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HomeMy WebLinkAboutBLD2015-00178 - MECHANICAL • 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#: BLD15-00178 Received Date 5/28/2015 SITE ADDRESS: 2552 S DISCOVERY RD Issue Date 5/28/2015 PORT TOWNSEND, 98368 APPLICANT: GLEN W KOCH PHONE: LAUREL J SOLANA PO BOX 1192 PORT TOWNSEND WA 98368-0992 10+ SUBDIVISION: 9590- HERON POND RANCH Block: Lot: PARCEL NUMBER: 959000010 Section: 29 Township: 30N Range: 1W CONTRACTOR: PENINSULA HEAT INC PHONE: 360-681-3333 PO BOX 173 CARLSBORG WA 98324 Contractor's License PENINI*0440W Expires 3/2/2016 OWNER, GLEN W KOCH PHONE: if different: LAUREL J SOLANA PO BOX 1192 PORT TOWNSEND WA 98368-0992 PROJECT DESCRIPTION: NEW MECHANICAL PERMIT Directions INSTALL 2 HEAT PUMPS 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 5128/2016. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: Tank/Line/Appliance: Final Approval: q174119 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 11 tidemark\data\forms\F_BLD_Permit_Propane.rpt 5/28/2015 iltUILDING PERMIT APPLICAN BLD15-00178 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD15-00178 Received Date: 5/28/2015 SITE ADDRESS: 2552 S DISCOVERY RD PORT TOWNSEND, 98368 OWNER: GLEN W KOCH PHONE: LAUREL J SOLANA PO BOX 1192 PORT TOWNSEND WA 98368-0992 9590- HERON POND RANCH SUBDIVISION: Block: Lot: 10+ PARCEL NUMBER: 959000010 Section: 29 Township: 30 N Range: 1\ CONTRACTOR: PENINSULA HEAT INC PHONE: 360-681-3333 PO BOX 173 CARLSBORG WA 98324 Contractor's License PENINI*044OW Expires 3/2/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPT1011 NEW MECHANICAL PERMIT INSTALL 2 HEAT PUMPS 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: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $0.00 SRE 05/28/15 APPROVED Total: $0.00 MAY 2 8 2015 Jefferson County DCD l\firimmnrI,\r1mfa\fnrmc\F RI fl Ann Rid m} 5/9R/91115 • • ti<,\`— '06 DEPARTMENT OF COMMUNITY DEVELOPMENT Q, 1-^ 621 Sheridan Street,Port Townsend,WA 98368 r y �� L1.1 ..0 Tel 360379.4450 I Fax:360 379.4451 1 Th' 17:� C f�—, EI V 1 Web:www.co.Jefferson.wa_us/cotnmunitFdevelopment ■ r- iir E-mail:dcd(aco.jcfferson.wa.us 9s J N6C9� �fl 1 MAY 2 8 2015 1 MECHANICAL PERMIT APPLICAT ON' iErr[asoN couNTy Steps in the Permit Process: _ D`PT.c■ COMMUNITY DEVFLQ MFNT -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#: Date: Related Application Us: 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 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: 615-700 00 /0 Site Address and/or Directions to Property: asst. 5• p,:,;-ca v‘i-7 0(4 Pot f Io/,-SGnr.E- Access(name of street(s)from which access will be gained: Description of Work: Re,lact, exit nil Ffrp t /{fit Iei..G4— l ' old {oi ewe,- floor. T„sh_,(/ 5tity!e /at / St4c1-45S' he-4.-/-"am, /0 h4fenrwf Property Owner Name: /.iILI,e/ YD&i1UJ Q1 Address: 2.5 2.