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Home My WebLink AboutBLD2015-00011 - MECHANICAL , 0miti 11. 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#: BLD15-00011 Received Date 1/12/2015 SITE ADDRESS: 471 DIETZ DR Issue Date 1/12/2015 QUILCENE, 98376 APPLICANT: ROLAND FARAGHER-HORWELL PHONE: 206-383-7723 COLLEEN FARAGHER HORWELL 1718 NW GREENBRIER WAY SEATTLE WA 98177-5325 T 22+ SUBDIVISION: Block: Lot: PARCEL NUMBER: 501032017 Section: 3 Township: 25N Range: 1W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 ((gg g5 Contractor's License SUNSHP*077QP Expires 1916P/OR-5875 OWNER, ROLAND FARAGHER-HORWELL PHONE: 206-383-7723 if different: COLLEEN FARAGHER HORWELL 1718 NW GREENBRIER WAY SEATTLE WA 98177-5325 PROJECT DESCRIPTION: PROPANE TANK SWAP OUT 1000 gallon tank 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 1/12/2016. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: -9,Tank/Line/Appliance: 3\i\ \ 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 1\tidemarkldata\forms\F_BLD_Permit_Propane.rpt 2/11/2015 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#: BLD15-00011 Received Date 1/12/2015 SITE ADDRESS: 471 DIETZ DR Issue Date 1/12/2015 QUILCENE, 98376 APPLICANT: ROLAND FARAGHER-HORWELL PHONE: 206-383-7723 COLLEEN FARAGHER HORWELL 1718 NW GREENBRIER WAY SEATTLE WA 98177-5325 T 22+ SUBDIVISION: Block: Lot: PARCEL NUMBER: 501032017 Section: 3 Township: 25N Range: 1W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 'PPP 3g5 Contractor's License SUNSHP*077QP Expires 11/17/2018 5875 OWNER, ROLAND FARAGHER-HORWELL PHONE: 206-383-7723 if different: COLLEEN FARAGHER HORWELL 1718 NW GREENBRIER WAY SEATTLE WA 98177-5325 PROJECT DESCRIPTION: PROPANE TANK SWAP OUT 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 1112/2016. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: 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\data\forms\F_BLD_Perm it_Propane.rpt 1/12/2015 • BUILDING PERMIT APPLItION BLD15-00011 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD15-00011 Received Date: 1/12/2015 SITE ADDRESS: 471 DIETZ DR QUILCENE, 98376 OWNER: ROLAND FARAGHER-HORWELL PHONE: 206-383-7723 COLLEEN FARAGHER HORWELL 1718 NW GREENBRIER WAY SEATTLE WA 98177-5325 SUBDIVISION: Block: Lot: T 22+ PARCEL NUMBER: 501032017 Section: 3 Township: 25 N Range: 1V1 CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION PROPANE TANK SWAP OUT 1000 gallon tank TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC VALUATION MAIN: ADD'L: HEAT TYPE: CODE EDITION: 2012 OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: 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: Approve Permit $152.00 JLA 01/07/15 153999 ApPR � Total: $152.00 JAN 1 2 2015 Jefferson County DOD 11tidem ark\data\forms\F_BLD_App_Bld.rpt 2/11/2015 • B•DING PERMIT APPLOATI•110 BLD15-00011 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD15-00011 Received Date: 1/12/2015 SITE ADDRESS: 471 DIETZ DR QUILCENE, 98376 OWNER: ROLAND FARAGHER-HORWELL PHONE: 206-383-7723 COLLEEN FARAGHER NORWELL 1718 NW GREENBRIER WAY SEATTLE WA 98177-5325 SUBDIVISION: Block: Lot: T 22+ PARCEL NUMBER: 501032017 Section: 3 Township: 25 N Range: 1V) CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI' PROPANE TANK SWAP OUT TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION CODE EDITION: 2012 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: 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 $152.00 JLA 01/07/15 153999 Total: $152.00 APPROVED JAN 12 2015 Jefferson County DCD 11+iriem.,rL1rinfn1fnrme1r RI fl Ann Pirl mf 111 or) • • C_ ti 4-r1- SfAA) d {ENT OF COMMUNITY DEVELOPMENT "-)cedw l t,Port Townsend,WA 98368 L5-1I Fax:360 379.4451 erson.wa.usicommunitydevelopmcnt fferson.wa.us 3ANICAL PERMIT APPLICATION information is completed prior to submitting application. fice-and do not require an appointment. I permits are generally issued within 5 business days. 