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Home My WebLink AboutBLD2015-00001 - MECHANICAL lia BLD15-00001 13 DING PERMIT APPLICATIO. Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD15-00001 Received Date: 1/5/2015 SITE ADDRESS: 101 MARINER PL PORT LUDLOW, 98365 OWNER: FREDERICK NORD PHONE: 360-437-4122 101 MARINER PL PORT LUDLOW WA 98365-8738 9319 SUBDIVISION: Block: Lot: 10 PARCEL NUMBER: 931900010 Section: 16 Township: 28 N Range: 1E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI NEW MECHANICAL PERMIT- INSTALL NEW GAS FIREPLACE & GAS PIPES 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: touting Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $228.00 SRE 01/05/15 154011 APPROVED p �! Total: $228.00 APPRO !/ ED JAN 01 26Z Jefferson County DCC \\tidemark\data\forms\F_B LD_App_Bid.rpt 1/5/2015 Parcel Details Page 1 of 2 Jefferson County Home County Info Departments Search Parcel Number: 1994800601 1 SEARETil Parcel Number: 994800601 Printer Friendly Owner Mailing Address: PATRICK FOWLER 430 SENTINEL FIRS RD PORT HADLOCK WA98339-9736 Site Address: 51 MASONIC HALL RD PORT HADLOCK 98339 Section: 2 School District: Chimacum (49) Qtr Section: NE1/4 Fire Dist: Chimacum (1) Township: 29N Tax Status: Taxable Range: 1W Tax Code: 0211 Planning area:Tri-Area (4) Sub Division: 9948 - SHOLD'S Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: SHOLD'S ADDITION BLK 6 LOTS 1 TO 3 Tax,A/V, Sales, Photos, and Permit Data Blda Data Map Parcel lats &Surve s Septic Monitoring Info Jefferson County HOME I COUNTY INFO I DEPARTMENTS I SEARCH #00, Best viewed with Microsoft Internet Explorer 6.0 or later Windows - Mac ---GUCCf 5 http://www.cojefferson.wa.us/assessors/parcel/parceldetail.asp?Parcel NO=994800601 1/5/2015 Cases Associated with a Parcel Page 1 of 1 �.w Jefferson County Home County Info Departments Search Cases Associated with Parcel No: 994800601 This may not be a complete listing of information that exists for this parcel. There may be other information pertinent to the property on file. Please contact the Department of Community Development for additional information. *Parcel Tags Case Number CAM14-00182 Description Segregate three legal lots of record Last Name JPMORGAN CHASE BANK NATL ASSOC Received Date 3/19/2014 2:22:39 PM No Images Case Number SEP06-00092 Description THIS IS NOT A PERMIT!!!! EES ONLY DONE 3/24/06 Last Name BRASSFIELD Received Date 3/28/2006 J' \ No Images t\ J Case Number SOM06-00092 Description Last Name HOLLOWAY Received Date No Images .y +..a Jefferson County HOME I COUNTY INFO I DEPARTMENTS I SEARCH Best viewed with Microsoft Internet Explorer 6.0 or later Windows- Mac http://www.co.j efferson.wa.us/commdevelopment/ppquery/cm.asp?value=994800601 1/5/2015 i �go c�G DEPARTMENT OF COMMUNITY DEVELOPMENT 4L , t 621 Sheridan Srreet,Port Townsend,WA 98368 ■< Tel:360.379.4450 Fax:360.379.4451 Web www.co.icftcrson.wa.us/communitpdevelopment leacteo.jeffersonma.us 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#: i` Date: 1/Ca/It- 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- an-showing propane tank, lines,and distance from tank to all existing structures. Required Submittal Items—for Solar Panel installation only rr _ Corn. -te fir sage and signature block only of Mechanical Permit Application. A - . ete • -r panel supplemental application. 