- c , D/561 iV e„47 J 0 Phone#: 3�D - 30S- ZZ9� E-mail Address: /hoor+flOt✓e-thtih+ e ar}/G;, m l/ Please contact Authorize, Agent/R- •resentative with project info. -44- K CZ r Property Owner Signature: _Sc" Date: -5 g Applicant/Contractor: Authorized Agent/Representative Name: PG/Llltsl � f1Cw (AM,O Phone#: 3tra-1:9/-3333 E-mail Address: /,1 w/ - un• License#: )IIEN a Vot o Y-6.v✓ Expiration Date: /0//r /,6 Mechanical Application 1 • • Heat Source Electric X Heating Oil Propane* Wood Indicate Quantity and Fixture Types Below Quantity Fixture Type *Propane is prohibited in 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 Water Heater-Gas Gas WH Vent and Combustion Air submitted with the Gas Pipe System Gas Pipe System LPG/Oil application showing the Propane Tank setbacks. If propane tank is LP Fuel Tank(#gallons: ) over 500 gallons,a site plan is Heat Pump 3 y7I n G///ndiw 411 required to accompany this Generator application,and a separate r Air Condition r Fire Code approval is also n� Hi) p 4LL9b ,P/ • s q re wired, 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 t this appli ion and subsequent permit issuance. Signature: Print Name: ii(dd'�J kh fp 0677/3491--C— OFFICE / Date: 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* --------� 1.-=-;; �� r of [1:., *Additional fees may apply 1 l� i, 1�== MAY 222015 Mechanical Application 2 v 1 \TY PENINSULA HEAT INC Page 1 of 2 Home thick,en Espanol Contact Search L&I -'�_.- %' uaw A-Z Index Help My Secure L&I Safety Claims&Insurance Workplace Rights Trades&Licensing 0 Washington State Department of Labor & industries PENINSULA HEAT INC Owner or tradesperson 782 KITCHEN DICK RD SEQUIM,WA 98382 Principals 360-681-3333 LOFSTROM,KENNETH JOHN,PRESIDENT CLALLAM County LOFSTROM, MARY E,SECRETARY Doing business as PENINSULA HEAT INC WA UBI No. Business type 601 737 680 Corporation Governing persons KENNETH J LOFSTROM MARY E LOFSTROM; 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. PENINI.0440W Effective—expiration 09/1611996-10/1 812016 Bond CBIC $12,000.00 Bond account no. SA4812 Received by L&I Effective date 07/02/2001 09/16/2001 Expiration date Until Canceled Insurance Ohio Security Ins Co $1,000,000.00 Policy no. BKS 55013351 Received by L&I Effective date 03/16/2016 04/26/2013 Expiration date 04/26/2016 Insurance history Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601737680&LIC=PENINI*0440W&SAW= 5/28/2015 • BUILDING PERMIT APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00440 . Received Date: 6/30/2000 SITE ADDRESS: HWY 101 BRINNON, 98320 APPLICANT: GERALD WILLIAMS PHONE: (253)630-8187 21210 SE 286TH PL KENT WA 98042-6856 SUBDIVISION: BELLEVIEW Block: 14 Lot: 13-18 PARCEL NUMBER: 932101402 Section: 29 Township: 25 N Range: 02 W CONTRACTOR: VICTOR GRANT DBA A-SQUARE CONST PHONE: (360)796-3014 733 WAWA POINT RD BRINNON WA 98320 Contractor's License SQUAR**02352 Expires 09/04/1998 ARCHITECT/ CLARK RAMS OFFICE ENGINEER : 935 N 5TH AVE SEQUIM WA 98382 PROJECT DESCRIPTION: SINGLE FAMILY RESIDENCE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 565 VALUATION 66,544.00 ADD'L: 565 HEAT TYPE: EEE CODE EDITION: 1997 HEAT BASE: HEAT TYPE: WOD OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: SETBACK: DECK: 400 BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PWELL PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: Exist: Wetland Erosion Prop: 2 Prop: 2 Seismic Streams Total: 2 Total: 2 Flood Way Flood Plane F&W Landslide Routing Date: Shoreline Aquifer Forest: Commercial Rural Pr xlm.itV Plat Conditions Type Amount Paid By: Date: Receipt: Approveae Permit $762.75 MAM 06/30/00 32034 APPROVED Code Violation $762.75 MAM 06/30/00 32034 Plan Check $228.83 MAM 06/30/00 32034 State Building Code $4.50 MAM 06/30/00 32034 JUN 0 7 2001 Potable Water Application $30.00 MAM 06/30/00 32034 �EFFERSCQM fJN NI °COD UNTY Total: $1,788.83 DEPT. OF ENT SIGNATURE: / �'- i:1F_BLD_App_Bld.rpt 10/29/99 Jefferson County 1 1.1 artment of Canunwilty Devefonment w4sON C0G 621 Sheridan Street,Port Townsend WA 88368[360]378-4450 .. :t7 ,■' ~, , o prm pp _ iica?jon Project Des cri.tion: Building Type: Project Type: Frame Type: Single Family X New Wood : Garage Attached/Detached : Addition = Steel = Modular E Alteration/Remodel E Concrete 1 = Commercial .2 Repair Masonry _ lvluld-family/#of Units = Demolition ❑ Other. = Industrial Other 1 Bedrooms: Bathrooms: Type of Sewage Disposal: Type of Heat: Choose one: Existing: 1 Existing: 2- = Sewer :Community System X Electricity E Oil Proposed: ____L_ Proposed: = Individual System X Woodstove E Propane Total: 7..— Total: —2— If not sewer,fill out the following: E Heat Pump XConventional E. Alternative 7 Other Permit # SEP 00" 14 Water Supply: - Private well = Two Party Well E. Public:Name of water system: Square Footage: For Office Use Only 31 1.-1 2 3 Main Floor s-6 S 1- UBC OCCUPANCY GROL P -742.-1 S 21vD Floor S-'Qs Pt-t 31Z/2- Base OL 4 lo/) " ?lea .,S 3rd Ficor Al/A Plan Check fee 22g . %3 Htd Basement /U/A State Surcharge fee 4.s1) Unhtd Basement AU//4 Subtotal I 7 S g • q3 Garage/Carport ilv/pt Pot Water Review fee 30 • 00 Decks q. 0 i Et' �0 911/Rd Approach fee Z9 °3 Commercial TOTAL I ( II Industrial Receipt # 3 Da-)3 tf ! Other Cash/Check# e--- ___� _- T,ital Valuation: 1QO ?'1l Initials , 1 . _ Or d Date l� � Cr— °S./ Estimated Cost: To coo If within 200' of the Shoreline, Distance to Bank or Ordinary High Water Mark ft.Bank Height ft. By signing the application form,the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner with respect to this application packet may result in this permit being null and void I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and it's employees,representatives or agents for the purpose of application review and any required later inspections. Access and right of entry to the applicant's property or structure shall be request and shall occur during regular business hours. Sirs ature: _ _- _ __ Date: , /3 / .70'2'3' Kathie Anne Sukert To: Mark Burnfield Subject: RE: BLD00-440 THIS IS A BUILDING PERMIT FOR HEROLD, ADDRESS 311486 HWY 101 NEED FROM ARCHIVES THANK YOU KATHIE ANNE t/3 tASQ_ kr env lcx Y1-17 �'-� 24q old S (NO\ on 1 '�rCx�►'�' N • e. fl flrC '� 1�2Alt f( (04--(on D ; b� (e % neD �Q .�►-� �, oeC Q Z • S • JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan St. Port Townsend, WA 98368 INSPECTION RESULTS I /(i.w5 Owner: HER(J p Date: 41)474'40, Address: 3 (/ 8`x,6 ?i9 J /0/ Contact Phone: 7`'C D/57 Permit#: Type of Insp: ,c/N.41-,_ Results: Approved II Approved with X conditions Failed ❑ Must call for reinspection prior to proceeding Failed with penalty ❑ Must call for reinspection and pay reinspection fee prior to proceeding CONDITIONS: 1 Si W He e.) RC: -WS to-, u,�3 6-uotico Rai l/N~ro/2>?;i Ho L-iN UI To '� v'1 To 3B " ©ter- AJC1 .)c Stole r.i lI NOT aL USLC-0 0 t.,..1Qc Arcs Go:.-,.y t. Boy Ar•lei✓J si " nt W. 1I SET A w oopsr+J &r ev.. l Inspector & Date ;;An (L y:.� BUILDING DIVISI N (360) 379-4450 INSPECTION HOTLINE (360) 379-4455 THIS NOTICE MUST BE KEPT WITH APPROVED PLANS ON SITE ORIGINAL — CUSTOMER COPY - OFFICE H:/Permit/Plnctr/Infobldg/Forms/Inspection Results Form • p JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan St. Port Townsend, WA 98368 INSPECTION RESULTS OGt 1' 'rw !,c4.1n,Cr1 Owner:Ai/4 //-' Date: h/2 3/604 t» �� e"9oCaTZ Address:3// FY 6 /-14d•,/ /0 / Contact Phone: 74 6 - 4; ©`'Q Permit#: ejt) 474 5( C Type of Insp: F/ (\/77 Results: Approved ❑ Approved with ❑ conditions Failed ❑ Must call for reinspection prior to proceeding Failed with penalty ❑ Must call for reinspection and pay re' spection fee prior to proceeding CONDITIONS: •` CH(: mN L LCGT/PlcA-L psprc>ia/� laPtUlS‘b ELC-4-rtc,e4 ■(-1 :s t-ca- N o T ro .P3,_9 e� 4x6 ‘,11,(0 G.c 1 N Ctcnw —�os7 tsar RC;1":".) a N r-o,.r,, P._ CA AvIo?A 3 A,)=.."oc;l Inspector & Date BUILDING DIVISION (360) 379-4450 INSPECTION HOTLINE (360) 379-4455 THIS NOTICE MUST BE KEPT WITH APPROVED PLANS ON SITE ORIGINAL - CUSTOMER COPY - OFFICE H:/Permit/Plnctr/InfobldglForms/Inspection Results Form .� • • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 (800) 831-2678 PERMIT #: BLD00-00440 Received Date 06/30/2000 SITE ADDRESS: 311846 HWY 101 Issue Date 06/7/2001 BRINNON, 98320 Expiration Date 06/7/2002 APPLICANT: GERALD WILLIAMS PHONE: (253)630-8187 21210 SE 286TH PL KENT WA 98042-6856 SUBDIVISION: BELLEVIEW Block: 14 Lot: 13-18 PARCEL NUMBER: 932101402 Section: 29 Township: 25 N Range: 02 W CONTRACTOR: PHONE: Contractor's License: LOAN LENDER/ UNITED PACIFIC INS CO BOND HOLDER: RELIANCE SURETY CO PO BOX 9719 FEDERAL WAY WA 98063 PROJECT DESCRIPTION SINGLE FAMILY RESIDENCE REQUIRED INSPECTIONS: [ ] Setbacks (Shoreline Setbacks): [ ] Footings: [ ] Foundation: [ ] Underground Plumbing/Underground Insulation: [ ] Shear Wall: [ ] Framing/Plumbing: [ ] Propane Tank/Lines: [ ] Insulation: [ I Sheetrock: (� [ Final/Occupancy Approval: {,2 Cwt � a�—eDy HEALTH DEPART ENT A PROVAL REQUIRED PRIOR TO FINAL INSPECTION. THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. SPECIAL CONDITIONS APPLY - SEE REVERSE HOT LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS FOR CASE BLD00-00440 1.) SEPTIC SYSTEM to be installed ASAP --- Septic Permit SEP00-141 EXPIRES 6/5/02. i:1F_BLD_Permit_Buildng.rpt 10/29/99 woc, - -.t C f all 8447 Hwi id1 /To ❑ URGENT A.M. Date Time P.M. WHILE YOU WERE OUT From DLC. K- ire of Phone L2—" 4x00 Area Code Number Ext. Fax Area Code Number Telephoned Please call Came to see you Wants to see you Returned your call Will call again Message Gall .' Or ne x,+ wee K . �lee�s F►'riat Insp&c bv, ;5-'n ►.�� (Perm + s ssue �a f-► 4, ;+ was 1 'lt ) `Signed ` Quill Corporation•° To C URGENT Date 5/a7/03 Time �C� P.M. WHILE YOU WERE OUT From in tc.h0-12-e d of Phone 800 --19(0 - 0181 Area Code Number Ext. Fax Area Code Number Telephoned Please Call Came to see you Wants to see you Returned your call Will call again Message Can n no- Cer_La �a�� f(hec (-v tc4 -b c o ct_r+12_ a C08n _. dC . Sign: d iNI/ t J Quill Cor•- ation 1-800-789-1331 #7-92001 Reorder No.