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Home My WebLink AboutBLD2004-00603 :.', • ..,.r BUILDING PERMIT Jefferson County Department Townsend,of Community WAe98368 velopment • 621 Sheridan Street, Po (360)379-4450 FAX (360)379-4451 Received Date 09124/2004 BLD04-00603 PERMIT #: 5500 WEST VALLEY RD Issue Date 10/25/2004 SITE ADDRESS: CHIMACUM, 98325 PHONE: (360)732-4328 APPLICANT: CHARLES D NISBET JUDY NISBET 5500 W VALLEY RD CHIMACUM WA 98325-9750 Block: Lot: + SUBDIVISION: 801044012 Section: 4 Township: 28 N Range: 01 W PARCEL NUMBER: PHONE: (360)697-9434 CONTRACTOR: PO BOX 2435 ND ER LLC POULSBO WA 98370 (360) 697-6811 Contractor's License: ISLANHL015R9 Expires: 12/31/2004 PROJECT DESCRIPTION: ROOM &DECK ADDITION CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: UFFER: Footing: if.. %/ s Foundation: Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: Shear Wall : --- Framing: ------- Plumbing: Propane Tankines. Insulation: Sheetrock: (- Septic Syt Final Approval (If not on sewer): Road Approach Final Approval: Zoning Final Approval: in it-Occupancy Approval: HEALTH DE PARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO RENEWED INSPECTION PERLY THIS PERMIT IS VALID FOR O ALL 24 HOURS IN ADVANCENE YEAR OR IT MUST BE OTO SCHEDULE INSPECTIONS. BUILDING INSPECTION HOT-LINE 37Offi ce Hours 9:00 a.m. -4:30 p.m. HOT LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS APPLY - SEE REVERSE BUILDING PERMIT APPLIC ION MRLA04 005eviewe64 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT.#: "'BUILDING Received Date: 9/24/2004 SITE ADDRESS: 5500 WEST VALLEY RD CHIMACUM, 98325 OWNER: CHARLES D NISBET PHONE: (360) 732-4328 JUDY NISBET 5500 W VALLEY RD CHIMACUM WA 98325-9750 SUBDIVISION: Block: Lot: + PARCEL NUMBER: 801044012 Section: 4 Township: 28 N Range: 01 W CONTRACTOR: ISLAND HAMMER LLC PHONE: (360) 697-9434 PO BOX 2435 POULSBO WA 98370 gg )) gggg gg Contractor's License ISLANHL015R9 Expires (1 293 1/2004 1 1 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI` ROOM & DECK ADDITION TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ADD MAIN: 123 VALUATION 17,250.00 ADD'L: HEAT TYPE: CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: SETBACK: DECK: 194 BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: PARCEL TAGS: YES _NO_ BEDROOMS: BATHROOMS: STORMWATER: YES_ NO _AREA _ Exist: 3 Exist: 2 Wetland_ Erosion Prop: Prop: Seismic _ Streams Total: 3 Total: 2 Flood Way _ Floodplain Routing Date: V.2(i F&W Landslide ( (1( C Shoreline _Aquifer _ Forest: Commercial Rural Type Amount Paid Bv: Date: Receipt: A PPROV E Permit $293.25 KAS 09/24/04 67752 D Plan Check $190.61 KAS 09/24/04 67752 OCT 2 5 2004 State Building Code $4.50 KAS 09/24/04 67752 Jefferson County Planning Total: $488.36 & Building Department • • 4..kt tOOZ id3s ii PERMIT # OLD _ 3 = "` k O4 - 603 o � � -a� N 3 JEFFEILT1 COUNTY DCD d N � \[1 3 1 60 I Q (I) , , > , ,:,, , .../ 11111 _,,, (,,, ,, I _ ! ,_ , v„ _ co = - I �� u IN �! O I 3 p I x 0 I u (o n n -4 - --1 r 1 i ), O h- 1 �jN�t Oath 2 e) N 4 •BOISE BUILDING SOLUTIONS, DISTRIBUTION - ee•t Engineered Wood Products Sh Job: of 8720—216th Street SE PO Box 168 Woodinville,WA 98072 Location: Tel: 425 486 7477 800 342 2299 Fax: 425 402 1567 `E! Ir' • BID Date: 1 I , I ��__- ,:I-. ■��:�►\it �.�7■■M■■iui U �■■ ■•,(Any■,- ®■I 11' i ■■I■r!! ! 'I�R1TR►i ��1■■■S il•■■•• I ___■SUS ■� 11■ ■ ■ ■ SOCO 1111 I \i■ ■ ■ipp ■■■■ rffilT311111111101112=ECINEr MIIIMM ' \ 144111PQMEMMEmEMEMEMEMME M 1 PIP ■■■ .e■u■/J■■■ ■ u-id - MO NAM IIIP.TRAmmmummium 1111 ■■/I■■l1,10■140011100PM/J1 ■ I ■■■■■■L!N ■ eu■ .,ip. o , - !!ail! 