0 E Site Information Assessor Tax Parcel Number: 1 3 I 9 o 0 o I o J Ji; - 015 j' Site Address and/or Directions to Property: lc) i AAA /J L • 1 i PT - 1-L(_O 1_0 LJ f1 GU�IlY--►� Access (name of street(s) from which access will be gained: —�`!_°rig Description of Work: lnST ALL 'f�� er/sk_cc 2 IO (P/ar2 .Q s ?Li"Jam) Property Ow - Name: Li 1, Vg . FR.-EJJ Fv 5 2p Co Addres . 101 / • >' >°2 :L& - 'i Lt� f2Lot,J L (- q if)3 ` S 0 P. e #: E-mail Address: m Please contact Authorized Agent/Representative with project info. Property Owner Signature-:-) Date: Appjhcnn /i =ctor `Authorized Agent/Representative Tjj. Name: �� I r tstal Phone #: E-mail Address: License #: sLt hs ttp)k t 77 Q p Expiration Date: !1 /1 7 tkirk S t/1 lo/'o- 7 r c fi Mechanical Application 1 V c3 e m-) .t p �,-1 /‹) • • Heat Source Electric Heating Oil Propane* 1/ 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" f 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: I 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. [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. Ap icant may request notice of the County's intent to enter upon the property for visits thi applic ion and ubsequent permit issuance.r a/ A , Signatur Print Name: R----0117) 1CIC , IV opb Date: OFFICE USE ONLY Building Permit Fees Mechanical Permit fee (tank swap,woodstove,furnace,etc) $152.00 Propane— Lines, tank, and appliance (add'I $76.00) Project Scanning Fee $19.00 Total Fees* *Additional fees may apply, Mechanical Application 2 Parcel Details Page 1 of 2 • • Jefferson County t lr».. ��$„iaCFa3` YR -c r t "F 7c :, "x.. -. ,r yam+'° Home County Info Departments Search Parcel Number: 931900010 SEARCH Parcel Number: 931900010 Printer Friendly Owner Mailing Address: FREDERICK NORD 101 MARINER PL PORT LUDLOW WA98365-8738 Site Address: 101 MARINER PL PORT LUDLOW 98365 Section: 16 School District: Chimacum (49) Qtr Section: SE1/4 Fire Dist: Port Ludlow (3) Township: 28N Tax Status: Taxable Range: 1E Tax Code: 0231 Planning area: Port Ludlow (7) Sub Division: 9319 - BAYVIEW VILLAGE DIV 1-3 Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: BAYVIEW VILLAGE DIV 2 LOT 10 Tax,AN, Sales, Photos, and Permit Data Bldg Data Map Parcel 'fats&Surve s Septic Monitoring Info J ' ';; Jefferson County HOME I COUNTY INFO I DEPARTMENTS I SEARCH Best viewed with Microsoft Internet Explorer 6.0 or later 0 Windows - Mac http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?Parcel_NO°931900010 1/5/2015 SUNSHINE PROPANE Page 1 of 3 • • Washington State Department of Labor & Industries SUNSHINE PROPANE Owner or tradesperson 10853 RHODY DR CHAWES, RICHARD HENRY PORT HADLOCK, WA 98339 360-385-5797 Principals JEFFERSON County CHAWES, RICHARD HENRY, PRESIDENT LEMLEY, DAVID BARRY, VICE PRESIDENT SIMPSON, LAURA ANNE, SECRETARY YOURISH, ROBERT B, TREASURER FLANDERS, RONALD LEE, MEMBER EWING, MICHAEL HOYT, MEMBER ROSS, LEVI K (End: 01/01/1980) CHAWES, RICHARD (End: 01/01/1980) YOUNT, JO (End: 01/01/1980) SPRING, PERRY (End: 11/05/2010) PETERSEN,JAMES (End: 11/05/2010) Doing business as SUNSHINE PROPANE WA UBI No. Business type 600 342 368 Corporation Parent company ENVIRONMENTAL HOUSING INC License Verify the contractor's active registration/license/certification (depending on trade) and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. SUNSHP*077QP Effective—expiration 11/17/1993-11/17/2016 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600342368&LIC=SUNSHP*077QP&SAW= 1/5/2015 SUNSHINE PROPANE Page 2 of 3 Bond 1110 410 No current bond account. See the bond history. Bond history Insurance .