HomeMy WebLinkAboutBLD2004-00571 BUILDING PERMIT•
Jefferson County pm
621 Sheridan De Streetart, Portentof TownsendCommunity, WA 98368 Development
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD04-00571 Received Date 09/8/2004
SITE ADDRESS: 361 S PALMER DR Issue Date 09/15/2004
PORT TOWNSEND, 98368
APPLICANT: RHEBE GREENWALD TRSTE PHONE: (360) 379-0589
RHEBE GREEWALD REV TRUST
361 PALMER DR
PORT TOWNSEND WA 98368-8913
SUBDIVISION: CAPE GEORGE COLONY DIV 4 Block: 10 Lot: 28
PARCEL NUMBER: 938701026 Section: 13 Township: 30 N Range: 02 W
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: SFR REMODEL- NO MLA REQ'D
REQUIRED INSPECTIONS:
[ ] SETBACKS: _
[ ] UFFER:
[ ] Footing:
[ ] Foundation:
[ ] Stormwater FINAL Approval:
[ ] Underground Plumbing:
[ ] Underground Insulation:
[ ] Shear Wall :
4 Framing: il pt 1,,.,& oY L 1 11/Ni 4€004M 5 .a
11 Plumbing:
[ ] Propane Tank/Lines: 1 a " 1-0
bk Insulation: Ppvet,P,c. 4...1J,,N0 2eo w. tz-ul-�il
SheetrockZ Ft.400gtoke (--2k'0S' d4-.);Emuit%-
[ 1 Septic Sytem Final Appro%l:
Road Approach Final Approval:
[ - Zoning Final Approval:
Final/Occupancy Approval 514 s
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
I:\F_BLD_Permit_Buildng.rpt 10/29/1999
• BUILDING PERMIT APPLI• Review Ty 571
TION BL Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD04-00571 Received Date: 9/8/2004
SITE ADDRESS: 361 S PALMER DR
PORT TOWNSEND, 98368
OWNER: RHEBE GREENWALD TRSTE PHONE: (360) 379-0589
RHEBE GREEWALD REV TRUST
361 PALMER DR
PORT TOWNSEND WA 98368-8913
SUBDIVISION: CAPE GEORGE COLONY DIV 4 Block: 10 Lot: 28
PARCEL NUMBER: 938701026 Section: 13 Township: 30 N Range: 02 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI` SFR REMODEL - NO MLA REQ'D
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ALT MAIN:
VALUATION 10,500.00 ADD'L: HEAT TYPE:
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: 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: 2 Exist: 3 Wetland Erosion
Prop: Prop: Seismic Streams
Total: 2 Total: 3 Flood Way Floodplain
Routing Date: I F&W Landslide
. C� ! Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: /\ O?c/rR E
Permit $195.25 KAS 09/08/04 67564 /`� `J �/
Plan Check $126.91 KAS 09/08/04 67564 SEP 1 5 2004
State Building Code $4.50 KAS 09/08/04 67564
Total: $326.66 Jefferson County Planning
& Building Department
Ia.,.-25rYNC:
V C CID`.�-4-6
• OWNER BUILDER STATEMENT • ' —�
The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors pndithat
they will be ing the respo i llity of the General Contractor for the proposed project.
