Taxable Range: lE Tax Code: 0211 Planning area: 98072-4618 Sewer: Drainage: Bank: View 1: View 2: Zoning 1: RR-5 - Rural Residential Zoning 2: Zoning 3: Sub Division: Land Use Code: 1100 98072-4618 Property Description: S6 T29 R1E TX 36 &TL TX C-4(LS TL TX C-5) http://www.co.jefferson.wa.us/assessors/parcel/parcelprint.asp?value=921063012 8/5/2015 GREENWOOD HEATING &A/C. Page 1 of 4 Home Inicio en Espanol Contact Search L&I A-Z Index Help My Secure L&I Safety Claims&Insurance Workplace Rights Trades&Licensing `0 Washington State Department of , Labor & Industries GREENWOOD HEATING & A/C Owner or tradesperson 2850 SW YANCY ST PMB 203 Principals SEATTLE,WA 98126 206-365-3313 PORTER,MICHAEL,PRESIDENT KING County PORTER,KELLEY LEE,VICE PRESIDENT Doing business as GREENWOOD HEATING&A/C WA UBI No. Business type 602 259 014 Corporation License Verify the contractor's active registration I license I certification(depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. GREENHA922U7 Effective—expiration 0312712008—02/03/2017 Bond CBIC $12,000.00 Bond account no. 514989 Received by L&I Effective date 01/13/2010 01/14/2010 Expiration date Until Canceled Bond history Insurance Federated Mutual Ins Co 51,000,000.00 Policy no. 9363113 Received by L&I Effective date 06/30/2015 08/01/2015 Expiration date 08/01/2016 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 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602259014&LIC=GREENHA922U7&SAW= 8/5/2015 S 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 #: BLD15-00275 Received Date 8/5/2015 SITE ADDRESS: 68 LAUREL ST Issue Date 8/5/2015 PORT HADLOCK, 98339 APPLICANT: MATTHEW SIMPSON PHONE: 14525 132ND CT NE WOODINVILLE WA 98072-4618 SUBDIVISION: Block: Lot: PARCEL NUMBER: 921063012 Section: 6 Township: 29N Range: 1E CONTRACTOR: GREENWOOD HEATING AND AC PHONE: 206-784-1818 825 S STACY ST SEATTLE WA 98134 Contractor's License GREENHA922D7 Expires 3/27/2016 OWNER, MATTHEW SIMPSON PHONE: if different: 14525 132ND CT NE WOODINVILLE WA 98072-4618 PROJECT DESCRIPTION: Replace electric air handler. Install heat pump. 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 8/5/2016. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: Tank/Line/Appliance: Final Approval: 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 ADAY \\tidemark\data\forms\F_BLD_Permit_Propane.rpt 8/5/2015