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Home My WebLink AboutBLD2015-00052 - 01 PERMIT APPLICATION •UILDING PERMIT APPLICATN BL 05 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD15-00052 Received Date: 2/24/2015 SITE ADDRESS: 4429 COYLE RD OWNER: PEN AIR LLC HOOD CANAL INVESTMENTS LLC PHONE: 360-301-0257 PO BOX 130 QUILCENE WA 98376-0130 SUBDIVISION: Block: Lot: PARCEL NUMBER: 701142002 Section: 14 Township: 27 N Range: 1V1 CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: DAVE WARD PHONE: 360-301-0257 P.O. BOX 130 QUILCENE WA 98376 PROJECT DESCRIPTIOI NEW COMMERICAL FENCE (1-502) SEP15-00002 TYPE OF WORK COM SQUARE FOOTAGE: COMMERCIAL: TYPE OF IMP NEW MAIN: INDUSTRIAL: VALUATION 9,600.00 ADD'L: HEAT TYPE: UH 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 NUMBER OF EMPLOYEES: WATER SYSTEM: 1PWELL BATHROOMS: Exist: Prop: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $157.00 SRE 02/23/15 154126 Plan Check $102.05 SRE 02/23/15 154126 APPPO`CIF® State Building Code $4.50 SRE 02/23/15 154126 Total: $263.55 AF':: ° J 2JI5 Jefferson County DCD 1\tidemark\data\forms\F BLD_App_Bld.rpt 2/24/2015 • y�SON c'o) DEPARTMENT OF COMMUNITY DEVELOPMENT (,21 Skndan'nco.Port I(A‘uacnd, A 9836# Q.) 1'd 36O.-1V9 4=13o as:3611 d1 F.1 wci) vcww_oi11:1:114.11,1.1)11.wa.Ili comma mty leccluinncnt 1 1-1 1 1.1F dcd(i:n■.ictfcrson.w_i_u= 9SH1NCiS� D � PERMIT APPLICATIO 2 3 X415 Steps in the Permit Process: 1` ,, , DEB -Review application checklist to ensure all information is completed prior to subm g`applica • SENcc 3{r -Make sure septic has been applied for and water availability has been proven. pEVEERQpE -Make an appointment to meet with the Permit Technician by calling 360-379-4450. ,,,:t.GF CONIt kl.V -This is not a standalone application;it must be accompanied by a project specific supplemental application. -Fees will be collected at intake. Additional fees may apply after review and payment is required before permit is issued. For Department Use Only Building Permit# Related Application#s: MLA# Site Information Assessor Tax Parcel Number: 701142002 Site Address and/or Directions to Property: 4429 Coyle rd. Access (name of street(s)) from which access will be gained: Coyle Rd. Present use of property: Commercial Forest Land Description of Work(include proposed uses): We are building an eight foot tall cedar fence 1100 lineal feet long (450' X 200' X 450') Wastewater-Sewage Disposal This property is served by Port Townsend of Port Ludlow sewer system? YES _ _ NO ✓ If not served by sewer identified above, identify type of septic system below: Type of Sewage System Serving Property: Septic Septic Permit#: Community Septic Name of System: Case#: Are other residences connected to the septic system? NO Additions or repairs to sewage system: NO Is it a complete or partial system installation: Complete _ Partial Has a reserve drainfield been designated? Yes _ _ No Date of Last Operations&Maintenance check: Attach last report to application Describe or attach any drainfield easements, covenants or notices on title,which may impact the property: • • The authorized agent/representative is the primary contact for all project-related questions and correspondence. The County will mail/ e-mail requests and information about the application to the authorized agent/representative and will copy(cc) the owner noted below. The authorized agent/representative is responsible for communicating the information to all parties involved with the application. It is the responsibility of the authorized agent/representative and owner to ensure their mailbox accepts County email(i.e., County email is not blocked or sent to `junk mail'). Applicant/Property Owner information Property Owner: Name: Northern Canal Investments LLC Address: P.O. Box 130 Quilcene WA 98376 Phone#: 360-301-0257 E-mail Address: davew @olypen.com Please contact Authorized Agent/Representative