HomeMy WebLinkAboutBLD2004-00798 •UILDING PERMIT APPLICAN MRLA04 00eview p698
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD04-00798 Received Date: 12/15/2004
SITE ADDRESS: 1864 BEAVER VALLEY RD
PORT LUDLOW, 98365
OWNER: CARL D LOPEMAN PHONE: (360) 732-4582
CAROLYN LOPEMAN
1864 BEAVER V ALLEY RD
CHIMACUM WA 98325
SUBDIVISION: C&C LOPEMAN SHORT PLAT Block: Lot: 1
PARCEL NUMBER: 821183021 Section: 18 Township: 28 N Range: 01 E
CONTRACTOR: HANS VODDER CONST PHONE: (360)732-4985
231 BELFRAGE RD
PORT LUDLOW WA 98365
Contractor's License HANSVC*198MG Expires 8/29/2003
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOF NEW SFR W/ATTACHED GARAGE &
A/G 120 GALLON PROPANE TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: [ .< 1,976
VALUATION 195,682.00 ADD'L: HEAT TYPE: PRO
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: # OF STORIES:
OCCUPANCY:
OTHER:
CONST TYPE: 5N GARAGE: 73Z-788 SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: PWELL PARCEL TAGS: YES NO
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Exist: Exist: Wetland Erosion
Prop: 3 Prop: 2 Seismic Streams
Total: 3 Total: 3 Flood Way Floodplain
Routing Date: _ (3_______)' F&W Landslide
,( C� ��`� Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid Bv: Date: Receipt: Approved/Date
Permit $1,531.35 BAC 12/15/04 68857 APPROVED
^
Plan Check $995.38 BAC 12/15/04 68857
State Building Code $4.50 BAC 12/15/04 68857 MAR _ 2 2005
Potable Water Application $52.00 BAC 12/15/04 68857
Jefferson County Planning
Total: $2,583.23 & Building Department
atc,,,.. ()Pp
i
BUILDING PERMIT •
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD04-00798 Received Date 12/15/2004
SITE ADDRESS: 1864 BEAVER VALLEY RD Issue Date 03/2/2005
PORT LUDLOW, 98365
APPLICANT: CARL D LOPEMAN PHONE: (360) 732-4582
CAROLYN LOPEMAN
1864 BEAVER VALLEY RD
PORT LUDLOW WA 98365
SUBDIVISION: C&C LOPEMAN SHORT PLAT Block: Lot: 1
PARCEL NUMBER: 821183021 Section: 18 Township: 28 N Range: 01 E
CONTRACTOR: HANS VODDER CONST PHONE: (360).73z''-4312
231 BELFRAGE RD - r�� $5-
PORT LUDLOW WA 98365
Contractor's License: HANSVC*198MH Expires: 8/29/2005
PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE &
A/G 120 GALLON PROPANE TANK
CALL IN FOR THE REQUIRED IN PECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS: Off' //M. os
UFFER: DK 3/14/06
Footing: ay t/ethn 045, E 1-E z i r fres * CA45
Foundation:0k /z�,os*
Stormwater FINAL Approval:
Underground Plumbing:
Underground Insulation:
Shear Wall : E r6Zok . i46;402A441.14 erk 005, --
Framing: COCO 6 1 7—v �—�
Plumbing: �Z
Propane Tank/ Lines: D.. >.o* `,, , l c���� t (J e 70-2 c�
Insulation:C.4k,'( -ICI
• Sheetrock: D,�C 7�oS �/ 5,4e-A.e./.4izz.z.s Die 0/0Vgli
Septic.Sytem Final Ap rova (If not on sewer):
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval: -m- �D 213/4
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 A BLD04-00798 •
1.) 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.
2.) A Medium Stormwater Plan has been submitted and approved by the Department of
Community Development. 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.
3.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
4.) 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).
5.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
6.) The building height is not to exceed 35 feet.
7.) Setback from SR 19 right-of-way is no less than 35 ft., 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.
8.) 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.
9.) 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.
10.) A minimum of two (2) on-site parking spaces is required for the single-family residence.
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• 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 vial be assuming Lie responsibility of the feral Contractor for the proposed project.
Signature: - Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
/�f/t,4 > I; L:1646%/1 (5 r )7 3A ' '19ard_J— ( )
MAILING ADDRESS: 3, / /g•/f,,i J' y_3� pe�S 7/u�A.v _ EMAIL:
CONTRACTORS LICENSE /� WAINS
NUMBER: //,'y iI- 'is or 344- / 7g /// NUMBER -
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: frame Type: Bathrooms: " Shoreline: Type of Sewage Disposal:
New 14 Wood Existing: ❑ Sewer <.J
❑ Addition 0 Steel Proposed: �,_ Bank 0 Community System /' J
❑ Alteration/Remodel ❑ Concrete Total: Height: t lndividual System {.�
❑ Repair ❑ Masonry SEP Permit# :0*21 C.
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: t Private well ❑ Two Party
Type of Heat: Proposed: ❑ Public
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:
❑ Undergrounc4Tank -Ei.Above ground Tank Size of Propane Tank: /_ 2. 0
❑ Heat Stove Cook Stove 0 Woodstove k 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:
he propane tank to all property lines,buildings and se
tem components,
including the reserve area.
.,,A..:___ (4 .2,,
Square Footage "p''1. �"� �; F'"ip7:Current Proposed .A t1'x � ,. . • ; 1 , t �"r�4 `Main Floor /� �^ `dt . a"'c2 Floor .� p .. ,,, yowl!" " I-0
3"0 Floor f L
t . " .d EMezzanine: - S44.0
Heated Basement 1 , e -� , s � *�-�i h¢., ti CUnheated Basement �t r ) `,`���rr�-� ` ' �,T.���?�,� r ,.-,= , -� �Ty-�� ,,i 7u�t ,-�R,"" .Y`�Ti e '�, t s ' ti 1"
Other Unheated 11 p�53� t. �Erb 4rz=�iiK"•K i` ' - �+� r 4
Garage/Carport- 7.,y' +iv,. . (ct pp h w b .w.
L (`ter YM `� b,,:s ,- 1iw ,RT
Decks 12 a a rr i "a., rt
Other . t, . '.:ttc, ; `'s 7
ESTIMATED COST(REQUIRED) _ E iti., �«a :t f e,. .y ',�' 4*r sx,,p' +s si r. _,a
•Fair market value of all labor andy`materials foundation to finish
' f�` ! `�- ,t f - (a j S i
(i' C% .. _ ... �, ..�-.:',4kft 'C' ram_ �+ \)``
yI f I Li/ I I kik 4 V
G:\Pe:mitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc e f , . _
4., ' °N c0< JEFFERSOWOUNTY III�4 DEPARTMENT OF COMMUNITY DEVELOPMENT ‘)
`i . 621 Sheridan Street • Port Townsend-Washington 98368
360/379-4450 • 360/379-4451 Fax
p� www.co.jefferson.wa.us/commdevelopment DEC 1 5 2004
�iINO
Master Permit Application ;MLA: Z_ (.0q
Project Description(include separate sheets as necessary): —. -- ,
._. )'/?c /•-• 4.1 y-1-, ;1,4 g tit 9e.-4 r-6,t, ._::e.---).
Tax Parcel Property Number:/ /.5 3 rJ2./ Size: /-4L1e,, x r,,,,16 3, /�;
..,jacr quare feet)
Site Address and/or Directions to Property: f6 7` L�4,adt,- / //c'c,. M-/
Property Owner(s)of Record: A/e./ L , pe i,-re-r♦/
Telephone:3 ) 7 5'v? ,/SS''2- F email: .
Mailing Address: /�'4:• L3r-a �- /�M//tee jet/.
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies)
A Building ❑Variance(Minor, Major or Reasonable Economic Use)
❑ Demolition Permit 0 Conditional Use[C(a),C(d),or Cj**
A Single Famil ❑ Discretionary'IX or Unnamed Use Classification
Garage Attach-• Detached ❑ Special Use(Essential Public Facilities)**
❑ Manufactured Home 0 Boundary Line Adjustment
❑ Modular Cl Short Plat**
❑ Commercial* ❑ Binding Site Plan--
❑ Change of Use ❑ Long Plat**
❑Address 0 Road Approach El Planned Rural Residential Development(PRRD)/Amendments**
0 Propane ❑ Plat Vacation/Alteration**
❑Mowed"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 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 ifs 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.
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 inspecti .Access and right of entry to this property shall be requested and shall occur only during regular business
hours.
Signature: ( ez Date: / v - ` c'y
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 compl' wt e Jitr,.on County development code.The Applicant acknowledges that he,she or it holds individual
and non-transf a res n iiili y'adher g tc:A complying with the ESA. The Applicant has read this disclaimer and signs an dates it below.
Signature: �� � �`l Date: f 2 '/ .— C%I
G:\PenmitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc jjjj