HomeMy WebLinkAboutBLD2004-00550 •UILDING * ,PERMIT APPLICA N ML Review Ty 517
Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD04-00550 Received Date: 8/27/2004
SITE ADDRESS: 1260 E QUILCENE RD
QUILCENE, 98376
OWNER: JANIS C HENRY PHONE: (206) 265-4189
514 WARD ST#102
SEATTLE WA 98109-6107
SUBDIVISION: Block: Lot: T 4+
PARCEL NUMBER: 701184004 Section: 18 Township: 27 N Range: 01 W
CONTRACTOR: QED BUILDERS INCORPORATED PHONE: (360)385-5743
630 CASS STREET
PORT TOWNSEND WA 98368 Contractor's License QEDBUL*043D1 Expires (38/gop
�/1E17627
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOl NEW SFR W/ATTACHED GARAGE & COVERED DECK & BALCONY
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW
VALUATION 230,000.00 MAIN: 1,274
CODE EDITION: 2003 ADD'L: HEAT TYPE:
OCCUPANCY: R_3 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: 5N OTHER: 260
CONST TYPE: GARAGE: 240 SHORELINE:
DECK: SETBACK: 65
SEWAGE DISPOSAL: CON BANK HEIGHT: 3
WATER SYSTEM: PWELL
PARCEL TAGS: YES NO
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Exist: 3 Exist: 2 Wetland Erosion
Prop: 2 Prop: 2 Seismic Streams
Total: 2 Total: 2 Flood Way Floodplain
Routing Date/�/ F&W Landslide
l( Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid Bv: Date: Receipt: Approved/Date
Permit $1,721.75 KAS 08/27/04 67497 APPROVED
Plan Check $1,119.14 KAS 08/27/04 67497
State Building Code $4.50 KAS 08/27/04 67497 OCT 2 6 2004
Potable Water Application $52.00 KAS 08/27/04 67497
Total: $2,897.39 Jefferson County Planning
& Building Department
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD04-00550 Received Date 08/27/2004
SITE ADDRESS: 1260 E QUILCENE RD Issue Date 10/26/2004
QUILCENE, 98376
APPLICANT: JANIS C HENRY PHONE: (206)265-4189
514 WARD ST#102
SEATTLE WA 98109-6107
SUBDIVISION: Block: Lot: T 4+
PARCEL NUMBER: 701184004 Section: 18 Township: 27 N Range: 01 W
CONTRACTOR: QED BUILDERS INCORPORATED PHONE: (360)385-5743
630 CASS STREET
PORT TOWNSEND WA 98368
(360) 385-7627
Contractor's License: QEDBUL*043D1 Expires: 9/14/2006
PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE & COVERED DECK& BALCONY
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
�FTBACKS: oz. /b^2.S-vkC vs
UFFER: W., /o,2- -Otk VIZ
Footing: 0g. Ld ')'4S"2
Foundation: w(Gr11p no,-- C`_o t --(i
Stormwater FINAL Approval: �_ \\
Underground Plumbing: IL fPj ti--p1'-0
Underground Insulati n: (( -lb-v -- Ittri TO$6S f c+t- w.TI ' 1 -ik-oy
Shear Wall :
Framing
Plumbin.1. S73//0•6
Propane T Lin s:k/
Insulation: 2, d �
Sheetrock( /3 PS
Septic Syt Final Approval (If not on sewer):
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval:
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 CONDITIONS FOR CIE # BLD04-00550 •
1.) Residential developers and individual builders shall be required to preserve shoreline
vegetation and reduce the associated risk of erosion during construction and any future
activity which may impact the stability of the shoreline.
2.) The shoreline 30 foot buffer shall be maintained in its natural condition, however, minor
pruning or alteration of vegetation may be permitted as long as the function and character
of the buffer is not diminished.
3.) All construction activities shall not encroach upon the buffer. This includes the storage or
preparation of materials.
4.) To help prevent seawater from intruding landward into underground aquifers, all new
development activity on Marrowstone Island, Indian Island and within 1/4 mile of any
marine shoreline shall be required to infiltrate all stormwater runoff onsite.
5.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ:
Water conservation measures:
1. Roof and other intercepted precipitation shall be routed to on-site detention ponds
and/or other approved means and allowed to be released to the soil slowly.
2. Water collected from Storm water and roof catchments may be used for watering
lawns and gardens. Unless catchment water has been treated to meet drinking water
standards, there shall be no cross connections allowed between the potable supply and
impounded water.
3. Water withdrawn from wells on each property shall not be used for watering of lawns
and/or gardens.
4. Ground water withdrawn from each property shall be restricted to a rate of three (3)
gallons per minute.
5. Installation of water conserving fixtures such as low flow toilets, faucets and shower
restrictors and other water saving plumbing fixtures.
6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation).
Please NOTE that the above listed measures are not intended to be exhaustive, but rather
is intended to be illustrative of the types of water conservation measures.
6.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ:
1. Installation of a flow meter.
2. On-going well monitoring for chloride concentration.
3. Submittal of monitoring data to County.
7.) MANDATORY MEASURES FOR COASTAL SIPZ:
1. For proof of potable water on a building permit application, applicant must utilize
DOH-approved public water system if available.
2. If public water is unavailable, a qualifying alternative system may be used as proof of
potable water or an individual well may be used as proof of potable water subject to the
following requirement:
a. Chloride concentration of a laboratory-certified well water sample submitted with
building permit application.
3. If public water is unavailable, a qualifying alternative system may be used as proof of
potable water.
8.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP)
Elements#1 through#12 of the Department of Ecology's Stormwater Management
Manual for Western Washington to control stormwater, erosion and sediment during
construction. BMPs shall address permanent measures to stabilize soil exposed during
construction, and in the design and operation of stormwater and drainage control systems.
9.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
10.) Not more than two (2) unliced or inoperable vehicles shall be stored onny 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).
11.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
12.) The building height is not to exceed 35 feet.
13.) Minimum setback from E. Quilcene Rd right-of-way is 20 feet. Minimum side setbacks
are 5 feet. Minimum shoreline setback is 30 feet from the bulkhead.
14.) A minimum of two (2)on-site parking spaces is required for the single family residence.
15.) The requirements for approval of the demolition permit(BLD04-00665) shall be met, and
the existing SFR shall be demolished prior to final building permit inspection for the new
single family residence.
I:\F_BLD_Permit_Buildng.rpt 10/29/19
OWNER BUILDER STATEMENT •
The signer of this statement does hereby certify 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: Date:
GENERAL }COONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: ! FAX: S y/ y
{ G-- `-) i d,V �. /h l/' Cob ) _5:c 5 A%,`7 (J60 ) S e i l !6,1 /
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE / WAINS
v!
NUMBER: 01 2 J V)P1) 4 /-i'dt �'! j NUMBER
„ARCHITECT/ENGINEER: Xt k � ti i'(.fr 4,c a' , Lam! PHONE ('Ce) )shy —z--z?(FAX: ( )
MAILING ADDRESS: 67.30 Ca�.<.\S / rt /T 1)7Y7 6f, f, 4 EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disp
osal:
m New lil Wood Existing: 2. ❑ Sewer
❑ Addition ❑ Steel Proposed: Bank
❑ Atteration/Remodel ❑ Concrete ' Height: ❑ Community Systemem
Total: .., 9 � Irdi��d��al
❑ Repair ❑ Masonry 4 /' SEP Permit# 7.2, 3..7
I Demolition +3. ❑ Other: Bedrooms: Water Supply:
v Existing: 5 Setback: g7 Private well ❑ Two Party
Type of Heat: Proposed: /' ❑ Public
Total: d;5 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 apply:
L i Underground Tank l 1 Above ground Tank Size of Propane Tank:
I I Heat Stove I I Cook Stove 11 Woodstove 11 Fireplace Insert 11 Hot Water Tank i I Pellet Stove 11 Other
Is this appliance being installed in a Manufactured/Mobile Home? Yes / No
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 Office Use Only
Current Proposed Amount
Main Floor f �� r '�/ i Consistency Review:
•
2ND Floor f `S 1 t0 Base fee:
I1rial, 7
3`'Floor Additional Section:
Mezzanine: Plan Check fee:
I ,�i
) � 1�t .
