HomeMy WebLinkAboutBLD2004-00592 lit
UILDING PERMIT APPLICAON MLA
0400555
Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD04-00592 Received Date: 9/21/2004
SITE ADDRESS: 73 PETERSON RD
PORT TOWNSEND, 98368
OWNER: COLLEEN SMITH PHONE: (360)732-4241
101 VAN TROJEN RD
CHIMACUM WA 98325
SUBDIVISION: Block: Lot: 1 +
PARCEL NUMBER: 801061001 Section: 6 Township: 28 N Range: 01 W
CONTRACTOR: PHONE:
PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP NEW MAN HOME
TYPE OF WORK MOB SQUARE FOOTAGE:
TYPE OF IMP NEW
VALUATION MAIN:
CODE EDITION: 2003 ADD'L: HEAT TYPE:
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: # OF STORIES:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM: PARCEL TAGS: YES NO
BEDROOMS: BATHROOMS: STORMWATER: YES_ _ NO___AREA
Exist: Exist: Wetland_ Erosion
Prop: 3 Prop: 2 Seismic Streams _
Total: 3 Total: 2 Flood Way _ Floodplain
Routing Date: C F&W Landslide
/i2Q/01 Shoreline _Aquifer _
Forest: Commercial Rural
Type Amount Paid Bv: Date: Receipt: A[�p�rQ��fD V E D
Manufactured Homes $154.00 RAC 09/21/04 67706 r r fl lJ V
Potable Water Application $52.00 RAC 09/21/04 67706 NOV 2 9 2004
Total: $206.00
Jefferson County Planning
& Building Department
' •
MANUFACTURED/MOBILE HOME INSTALLATION PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT#: BLD04-00592 Received Date: 9/21/2004
SITE ADDRESS: 73 PETERSON RD Issue Date: 11/29/2004
PORT TOWNSEND, 98368
APPLICANT: COLLEEN SMITH
101 VAN TROJEN RD
CHIMACUM WA 98325
SUBDIVISION: Block: Lot: 1 +
PARCEL#: 801061001 Section: 6 Township: 28 N Range: 01 W
CONTRACTOR/
DEALER
PROJECT DESCRIPTION: NEW MANUFACTURED HOME
MAKE: COMET
YEAR: 1983
SIZE: 56 X 24
THIS PERMIT IS VALID FOR ONE YEAR.
THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR.
THE EXPIRATION DATE IS 11/29/2005.
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
Setbacks/Footing (CONTINUOUS FOOTING, SLAB or PADS USED):
Stormwater FINAL Approval:
Blockinlum biigN _ )
Propane Tank/Lines
Zoning Final Approval:
Septic System Final Approval (If not on sewer):
Road Approach Final Approval: �,
Final/Skirting/Vents/Porches/Steps:C� 10,
HEALTH DEPARTMENT AND PUIC 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 CASE # BLD04-00592
1.) The application was reviewed by the Jefferson County Department of Community
Development staff on October 17, 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: Type 3 Stream, Wetland, Frequently
Flooded Area, Susceptable Aquifer Recharge Area (SUSC), Adjoining Rural Forest.
2.) 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.
3.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions
that promote rapid infiltration of recharge waters to groundwater aquifers.
4.) Jefferson County has determined that the use of real property for agriculture and forestry
operations is a high priority and favored use in the county. The county will not consider to
be a nuisance those inconveniences or discomforts arising from such operations, if such
operations are consistent with commonly accepted best management practices in
compliance with local, state, and federal laws. If your real property includes or is within
five hundred (500) feet of real property designated as Rural Residential 1:10 or 1:20,
Rural Industrial, Rural Commercial, Agriculture, or Forestry, you may be subject to
inconveniences or discomforts arising from such farming and forestry operations,
including but not limited to noise, tree removal, odors, flies, fumes, dust, smoke, the
operation of farm and forestry machinery during any 24-hour period, the storage and
disposal or manure, and the application of permitted fertilizers and permitted pesticides.
One or more of these inconveniences may occur as a result of agricultural and forestry
operations which are in conformance with existing laws and regulations.
5.) A Type 3 Stream (Fish and Wildlife Habitat Area) has been identified on the subject
property. The stream will require a setback of 100-feet. The setback shall be measured
horizontally from the Ordinary High Water Mark (OHWM). Fish and Wildlife Habitat Areas
shall also have Buffers and Building Setbacks established.