Signature.`R.�P �l C L + 1 i
�t-1 LLn I ( Date: `1�` '(p V i` SEP - 8 ,.. „
L-;,t D
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: L
PHONE: JCf=1�),�.u[v GOtJ�1Y
( 'J(oC�) 3S. ~ .• COP 1ti Uh11?�LVELOPN4,
MAILING ADDRESS: Hoer) +11 ' ' 360 ) 3$S-�(��/
i , ;sc,,4e pf 'Pool- /ctti,,,f,c.,;:1�MAIL: q
CONTRACTOR'S LICENSE al�445,N �974c,<<rr�
WA
NUMBER: 'i6i)C UIU c)L, 1 7el K N MIB R
ARCHITECT/ENGINEER: WI Y k c
t ke PHONE ( >O 3 fSC-b/yV FAX:( )
MAILING ADDRESS: 7 S-c( 0, ,'ry C 1 5,1' 1 1,)e)f f I p� `eu jjEMAIL Ct(C h I-t ec{ @Lcr^C' S t , rue}
Project Type: Frame Type: Bathrooms: Y'-
❑ New tt' Wood Existing: 3 Shoreline: H Sewere of Sewage Disposal:
❑ Addition ❑ Steel Proposed: ❑
0 Additi ion/Remodel Bank ❑ Community System
❑ Concrete Total: 3 Height:
❑ Repair ❑ Masonry Individual System
❑ Demolition ill Other: Bedrooms: SEP Permit#'(g -000
Existing: Water Supply:
Type of Heat: Setback: [7 Private well ❑ Two Party
Proposed: PLbli�
Total: 7x_ Ca r.�mu N i a,
Name of System:(,
0,,..^r"Y, ei
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
IBC Occupancy: IBC Type of construction: Proposed
If this is a Propane Tank and/or Appliance Installation permit,mark all items e ow that apply:you have Food
Service? Yes / No
❑ Underground Tank [II Above ground Tank
Size of Propane Tank:
❑ Heat Stove I i Cook Stove I i Woodstove [J Fireplace Insert I I Hot Water Tank I i Pellet Stove I I 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 systemcomponents,
including the reserve area.
ISquare Footage For Office Use Only I
Current Proposed Amount
Main Floor
Consistency Review: ....- --..
2Nu Floor
Base fee: Q
3rd Floor "1 5•ZS
Additional Section: /
Mezzanine:
Plan Check fee: 12160•q `
Heated Basement State Surcharge fee: [y
Unheated Basement ` -��
Pot Water Review fee: ,y(
Other Unheated 911/Rd Approach fee: C�J
0 Garage/Carport
TOTAL: $
Decks
Receipt Number: �?
Other Cash/Check Number: �i-t,p 22
ESTIMATED COST(REQUIRED) Date: n 17
.Fair market value of all labor and materials foundation to finish IgCo 47 0, 'j C (_' Initials:
fri.
G:\PerrnitCenter\FORMS\DRD FORMS\Master Penmt Application 7-8-04.doc
ifrcoJEFFERSONLIP UNTY E C lc,GWE�7A DEPARTMENT OF COMMUNITY DEVELOPMENT
"n114 `� 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax SEP -
; ,:2)
i V
0 www.co.jefferson.wa.us/commdevelopment L
_
lc, N�� JEFF EItSON COUNTY
C Z OF COb�h'UIJI�TY f`�'`,'FLQ°"l�;'tdT
Master Permit Application
Project Description(include separate sheets as necessary):
Tax Parcel Property
Number: I.?j 53 7 0 I c 2- W
Size: /-I, ? ' (acres/square feet)
Site Address and/or Directions to Property: 36,( •P4 l r. D _p (C h
Property Owner(s)of Record: Oli be (-reeiv e tt k Red, I ' s+ 1l/'7/0:.t-
Telephone: :>l, C--3?et`OSS'`j Fax: 371-O'1 •-(all -Flrst email: rlubeI)coblesee<<((•eea7,
pck.I me c c 1 v� I-VE>,,c`t 7 c tA_s nt S e ry tp
Mailing Address: �jc,- 1at et T�us+e
Applicant/Agent(if different from owner): AZ1�be (r,ree ,.--(
Telephone: 5(oO 3 7`!'US g`i
Fax: email:
Mailing Address: -41''e etc. ct ba-re
What kind of Permit?(Check each box that applies)
❑Variance(Minor, Major or Reasonable Economic Use)
Id'�uilding i ❑Conditional Use[C(a),C(d),or C]**
❑ Demolition Garage Familye Permit ❑ Discretionary"D"or Unnamed Use Classification
❑ ❑ Special Use(Essential Public Facilities)**
❑ Attached/Detached ❑ Boundary Line Adjustment
Ll❑ Manufactured Home ❑ Short Plat**
Modular ElBinding Site Plan**
CI Commercial* ❑ Long Plat*"
Li of Use❑Address l I Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments**
❑ 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 **Requires a Pre Application Conference
*May require a Pre-Application Conference
Please identify any other local, state or federal permits required for this proposal, if known:
DESIGNATION OF AGENT for permit(s).
