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HomeMy WebLinkAboutBLD2004-00588 BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD04-00588 Received Date 09/17/2004 SITE ADDRESS: 372 PULALI POINT RD Issue Date 05/3/2005 BRINNON, 98320 APPLICANT: CHARLES M SMITH PHONE: 374 PULALI POINT RD BRINNON WA 98320-9774 SUBDIVISION: CORN SHORT PLAT Block: Lot: 1 PARCEL NUMBER: 601183016 Section: 18 Township: 26 N Range: 01 W CONTRACTOR: SEAHOME SERVICES, INC PHONE: (360)765-3749 7425 THORNDYKE RD QUILCENE WA 98376 • Contractor's License: SEAHOSI077KS Expires: 11/17/2005 PROJECT DESCRIPTION: RETAINING WALL CALL IN FOR THE REQUIRED INSPEC NS THAT APPLY TO YOUR PROJECT. SETBACKS: OK 59 .06 UFFER: Footing: z;v< 3/9/4 p Foundation: Id4Qk S/u/4 Stormwater FINAL Approval: ids -r QE P.e v c) Underground Plumbing: Underground Insulation: Shear Wall : Sheathing: Framing: Plumbing: Propane Tank/ Lines: Insulation: Sheetrock: Septic Sytem Final Approval (If not on sewer): Road Approach Final Approval: Z in'Final Approval: final/ cupancy Approval: -15 v(p M ALTH 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 I Illt UILDING PERMIT APPLICADN M Re viewview Re Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD04-00588 Received Date: 9/17/2004 SITE ADDRESS: 374 PULALI POINT RD BRINNON, 98320 OWNER: CHARLES M SMITH PHONE: 374 PULALI POINT RD BRINNON WA 98320-9774 SUBDIVISION: CORN SHORT PLAT Block: Lot: 1 PARCEL NUMBER: 601183016 Section: 18 Township: 26 N Range: 01 W CONTRACTOR: SEAHOME SERVICES, INC PHONE: (360)765-3749 7425 THORNDYKE RD QUILCENE WA 98376 Contractor's License SEAHOSI077KS Expires 11/17/2005 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI RETAINING WALL TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION 10,000.00 MAIN: CODE EDITION: 2003 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: CONST TYPE: OTHER: GARAGE: SHORELINE: CONST TYPE: SETBACK: DECK: 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:?/ //1 7 ` Landslide V Shoreline _Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Permit $181.25 MZL 09/17/04 67650 APPROVED Plan Check $117.81 MZL 09/17/04 67650 State Building Code $4.50 MZL 09/17/04 67650 MAY - 3 2005 Total: $303.56 Jefferson County Planning &Building Department ()c..a 1 ,/..„... i pi2:0 • • LAc -5 JEFFERSON COUNTY 47 `„ , DEPARTMENT OF COMMUNITY DEVELOPMENT 4 :10'-}-' .e. 621 Sheridan Street •Port Townsend •Washington 98368 '1 . .1O 360/379-4450•800/831-2678•360/379-4451 Fax �� www.co.jefferson.wa.us/commdevelopment Master Land Use Permit Application Form PROPERTY INFORMATION Tax Parcel Number: 1I J UI ® [I © I j I I7 I Subdivision Name: e., 2 Ai s ,"'r ^,l A 'I— Lot Number: l f Property Size: (acres/square�fe�ett)) Existing Use of Pro erty: Site Address and/or Directions to Property: -1 7 F SAL `t } A APPLICANT&OWNER(INFORMATION Applicant(if applicable): tt'' RfV2I�ot,' Telephone: 76 c ?419 Address: 7 Las- -1-11,0C4Vcj f tad City: 7X U"Pi Zip Code: ^•'�') i I �4- State: � �7�, Email Address Applicant's Signature: Property Owner(s)of Record: cLH4P-1- S -.CPI J /r) Telephone: Address: '3 7 / p j L-A-L �v 1 ( ct City: k,(mAV SJ State:(,4J j Zip Code: q g32O Email Address ------------- I acknowledge that the applicant above is applying for a building permit on my property. Owner's Signature: - -- ----T‘:--(_, Y �o�r--✓ 7 I hereby designate_-L3LQ ' TAR.R.I�i l to act as my agent in matters relating to this application for permit(s). � 2' -g --1la -- -(PROPERTY --OWNER SIGNATURE) (DATE) DESCRIPTION OF PROPOSED USE OR ACTIVITY(include separate sheets as necessary) -----Wl bt—lell+fi"0 ilil- 1 k.ki 'a [THIS SECTION FOR OFFICE USE ONLY] Refer to the specific sections of the UDC referenced below for more information and further requirements. An asterisk(*)indicates that a supplemental application or questionnaire may be required. Type I Permits Refer to: ❑ Septic Permit/Evaluation of Existing System(EES) UDC Section 6.4.1 and Chapter 8.15 JCC ❑ Building/Demolition Permit UDC Section 3.2.1 and Table 3-1 Allowed"Yes"Use Consistency Analysis UDC Section 3.2.1 and Table 3-1 0 Home Business Table 3-1 and UDC Section 4.20 0 Stormwater Management* UDC Section 6.7 ❑ Road Access* UDC Section 6.8 0 Boundary Line Adjustment* UDC Section 7.2 ❑ Minor PRRD Amendments UDC Section 3.6.13.15 ❑ Sign Permit* UDC Section 6.15 Ti_, -- -- -- ❑ Site Plan Approval Advance Determination(SPAAD) ' UDC Section 8.7 -�� �� fa r ��` _ 0 Shoreline Master Program Exemption/Permit Revisions UDC Section 5 ❑ Temporary Use(based on use may be Type II or Type III)` UDC Sections 4.38 a{*C4:39 (OVER) i' $EP 1 7 MASTER LAND USE PERMIT.DOC REV.02/25/2002 • • SPECIAL CONDITIONS FOR CASE # BLD04-00588 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.) 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. 3.) 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. 4.) 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. 5.) 