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Home My WebLink AboutBLD2016-00270 - MECHANICAL ue, JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street I Port Townsend, WA 98368 360-379-4450 I email: dcd@co.jefferson.wa.us "4XI N Geo www.co.jefferson.wa.us/commdevelopment MECHANICAL AND DEMOLITION PERMIT PERMIT#: BLD16-00270 Received Date 6/15/2016 SITE ADDRESS: 364 S BAY LN Issue Date 6/15/2016 PORT LUDLOW, 98365 APPLICANT: SUSAN J KAYSINGER PHONE: 364 SOUTH BAY LANE PORT LUDLOW WA 98365-8785 SUBDIVISION: 9693 - LUDLOW POINT TRACTS Block: Lot: PARCEL NUMBER: 969300011 Section: 16 Township: 28N Range: 1E CONTRACTOR: BRENNAN HEATING &A/C LLC PHONE: 206-248-7900 4601 S 134TH PL SEATTLE WA 98168 I�m Contractor's License BRENNHA971 R9 Expires 11/29/ 01b7 2eenan heating.com PROJECT DESCRIPTION: Heat Pump swap out 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 6/15/2017. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: v' V Tank/Line/Appliance: � c>/li4i) t)k ),/z-//7 Final Approval: �j� jii/iy 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 6/15/2016 IlltUILDING PERMIT APPLICAIJN BLD16-00270 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD16-00270 Received Date: 6/15/2016 SITE ADDRESS: 364 S BAY LN PORT LUDLOW, 98365 OWNER: SUSAN J KAYSINGER PHONE: 364 SOUTH BAY LANE PORT LUDLOW WA 98365-8785 9693 - LUDLOW POINT TRACTS SUBDIVISION: Block: Lot: PARCEL NUMBER: 969300011 Section: 16 Township: 28 N Range: 1E CONTRACTOR: BRENNAN HEATING &A/C LLC PHONE 206-248-7900 4601 S 134TH PL SEATTLE WA 98168 Contractor's License BRENNHA971R9 Expires 12/29/2017 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION: Heat Pump swap out TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC VALUATION MAIN: CODE EDITION: 2012 ADD'L: HEAT TYPE: HTP 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: Type Amount Paid By: Date: Receipt Exist: Exist: Permit $170.00 HAC 06/15/16 163106 Prop: Prop: Scannin Fee Total: Total: 9 $21.00 HAC 06/15/16 163106 Total: $191.00 Approved/Date APPROVED JUN 15 2016 Jefferson County DCG \\firlcmor4\ri,t,\fnrrnc\C' RI fl Ann PI,- rnf R/1 FPN11R r , SON DEPARTMENT OF COMMUNITY DEVELOPMENT ;¢ C 6� 621 Sheridan Street,Port Townsend,WA 98368 Tel:360.379.4450 I Fax:360.379.4451 . CIFOM ti �G Web:www.co.jefferson.wa.us;`communitydevelopment i E-mail:dcd@co.jefferson.wa.us I � SJ7 J UH 52016 I N G`S MECHANICAL PERMIT APPLICATION/ �� Steps in the Permit Process: j JEFFERSON COUNTY -Review required submittal items to ensure all information is completed prior to submitting app'iIEPT.OFCOMMUNITY DEVFI.OPP;IENT -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. 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: C 0 3 0 d O j Site Address and/or Directions to Property: M3 <Li S, f'e'y r o(4— �v�(().w lstJa. ` ,t; Access(name of street(s)from which access will be gained: Description of Work: t-{-6s,.,.e,'! ,er x i r-in be, tqi.4'- r '-t''-nom 11`it) ll Property Owner Name: 5v'a ��;+- f,°,,�_� co Address: 3 64-f 5'giij O / e_ Fc — L.vrd(6cu L 1Cr, ,:� E a 5— 0 Phone#: 7 1, 0�- 9 0 ) ® 6 -) E-mail Address: rn Applicant/Contractor: Authorized Agent/Representative Name: ►-cam 2„ E k- y Al( Ca Phone#: 2-0 -- 7.)I 8--71709 E-mail Address► 1-c b(4-"R°"(11 �^ License#: f j/Z NA) H '\ ( k' Expiration Date: /1 01 { Q ��, i` tory, Mechanical Application 1 • ! Heat Source Electric _( Heating Oil Propane* Wood 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 Propane Tank LP Fuel Tank(#gallons: ) over 500 gallons,a site plan is 1 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 applical..n and subsequent permit issuance. Property Owner..// Signature: .}C'G,!lk"a .' < / A- Print Name: ,O!,f c.. S(r) ' '7 Date: 6/4 '/6 OFFICE USE ONLY Building Permit Fees Mechanical Permit fee(tank swap,woodstove,furnace,etc) $170.00 Propane—Lines,tank,and appliance (add'l$85.00) Project Scanning Fee $21.00 Total Fees* *Additional fees may apply. ` EC QMI Mechanical Application 2 D 1 JUN 1 5 2016 JEFFERSON COUNTY �, DEPT.OF COMMUNITY DEVELOPMENT • • Goy Ie earth Page 1 l • 364 S aay Ln t- } s > Existing & Replacement neat p_amp location • Google earn Existing & Replacement heat pump location 1` JUN 1 5 2016 I 11 t LI Li )EFN' U COMMFERSGUNITYCODEVELGPr"FNTNTY GF _tea t-kIr in � { c9 . . _ , • • IscEovE cul ,' , JUN 1 5 2016 clc u I JEFFERSON COUNTY JILT OF COMMUNITY DEVELOPMENT 'r 1. ..,......„1- ... ... ;_..., , - . ,,,, in•,,,,,....••••§3w ,...„......, -„,...-.........____,_-__..-„-____=..-...-- ,...-_,-._,.....:...„...---„-_,___:_--,_—_-=-___---..--=---------:s. -41 ----- ----------. .._____-----'' -------' ---=---='-- _________„_______,...,:-__.„._- . pi .. ' '111" °';. ''' ' ' ' '•, ... ' id 451...Ait • F ' 4, If"''...‘' 1 ',k ,,i (.". '•,' * ' . . . .0 y'''...., •„', , .. 4,.. , 1 ' ''''' ' •'.t.. •‘ 4.....'.'4., . .. •,. , ....,-44t.,-• -•-•... , • . . .. ..,:', — *.t.• • e...,!• ,-. ;, '!' „ , ',', *. =.i.-• • „t, A.• . " • i f.. • __ it - ,.. .. .:. , .. . ,.._..-.-„,.,, ..-. .t.t. ., ,,, ,,t . . . . ‘„.r., ,..„., ,.... . , . , I • • .;.,„. ..N.,,`i.:' v• , . • :',y , . 0,1 r # , ..,,,,,,-- --. .- ,• ...',..,',.t:;. .,, ot .- ---0, - -,' , ' i'', '4 , V.,..', "' ', •' I, 4 4 -41-4,-; ;'' '',:, —4,..1*.1 ' •,•;`, % % . ' ' - . , e; • . • ' ."4 '',.,',.•',.,.1. .F.' .',,',% . * -..% ,4 • ,'"'',0 ••• .'''' • .., ' . Aft.14 t . — '' \t , ,,,.. ..... ., ,..1;,, - f .7 1.".,,,'" I 141 , t _ ' •' '- ii. ..4 • . , Ir.1' • • , ,,, - e.• , • k ' r ,, e BRENNAN HEATING& A/C LLC. Page 1 of 2 Home Espanol Contact Search L&I ECU A-Z Index Help My L&I Safety&Health Claims&Insurance Workplace Rights Trades&Licensing 0 Washington State Department of Labor & Industries BRENNAN HEATING &A/C LLC Owner or tradesperson 4601 S 134TH PL Principals SEATTLE,WA 98168 206-248-7900 ERDAHL,DARRIN PAUL,PARTNER/MEMBER KING County Doing business as BRENNAN HEATING&NC LLC WA UBI No. Business type 602 346 866 Limited Liability Company Governing persons DARRIN P ERDAHL ERIC L BEARDEMPHL; JAMES JOLLY; STEFANIE ERDAHL; 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. BRENNHA971R9 Effective—expiration 12/29/2003-12/29/2017 Bond FEDERATED MUTUAL INS CO $12,000.00 Bond account no. 9127230 Received by L&I Effective date 11/04/2004 12/22/2004 Expiration date Until Canceled Insurance Federated Mutual Ins Co $1,000,000.00 Policy no. 9820726 Received by L&I Effective date 06/16/2015 07/13/2015 Expiration date 07/13/2016 Insurance history Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602346866&LIC=BRENNHA971 R9&SAW= 6/15/2016 Parcel Details • Page 1 of 2 •_,. � . def County Weather Station '"' Database Tools MiiiN Maps Webcam Home County Info Departments Search 1 Parcel Number: 969300011 SEARCH Parcel Number: 969300011 Printer Friendly Owner Mailing Address: SUSAN J KAYSINGER 364 SOUTH BAY LANE PORT LUDLOW WA98365-8785 Site Address: 364 SOUTH BAY LN PORT LUDLOW 98365 Section: 16 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 CWF) Drainage: Bank: View 1: View 2: Zoning 1: MPR-SF-4 - Master Planned Resort - Single Family Zoning 2: Zoning 3: Sub Division: 9693 - LUDLOW POINT TRACTS Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: LUDLOW POINT TRACTS LOT 15 SUB] TO EASE Tax,A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel Plats&Survev Septic Monitoring Info ,: Jefferson COuflly HOME I COUNTY INFO I DEPARTMENTS I SEARCH 00/ Best viewed with Microsoft Internet Explorer 6.0 or later AO Windows - Mac http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?value=969300011 6/15/2016