__....._............ FEDERATED SERVICE INS CO $1,000,000.00 Policy no. 633829 Received by L&I Effective date 11/09/2006 11/17/2006 Expiration date Until Canceled United States Fire Insurance C $1,000,000.00 Policy no. 506-878572-6 Received by L&I Effective date 11/13/2014 11/17/2014 Expiration date 11/17/2015 Insurance history Savings ..._......_........ (in lieu of bond) $12,000.00 Received by L&I 09/16/2014 Savings account ID Effective date 0770001033 09/10/2014 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. 422,171-00 ........._.........._........ Doing business as SUNSHINE PROPANE Estimated workers reported Quarter 3 of Year 2014"11 to 20 Workers" L&I account representative T1 /JAN BENTLEY (360)902-4652 -Email: STRO235 @Ini.wa.gov I I https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600342368&LIC=SUNSHP*077QP&SAW= 1/5/2015 SUNSHINE PROPANE Page 3 of 3 Workplace safety and healtt ! I No inspections during the previous 6 year period. ©Washington State Dept.of Labor&Industries. Use of this site is subject to the laws of the state of Washington. Access AIM Washington ' >4Yr;,f_nt`kid,*4,, https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600342368&LIC=SUNSHP*077QP&SAW= 1/5/2015 osON ec, ?, JEFFERSON COUNTY & $T DEPARTMENT OF COMMUNITY DEVELOPMENT 9SHtNG.Io Date: / Time Received: I / ,:�� am/pm Mon. Tue. ed. Thur. Fri. Date: S-12 I BLD: /c— ( Contact Name: Owner: Pat') Contact Number: 360 5 -) -- Address: /(9/ L7i,-k,.q /.1- 206 Notes: Foundation Plumbing Framing Propane Tank P Mechanical Setbacks Underground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Straps Hot Water Htr Interior shear Oil Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection iy Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling FY�S� `� JEFFERSON COUNTY 2 DEPARTMENT OF COMMUNITY DEVELOPMENT V Date: I-2_1 Time Received: ,at am/a) Mon. Wed. Thur. Fri. Date: 1 _2? BLD: I S - i Contact Name: Owner: Contact Number: 360 35" 549 Address: j p t iiKAP-,v-v4., f L 206 Notes: Foundation Plumbing Framing Propane Tank p 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 JEFFERSON COUNTY DCD No. 154011 DATE I/S/ 1 RECEIVED FROM FNItIL-t\S hnne ¶ro'�`^// .ne 1 BARSW AMOUNT DESCRIPTION % CURRENCY thibp6— j '0V I"IDX f\iU/li` I Vt,' � - COIN IAI1Y,tI4n 1 Ft ' °C) CHECKS '-R,uCa 0131 -qOO to 51 lec 0 1 11Ac; lner1 • 0 8 ca RECEIVED f-" RECEIVED BY TOTAL • 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#: BLD15-00001 Received Date 1/5/2015 SITE ADDRESS: 101 MARINER PL Issue Date 1/5/2015 PORT LUDLOW, 98365 APPLICANT: FREDERICK NORD PHONE: 360-437-4122 101 MARINER PL PORT LUDLOW WA 98365-8738 10 SUBDIVISION: 9319 Block: Lot: PARCEL NUMBER: 931900010 Section: 16 Township: 28N Range: 1 E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 (3 l g5 Contractor's License SUNSHP*077QP Expires 11/17/2016 5875 OWNER, FREDERICK NORD PHONE: 360-437-4122 if different: 101 MARINER PL PORT LUDLOW WA 98365-8738 PROJECT DESCRIPTION: NEW MECHANICAL PERMIT- INSTALL NEW GAS FIREPLACE & Directions GAS PIPES 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 1/5/2016. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: r,. Tank/Line/Appliance: V22) Final Approval: 5/2J/)r 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 11tidemark\data\form s1F_BLD_Permit Propanexpt 1/5/2015