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Home My WebLink AboutBLD2015-00371 - MECHANICAL tILDING PERMIT APPLICATION BRLD1e 0033771 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD15-00371 Received Date: 10/22/2015 SITE ADDRESS: 150 GARDEN CLUB RD NORDLAND, 98358 OWNER: JEREMY R SEVERN PHONE: 360-301-6079 SHANNON I SEVERN 26255 IOWAAVE NE KINGSTON WA 98346-6600 SUBDIVISION: Block: Lot: PARCEL NUMBER: 921092015 Section: 9 Township: 29 N Range: 1E CONTRACTOR: JOSH WHITE PHONE: 360-531-4243 72 SOUTH WHITE FIR WAY PORT HADLOCK WA 98339 Contractor's License PIPEMM*863NM Expires 8/6/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIO1 NEW MECHANICAL PERMIT NEW PROPANE STOVE , TANKS AND LINES 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 $234.00 SRE 10/22/15 159288 c Total: $234.00 APP ROVED OCT 222015 Jefferson County DCD 1\firlomsr41r1afnlfnrmc1F RI Il Ann RI.. rnf 1nrymnis • • ,.SON co DEPARTMENT OF COMMUNITY DEVELOPMENT �� 6 621 Sheridan Street,Port Townsend,WA 98368 W Tek 360.3?9.A450 I b'ax:360.379.4151 `- ,-C1 Web:www.co.icifcrson.wa.us/comrnumtydevelopmcnt I?-mail:dcdt c(,.iefferson.wa.us 4;1 yo 0MECHANICAL 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. For Department Use Only Receipt#: Date: Related Application#s: 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 LGeneral Site plan -showing propane tank, lines,and distance from tank to all existing structures. Re•uired Submittal Items-for Solar Panel installation only Complete first page and signature block only of Mechanical Permit Application. A complete solar panel supplemental application. 1 Site Information Assessor Tax Parcel Number: 6D...A .04O k 5 Site Address and/or Directions to Property: 150 Ci1.1aArGt-eYI C IAN-p Re. )U c\ -ct l u vA ctx 3 Sig Access (name of street(s)from which access will be gained: C-1G0.(-cl„Ev\ Gko,., P-et Description of Work: 1( WLA)-e- ? V) 00 GL--ove- x9\ Srk-L.LAei s2 1t13 ('7GLV1-e, Property Owner ; . ah•4 Name: 1reWt4.4 C(vino-vi c_Cfl/e-r✓l Co W Address: a r.,f, J 0‘,..)c4., Ar-e /AJC 1Gt,C/1 c-k-Avt W Pr- °I, '34(p 61 Phone#: j(p0) �v l_ 62016i E-mail Ad ress: St- i-etry s - ,c,.4.);;2w\,sTA, - vv JJ '30 I- !a Q S'3 c o K Applicant/Contractor: Authorized Agent/Representative -I Name: V,p y1/LC2_4,frc-v- — 305,VI \A)\/4t\-e-- Phone#: < (eo) 431 — L t--k 3 E-mail Address: y<ici G.5.k r^s``\vim., License#: C C. 12 t.?e MW\- 2 t 3 Ni M. Expiration Date: niveit • Mechanical Application 1 • • Heat Source Electric ❑ Heating Oil n Propane* R. Wood I I 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(#gallons: ) 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 O er Signature .2k,44il `— Print Name:Sk tV(_G'Vt &N I��/� Date: O(" 2_ 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. Mechanical Application 2 • • 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 #: BLD15-00371 Received Date 10/22/2015 SITE ADDRESS: 150 GARDEN CLUB RD Issue Date 10/22/2015 NORDLAND, 98358 APPLICANT: JEREMY R SEVERN PHONE: 360-301-6079 SHANNON I SEVERN 26255 IOWAAVE NE KINGSTON WA 98346-6600 SUBDIVISION: Block: Lot: PARCEL NUMBER: 921092015 Section: 9 Township: 29N Range: 1 E CONTRACTOR: JOSH WHITE PHONE: 360-531-4243 72 SOUTH WHITE FIR WAY PORT HADLOCK WA 98339 Contractor's License PIPEMM*863NM Expires 8/6/2016 OWNER, JEREMY R SEVERN PHONE: 360-301-6079 if different: SHANNON I SEVERN 26255 IOWA AVE NE KINGSTON WA 98346-6600 PROJECT DESCRIPTION: NEW MECHANICAL PERMIT Directions NEW PROPANE STOVE , TANKS AND LINES 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 10/2212016. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: Tank/Line/Appliance to_2'1-1-7 Final Approval: I012.41-5- BUILDING 2S'+IJBUILDING 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 \\tidemark\data\forms\F_BLD_Permit_Propane.rpt 10/22/2015 IncuCe the oilowine items c•n ycur plot pian: Prc;.e_/ `.cundarles • 0 Well. — Names c adlac ni streets 0 Sect c tan':(, EriVeN2/S and par' inc =daces ] r'rcnGc&C (•-=-Rter Nisi f _'(,'C'•'r. S::itace'H = , Ones ree . _:c) 2 Ncrh Arrcw j' _ Culicincs(res cent . Suets. Carates, e`C,' -FLOT FLAN OCT 222015 � L ! J JEFFERSON COUNTY _DEP?.OF COMMUNITY DEVELOPMENT C.7/k9-c)e CLL Ra QL r 7....... / 1 \\N---- LocWItS a ,,,vks ir I /4(' q 1 14i ; k ao- `'2 JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT . SSE/I NGS Date: /e)/ja Time Received: //,z,S' pm Mon. Wed Thur. Fri. T Date: �'••_I-'=' /O -2 BLD: /57" 37/ Contact Name: Owner: Contact Number: 360 30/ 4079 Address: /5-0 6-,r}2p�J c-(-JO //, 206 Notes: A Foundation Plumbing Framing Propane Tank Mechanical 11 Setbacks Under-ground Framing Underground Furance Footing Rough In Air Seal Above groun• 1-' Gas Stemwall Hydronic Exterior shear Exterior line l Oil Straps Hot Water Htr Interior shear Interior lines All Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove")/ Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block& Tile Ceiling