HomeMy WebLinkAboutBLD2019-00049 - MECHANICALIo
JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street I Port Townsend, WA 98368
360-379-4450 | email: dcd@co.jefferson.wa.us
www. co.jefferson. wa. u s/co m mdevelopment
MECHANIGAL AND DEMOLITION PERMIT
PERMIT #:
SITE ADDRESS:
APPLICANT:
SUBDIVISION:
PARCEL NUMBER
CONTRACTOR:
BLD19-00049
43 MOUNTAIN VISTA CT
PORT TOWNSEND, 98368
DAVID DEAN
43 MOUNTAIN VISTA CT
PORT TOWNSEND WA 98368.2598
9999 - WOODLAND HILLS #2
Received Date
lssue Date
2t19t2019
2t19t2019
999900122
TEMPLEFIRE INC ATTN: JASON TEMPLE
P.O. BOX 2085
PORT TOWNSEND WA 98368
Contractor'sLicense TEMPL|.816BM Expires 111412021
PHONE: 360-821-2472
Block: Lot:
Section: 28 Township: 30N Ranqe: 1W
PHONE: 360-379-2877
PROJECT DESCRIPTION NEW MECHANICAL PERMIT
MASONRY HEATER
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 IS2I19I2O2O,
REQUIRED INSPECTIONS:
uu)
TanULine/Applia
+/r,l,q LFinalApproval.
BUILDING INSPECTION HOT.LINE 3794455.
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
\\tidema rk\data\forms\F_BLD_Perm it_Propane. rpt
HOT LINE AVAILABLE 24 HOURS A DAY
2t1912019
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UAR fa-2019
Structural Calculations for:
Client: TempleFirc Inc.
11 March 2019
giraf design
9220 Roosevelt U/ay NE Seattle WA 98'115-2842
(206) 621-0060 Office (206) 8984229 Cett
orrafdesrqn@qmal-com htto //qirafdesign net
Dean Residence
Fireplace Suppoft
38s67
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GENERAL STRUCTURAT NO?ES
(The following apply unless shown otherwise on the plans)
CRITERIA
1 ATL MATERIAIS, WORKMANSIIIP, DESIGN, AND CONSTRUCTION SHALL CONEORM TO
DRAWINGS, SPECIFICATIONS, AI{D THE INTERNATIONAL BUILDING CODE
EDITION) WITH STATE OE WASHINGTON A!,IENDMENTS.
1.2 DESIGN LOADING CRITERIA
1 THE
( 2015
FLOOR LIVE LOAD (RESIDENTIAI)
MASONRY FIREPLACE
40 PSE
3,900*
1
1
L.4 CONTRACTOR SHALL VERIFY ALL EXISTING DTMENSIONS, MEMBER SIZES, AND
CONDTTIONS PRIOR TO COM}iIENCING ANY WORK. ALL DIMENSIONS OE EXISTING
CONSTRUCTION SHOWN ON THE DRAT{INGS ARE INTENDED AS GUIDELINES ONLY AND MUST
BE VERIFIED.
5 CONTRACTOR SHALI PROVTDE TEMPORARY BRACING EOR THE STRUCTURE AND STRUCTURAL
COMPONENTS UNTIL ALL EINAI CONNECTIONS HAYE BEEN COMPLETED IN ACCORDANCE
W]TH THE PIANS.
6 CONTRACTOR SHALL BE RESPONSIBLE FOR ALL SAI"ETY PRECAUTIONS AND THE METHODS,
TECHNIQUES, SEOUENCES OR PROCEDURES REQUIRED TO PERFORM THE CONTRACTORS
WORK. THE ENGINEER OE RECORD HAS NO OVERALL SUPERVISORY AUTHORITY ORACTUAI AND/OR DIRECT RESPONSIBILITY EOR THE SPECIEIC WORKTNG CONDITIONS
AT THE SITE AND/OR FOR ANY HAZARDS RESULTING FROM THE ACTIONS OF ANY TRADE
CONTRACTOR. THE ENGINEER OE RECORD I{AS NO DUTY TO INSPECT, SUPERVISE,NOTE, CORRECT, OR REPORT ANY HEALTH OR SAFETY DETICIENCIES TO THE OWNER,
CONTRACTORS, OR OTHER ENTITIES OR PERSONS AT THE PROJECT SITE.
7.7 CONTRACTOR-INTTIATED CHANGES SHATL BE SUBMITTED IN WRITTNG TO THE ENGINEER
OF RECORD ElR APPROVAL PRIOR TO FABRICATION OR CONSTRUCTION.
CHANGES SHOWN ON SHOP DRAWTNGS ONLY WrLL NOT SATTSFY THrS REQUTREMENT.
8 DRAWINGS INDICATE GENERAL AND TYPICAI DETAILS OE CONSTRUCTION. WHERE
CONDITIONS ARE NOT SPECIFICA],LY INDTCATED BUT ARE OF STMILAR CHARACTER TO
DETATLS SHOWN, SIMILAR DETATLS OF CONSTRUCTION SHALL BE USED, SUB.IECT TO
REVIEW AND APPROVAL BY THE ARCHITECT AND THE ENGINEER OF RECORD.
GEOTECHNICAI
3.1 FOUNDATTON NOTES: ALLOTIABLE SOfL PRESSURE IS
ASSUMED AND THEREEORE MUST BE VERIFIED BY A QUALIEIED SOILS ENGINEER OR
APPROVED BY THE BUILDING OFFICIAL. IF SOILS ARE TOUND TO BE OTHER THAN
ASSUMED, NOTIFY THE ENGINEER OF RECORD TOR POSSIBLE EOUNDATION REDESIGN.
ALLOWABLE SOIL PRESSURE.2000 PSr
1
4
RENOVATION
4.1 DEMOLITION: CONTRACTOR SHALL VERIEY AIL EXISTING CONDITIONS BEEoRE
COMMENCING ANY DEMOLITION. SHORING SHALL BE INSTAILED TO SUPPORT EXISTING
CONSTRUCTION AS REQUIRED AIiID IN A MANNER SUITABLE TO THE I{ORK SEQUENCES.
DEMOLITION DEBRIS SHALL NOT BE ALLOWED TO DAI,'AGE OR OVERIOAD THE EXISTING
STRUCTURE. LrMrT CONSTRUCTTON LOADTNG (TNCLUDTNG DEMOLTTTON DEBRIS) ON
EXISTING FLOOR SYSTEMS TO 40 PSF.
5 CONTRACTOR SHALL CHECK EOR DRYROT AT AIL AREAS OE NEW WORK. AIL ROT SHALL
BE REMOVED AND DAI,IAGED MEMBERS SHALL BE REPI"ACED OR REPAIRED AS DIRECTED
BY THE ENGINEER OF RECORD OR ARCHITECT.
WOOD MEMBERS W]TH ROT OR WATER DAI.{AGE THAT ARE NOT REMOVED SHALI BE TREATEDwrTH 'PC-ROT TERMINATOR' 2-PART EPOXY WOOD CONSOLTDANT (OR APPROVED EQUAI,).
CONSOLIDANT SHALL BE USED IN STRICT ACCORDANCE WTTH THE MANUFACTURER'S
RECOMMENDATIONS.
CONCRETE
5.1 CONCRETE SHALL BE MIXED, PROPORTIONED, CONVEYED AND PI,ACED IN ACCORDANCEITTH IBC SECTION 1905, 1906, AND ACI 301. STRENGTHS AT 28 DAYS AND MlX
CRITERIA SHALI BE AS FOLLOWS:
TYPE OE CONSTRUCT]ON 28 DAY
STRENGTH(f'c)
MAXIMUI4 ABSOLUTE
WATER- CEMENT RATIO
NON-AIR ENTRAINED ATR ENTRAINED
CONCRETE CONCRETE
tr
A. AIL STRUCTURAL CONCRETE 2,500 PST 0.58 0-46
.2 THE MINIMUM AMOUNTS OF CEMENT MAY BE CHANGED IE A CONCRETE PERFORMANCE MIXIS SUBMITTED TO THE ENGINEER OE RECORD AND THE BUILDING DEPARTMENT FOR
APPROVAI TWO WEEKS PRIOR TO PLACING ANY CONCRETE. THE PERFORMANCE MIX
SHALT INCLUDE THE AIIOUNTS OF CEMENT, TLYASH, ETNE AND COARSE AGGREGATE,
WATER AND ADMIXTURES AS WELL AS THE WATER CEMENT RATTO, SrUMp, CONCRETE
YIELD AND SUBSTANTIATING STRENGTH DATA TN ACCORDANCE WITH IBC 1905.6. THE
USE OF A PERFORMANCE MIX REOUIRES BATCH PI,A}.IT INSPECTION, THE COST OF WHICH
SHALL BE PAID BY THE GENERAL CONTRACTOR. REVTEW OF MIX SUBMITTAIS BY THE
ENGINEER OF RECORD TNDICATES ONLY THAT INFORMATION PRESENTED CONFORMS
GENERALLY WITH CONTRACT DOCUMENTS. CONTRACTOR OR SUPPLTER MAINTAINS EULL
RESPONSIBILIIY EOR SPECIFIED PERPORMANCE.
AI,L CONCRETE WITH SURFACES EXPOSED TO STANDING WATER SHALL BE ATR-ENTRATNEDWrTH AN AIR-ENTRAINING AGENT CONEORMING TO ASTM C260, C494, and C618.
TOTAL AIR CONTENT EOR FROST_RESISTANT CONCRETE SHALL BE TN ACCORDAIICE WITH
TABLE 1904.2 OF THE INTERNATIONAL BUILDING CODE.
.4 RETNFORCING STEEI SHALL CONFORM TO ASTM A615 (TNCLUDTNG SUPPLEMENT
GRADE 60, fy - 60,000 PSI. OR GRADE 40, fy = 40,000 pSI.
.8 CONCRETE PROTECTION (COVER) EOR REINFORCING STEEL SHALL BE AS EOLLOWS:
s1),
FOOTTNGS AND OTHER UNTORMED SURFACES CAST AGAINST A}.TD PERMANENTLY E:XPOSED
TO EARTH 3r
TORMED SURFACES EXPOSED TO EARTH OR WEATHER (*S BARS OR SMALLER) 7-1/2"
5
5
6
ANCHORAGE
.2 EPOXY-GROUTED ITEMS (THREADED RODS OR REINFORCING BAR) SPECTFIED ON THE
DRAWINGS INTO EXISTING CONCRETE AND GROUTED CMU SHALT BE INSTALLED USING
"SET-XP" EPOXY AS MANUEACTURED BY THE STMPSON STRONG TIE COMPANY. INSTAILIN STRICT ACCORDANCE WITH ICC-ES REPORT NO. 2508. SPECIAL INSPECTION OF
INSTALLATION IS REQUIRED. RODS SHALL BE ASTM A-36 UNLESS OTHERWISE NOTED.
6.4 SCREW ANCHORS INTO CONCRETE AND CONCRETE MASONRY UNITS SHALI BE "TITEN HD"
HEAVY DUTY SCREW ANCHORS AS MANUFACTURED BY SIMPSON STONG-TIE. BOLTS INTO
CONCRETE MASONRY OR BRICK MASONRY UNITS SHALL BE INTO EULIY GROUTED CELLS.
SUBSTITUTES PROPOSED BY CONTRACTOR SHALL BE SUBMITTED TOR REVIEW WITH ICBO,
OR ICC REPORTS TNDICATING EQUIVALENT OR GREATER LOAD CAPACITIES. INSTAIIIN STRICT ACCORDANCE WITH ICC-ES REPORT NO. 1056.
wooD
9.1 FRAMTNG LUMBER SHALL BE KILN DRIED OR MC-19, AND GRADED AND IIARKED IN
CONFORMANCE WITH W.C.L.B. STAI{DARD GRADING RULES EOR WEST COAST LUMBER NO.L7. EURNISH TO THE FOLLOWING MINIMW STAT.IDARDS:
JOTSTS (2X & 3X MEMBERS) HEM-FrR NO. 2
AND BEAMS: MINIMUM BASE VALUE, Etr : 850 pSI
(4X MEMBERS) DOUGLAS FTR.I,ARCH NO. 1
MINfMUM BASE VALUE, Eb : 1000 PSI
BEAMS: (fNCL. 6x AND LARGER) DOUGTAS FfR-LARCH NO. 1
MINIMUM BASE vAlUE, Eb : 1350 PSI
POSTS: (4X I,IEMBERS) DOUGLAS FIR-LARCH No. 2
MINIMUM BASE VALUE, Fc : 1350 PSI
(6X AND LARGER) DOUGLAS FTR-I,ARCH NO. 1
MINIMTM BASE VALUE, Ec : 1000 PSI
2 X 4 STUDS, PLATES & MISC. FRAMING: DEIL OR HF STUD GRADE
2 X 6 STUDS, PLATES e MISC. FRAMTNG: DEIL OR HE *2
9.10 PLYWOOD SHEATHING SHALL BE GRADE C-D, EXTERIOR GLUE OR STRUCTURAT IT,
EXTERTOR GLUE IN CONEORMANCE WITH DOC PS 1. ORIENTED STRAND BOARD OF
EQUIVAI,ENT THICKNESS, EXPOSURE RATING A}.ID PANEL INDEX T'{AY BE USED IN LIEU
OF P],YWOOD.
9.12 AIL WOOD IN DIRECT CONTACT WITH CONCRETE OR MASONRY SITALL BE PRESSURE-
fREATED WTTH AN APPROVED PRESERVATIVE OR (2) LAYERS OF ASPITALT IMPREGNATED
BUILDING PAPER SHALL BE PROVIDED BETWEEN UNTREATED T{OOD AND CONCRETE OR
MASONRY.
PRESSURE TREATED WOOD SHALL BE TREATED PER AWPA STAI{DARD C2 EOR LUMBER ORC9 FOR PLYWOOD. WOOD TN CONTINUOUS CONTACT WTTI{ TRESII WATER OR SOIL SHALLBE TREATED TO A RETENTION OF O.4O PCF. PRESSURE TREATED WOOD EOR ABOVE
GROUND USE SHALL BE TREATED TO A RENTION OF 0.25 PCF. SODIU},I BORATE (SBX)
IREATED WOOD SHALL NOT BE USED WHERE EXPOSED TO WEATHER. TASTENERS(NAILS, SCREWS, BOLTS AND ANCITOR BOLTS) A!{D TIMBER CONNECTORS IN DIRECT
CoNTACT V[r?H ACQ-A, CBA-A, CA-B, OR SBX TREATED WOOD SItArr BE c].85 OR A1g5
HOT DIPPED OR CONTINUOUS IIOT-GAIVANIZED PER ASTM A653. FASTENERS A}TD TIMBER
CONNECTORS IN DIRECT CONTACT WITH ACZA TREATED WOOD SHAIL BE TYPE 304 OR 316
STAINLESS STEEL.
9.15 TIMBER CONNECTORS CAILED OUT BY LETTERS AND NT]MBERS SHALL BE 'STRONG-TIE'BY STMPSON COMPANY, AS SPECITIED IN THEIR CURRENT CATALOG. EQUIVALENT
DEVICES BY OTHER MANUEACTURERS MAY BE SUBSTTTUTED, PROVTDED THEY HAVEICC-ES APPROVAI, FOR EQUAI, OR GREATER LOAD CAPACTTIES. PROVIDE NUMBER A}IDSIZE OF EASTENERS AS SPECIFIED BY MANUFACTURER. CONNECTORS SIIATL BE
INSTAILED IN ACCORDANCE TIITH THE MANUFACTURER'S RECOMMENDATIONS.
WHERE CONNECTOR STRAPS CONNECT TWO MEMBERS, PI,ACE ONE-HAIE OE THE NAILS OR
BOLTS IN EACH MEMBER.
ALL SHTMS SHALI BE SEASONED
AS MEMBERS CONNECTED.
AND DRIED AND THE SAME GRADE (MINIMUM)
9.16 WOOD FASTENERS
NAIL SIZES SPECIFIED ON DRAWINGS ARE BASED ON THE EOLLOWING
SPECIEICATIONS:
A
SIZE
6d
8d
10d
L2d
16d BOX
16d SINKER
16d COMMON
LENGTII
2n
2-L/2"
3'
3-t/ 4"
3-1/2"
3-t/2"
3-L/2"
DIAMETER
0. 113n
0.131"
0.148"
0.148'
0. 135 "
0.149"
0.L62"
IF CONTRACTOR PROPOSES TIIE USE OF ATTERNATE NAILS, THEY SITALL SUBMTTNArL SPECTFTCATTONS TO TIIE ENGTNEER OF RECORD (pRrOR TO CONSTRUCTTON)
FOR REVTEW AND APPROVAL.
NAILS - PLYWOOD (APA RATED SHEATHTNG) FASTENERS TO FRAMING SHALL BE
DRIVEN ELUSH TO EACE OE SHEATHTNG WITH NO COUNTERSINKING PERMTTTED.
ALL BOLTS IN WOOD MEMBERS SHALL CONFORM TO ASTM A307. PROVIDE WASHERS
UNDER THE HEADS AND NUTS OF ALL BOLTS AND LAG BOLTS BEARTNG ON WOOD.
TNSTATLATION OF LAG BOLTS SHALL CONEORM TO THE NATIONAI, DESIGN
SPECIFICATION FOR WOOD CONSTRUCTION (2005 EDITION) WITH A LEAD BOREHOLE OE 60 TO 70 PERCENT OF THE SHANK DIAMETER. LEAD HOLES ARE NOT
REQUIRED TOR 3/8" DIAMETER AND SMALLER LAG SCREWS.
9.17 WOOD ERAMING NOTES--TIIE EOLLOWING APPLY UNLESS OTHERIIISE SHOWN ON THE
PI,ANS:
A. AIL WOOD TRAMING DETATLS NOT SHOTTN OTHERWTSE SITATL BE CONSTRUCTED TOTHE MINIMW STANDARDS OE THE INTERNATIONAL BUITDING CODE. MINIMUMNAILING, UNLESS OTHERWISE NOTED, SHATL CONEORM TO TABLE 2304.9.L.
COORDINATE THE SIZE AND LOCATION OF AII OPENINGS I{TTH MECHANICAI AND
ARCHTTECTURAL DRAWINGS.
B
l rr,.DtNG PERM'T orr,-,.llo*
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
BLDl9-00049
Review Type:
PERMIT #:
SITE ADDRESS
OWNER
SUBDIVISION:
PARCEL NUMBER
BLD19-00049
43 MOUNTAIN VISTA CT
PORT TOWNSEND, 98368
DAVID DEAN
43 MOUNTAIN VISTA CT
PORT TOWNSEND WA 98368-2598
999900122 Section
Received Date: 211912019
PHONE: 360-821-2472
9999 - WOODLAND HILLS #2
Block: Lot:
28 Township: 30 N Range: 1\i1
CONTRACTOR:
REPRESENTATIVE
TEMPLEFIRE INC ATTN: JASON TEMPLE
P.O. BOX 2085
PORT TOWNSEND WA 98368
Contractor'sLicense TEMPLl.816BM Expires
PHONE: 360-379-2877
4t28t2018
PHONE:
PROJECT DESCRIPTION: NEW MECHANICAL PERMIT
MASONRY HEATER
TYPE OF WORK
TYPE OF IMP
VALUATION
CODE EDITION:
OCCUPANCY:
OCCUPANCY:
CONST TYPE:
CONST TYPE:
SEWAGE DISPOSAL:
WATER SYSTEM:
BEDROOMS:
Exist.
Prop:
Total:
NON
MEC
2015
BATHROOMS:
Exist:
Prop:
Total:
SQUARE FOOTAGE:
MAIN:
ADD'L:
HEAT BASE:
UNHEATED:
OTHER:
GARAGE:
DECK:
Type
HEAT TYPE:
HEAT TYPE:
# OF STORIES:
SHORELINE:
SETBACK:
BANK HEIGHT:
Amount Paid Bv: Date: Receipt
Permit
Scanning Fee
Tech Fee
$188.00 SRE
$24.00 sRE
$10.60 sRE
02t19t19
02t19t19
02t19119
1 83552
1 83552
1 83552
Approved/Date Total:$222.60
o o
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Shcridan Street, Port Townsend, WA 98368
'I' el: 360.37 9.4450 | Irax: 360.31 9.4451
Wcb: www.co.ie ffcrson.wa.us/co,rnmunitydevelopment
I1-mail: dcd@co.iefferson.wa.us
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 are issued within 5 business
ls this application for use in a Mobile / Manufactured Home?* lf Yes: A permit from Washington State Department of Labor and lndustries, not Jefferson County, is
required for appliances installed within a mobile/manufactured home. L&l - 360-4L7-2702* lf No: Complete this form and make an appointment to submit to Jefferson County Permit Tech 350-379-4450
Required Submittal ltems - for propane tank only
Required Submittal ltems - 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.
Receipt #:
nt #:
Date
Related lication #s:
For Department Use Only
Site lnformation
Assessor Tax Parcel Number: qqq OOlz?
Site Address or Directions to P C
o,f
Access me of from which access will be J
of Work:I enltr I oe
v'e
Propefi Owner
Name:
Address:
Phone #:o-E-mailAddress: 4[trtol {l/.r Q 3,*,r,1.c"*
@r0o
!mv
-r
rt
FO
E
[F
Applicant / Contractor: Authorized Agent/Representative
Name:
Phone #:
License #:
{<T.
76o- 311 -7-8-7)E-mailAddress:
Expiration Date'T LMPLI* 8t 6 | -11- Zol
Mechanical Application 1
General Site plan - showing propane tank, lines, and distance from tank to all existing structures.
,Jl l,'
LM
Heat Source
Electric Heating Oil Propane+Wood w
O
lnstallation 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
Property
nt Name = 2rnJ tr 7larl Date: z'/f-?2//Sign
o
lndicate quantity of NEW Fixture Types Below *Propane is prohibited in
hazardous locations such as
basements or pits or
anywhere "heavier-than-air"
gas can unsafely collect.
*Propane tanks over 125
gallons require a minimum
setback of 10 ft. from
property line and buildings,
and a site plan must be
submitted with the
application showing the
setbacks. lf propane tank is
over 500 gallons, a site plan is
required to accompany this
application, and a separate
Fire Code approval is also
required.
Quantity Fixture Type Description
Fan Bath Fan and/or Exhaust Fan
Clothes Dryer Clothes Dryer with Exhaust Vent
Cook Stove Cook Stove, Range Hood Exhaust
Fireplace - Gas Fireplace-Gas or Gas Log lnsert
I
Fireplace - Wood Fireplace-wood, Wood Stove, or
Pellet Stove
Electric Furnace Electric Furnace or HP +/- Ducting
Propane (LP) Gas Furnace Propane Furnace +/- Ducting
Water Heater - Gas Gas WH Vent and Combustion Air
Gas Pipe System Gas Pipe System LPG/Oil
Propane Tank LP FuelTank (# gallons )
Heat Pump
Generator
Air Conditioner
OFFICE USE ONLY
Building Permit Fees
Mechanical Permit fee ltank swap, woodstove, furnace, roof -sotar panet, etc )S188.oo
Propane - Lines, tank, and appliance (add'l 594.00)
Project Scanning Fee s24.00
Technology Fee-5%
Total Fees*
*Additional fees may apply
Mechanical Application 2
Templefire Inc t Page 1 of2
@Home Espafrol Contact
A-Z Index Help My L&I
Safety & Health Claims & lnsurance Workplace Rights Trades & Licensing
Templefire lnc
Owner or tradesperson
Temple, Jason Robert
Principals
Temple, Jason Robert, PRESIDENT
WA UBI No.
604 212 966
PO Box 2085
PORT TOWNSEND, WA 98368
360-379-2877
JEFFERSON County
$6,000.00
Effective date
o1t11t2019
Expiration date
Until Canceled
$1,000,000.00
Effective date
04128t2018
Expiration date
04t28t2019
Business type
Corporation
License
Verify the contracto/s active registration / license / certification (depending on trade) and any past violations.
Construction Contractor Actlve.
Meets current requirements.
License specialties
MASONRY
Lrcense no.
,, TEMPLI-8I6BM
(t Effective - expiration
01 I 1 4t 2019- 01 I 1 4t2021
Bcn9
RLI lns Co
Bond account no.
LSM0614553
Received by L&l
o'il14t2019
lnsurance
Contractors Bonding & lnsuranc
Policy no.
cl 1s13553
Received by L&l
01t14120't9
s?v!f9s
No savings accounts during the previous 6 year period.
Lawsuits against the bond or savings
tto ii'irsuits agaiiist thC biind oiiCVirigs accounts during the previous 6 year period.
L&l Tax debts
Nii Liil tii 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 ticense viotations during the prevlous 6 year period.
Workers'comp Help us improve
2lt9l20t9https://secure.lni.wa.gov/verifu/Detail.aspx?UBL:604212966&LIC:TEMPLI* 8 16BM&SAW:
/l washington state Deparilnent 01t, Labor & industries
Templefire Inc
No active workers' mmp accounts during the
a Page2 ofZ
,l," 6 year period.
Public Works Strikes and Debarments
Verify the contractor is eligible to perform work on public works projects.
Contractor Strikes
No Ctiikis hCve been issued against this contractor.
Contractors not allowed to bid
No iiebarments haVe been issued against this contractor.
Workplace safety and health
No inspections during the previous 6 year period.
@ Washington State Dept. of Labor & lndustries. Use of this site is subjecl to the laws of the state of Washington.
Help us improve
211912019https://secure.lni.wa.gov/veriff/Detail.aspx?UBI:604212966&LIC:TEMPLI*8168M&SAW:
Jefferson Co Dept of Coml)v WA - Online Payments I Page 1 of 1
Step l: Select Paymont Stop 2: Review and Submlt Stop 3: Conlirmation and Receipt
Step 3: Confirmation and Receipt
Result: Payment Authorized
Confirmation Number: 548251 1 1
Your payment hs been authorized suocssfully md payment will bc prmesed.
Jeffemon County Department of Comunity Devclopment thmks you for your payment. For qu$tions about you accout, pleae csll 36G379-4452 Thank you for uing our bill payment
sryics.
Plere save or print a copy ofthis receipt for record keeping purposes.
M Bills
Customer
First Name:
Lasl Name:
Address Line 1:
Address Line 2:
City:
State:
Zip Code:
Phone Number:
Email Address:
lnformation
JASON
TEMPLE
P.O. 80X 2085
PORT TO!(NSEND
Washington
98368
360-379-2877
JASON@TEMPLEFIRE.NET
Payment lnformation
Payment Dat6: 0211912019
Check Routing Number: 325182289
Check Account Number: '*"'80
Account type: Checking
Print
Description Amount Due
lnvoice Payment payment of $222.60 on lnvoice Number 201981D19-00049 $222.60
Subtotal $222.60
Convenience Fee:$2.50
Total Payment:$225.10
http s : //c lient. pointandpay. net/web/Je ffersonCo DeptofCommDevWA 211912019
Jeffer$on (uun