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Home My WebLink AboutBLD2015-00329 - MECHANICAL •UILDING PERMIT APPLICAN BLD15-00329 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD15-00329 Received Date: 9/28/2015 SITE ADDRESS: 2261 OLD GARDINER RD #54 SEQUIM, 98382 OWNER: DISCOVERY BAY LSEHLDRS ASSOC PHONE: 2261 OLD GARDINER RD SEQUIM WA 98382-8718 SUBDIVISION: Block: Lot: PARCEL NUMBER: 002353002 Section: 35 Township: 30 N Range: 21P CONTRACTOR: AMERIGAS PROPANE L P PHONE: 425-219-9972 2831 74TH DR NE MARYSVILLE WA 98270 Contractor's License AMERIPL055LL Expires 8/2/2017 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION Install Propane Tank and Lines 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: 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 $234.00 HAC 09/28/15 159224 „APPROVED Total: $234.00 SEP 2 8 2015 Jefferson County DCE \\firlcm�r4\rl of�\fnrmc\G RI rl Ann RId rr.f Q/9R/9Mr. ,soNco DERTMENT OF COMMUNI'I VELOPMENT .Cc� 631 Shcrid t 1 gree..Port I c -ns nd.A\ \ 9 ��6ti 1 cl:360.3-9.4450 lac 360.3-9.-1451 .0 \\cb.w\\w.co.ier*c son'.va.,s'Con1: tt,.i, do c, p-r.c:,r E-_rail:dcd,it<co.ietfer,on y a.ta .........) 17sHI N G,c 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#:j qz-ey Date: 19/r4/6 Related Application#s: Payment#: (C Is this application for use in a Mobile/ Manufactured Home? tkvF) * 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 LGeneral 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. I Site Information Assessor Tax Parcel Number: Site Address and/or Directions to Property: /E / VaT-,t — 1)8 — i s c_r) den br)L1 res®Ir -z � i O/c )f�r/P/)r-)�-- A' c /Aoi 3( .5 �_,;,-L L/j) Access (name of street(s) from which access w'rfI be gained: />,��,�,GL , c 1. Description of Work:� / / �{ / / /g-Sc. ., Property Owner J Name: e4),� /y Z� '5-jaml(1 r . ,C9e_i i c_ Address: Z-Com/ 0 L% ra—Chi-7�' .'- , LUT.j Y1? ,�';�1 �,j 0 G) Phone #: i d E -m1ll Address: m w K Applicant/Contractor: Authorized Agent/Representative ri 4 Name: ft0/7 /'-1 �7C'�7 79-A) / / c-e'/c'P.s } , G ..71vr`71 r Phone #: 2, -- — C - 3 E-mail Address: �►! C?/nee/g-td , License Q/- L/q -'D Expiration Date: 0/.30//6. 1 1 Mechanical Application 1 1 • • t Heat Source ' Electric u Heating OilPropane* � Wood Indicate Quantity and Fixture Types Below *Propane is prohibited in Quantity Fixture Type Description i 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 / k9/)..A- ,. Cook Stove, Range Hood Exhaust I gas can unsafely 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, and a site plan must be Propane (LP) Gas Furnace Propane Furnace+/- Ducting 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 i 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. Property Owner / l Signature`. - i p> /J~klio. p1 nt Name: •,,L, 1i�LS 11. / tk/_S 4.7-1Date: ` 2 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 NO. 15112 2 4 JEFFERSON COUNTY; DATE i/ �� RECEIVED FROM &1\ J �,-h ..r_ f iC-'`+ DESCRIPTION BARS# AMOUNT �+ CURRENCY / y�C•e 9,,3"1/ aQ 00„,....,‘, CHECKS C 1' CO ciiiinica zzLigee)( 0 ..., ,,-. x...,... j___ 67111 4 ,'7- o -. _< RECEIVED BY /....,/ TOTAL C -.9 ap Parcel Details • • Page 1 of 2 (*\\I Count • M Nome County Info Departments Search Parcel Number: 002353002 SEARCH Parcel Number: 002353002 Printer Friendly Owner Mailing Address: DISCOVERY BAY LSEHLDRS ASSOC 2261 OLD GARDINER RD SEQUIM WA98382-8718 Site Address: 276875 HIGHWAY 101 SEQUIM 98382 Section: 35 School District:Sequim (323) Qtr Section: SW1/4 Fire Dist:Sequim (8) Township: 30N Tax Status: Taxable Range: 2W Tax Code: 0781 Planning area: Discovery Bay (5) Sewer: Drainage: Bank: View 1: View 2: Zoning 1: RR-10 - Rural Residential Zoning 2: Zoning 3: Sub Division: Assessor's Land Use Code: 7500 - Resorts - Seasonal - RV Parks Property Description: S35 T30 R2W E 1/2 NW SW (LESS S OF ST RD #9) SUBJ/EASE Tax, A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel Plats&Survev Septic Monitoring Info Jefferson County HOME I COUNTY INFO I DEPARTMENTS I SEARCH Best viewed with Microsoft Internet Explorer 6.0 or later Windows - Mac http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?value=002353002 9/28/2015 AMERIGAS PROPANE L PID • Page 1 of 2 Home Inicio en Espanol Contact i Search L&I SEARCH A-Z Index Help My Secure L&I Safety Claims&Insurance Workplace Rights Trades&Licensing 0 Washington State Department of Labor & industries AMERIGAS PROPANE L P Owner or tradesperson 2831 74th DR NE MARYSVILLE,WA 98270 Principals 425-219-9972 Amerigas Propane Inc,PARTNER/MEMBER SNOHOMISH County Samuel,Steven Alan,PARTNER/MEMBER Prentice Hall Corp,AGENT MAUCH,ROBERT C,PARTNER (End:07/27/2011) GOMEZ,LUIS A,PARTNER (End:07/27/2011) KNAUSS,ROBERT H,PARTNER (End:07/27/2011) Doing business as AMERIGAS PROPANE L P WA UBI No. Business type 601 619 800 Limited Liability Partnership Governing persons B P BOVAIRD E A COMPTON; EV N BISSEL; HOLDING AMERIGAS EAGLE; HOLDINGS AMERIGAS EAGLE; M B LINDSAY; N NEW AMERIGAS PROPANE; P G GRADY; PARTNERS L AMERIGAS; PROPANE NEW AMERIGAS; PROPANE N NEW AMERIGAS; R R EYNON; R H KNAUSS; R W KRICK; W D KATZ; 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. AMERIPL055LL Effective—expiration 06/13/1995—08/02/2017 Bond SAFECO INS CO OF AM $12,000.00 Bond account no. 5799215 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601619800&LIC=AMERIPL055LL&SAW= 9/28/2015 S Discovery Bay RV Resort 2261 Old Gardiner Road Sequim, WA 98382 Phone 360 797-7222 September 28, 2015 S. Ellis, Jefferson County, Discovery Bay Leaseholders Association is the legal owner of lot number 54 at Discover Bay RV Resort. We authorize Janis Christian to install a propane tank on Lot number 54. Linda Enger Director at Large S 4w,-5°N °oo JEFFERSON COUNTY 6032-9 )oma 1 DEPARTMENT OF COMMUNITY DEVELOPMENT 9`SFlING Date: —S Time Received: //J7 &/pm Mon. Tue. Wed Thur. Fri. Date: BLD: Contact Name: Owner: C i,.Ir:S 4-e".1 Contact Number: 360 5-0 7- 25'-. '914 Address: 'i-z.-C I a/i' M • 206 iNote5/AC-I- .--.S— Notes: s: Foundation Plumbing Framing Propane Tank Mechanical 11111.11 Setbacks Under-ground Framing Under ground 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 --- - Ceiling • ! 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 #: BLD15-00329 Received Date 9/28/2015 SITE ADDRESS: 2261 OLD GARDINER RD #54 Issue Date 9/28/2015 SEQUIM, 98382 APPLICANT: DISCOVERY BAY LSEHLDRS ASSOC PHONE: 2261 OLD GARDINER RD SEQUIM WA 98382-8718 SUBDIVISION: Block: Lot: PARCEL NUMBER: 002353002 Section: 35 Township: 30N Range: 2W CONTRACTOR: AMERIGAS PROPANE L P PHONE: 425-219-9972 2831 74TH DR NE MARYSVILLE WA 98270 Contractor's License AMERIPL055LL Expires 8/2/2017 OWNER, DISCOVERY BAY LSEHLDRS ASSOC PHONE: if different: 2261 OLD GARDINER RD SEQUIM WA 98382-8718 PROJECT DESCRIPTION: Install Propane Tank and Lines 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 9/28/2016. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: _1/'h / L •% L Tank/Line/Appliance: Thkv /1 a-- Zo',+dt X-- 1-6 Final Approval: I — I t, -� 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 9/28/2015