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HomeMy WebLinkAboutBLD2015-00306 - MECHANICAL • • 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#: BLD15-00306 Received Date 9/3/2015 SITE ADDRESS: 2481 ANDERSON LAKE RD Issue Date 9/3/2015 CHIMACUM, 98325 APPLICANT: EVERGREEN COHO ESCAP RETREAT PHONE: 2481 ANDERSON LAKE RD CHIMACUM WA 98325-9795 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901101039 Section: 10 Township: 29N 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, EVERGREEN COHO ESCAP RETREAT PHONE: if different: 2481 ANDERSON LAKE RD CHIMACUM WA 98325-9795 PROJECT DESCRIPTION: Install Ductless Heat Pump and Air Handler. 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 9/3/2016. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: Tank/Line/Appliance: Final Approval: 91231 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 HOURSADAY \\tidemark\data\forms\F BLD_Permit_Propane.rpt 9/3/2015 •UILDING PERMIT APPLICAIN BLDI5-00306 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD15-00306 Received Date: 9/3/2015 SITE ADDRESS: 2481 ANDERSON LAKE RD CHIMACUM, 98325 OWNER: EVERGREEN COHO ESCAP RETREAT PHONE: 2481 ANDERSON LAKE RD CHIMACUM WA 98325-9795 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901101039 Section: 10 Township: 29 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 Install Duckless Heat Pump and Air Handler. 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: 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 09/03/15 159159 APPROVED Total: $156.00 SEP 0 3 2015 Jefferson County DCC \\4ir40MnrIrlrin4alfnrmalF RI n Ann PIA rn4 O/4/9/11A . . • ON co DEPARTMENT OF COMMUNITYYEVELOPMENT +s (;_:":1,Shuidan Srr«t 1 a:.t i n v t,c:ad,Vl.1 98368 � �� 36v i'9�15ft 11)::x: �e_?( s i79.=4411 I� r-. ,_ ^C l�'cb 1�4u.co.icttcrs■,nw; t,icummunin dcr-eiupment C-mall &ciao.);ff t" \\ }1s " � — 32015 YSNLNG - 11ES9EP MECHANICAL PERMIT APPLICATION 1 JEFFERSON COUNTY Steps in the Permit Process: DEPT.OF COMMUNITY DEVELOPMENT -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#: he/ /4-1(f Date: 9/3/1 Related Application Its: .#: gj/, SAL ur 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: `1 / - I I 0 !(( Site Address and/or Directions to Property: ,3 tie, -el-fl19XSCn1 ..„irc9..44 . av ima.0,V M, v�A Access (name of street(s) from which access will be gained: Description of Work: )y 0'(>( 000714,v6, 14 faf-PUv 1 e /A I ' ha IAA ttr Property Owner Name: t Lr(i1r l� r k' r71 5 (4,1) L 14_,t"r1' m Address: 94j �UYI L' ..L ci Phone #: 3(D0 °IU ( S'i -Y_-_ E-mail Address: v Applicant/ Contractor: Authorized Agent/Representative Name: 3— VII') t— .InCA ‘AtAci [-i air 1' UJ Phone #: 3(pp -3C-S a Sy E-mail Address: edi Ill 9 , WA/ License#: Ail,K,i 1,4 .000 bt,7 Expiration Date: ill ta.,9 t 'n Mechanical Application 1 Heat Source Electric Heating Oil Propane* n Wood El 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: 1 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 o this application and subsequent permit issuance. Property wn / / Signatu • Print Name: l M ttk �- CI-AS©-) up Date: gl"?81 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* I` "-, , (--)/2 *Additional fees may apply. Mechanical Application 2 • >� This combination qualifies for a Federal Energy 14 U: i 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: 3589025 Date: 8/28/2015 Product: Variable Speed Multi-Split Heat Pump D L�F� C 2 W Outdoor Unit Model Number: MXZ-2B2ONA L� v Indoor Unit Model Number: MSZ-GEO9NA(2) SEP - 3 2015 Manufacturer: MITSUBISHI ELECTRIC COOLING & HEATING [ Trade/Brand name: MR. SLIM — • Series