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Home My WebLink AboutBLD2015-00054 - MECHANICAL • • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD15-00054 Received Date: 2/25/2015 SITE ADDRESS: 101 E COLUMBIA ST Issue Date 2/25/2015 QUILCENE, 98376 Expiration Date 2/25/2016 OWNER: QUILCENE HISTORICAL MUSEUM PHONE: 360-531-2776 PO BOX 574 QUILCENE WA 98376-0574 9561 SUBDIVISION: Block: Lot: 4 PARCEL NUMBER: 956100001 Section: 13 Township: 27 N Range: 2V' CONTRACTOR: PENINSULA HEAT INC PHONE: 360-681-3333 PO BOX 173 CARLSBORG WA 98324 Contractor's License PENINI"0440W Expires 3/2/2016 PROJECT DESCRIPTION: NEW MECHANICAL PERMIT- REINSTALLATION OF AIR HANDLER HEAT PUMP INSTALLATION OF NEW DUCT WORK 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: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $156.00 SRE 02/23/15 154162 Exist: Exist: Total: $156.00 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 • • Jefferson County Building Division Permit Number: BLD15-00054 Applicant: QUILCENE HISTORICAL MUSEUI BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2012 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 day's 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 Miscellaneous A final inspection will not be scheduled until the following are completed andby signed off theapplicable Department: P pp • 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 IDI'MJt� FINAL INSPECTION UST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR 0054 BUILDING PERMIT APPLICWION B Review Type:Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD15-00054 Received Date: 2/25/2015 SITE ADDRESS: 101 E COLUMBIA ST QUILCENE, 98376 OWNER: QUILCENE HISTORICAL MUSEUM PHONE: 360-531-2776 PO BOX 574 QUILCENE WA 98376-0574 9561 SUBDIVISION: Block: Lot: 4 PARCEL NUMBER: 956100001 Section: 13 Township: 27 N Range: 2V1 CONTRACTOR: PENINSULA HEAT INC PHONE: 360-681-3333 PO BOX 173 CARLSBORG WA 98324 Contractor's License PENINI*0440W Expires 3/2/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOt NEW MECHANICAL PERMIT- REINSTALLATION OF AIR HANDLER HEAT PUMP INSTALLATION OF NEW DUCT WORK 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: 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 02/23/15 154162 APPROVED Total: $156.00 FEB 252015 Jefferson County DCC 1\tidemark\data\forms\F_BLD_App_Bld.rpt 2/25/2015 • • SON �w`� (be" DEPARTMENT OF COMMUNITY DEVELOPMENT W4-,:,1621 Sheridan Street,Port Townsend,WA 98368 .C' Tel:360.379.44360.379.4451 Web:www.co,ieff50erson.waFax: .us/communitydevelopment E-mail:dcd(zC(.jefferson.wa.us -1S4 I N G,c,0 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. 4/for Department Use Only Receipt#: J6 Date: 2/2//5 Related Application#s: Payment#: de, /L!go-- 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: q 5(o i000 4 Site Address and/or Directions to Property: ID I C • Cot_U14 a%A- si-KeE j i { -0...c Jy e Rtvy tot C 4 gum;Ick Iee-op E . L.tt. h � c+• IP Access (name of street(s)from which access will be gained: Description of Work:- Re INSTAu-A-T tbN OF AIA 1-174AbLE1L 1 HEAT °i11c - StIN`:TAc1i¢-Y!oma) or uEw Dva U7bKk - Property Owner Name: C Lj L.ceNE rl-ISrog_l C14t- 1k-USevm Address: ISI E • CioWk61 ft ) OLULGENE- 4�?.,h / 1.0• BaK Seq. ci ° Phone#: Ck 366-&---31 _ ,2:44%, E-mail Address: � m m _ Please contact Authorized Agent/Representative with project info. g Property Owner Signature: k2ry P ^Itc pS Date: 002/)1PO/S- 4 Applicant/Contractor: Authorized1Agent/Representative Name: Pe'i /'15414 �7 (6 Phone#: Zp - (vg/— 3333 E-mail Address:AffektiedalutgitIVP. License#: PEN/AO Expiration Date: )p1Is,Lae 4 (1 Mechanical Application 1 . • Heat Source Electric Heating Oil Propane* 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" Cook Stove Cook Stove,Range Hood Exhaust gas can unsafety 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(t3 gallons: ) over 500 gallons,a site plan is Heat Pump i\ej//S-+ a."- 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 rela '��o this application and subsequent permit issuance. Signature. 'e-' tt _ Print Name: �'c f41',. Date: C; 3y)c'/)_ OFFICE USE ONLY Building Permit Fees Mechanical Permit fee(tank swap,woodstove,furnace,etc) $156.00 Propane—Lines,tank,and appliance (add"l $78.00) Project Scanning Fee $19.50 Total Fees* � � } v *Additional fees may apply. Mechanical Application 2 Parcel Details r i Page 1 of 2 fiefferson Count r _ ' Home County Info Departments Search Parcel Number: 956100001 SEARCH Parcel Number: 956100001 Printer Friendly Owner Mailing Address: QUILCENE HISTORICAL MUSEUM PO BOX 574 QUILCENE WA98376-0574 Site Address: 101 E COLUMBIA ST QUILCENE 98376 Section: 13 School District: Quilcene (48) Qtr Section: SW 1/4 Fire Dist: Quilcene (2) Township: 27N Tax Status: Taxable Range: 2W Tax Code: 0324 Planning area: Quilcene (10) Sewer: Drainage: Bank: View 1: VIEW - Territorial View 2: Zoning 1: Zoning 2: Zoning 3: Sub Division: 9561 - HAMILTON'S 5 ACRE TRACTS Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: HAMILTON'S 5AC TRACTS LOT 4 W/PTN VAC WASHINGTON ST ADJ Tax, AN, Sales, Photos, and Permit Data Bldg Data Map Parcel Plats&Surveys Septic Monitoring Info ✓" . r '+;, j; : r'.; Co C HOME I COUNTY INFO I DEPARTMENTS I SEARCH 00, Best viewed with Microsoft Internet Explorer 6.0 or later Windows - Mac http://www.co.jefferson.wa.us/assessors/parceUparceldetail.asp?Parcel N0=956100001 2/25/2015 PENINSULA HEAT INC • . Page 1 of 2 [eine Leek)en Fspanol Contact Search L&i j w Al,Index Help My Secure I&I •afety Claims&Insurance Workplace Rights Trades&Licensing Washington State Department of I,, Labor & Industries PENINSULA HEAT INC Owner or tradesperson PO BOX 173 111 LOFSTROM,KENNETH JOHN CARLSBORG,WA 98324 360.681-3333 Principals CLALLAM County LOFSTROM,KENNETH JOHN,PRESIDENT LOFSTROM,MARY E,SECRETARY Doing business as PENINSULA HEAT INC WA UBI No. Business type 601 737 680 Corporation 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. PENIN/*0440W Effective—expiration 09/16/1996—10/18/2016 Bond CBIC $12,000.00 Bond account no. SA4812 Received by L&I Effective date 07102/2001 09116/2001 Expiration date Until Canceled Insurance Ohlo Security Ins Co $1,000,000.00 Policy no. BKS 55013351 Received by L&I 1 Effective date 04/04/2014 04/26/2013 Expiration date 04/26/2015 Insurance history Savings No savings accounts during the previous 6 year period. Lawsuits 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. https://secure.Ini.wa.gov/verify/Detail.aspx?UBI=601737680&LIC=PENINI*0440W&SAW= 2/25/2015 PENINSULA HEAT INC Page 2 of 2 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. 920,088-00 Doing business as PENINSULA HEAT INC Estimated workers reported Quarter 4 of Year 2014"11 to 20 Workers" L&I account representative T4 I CARIE PICKETT(360)902-5592-Email: PICC235@Ini.wa.gov Workplace safety and health No inspections during the previous 6 year period. D Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. p g ify Ox?UBI=601737680&LIC=PENINI*044OW&SAW= 2/25/2015 htts://secure.lni.wa. ov/veri /Detail.as