HomeMy WebLinkAboutBLD2004-00555 ItUILDING PERMIT APPLICAl''.'JN MRAO-00 19
eview Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD04-00555 Received Date: 8/31/2004
SITE ADDRESS: 741 LUDLOW BAY RD
PORT LUDLOW, 98365
OWNER: EMMA JEAN CARKIN PHONE: (253) 833-1404
LIFE ESTATE
1404GSTSE
UR AUBURN WA 98002-6732
SUBDIVISION: LUDLOW BEACH TRS 2 Block: Lot: 8
PARCEL NUMBER: 969000008 Section: 16 Township: 28 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI DEMOLITION OF CABIN
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP DEM MAIN:
VALUATION
CODE EDITION: 2003 ADD'L: HEAT TYPE:
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM: PARCEL TAGS: YES NO
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Exist: Exist: Wetland Erosion
Prop: Prop: Seismic Streams
Total: Total: Flood Way Floodplain
Routing Date: F&W Landslide
q/a/O.„F Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: e R2V E r
Permit $48.00 KAS 08/31/04 67500 /'l
State Building Code $4.50 KAS 08/31/04 67500 SEP 3 0 2004
Total: $52.50 Jefferson County Planning
& Building Department
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SIGNATURE: DEPT. OF COMMUNITY DEVELOPMENT
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0RCAA
' 0 - -ego JEFFERSON COUNTY DCD
Notification of Demolition Permit
It is unlawful for any person to cause or allow the demolition (or major renovation)of any structure unless all asbestos-
containing materials have been removed from the area to be demolished. Work shall not commence on an asbestos project
or demolition unless the owner or operator has obtained written approval from ORCAA. A written application for a
demolition shall include a certification that there is no known asbestos-containing material remaining in the area of the
structure. �-7 /
Project Site Address: l 4/ �l�{ 1.OLc_) gi4 �� County: 3Q--�- tSo�
City: P - L U�,r)�,6W State: 44.7.7¢ Zip:5T P74 S--
Starting Date: E3702 7l p T Completion Date: k - 1 7-o Cf
*(There is a 10 working day advance notification period from receipt of permit application)
Property Owner: 'e A b0 C A‘e lC Telephone:,26'3 /(40 y Fax:
Mailing Address: t "t O`-k c4 .e
City: - Ot.4 J State: L)F Zip: 13.60
Demolition Contractor: fr S e kx ce iu m.r;A13 L-State License#: i.3. cll NiP
Mailing Address: PO. t o 'l.2-
City: W1e' SA 1 so bt r . State: 1 Zip:1(Cci,
Contact Person: Telephone:1(.b - 24Ct_ CS...t Fax:
NO .�.4.c ,ray /-• 0-51Nc,
✓ Demolition by Wrecking or Dismantling? ($25.00 fee)check# 4 4a.frmn r, Cmu-Ink-fox,
1. Training Fire Demolition? (If yes, attach fire department request for training fire)
Renovation,Alteration, Remodeling, Maintenance, or other Construction?
i/ Asbestos found or suspected*
*An ORCAA "Notice of Intent to Remove or Encapsulate Asbestos"form and appropriate fee must be submitted prior to any asbestos
removal work. Asbestos removal projects involving demolition must be preformed by a Certified Asbestos Contractor and all friable or
potentially friable asbestos must be removed before any demolition begins. Refer to ORCAA Regulation I Article 14 for additional
requirements that may apply.
Asbestos Survey Completed by
AHERA Certified Inspector r ab (J
Certification# Gr.; ato 4 - cr) L —
This approved permit must Enclose$25 Certification of the Asbestos Survey must
be available at the job site Processing Fee accompany this form
2940 B Limited Lane NW,Olympia,Washington 98502
360-586-1044 * 800422-5623 * fax 360491-6308
homepage:www.orcaa.org * email: info@a,orcaa.org
Rev.07/11/02
• •
DEMOLITION PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD04-00555 Received Date 8/31/2004
SITE ADDRESS: 741 LUDLOW BAY RD Issue Date 9/30/2004
PORT LUDLOW, 98365
APPLICANT: EMMA JEAN CARKIN PHONE: (253)833-1404
LIFE ESTATE
1404 G ST SE
AUBURN WA 98002-6732 8
SUBDIVISION: LUDLOW BEACH TRS 2 Block: Lot:
PARCEL NUMBER: 969000008 Section: 16 Township: 28N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
OWNER, EMMA JEAN CARKIN PHONE: (253) 833-1404
if different: LIFE ESTATE
1404 G ST SE
AUBURN WA 98002-6732
PROJECT DESCRIPTION: DEMOLITION OF CABIN
THIS PERMIT IS VALID FOR ONE YEAR AND IS NOT RENEWABLE.
THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR.
THE EXPIRATION DATE IS 09/30/2005.
REQUIRED INSPECTION:
[: I FinalApproval: App,QOVeo F/a)AL
BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9:00 a.m. -4:30 p.m.
SPECIAL CONDITIONS APPLY - SEE REVERSE
HOT LINE AVAILABLE 24 HOURS A DAY
• .
SPECIAL CONDITIONS FOR CASE#BLD04-00555:
1.) NO CLEARING OF TREES OR VEGETATION WAS APPROVED FOR THIS PERMIT.
2.) 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.
3.) The application was reviewed by the Jefferson County Department of Community
Development staff on September 14, 2004 for the potential presence of Environmentally
Sensitive Areas (ESAs) under the provisions of the Unified Development Code (UDC).
After an initial Geographic Information Systems mapping review the following ESAs were
confirmed to be present on the subject property: Shoreline Designation: Suburban, Type 4
Stream, Heron, Osprey, Bald Eagle Habitat, Susceptable Aquifer Recharge Area, Coastal
Seawater Instrusion Protection Zone (SIPZ).
4.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological
formations that allow percolation of the surface water into the soils and the underlying
zone of saturation. Aquifers are geologic formations that contain sufficient saturated
permeable material to yield significant quantities of water to wells and springs. Aquifers
serve as the source of drinking water within most of the rural portions of Jefferson County.
5.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions
that promote rapid infiltration of recharge waters to groundwater aquifers.
6.) The parcel is located within a coastal SIPZ (seawater intrusion protection zone) according
to the County GIS map. There are voluntary and mandatory measures identified in the
Jefferson County Seawater Intrusion Policy(Resolution 44-22, effective September 23,
2002)that apply to well drilling proposals and building permit applications on existing lots
of record.
A Coastal SIPZ is defined as: all islands and area within one-quarter mile of marine
shoreline, but no history of chloride concentration above 100 mg/L in groundwater sources
within 1000 feet.
7.) The project shall adhere to the Best Management Practices (BMPs)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.
8.) The applicant is proposing to create 320 square feet of land disturbing activities. Sections
6.6 and 6.7 of the Jefferson County Unified Development Code requires that your
proposal comply with Minimum Requirement#2 (Construction Stormwater Pollution
Prevention) of the Department of Ecology 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.) Jefferson County determined that this proposal is categorically exempt from review under
the State Environmental Policy Act (SEPA) pursuant to WAC 197-11-800(1)(b)(i).
10.) The site plan as submitted with the demolition permit application on August 31, 2004 has
been reviewed for consistency under the UDC, and has been approved by Jefferson
County Department of Community Development. Any modifications, changes, and/or
additions to the stamped, approved site plan dated September 29, 2004 shall be
resubmitted for review and approval by Jefferson County Department of Community
Development.
11.) This approval is for a demolition of the 320 sq ft residence only. Any future permits on this
site are subject to review for consistency with applicable codes and ordinances and does
not preclude review and conditions which may be placed on future permits.
12.) Ludlow Bay Rd. (C508209) is a county road. An address of 741 Ludlow Bay Rd. has been
assigned to the parcel.
13.) A permit for a 360 gallon per day septic system (SEP01-00128)was approved on
September 4, 2001.
14.) This parcel was created through the Ludlow Beach Tracts No. 2 under AFN 115609,
recorded November 4, 1948 , Volume 3, page 28 in with the Jefferson County Auditor's
office.
•
15.) This nonconforming legal parcel is designated as Rural Residential 1:5 under the
Jefferson County Comprehensive Plan Land Use Map effective August 28, 1998.
16.) The Dept. of Fish and Wildlife reviewed this proposal. No eagle habitat management plan
is required for this project. The Dept. of Fish and Wildlife will comment on future
development of the parcel and may require an eagle habitat management plan at that
time.
17.) The GIS mapping identifies a type 4 stream in close proximity to the parcel. However,
based on the site visit conducted on September 28, 2004 no evidence of a defined
channel or ravine are present on the property and therefore additional setbacks do not
apply.
18.) 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.
19.) 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.
20.) 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.
21.) This parcel is served by a private well.
22.) This application is within 200-feet of the Ordinary High Water Mark (OHWM). Whereas
the valuation of the demolition of the structure is valued under$5,000, this proposal is
exempt from the Jefferson County Shoreline Management Master Program (per SMP
3.402.1).
I:\F_BLD_Permit_Propane.rpt 10/29/19c
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o�� JEFFERSO OUNTY 1 (>., . , ,
` DEPARTMENT OF COMMUNITY DEVELOPMENT {/ ! i
621 Sheridan Street• Port Townsend •Washington 98368 I 41i.,
360/379-4450 • 360/379 4,51 Fax
\ 0. www.co.jefferson.wa.us/commdevelopment
Master Permit Application A �;,, `'`�, `r
of C.
Project Description (include sep at9-sheets as necessary):
•
Tax Parcel t
Property
Number: elk, 9circe t Size:
'J (acres/square feet)
Site Address and/or Directions to Property: '74 / ,, / k'( � .
Property Owner(s)of Record: ]-o/w ,-• t;r �Kt t.v-1
Y J 1rs' z�'" �Lf:�
Telephone:,.S-3— S 3 3 — i'{r; Fax: T rxt t tc- 111 J
Mailing Address: � L S T S J email: ._ /y.•(
Gt14L.CJttrt
Applicant/Agent(if different from owner):
Telephone: Fax:
email:
Mailing Address:
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]**
❑Single Family ❑ Discretionary"Dv or Unnamed Use Classification
0 Garage Attached/Detached ❑ Special Use(Essential Public Facilities)**
❑ Manufactured Home ❑ Boundary Line Adjustment
0 Modular ❑ Short Plat**
❑ Commercial* ❑ Binding Site Plan**
❑Change of Use ❑ Long Plat**
❑Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments**
❑ Propane ❑ Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions**
[7 Stormwater Management ❑ Shoreline Management Substantial Development**
[7 Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance
U Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment
U 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 to act as my agent in matters relatingto this
7 --�j application for permit(s).
OWNER SIGNATURE �- liJL Yu Date: ,% ''/
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 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 provide arrpg5 and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application
review and any required later ins ctions.Access and right of entry to this property shall be requested and shall occur only during regular business
hours. U
Signature: ,�_ Date: , /3/ /
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"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)e f you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non- •�•table res tsibility for dhering to and complying with the ESA. The Applicant has read this disc ' r a signs and dates it below.
Signature: �2�. '� Date: 3/ , C.,C
71
G:\PennitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
0 OWNER BUILDER STATEMENT :.; a - 1
The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein, ey are not licensed contractors and that
they.will be. ing the responsibility-of/the General Contractor for the proposed project- `, --
Signature: Date: _ G ,s
i
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: J.` FAX: t 1 Q� `, -
I
DEPT. OF C .?,
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
•
NUMBER: NUMBER -
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: flame Type: ; Bathrooms: Shoreline: Type
❑ New ID Wood Existing: of Sewage Disposal:
❑ Sewer
❑ Addition ❑ Steel Proposed: Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System
❑ Repair ❑ Masonry SEP Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: ❑ Public
Total: Name of System:
If this is a Commercial Protect 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:
❑ Underground Tank ❑ Above ground Tank Size of Propane Tank:
[I Heat Stove ❑ Cook Stove ❑ Woodstove 17 Fireplace Insert ❑ Hot Water Tank ❑ Pellet Stove ❑ 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 `forOffice'Use Only `-' ;^hama 1, ' j " ;'"fi<;
Current Proposed ,,
,o 1' . . >;
Main Floor Consists Re � ` i �3`r •
2NU Floor 'Base fee: ,,; `' ,` �`• . ;s 4a ~'
�. tiott ,+ x 4.
3 Floor dl Cori: " �:" � ,,, r ���t� `���� � �.���
Mezzanine: tan fieckfee r ^'`` ' l , -- ,
Heated Basement �" t 1 �:
state
Surcii �e
� i�
Unheated Basement "� A, Z s l.�xv y�"� ,, iF,ti'"�*+;
Other Unheated ,���
: _ s ot` -, w�'�- �- .'i; 2"-' °� ��.
Garage/Carport = ti 4 e 4,,...3 _. ,
18,54
Decks 7" ,� 3 - �, 5, :,,:-' ° ,,
7 i > r• a,
Other , , ° ,G K
{ t '� 1 ..'14t4' `.444.1,, s,,?,.6.„ �� y./f;$ 4,,s' i -:tr't$�C�.,,
} f ,+r �^k • ... ?sue, `'O 7,R ; as
ESTIMATED COST(REQUIRED) •tk 4 1 ♦. - - ; 4 ter. ,ice^, ` ,4 ;v
•Fair market value of all labor and materials foundation to finish "7 ,-1.0 , . q��r ` �, % . r
t. ,Fr-,: 45 max." - " _:;%-, .
AP
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc