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Home My WebLink AboutBLD2015-00415 - MECHANICAL • ! • 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 #: BLD15-00415 Received Date 11/23/2015 SITE ADDRESS: 2481 ANDERSON LAKE RD#633 Issue Date 11/23/2015 CHIMACUM, 98325 APPLICANT: JUDYANN JONES PHONE: 206-612-9354 2481 ANDERSON LK RD#633 PORT HADLOCK WA 98339 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901101039 Section: 10 Township: 29N Range: 1W CONTRACTOR: BRENNAN HEATING &A/C LLC PHONE: 206-248-7900 4601 S 134TH PL SEATTLE WA 98168 almie breenan heating.com Contractor's License BRENNHA971 R9 Expires 112/29/2 15 OWNER, EVERGREEN COHO ESCAP RETREAT PHONE: if different: 2481 ANDERSON LAKE RD CHIMACUM WA 98325-9795 PROJECT DESCRIPTION: NEW MECHANICAL PERMIT Directions INSTALL NEW DUCTLESS HEAT PUMP 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 11/23/2016. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: Tank/Line/Appliance: Final Approval: /'nit — rI�� PICitreSS(.9(- � �`r l r �� \ 1 ' N�c ��V�11 �,��y1� q �(��'�1 i� t � s �;C � F y ��li 1-40/1,e I I (), yt VJ``'/ Dept- jE L_ rL 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 1ltidemark\data1forms\F_BLD_Perm it_Propane.rpt 11/23/2015 •UILDING PERMIT APPLICA N BRD15-00 15 eview Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD15-00415 Received Date: 11/23/2015 SITE ADDRESS: 2481 ANDERSON LAKE RD#633 CHIMACUM, 98325 OWNER: JUDYANN JONES PHONE: 206-612-9354 2481 ANDERSON LK RD#633 PORT HADLOCK WA 98339 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901101039 Section: 10 Township: 29 N Range: 1V1 CONTRACTOR: BRENNAN HEATING &NC LLC PHONE: 206-248-7900 4601 S 134TH PL SEATTLE WA 98168 Contractor's License BRENNHA971R9 Expires 12/29/2015 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIO NEW MECHANICAL PERMIT INSTALL NEW DUCTLESS HEAT PUMP 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 11/23/15 159429 APPROVED Total: $156.00 NOV 2 3 2015 Jefferson County DCC GtOjeCi 14/)-3/15 ll firlomnr4\i1nfv\fnrmc\F RI fl Ann Rid mf 11/92/9(11S r • • iso �'" \ �ti (be" DEPARTMENT OF COMMUNITY DE • .SC' E`NT IA 601 'hcrid In~neer,P,nrown,zend WA 9S3G8 \: W ..< T\\rl .360.3'9 4450 I Fa 3GO 3'9.4451 � \ rh u,u�»v ietten �[[,m u,'crrmmunin'dc,�cJ,q>mcn[ \�� . i .G ti i r-mall.dcd t1 eo irftcrvon.wa.us `� '[, 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. For Department Use Only Receipt#:I Lc)9 Date:IA/2-3fJ P. Related Application#5: Payment# C' &I ' : b3`10'1I1 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&l- 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. L7 — — 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. LA Site Information Assessor Tax Parcel Number: q t:-.)1101 o3 c ` j I , I Site Address and/or Directions to Property: 0 '4 S \ .t.l' ori `a 4- 12 el (033 ,. Access (name of streets) from which access will be gained: Description of Work: I V\.3. �. ( t /a r 000 Property OwnerJ 4-7�pQ) Name: j w Address: c... /g.7'.+ et`sOXj PLE-. pp - o, C0 u Lthi jd 95732'- °i Phone it: ,,..9plp — ,/,12 — 93c E-mail Address: �eo.,12�12,5 �7 j/a m _ Please contact Authorized 'gent/Representative with project info. `='4 eG/n K Property Owner Signature: _o%4, ,0r i/ Date: /1 x Applicant/Contractor: Authorized A:ent/Represent•tive Name: 6(4./v\,v\.p-n r\q Phone #: 0..0‘..o . a p, - �J- O f _ E-mail Address:j0.[ LA, la7• A I'ivq. G n' License it: -yjl.� \ 4-4 V,c Expiration Date: , , q . Mechanical Application 1 • S 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: i over 500 gallons, a site plan is ` Heat Pump ! [) C_W.css) 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 • this application and subsequent permit issuance. Signature.e i Print Name: 9Q4/2 pJ 'S Date: fi /ifs 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* I 5.