HomeMy WebLinkAboutBLD2015-00375 - HEAT PUMP !UILDING PERMIT APPA N BLDI5-00375
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD15-00375 Received Date: 10/26/2015
SITE ADDRESS: 12 TIMBER RIDGE DR
PORT LUDLOW, 98365
OWNER: WILLIAM R RAY PHONE:
MARTA L RAY
12 TIMBER RIDGE DR
PORT LUDLOW WA 98365-9734 9985 -TIMBERTON VILLAGE PHASE
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 998500059 Section: 17 Township: 28 N Range: 1E
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 DESCRIPTIOP Install Heat Pump and Air Handler
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: SETBACK:
DECK: 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 10/26/15 159335
Total: $756.00 APPROVED
/'� OCT 2 6 2015
Jefferson County DCD
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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.
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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
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General Site plan —showing propane tank, lines, and distance from tank to all existing structures.
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Complete first page and signature block only of Mechanical Permit Application.
A complete solar panel supplemental application.
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Assessor Tax Parcel Number: tC
Site Address and/or Directions to Property: L \N-\\CrCA2 O\ 11) y
Access (name of streets) from which access will be gained:
Description of Work: ��5 \ nikk •y _iii\vc) ('\, ( ,f
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Name: L \ 4 k.► _a� .
Address: �/ � �� .� a
Phone #: EMIUMUMIK1 E-mail Address: . & r i
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Name: 1 l / , -) lea i ° 0 /Ai
Phone #: * (), i E-mail Address: / , d 1711714.1,
License #: ,A j L t" J&21).L.1 Expiration Date: I/I ,s
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Mechanical Application 1 `
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Electric Heating Oil Propane* I 1 Wood _
ilnd i ixtur i�t .n.-,` = *Propane is prohibited in
'` xture ,, „ *' ;tiorl,i r , I} ,, ,,r-L.': 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 loft, 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 Phan:di 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 iritent to enter upon the property
for •visits related to this appli on and subsequent permit issuance.
Property • n: — 1
Signature '��.��_\� 1 int Name: \ "Ix �V _ Date:`�/`�� `\lT
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*Additional fees may apply .
Mechanical Application 2
,�: "" `%:, JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
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Date: /1/7-3 Time Received: 9:15am m Mon. Tu Wed. Thur. Fri.
Date: fig/
BLD: /5- 43 J$ Contact Name:
Owner: 4igY Contact Number: 360
Address: iz —1;;48h7e k19sL DK, 206 GZr,_, - 1969
Notes: /7�//�
EAT 171.4' MP 4 AK. �AmP[.C-[
Foundation Plumbing Framing Propane Tank (echanical
Setbacks Under-ground Framing Underground Furance
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
• 0 Indoor Air Experts • •
Name: William Ray Consultant Jara Reno
Site Address: 12 Timber Ridge Drive Date: 9/29/2015 Billing Address:
City: Port Ludlow Proposal#: R10929201517031-1 City:
State: WA State:
Phone:206-953-1969Zip: 98365 Phone: Zip:
TRANE AIR HANDLER TRANE XR15 HEAT PUMP System Investment
Base System: $9,092.00
Optional Items Total: $0.00
<$0.00>
<$0_00>
Sales Tax: $818.28
System Total: $9,910.28
Initial Investment: $0.00
Balance: $9,910.28
Term: 36 Rate: 0% Est. Payment $275.29
Investment Type: promo
Net Investment After Credit&Rebates $9,910.28
By signing this agreement I acknowledge that I have read and Representative Date
understand each page,including the terms and conditions.
Custorieg Z Dat/D`Z //s... Approved by (J Dae I 'S
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AIR FLO HEATING COMP l • •
Page 1 of 2
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Washigton State Department of
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AIR FLO HEATING COMPANY INC J
Owner or tradesperson 221 W 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:04/01/2010)
Doing business as
AIR FLO HEATING COMPANY INC
WA UBI No. Business type
600 347 761 Corporation
Governing persons
MARK
BEQUETTE
SANDRA BEQUETTE;
License
Verify the contractor's active registration/license I certification(depending on trade)and any past violations.
Construction Contractor Active.
Meets current requirements.
License specialties
Heating/Vent/Air-Conditioning and Refrig
(HVACIR)
License no.
AIRFLI*206DG
Effective—expiration
03/07/1980—04/25/2016
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= 10/26/2015
Parcel Details • • Page 1 of 2
•
Jefferson County
e _
Home County Info Departments Search
Parcel Number: 998500059 SEARCH
Parcel Number: 998500059 Printer Friendly
Owner Mailing Address:
WILLIAM R RAY
MARTA L RAY
12 TIMBER RIDGE DR
PORT LUDLOW WA98365-9734
Site Address:
12 TIMBER RIDGE DR
PORT LUDLOW 98365
Section: 17 School District:Chimacum (49)
Qtr Section: SW1/4 Fre Dist: Port Ludlow (3)
Township: 28N Tax Status: Taxable
Range: 1E Tax Code: 0231
Planning area: Port Ludlow (7)
Sewer: PLSEWER - Connected(No Drainage:
CWF)
Bank: View 1:
View 2: Zoning 1: MPR-SF-4 - Master Planned Resort - Single
Family
Zoning 2: Zoning 3:
Sub Division: 9985 - TIMBERTON VILLAGE PHASE II
Assessor's Land Use Code: 1100 - Residential - Single Unit
Property Description:
TIMBERTON VILLAGE PHASE II LOT 59 SUBJ TO EASE
Tax,A/V, Sales, Photos, and
Permit Data Bldg Data Mao Parcel Plats&Surveys
Septic Monitoring Info
�l "`•.. Jefferson County HOME I COUNTY INFO I DEPARTMENTS I SEARCH viol
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Windows- Mac
http://www.co.j efferson.wa.us/assessors/parcel/parceldetail.asp?value=998500059 10/26/2015
• .
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#: BLD15-00375 Received Date 10/26/2015
SITE ADDRESS: 12 TIMBER RIDGE DR Issue Date 10/26/2015
PORT LUDLOW, 98365
APPLICANT: WILLIAM R RAY PHONE:
MARTA L RAY
12 TIMBER RIDGE DR
PORT LUDLOW WA 98365-9734
SUBDIVISION: 9985-TIMBERTON VILLAGE PHASE Block: Lot:
PARCEL NUMBER: 998500059 Section: 17 Township: 28N Range: 1E
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, WILLIAM R RAY PHONE:
if different: MARTA L RAY
12 TIMBER RIDGE DR
PORT LUDLOW WA 98365-9734
PROJECT DESCRIPTION: Install Heat Pump and Air Handler
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 10/26/2016.
REQUIRED INSPECTIONS:
Installation per Manufacturer Specifications/CO2:
Tank/Line/Appliance:
2Final Approval: l2-t -IC-
BUILDING
IC-
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
11tidemark\datalforms\F_BLD_Perm it_Propane.rpt 10/26/2015