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Home My WebLink AboutBLD2018-00345 - MECHANICALo JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street I PortTownsend, WA 98368 360-379-4450 | email: dcd@co.jefferson.wa.us www. co.jefferson.wa. us/com mdevelopment MECHANICAL AND DEMOLITION PERMIT o PERMIT #: SITEADDRESS: APPLICANT SUBDIVISION: PARCEL NUMBER CONTRACTOR: BLD18-00345 547 S POINT RD PORT LUDLOW, 98365 RICKKIM HELMONDS 99% RONALD HELMONDS 1% 60 TIMBER COVE DR CAMPBELL CA 950084124 9966. SQUAMISH HARBOR BEACH Received Date lssue Date 8t6t2018 816t2018 996600031 AIR FLO HEATING COMPANY INC 221 W CEDAR SEQUIM WA 98382 Contractor'sLicense AIRFLI-206DG Expires 412512020 PHONE: 360-531-2072 Block: Lot: Section: 5 Township: 27N Ranqe: 1E PHONE: 360-683-3901 PROJECT DESCRIPTION: NEW MECHANICAL - HEAT PUMP THIS PERMIT IS VALID FOR ONE YEARAND IS NOT RENEWABLE. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WlTHlN THAT YEAR. THE EXPIRATION DATE IS 8/6/2019. REQUIRED INSPECTIONS: lnstallationperManufacturerSpecifications/Co: Final BUI LDI NG I NSPECTION 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 \\tidemark\data\forms\F_BLD_Perm it_Propane. rpt HOT LINE AVAILABLE 24 HOURS A DAY 816t2018 QurorNG PERMTT APPt,coGru Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 BLD18-00345 Review Type: NA PERMIT #: SITEADDRESS: OWNER: BLD18-00345 547 S POINT RD PORT LUDLOW, 98365 RICI(KIM HELMONDS 99% RONALD HELMONDS 1% 60 TIMBER COVE DR CAMPBELL CA 95008-4124 996600031 Section: Received Date: 81612018 PHONE: 360-531-2072 9966 - SQUAMISH HARBOR BEACHBlock: Lot:5 Township: 27 N Range: 1E CONTRACTOR: REPRESENTATIVE: AIR FLO HEATING COMPANY INC 221 W CEDAR SEOUIM WA 98382 Contractor'sLicense AlRFLl.206DG pHONE: 360-683-3901 Expires 412512020 PHONE: PROJECT DESCRIPTION: NEW MEGHANICAL - HEAT PUMP 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: HTP SHORELINE: SETBACK: BANK HEIGHT: Amount Paid Bv: Date: Receipt Permit Scanning Fee Tech Fee $184.00 JJC $23.00 JJC $10 35 JJC 08/06/1 I 08/06/1 8 08/06/1 8 178372 178372 178372 Approved/Date A.Pi}iiCVE,D Ats 0 6 208 Jefferson CountY DCE Total:$217.35 \\+i.lam.rL\.{.+.\farmc\tr Etl 11 Ann Ellrl rn+alAt'>da e SUBDIVISION: PARCEL NUMBER: oO DEPARTiVIENT OF COMMUNITY DEVELO 621 Slreridan Strect, I)ort'l rtu'tt.tlcl. \\'\ 98368 'l'cl: 3 60. 379.4 4.50 j liat: .1(rt)..]-i9.{ I 5 I \\'t:b: wurv.co.isffcr'sori.rv.r.us''t:r rrtrrnttrtiq tlcvcluPnrcrtt I'i-rnail: dcd(ii)co.icf fcts,,n.rva.us MECHANICAL PERMIT APPLICATI Steps in the Permit Process: -Review required submittal items to ensure all information is completed prior to submitting appli -Mechanical Permits can be mailed into our office-and do not require an appointment. -Fees are due at time of submittal, Mechanical rmits are nera 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 - 360-417-2702* lf No: Complete this form and make an appointment to submit to Jefferson County Permit Tech 360-379-4450 General Site plan - showing propane tank, lines, and distance from tank to all existing structures. Complete first page and signature block only of Mechanical Permit Application A complete solar panel supplemental application. Assessor Tax Parcel Number: 1Q U U00 0 Z t Site Address and/or Directions to Property: 547 South Point Road Port Ludlow WA 98365 Access (name of street(s) from which access will be gained Description of Work: lnstall One Mitsubishi Ductless Heat Pump System E-mailAddress AIRFLI-206DG Ronald Helmonds Air Flo Heating Company 360-683-3901 E-ma il Add ress: ellie@airfloheating.com 547 South Point Road Port Ludlow, WA 98365 360-531-2072 Expiration Date 04125t2020 Name: Add ress: Phone #: Name: Phone #: License # Nlechanical Application 1 Required Submittal ltems - for propane tank only Required Submittal ltems - for roof mount Solar Panel installation only (ground mount complete cAM) Receipt #: #: For Department Use Only Related #s: Site lnformation Property Owner @ro 6r -a mp 3 =Applicant / Contractor: Authorized Aeent/Representative o o Heating Oil Propane*Wood 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 attachm-ents, 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 compl ete associated with this permit will be performed in complianc-e with all a county laws and reg ulations and I agree to provide access and right of entry to Jefferson representatives or ts for the sole purpose of application review and any required later for visits related to this Property S\ Lpplicable federal, state and County and its employees, inspections.licant may uentapplicationsubseq permit issuance Print Name agen' of therequest notice County's intent to enter upon the property Date ?Signature of W *Propane is prohibited in hazardous locations such as basements or pits or anywhere "heavier-than-a ir" 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 requ ired. Quantity Fixturq;IYPe Ean Description Bath Fan and/or Exhaust Fan Clot[eC6ryer Clothes Dryer with Exhaust Vent €ook Stove Cook Stove, Range Hood Exhaust Fireplace - Gas Fireplace-Gas or Gas Log lnsert Fireplace - Wood Fireplace-wood, Wood Stove, or Pellet Stove I 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 Fuel Tank (# gallon I Heat Pump Generator Air Conditioner *Additional fees may apply N{echanical Apphcation 2 n filio u1 n) OFFICE USE ONLY Building Permit Fees Mechanical Permit fee (tant< swap, woodstove, furnace, roof -solar panel, etc )$raq.oo Propane - Lines, tank, and appliance (add'l $92.00) Project Scanning Fee s23.00 Total Fees* Page I of I ttuh^ortfr o o WATER lsJi :4* /q. €) GATT 384 ftl] http://trueweb jeffcowa.us/PropertyAccess/Sketch.aspx?cid:0&img-id:8310 7t3012018 16fr 7c) 33f? ,o) fi*s"fiS* f .,loJ (r S ' HPECK EL}ILDIHG 1 OT 3 :stt E 6 :rft v M,4, futre*:896 ft:l - -t::- ---: ==---:,o-:4=-'-;-- ---=== o 360/ 683-3901 360/ 385-53s4 360/ 307-7822 FAX:683-3971rJHTtto co.221 West Cedor Street Sequim, lVA23?.8? ,A'DOOR A'R, EXPERTS Name: Ron Helmonds Site Address: 547 S Point Road City: Port Ludlow State: WA Phone:36G531-2O72Zip: 98365 IndoorAir Experts Date: 7ROf2018 Proposal #: R107302018141614-1 www. oi rfloheoti ng. com Consultant Jara Reno Billing Address: Crty: State: Phone: Zip Base System: Optional ltems Total: Setf Referral Credit Sales Tax: System Total: lnitial lnvestment: Balane: Term: Rate: % Est. Payment: lnvestment Type: Check Net lnvestment After Credit & Rebates $3,953.49 C-\,,,1Y--?ocuo" oo d*pa--Y t1s3.q\ $4,,161.00 $0.00 <$100.00> <$0.00> $392.49 $4,753.49 $800.00 $3,953.49 $0.00 q{^ .-J*s}<-,.*l*\ By signing this agreement I acknowledge that I have read and understand each page, including the terms and conditions. Customer Date Representative Date '"'7 ra 1k Page 1 Approved