I hereby designate to act as my agent in matters relating to this applicationP ( )•
Date:
OWNER SIGNATURE
n,and in any
ments,is true and correct to the best
signing this application foAny material falhe sehent ood oranysts that the om ssionformation of a material)fact maderovided 'by the owner/agent with respect to this application packet of
his,her or it's knowledge. Any
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 attorney'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 access and right of entry to Jefferson County and its employees,berepresentatives
ewes ated and shall agents
tocsuor only duringhe ole purpose
ser of
applicationlics
review and any,squired later inspections.Access and right of to this property
hours. > �� Date: �� /L�
Signature:-.�k� ., )2 n �,Q�I
may negatively impact
n one or more threatened or
The action ge a or actions
and icant couldegad to a potential"take"undertake as a toff the issuance of this an endangered species as those terms are defined in thefederal law known as the
endangered species that the actions that will be undertaken because this
"Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant
arding your
permit has been issued
are nl not compl compliance with the Jeffersonhe ESA. Any vidual,group or agency can file a County development code.The Applicant acknuit on owledges that he,she or it holdssiindividual
action(s)even if youP has read this disclaimer and signs and dates it below.
and non-tra f le res nsi Mfor adhering to and p mplying with the ESA. The ApplicantDate: / ���y
p/f L-t.v c
Signature:
G:\PemutCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
• •
ea'N
c°c> JEFFERSON COUNTY - fy ,- .-�
40,0 ri + DEPARTMENT OF COMMUNITY DEVELOPMENT ii) IL G' �4 li l�'� i� [i
621 Sheridan Street•Port Townsend• Wash' `1 1
360/379-4450 •• 360/379-4451 Fax 98368 E P - 8 * 4 l`�J
D` http://www.co.jefferson.wa.us/commdevelopment/
RI f LRSUh! COUNTY
DEPI. Or COMMUNITY D,1 VELOPMENT
Stormwater Calculation Worksheet
MLA#
PROJECT/APPLICANT NAME: . e G r f E'rTY ,:/,j
DETERMINING STORMWATER MANAGEMENT REQUIREMENTS:This stormwater calculation
to classify the proposal as"small,""medium,"or large." The size determineswSite Plan should re in completed first
with a stand-alone stormwater management permitwhether a Stormwater Site is required in conjunction
involves stormwater review. The basic information will application,
buildingr permit ton, or other land use approval application that
completing a Stormwater Site Plan,if required.
PARCEL SIZE(I E SITE)
Size of parcel acres An acre contains 43,560 square feet. Multiply the acreage by this figure.
Size of parcel in square feet___/ R r1)r ' sq/ft
Land-disturbing activity is any activity that results in movement of earth, or a
non-vegetative) and/or the existing soil topography. Land disturbing activities include, but ae in re not limited cover sod clearing, vegetative and
excavation,and compaction associated with stabilization of structures and road construction. 9r grading, filling,
ng.
