HomeMy WebLinkAboutBLD2004-00754 1
SJILDING PERMIT APPLICAAIN MRL 04 Review Ty
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Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD04-00754 Received Date: 12/1/2004
SITE ADDRESS: r- A( MONTGOMERY LN
'' PORT LUDLOW, 98365
OWNER: MELINDA MORGAN PHONE:
25659 MARINE VIEW DR S
SEATTLE WA 98198
SUBDIVISION: PORT LUDLOW NO. 2 Block: Lot:
PARCEL NUMBER: 990600117 Section: 9 Township: 28 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION NEW SFR W/ ATTACHED GARAGE & DECK AND
A/G 120 GALLON PROPANE TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,959
VALUATION 189,230.00 ADD'L: HEAT TYPE: PRO
CODE EDITION: 2003 HEAT BASE: HEAT TYPE: HTP
OCCUPANCY: R-3 UNHEATED: # OF STORIES:
OCCUPANCY:
OTHER:
CONST TYPE: 5N GARAGE: 400 SHORELINE:
CONST TYPE: DECK: 208 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: SEW
WATER SYSTEM: LUDLOW 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 ate' F&W Landslide
1 1,5101-1 Q Iti, Shoreline Aquifer
Forest: Commercial Rural
Type 1 PPi� El I
T e Amount Paid Bv: Date: Receipt: d/
Permit $1,497.75 BAC 12/01/04 68734
Plan Check $973.54 BAC 12/01/04 68734 JAN 1 02005
State Building Code $4.50 BAC 12/01/04 68734 Jefferson County Planning
Potable Water Application $52.00 BAC 12/01/04 68734 & Building Department
Total: $2,527.79 uothir'1 .N0
r C-10_ 6_,0.-0-6
• •BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD04-00754 Received Date 12/1/2004
SITE ADDRESS: 394 MONTGOMERY LN Issue Date 01/10/2005
PORT LUDLOW, 98365
APPLICANT: MELINDA MORGAN PHONE:
25659 MARINE VIEW DR S
SEATTLE WA 98198
SUBDIVISION: PORT LUDLOW NO. 2 Block: Lot: 17
PARCEL NUMBER: 990600117 Section: 9 Township: 28 N Range: 01 E
CONTRACTOR: WEST SOUND DEV OF BAIN. ISLAND PHONE: (206) 786-5714
321 HIGHSCHOOL RD NE #265
BIANBRIDGE ISLAND WA 98110
PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE & DECK AND
AIG 120 GALLON PROPANE TANK
CALL IN FOR THE REQUIRED I SPCTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS: Z 2/23/�
U F F E R: Ale7 /iU2.57s?uE0 0-0-,5,0`;
J
Footing: ' z�z3 A5 '
Foundation: > G A5`
Stormwater FINAL Approval: j4sg-5' et_ / °6 alk lvri rife ygA� � �/
k 15
Underground Plumbing: l /
Underground Insulati
Shear Wall : j,eb) e ) jt MM .1//9/o5/
Framing: i C,pvt,GO (N3 4.--).,71-0'J— �16GCrieius 4K01/051#A,Plumbing: W(CA W I�(fij�7-2rli`1 J ,,Q� -��v £� 4.,,, goggereWS dk 1/29(OS
Propane Tank/ Lines: Arc P i i OK 4/9 d5 \� _
Insulation: Dk f/z,6 OS
Sheetrock: � 15
Septic Sytem Final A prov I (If not on sewer): -
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval: ;91Y 4, ??/O1 <cyz/'S
4 7 4/, '
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 # BLD04-00754 •
1.) 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.
2.) 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.
3.) 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.
4.) 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.
5.) The property owner shall comply with Water Conservation Measures (per list maintained
by the UDC Administrator).
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.) A Revised Stormwater Site Plan has been submitted and approved by the Department of
Community Development and accepted by the Port Ludlow Drainage District. Once the
subject permit has been issued the applicant shall fully implement the provisions of the
submitted plan and contact the Jefferson County Department of Community Development
to arrange a schedule to inspect the property for plan compliance. A Certificate of
Occupancy will not be issued until the Department verifies plan compliance. No clearing
for roadways or utilities shall occur on the project site until clearing necessary for the
installation of temporary sedimentation and erosion control measures have been
completed.
8.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
I
•
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 45%. 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.) Minimum setback from Montgomery Lane right-of-way shall be 20 feet. Minimum side
and rear yard setbacks shall be 5 feet.
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 shall be provided for the single family
residence.
16.) Per MPR Code Section 3.107, Accessory Dwelling Units (ADU's) shall not be allwed in the
MPR-SF zone.
17.) IN ADDITION TO ROOF DRAINS, A FOOTING DRAIN ALSO BE INCLUDED THAT
EXTENDS AROUND THE ENTIRE HOUSE. BOTH OF THESE SYSTEMS SHOULD BE
DRAINED BY A TIGHT-LINE TO THE MONTGOMERY LANE ROADSIDE DITCH
18.) AN INTERCEPTOR DRAIN SYSTEM BE INCLUDED ACROSS THE BACK (WEST SIDE)
ALONG THE NORTH SIDE OF LOT 17 TO INTERCEPT THE UPLAND FLOW AND
ROADWAY RUNOFF. THE INTERCEPTED FLOW SHOULD BE CONVEYED TO THE
MONTGOMERY LANE ROADSIDE DITCH.