° *Additional fees may apply Mechanical Application 2 • Googleeart h 6�� Page 1 � � �� (rtde„po, 6 4 ke Rid. Ch,;r,,�cuM ?6747 sv'`1` HEAT.PUMP LOCATION _ �, ; , Y q, 35: —a 5~ f fin' 1 , HEAT PUMP LOCATION AE ,v /,PECrt ti PI 5 �D —\ S� 3;7,f pcN cc Vc 633 o)( 1 �� BRENNAN HEATING & A/C LLC Page 1 of 2 4111 1111 Home Inicio en Espanol Contact Search L&I 1 laii.64 A-Z Index Help My Secure 1.Sri Safety Claims&Insurance Workplace Rights Trades&Licensing ClikWashington State Department of ,Labor & Industries BRENNAN HEATING &A/C LLC Owner or tradesperson 4601 S 134TH PL SEATTLE,WA 98168 Principals 206-248-7900 ERDAHL,DARRIN PAUL,PARTNER/MEMBER KING County Doing business as BRENNAN HEATING&A/C LLC WA UBI No. Business type 602 346 866 Limited Liability Company Governing persons DARRIN P ERDAHL ERIC L BEARDEMPHL; JAMES JOLLY; STEFANIE ERDAHL; 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. BRENNHA971R9 Effective—expiration 12129/2003—12/29/2015 Bond FEDERATED MUTUAL INS CO $12,000.00 Bond account no. 9127230 Received by L&I Effective date 11/04/2004 12/22/2004 Expiration date Until Canceled Insurance .................. Federated Mutual Ins Co $1,000,000.00 Policy no. 9820726 Received by L&I Effective date 06116/2015 07/13/2015 Expiration date 07/13/2016 Insurance history Savings No savings 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. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602346866&LIC=BRENNHA971R9&SAW— 11/23/2015 BRENNAN HEATING &A/C LLC Page 2 of 2 L&I Tax debts No L&I tax debts are recorded for this con or license during the previous 6 year period,but some •ebts may be recorded by other agencies. License Violations Infraction no. PPEJP00330 Satisfied Issue date RCWNVAC 09/14/2012 18.106.020 Violation city Violation amount Seattle $250.00 Type of violation PLUMBER INFRACTION Description Contractor employed a person to engage in the trade of plumbing without a current journeyman,specialty or trainee certificate, temporary permit or medical gas endorsement as required.On 9111112,Brennan Heating& A/C LLC employed Levy Malcom Steere to perform plumbing related duties without proper plumbing certification. 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. 803,761-08 Doing business as BRENNAN HEATING&AIR CONDIT Estimated workers reported Quarter 3 of Year 2015"Greater than 100 Workers" L&I account representative T5/STEPHANIE HENDERSON(360)902-6266-Email:HSTE235@Ini.wa.gov Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. 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=602346866&LIC=BRENNHA97IR9&SAW= 11/23/2015 JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELO MENT REFUND REQUEST/POSTING MEMO DATE: 12/2/2015 O The amount of: $175.50 received from: Brennan Heating &A� for(case#): BLD15-00415 is to be refunded to: Permit was for a Heat Pump inside a Manufactured Home. We do not permit for M/F Homes. as a result of: Date & number of original receipt: 11/23/2015 Receipt# 159429 REVENUE FUND CODE NO. REVENUE SOURCE NAME 001-250-000 369.90.00.0000 BAD CHECK FEE AMOUNT 127-000-010 346.23.11.5200 WATER AVAILABILITY FEES-EH H2O 127-000-010 346.23.11.5400 DCD BLDG REVIEW-SEPTIC 127-000-010 346.23.11.5800 SHORT/LONG PLAT FEES 143-000-010 322.10.00.0000 BUILDING BASE & INSPECTIONS 143-000-010 322.10.10.0000 BUILDING PERMIT RENEWAL FEE 156.00 143-000-010 322.40.80.0000 ADDRESSING FEES 143-000-010 341.60.00.0000 DUPLICATING SERVICES 143-000-010 341.75.00.0000 SALE OF MAPS& PUBLICATIONS 143-000-010 345.70.00.0000 DCD TECH ASSIST FEE 143-000-010 345.81.00.0000 SUBDIVISION APPLICATIONS 143-000-010 345.81.20.0000 SHORELINE SUBSTANTIAL DEV. PERM. 143-000-010 345.81.30.0000 CURRENT USE TAX ASSESSMENT APP 143-000-010 345.81.40.0000 ZONING APPROVAL APPLICATIONS 143-000-010 345.81.60.0000 CONVERSION OPTION HARVEST PLAN 143-000-010 345.83.00.0000 PLAN CHECK FEES 143-000-010 345.83.10.0000 FIRE MARSHALL PLAN REVIEW 143-000-010 345.89.00.0000 SEPA/ENVIRONMENTAL REVIEW 143-000-010 345.89.00.0143 PERMIT SCANNING FEE 143-000-010 346.22.30.0040 DCD WATER REVIEW 19.50 143-000-010 389.40.00.0000 CASP- NON-REVENUE CUST DEPOSITS 180-000-010 322.40.40.0000 MISC APPLICATIONS& PERMITS 180-000-010 322.40.50.0000 RIGHT-OF-WAY APPLICATIONS 180-000-010 343.20.10.0000 DEVELOPMENT REVIEW FEES 650-511-000 386.00.00.0000 STATE BUILDING CODE FEES TOTAL REFUND r / I 175.50 Authorized person signature: Treasurer's check# Date: Treasurer's signature: JEFFERSON COUNTY Dc1 NO. 159429 nn � DATE 11/ �. VI C RECEIVED FROM YG hnph Y (Aar) ^ V) 411- DESCRIPTIONRA�RRS`# AMOUNT CURRENCY tIA bc,se 15(0 - 00 Qiit,,,kCOIN #', LU L BOJ 7HECKS c aL4b < �u 6o/son a . 43364 0 33 s\1 Q v0 C1 CGS o J _.< ..�; RECEIVED BY OA ak TOTAL 19-5