6.) Stream and wetland buffers are areas that shall be maintained in their natural condition,
however, minor pruning or alteration of vegetation may be permitted as long as the
function and character of the buffer are not diminished.
7.) Among the native conifer species which may be used in buffers or for re-vegetation
include, but are not limited to: Grand Fir (Aibes grandis), Sitka Spruce (Picea Sitchensis),
Shore Pine (Pinus Contorta), Douglas Fir(Pseudotsuga Menziesii), Western Red Cedar
(Thuja Plicata), and Western Hemlock (Tsuga Heterophylla).
Among native tree species which may be used includes: Vine Maple (Acer Circinatum),
Big-Leaf Maple (Acer Macrophyllum), Red Alder(Alnus Rubra), Pacific Madrone (Arbutus
Menziesii), Quaking Aspen (Populus Tremula), Black Cottonwood (Populus Trichocarpa),
Bitter Cherry (Prunus Emarginata), Oregon White Oak (Quercus Garryana), Cascara
(Rhamnus Purshiana), Pacific Willow(Saliz Lasiandra), and Scouler's Willow (Saliz
Scouleriana).
Among the native shrub species which may be used are: Sevice-Berry (Amalanchier
Alnifolia), Red Osier Dogwood (Cornus Stolonifera) Salal (Gaultheria Shallon), Ocean
Spray (Holodiscus Discolor), Indian Plum (Oemlaria Cerasiformis), Pacific Ninebark
(Physocarpus Capitus), Red Flowering Currant(Ribes Sanguineum), Wild Rose (Rosa
Nutkana), Swamp Rose (Rosa Pisocarpa), Willows (Salix ssp.), Red Elderberry
(Sam bucus Racemosa), Snowberry(Symphoricarpos Albus), Evergreen Huckleberry
(Vaccinium Ovatum), Red Huckleberry (Vaccinium Parvifolium).
8.) All construction activities shall not encroach upon the buffer. This includes the storage or
preparation of materials.
9.) A setback of 75-feet, measured perpendicularly from the wetland edge, shall be
permanently maintained as a buffer. No filling, grading, clearing, or other alteration of the
wetland or its buffer is allowed.
10.) Buffer perimeters shall be marked with temporary signs at an interval of one per parcel or
every one hundred (100) feet, whichever is less. Signs shall contain the following
statement: "Wetland & Buffer- Do Not Remove or Alter Existing Vegetation."
11.) A permanent physical separati long the upland boundary of the wetland lier area
shall be installed and permanently maintained. Such separation can include installing
logs, trees, a hedgerow, or any other prominent physical marking approved by the UDC
Administrator.
12.) The identified Fish and Wildlife Habitat Area (Type 3 Stream), shall maintain a vegetative
buffer setback of 100 feet. The setback shall be measured horizontally from the Ordinary
High Water Mark (OHWM) to the new manufactured home.
13.) An additional setback of five (5) feet is required from the edge of the buffer area to the
proposed manufactured home.
14.) A permanent physical separation along the boundary of the buffer area shall be installed
and permanently maintained. Such separation can include installing logs, trees, a
hedgerow, or any other prominent physical marking approved by the UDC Administrator.
15.) Buffer perimeters shall be marked with temporary signs at an interval of one per parcel or
every one hundred (100)feet, whichever is less. Signs shall be in place prior to and
during construction activities. The signs shall contain the following statement: "Buffer- Do
Not Remove or Alter Existing Vegetation."
16.) Stormwater shall be retained and infiltrated on site. The owner shall control all
sedimentation and erosion on the property.
17.) The applicant is proposing to create or add 1,344 square feet of impervious surface and
2,000 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.
18.) 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.
19.) 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.
20.) 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).
21.) The revised site plan as submitted on November 1, 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 November 23, 2004 shall be resubmitted for review and approval
by Jefferson County Department of Community Development.
22.) This approval is for a manufactured home 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.
23.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
24.) 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).
25.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
26.) The building height is not to exceed 35 feet.
27.) The setback from Peterson Rcght-of-way is no less than 20 ft. The setblCfrom Old
Eaglemount Rd. right-of-way is no less than 20 ft. The setback from the property line
adjoining the parcel zoned Rural Forest 1:40 to the west is no less than 100'. The setback
from the south property line is no less than 5 ft. If an environmentally sensitive area (ESA)
is present, then the more restrictive setback shall apply.
