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Home My WebLink AboutBLD2015-00270 - MECHANICAL UILDING PERMIT APPLICA1IN BRD1e 00270 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD15-00270 Received Date: 8/4/2015 SITE ADDRESS: 284 CEDARVIEW DR PORT TOWNSEND, 98368 OWNER: ALAN HENSHALL PHONE: ANNE HENSHALL 284 CEDARVIEW DR PORT TOWNSEND WA 98368-2501 9650 - KALA POINT 3-8 SUBDIVISION: Block: Lot: PARCEL NUMBER: 965000329 Section: 27 Township: 30 N Range: 1V 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 DESCRIPTIOII HEAT PUMP & AIR HANDLER (LIKE IN KIND) TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION ADD'L: HEAT TYPE: EEE 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 JLA 08/04/15 156347 Total: $156.00 APPROVED AUG 0 4 2015 Jefferson County DCD 11/irlemarLkeinln1fnrmelr RI n Ann Rb1 m+ Q/Aflfl1 • • .50N ec. DEPARTMENT OF COMMUNITY RVELOPMENT 4� U 621 �hctidan Salvo,Past 11 nscn.''.WA 98.368 44 . 2A 1x{:36(13;9.4450 : 1'x<36t. 179.4451 ' '- Wel) a i�r.co.ic.ttenvn.lya t iQ∎rnmunitydevelopment F.rn it dcdIj. cc :cif,.r.,,-)n n'i u qs�J N�.�0 MECHANICAL PERMIT APPLICATION Steps in the Permit Process: -Review required submittal items to ensure all information is completed prior to submitting application. -Mechanical Permits can be mailed into our office-and do not require an appointment. -Fees are due at time of submittal, Mechanical permits are generally issued within 5 busines"�days. For Department Use Only Receipt#:I5(:,„,l- `7 Date: /$/i a Related Application #5: Payment#: 44463 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. IA A complete solar panel supplemental application. — Site Information Assessor Tax Parcel Number: ° 4' C C L ( >'2! Site Address and/or Directions to Property: 2 .L..( 0 Ea AyQ„V iCkii J ( . P-r1- -row 6oend WA Access (name of street(s)from which access will be gained: Description of Work: 116 51A LL 6Vlt I.✓160. c. /Vl & A i r kia.inc . rte— (Li lct( I lv V.-Ina ) Property Owner Name: ALfix'l q ` rl Y1 'C 4- 4 r),.,vl . LLB to Address: 21.-1 t 1 0 .G(A-r'v I i iru Of • Prf .t- j oxii8eino1 VGA n Phone #: C > 52 E-mail Address: m Applicant/ Contractor: Authorized Agent/Representative �' Name: ,t j L L k-A t., )-.1--H el (n `../1 ill)iLiCI vt.I t l-li_ Phone#: >0 Ors?, J 1 t E-mail Address: kx.(-i Y1C , CiOrv1 �" License#: A 112. c T 204206, Expiration Date: 11 I gc, I Ca N Mechanical Application 1 0 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 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 s application and subsequent permit issuance. Property Owner / Signature: Print Name: it.019 //EA/S/e4l�— Date: / 22�� OFFICE USE ONLY !!! Building Permit Fees Mechanical Permit fee (tank swap,woodstave,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 45 ON p Er Loa JEFFERSON COUNTY 4 -� $ DEPARTMENT OF COMMUNITY DEVELOPMENT ySSrNOS Date: g-29-Time Received: /DO I pm Mon. Tue. Thur. Fri. Date: Y--2.6 BLD: }5-- ?■7() Contact Name: Owner: Contact Number: 360 SS's- 5Z75 Address: , P-/ � r-i1 206 Notes: kQ Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Underground 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 . biew 5 v • 114),Lve \?-#'''` v14 14 ► IA o z3 t ZN • 81/4 45if / 1 1q4 o 7,1 it. ■ Z3xz o// vo i- x .Y 23y` Parcel Details • Page 1 of 2 • 1Jefferson Co1n ?J:zt ` �' - Home County Info Departments Search Parcel Number: 102132102- SEARCH Parcel Number: 021321024 Printer Friendly Owner Mailing Address: LOIS L HUTH 1191 GRIFFITH POINT RD NORDLAND WA98358-9503 Site Address: 1191 GRIFFITHS POINT RD NORDLAND 98358 Section: 32 School District: Chimacum (49) Qtr Section: NE1/4 Fire Dist: Chimacum (1) Township: 30N Tax Status: Taxable Range: 1E Tax Code: 0211 Planning area: Marrowstone (3) 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: S32 T30 R1E TX 48(REVISED) TR 45 &TL ADJ SURVEY V10/PG 162 Tax,A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel •fats&Surveys Se!ticMOnitorin. Info > _ Jefferson County HOME I COUNTY INFO I DEPARTMENTS I SEARCH N a Best viewed with Microsoft Internet Explorer 6.0 or later Windows - Mac http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?value=021321024 8/4/2015 JEFFERSON COUNTY 00CD NO. 1 c. = 47 • DATE �O RECEIVED FROM air 80 ill eA7iii �i DESCRIPTION BARS AMOUNT J �y�I�,,� CURRENCY , 4-7 7 COIN Q 7 CHECK) r Cl - 0447 // o S _� ' 32 m -f 'c4-tiDr, /p5 ill At). /gyp //( RECEIVED BY / / r/lf.� TOTAL I 75- r AIR FLO HEATING COMPANY Page 1 of 2 Home [nieio en Espanol Contact Search L&I SEARCH A-Z Index Help 343/Secure L&I Safety Claims&Insurance Workplace Rights Trades&Licensing OWashington State Department of Labor & Industries AIR FLO HEATING COMPANY INC Owner or tradesperson 221 W 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 COO 1.47 9CI r..........•:.... 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 Bond account no. S15215 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 04/21/2016 04/25/2014 Expiration date 04/2512016 Insurance history Savings No savings accounts during the previous 6 year period. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&L IC=AIRFLI*206DG&SAW= 8/4/2015 AIR FLO HEATING COMPANY I Page 2 of 2 Lawsuits against the bond or savings • No lawsuits against the bond or savings acco during the previous 6 year period. L81 Tax debts No L8I tax debts are recorded for this contractor license during the previous 6 year period,but some debts may be recorded by other agencies. Lice nse 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 2 of Year 2015"21 to 30 Workers" L&l 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 07124/2012 Violations Inspection no. 315954529 Location 125 Horizon View Dr. Sequim,WA 98382 ®Washington State 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= 8/4/2015 0 • 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#: BLD15-00270 Received Date 8/4/2015 SITE ADDRESS: 284 CEDARVIEW DR Issue Date 8/4/2015 PORT TOWNSEND, 98368 APPLICANT: ALAN HENSHALL PHONE: ANNE HENSHALL 284 CEDARVIEW DR PORT TOWNSEND WA 98368-2501 SUBDIVISION: 9650 - KALA POINT 3-8 Block: Lot: PARCEL NUMBER: 965000329 Section: 27 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, ALAN HENSHALL PHONE: if different: ANNE HENSHALL 284 CEDARVIEW DR PORT TOWNSEND WA 98368-2501 PROJECT DESCRIPTION: HEAT PUMP&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 814/2016. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: Tank/Line/Appliance: Final Approval: g) LEI))5 - 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 HOURSA DAY Cmctitz(I 10 COr 1.- -C-O( 8/v) c 5- \\tidemark\data\forms\F_BLD_Permit_Propane.rpt 8/4/2015