'nINIIIIIIIILIM ■ �f■ M! . . I - :O//■ ■■■r; ■ 111111111.111 11■ a f°, RIME%■■■OMM I!iii i �$E„ BCI® Joists, VERSA-LAM° Beams s and BOISE GLULAMT"" Beams 1 L .. --- arts c•J' Y;r. .,.:::: .:f 4. n... BUILDING PERMIT APPLICM'i : Review Ty Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 Received Date: 9/24/2004 PERMIT,#: BLD04-00603 SITE ADDRESS: 5500 WEST CHIMACUM, 98325 VALLEY RD OWNER: CHARLES D NISBET PHONE: (360) 732-4328 JUDY NISBET 5500 W VALLEY RD CHIMACUM WA 98325-9750 SUBDIVISION: Block: Lot: + PARCEL NUMBER: 801044012 Section: 4 Township: 28 N Range: 01 W CONTRACTOR: ISLAND HAMMER LLC PHONE: (360) 697-9434 PO BOX 2435 POULSBO WA 98370 (3601597-6611 Contractor's License ISLANHL015R9 Expires 12/31/2004 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION ROOM & DECK ADDITION TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ADD MAIN: 123 VALUATION 17,250.00 ADD'L: HEAT TYPE: CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: OCCUPANCY: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: CONST TYPE: DECK: 194 BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: PARCEL TAGS: YES _NO_ BEDROOMS: BATHROOMS: STORMWATER: YES__ NO__ _AREA__ Exist: 3 Exist: 2 Wetland_ Erosion -_ -- Prop: Prop: Seismic _ Streams Total: 3 Total: 2 Flood Way _ Floodplain F&W Landslide __ Routing Date: qj7 r, , Shoreline _Aquifer _�i ' � Forest: Commercial Rural Type Amount Paid By: Date: Receipt: A P Permit $293.25 KAS 09/24/04 67752 Plan Check $190.61 KAS 09/24/04 67752 OCT 2 5 2004 State Building Code $4.50 KAS 09/24/04 67752 Jefferson County Planning Total: $488.36 & Building Department • S BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 • (360)379-4450 FAX (360)379-4451 PERMIT #: BLD04-00603 Received Date 09/24/2004 SITE ADDRESS: 5500 WEST VALLEY RD Issue Date 10/25/2004 CHIMACUM, 98325 APPLICANT: CHARLES D NISBET PHONE: (360) 732-4328 JUDY NISBET 5500 W VALLEY RD CHIMACUM WA 98325-9750 SUBDIVISION: Block: Lot: + PARCEL NUMBER: 801044012 Section: 4 Township: 28 N Range: 01 W CONTRACTOR: ISLAND HAMMER LLC PHONE: (360) 697-9434 PO BOX 2435 POULSBO WA 98370 (360)697-6811 Contractor's License: ISLANHL015R9 Expires: 12/31/2004 PROJECT DESCRIPTION: ROOM & DECK ADDITION CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. ETBACK:.: UFFER: ,, Footing: if % :,- Foundation: Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: Shear Wall : Framing: Plumbing: Propane Tank/Lines. Insulation: K y lit Sheetrock: l' `/" Septic Syt Final Approval (If not on sewer): Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval( 9) ��(`-f--C:r< /' 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 CASE # BLD04-00603 1.) All construction activities shall not encroach upon the buffer. This includes the storage or preparation of materials. 2.) 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 addition to the single-family residence. 3.) An additional setback of five (5)feet is required from the edge of the buffer area to the proposed addition to the single-family residence. 4.) 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. 5.) 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." 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.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 11.) The building height is not to exceed 35 feet. 12.) The setback from access easement right-of-way is no less than 20 ft., side setbacks are no less than 5 ft., rear setback shall be no less than 100'to the property zoned Rural Forest 1:40 to the west of this parcel. If an environmentally sensitive area (ESA) is present, then the more restrictive setback shall apply. 13.) Exterior lighting for residential uses shall not exceed twenty feet(20') in height from the finished grade, excepting when such lighting is an integral part of a building or structure. Ground level lighting is encouraged. 