Heated Basement State Surcharge fee: C)
S
Unheated Basement Pot Water Review fee: -
Other Unheated
00( ,� 911/Rd Approach fee:
Garage/Carport agL/0 C q 0 TOTAL: $ Q '] 39
Decks - 1 • � C
r , / , ,-, ... .J- J? aG - Y� Receipt Number: ~] .�
0 1
Other • ,, ash/Che C ck Number:
�,7, • 3
ESTIMATED COST EUIRED
(� ) .3'I<GI4:Date: A to___7..
.Fair market-value of all labor and materials foundation to finish J ,�
2 20 ;'j Ji) ) Initials:
G:\PecmitC rater Muter Pe nit Application 7-8-04.doc
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�¢SON r~o�� JEFFERSON JUNTY �-- ---(� L� 1
,..� DEPARTMENT OF COMMUNITY DEVELOPMENT if i C ' L=11 U 1
'� 621 Sheridan Street • Port Townsend •Washington 98368 I�'`)' i(i \ ,
360/379-4450 • 360/379-4451 Fax 1,Fr 3 ,{ ! I i
qS, Sp www.co.jefferson.wa.us/commdevelopment U 1..:.1 fit'
HIND ,��_ �
Master Permit Application M LJ,), f-`s 's 4,, a�,,
p'_P , . � __.
Project Description(include separate sheets as necessary):
Jr h fir r v t /'
) -i )A /(' t^
Tax Parcel 7 2 Property ,
Number: ' of f O ,,�C �y Size: i (acres/square feet)
Site Address and/or Directions to Prope �' �/ �j �a "1' ene r-4,
Property Owner(s)of Record: , 41.61 t""n V'
7
Telephone: 2l& ' • Fax: email:
Mailing Address: S/ <-j lC.i Q 9 /0
Applicant/Agent(if different from owner): ,(a - j -,
Telephone: 4" x. ' Fax: i email:
Mailing Address: , 7/
What kind of Permit?(Check each box that applies)
D Building ❑Variance(Minor,Major or Reasonable Economic Use)
19 Demolition Permit ❑ Conditional Use[C(a),C(d),or Cj**
Li Single Family Li Discretionary"D"or Unnamed Use Classification
[l Garage Attached/Detached ❑ Special Use(Essential Public Facilities)**
❑ Manufactured Home ❑ Boundary Line Adjustment
I I Modular 0 Short Plat**
Li Commercial* ❑ Binding Site Plan''
❑ Change of Use 0 Long Plat**
❑Address ❑ Road Approach 0 Planned Rural Residential Development(PRRD)/Amendments**
0 Propane ❑ Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis Li Shoreline Master Program Exemption/Permit Revisions**
❑ Stormwater Management Cl Shoreline Management Substantial Development**
I) Site Plan Approval Advance Determination (SPAAD)* ❑ Shoreline Management Variance
0 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 Conference
Please identify any other local, state or federal permits required for this proposal, if known:
' DESIGNATION OF AGENT
I hereby designate' `, ✓,', r. /.r ` l%� t,,_ to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE Date: f c 3/0`f
By signing this application orm,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of
his,her or it's 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 this permit being null and void.
I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attomey's 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 pro ':- access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application
review and any re.r . later inspections.A ss and right of entry to this property shall be requested and shall occur only during regular business
hours. /) 7� �i } /�Signature :i I a Date: v O j�3/o y
The action or actio 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"take"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- nsfer ble respo ibility forca/ r-dog to and plying with the ESA. The Applicant has read this disclaimer and si n s and dates it below.
� ! _ t i
Signatur .�-`i"� , � er?.< ;% - . Date: r ,k /� , `j' r
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auilcene Bay QED BUILDERS LLC DESIGN RICK ERICKSON
360.301.2802 CASS ST.RT.98368 . ....,_,
360.643.1617 ERICKSON @MAC.COM -__
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