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HomeMy WebLinkAboutBLD2015-00201 - MECHANICAL • BUILDING ILDING PERMIT APPLICATIN BLD15-00201 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD15-00201 Received Date: 6/12/2015 SITE ADDRESS: 222 SICKLE LOOP BRINNON, 98320 OWNER: GEORGE Z SICKEL PHONE: 360-796-4450 KAREN M SICKEL 222 SICKEL LOOP RD BRINNON WA 98320-9509 SUBDIVISION: Block: Lot: PARCEL NUMBER: 502072019 Section: 7 Township: 25 N Range: 2111 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 DESCRIPTION NEW MECHANICAL PERMIT - INSTALL HEAT PUMP AND AIR HANDLER 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 06/11/15 156183 Total: $156.00 AP P RO , JUN 122 Jefferson Cour • 11f irlomarlelr4af.lfnrmc1P RI rl Ann Rlrl rnf FH9MM6 EPARTMENT OF COMMUNITY DEVELOPMENT (--(„soN ��i :Dc, ISh�ndan Sti I I'nrt Ini nc V. 1 9ft3GH�j eI Stn.i'9.aa7u l t 1e: )6ri , 7.4 71V t�" X ch WR co 1Ulu,o m.a tcl wnn umtyderclopment m vI dcd ii cr>i�ff�rso� ua -� s JUN 1 1 2015 �`S 4J N��� MECHANICAL PERMIT APPLICATIO Steps in the Permit Process: JEFFERSON COUNTY -Review required submittal items to ensure all information is completed prior to submittin: ..:EPL F OMMUNITYDEVELOPMENT -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#:1,-.4.4 E)-) Date: id( Related Application#s: Payment#: t •V) 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 JL 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: 502.01-2 CA / t 2'ZZ (' ,� Site Address and/or Directions to Property: EA t,04). -o( , 676 A vvovi 1 W A �2 Access (name of street(s)from which access will be gained: 1 Description of Work: i 01,111 1,(. 14 t4 pV imp e A . A-yil t t Property Owner Name: 64/21),(C4, 4 '11J ?S i .�_4,1_, .' Address: 72_7_ 9��,. W Q - IA,'w1 4 V)Q/1 [A J Phone#: 92v , 4 so E-mail Address: x K Applicant/Contractor: Authorized Agent/Representative -74 Name: ik i�.- i -t o �►�f� I• ' t t ir-kw ( Phone#: V �j ?�.. saw ' E-mail Address:64,ic . (oM License #: Awl_Fwv, ,cito Dia Expiration Date: 0yl ? Ot (p Mechanical Application 1 • Heat Source Electric I 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 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 appf -tion a i i subsequent permit issuance. Property O Signature: � % r Print Name: 7 i cJ -r-- Date: 000 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* 1 ) `>U *Additional fees may apply Mechanical Application 2 6/812015 Jefferson Count: .sor&Treasurer-Property Details-56 GEORGE Z ' L for Year 2014-2015 Jefferson County Assessor & Treasurer e If a kxr Property :. ra. ., Account Property ID: 14156 Legal Description: S7 T25 R2W TAX 31 Parcel Number: 502072019 Agent Code: Type: Real Tax Area: 0441-1-46F4E4H2C1L1P2 Land Use Code 11 Open Space: N DFL N Historic Property: N Remodel Property: N Multi-Family Redevelopment: N Township: 25N Section: 7 Range: 2W Location Address: 222 SICKEL LOOP Mapsco: BRINNON,WA 98320 Neighborhood: S7&S8 T25N R2W Map ID: Neighborhood CD: 1215 Owner Name: GEORGE Z SICKEL Owner ID: 27344 Mailing Address: KAREN M SICKEL %Ownership: 100.0000000000% 222 SICKEL LOOP RD BRINNON,WA 98320-9509 Exemptions: axes and Assessment Details Property Tau Information as of 06/08/2015 Amount Due if Paid on B. NOTE:If you plan to submit payment on a future date,make sure you enter the date and click RECALCULATE to obtain the correct total amount due. Click on"Statement Details'to expand or collapse a tax statement. Year Statement ID First Half Second Half Penalty Interest Base Paid Amount Due Base Amt. Base Amt. ►Statement Details 2015 4020 $1888.80 $1888.21 $0.00 $0.00 $1888.80 $1888.21 ►Statement Details 2014 4061 $1792.16 $1791.56 $0.00 $0.00 $3583.72 $0.00 ' �4 aiues m (+)Improvement Homesite Value: + $0 (+)Improvement Non-Homesite Value: + $349,918 (+)Land Homesite Value: + $0 (+)Land Non-Homesite Value: + $68A05 ) n p/J IE (+)Curr