name: JEFFERSON COUNTY DEPT.OF COMMUNITY DEVELOPMENT Manufacturer responsible for the rating of this system combination is MITSUBISHI ELECTRIC COOLING & HEATING Rated as follows in accordance with AHRI Standard 210/240-2008 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): 18000 EER Rating (Cooling): 12.50 SEER Rating (Cooling): 18.00 Heating Capacity(Btuh)@ 47 F: 22000 Region IV HSPF Rating (Heating): 8.90 Heating Capacity(Btuh)@ 17 F: 12500 CERTIFIED RATINGS FOR VARIABLE-SPEED,MINI-AND MULTI-SPLIT SYSTEMS ARE VALID FOR ALL COMBINATIONS OF INDOOR UNITS (BASED ON COMBINATION TYPES)WITH THE SPECIFIC OUTDOOR UNIT LISTED ABOVE AND IN THE AHRI DIRECTORY OF CERTIFIED EQUIPMENT.VISIT WWW.AHRIDIRECTORY.ORG TO VERIFY THAT THIS COMBINATION IS AN ACTIVE LISTING AND THE DATA LISTED ON THIS CERTIFICATE IS ACCURATE.SEARCH ON THE AHRI REFERENCE#TO QUICKLY LOCATE THIS COMBINATION IN THE DIRECTORY. "Ratings followed by an asterisk()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.ahrldlrectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI.This 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; 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 &REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.org,click on"Verify Certificate"link we lire 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.: 130852565213503195 � N- I—RI Y � (,f Lyy-e.)113, 53clesae),\,,,3Ecp,„„ , . . - co,„ -Loz pp,p-ry ,-, , -, tvik as � .. c fo '6 If 7-k.URA V . PtA ,__'� i OA — 5 cmiL. 5 v-k-v.N S crFw g1--- . I 4 15 . , NI 560 G - '1 3.'"7-iii.i5 2 b 8 S V ' (stb (624 3c17-1 37 U-t J }102 700 X37 ........... ■ 2 )) ,IP 5 s , ag5 ?ex .EC.E.I V o 3,,,, -2, - ,-L ) 35S v 1 20 �cJ SEP 3...2015 JEFFERSON COUNTY �_ cot-1 DEPT.OF COMMUNITY DEVELOPMENT z 4 5?)3 6..4>b .,,,,/ , 5-20 Cit-f 12 SHOT NOTE -` APA°... . !,/ Parcel Details • • Page 1 of 2 :04 Jefferson Count y WAS WASHINGTON Weather Station Database Tools Maps Webcam Home County Info DepGftillents Search Parcel Number: 1901101039 [SEARCH Parcel Number: 901101039 Printer Friendly Owner Mailing Address: EVERGREEN COHO ESCAP RETREAT 2481 ANDERSON LAKE RD CHIMACUM WA98325-9795 Site Address: 2481 ANDERSON LAKE RD CHIMACUM 98325 Section: 10 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) Sewer: Drainage: Bank: View 1: View 2: Zoning 1: Zoning 2: Zoning 3: Sub Division: Assessor's Land Use Code: 7500 - Resorts - Seasonal - RV Parks Property Description: EVERGREEN COHO ESCAPEE RESORT RECREATIONAL VEHICLE PARK 177 SP Tax,A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel Plats &Surveys Septic Monitoring Info Jefferson County HOME I COUNTY INFO I DEPARTMENTS I SEARCH I" Best viewed with Microsoft Internet Explorer 6.0 or later ,/ 6 Windows - Mac http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?value=901101039 9/3/2015 AIR FLO HEATING COMPANY* • Page 1 of 2 Home Inicio en Espanol Contact Search L&I I A-Z Index Help My Secure I&I Safety Claims&Insurance Workplace Rights Trades&Licensing Washington State Department of " Labor & Industries IAIR FLO HEATING COMPANY INC Owner or tradesperson 221 W CEDAR SEQUIM,WA 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 contractor's active registration/license/certification(depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties Heating/VentlAir-Conditioning and Refrig (HVAC/R) License no. AIRFLP206DG Effective—expiration 03/07(1980—04/25/2016 Bond CBIC $6,000.00 Bond account no. $15215 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 04121/2015 04/25/2014 Expiration date https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&LIC=AIRFLI*206DG&SAW= 9/3/2015