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 gy* If No: Complete this form and make an appointment- gto submit to Jefferson County Permit Tech 360-379-4450{ t� � 1�� }'} IL P,A'.a. IN $4�14n tlI1 i��l�ll�lll�� 1 11 � .n �' I�.I �" � � ��i��ll i�i��0,1t General Site plan-showing propane tank, lines,and distance from tank to all existing structures. - , ,:•; %w woo* rv. :.,ut 1 $7j�1' v;° Po°rwi in 3 P IFS'. 'iIN fp 1;h: „I II - - Complete first page and signature block only of Mechanical Permit Application. A complete solar panel supplemental application.- atI1 ,1,,I :H:4, ovvzi:: yM, ,1i111y "}a ', . Assessor Tax Parcel Number: D \ 0 �1 Site Address and/or Directions to Property: Access (name of street(s) from which access will be gained: Description of Work: jr Name: `PcKonizeLi- Address: 2f'./ lDi 'T D2+1.41-i Q ut , W A. /E'i-S "9-Co _ Phone#: Zo(o 3 ,3 - 3-'L3 E-mail Address: go c.pr,�p•TA,2,AC,i{C! - - Please contact Authorized Agent/Representative with project info. Gori4-1 t. • (....041 Property Owner Signature: Date: 12-- r--( Appl ca; #/,;4C,ort1,,tactor hQ .zedlAgent/Re; msentative I. Name: 6'(-4-^46 h( °P oPCLVIL, Phone#: 356 5-- S`29 E-mail Address: tNik51, ,16),ht 1p. • • I , License#: StgtJ 5 cD--f-Jcztp Expiration Date: 1 C t b it Mechanical Application I 11', Heat Source Electric Heating Oil Propane* \ Wood dJI Indicate Quantity and Fixture Types Below *Propane is prohibited in Quantity 1Fixture 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: , 7)--1) ) 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 application and subsequent permit issuance. Signature: Print Name: 72°4-4D-'0 1174 A&Nett �!,(.WekDate: 12- - la- OFFICE 1a`OFFICE USE ONLY Building Permit Fees Mechanical Permit fee (tank swap,woodstove,furnace,etc) $152.00 Propane-Lines, tank, and appliance (add'I $76.00) Project Scanning Fee $19.00 Total Fees* 17 / , O� *Additional fees may apply. Mechanical Application 2 SUNSHINE PROPANE • • • • Page 1 of 3 4,,. oft, Washington State Department of Labor & Industries SUNSHINE PROPANE Owner or tradesperson 10853 RHODY DR CHAWES, RICHARD HENRY PORT HADLOCK, WA 98339 360-385-5797 Principals JEFFERSON County CHAWES, RICHARD HENRY, PRESIDENT LEMLEY, DAVID BARRY, VICE PRESIDENT SIMPSON, LAURA ANNE, SECRETARY YOURISH, ROBERT B, TREASURER FLANDERS, RONALD LEE, MEMBER EWING, MICHAEL HOYT, MEMBER ROSS, LEVI K (End: 01/01/1980) CHAWES, RICHARD (End: 01/01/1980) YOUNT, JO (End: 01/01/1980) SPRING, PERRY (End: 11/05/2010) PETERSEN,JAMES (End: 11/05/2010) Doing business as SUNSHINE PROPANE WA UBI No, Business type 600 342 368 Corporation Parent company ENVIRONMENTAL HOUSING INC 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. SUNSHP*077QP Effective—expiration 11(17/1993-11/17/2016 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600342368&LIC=SUNSHP*077QP&SAW= 1/12/2015 SUNSHINE PROPANE Page 2 of 3 Bond No current bond account. See a bondory. Bond history Insurance FEDERATED SERVICE INS CO $1,000,000.00 Policy no. 633829 Received by L&I Effective date 11/09/2006 11/17/2006 Expiration date Until Canceled United States Fire Insurance C $1,000,000.00 Policy no. 506-878572-6 Received by L&I Effective date 11/13/2014 11/17/2014 Expiration date 11/17/2015 Insurance history Savings (in lieu of bond) $12,000.00 Received by L&l 09/16/2014 Savings account ID Effective date 0770001033 09/10/2014 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. 422,171-00 Doing business as SUNSHINE PROPANE Estimated workers reported Quarter 3 of Year 2014"11 to 20 Workers" L&I account representative T1 /JAN BENTLEY(360)9024652 -Email: STRO235@Ini.wa.gov https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600342368&LIC=SUNSHP*077QP&SAW= 1/12/2015