28.) A minimum of two (2) on-site parking spaces is required for the single-family residence.
29.) Peterson Rd. (C507109) is a county local access road. A road approach is existing an
address of 73 Peterson Rd. has been assigned to the parcel.
30.) A septic permit (SEP00-00244)was approved December 22, 2000 for a capacity of 360
gallons per day. This permit was finalled September 15, 2003.
31.) This parcel is served by a private well.
32.) This is a legal non-conforming parcel designated as Rural Residential 1:10 under the
Jefferson County Comprehensive Plan Land Use Map effective August 28, 1998.
33.) A letter dated October 27, 2004 from Hagen Consulting (Subject: Wetland Field Visit near
Peterson Rd., Jefferson County/parcel#801-601-001) classifies the wetland on this parcel
as Category 3.
34.) The project components are more than 75' from the identified category III wetland. The
requirement for a wetland delineation and report is waived based on maintenance of a 75'
buffer from the wetland per UDC Table 3-3.
35.) The frequently flooded area is mapped in the northwestern most corner of the parcel
encompassing the type 3 stream. Based on the site plan submitted on November 1,
2004, this frequently flooded area is a significant distance from the proposed
manufactured home.
•
FFERSON COUNTY ASSESSOR
JACK WESTER AN III 11IF JEFFERSON COUNTY COURTHOUSE
ASSESSOR PO BOX 1220,POST TOWNSEND WA 98368 ,
j(360) 385-9105
itr
MOBILE HOME INFORMATION FORM'` 21
OWNER'S NAME / MAILING ADDRESS:
THIS IS NOT A TAX STATEMENT
NAME: CO E'e..h SYVI 1-4) The purpose of this questionnaire is to obtain information
ADDRESS: �i I �Ce regarding either the current location of a mobile home or the
'r�J 'e'er cia previous ownership and location of a mobile home. This will
,.. v 1� help our office determine whether the mobile home is already
t t C rv-1 � 3R5 on the tax rolls in Jefferson County_or if it has been moved to
this county from another area. Please see reverse side for
TELEPHONE NO: 7 3 — a 4) additional information.
1) MOBILE HOME DATA: 0 pvir
(A) MAKE ( o i'VI E + (B) MODEL S CV..? (C) YEAR ( ' 3
(D) LENGTH 5-6 (E) WIDTH c (F)SERIAL NUMBER / / 7
(G) YOUR PURCHASE PRICE(DO NOT INCLUDE SALES TAX) C`. (H) PURCHASE DATE 9//c5 0-"L
2) PREVIOUS OWNER / LOCATION OF MOBILE HOME:
(A) FROM WHOM DID YOU PURCHASE MOBILE .j/4,1.,21y1 /5 •r- gee)er , Peres el
ADDRESS Po. t3 i II& 7 983.1) - 9q 6 7
(B) WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR? YES NO (IF NO,WHAT COUNTY? Kt,"1 Sci e
IF YES,WHAT WAS PREVIOUS ADDRESS OF MOBILE?
3) WHERE MOBILE HOME IS TO BE LOCATED:
(A) WILL THE MOBILE HOME BE IN A MOBILE HOME PARK? YES �o
(B) IF LOCATED IN A MOBILE HOME PARK:
NAME 8T ADDRESS OF PARK SPACE NO.
(C) IF NOT LOCATED IN A MOBILE HOME PARK:
NAME OF LAND OWNER: 4/GLJ i �' -CPS a€ e n 4 S
LOCATION (ADDRESS) '..3 Pc--f-'e t''cc y1 RGG L— PO r�— a ns e 4 '7 '3 Co
REAL PROPERTY PARCEL NUMBER/DESCRIPTION ,SOS °6/ - iC96`
THANK YOU FOR YOUR HELP! 6--e-e
SIGNATURE
KELLI LARSON, roperty Technician
THIS FORM CONFORMS TO THE STANDARDS OF THE STATE DEPARTMENT OF REVENUE AND IS SUBJECT TO AUDIT VERIFICATION.
