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Home My WebLink AboutBLD2017-00237 - MECHANICAL 0 • SON c, :' (� JEFFERSON COUNTY f-Li -4 DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street 1 Port Townsend, WA 98368 360-379-4450 I email: dcd@co.jefferson.wa.us gs&7Z NL,-- www.co.jefferson.wa.us/commdevelopment MECHANICAL AND DEMOLITION PERMIT PERMIT#: BLD17-00237 Received Date 6/5/2017 SITE ADDRESS: 191 LORDS LAKE LOOP RD Issue Date 6/5/2017 QUILCENE, 98376 APPLICANT: RORY VAIL PHONE: 907-317-6275 PO BOX 531 QUILCENE WA 98376-0531 SUBDIVISION: Block: Lot: PARCEL NUMBER: 702111039 Section: 11 Township: 27N Range: 2W CONTRACTOR: PENINSULA HEAT INC PHONE: 360-681-3333 PO BOX 173 CARLSBORG WA 98324 Contractor's License PENINI*0440W Expires 10/18/2018 PROJECT DESCRIPTION: NEW MECHANICAL PERMIT INSTALL OF SINGLE PORT DUCTLESS HEAT PUMP 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 6/5/2018. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO: Tank/Line/Appliance: Final Approval: `i +7 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_P ropane.rpt 6/5/2017 MILDING PERMIT APPLICATA BLD17-00237 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD17-00237 Received Date: 6/5/2017 SITE ADDRESS: 191 LORDS LAKE LOOP RD QUILCENE, 98376 OWNER: RORY VAIL PHONE: 907-317-6275 PO BOX 531 QUILCENE WA 98376-0531 SUBDIVISION: Block: Lot: PARCEL NUMBER: 702111039 Section: 11 Township: 27 N Range: 2V1 CONTRACTOR: PENINSULA HEAT INC PHONE: 360-681-3333 PO BOX 173 CARLSBORG WA 98324 Contractor's License PENINI*0440W Expires 10/18/2018 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION: NEW MECHANICAL PERMIT INSTALL OF SINGLE PORT DUCTLESS HEAT PUMP TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION ADD'L: HEAT TYPE: CODE EDITION: 2015 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: Type Amount Paid By: Date: Receipt Exist: Exist: Permit $180.00 SRE 06/05/17 169834 Prop: Prop: Scanning Fee $23.00 SRE 06/05/17 169834 Total: Total: Total: $203.00 Approved/Date APPROVED Asim / 5 2017 Jefferson County DCD \\firarnnrL\rinfn\fnrmc\F RI fl Ann RId rnf Ric,/7(197 • • 6ON DEPARTMENT OF COMMUNITY DEVELOPMENT OL. 621 Sheridan Street,Port Townsend,WA 98368 Rte,,, w Tel:360.379_-1450 Fax:360.79.-1-t-51 -C( \1'eb:wuw.co.iefferson.wa.us/communirec1 elupment s ' E-mail:dcd rt co.iefferson wil us I )E`er SkINO� 4 '&y MECHANICAL PERMIT APPLICATIO p ,f, I Y Steps in the Permit Process: -Review required submittal items to ensure all information is completed prior to submitting applicatio O1 j• . -Mechanical Permits can be mailed into our office-and do not require an appointment. M -Fees are due at time of submittal,Mechanical permits are generally issued within 5 business days. For Department Use Only Receipt#: 101(2),7)4-1 Date: /C Related Application#s: Payment#: t 2. C) 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&1-360-417-2702 * 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. Required Submittal Items—for roof mount Solar Panel installation only(ground mount complete CAM) Complete first page and signature block only of Mechanical Permit Application. A complete solar panel supplemental application. Site Information Assessor Tax Parcel Number: q(:),),1 Lt b 3 1 Site Address and/or Directions to Property: :lel 1, Le),--ds L_ . Access(name of street(s)from which access will be gained: con-Fact Description of Work: ;,a S �Cc v✓� ac 5;��(,� _ A- dw,,-SSS � --E- p Property Owner Name: gars \/o--C.\ r- Address: _del L,rets p Phone#: 1 -(0a 7-5 E-mail Address: pkh ook2cj(o ,l,(a— Applicant/Contractor: Authorized Agent/Representative Name: Deni ns Phone#: 3(40- (.o ,\ - 3333 E-mail Address: -vie w[:,, , License#: P Expiration Date: /0 i a Mechanical Application 1 • • Heat Source i ElectricX Heating Oil Propane* Wood I Indicate Quantity and Fixture Types Below Quantity Fixture Type Propane is prohibited in Deshazardous 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 Water Heater-Gas Gas WH Vent and Combustion Air submitted with the Gas Pipe System Gas Pipe System LPG/Oil application showing the Propane Tank LP If propane tank is LP Fuel Tank(#gallons: ) over 500 gallons,a site plan is Heat Pump/Di—i p ';4-5,,� 2 � LS 3 required to accompany this Generator application, and a separate Air Conditioner I Fire Code approval is also required. llnst 011at oi- manual must be on site at time of inspect.n or a re-inspection fee wiii 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 O T Signature: Print Name: � ' 5/3 1 (----k- <_. - ��v�r�_Date: OFFICE USE ONLY Budding Permit Fees Mechanical Permit fee(tank swap,woodstove,furnace,etc) t.170-�O qt; )TO Propane—Lines,tank, and appliance (add'i $85.00) ��v 7" D Project Scanning Fee x-80 g-3 Total Fees* �03, : ''Additional fees may apply. Mechanical Application 2 • PENINSULA. HEAT Thank you for choosing Peninsula Heat for our services. Due to your property being located in Jefferson County, we are required to receive approval from you to apply for a mechanical permit from the County. Please sign and date below indicating your acceptance. Thank you very much! Print Name; Address: \c\\ L.,,,,cc. L-(-4"‘) Q-e\ ( 57') Date: s 3 Sign: ( ) (1164 •