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HomeMy WebLinkAboutBLD2005-00134 , IJILDING PERMIT APPLICAAN SEP92-00142 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00134 Received Date: 3/7/2005 SITE ADDRESS: 284 CORMORANT VIEW DR BRINNON, 98320 OWNER: IAN MCFALL PHONE:('70) -] "I� --0 GENY MCFALL BOX 507 BRINNON WA 98320 SUBDIVISION: rixiAtikeEPZ5§111ORT PLAT Block: Lot: 1 PARCEL NUMBER: 502153051 Section: 15 Township: 25 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION REMODEL - CONVERT GAR TO BDRM TYPE OF WORK RES SQUARE FOOTAGE TYPE OF IMP ALT VALUATION 5,000.00 MAIN: 1,360 CODE EDITION: 2003 ADD'L: HEAT TYPE: HTP OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: CONST TYPE: OTHER: GARAGE: SHORELINE: CONST TYPE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: 2WELL — BEDROOMS: BATHROOMS: Exist: 1 Exist: 2 Prop: 1 Prop: 1 Total: 2 Total: 3 Routing Date: f %� f Type Amount Paid By: Date: Receipt: v t Permit $111.25 BAC 03/07/05 71565 AppR E r, Plan Check $72.31 BAC 03/07/05 71565 State Building Code $4.50 BAC 03/07/05 71565 MAR 3 t 2005 Potable Water Application $53.00 BAC 03/07/05 71565 Jefferson County Planning Total: $241.06 &Building Department i • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD05-00134 Received Date 03/7/2005 SITE ADDRESS: 284 CORMORANT VIEW DR Issue Date 03/31/2005 BRINNON, 98320 APPLICANT: IAN MCFALL PHONE: 360-796-0551 GLENYS MCFALL BOX 507 BRINNON WA 98320 SUBDIVISION: THACKER SHORT PLAT Block: Lot: 1 PARCEL NUMBER: 502153051 Section: 15 Township: 25 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: REMODEL - CONVERT GAR TO BDRM CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: UFFER: Footing: Foundation: Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: Shear Wall : Sheathing:Framing: J..)1 < b n^ om4--`-I Z) I J a_ Plumbing: Propane Tank/ Lines: Insulation: Sheetrock: Septic Sytem Final Approval (If not on sewer): Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: / 3_ ' HEALTH DEPARTMENT ND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. HOT LINE AVAILABLE 24 HOURS A DAY I:\F_BLD_Permit_Buildng.rpt 10/29/19 0 • c-c-,I Dining / 48=0" —3=2" A" 6=10" 4' 18=11' 3'-4" 1\ Tr x 4,11. OW'x rd.SO 2,10.1111,0. 2.-W x11,1r 2.4 r x ow- TM'11,0- 2,10.if Ire r-W it NW re) Nt J a Bedroom i t 0 ZN, co-n 1 0 '17 Living ... 4; i'd x fr-r PO mmmm Y-0-' , I 11 I ... \— 2=6" 8=4" / Closet J., , . 001 I 2...„.„,>. NLOCx7.09 1 Kitchen aamoysignicyl c.) c) t o D 12=0" X 1 en to _ t i c?._ 11.-11- / 8 v 1 I I CV CV a g t4r.OW co I 13'-4 X 16=6" ... . ...._ 3.../7. 21Laundry INP.x erd n, na )1.1 Si l W 1:c t c-i%(7,_ -?L--(3--ru ,..-. Garage g Goa kINC100 NOM-4r 1 0, ....- .... r .1 . . , a. ArYfOr4 4 �, „$oN-06 JEFFERSON•UNTY . 03C( De DGtS&ZGJ e• w A DEPARTMENT OF COMMUNITY DEVELOPMENT P(I L ~' ./ ` `' 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax _ ' 06 (4 V4� .1 ,,, O www.co.jefferson.wa.us/commdevelopment ` �; tt,' i J(fl i ' S'HINW. ---- = I. t: Master Permit Application 111114",, MLA: Project Description(include separate sheets as necessary): [ c.,0✓MI I)(,S'i,ivc- Pr77AcH-z Gam!''•-i L_ i,o- -- fi11�:owi Tax Parcel t)!r'1_ (.. Property Number: 5 / - I S"3 — U SI Size: I ,t-14 PcC(-i--S (acres/square feet) Site Address and/or Directions to Property: '2- 4 <c r-t c,(LA-ni V i, ►,-, (7--O (1 i,vlJ.:ry Property Owner(s)of Record: -+-IAtom •4 -c e-i[-y; rve F74-L--- ' Telephone: '3(.c - %'0.. - t.; S-:;"r Fax: email: 1•-e�ci Cl 3I2E.j Mailing Address: PA `�1 ( 1"/,"lv--,L +v.4 9 3 2- 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) ❑ Demolition Permit ❑ Conditional Use[C(a), C(d),or C]** XSingle Family ❑ Discretionary"D"or Unnamed Use Classification Cl Garage Attached/Detached ❑ Special Use(Essential Public Facilities)** I 1 Manufactured Home ❑ Boundary Line Adjustment H Modular ❑ Short Plat** 1 1 Commercial* ❑ Binding Site Plan** I i Change of Use ❑ Long Plat** [1 Address I I Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments** [J 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 ❑ 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 