Native vegetation is vegetation comprised on plant
species,other than noxious weeds,that are indigenous to the coastal region of the
Pacific Northwest and which reasonably could have been expected to naturally
Douglas fir,western hemlock,western red cedar,alder,big-leaf occur on the site.such Examples include species such as
and salal;herbaceous plants such as sword fern,foam flower,andfireweed.maple,
vine maple;shrubs as willow,elderberry,salmonberry,
LAND DISTURBING ACTIVITY CONVERSION OF NATIVE VEGETATION AND VOLUME OF CUT/FILL
Calculate the total area to be cleared,graded,filled,
excavated,and/or compacted forAnswer the following two questions related to
project. Include in this calculation the proposed to be cleared for.opment conversion of native vegetation:
Construction site for structuresDoes the project convert ifi acres or more of
sq/ft native vegetation to lawn or landscaped areas?
Drainfield,septic tank,etc.
sq/ft Circle: Yes No
Well,utilities,etc.
sq/ft Does the project convert 21rz acres or more of
Driveway,parking,etc. native vegetation to pasture?
sq/ft
Lawn,landscaping,etc. Circle: Yes No
sq/fl
Other compacted surface,etc. sq/ft Indicate Total Volumes of Prop
osed:
Total Land Disturbance
sq/ft Cut Fill (cu/Yd)
[over]
stormwater calk worksheet—REV.10/12003
1
• •
Impervious surface is a hard surface that either prevents or retards the entry of water into the soil mantle as under natural conditions
prior to development. A hard surface area which causes water to run off the surface in greater quantities or at an increased rate of flow
from the flow present under natural conditions prior to development. Common impervious surfaces include,but are not limited to roof
tops, walkways, patios, driveways, parking lots or storage areas,concrete or asphalt paving, gravel roads, packed earthen materials,
and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater.
STORMWATER CALULATIONS—IMPERVIOUS SURFACE
NEW EXISTING
Structures(all roof area) sq/ft Structures(all roof area) aril 0 0 sgrft
Sidewalks sq/ft Sidewalks 333
Patios d o 0 - sq/ft
Patios -�" sq/ft `.
` `rl
�� �: So(id Decks Saki Decks 11 \.� ,--. sclift
_
(withoutinfiltration below)
(without infiltration below)
Driveway sq/ft Driveway
Other , T scot
Other ), sq/ft , /
Total New 0..?•�---' sq/ft Total Existing sq/ft
TOTAL NEW+TOTAL EXISTING* sq/ft 'This amount will be used to check total lot coverage.
The following questions will help determine whether the proposed project is considered development or redevelopment.
DEVELOPMENT v.REDEVELOPMENT
Divide the total existing impervious surface above by the size of the parcel and convert to a percentage:
Does the site have 35%or more of existing impervious surface? Circle: Yes
" No
FURTHER INSTRUCTIONS: If the answer is yes, the proposal is considered redevelopment and the attached Figure 2 should be
used to determine the applicable Minimum Requirements. If the answer is no,the proposal is considered new development and the
attached Figure 1 should be used. At this juncture,the applicant should refer to the applicable Flow Chart to determine the Minimum
Requirements for stormwater management. DCD staff will help verify the classification of the project and the application requirements.
For proponents of "small" projects who must comply only with Minimum Requirement *2—Construction Stormwater Pollution
Prevention—an additional submittal is not required. The proponent is responsible for employing the 12 Elements to control erosion and
prevent sediment and other pollutants from leaving the site during the construction phase of the project. Pick up the Construction
Stormwater Pollution Prevention(SWPP) Best Management Practices (BMPs) Packet. Proponents of"medium"projects—those
that must meet only Minimum Requirements #1 through #5—and for "large" projects—those that must meet all 10 Minimum
Requirements—are required to submit a Stormwater Site Plan. DCD has prepared a submittal template of a Stormwater Site Plan,
principally for rural residential projects. Complete the templatei thet �omrnw Management Mae Plan nuals and Submittal Template or
prepare a Stormwater Site Plan usingthe step-by-step guidance
APPLICANT SIGNATURE
By signing the Stormwater Calculation 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
owne of the affected property.
4 (._,,v_r_ _2,-461- )— -0 7fC(/
(LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
2
stormwater calk worksheet—REV.10/12003
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