,/ ON C.O6 JEFFERSON®UN1Y
DEPARTMENT OF COMMUNITY DEVELOPMENT M{I l
41
4401
` 621 Sheridan Street• Port Townsend •Washington 98368 i r
360/379-4450 • 360/379-4451 Fax
4q O� www.co.jefferson.wa.us/commdevelopment SEP 21 2
SING S
Master Permit Application -
MLA:T. CA „S5
Project Description(include separate sheets as necessary):
?// Sfa-1/ / , i//7. G f e„,i- r s/ �cn a-1 i -'
Tax Parcel Property
Number: 96I t 40/ p-0/ Size: 7, g5 acres (acres/squarefeet)
Site Address and/or Directions to Property: 7 3 ,Ye-7 e r.5 o n A.-)et,-1 / .9r
/ - t '1 n c�:l 5 Cr!9/
Property Owner(s)of Record:///"Crl/>`. .T• q-- C'o/r'e eri it). 3 ryl /44,
Telephone: 73 2-SLa'/ Fax: / email:
Mailing Address: /a/ l�arl ./,rr,, N,-. c ?�. /1-41a c_4-1 rn / �l-k- 9g3 S
Applicant/Agent(if different from owner):
Telephone: 73,. —t/a 4/ Fax: email:
Mailing Address:
Wiat kind of Permit?(Check each box that applies)
'Building D Variance(Minor,Major or Reasonable Economic Use)
D Demolition Permit ❑ Conditional Use[C(a),C(d),or C]**
D Single Family D Discretionary"D"or Unnamed Use Classification
❑G.�arage Attached/Detached ❑ Special Use(Essential Public Facilities)**
��r
,6�manufactured Home ❑ Boundary Line Adjustment
D Modular ❑ Short Plat**
❑Commercial* ❑ Binding Site Plan*"
❑ Change of Use ❑ Long Plat**
❑Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments**
❑ Propane D Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions**
❑ Stormwater Management Cl Shoreline Management Substantial Development**
❑ Site Plan Approval Advance Determination(SPAAD)* El Shoreline Management Variance
D Temporary Use D Comprehensive Plan/UDC/Land Use District Map Amendment
D Wireless Telecommunication* D Jefferson County Shoreline Master Program Amendment
El 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 access 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:� ��L2 t,z,h l �-
-IC���..tr Date: 9/.-F—U`/
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-transferable7 responsibility for adheri to and complying with the ESA. The Applicant has read this di aimer and signs and dates it below.
Signature: r����.z-,"� ,4 Date /3 ,!✓o dye
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
•
OWNER BUILDER STATEMENT i yl 1 '
The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,tha g arse not licensed contractors and that
they will be assuming the responsibility of the General Contractor for the proposed project. l r
Signature:___ Date: 1 6. S L P 2 1 20',
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ". ,`", _�
:,.r 1 Lie 1.
yy� i
(34,c� 3-73--3/ cr—f . )_._______.____._
I I �1�e; ��b t c�m'� f�'1u�t ��.
MAILING ADDRESS: � . /.-.? 0/ A/e//e/ �� /7 j,,,y t,r v N EMAIL:
CONTRACTOR'S LICENSE /, Cam! WAINS C K,'.7`-,r-I<s. It- )c ,i ��t -c
NUMBER: NUMBER (�,. 'sv I .- C 'T
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
❑ New Er Wood Existing: ,9` 0 Sewer
❑ Addition 0 Steel Proposed: Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: .%- Height: 0 Individual System
O Repair ❑ Masonry SEP Permit# Sep cc-,,,g I4
O Demolition 0 Other: Bedrooms: Water Supply:
Existing: 3 Setback: k Private well 0 Two Party
Type of Heat: Proposed: 0 Public
fw c-i'r,c; Total: 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:
❑ Underground Tank ❑ Above ground Tank Size of Propane Tank:
I
Ii Heat Stove 0 Cook Stove ❑ Woodstove ❑ Fireplace Insert 0 Hot Water Tank ❑ Pellet Stove ❑ Other
Is this appliance being installed in a Manufactured/Mobile Home? Yes / No
must alsosubmit a siteplan showingall of the buildings,all property
applying for a permit to install a propane tank you u t g , p perty
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 Consistenp/RevieW:. 4\2
2ND Floor Base fee: 15/i
3`a Floor Additional Section: _
Mezzanine: -Man Check fee:
Heated Basement State Surcharge fee:
... 99457
Unheated Basement Pot Water'Review fee: aii v
Other Unheated 911/Rd p ach fee:
Garage/Carport TOTAL: $
Decks Receipt Number:
Other Cash/Check Number fl 25G
ESTIMATED COST(REQUIRED) Date: 1
•Fair market value of all labor and materials foundation to finish
yr Initials:
, C
t✓ .„-------
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc