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Home My WebLink AboutBLD2015-00114 - MECHANICAL • • MECHANICAL AND DEMOLITION PERMIT Jefferson County Department of Community Development l 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD15-00114 Received Date 4/8/2015 SITE ADDRESS: 190 MONTGOMERY LN Issue Date 4/8/2015 PORT LUDLOW, 98365 APPLICANT: DIXIE L HENDRIE PHONE: 360-437-5198 190 MONTGOMERY LN PORT LUDLOW WA 98365-9602 SUBDIVISION: 9906 Block: Lot: PARCEL NUMBER: 990600134 Section: 9 Township: 28N Range: 1 E CONTRACTOR: FAST WATER HEATER COMPANY PHONE: 425-636-7055 12601 132ND AVE NE KIRKLAND WA 98034 Contractor's License FASTWWH947BK Expires 1/20/2016 OWNER, DIXIE L HENDRIE PHONE: 360-437-5198 if different: 190 MONTGOMERY LN PORT LUDLOW WA 98365-9602 PROJECT DESCRIPTION: NEW MECHANICAL PERMIT Directions REPLACE ELECTRIC WATER HEATER SAME FOR SAME 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 4/812016. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: JJJv =O . - / «,_a ..il Tank/Line/Appliance: 04' Final Approval: Z9k' /�{�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 HOURS A DAY 11 tidemark\data\forms\F_BLD_Permit_Propane.rpt 4/8/2015 • BLD15-00114 BUILDING PERMIT APPLICION Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD15-00114 Received Date: 4/8/2015 SITE ADDRESS: 190 MONTGOMERY LN PORT LUDLOW, 98365 OWNER: DIXIE L HENDRIE PHONE: 360-437-5198 190 MONTGOMERY LN PORT LUDLOW WA 98365-9602 9906 SUBDIVISION: Block: Lot: PARCEL NUMBER: 990600134 Section: 9 Township: 28 N Range: 1E CONTRACTOR: FAST WATER HEATER COMPANY PHONE: 425-636-7055 12601 132NDAVE NE KIRKLAND WA 98034 Contractor's License FASTWWH947BK Expires 1/20/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NEW MECHANICAL PERMIT REPLACE ELECTRIC WATER HEATER SAME FOR SAME 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 $156.00 SRE 04/08/15 154278 Total: $156.00 APPROVED APR 0 8 2015 Jefferson County DCD \\tidemark\data\forms\F_BLD_App_Bld.rpt 4/8/2015 • i ' • ..tSON c DEPARTMENT OF COMMUNITY DEVELOPMENT �".., - 06. 621 Sheridan Street,Port Townsend,WA 98368 4, ,° Tel:360.379.4450 I Fax 360.379.4451 1 [EWE ti J . , -C Web:www.co.ieffersonowa,usicommunitydevelopmem , E-mail:dcd(a o.jetterson wa.us VI o� APR — 6 2015 MECHANICAL PERMIT APPLICATION Steps in the Permit Process: CDU,1T1 -Review required submittal items to ensure all information is completed prior to submitting applicatiorri l iTY DEVFI_D°MENT -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. / ��/� rFor Department Use Only Receipt#: 154-p,--) .K Date:4/Ire/ Related Application Us: Payment-ft: M'i20 Hs 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: ciRb6OO13 `1 Site Address and/or Directions to Property: Access (name of street(s)from which access will be gained: Description of Work: I2(2)A4 V _ ( , '�ITJ2''it l'f,.'1� x.1&2 � c i'1&Q, 3-vw.'.� ��s •,. Property Owner Name: Hevt d A t? 11 Address: q• • • otet6' f of o • ---- ° Phone#: 37 . • - y ift _ E-mail Address: _ m z Applicant/ Contractor: Authorized Agent/Representative '' Name: f�y �`L _ Phone #. uj...6;4„-1Og ti E-mail Address:(St,, S., ,; hj( ", tot/ License#: �Hailge __ Expiration Date: 12-ra"n' Mechanical Application 1 • • • Heat Source Electric Heating Oil C Propane* n Wood l__l 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+1- 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 to this application and subsequent permit issuance. Property Owner Signature: Print Name: Date: 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* *Additional fees may apply 1 r� Mechanical Application 2 • APA - 6 2015 'FPI CD°M`[UNITY DFVI OPMFNT • • WA Lisc#FASTWWH948BC O12'LISCYf 568049 Form#13 3110Copy Part#15-0-0-13 CA Lisc#931297 Tci l.�� i G"O.SEATER Job# {A�yc}��s� �� 5�p 'Per Water Hewer Expert' City RYA' 1.+VW1 Do not sign this unless you have read and understand the following Is the additional work required by code? Yes On the proposal, any item marked as"Required by Code", was determined as necessary according to the appropriate code adopted by the State. For the more common items, the actual excerpt from the code is printed on the back of our proposal . Is this additional work enforced in my city? Uncertain The majority of the cities do enforce the code as it is written and adopted. However, the enforcement and interpretation of the code varies dramatically across cities and inspectors and we have no way of knowing what they will or will not require until they perform the inspection. Some cities have provided their enforcement guidelines which if available we will provide to help you decide what work you want done. Please be aware that the inspector may tell you that an item was not necessary, the item is still code, it just means it is not being enforced by their city. Must all of the additional work be done to replace the water heater? No We will provide a thorough bid so you can make an informed decision about what work you want completed. Ultimately, it is your decision on what work is to be done. As long as the issue is not life threatening and we document that you declined the work, we can perform the installation without doing everything on the proposal. For some items, the removal and reinstallation of the tank may be necessary to perform the work at a later date and we do encourage that this work be done as the cost to do after the fact is not worth the risk. What happens if the inspection fails? if the inspection fails because the work we quoted was not done, we can perform this work at the price quoted on the original quote. If the tank has to be re-installed to perform the work, then additional cost for re-installation would also apply. What happens if there is a problem? In the event that a problem or loss should occur from a quoted item being declined, it has been documented that we have made you aware of the problem and Fast Water Heater will not be held liable for any damage or loss. OAW1,3 3_. 1 y_I Technician Name Tech ;an ignatture Date a l t 91 glIA/4 a �1111,.J i 1 /t'1 Customer Name Customer4 Signature Date Top-Fast Copy Bottom-Customer Copy