I:\F_BLD_Permit_Buildng.rpt 10/29/1999
1;',-,
ox JEFFERSON $JNTY ,DEPARTMENT OF COMMUNITY DEVELOPMENT
�' ` 14 621 Sheridan Street• Port Townsend •Washington 98368 DEC _ 1 2004
360/379-4450 • 360/379-4451 Fax
� www.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA: 04 _ 2 (Osq
Project Description(include separate sheets as necessary):
S F fZ i ..,1f ,P C9
Tax Parcel Property
Number: 99 0(,o0 117 Size: (acres/square feet)
Site Address and/or Directions to Pro, fit
: X /fb,�$q o,,i e_r 1.w,4._ PO 1-} /-- ,�I s w' 1-i� 9 3&S
Property Owner(s)of Record: 1�gt1e i1, "A,re)eA r\ r
Telephone: 2O ro -286- S 7/`/ Fax: Z00-8-3 -/0/7 �"' email:
Mailing Address: a/o /Ke,a,-. C r'�sS 3.z i ,�-_-,ei JG AO.,I IC /\/ /3;1,n 5e',J L S/) iii`, 47 6"
Applicant/Agent(if different from owner): We -- _Co v,.,,C IZ=�<-dot,irt,-,,-I /5e4,-,,-, ,,ii •A,1,-,,,,-, k,--
Telephone: 26)6 786,`S-2ry Fax: Za6 - 13--'0/3 email:
Mailing Address:32 / i-/! /-.f�c.s+d/ Q} ",;• g..--,,-. ,. c,o�,, .22S/, _�.0 G.��j .-,3 /C- j'//0
What kind of Permit?(Check each box that applies)
X Building El Variance(Minor, Major or Reasonable Economic Use)
❑ Demolition Permit ❑ Conditional Use[C(a),C(d),or C]**
l Single Family ❑ Discretionary"D"or Unnamed Use Classification
)i 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**
XAddress ❑ 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
0 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 Wi s 1-�So..,J !l, I,/,-,e...%� /Ce,,,;z C ai;fo act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE J� \ yN, Sv � �3�,� Date: // -�r'�) ,_ °'-'
r
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: - ,,- ��v,,,r �/ Date: //—3U—C(/
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: - Date: //—.7U'ciV
G:\PennitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
. 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 and that
they will be assuming the ressibility of the General Contractor for the proposed project.
Signature: -----
/1776,u� Date: //- ?o —vY
DEC - 1 71104
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
-, 1, 1" / . . ./ (206 ) (2Ci&) 8s,5=iv,3
MAILING ADDRESS: ,,,"..,/ r-MA �� .q 0//0
CONTRACTOR'S LICENSE INAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: Upsd- 5,,,,,,.. i2,S1 y,,, Gc,,,J-c - PHONE{,.� (3(00 )�.ot 7-8237 FAx:(3Gv )297 - Si33o
-MAILING ADDRESS:10ct00 N(s suede l i,7„ !OS! go, Bow, /if y 2. EY"Cl/ti5 S L✓`1 l B?y(Q
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
X New X Wood Existing: XSewer
❑ Addition 0 Steel Proposed: 2 Bank ❑ Community System
❑ Alteration/Remodel 0 Concrete Total: 2 Height: ❑ Individual System
❑ Repair ❑ Masonry SEP Permit#
❑ Demolition 0 Other: Bedrooms: Water Supply:
Existing: Setback: 0 Private well 0 Two Party
Type of Heat: Proposed: 3 X Public
l=kc•►-nc (/it., PL.. ) Total: 3 Name of System:
CS/y.•yir Is/S/er /J«.-tc
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 ,'l3C Above ground Tank Size of Propane Tank: /.26,
❑ Heat Stove 0 Cook Stove 0 Woodstove X 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 For'Office`Use Only z v, 4 ' ' `,;,
Current Proposed , "1 f' ''� �' �` '&
Main Floor „.Consistency Review: 4,4,4 4 : 4w � f i. U ".
/,IS, Il9R , r:
2Nu Floor t 'Ease fee: ,; , k
3f 3 Floor Additioonal Section ,ry, �'{, r s� . trip.,;,,
N/� i �t 4wa..
Mezzanine: `' Plan heckfee t, ' ▪ i
Heated Basement - State;Surchagefee: ; a -9 ;
l
Unheated Basement Pot Water Re r i Y $ t'
Other Unheated /�/ 911/Rd Approach fee::t � ,� i 4 ",4
61
Garage/Carport T r�C�3f� °, --4.i,ei.;^� - `y ,
Decks Receipt Number. �' sti ' = x "(fur,2v zy d `r Mtn'�L + a '''''AZ'
t
Other — -Cash/Check Number - . 1 �`.`' , ari - a `
/ � �.0 IJ. �, '��sTr" '.!-'�iy ¢ + t� yr. �
ESTIMATED COST(REQUIRED) a304bate: ,r am i ru1,'�,4 4 ,*, ,� ! #4.1
•Fair market value of all labor and materials foundati to fi $° ':`tt ' W ` '▪ `
��� �4"A xf y�^'{� yL u x
dials: , '!4 ,. r, �.• 3 ' ;,-
/6.0,o ov
G:\PemritCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc