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Home My WebLink AboutBLD2015-00363 - MECHANICAL •UILDING PERMIT APPLIC IchON BLD15-00363 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD15-00363 Received Date: 10/19/2015 SITE ADDRESS: 87 PORT TOWNSEND BAY DR PORT HADLOCK, 98339 OWNER: DINA M CLARKE PHONE: PO BOX 1408 PORT HADLOCK WA 98339-1408 9979 -VILLAS BY THE SEA SUBDIVISION: Block: Lot: PARCEL NUMBER: 997900006 Section: 1 Township: 29 N Range: 11C CONTRACTOR: PENINSULA HEAT INC PHONE: 360-681-3333 PO BOX 173 CARLSBORG WA 98324 Contractor's License PENINI*0440W Expires 10/18/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION Install Ductless Heat Pump 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 Bv: Date: Receipt: Approved/Date Permit $156.00 HAC 10/19/15 159318 APPROVED Total: $156.00 OCT 19 2015 Jefferson County DCC 111 irlan,e fl.-IM,\forme\C RI n emir. Rlrl rN 1/1/10/0!116 ,44gON ''0G DEPARTMENT OF COMMUNITY DEVELOPMENT 4, �� 621 Sheridan S eet,Port Townsend,WA 98368 -, .< Tel:360.379.44%0 i Fax:360.379.4451 I Web:www.co:;ffenon.wa.us communi •dev eln men O� E-mail: - , n.' fferson.wa.us 4SN1 NGS ME I HANICAL 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 it: dbt") I rS"'" Date: whei/6. Related Application#s: Payment#: i q 7 G 67 I 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 9 ?-?c OO b Site Address and/or Directions to Property: 7. Pati 7 ui?3end & q Dr . 1�+ 1-1-4:1 (Oa— Access ff J Access (name of street(s)from which access will be gained: Description of Work: .._nl -f ua-17 Es g'1hj (e 1106-+ G(uc-"le Sc -1-- p vmi1 . Property Owner Name: Q j p a. 14 • clerk- o Address: o. UX 1 zFo5 i Pori- 14-ad Lock, 1itJ/� ' '3 3 y ci Phone#: cs3/ - 33Z — ��SO E-mail Address: ,75 m ../Please contact Authorized Agent/Representative with project info. K Property Owner Signature: Date: z Applicant/Contractor: Authorized Agent/Representative Name: Pe/iLL/1S(,G_2 CO . Phone#: 3&D - bgi— 3333 E-mail Address: pchS A.124puf/ •Coa..` License#: p1iV/N/ -Ov-40 ii/ Expiration Date: /O!/Y//6 Mechanical Application 1 `w-s"" o')G JEFFERSON COUNTY / ': ~ DEPARTMENT OF COMMUNITY DEVELOPMENT • V :1111141111o= _ Date: /r Time Received: /:Z7 a ,C-StMon. Tue. Wed. `Thur. OF Date: /'/.y0//5 BLD: /5- O 3`3 Contact Name: Owner: Contact Number: 360 Address: R j –1:2GL•'- -a_o1J5EMP .901-`1" Pr---- 206 3/ 332- 836-0 Notes: e0 vcrc�{ ' "Duc`rLb 55 f-IEk'r -frui p Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furan 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 • • 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(#gallons: ) over 500 gallons,a site plan is Heat Pump/ DHP Duc I(L cis- cg, k ,I"Ol f- 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 relat d to this a lition and subsequent permit issuance. Signature: / Print Name: iIdiY 47ch7191-t Date: /ells-A OFFICE USE ONLY Building Permit Fees Mechanical Permit fee(tank swap,woodstove,furnace,etc) $156.00 Propane—Lines,tank, and appliance (ad'Id'I $78.00) Project Scanning Fee $19.50 Total Fees* Ts' *Additional fees may apply. Mechanical Application 2 Mail-Mary Lofstrom-Outlook h s://outlook.live.com/owa/ ttP #path=/maillinbox/tp • • Outlook Mail (Preview) Search Mail and People New I Reply I Delete Archive Junk Sweep Move to Folders Re: Jeff Co Permit Inbox 7 Junk Email 4 at Dina Clarke Reply Drafts 2 RIM To:Mary Lofstrom<peninsulaheat@outlook.com>; Fri 10/16/2015 4:13 PM Sent Items I Dina Clarke authorize peninsula Heating to act on my behalf to obtain the necessary permit to install my heat pump.Thank you! Deleted Items 13 Archive Sent from my iPhone Bell and Futch On Oct 15,2015,at 3:15 PM,Mary Lofstrom <peninsulaheat@outlook.com>wrote: Callis Insurance CC Permits CC PUD Forms CC Rebates CC PUD Forms Mary L�atrom City of PA Rebates PP.ni vt6ttlsv}featCompavty City of PT 360-68/-3333 Correspondence Jeff PUD Rebate Reinsurance 1 - '-- From:Mary Lofstrom SVC Financing Sent:Thursday,October 15,2015 9:28 PM To:kmow.clrke@net Subject:Jeff Co Permit Hello Dina, I am the one you spoke with initially before Ken came to see you! Thanks for taking us on. In order to comply with Jefferson County I need to get your authorization to act as your representative for the mechanical permit we must get. May I ask that you simply reply to this email by stating you give Peninsula Heat authority to act on your behalf with respect to obtaining your mechanical permit??? Appreciatively Mary Lo/strorw Pevv%vtsula.}featCompa.wy 360-681-3333 • 0 1 I „,-ji A i rkvritre13-04---_, . 1 • i \.. . , 'i i I / / 1 ;.. , / r H , 1 ' . / , . ti r 'ff i . , \.., • 1 .0 - 1 ' . ; •••••.............."4 1 f)t.i/ fa g_LS 0 S l' 1 ":" PENINSULA HEAT INC • Page 1 of 2 Home lnicio en Esparto] Contact Search L&IILMEM 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 PO BOX 173 Principals CARLSBORG,WA 98324 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. .i ...... Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. PENINI*0440W Effective—expiration 0911611996—10118/2016 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 03/16/2015 04/26/2013 Expiration date 04126/2016 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= 10/19/2015 Parcel Details • Page 1 of 2 • OJefferson County ASHIlNGTON Weather Station � Database Took diti Maps 71. Webcam Home County Info Departments Search Parcel Number: 997900006 SEARCH Parcel Number: 997900006 Printer Friendly Owner Mailing Address: DINA M CLARKE PO BOX 1408 PORT HADLOCK WA98339-1408 Site Address: 87 PORT TOWNSEND BAY DR PORT HADLOCK 98339 Section: 1 School District: Chimacum (49) Qtr Section: SE1/4 Fre Dist:Chimacum (1) Township: 29N Tax Status: Taxable Range: 1W Tax Code: 0211 Planning area:Tri-Area (4) Sewer: Drainage: Bank: View 1: View 2: Zoning 1: RR-5 - Rural Residential Zoning 2: Zoning 3: Sub Division: 9979 - VILLAS BY THE SEA Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: VILLAS BY THE SEA LOT 6 Tax, A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel Plats&Survey Septic Monitoring Info Jefferson County HOME I COUNTY INFO I DEPARTMENTS I SEARCH ' JAL Best viewed with Microsoft Internet Explorer 6.0 or later le Windows - Mac 7 — http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp.value-997900006 10/19/2015 • • 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#: BLD15-00363 Received Date 10/19/2015 SITE ADDRESS: 87 PORT TOWNSEND BAY DR Issue Date 10/19/2015 PORT HADLOCK, 98339 APPLICANT: DINAM CLARKE PHONE: PO BOX 1408 PORT HADLOCK WA 98339-1408 SUBDIVISION: 9979 -VILLAS BY THE SEA Block: Lot: PARCEL NUMBER: 997900006 Section: 1 Township: 29N Range: 1W CONTRACTOR: PENINSULA HEAT INC PHONE: 360-681-3333 PO BOX 173 CARLSBORG WA 98324 Contractor's License PENINI"0440W Expires 10/18/2016 OWNER, DINA M CLARKE PHONE: if different: PO BOX 1408 PORT HADLOCK WA 98339-1408 PROJECT DESCRIPTION: Install Ductless Heat Pump Directions 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 10/19/2016. REQUIRED INSPECTIONS: +/ Installation per Manufacturer Specifications/CO2: �]dK /0/30 15 Tank/Line/Appliance: Final Approval: 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 \\tidemark\datalforms\F_BLD_Permit_Propane.rpt 10/19/2015 • S Jefferson County DCD Building Division co Correction Notice ti � PERMIT NUMBER /5-00303 OWNER ��.o t- �gslNoo JOB LOCATION R7 r2z lad iun 8u r r Inspection of this structure has found the following violations: kio ZSrJ 1-GMF - Ai - Le,S ,p X11 c. FOE /AA5 PE. tot) Lc4 Sao 50Ree DI IS $e 1.1G You are hereby notified additional work shall not be done upon these premises until the above violations are corrected, unless otherwise noted. When corre tions have been made, 1for Date �G) CJ / caalInspector�J�, ,A-1 t " Building Division (3 0) 379-4450 Inspection Hotline (360) 379-4455 THIS NOTICE MUST BE KEPT WITH APPROVED PLANS ON SITE.