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HomeMy WebLinkAboutBLD2014-00375 - MECHANICAL ItUILDING PERMIT APPLICAi'UN BRDI4-00375 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD14-00375 Received Date: 10/16/2014 SITE ADDRESS: 110 SEA VISTA TERR PORT LUDLOW, 98365 OWNER: ESTHER M DARROW TRUSTEE PHONE: 360-437-9208 E M DARROW REVOCABLE TRST 110 SEA VISTA TER PORT LUDLOW WA 98365-8721 9987 SUBDIVISION: Block: Lot: PARCEL NUMBER: 998700051 Section: 21 Township: 28 N Range: 1 E 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 DESCRIPTIOP NEW HEAT PUMP TYPE OF WORK RES 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: 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 $152.00 SRE 10/16/14 151635 Total: $152.00 APPROVED OCT 16 2014 Jefferson County DCD \\tidemark\data\forms\F_BLD_App_Bld.rpt 10/16/2014 Ali / JJ= ON COUNTY II nn l ` / DEPARTMENT OF COMMUNITY DEVELOPMENT �U✓ 1 L` 13 c I 621 Sheridan Street•Port Townsend-Washington 98368 joctt4b. .4 wwwe9-4450. 360/379-4451 ov www.ca.Jvffonoon.wa_voloom mdovebpn,o.ti+ Master Permit Application MLA: Project Description(include separate sheets as cry): 01112-Wart, uft9vi iP (c•4 Tax Parcel Number: ll I coos ( Property Size: (acrestsquere feet) Site Address and/or Directions to Property: 1 i Uis-&, -,vr(ta PorettOoL1.OLA) Property Owners)of Record: �S r-jfER /4, -DAAARQ LA) 1—r L.11-- Telephone: 3ioo 411" 32.oR Fax emaL ck_Scle-rfoW 0a(/134-n.carn MadingAddress: '(0 Safi v sr/t'T t?kRc.e, Pc),er 1.-0,24-ow r,Jfl9633(oS 1 Applicant/Agent(If different from owner): Ai tie_ /G-Lc) ^ C-� Telephone:∎,, • 04•. A II Floc AO 4.'s AVAAtt email:h+t-rvief CrIreTtrEfielv , Mailing Address: , -_ _ _ _ r i ,`/ .:�/ A a j<! - �.r C.f) ' What kind of Permit?(Check each box that applies 08uilding 0 Critical Areas Stevwardahip Plan O Demoition Permit Cl Variance(Minor,Major or Reasonable Economic Use) 0 Single Family ❑Garage Attached I Detached 0 Conditional Use[C(a),C(d).or CI" ❑ Manufactured Home ❑ Modular ❑Discretionary"D'or Unnamed Use Classification O Commercial ❑Special Use(Essential Public Facilities)" ❑ Change of Use 0 Boundary tine Adjustment ❑ Address 0 Road Approach ❑Short Plat" ❑Home Business ❑Cottage industry 0 Binding Site Plan" ❑Propane ❑Long Plat" O Sign 0 Planned Rural Residential Development(PRRU)lAmendmertts" Q Allowed'Yes"Use Consistency Analysis ❑Plat Vacation/Alteration" O Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions" ❑Site Plan Approval Advance Determination(SPAAD)' ❑Shoreline Management Substantial Development" 0 Temporary Use ❑Shoreline Management Variance ❑Wireless Telecommunication• ❑Comprehensive Plan/UDC/Land Use District Map Amendment o Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment 'May require a Pre-Application Conference ❑Tree Vegetation Request "'R,... , .. a Pm-A;,L.,cat/on Conference Please Identify any other local,state or federal permits required for this proposal,if known: ,ea-PLa-k• !/c(,�age cti r�i.�e., c� ' ,� SIGMA OF AGENT I hereby designate to ad as my agent in matters relating to this application for pemit(s). OWNER SIGNATURE iff4.44 rn 4 Date: — By signing this application form,the nenetfegent attests that the tnfeentatbn provided herein,and in any attad;ments,is true and correct to the best of his,her or is knowledge. Any material falsehood or any omission of a material fed made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnity and told harmless Jefferson County against alt 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 father 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 rater inspections. Staffs access- •right of- • will ,,,,. .. n ed unless the applicant informs the County in writing at the ••1 1 that he or • =wants prior • // Signature: SZG_ ! , . .�_a- rlikajj/. .„l Li-td) Date: a? Uc E . 2 0l al i The action or actions Applicant will underfdae as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take-of an endangered species as those terms are defined in the federal taw known as the 'Endangered Species Act'or'ESA.'Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can.file a lawsut on behalf of an endangered species regarding your action(s)even ijeOu am In compliance with the Jeffe aunty development code.Tha Applicant acknowledges that he,she or it holds individual and non-trans rabfe respons' for adhering to plying_ /rite Applicant has read this disclaimer and signs and dates it below. signature: i 4zyi<7 L/ y ,?„4..„1_,,,,) ,,,.— Date a :1(! •z of GApconiK:enta\ahusfpciathitsliffaa\DRM)FORMSWaarer Permit Application 5-29-43e4oc C keci24+ - y5I L3c____04___4-aciq _ , 151' V� I • ScEli1 - --_ 1-11 -00 This combination qualifies for a Federal Energy IIA"II Ira l C E RT I H E Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2013. www.ahridirectory.org Certificate of Product Ratings AHRI Certified Reference Number: 5021416 Date: 10/7/2014 Product: Split System: Heat Pump with Remote Outdoor Unit-Air-Source Outdoor Unit Model Number: 4TWR5030G1 Indoor Unit Model Number: `AM7A0B30H21 Manufacturer: TRANE Trade/Brand name: TRANE Series name: XR15 WEATHERTRON Manufacturer responsible for the rating of this system combination is TRANE 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): 31600 EER Rating (Cooling): 12.50 SEER Rating (Cooling): 15.00 Heating Capacity(Btuh)@ 47 F: 30000 Region IV HSPF Rating (Heating): 9.00 Heating Capacity(Btuh) @ 17 F: 18900 •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.ahridirectory.org. TERMS AND Certificate I s COND oNS TEis and 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 make life 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. 130572008933687354 ©2014 Air-Conditioning, Heating,and Refrigeration Institute CERTIFICATE NO.: • • 2 •- --Q/) A t.... 1 i..„ _ ).- y , , , .....__ i \ t , i \ .....2 A), ‘.r.8 ...s- 1 ! ; 1 ; 1 1 , 2 ,. ..\ , , fi... AIR FLO HEATING CO INC Page 1 of 3 • • 0 Washington State Department of Labor & Industries AIR FLO HEATING CO INC 221 W CEDAR ST Owner or tradesperson SEQUIM,WA 98382-3320 BEQUETTE, MICHAEL 360-683-3901 Principals CLALLAM County BEQUETTE, MICHAEL FULLAWAY, MICHAEL BEQUETTE, MARK A, PRESIDENT BEQUETTE, SANDRA A, VICE PRESIDENT BERSON, JOEL R, SECRETARY RDCf1AI Ir1cI 0 TDDACI!RFD ILicense I Verify the contractor's active registration/license/certification (depending on trade) and any past violations. Electrical Contractor Active. Meets current requirements. License specialties HVAC/RFRG License no. AIRFLHCOO9C8 Effective—expiration 02/2812000—02/28/2016 Designated administrator Active. BERSON,JOEL RAY Meets current requirements. License type License no. Master Electrician BERSOJR975LB Bond CBIC $4,000.00 Bond account no. si6233 Received by L&I Effective date 05/19/2010 07/06/2010 Expiration date Until Canceled Bond history Savings ... ..... .... No savings accounts during the previous 6 year period. License Violations ....._._..... https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&LIC=AIRFLHC009C8&SAW= 10/16/2014 AIR FLO HEATING CO INC Page 2 of 3 Infraction no. S Satisfied EDORN00206 RCW'WAC Violation date 19.28.161(6) RCW 03/28(2013 Violation amount Violation city $250.00 Sequim Type of violation ELECTRICAL CITATION Description Failure of the electrical contractor to accurately verify electrical training hours on an Affidavit of Experience. IWorkers' comp Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. L&I Account ID Account is current. 351,432-00 Doing business as AIR FLO HEATING COMPANY INC. Estimated workers reported Quarter 2 of Year 2014"21 to 30 Workers" L&I account representative T1 / FEARAED FEROZE (360)902-4797 -Email: FERH235 @Ini.wa.gov IWorkplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. Citation issue date 07/24/2012 Violations Inspection no. 315954529 Location 125 Horizon View Dr. Sequim,WA 98382 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&LIC=AIRFLHC009C8&SAW= 10/16/2014 AIR FLO HEATING CO INC • Page 3 of 3 ©Washington State Dept.of Labor&Industries. Use of this site is subject to the laws of the state of Washington. c.te$S WaSltiftgick https://secure.lni.wa.gov/verify/Detail.aspx?UBI600347761&LIC=AIRFLHC009C8&SAW= 10/16/2014 Parcel Details Page 1 of 2 ti Jefferson County _ , ..,„ ,%,,,,- - N - 1/4 ='-‘4:1,::,-t;°'7..."7- 4t '-a-t--;:iVF'7:7.'''''''":7":7ff7t.'--::: 77,' ':'-'^-7471 Home County Info Departments Search Parcel Number: 1998700051 SEARCH Parcel Number: 998700051 Printer Friendly Owner Mailing Address: ESTHER M DARROW TRUSTEE E M DARROW REVOCABLE TRST 110 SEA VISTA TER PORT LUDLOW WA98365-8721 Site Address: 110 SEA VISTA TERRACE PORT LUDLOW 98365 Section: 21 School District: Chimacum (49) Qtr Section: NW1/4 Fire Dist: Port Ludlow (3) Township: 28N Tax Status: Taxable Range: 1E Tax Code: 0231 Planning area: Port Ludlow (7) Sub Division: 9987 - TEAL LAKE VILLAGE Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: TEAL LAKE VILLAGE LOT 51 I Tax,A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel 'fats&Surve s Se.tic Monitorin. Info ---- ,/= " . Jefferson County HOME I COUNTY INFO I DEPARTMENTS I SEARCH Best viewed with Microsoft Internet Explorer 6.0 or later 40 Windows - Mac http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?Parcel NO=998700051 10/16/2014 Parcel Details Page 2 of 2 http://www.co.j efferson.wa.us/assessors/parcel/parceldetail.asp?Parcel_N0=998700051 10/16/2014 el3eN `'b� JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT ,,,,,y,,,,-;\° Date: '7-/3 Time Received: & gz_ am,6)1i Mon. i.117) TO ri. Date: F—/S- BLD: /4375- Contact Name: Owner: Contact Number: 360 1(379'20k Address: /1© -524- (J/574 -v''r-- . 206 Notes: �t'C,�. Pt)7, Foundation Plumbing Framing J 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 _�ON go,.. (6, DEPARTMENT OF COMMUNITY DEVELOPMENT 1, 621 Sheridan Street,Port Townsend,87.-198368 -- — Tel:360.379.4450 Fax:360.379.4451 Web:www.co.iefferson.wa.us/communitydevelopment E-mail:dcdna co.jefferson.wa.us `S'fflNC' ' September 09, 2015 ESTHER M DARROW TRUSTEE E M DARROW REVOCABLE TRST 110 SEA VISTA TER PORT LUDLOW WA 98365-8721 RE: SUBJECT: PERMIT TO EXPIRE - NOT RENEWABLE SITE ADDRESS: 110 SEA VISTA TERR PERMIT#: BLD14-00375 LEGAL DESCRIPTION: 9987 - TEAL LAKE VILLAGE BLOCK: LOT: PROJECT DESCRIPTION: NEW HEAT PUMP DEAR ESTHER M DARROW TRUSTEE PERMIT# BLD14-00375 WAS ISSUED BY THIS DEPARTMENT ON 10/16/2014 , WAS VALID FOR ONE YEAR AND IS NOT RENEWABLE. According to our records, a final inspection has either not been scheduled or has not been passed. TO SCHEDULE A FINAL INSPECTION, CONTACT THE DEPARTMENT OF COMMUNITY DEVELOPMENT INSPECTION HOTLINE AT 379-4455 and leave your request after the recorded message. In the event a final inspection is not passed, the inspector will give you a written notice of required corrections. You must call for a re-inspection to receive final approval. A FINAL INSPECTION MUST BE SCHEDULED BY 10/10/2015. Please contact the Department of Community Development (360) 379-4450 with any questions. Sincerely, Permit Technician cc: file 1\tidemark\data\forms\F_BLD_pro_exp_ntc.rpt 9/9/2015 • S Jefferson County Building Division Permit Number: BLD14-00375 Applicant: ARROW TRUSTEE BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 012 International Building Codes To schedule inspections, call (360)379-4455 no later than 3:00PM the day before the inspection is needed. Requests received after 3:00 PM will not be scheduled for the next days inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Mechanical Systems /61.5-- 12. 4..5 A final inspection will not be scheduled until the following are completed and signed off by the applicable Department: • Building Permit Conditions are met • Septic Permit Final/Complete for any building containing plumbing • Land Use Conditions met and signed off • Public Works Permit Final(where applicable) _ . -- FINAL INSPECTION V S""/c1 /1'lZ_"� - /S FINAL INSPE TION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD14-00375 Received Date: 10/16/2014 SITE ADDRESS: 110 SEA VISTA TERR Issue Date 10/16/2014 PORT LUDLOW, 98365 Expiration Date 10/16/2015 OWNER: ESTHER M DARROW TRUSTEE PHONE: 360-437-9208 E M DARROW REVOCABLE TRST 110 SEA VISTA TER PORT LUDLOW WA 98365-8721 9987 SUBDIVISION: Block: Lot: PARCEL NUMBER: 998700051 Section: 21 Township: 28 N Range: 1E 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 PROJECT DESCRIPTION: NEW HEAT PUMP TYPE OF WORK RES 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: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $152.00 SRE 10/16/14 151635 Exist: Exist: Total: $152.00 Prop: Prop: Total: Total: Directions to Site: HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. Request must be received by 3pm the day before the inspection is needed. Office Hours 9:00 am -4:30 pm MONDAY- THURSDAY HOT LINE AVAILABLE 24 HOURS A DAY AIR FLO HEATING COMPANY 4 3 019 Check Number: 43019 Jefferson County Building Dept Date Description Amount 10/09/2014 Permit for Darrow 171.00 JEFFERSON COUNTY • CD No. 1 15 DATE 10/ I Go/ ► `--I RECEIVED FROM (r Fl n GARS# AMOUNT DESCRIPTION ) CURRENCY 6 L I�fk� I SL- tJU � t 14-- COIN car, L [)() ' ci (6" 7rn-USI .. ECK ;( p,paw() - . ��paw() 0 m 110 e(-ti v ; S jr. -ev✓act 0 0 RECEIVED BY S ,(I Q,S1 TOTAL i 74"1 . `) "