with project info. (select only one). — — Property Owner Signature: Date: 1/ /2015 Note: For projects with multiple owners,attach a separate sheet with each owner(s)information and signatures. Applicant Authorized Agent/Representative(If other than owner) Name: David Ward Address: P.O. Box 130 Quilcene WA. 98376 Phone#: 360-301-0257 E-mail Address: davew @olypen.com Professional: Is this an Authorized Agent/Representative for this project? NO YES Engineer Architect Surveyor Contractor Consultant Name: Address: Phone#: E-mail Address: Professional: Is this an Authorized Agent/Representative for this project? NO YES Engineer Architect Surveyor Contractor Consultant Name: Address: Phone#: E-mail Address: Professional: Is this an Authorized Agent/Representative for this project? NO YES Engineer Architect Surveyor Contractor Consultant Name: Address t Phone#: E-mail Address: i I), 5 Professional: Is this an Authorized Agent/Representative for this project? NO YES Engineer Architect Surveyor Contractor Consultant Name: Address: Phone#: E-mail Address: Attach additional pages if necessary Builders Statement The signer of this statement certifies that they are the Owners of the parcel referenced herein,that they are not licensed contractors and at the will be assuming the responsibility of the General Contractor for the proposed project. Signature: '7! � Print Name: -L , , ..4 �q Dateaf 3/2015 4 SON DEPARTMENT OF COMMUNITY DEVELOPMENT � co G 621 Sheridan Street,Port Townsend,WA 98368 W Tel:360.379.4450 I Fax:360.379.4451 C Web:www.co.jefferson.wa.us/communirydevelopment E-mail:dcdCatco.jeffetson.wa.us III NG�O� SUPPLEMENTAL APPLICATION RESIDENTIAL OR COMMERCIAL BLDG PERMIT For Department Use Only Receipt#: Date: Related Application#s: Payment#: Site Information Owner Name: ///0.7/1..g�„ �a (' ��t✓ es�re _1-5 '-C Assessor Tax Parcel Th 1p//Yd-vva, Type of Building New Replacement Relocated Addition Repair Demolition •A separate permit is required Select One: Single Family Residence Modular Other list Proposed Building/Project Number of floors #new bedrooms existing total bed # new bathrooms existing total bath Heat Source Select all that apply: Electric Heating Oil Wood Propane Enter the square footage(sq/ft)that applies in each field: Structure Existing Sq/Ft Proposed Sq/Ft Residential/Commercial Main Floor Residential/Commercial Second Floor Additional Floors-heated/unheated Basement-unfinished �a n Basement-finished space or habitable I' — f,--" Detached Garage- heated/ unheated Attached Garage- heated/unheated r F t B 2 3 2015 Garage 2nd fl- unfinished storage Garage 2nd fl-finished space or habitable JEFi{Ra I' LL nrCCrtFi;0 IIYorztONMENI Carport-2 walls or less Deck-uncovered Covered porch Other(shed, barn, pole bldg,etc.) Estimated Cost of Project (Required): $ F 6 00 0 List existing buildings on propert�e. house,garage, accessory dwelling unit, shed, barn, mobile home,other): All Existing Buildings on Property Use 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. Signature: I---.�to" Print Name: l' a 6-I J `-4-14--.4 Date: 0347?//%5"-- Estimated Cost of Project $ For Department Use Only Building Base Fees Building Base _ 1 .°<') Plan Check Review 1. 0 a. oS Land Use Review $234.00 Septic Review ''gb.ep-- Potable Water $ggg,gCL- Technology/Scan $19.50 State Fee $4.50 Other Fees Shoreline Exemption Zoning Zoning Other New Address Road Approach Total Fees Receipt # Date: Cash/Check/CC: 0 • ��SON e DEPARTMENT OF COMMUNITY DEVELOPMENT 6 621 Sheridan Street,Port Townsend,WA 98368 ti ,.< Tel 360.3 724150 I Fax:360.379.4151 _ \Veb:www.co.iefferson.wa.usicommunitydevelopment �L - - E-mail:dcd@co.iefferson.wa.us 1SllINC; O PERMIT FEES WORKSHEET Name Northern Canal Parcel# 701142002 Estimated Cost of Project $9,600.00 Permit# Building Base Fees Building Base $157.00 Plan Check Review $102.05 Land Use Review $234.00 Septic Review Potable Water Technology/Scan $19.50 State Fee $4.50 Other Fees Shoreline Exemption Zoning Zoning New Address Public Works � r Total Fees )1 C , j,1e j lit Office Use Only I [l l 3 1015 Receipt Number: Cash/Check/CC: 50oc J rrcR„(','CLUNTy"—� Ifs nrC0__,2 TYDEVFLOPMENT Date: / Parcel Details Page 1 of 2 . • Jefferson County Home County Info Departments Search Parcel Number: 701142002 SEARCH Parcel Number: 701142002 Printer Friendly Owner Mailing Address: PEN AIR LLC PO BOX 130 QUILCENE WA98376-0130 Site Address: 4429 COYLE RD QUILCENE 98376 Section: 14 School District: Quilcene (48) Qtr Section: NW1/4 Fire Dist: None Township: 27N Tax Status: Taxable Range: 1W Tax Code: 0302 Planning area: South Toandos Peninsula,Coyle Area (9) Sewer: Drainage: Bank: View 1: View 2: Zoning 1: Zoning 2: Zoning 3: Sub Division: Assessor's Land Use Code: 8800 - Designated Forest Land 9100 - Vacant Land Property Description: S14 T27 R1W SW NW,NW SW, N1/2 SW SW Tax, A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel Plats &Surveys Septic Monitoring Info Jefferson County - HOME 1 COUNTY INFO 1 DEPARTMENTS I SEARCH , Best viewed with Microsoft Internet Explorer 6.0 or later Windows - Mac http://www.co.jcfferson.wa.us/assessors/parcel/parceldetail.asp?Parcel NO=701142002 2/24/2015 • BUILDING PERMIT APPLICION BLD15-00052 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD15-00052 Received Date: 2/24/2015 SITE ADDRESS: 4429 COYLE RD OWNER: PEN AIR LLC HOOD CANAL INVESTMENTS LLC PHONE: 360-301-0257 PO BOX 130 QUILCENE WA 98376-0130 SUBDIVISION: Block: Lot: PARCEL NUMBER: 701142002 Section: 14 Township: 27 N Range: 1V\ CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: DAVE WARD "`DR J i7 P.O. BOX 130 QUILCENE WA 98376 07�(,�� PROJECT DESCRIPTIOI NEW COMMERICAL FENCE (1-502) SEP15-00002 TYPE OF WORK COM SQUARE FOOTAGE: COMMERCIAL: TYPE OF IMP NEW INDUSTRIAL: VALUATION 9,600.00 MAIN: CODE EDITION: 2012 ADD'L: HEAT TYPE: UH OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK. BANK HEIGHT: SEWAGE DISPOSAL: ALT NUMBER OF EMPLOYEES: WATER SYSTEM: 1 PWELL BATHROOMS: Exist: Prop: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $157.00 SRE 02/23/15 154126 Plan Check $102.05 SRE 02/23/15 154126 State Building Code $4.50 SRE 02/23/15 154126 Total: $263.55 C .-R( 2-oN 1 itL42 ) \\tidemark\data\forms\F_BLD_App_Bld.rpt 2/24/2015 • • ON Cb DEPARTMENT OF COMMUNITY In_ : • , . 6 21 tiht:ndan Street.Trott I own<end.11.1 98363 /j !o:360.379.-1450 r ax: 360 3-6 1451 (I v 1�ib www.c tettnon.wr a .'comm unit- -elopnx•nt ' ' - I-n,atl.tiaras t.it.ttcr,rm,ca.n.� I i �� i FEB 2 9st�lriG Ji 3 2015 PERMIT APPLICATION . F:r1001, Steps in the Permit Process: -Review application checklist to ensure all information is completed prior to submitting application. -Make sure septic has been applied for and water availability has been proven. -Make an appointment to meet with the Permit Technician by calling 360-379-4450. -This is not a standalone application;it must be accompanied by a project specific supplemental application. -Fees will be collected at intake. Additional fees may apply after review and payment is required before permit is issued. For Department Use Only Building Permit# Related Application #s: MLA# Site Information Assessor Tax Parcel Number: 701142002 Site Address and/or Directions to Property: 4429 Coyle rd. Access(name of street(s)) from which access will be gained: Coyle Rd. Present use of property: Commercial Forest Land Description of Work(include proposed uses): We are building an eight foot tall cedar fence 1100 lineal feet long (450' X 200' X 450') Wastewater-Sewage Disposal This property is served by Port Townsend of Port Ludlow sewer system? YES _ NO _✓ If not served by sewer identified above,identify type of septic system below: Type of Sewage System Serving Property: ✓_ Septic Septic Permit#: Community Septic Name of System: Case#: Are other residences connected to the septic system? NO Additions or repairs to sewage system: NO Is it a complete or partial system installation: Complete _ Partial Has a reserve drainfield been designated? Yes _ No Date of Last Operations& Maintenance check: Attach last report to application Describe or attach any drainfield easements, covenants or notices on title,which may impact the property: 0 0 The authorized agent/representative is the primary contact for all project-related questions and correspondence. The County will mail /e-mail requests and information about the application to the authorized agent/repr : .•• noted below. The authorized agent/representative is responsible for communicating the i t �._•11-'W. -i�.a at h the application. It is the responsibility of the authorized agent/representative and owner iloi heir-rn ••, a e r ou email((i.e.,County email is not blocked or sent to "junk mail"). Applicant/Property Owner Information Property Owner: F F H 2 3 2015 Name: Northern Canal Investments LLC J Address: P.O. Box 130 Quilcene WA 98376 Phone#: 360-301-0257 E-mail Address: davew @olypen.com ✓_ Please contact Authorized Agent/Representative with project info. (select only one). Property Owner Signature: Date: 1/ /2015 Note: For projects with multiple owners,attach a separate sheet with each owner(s)information and signatures. Applicant: Authorized Agent/Representative Of other than owner) Name: David Ward Address: P.O. Box 130 Quilcene WA. 98376 Phone#: 360-301-0257 E-mail Address: davew @olypen.com Professional: Is this an Authorized Agent/Representative for this project? NO YES Engineer Architect Surveyor Contractor Consultant Name: Address: Phone#: E-mail Address: Professional: Is this an Authorized Agent/Representative for this project? NO YES Engineer Architect Surveyor Contractor Consultant Name: Address: Phone#: E-mail Address: Professional: Is this an Authorized Agent/Representative for this project? NO YES Engineer Architect Surveyor Contractor Consultant Name: Address: Phone#: E-mail Address: Professional: Is this an Authorized Agent/Representative for this project? NO YES Engineer Architect Surveyor Contractor Consultant Name: Address: Phone#: E-mail Address: Attach additional pages if necessary Builders Statement The signer of this statement certifies that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming the responsibility of the General Contractor for the proposed project. Signature: Print Name: Date:1/ /2015 1 • • SOS DEPARTMENT OF COMMUNITY DEVELOPMENT 4tU� CMG 621 Sheridan Street,Por Townsend,\\.\98368 j Tel:360.3?9.1430 Fax:360.379 4451 ^� -G \Veb:ww v.eo.iefferson-tics-us/communin-deccloptnent E-mail:dcdt.:co.Leffetson.wa.us �' /INO�O� SUPPLEMENTAL APPLICATION RESIDENTIAL OR COMMERCIAL BLDG PERMIT For Department Use Only Receipt#: Date: Related Application#s: Payment#: Site Information Owner Name: ///,,�7/1k`-„ Ca,,,,„,( 270,Ai str e., f, Lc-CAssessorTaxParcel #: ,7p//yol()0.). Type of Building New Replacement Relocated Addition Repair Demolition * `A separate permit is required Select One: Single Family Residence Modular Other list Proposed Building/Project Number of floors # new bedrooms existing total bed # new bathrooms existing total bath Heat Source Select all that apply: Electric Heating Oil Wood Propane Enter the square footage(sq/ft)that applies in each field: Structure Existing Sq/Ft Proposed Sq/Ft Residential/Commercial Main Floor Residential/Commercial Second Floor Additional Floors heated/unheated — - Basement-unfinished �E- V I I \\ i Basement-finished space or habitable I.' ,' Detached Garage -heated /unheated ;i FEB 2 3 2015 Attached Garage -heated/unheated I Garage 2nd fl- unfinished storage i-- }.bftRan"i GOUidTY Garage 2nd fl-finished space or habitable PPT.OF C0M!ulliffllY oF'dF!— M1"�=- - Carport- 2 walls or less Deck-uncovered Covered porch Other(shed, barn, pole bldg,etc.) Estimated Cost of Project (Required): $ 1/ 6 oa