Use(HS): + $0 $0 f li LI v (+)Curr Use(NHS): + $0 $0 (_)Market Value: _ $418,323 .11 I JUN 2015 (—)Productivity Loss: — $0 ! ` JEFFERSON COUNTY _ DEPT.OF COMMUNITY DEVELOPMENT (=)Subtotal: $418,323 (+)Senior Appraised Value: + $0 (+)Non-Senior Appraised Value: + $418,323 httpJArueweb.jeffcowa.us/propertyaccess/Property.aspx?cid=0&year=201481xop_id=14156 1/3 &'8/2015 Jefferson Couresessor&Treasurer-Property Details-56 GEORGE iiKEL for Year 2014-2015 (=)Total Appraised Value: $418,323 (-)Senior Exemption Loss: - $0 (-)Exemption Loss: - $0 (_)Taxable Value: _ $418,323 axing Jurisdiction Owner: GEORGE Z SICKEL %Ownership: 100.0000000000% Total Value: $418,323 Tax Area: 0441-1-46F4F4H2C1L1P2 Levy Code Description Levy Rate Appraised Value Taxable Value Estimated Tax CE COUNTY CURRENT EXPENSE 1.6095025425 $418,323 $418,323 $673.29 CNTYDD DEVELOPMENTAL DISABILITIES 0.0092897204 $418,323 $418,323 $3.89 CNTYVET VETERANS RELIEF 0.0094066380 $418,323 $418,323 $3.94 MENTAL MENTAL HEALTH 0.009 28 97 204 $418,323 $418,323 $3.89 ROADS COUNTY ROADS 1.0582344346 $418,323 $418,323 $442.68 ROADSCU COUNTY ROADS TO CUR EXP 0.2189869738 $418,323 $418,323 $91.61 HOS2BOND HOSP DIST#2 GO BOND 2004 NON VOTED 0.0568729080 $418,323 $418,323 $23.79 HOSP2CASH HOSP DIST#2 GENERAL 0.0347265142 $418,323 $418,323 $14.53 SCH46M0 SCHOOL DIST#46 M&0 1.0994853662 $418,323 $418,323 $459.94 CEM1 CEMETERY DIST 41 GENERAL 0.0191076669 $418,323 $418,323 $7.99 CONSERVE CONSERVATION FUTURES 0.0479216355 $418,323 $418,323 $20.05 EMS4 FIRE DIST#4 EMS 0.4999999981 $418,323 5418,323 $209.16 FD4 FIRE DIST#4 GENERAL 1.2500000000 $418,323 $418,323 $522.90 LIB1 LIBRARY DIST#1 GENERAL 0.5000000000 $418,323 $418,323 $209.16 PORTPT PORT OF PT GENERAL 0.2021843047 $418,323 $418,323 $84.58 PUD1 PUD#1 GENERAL 0.1155376853 $418,323 $418,323 $48.33 STATE STATE LEVY(SCHOOL) 2.1977870495 $418,323 $418,323 5919.38 Total Tax Rate: 8.9383331581 Taxes w/Current Exemptions; $3,739.11 Taxes w/o Exemptions: $3,739.11 nprOVeMent/Building , ' Improvement#1: RESIDENTIAL BLDGS State Code: 11 2688.0 sgft Value; $,4g,i 1.b 1 Bathrooms (#); 3 (FULL) Bedrooms (#): 3 Exterior Wall: SI/ST Fireplace: WD ST-GOOD Floor Construction: FRAME Foundation: CONPR Heating/Cooling: HPUMP Roof Cover: COMP Type Description Class Sub Year Area CD Class CD Built l * MA Main Area 4- 1S 1998 2688.0 H0 HCPOR House Concrete Porch 3 * 1998 50.0 * HDECK House Deck 3 * 1998 640.0 i * GATT House Attached Garage 3 15 1998 676.0 - * BSMTF House basement finished 3 * 1998 1021.0 * GARAG Garage(Flat Rate) 3 * 1998 1575.0 ketch til Property Image Land htpJftrueweb.jeffcowa.us/propertyaccess/Property.aspx?cid O&year=2014&.prop_id=14156 213 • \mom.<mw fit This combination qualifies for a Federal Energy .�a. 1 CERTIFIED Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2014. www.ahridirectory.org Certificate of Product Ratings AHRI Certified Reference Number: 6750235 Date: 6/8/2015 Product: Split System: Heat Pump with Remote Outdoor Unit-Air-Source Outdoor Unit Model Number: 4TWV8048A1 Indoor Unit Model Number: *AM8C0C48V41 Manufacturer: TRANE Trade/Brand name: TRANE Series name: XV18I 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: i (Btuh):Capacity 47000 EER Rating (Cooling): 12.50 SEER Rating (Cooling): 18.00 Heating Capacity(Btuh)@ 47 F: ` 41000 Region IV HSPF Rating(Heating): 10.00 Heating Capacity(Btuh)@ 17 F: 34400* LFERSONCOUN0 00MMUNITY DEVELOPMENT Ratings followed by an asterisk(')indicate a voluntary rerale of previously published date,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.ahrldlrectory.org. TERMS AND CONDITIONS This Certificate and its 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; r 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.ahrldlrectory.org,click on"Verify Certificate"link wt:mike lite beau" 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. "' --- _ ---- ©2014 Air-Conditioning, Heating,and Refrigeration Institute CERTIFICATE NO.: 130782579723298994 AIR FLO HEATING COMP 40. Page 1 of 2 Home [Melo en Espanol Contact Search L&I ti A-Z Index Help My Secure LFI Safety Claims&Insurance Workplace Rights Trades&Licensing Washington State Department of Labor & Industries AIR FLO HEATING COMPANY INC Owner or tradesperson 221 WEST CEDAR SEQUIM.WA 98382 Principals 360-683-3901 BEQUETTE,MARK A,PRESIDENT CLALLAM County BEQUETTE,SANDRA A,VICE PRESIDENT BERSON,JOEL R,SECRETARY FULLAWAY,MICHAEL (End:04/0112010) Doing business as AIR FLO HEATING COMPANY INC WA UBI Na. Business type 600 347 761 Corporation Governing persons MARK BEQUETTE SANDRA BEQUETTE; License Verify the contractor's active registration/license/certification(depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties HeatinglVentlAir-Conditioning and Refrig (HVACIR) License no. AIRFLI*206DG Effective—expiration 0310711980—04/26/2016 Bond CBIC $6,000.00 Bond account no. S15215 Received by L&I Effective date 02/05/2010 02/01/2010 Expiration date Until Canceled Bond history Insurance ....._............ American Hallmark Ins Co of Te $1,000,000.00 Policy no. 44CL483619 Received by L&I Effective date 04/21/2015 04/25/2014 Expiration date https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&LIC=AIRFLI*206DG&SAW= 6/12/2015 AIR FLO HEATING COMPANY 11014 011110 Page 2 of 2 04/2612016 Insurance history Savings Nonsavings accounts during the previous 6 year period. Lawsuits against 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. 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. 351,432-00 Doing business as AIR FLO HEATING COMPANY INC. Estimated workers reported Quarter 1 of Year 2015"21 to 30 Workers" L&I account representative T3/NATASHA DRAGOVICH(360)902-4679-Email:DRAG235@Ini.wa.gov Workplace 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 ®Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600347761&LIC=AIRFLI*206DG&SAW= 6/12/2015 Parcel Details • • • Page 1 of 2 II. TT oonty ysx , ».ug rro tns.L aI Home . county Info Departments Search Parcel Number: 502072019 SEARCH Parcel Number: 502072019 Printer Friendly Owner Mailing Address: GEORGE Z SICKEL KAREN M SICKEL 222 SICKEL LOOP RD BRINNON WA98320-9509 Site Address: 222 SICKEL LOOP BRINNON 98320 Section: 7 School District: Brinnon (46) Qtr Section: NW1/4 Fire Dist: Brinnon (4) Township: 25N Tax Status: Taxable Range: 2W Tax Code: 0441 Planning area: Brinnon (11) Sewer: Drainage: Bank: View 1: View2: Zoning 1: RR-5 - Rural Residential Zoning 2: Zoning 3: Sub Division: Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: S7 T25 R2W TAX 31 Tax,NV, Sales, Photos, and Permit Data Bldg Data Map Parcel lats&Surveys Septic Monitoring Info 2. : Jeffers Count, ;° ; HOME I COUNTY INFO I DEPARTMENTS I SEARCH Best viewed with Microsoft Internet Explorer 6.0 or later i Windows - Mac http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?value=502072019 6/12/2015 • , 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#: BLD15-00201 Received Date 6/12/2015 SITE ADDRESS: 222 SICKLE LOOP Issue Date 6/12/2015 BRINNON, 98320 APPLICANT: GEORGE Z SICKEL PHONE: 360-796-4450 KAREN M SICKEL 222 SICKEL LOOP RD BRINNON WA 98320-9509 SUBDIVISION: Block: Lot: PARCEL NUMBER: 502072019 Section: 7 Township: 25N Range: 2W 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 OWNER, GEORGE Z SICKEL PHONE: 360-796-4450 if different: KAREN M SICKEL 222 SICKEL LOOP RD BRINNON WA 98320-9509 PROJECT DESCRIPTION: NEW MECHANICAL PERMIT- INSTALL HEAT PUMP AND AIR Directions HANDLER 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 6/12/2016. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: Tank/Line/Appliance: Final Approval: 101 57)I 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\data\forms\F_BLD_Permit_Propane.rpt 6/12/2015