HomeMy WebLinkAboutBLD2004-00511V
• BUILDING PERMIT APPLI ION MLA04-00479
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD04-00511 Received Date: 8/4/2004
SITE ADDRESS: MEADOW RD
PORT TOWNSEND, 98368
OWNER: MARK G SABELLA PHONE: (360) 385-3929
STACY A SABELLA
330 RAVENS RD
PORT TOWNSEND WA 98368-9433
SUBDIVISION: RAVENS RIDGE SHORT PLAT Block: Lot: 1+
PARCEL NUMBER: 002124028 Section: 12 Township: 30 N Range: 02 W
CONTRACTOR: PHONE:
PHONE:
REPRESENTATIVE: LAURIE STEWART PHONE: (360) 385-1142
1604 UMATILLA AVE
PORT TOWNSEND WA 98368
PROJECT DESCRIPTION NEW SFR
ALSO 250 GAL AG PROPANE TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW
VALUATION 157,211.00 MAIN: 1,754
CODE EDITION: 2003 ADD'L: HEAT TYPE: PRO
OCCUPANCY: R_3 HEAT BASE: HEAT TYPE: RAD
OCCUPANCY: UNHEATED: #OF STORIES: 1
OTHER:
CONST TYPE: 5N
GARAGE: SHORELINE:
CONST TYPE: SETBACK:
DECK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: 2WELL
PARCEL TAGS: YES NO
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Exist: Exist: Wetland Erosion
Prop: 2 Prop: 2 Seismic Streams
Total: 2 Total: 2 Flood Way Floodplain
Routing Date: , / F&W Landslide
/ �� Shoreline Aquifer
` Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: A PPR°V E r
Permit $1,318.55 KAS 08/04/04 66643
Plan Check $857.06 KAS 08/04/04 66643 SEP 1 6 2004
State Building Code $4.50 KAS 08/04/04 66643
Potable Water Application $52.00 KAS 08/04/04 66643 Jefferson County Plan,tit,f;
& Building Department
Total: $2,232.11
• "" -
BUILDING PERMIT •
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD04-00511 Received Date 08/4/2004
SITE ADDRESS: 235 MEADOW RD Issue Date 09/16/2004
PORT TOWNSEND, 98368
APPLICANT: MARK G SABELLA PHONE: (360) 385-3929
STACY A SABELLA
330 RAVENS RD
PORT TOWNSEND WA 98368-9433
SUBDIVISION: RAVENS RIDGE SHORT PLAT Block: Lot: 1+
PARCEL NUMBER: 002124028 Section: 12 Township: 30 N Range: 02 W
CONTRACTOR:
PROJECT DESCRIPTION: NEW SFR
ALSO 250 GAL AG PROPANE TANK
REQUIRED INSPECTIONS:
`il SETBACKS:
[XI UFFER:
4 Footing:
14 Foundation:
x1 Stormwater FINAL Approval:
Underground Plumbing: 'tL TS /47-01( 14elVr "%PUS .- q `3°'-`r
TA Underground Insulation: di COVOLt
,pis Shear Wall : 6r fie OK /VA 0-I.
,;tq Framing: `iu,c�i t+.gJi'/py 24C-
q(Ay
44 Plumbing:ti`i 96.5pl Propane 3a..i</Li s riI K -) t,
9As64. InsulationL+ 13 9 Sheetrock: -< V... C9/6,S--- -
N Septic Sytem Final Approval:
I 1 Road Approach Final Approval: r•r:Vciit-e. 12ioo a
Zoning Final Approval:
(jq Final/Occupancy Approval: •.�c1�GYo�,.''
HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION
THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED
BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9:00 a.m. -4:30 p.m.
HOT LINE AVAILABLE 24 HOURS A DAY
SPECIAL CONDITIONS APPLY-SEE REVERSE
• •
SPECIAL CON
DITIONS FOR CASE t BLD04-00511
1.) Critical Aquifer Recharge Areas may require special protection measures to mitigate water
quality degradation. The submitted proposal does not require additional aquifer
protection measures. However, during construction the project shall follow the Best
Management Practices (BMPs) and facility design standards as identified and defined in
the Stormwater Management Manual for the Puget Sound Basin.
2.) Not more than two (2) unlicensed or inoperable vehicles shall be stored on any lot less
than one-half acre unless totally screened from view of neighboring dwellings and
rights-of-way. Such screening shall meet all applicable performance and development
standards specific to the district in which the storage is kept, and shall be in keeping with
the character of the area. Screening shall meet the requirements of Unified Development
Code (UDC) Section 6. Outdoor storage of thirteen (13) or more unlicensed or inoperable
vehicles is prohibited except in those districts where specified as an automobile wrecking
yard or junk (or salvage) yard and allowed as a Permitted Use in Table 3-1 of the UDC,
and such storage shall meet the requirements of UDC Section 4.10. In no case, shall any
such unlicensed or inoperable vehiclesbe stored in an Environmentally Sensitive Area
(ESA).
3.) Meadow Road setback is no less than 20 ft from edge of easement, rear setback should
be no less than 5 ft , side setbacks should be no less than 5 ft.
4.) The building height is not to exceed 35 feet.
5.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
6.) A Medium Stormwater Plan has been submitted and approved by the Department of
Community Development. Once the subject permit has been issued the applicant shall
fully implement the provisions of the submitted plan and contact the Jefferson County
Department of Community Development to arrange a schedule to inspect the property for
plan compliance. A Certificate of Occupancy will not be issued until the Department
verifies plan compliance. No clearing for roadways or utilities shall occur on the project
site until clearing necessary for the installation of temporary sedimentation and erosion
control measures have been completed.
7.) A minimum of two (2) on-site parking spaces are required for the single family residence.
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APPROVED' tk_ -;:
STORMWATER PLAN ��V %< ,n MIA
2004 0e AUG 3 0 2014
JEFFERSONCOUNTY ���� JEFFERSON COUNTY DCD
DEPT.OF Cl*C14SIONATIIR{: ` • FNT ,���
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�,��4`'$ON eo�� JEFFERSOIVIoln( • _._____.-__..-,
14
DEPARTMENT OF COMMUNITY DEVELOPMENT i �� rj �VI I
.--- -44
'� 621 Sheridan Street • Port Townsend •Washington 98368 i I f! i
'
360/379-4450 • 360/379-4451 Fax
qc, N�e0o www.co.jefferson.wa.us/commdevelopment 1.1 AUG 4 2004i�I_;;;'
Master Permit Application
MLA: . 3h,;-. - r i•T
tr_,Alige,'t;',.Y`D ELOPMENr
Project Description(include separate sheets as necessary):
/159 1.a /tje / eY), .
Tax Parcel
Number: ���� Z �y �� Property
7� Size: .Jac l'"t'? (acres/square feet)
Site Address and/or Directions to Property: 24--c. ea4ti ) TA ?-t- jbail^SPLtd -
Property Owner(s)of Record: //1Q rk r a n 4 stetcy
Telephone: 360 - 3TC 3G 2') Fax: 3490 35$- 1 CC I
email: rQIleLtS(lacaFo(tirt1 pus. heft
Mailing Address: 33t) 1/eN s fi oAk W q 36
Applicant/Agent(if different from owner): r CEu PciOl.f ' - 13to0 042a 3CI iS�-
Telephone: Fax:
Mailing Address: ema'.
What kind of Permit?(Check each box that applies)
Building ❑Variance(Minor,Major or Reasonable Economic Use)
❑ Demolition Permit ❑Conditional Use[C(a),C(d),or C]**lir-Single Family 0 Discretionary"D"or Unnamed Use Classification
❑Garage Attached/Detached ❑Special Use(Essential Public Facilities **
❑Manufactured Home ❑ Boundary Line Adjustment )❑ Modular --
❑ Commercial* ❑ Short Plat
C1 Change of Use ❑ Binding Site Plan**
0 Address ❑ Long Plat**
❑ Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments'*
()1.Propane ❑ Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions**
❑ Stormwater Management ❑ Shoreline Management Substantial Development**
❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance
❑Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment
❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment
❑ Forest Practices Act/Release of Six-Year Moratorium
*May require a Pre-Application Conference **Requires a Pre-Application Please identify any other local, state or federal permits required for this proposal, if known:Conference
' A4 -€. p�/A6,5 45 /71�Z
5 ,R 4-DESIGNATION OF AGENT
.
I hereby designate 4 lc/ qe/ it't,l Sfev to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE
Date: Cs y/Z/4v
By signing this application form,the owner/agent attests that the information provided
e best
his,her or it's knowledge. Any material falsehood or any omission of a material fa made by the owner/agent herein,and in any c withn respect tothtl ppl catiots,is true and correct tonpacketof
may result in this permit being null and void.
I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorneys fees and
expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit.
I further agree to provide acrpcs 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.Access and right of entry to this property shall be requested and shall occur only during regular business
hours. /�
Signature: A
l 2 - {J'G i t!, •7�
Date: Zrile q
The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or
endangered species and could lead to a potential lake"of an endangered species as those terms are defined in the federal law known as the
"Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this
permit has been issued will not violate the ESA_ Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your
action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transferable responsibili for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: Z� /J _ ixiC1
���rrr Date: '�//�IA
;/�}V 1
\ Permit G:\PermitCenterFORMS\DRD FORMS\Master Application 7-8-04.doc J
OWNER BUILDER STATEMENT c I r r --3 �� ,
The signer of this statement does hereby certify th�y are the Owners of the parcel referenced herein,tf�ey C contractors and-that;�I t'
they will be assuming the responsibility of the Gener tractor for the proposed project I
Signature: • i•C‘' l 1L Date: 21jfte,-/ ' _ #
1
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: tAX,.- ;: s
( ) i OEP .Of CC)i�`f�i,iNlt'r UE ELOPh 1Et3T
MAILING ADDRESS: 41 / EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBS ' Sfe�rNi f Aat t,r Q S/a, 'u� zyJ' NUMBER /
t • : ` QL(PSS1tT 5 aC.ba r t./' pkt e.S PHONE ( );3 3/ S f. FAx:( )
MAILING ADDRESS: ra ii be !i/1`fork/ ! A h/ril EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
x- New Xi Wood Existing: ❑ Sewer
❑ Addition 0 Steel Proposed: 02 Bank 0 Community System
❑ Alteration/Remodel 0 Concrete Total: c . Height: tif,Individual System
❑ Repair 0 Masonry SEP Permit# SEP95-/v3
❑ Demolition 0 Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well 1'1 Two Party
Type of Heat: ProposedTotal. 02 ❑ Public
frc pd ii Name of System:
If this is a Commercial Project you must answer the following:
Number of Parking Spaces: Current Proposed: Number of ADA Parking Spaces:
Number of occupants(includes owners,tenants,employees,etc) Current Proposed
IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No
If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apt
❑ Underground Tank k Above ground Tank Size of Propane Tank: 25b 9 4tt t Ian _
[1 Heat Stove tlx:Cook Stove CI Woodstove ❑ Fireplace Insert IX Hot Water Tank ❑ Pellet Stove I] Other .//(.( hea
Is this appliance being installed in a Manufactured/Mobile Home? Yes /(Noj
When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property
lines,tank location and size,distances from the propane tank to all property lines,buildings and septic system components,
including the reserve area.
Square Footage `For-Offic~Only '`' 1' t`
A a ¢ i,Current Proposeds: Amont.Main Floor / /3 .-(1 �a yonsistencY Review: V
2Nu Floor fee /3/F
3`tl Floor Additional Section:
Mezzanine: ,....-- Plan.Check-fee:
Heated Basement State Surcharge fee: Q
Unheated Basement - Pot Water RaVi IT'fee: a ; M
}}
Other Unheated St : ..> _ ▪ u
1s
Garage/Carport .- . TOTAL ; ` :-..
Decks ,;, Z"t, . '. .'
eipt Number' -.
7
Other CashlC{ 1�U__,L. ...'. T 7.
ESTIMATED COST(REQUIRED) Date,. :Y ,; ; ,, ▪ 0'�i ` `f y
•Fair market value of all labor and materials foundation to finish Y 5.f J R r, ''0 ;
G:\PemutCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
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°�?�, JEFFERSON COUNTY
h '► 1 DEPARTMENT OF COMMUNITY DEVELOPMENT AU6 3 0 2094
4'. �, , 626 Sheridan Street • Port Townsend •Washington 98368
% 360/379-4450 • 360/379-4451 Fax
NG` http://www.co.jefferson.wa.us/commdevelopment/ JEFFERSON COUNTY DCD
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# "J I CCU 1-Cl PROJECT/APPLICANT NAME: A,4+✓I.b ewe( a vtt G V J U &-
Please answer all of the following questions to the best of your ability. Where the question calls for depiction on a site map, the
applicant may choose to either incorporate the elements into the general plot plan for the Master Land Use Application or to submit a
separate stormwater site plan map.
Project Overview
1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the
site map.
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Existing Conditions Summary
2. Describe the existing topography. Indicate contours on the site map.
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3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
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4. Describe the existing soils. Indicate soil type on the site map.
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5. Describe the existing site hydrology(i.e.,drainage;behavior of water on the site—above,below, and on the ground). Indicate
existing stormwater drainage to and from the site on the site map. Depict separate drainage basins on the site map, if
applicable,and indicate acreage of each.
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6. Describe any excess levels of noise generated by the proposed use or activity:
stormwater site plan template—rev.10/1/2003 • It‘‘‘
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7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams,
steep slopes,etc.)on the site. Indicate location on the site map.
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8. Describe the general vicinity of the site, including adjacent land uses and structures, utilities, roads, and sensitive/critical areas
streams,wetlands,lakes,steep slopes,etc.).
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Permanent Stormwater Control Plan
This portion of the Stormwater Site Plan consists of the selection and installation of the appropriate stormwater control BMPs
and facilities to remain in place after construction of the project is completed.
"Medium" size projects are required to have the totals calculated of all impervious surfaces, pollution-generating impervious
surfaces, and pollution-generating pervious surfaces to verify that the thresholds for treatment facilities and flow control
facilities are not exceeded.
g_ Describe the developed site hydrology, as proposed. Indicate whether stormwater will be fully dispersed (i.e., per BMP T5.30
in the Manual) or, if not, what types of stormwater flow control will be utilized for the site or specific threshold discharge areas
within the site. Locate these facilities on the plan and differentiate proposed,facilities from existing facilities.
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10. If the project requires the use of stormwater treatment facilities,describe the types of stormwater treatment facilities proposed
for use on the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. [This is
normally for large"projects or projects that involve the potential for dispersion of contaminants.]
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11. Describe the performance goals and standards applicable to the project. f "- "
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12. Des ribe the flow control system. eti tei t' e Sj7Y41 GF,t1�> i m 17Y1/- �'if/JW7 5 G[Y_s fv
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Am 3 0 2004
stormwater site plan template—rev.10/1/2003
i cccRgnN COUNTY DCD
CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN(SWPPP)
The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the
template that follows must be installed on the ground during all construction phases of the project. The proponent is responsible for
preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater
Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential
development.
SECTION I—CONSTRUCTION SWPPP NARRATIVE
1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or
will.be addressed. Identify the type and location of BMPs used to satisfy the required element. If an element is not applicable
to the proposal,justify in writing. Descriptions of the 12 Elements are found at section 2.5.2 of the Manual(beginning on page
2-15).
12 Required Elements—Construction SWPPP
1. Mark Clearing Limits.
2. Establish Construction Access.
3. Control Flow Rates.
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4. Install Sediment Controls.
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5. Stabilize Soils.
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6. Protect Slopes.
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7. Protect Drain Inlets. f
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stormwater site plan template—rev.10!1/2003 + .
8
JEFF-EHbON (AUNTY Dcc
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13. Describe the water quality system.
14. Describe the conveyance system analysis and design.
15. Describe the source of fill material,physical characteristics of fill material,and deposition of excesp materi I.
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16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code.
17. Describe the proposed surfacing material.
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18. Describe methods for restoration of the site.
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19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for
large"projects only and only those for which facilities are required to control flow or treat runoff.] If included,list the Manuals
here.
•
20. List here and include any special reports or studies conducted to prepare the S,rmwater Site Plan.
•
21. List other necessary permits and approvals as required by other regulatory agencies. If those permits or approvals include
conditions that affect the drainage plan or contain more restrictive drainage-related requirements,describe those conditions or
restrictions here.
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stomnrater site plan template—rev.1W12003 JEFFERSON COUNTY DCD 7
b. Description off special requirements for working in or near environmentally sensitive areas.
4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site
soils(e.g.,erodibility,settleability,permeability,depth,texture,soil structure).
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5. Construction Phasing.
a. Construction sequence
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b. Construction phasing (if proposed)
6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
I. Provide a proposed construction schedule.
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II. Wet Season Cons ction Activities.
_ a. Proposed wet season construction activities.
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b. Proposed wet season construction activities for environmentally sensitive areas.
7. Financial/Ownership Responsibilities.
a. Identify the property owner responsible for the initiation of bonds and/or other financial securities.
b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impacts. n
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8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable.
a. Sediment Ponds/Traps.
b. Diversions. -1;` -i i ;: -y 7 - .�. ; .
c. Waterways. rl {
d. Runoff/Stormwater Detention Calculations
stormwater site plan template-rev.10/12003 .A F EAS N CO UN ,_ 10
12 Required Elements—Construction SWPPP(continued) •
8. Stabilize Channels and Outlets.
9. Control Pollutants.
10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site).
11. Maintain Best Management Practices(BMPs).
►Ale UI 14 Mrn P 5
12. Manage the Project. "
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2. Adjacent Areas.
a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential
areas,roads). `�
b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
Yards).
3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
°-
` x
.1013
stormwater site plan template rev.1 O/1/2003 ��� 9
Stormwater Site Plan Changes
If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan,the proposed revisions shall be
submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised
drawings showing any structural changes,and any other supporting information that explains and supports the reason for the change.'
Final Corrected Plan Submittal
If the project included construction of conveyance systems,treatment facilities,flow control facilities,or structural source control BMPs
(not standard on-site stormwater management BMPs),the applicant shall submit a final corrected plan ("as-builts")when the project is
completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as
constructed.
APPLICANT SIGNATURE
By signing the Construction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and
correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all
owners of the affected property.
(LANDOWNER&tLt2 AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES,IF NEEDED:
•
•
12
stormwater site plan template—rev.10/1l2003
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WALL PANEL (ABWP) =--h E (fs ( M
_(STRUCTURE APPROVED D
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SITE PLAN . . - ,
s than 32" ABWP height 10 ft.max.to top --._;.__..._.__.__ ). . _ ;._.___... ..
ing is required —� of plate
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4___-- 2 -2" x topplates-nail sheathingNTY
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to each plate with 8 common or 11
galvanized box(c .6" o/c staggered ,