attorney'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: , l --"Ne". Date: 3)-7 c/hi, 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-transferalt resp¢nsi ility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: /f - `. Date: ),/J7/2cw G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc 0 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 assum g th responsibility of the General Contractor for the proposed project. Signature: i Date: � ) 1 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: 1111 ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX: ( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System )i' Alteration/Remodel ❑ Concrete Total: Height: LI Individual System ❑ Repair ❑ Masonry SEP Permit# t Z-c 14 1- O Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: L I Private well Two Party Type of Heat: Proposed: [1 Public , uatt» t}1(z- i4c6-7 t'utl` Total: 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 LI Above ground Tank Size of Propane Tank: . I I Heat Stove ❑ Cook Stove t I Woodstove [i Fireplace Insert Li Hot Water Tank ❑ Pellet Stove I 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 tRReevview: WA 2""Floor Base fee: lll •Z5-- 3f°Floor Additional Section: '. Mezzanine: Plan Check fee: 12- 1 Heated Basement State Surcharge fee: ,SO Unheated Basement Pot Water Review fee: n Other Unheated 911/Rd Approach fee: , Garage/Carport TOTAL: $ 2�5.do Decks Receipt Number: 7/�,- c Other Cash/Check Number: lC,/t`k4 ESTIMATED COST(REQUIRED) Date: , �� •Fair market valu vials foundation to finish )c.c.,..., Initials: ( n yfi .... G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc • S ���' °N eo� JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT RP 1'4 j� „, 621 Sheridan Street • Port Townsend • Washington 98368 , 0 of ,O 360/379-4450 . 360/379-4451 Fax http://www.co.jefferson.wa.us/commdevelopment/ I Stormwater Calculation Worksheet MLA# IW WA- PROJECT/APPLICANT NAME: iA C DETERMINING STORMWATER MANAGEMENT REQUIREMENTS:This stormwater calculation worksheet should be completed first to classify the proposal as"small,""medium,"or"large." The size determines whether a Stormwater Site Plan is required in conjunction with a stand-alone stormwater management permit application, building permit application, or other land use approval application that involves stormwater review. The basic information will also be helpful for completing a Stormwater Site Plan,if required. PARCEL SIZE(I.E.,SITE) Size of parcel i acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet L.a1(o .? sq/ft Land-disturbing activity is any activity that results in movement of earth, or a change in the existing soil cover(both vegetative and non-vegetative) and/or the existing soil topography. Land disturbing activities include, but are not limited to clearing, grading, filling, excavation,and compaction associated with stabilization of structures and road construction. Native vegetation is vegetation comprised on plant species,other than noxious weeds,that are indigenous to the coastal region of the Pacific Northwest and which reasonably could have been expected to naturally occur on the site. Examples include species such as Douglas fir,western hemlock,western red cedar,alder,big-leaf maple,and vine maple;shrubs such as willow,elderberry,salmonberry, and salal; herbaceous plants such as sword fern,foam flower,and fireweed. LAND DISTURBING ACTIVITY,CONVERSION OF NATIVE VEGETATION,AND VOLUME OF CUT/FILL Calculate the total area to be cleared,graded,filled, Answer the following two questions related to excavated,and/or compacted for proposed development conversion of native vegetation: project. Include in this calculation the area to be cleared for: Does the project convert%acres or more of Construction site for structures sq/ft native vegetation to lawn or landscaped areas? Drainfield,septic tank,etc. sq/ft Circle: Yes No, Li' Well,utilities,etc. sq/ft Does the project convert 2 th acres or more of native vegetation to pasture? Driveway, parking,etc. sq/ft Circle: Yes No Lawn, landscaping,etc. sq/ft Other compacted surface,etc. sq/It Indicate Total Volumes of Proposed: Total Land Disturbance / IOW P* sq/ft Cut Fill (cu/yd) [over] stormwater calc worksheet—REV.10/1/2003 1 i • Impervious surface is a hard surfacWt either prevents or retards the entry of water into the soil mantle as under natural conditions prior to development. A hard surface area which causes water to run off the surface in greater quantities or at an increased rate of flow from the flow present under natural conditions prior to development. Common impervious surfaces include, but are not limited to roof tops, walkways, patios, driveways, parking lots or storage areas, concrete or asphalt paving, gravel roads, packed earthen materials, and oiled, macadam or other surfaces which similarly impede the natural infiltration of stormwater. 414 STORMWATER CALULATIONS—IMPERVIOUS SURFACE NEW EXISTING Structures(all roof area) " sq/ft Structures(all roof area) f 34 sq/ft Sidewalks e'" sq/ft Sidewalks ci sq/ft Patios 1 sq/ft Patios V. sq/ft Solid Decks sq/ft Solid Decks "A-0 1../ sq/ft (without infiltration below) (without infiltration below) Driveway . C =1-zi' sq/ft Driveway '1 1:5751' sq/ft Other sq/ft Other (6 sq/ft Total New ( sq/ft Total Existing r C y e. �' sq/ft TOTAL NEW+TOTAL EXISTING* f` , 5-6'-' sq/ft `This amount will be used to check total lot coverage. The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT v. REDEVELOPMENT Divide the total existing impervious surface above by the size of the parcel and convert to a percentage: I % Does the site have 35%or more of existing impervious surface? Circle: Yes No FURTHER INSTRUCTIONS: If the answer is yes, the proposal is considered redevelopment and the attached Figure 2 should be used to determine the applicable Minimum Requirements. If the answer is no, the proposal is considered new development and the , attached Figure 1 should be used. At this juncture, the applicant should refer to the applicable Flow Chart to determine the Minimum Requirements for stormwater management. DCD staff will help verify the classification of the project and the application requirements. For proponents of "small" projects who must comply only with Minimum Requirement #2—Construction Stormwater Pollution Prevention—an additional submittal is not required. The proponent is responsible for employing the 12 Elements to control erosion and prevent sediment and other pollutants from leaving the site during the construction phase of the project. Pick up the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet. Proponents of "medium"projects—those that must meet only Minimum Requirements #1 through #5—and for "large" projects—those that must meet all 10 Minimum Requirements—are required to submit a Stormwater Site Plan. DCD has prepared a submittal template of a Stormwater Site Plan, principally for rural residential projects. Complete the template in the Stormwater Site Plan Instructions and Submittal Template or prepare a Stormwater Site Plan using the step-by-step guidance in the Stormwater Management Manual. APPLICANT SIGNATURE By signing the Stormwater Calculation Worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the 'pest of my knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the ffected roperty. t. * / likr-v-7) s (LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) • ....skit , 0Pa . ..,_y 1 t`1 ,. _. _ 41*•',44k.-d"/, ., •4 .',,,,,, .w- tZ,•y . .�.i.". 1:. ,..� . stormwater talc worksheet—REV.10/1/2003 2 C©dZae�ir�� Veewa cw7 - 1 _ 4 Lo DRS'I+WE ,Q�. I �Ee5�ar�4.g?de�e- ! y lip / TANS, La; .. ()ezEr- ' ro ice/ t O$j vlcf�rTl mo,? fi NOT ro SCA69 9110 IL IS G QT N A gEc d �s y�Ty � C e¢Ire4wMr V �CVi ikowh 4 ? VS4 R 1� SV 3 JCL` PQO?iQ Ty irPy 1P 'e— Rog'aSuu RD, 11 12 f 1 MAR - 7 2005 pcoltC! r.J A 1" --�...+ .�—r � � � 6 1 •.JJb i i� �F;� '91a +"i 4#+at./ �ci',..3� tsky PP 2 c i� V N 9PTS A'Pgq(Z SS 9wJ (� ! ? I G 502 - IS'J- 061 ;-84 C00-twoONO--4'kwJ 90*r7 SP � P,Ar.3 \�� 3�it��:� -4� Hai OAq, ���.� 2B4 COlLsnoF�N: �.Ew j�A. fat NNnN: Ivy=;����x '1�4. 3fsa.74C.o5sI e�YnkaaR 4 W'A 9632-10