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Home My WebLink AboutBLD2015-00378 - MECHANICAL BUILDING• PERMIT APPLICATIO B Review 0378 Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD15-00378 Received Date: 10/28/2015 SITE ADDRESS: 202 GREENVIEW LN PORT LUDLOW, 98365 OWNER: RONALD B DAWSON PHONE: 360-437-4167 MARTHA HICKS DAWSON 202 GREENVIEW LN PORT LUDLOW WA 98365-8750 9556-GREENVIEW VILLAGE SUBDIVISION: Block: Lot: PARCEL NUMBER: 955600005 Section: 21 Township: 28 N Range: 1 E CONTRACTOR: HERITAGE FIREPLACE SHOP PHONE: 19410 VIKING AVE POULSBO WA 98370 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NEW MECHANICAL PERMIT INSTALL NEW PROPANE FIRE PLACE, EXISTING TANK- EXISTING LINES REPLACEMENT OF FIREPLACE ONLY 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: Ajaj�,J�/ C t+r Permit $156.00 SRE 10/28/15 159296 { Total: $156.00 OCT 28 2015 Jefferson County DCD llfirlcmch\rloblfnrmc1P RI r Ann RIr1 mf 1nrour9n1c SON co DEP MENT OF COMMUNITY D`ELOPMENT 44.'C' 4 621 Sheridan Street,Port Townsend,WA 98368 £4 12.1 Tel:360.379.4450 I Fax:360,379.4451 ti <C Web:www.co.Jefferson.wa.us/communitydevelopment �I E-mail:dcd@colefferson.wa.us I � ,D \5 -(3"-]��(8 . #_.1SHO'S() I N MECHANICAL PERMIT APPLICATION Steps in the Permit Process: -Review required submittal items to ensure all information is completed prior to submitting application. -Mechanical Permits can be mailed into our office-and do not require an appointment. -Fees are due at time of submittal, Mechanical permits are generally issued within 5 business days. For Department Use Only Receipt#: Date: Related Application#s: Payment#: Is this application for use in a Mobile/Manufactured Home? * If Yes: A permit from Washington State Department of Labor and Industries, not Jefferson County, is required for appliances installed within a mobile/manufactured home. L&I-360-417-2702 * If No: Complete this form and make an appointment to submit to Jefferson County Permit Tech 360-379-4450 Required Submittal Items—for propane tank only General Site plan-showing propane tank, lines,and distance from tank to all existing structures. Re1c wired Submittal Items—for Solar Panel installation only Complete first page and signature block only of Mechanical Permit Application. A complete solar panel supplemental application. Site Information Assessor Tax Parcel Number: / (, q ly9te'hit64 ; 07jjl Site Address and/or Directions to Property: 1'D 2. , '6 Access (name of street(s)from which access will be gained: C F}/Y►�14Q/� -in a,$�1,1^�f 'v (iA4j Description of W : gr,,(4-- J 9#( t1LJAt�,V I !�v'-I/l 4 Property Owner �y/,�, , / sl Name: gQN�LQ !�l"liA U l F2Address: 7/6/k 6 N' t 6 w u fr PO 'i 1 teW Atgreiy °�Phone#: dj .i' + E-mail Address: Cib�IkM&ANt K Applicant/Contractor: Authorized Agent/R presentative li Name: 1rt“)riA6. . f 1�Cb 'cA L✓E1�� x Phone#: A' V / ✓ / i / E-mail Address: License#: Expiration Date: • Mechanical Application 1 I . Heat Source 1111 Electric 1-F, Heating Oil n Propane* n Wood n 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 j Propane Tank LP Fuel Tank(#gallons: 20 ) 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 h. pplication and subsequent permit issuance. Property Ow �/�/� /� Signatur• //'' " Print Name: Pi f1r� '94/4/59V Date: 11(211 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 I „ro. ,,,,, JEFFERSON COUNTY / P� SX/NnSU DEPARTMENT OF COMMUNITY DEVELOPMENT t� a�11 ' 9 Date: Z 7 Time Received: ? an/a-0 Mon. 41a, Wed. Thur. Fri. Date: BLD: IC— 378 Contact Name: Owner: Contact Number: 360 L/3, L//L,7 Address: o2-02_ (.0rteri‘.f *-e.�, 206 Notes: Foundation Plumbing Framing Propane Tank Mechanical 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 • Inspections are required to be called in by 3:00 pm to receive an inspection the next day. Do to staffing issues, at this time, we cannot guarantee that you will receive an inspection the next day. day. Unless you receive a call from us, assume we will arrive on your requested inspection day. • You may leave an inspection request 24 hours a day, and Inspections are available from Monday through Friday. • We cannot determine the time we will arrive in advance. However, if you call our office the morning of your inspection, around 9:00 a.m., we can give an estimate of when the inspector will arrive. Our general office phone number is 360 379-4450. • An approved set of plans are to be on site with building permit for all inspections. If permit and plans are not on site at time of inspection, a re-inspection fee must be paid prior to re-scheduling another inspection. • If no access, no inspections will be performed, and a re-inspection fee must be paid prior to re-scheduling another inspection. • Inspectors will not access a home that has personal affects inside when the owner is not present. • Commercial projects require 24 hour notice for inspection. {�;o c� N JEFFERSON COUNTY 9s „� �_. DEPARTMENT OF COMMUNITY DEVELOPMENT ,, Date: //7--if Time Received: /:413 a pm Mon. Tue. drir /Thur. Fri. "/ Date: c BLD: 16 04,37,9 Contact Name: `� Owner: ..1/4.).%-em..) Contact Number: 360 ,Z3i - 4t/4,7 Address: 7-4 Z-- GoepP)Jv'i?� Lu + 206 / Notes: r1ebPL 4441C E81,,/L/7 Foundation Plumbing Framing Propane Tank Mechanical 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 • Inspections are required to be called in by 3:00 pm to receive an inspection the next day. Do to staffing issues, at this time, we cannot guarantee that you will receive an inspection the next day. day. Unless you receive a call from us, assume we will arrive on your requested inspection day. • You may leave an inspection request 24 hours a day, and Inspections are available from Monday through Friday. • We cannot determine the time we will arrive in advance. However, if you call our office the morning of your inspection, around 9:00 a.m., we can give an estimate of when the inspector will arrive. Our general office phone number is 360 379-4450. • An approved set of plans are to be on site with building permit for all inspections. If permit and plans are not on site at time of inspection, a re-inspection fee must be paid prior to re-scheduling another inspection. • If no access, no inspections will be performed, and a re-inspection fee must be paid prior to re-scheduling another inspection. • Inspectors will not access a home that has personal affects inside when the owner is not present. • Commercial projects require 24 hour notice for inspection. rliiJEFFERSON COUNTY 1DEPARTMENT OF COMMUNITY DEVELOPMENT 09Sf/I t�G�2 Date: / j) Time Received: `7`rf ( VIpm Mon. ue Wed. Thur. Thur. Fri. Date: 1 BLD: /S ,379 Contact Name: Contact Number: 360 43 7 9 ((c.7 Owner: I 206 Address: .V 0), 61,--c.4,11/4/0t....) L N Notes: i r---e-- Foundation Plumbing Framing Propane Tank Mechanical FramingUnder ground Furance Setbacks Under ground Gas Footing Rough In Air Seal Above ground- 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 SetbacksFloor Foundation Wall Address Posted Block&Tile Ceiling 0 Lo 1,41:43.\ 0 �p N C N \ C O y !I 0. 133 • C OAI Cr) co 2 Lc.) fi v, z to 3 _ y g - ` 2 O ,' , �--' r7 L▪ CO Cdi OC > > N H 0 0 - Y C 01 0 U ix a. O r o 1 O w 16 d a a. tl V .01/) C e c CI Z 0 Ln i 7 , 'O Q > V F CO �Z. _ 'T O t'— kJ a O ++ d w O ,7 W N 4 :4= — O p m =• CD CO 0 2 ft V• O O o `® Cl h >. w y a- C M C (.) Z Q C d _ O v ,n J O U O� OL4 `11 LE y > U HIc dd DH Ai •y CD ZEQ- zCC > m Q 01 d C m Q) W > O C 7 N O a) a N d L w", � O � >- « O O co H I • �- 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#: BLD15-00378 Received Date 10/28/2015 SITE ADDRESS: 202 GREENVIEW LN Issue Date 10/28/2015 PORT LUDLOW, 98365 APPLICANT: RONALD B DAWSON PHONE: 360-437-4167 MARTHA HICKS DAWSON 202 GREENVIEW LN PORT LUDLOW WA 98365-8750 SUBDIVISION: 9556-GREENVIEW VILLAGE Block: Lot: PARCEL NUMBER: 955600005 Section: 21 Township: 28N Range: 1 E CONTRACTOR: HERITAGE FIREPLACE SHOP PHONE: 19410 VIKING AVE POULSBO WA 98370 OWNER, RONALD B DAWSON PHONE: 360-437-4167 if different: MARTHA HICKS DAWSON 202 GREENVIEW LN PORT LUDLOW WA 98365-8750 PROJECT DESCRIPTION: NEW MECHANICAL PERMIT Directions INSTALL NEW PROPANE FIRE PLACE, To Site: EXISTING TANK- EXISTING LINES REPLACEMENT OF FIREPLACE nNi Y 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 10/28/2016. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: Tank/Lin /Appliance IQJ 59 Final Approval: 14511 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 10/28/2015