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. 6.) 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. 7.) 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. 8.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. • • • 9.) 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). 10.) Pre-ekisting legal lots of record less than one acre in size in Rural Residential districts are subject to the stormwater requirements in UDC Section 6.7 and must meet the "Area of Impervious Surface Coverage"to the maximum extent practicable as determined by the Administrator." Lot coverage is defined as amount of impervious surface, which includes rooftops, driveways, concrete, etc. 11.) The building height is not to exceed 35 feet. 12.) There is no setback from private easement road right-of-way. However, the retaining wall shall not encroach in the right-of-way. Side and rear setbacks are no less than 5 ft. If an environmentally sensitive area (ESA) is present, then the more restrictive setback shall apply. 13.) As per the approved Eagle Plan signed by the applicant on April 15, 2005, the applicant shall retain all known perch trees and conifers greater than or equal to 24 inches diameter at breast height (d.b.h.). The applicant shall also retain greater than or equal to 50% of pre-clearing or pre-construction conifer stand with diameter distributions representative of the original stand (>6 feet tall). Windowing and low limbing of trees is acceptable provided no more than 30% of the live crown is removed. • • • • • • I:\F_B LD_Permit_Bu ildng.rpt 10/29/19 • OWNER BUILDER STATEMENT • M 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 CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAx: Szt rb _ .ru zcs TA,c (36074S"371-r1 b ) )4S -`icc/ MAILING ADDRESS: -7`7 ac v rf.i6i it i i EMAIL: CONTRACTOR'S LICENSE I` WAINS NUMBER: 6 /1L N S : ►U /j NUMBER ARCHITECT/ENGINEER: JJ�� 1 r ,`r�n��`� ,�_ r PHONE (AC)) "7 77— FAX:( ) MAILING ADDRESS: jJ a, , x1 '` Q 6 1 w L s �� 7 ���u77 Q � EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New I f,i i01 ❑ Wood Existing: sCV ilt Cam, ❑ Sewer ❑ Addition Alf ❑ Steel Proposed: Bank ,,, [1 Community System ❑ Alteration/Remodel ry ncrete Total: Height: 11i dividual System El Repair Mason SEP Permit# ❑ Demolition ❑ Othei: Bedrooms: Water Supply: Existing: Setback: Type of Heat: Proposed: i [ Private well Two Party Total: S° [I Public Name of System: If this is a Commercial Proiect 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: i i Underground Tank I Above ground Tank Size of Propane Tank: i 1 Heat Stove I I Cook Stove i ! Woodstove I , Fireplace Insert i , Hot Water Tank i r Pellet Stove 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 system components, including the reserve area. Square Footage For Office Use Only Current Proposed Amount Main Floor Consistency Review: 2Nu Floor Base fee: l $ 1. as 3`tl Floor Additional Section: Mezzanine: Plan Check fee: 11 .g1 Heated Basement State Surcharge fee: Unheated Basement Pot Water Review fee: Other Unheated 911/Rd Approach fee: Garage/Carport TOTAL: $ 351 5C Decks Receipt Number: �f,�1 Other Cash/Check Number: l(� I ESTIMATED OST(REQUIRED) Date: I I 74 1 *Fair market e of all labor and materials foundation to finish q ( 11 r 0-1 f ''fi r 060 ) Initials: G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc <¢ ox cow JEFFERSOOOUNTY III 41 ' ` DEPARTMENT OF COMMUNITY DEVELOPMENT I ".4 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 p� www.co.jefferson.wa.us/commdevFaxelopment MD-, Master Permit Application MLA: 04 Project Description (include separate sheets as necessary J nt,vlC--) / Tax Parcel Property Number: ! 1 �• Size: (acres/square feet) • Site Address and/or Directions to Property: 37 1 pct LAr �t- Property Owner(s)of Record: Telephone: Fax: email: Mailing Address: Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) I I Building ❑Variance(Minor, Major or Reasonable Economic Use) Li Demolition Permit ❑ Conditional Use[C(a), C(d),or C]** ❑ Single Family ❑ Discretionary"D"or Unnamed Use Classification ❑Garage Attached/Detached ❑ Special Use(Essential Public Facilities)** ❑ Manufactured Home ❑ Boundary Line Adjustment ❑Modular ❑ Short Plat** ❑ Commercial* CI Binding Site Plan** ❑Change of Use ❑ Long Plat** ❑Address I I Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments** I I Propane ❑ Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** LI 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 Li 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 relating to this application for permit(s). OWNER SIGNATURE 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 arrpss 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: Date: 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)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 responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. 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