14.) Lighting fixtures shall be designed and hooded to prevent the light source from being directly visible from outside the boundaries of the property. The intensity or brightness of all lighting, during construction and after project completion shall not adversely affect the use of surrounding properties or adjoining rights-of-way. 15.) A minimum of two (2)on-site parking spaces is required for the single-family residence. I:\F_BLD_Permit_Buildng.rpt 10/29/19 OWNER BUILDER STATEMENT i he signer of this statement does hereby certify they are the Owners of the parcel referenced herein, y 4re knot licensed contractors and that they will be assuming the J reessponsibility of the General Contractor for the proposed project. , -, Signature: C' � Date: 5,-- b0 -' 011 �.'��' 1 1-`t. 3ff 2 4 2004 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: i FAX, /s LRN ) / tZ. L�C (340)69-2-9sf,,� ` 3ibii) Q7:6 8// MAILING ADDRESS: ,[ 37 EMAIL: ! UCI i.(;( „'.., NILE, . CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Ty pe of Sewage Disposal: ❑ New ❑ Wood Existing: ❑ Sewer Addition ❑ Steel Proposed: Bank ❑community System ❑ Alteration/Remodel ❑ Concrete Total: , 9; Height: kI Individual System ❑ Repair ❑ Masonry SEP Permit# Bedrooms: ❑ Demolition ❑ Other: Water Supply: Existing: 3-: Setback: . ❑ Private well ❑ Two Party Type of Heat: Proposed: 00 ❑ Public Foicte At,. 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: ❑ Heat Stove ❑ Cook Stove ❑ Woodstove ❑ 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 ail 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 Oftice'jJse'0iily .' ,,ti�, , ` �� .�,�,, �vt�,� �, 3Ls. Current Proposed .P o A, v �e t ,, Main Floor , �n .E 3 Main /4 ,.f ,I irc Consistency Review ^}ice .,* ▪ zill 2 Floor Base fee: ' , : � t 3 Floor Additional Section: • ,_ z; ,, Mezzanine: Plan Check fee: i, /V�� tr , Heated Basement State Surcha( e fee: • a <' Unheated Basement Pot Water Review fee: .a a Other Unheated w !. ,, 911/Rd Approach fee: ;,errs 4 x= Garage/Carport �^�`" - ' TOTAL $ ", „fi'"� ' Decks �� ?: 1 �� eipt Number: �'�7s .� Other ' r Cash/Check Number • f• �` z f n - �z V. ESTIMATED COST(REQUIRED) Date• ,- "�• A`4 i a �-, ;- '` •Fair market value of all a d materia nc a ion to finish c l -� ;. ` �:i i " ri`` r `•' / �>0 " i�!5aia� -pp. �d .F• ham' .a"` M.7`-"�jrr `'i:'c F G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc /0TV JEFFERSON NTY � _ -- " --4440.41,- DEPARTMENT OF COMMUNITY DEVELOPMENT C i [� 621 Sheridan Street • Port Townsend •Washington 98368 It \` 360/379-4450 • 360/379-4451 Fax 4't SEP 2 w.co.jefferson.wa.us/commdevelopment SIN130<! ;:y ;. ;T Master Permit Application M Project Description(include separate sheets as necessary): ,n'r bcc-R- Tax Parcel Property Number: 0I d V,70/a Size: (acres/square feet) Site Address and/or Directions to Property: j,SD D Al sr(/A-ec.1y iD j a/4I4* f� zi}g_ q Property Owner(s)of Record: Telephone: 36O --752 - Fax: r• email: Mailing Address: Applicant/Agent(if different from owner): /.c niIro LLC Telephone: ..40-44979t�3Y Fax: ,3fg-6?7-48'// email: Mailing Address: _ P.D. �t� ��S Po ut�'BD !•L/,¢ 9�3�� Wtyat 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]** 19-Single Family aye fool ❑ Discretionary"D"or Unnamed Use Classification ❑ Garage Attached/Detached ❑Special Use(Essential Public Facilities)** ❑ Manufactured Home ❑ Boundary Line Adjustment ❑ 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** Cl 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 Cl 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 I ,,�' to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE C. '}�t�/�'�` Date: 24* t 0 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: CC 7? (t a. '" fJ'-7 Date: i i ,of-1 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. Signature: tr•-i) Date: / mil, 0 `f G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc