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HomeMy WebLinkAboutBLD2016-00099 - 01 PERMIT APPLICATION likUILDING PERMIT APPLICA MLA16-00017 N Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD16-00099 Received Date: 3/11/2016 SITE ADDRESS: 4429 COYLE RD OWNER: PEN AIR LLC PHONE: 360-301-0257 DAVID WARD P.O. BOX 130 QUILCENE WA 98376-0130 SUBDIVISION: Block: Lot: PARCEL NUMBER: 701142002 Section: 14 Township: 27 N Range: 1U1 CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION: NEW MECHANICAL PERMIT 1-502 CLOSED LOOP EXTRACTION SYSTEM TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC VALUATION MAIN: CODE EDITION: 2012 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: GARAGE: SHORELINE: CONST TYPE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: BEDROOMS: BATHROOMS: Type Amount Paid By: Date: Receipt Exist: Exist: Permit Prop: Prop: $170.00 SRE 03/11/16 162681 Total: Total: Fire Marshall Review $85.00 SRE 03/11/16 162681 Scanning Fee $21.00 SRE 03/11/16 162681 Approved/Date State Building Code $4.50 SRE 03/11/16 162681 Total: $280.50 APPRO LL JUN 1 0 2016 - vDcr' firiomnr4\rinffnrmc\F RI fl Ann Rlrl rnf ,3/11/9(11 ,ON cDEPARTMENT OF COMMUNITY DEVELOPMENT �(V c)6. 6. 621 Sheridan Street,Port Townsend,WA 98368 s l � .y Tel 360.379.4450 I Fax:360.379.4451 ti < Web:www.co.jefferson.wa.us/communitydevelopment I� E-mail:dcdCa�co.jefferson.wa.us 4/p 0 .s 410e N o�o riSO IN MECHANICAL PERMIT APPLICATION CO Steps in the Permit Process: rN -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#: 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: -7 1 1L1-LC( Site Address and/or Directions to Property: /4-1 79 cenyi_e i'� ©c�«rr � w t1 9c253.-IG Access (name of street(s) from which access will be gained: Description of Work: "S,,asT�.4c �� �a51bNv4i_ COIL Cc.c, >\ LOC P %x7f 4 rO.c Property Owner Name: I�rr,t A I LLL CO Address: Lit-126k Cryc �� �cv«c� - c ��4 c-1(253`1(, Phone#: - Ozs'( E-mail Address: t��4v�c�3e((c-YPc-?l.cc�n.1 Applicant/Contractor: Authorized Agent/Representative Name: C.J‘Ac'Zt Phone #: ( o' 3c91 - E-mail Address: .0 Loepi_YPcti(. License #: Expiration Date: 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 Water Heater-Gas Gas WH Vent and Combustion Air submitted with the 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 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 r ( t Signature: JG�C L,tiPrint Name: \Ov4u L fia Date: /to/ t(o OFFICE USE ONLYArr Building Permit Fees Mechanical Permit fee (tank swap,woodstove,furnace,etc) $17Q.00 Propane— Lines, tank, and appliance (add'I $85.00) Project Scanning Fee $21.00 Total Fees* *Additional fees may apply. Mechanical Application 2 • • •v ¢soNco DEPARTMENT OF COMMUNITY DEv 621 Sheridan Street,Port Townsend,WA 98368 �! �' Tel:360.379.4450 I Fax:360.379.4451 LI LT.) �C Web:www.co.jefferson.wa.us/communitydevelopment ; E-mail:dcd[llco.jefferson.wa.us a�^!j ASN G�o� `k> �f IN MECHANICAL PERMIT APPLICATION 00 Steps in the Permit Process: -Review required submittal items to ensure all information is completed prior to submitting application. 0 -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: —701 1,--C7_00 Site Address and/or Directions to Property: tic/Z`j C �F ►2� c�c�,�cE c��} 9`2--3`l(.0 Access(name of street(s)from which access will be gained: Description of Work: �.r�s;a« �e ;� �; y� C�� Cc Cc,c p f� ;f2AcTo Property Owner Name: ��r_N i,(L GIL CP Address: �� lZ� Cc cF �� �c'c «c am ���4 `fie`u3` ( 0 Phone#: IZ-S(3(4."))3u1 - czs 1 E-mail Address: l�-4 Lues:c_,1Pe-14.ecii.4 ;13 Applicant/Contractor: Authorized Agent/Representative —� Name: Phone#: (:3c7,0 3c i -ca Ls-'A E-mail Address: `N.f,,r.„-we o1.YPc-jk-u-o-,, License#: Expiration Date: NOliel_ PCU I LO Mechanical Application 1 BUILDING PERMIT APPLICAI �!N MRLAI6-000Type:eview 7 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD16-00099 Received Date: 3/11/2016 SITE ADDRESS: 4429 COYLE RD OWNER: PEN AIR LLC PHONE: 360-301-0257 DAVID WARD P.O. BOX 130 QUILCENE WA 98376-0130 SUBDIVISION: Block: Lot: PARCEL NUMBER: 701142002 Section: 14 Township: 27 N Range: 1V1 CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION: NEW MECHANICAL PERMIT 1-502 CLOSED LOOP EXTRACTION SYSTEM TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION ADD'L: HEAT TYPE: 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: ALT WATER SYSTEM: BEDROOMS: BATHROOMS: Type Amount Paid By: Date: Receipt Exist: Exist: Permit $170.00 SRE 03/11/16 162681 Prop: Prop: Fire Marshall Review $85.00 SRE 03/11/16 162681 Total: Total: Scanning Fee $21.00 SRE 03/11/16 162681 Approved/Date State Building Code $4.50 SRE 03/11/16 162681 Total: $280.50 \\tlrlomnrL\rlofn\fnrmc\F RI fl Ann Rlrl rnf '/11 P)C11A ^ . - ����� ��� �� Product Information Detailed product information coming soon - please ask questionr>, , „„,,,,,,, ,67,,,,, Iron Fist EXI ^�(y / �—~ )LRActive Closed Loop Extraction System ��� '44 $4,899.00 ) i /*/).//) • 1 lb Collection Tank 4,3 04, __ ° }|hColumn Co • VhonGuvkc1s ° • N!r[ Fhdnms ,ti`b • PTFE Lines • High Pressure Clamps • Standard 30# Refrigerant Recover Tank 45O PSI Rated • CPSTRQ2\ Recovery Pump • • Product Information Detailed product information coming soon - please ask question* Iron Fist EXI 4 ""'` ,".c I LB Active Closed Loop Extraction System $4,899.00 4, v, irk • 1 lb Collection Tank d/v • 1 l Column • Viton GasketsO • NPT Fittings CQ • Pin Lines • High Pressure Clamps • Standard 30# Refrigerant R.ecovcry Tank (450 PSI Rated) • CPS TRS?1 Recovery Pump • • JEFFERSON COUNTY DATE /1r' � RECEIVED FROM NJ c DESCRIPTION ■ .I CURRENCY 0 AMOUNT ► o-® 11 F _ maiffilla a 1,, a t COIN .iu _ /4 0O a ..i,;,..._, _ W MINN ,.., ,,ff , . __„,,, • 1 z--aa_ . mon D lug 7 ;,;„ , - , 33MIIIIIIIII 13 M 0 •-1 IIIIIIIIIIIIIII RECEIVED BY ''''.. 1���I ` TOTAL re I - ) 1 Parcel Details • • Page 1 of 2 e erson ounty Weather Staiian...: Database Tc► Q F ...._...m° 5, eft£ t -tome County Info Departments Search Parcel Number: 701142002 SEARCH Parcel Number: 701142002 Printer Friendly Owner Mailing Address: PEN AIR LLC �PO BOX 130 [\,,1 l QUILCENE WA98376-0130 Site Address: 4429 COYLE RD QUILCENE 98376 Section: 14 School District: Quilcene (48) Qtr Section: NW1/4 Fre Dist: Quilcene (2) Township: 27N Tax Status: Taxable Range: 1W Tax Code: 0323 Planning area: South Toandos Peninsula,Coyle Area (9) Sewer: Drainage: Bank: View 1: View2: Zoning 1: CF-80 - Commercial Forest Zoning 2: Zoning 3: Sub Division: Assessor's Land Use Code: 8800 - Designated Forest Land 9100 - Vacant Land Property Description: S14 T27 R1W SWNW, NWSW AND N1/2 SW SW Tax, AjV, Sales, Photos, and Permit Data Bldg Data Map Parcel lats&Surve s Sestic Monitorin. Info iefferscn Cc . untv HOME I COUNTY INFO 1 DEPARTMENTS I SEARCH Best viewed with Microsoft Internet Explorer 6.0 or later Windows- Mac http://www.co.j efferson.wa.us/assessors/parcel/parceldetail.asp?value=701142002 3/11/2016