HomeMy WebLinkAboutBLD2005-00135 • •
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00135 Received Date 03/7/2005
SITE ADDRESS: 720 NO NAME RD Issue Date 03/23/2005
PORT LUDLOW, 98365
APPLICANT: LARRY L HESS PHONE: 360-732-6818
CAROLYN R COLLETT
PO BOX 951
CHIMACUM WA 98325
SUBDIVISION: Block: Lot: T 12+
PARCEL NUMBER: 821063013 Section: 6 Township: 28 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
•
PROJECT DESCRIPTION: NEW UNHEATED BARN/SHOP WITH 224 sf HEATED OFFICE. 544 sf
UNHEATED MEZZANINE Pc,k-bukA4,
1
15
CALL IN FOR THE REQUIRED S ECTI•NS THAT APPLY TO YOUR PROJECT.
SETBACKS: G1 /"5,:I
UFFER:
Footing: ios-t HOL&c OK 4/10 5 .7OST h— 3/s-/O i-
Foundation: ,i,'A
Stormwater FINAL Approval:
Underground Plumbing: N/,4
Underground Insulation: /'0/'4
Shear Wall :
Sheathing: /'1
Framing: i//l4/dd iV
Plumbing: 1 ./4
Propane Tank/ Lines: L • Ro N� __4fhv. (..ri,i4ae; 01< 11410i ,/'//�/y/��
Insulation: -i/c( /u. �z t./�alziI-�' -7 ( � /5,•-b< '� Y1
Sheetrock: c- r ez k'4-7/ .J /04/08/1/
Septic Sytem Final Approval (If not on sewer):
Road Approach Final Approval:
Zoning Final Approval: n
Final/Occupancy Approval: c 4( 4 r - ,e r.- I
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
� )N UILDING PERMIT APPLICA MLRAOe 00137
Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00135 Received Date: 3/7/2005
SITE ADDRESS: 720 NO NAME RD
PORT LUDLOW, 98365
OWNER: LARRY L HESS PHONE: 360-732-6818
CAROLYN R COLLETT
PO BOX 951
CHIMACUM WA 98325
SUBDIVISION: Block: Lot: T 12+
PARCEL NUMBER: 821063013 Section: 6 Township: 28 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION NEW UNHEATED BARN/SHOP WITH 224 sf HEATED OFFICE. 544 sf
UNHEATED MEZZANINE STOK,46E /t,/y Lor7
iu-J-111)iNf"\.5
TYPE OF WORK RES SQUARE FOOTAGE: �cy"'l
TYPE OF IMP NEW MAIN: 1,920
VALUATION 73,157.00 ADD'L: 224 HEAT TYPE: PRO
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: _,
OCCUPANCY: UNHEATED: 0 # OF STORIES:
CONST TYPE: " - OTHER: 544 SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM: PWELL
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total:
Routing Date/9 05 Cr .
Type Amount Paid By: Date: Receipt: AP�,p�rOv
Permit $811.75 BAC 03/07/05 71611 IL� p� ^
Plan Check $527.64 BAC 03/07/05 71611 MAR
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State Building Code $4.50 BAC 03/07/05 71611 2 3 2005
Total: $1,343.89 Jefferson County planning
&Building Department
SPECIAL CONDITIONS FOR CAE # BLD05-00135
1.) NO PLUMBING APPROVED FOR THIS STRUCTURE
2.) A setback of 225-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.
3.) The project is located in close proximity to an identified wetland and is subject to the
delineation provisions of Section 3.6.9 of the Jefferson County Unified Development Code.
Based upon the proposed location of the project in relation to the identified wetland, the
applicant has agreed to maintain a buffer (setback) that exceeds the standard buffer
requirements by fifty (50) percent. The applicant acknowledges the additional setback
and agrees to maintain the extra 50 percent buffer, therefore, waiving the wetland
delineation requirements of the Unified Development Ccce.
4.) 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."
5.) A permanent physical separation along the upland boundary of the wetland 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.
6.) All construction activities shall not encroach upon the buffer. This includes the storage or
preparation of materials.
7.) 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.
8.) 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.
9.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
10.) 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).
11.) Maximum lot coverage is not to exceed 10%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
12.) The building height is not to exceed 35 feet.
13.) Setback from No Name Rd. right-of-way is no less than 20 ft., setback from the easement
located along the northern parcel boundary is no less than 20 feet(or 50 feet from the
parcel boundary), 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.
I:\F_BLD_Permit. Buildng.rpt 10/29/19
• 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 esponsibility of the General Contractor for the proposed project"4//::kr--
Signature: Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAQ
( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shor Tine: Type of Sewage Disposal:
New r24, Wood Existing: _ N .11- n Sewer
O Addition ❑ Steel Proposed: a Ban ❑ Community System
❑ Alteration/Remodel 0 Concrete Total: Height: ❑ Individual System
❑ Repair ❑ Masonry SEP Permit#
Bedrooms:
❑ Demolition g Other: Water Supply:
3 Je 'gQ -r% Existing: Setback: Private well ❑ Two Party
Type of Heat: Proposed: D ❑ Public
ePrOparie, 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 0 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 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 ce-Use Only a.Ws j V
Current Proposed 0 Amount . . y
Main Floor Consist ;Review: Z. - -• °{
2rt"Floor r Base fee: r b : °Ca
h
3m Floor Additional Section: _ 3
Mezzanine: y/ oM ' , I S�/ , ! 0 Ie Plan Check fee:Li ��°
Heated Basement ---tate Surcharge fee: 1�
S 7, ,,4 Y
Unheated Basement Pot Water Review fee: = - R Y
1 �: • �6
t - ),.G, kayz�q 2ii ;
Other Unheated 911/Rd Approach fee: Y �-:i a
Garage/Carport 1 �';- € .� ,;
TOTAL z- ,
Decks a ! x h � .
Receipt Number. r . ,-`Y�
Other ., . .. Cash/Check Number ' � � ' Y
ESTIMATE I OST(REQUIRED) itittt%
�� Date: �db p — 7 2005 A � ►7y,,,,..- ,,,,,A.,,,, ,A0.427, , /us s
.Fair ma • value o I labor and materials foundation finish ::
Initials: `� �
4
G:\PeanitCenter\".•za.•. 10 FO etrnit Application 7-8-04.doc
(i/--;i:96—r,f----No_
b. •JEFFERSON C JNTY • 1
'� DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax [,(A P - 7 2005
�q c5 www.co.jefferson.wa.us/commdevelopment
S�NGrS . ..
Master Permit Application MLA: �. -. 13 9
Project Description(in de separate she as necessary):
Tax Parcel Property Number: 8 �7
21 CC 30 13 !Size: , 2 acre quare feet)
Site Address and/or Directions to Property: 7 20 N G N,h* E# - C2.D D . t�OR.T LuO La.J w
i 4 �83(os
Property Owner(s)of Record: L R ,.sz.y L. - c, Q.o LKN . I-- .5 5
Telephone: 36.0 7 32. !oB I B Fax: SAME email: NE ss&.AR iL4 LQ t..cow
Mailing Address: PO cnc 9 5-1 G Hi An,ACc)ivt I wtar .183 Z 5—
Applicant/Agent(if different from owner): —
Telephone: — Fax: email:
Mailing Address: —
What kind of Permit?(Check each box that applies)
)CBuilding ❑Variance(Minor,Major or Reasonable Economic Use)
❑ Demolition Permit ❑ Conditional Use[C(a),C(d),or C]**
❑Single Family ❑ Discretionary"D"or Unnamed Use Classification
❑Garage Attached/Detached ❑Special Use(Essential Public Facilities)**
❑ Manufactured Home Cl Boundary Line Adjustment
❑Modular ❑ Short Plat**
Commercial* ❑ Binding Site Plan**
❑ Change of Use ❑ Long Plat**
❑Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRD)IAmendments**
❑ 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 L.A.I2.((t4 L. . I- 5S to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE `...--- Date: Vii/Q.S-
m,By signing ication 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
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
1 hours.
Signature: Date: ?j 1...r—
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 r ponsibi ity for adhering to and complying with the ESA. The Applicant has read this disci ire nd signs and dates it below.
�y�Signature: Date: S
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
! t
. le r I I Ilikt,1, JEFFERSON COUNTY
144 DEPARTMENT OF COMMUNITY DEVELOPMENT
"4' 621 Sheridan Street• Port Townsend •Washington 98368
0 fi0 360/379-4450 • 360/379-4451 Fax
http://www.co.efferson.wa.us/commdevelopment/
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# 0 S-- 13 'J` PROJECT/APPLICANT NAME: 14-t..5s` ru /3ior` cxfr—AG.
Please answer all of the following questions to the best of your ability. Where the question calls for depiction`on a site map, the
applicant may choose to either incorporate the elements into the general plot plan for the Master Land Use Application or to submit a
separate stormwater site plan map.
Project Overview
1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the
site map.
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Existing Conditions]Summary
2. Describe the existing topography. Indicate contours on the site i„map
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3. Describe the existing vegetation. Indicate native veg- ation areas on the s"te map.
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4. Des• ibe th- existing soils. Indicate...sot type on t ye rrlap. 6 1
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5. Describe the 'sting site hydrology(i.e.,drainage;behavior of water on the site—above, below,and ion the ground). Indicate
existing stormwater drainage to and from the site on the site map. Depict separate drainage basins on the site map, if
applicable,and indicate acreage of ea .
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6. Describe any excess levels of noise generated by the proposed use or activity:(t
_ APPROVED
STORMWATER PLAN
MAR 222005
storrnwater site plan template—rev.10/1/2003 5
JEFFERSON COUNTY
1)EPT.OF C'n�IINITY DEVELOPMENT
SI(NATt;RE: 7 �1 lf-
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7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams,
steep slopes, tc.)on the site. Iodic to location on the site map.
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8. Describe the general vicinity of the site, including adjacent land uses and structures, utilities, roads,and sensitive/critical areas
st�e�ms,wetlands, lakes,steep lopes/ etc.)
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Permanent Stormwater Control Plan
This portion of the Stormwater Site Plan consists of the selection and installation of the appropriate stormwater control BMPs
and facilities to remain in place after construction of the project is completed.
"Medium" size projects are required to have the totals calculated of all impervious surfaces, pollution-generating impervious
surfaces, and pollution-generating pervious surfaces to verify that the thresholds for treatment facilities and flow control
facilities are not exceeded.
9. Describe the developed site hydrology, as proposed. Indicate whether stormwater will be fully dispersed(i.e., per BMP T5.30
in the Manual)or, if not,what types of stormwater flow control will be utilized for the site or specific threshold discharge areas
within the sit . Locate se.facilities on the sit lan nd differentiate propos facilities from exis ng fa ilities.
err ir-esh
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10. If the project requires the use of stormwater treatment facilities, describe the types of stormwater treatment facilities proposed
for use on the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. [This is
normally for large"projects or projects that involve the potential for dispersion of contaminants.]
11. Descria the performance goalQand standards applicable to the project.
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12. Describe the flow control system.
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stormwater site plan template—rev.10/1/2003 6
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13. Describe the water quality system.e r
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14. Desc 'be the conveyance system analysis and design.
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15. Describe the sou�of fill material,physical characteristics of fi mate'al,an de osition of excess material.
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16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code.
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17. Describe the proposed surfacing material.
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18. Describe methods for restgration of the site.
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19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for
"large"projects only and only those for which facilities are required to control flow or treat runoff.] If included,list the Manuals
here.
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20. List ere and include any special reports or studies conducted to prepare the Stormwater Site Plan.
A./ /I
21. List other necessary permits and approvals as required by other regulatory agencies. If those permits or approvals include
conditions that affect the drainage plan or contain more restrictive drainage-related requirements,describe those conditions or
restrictjons here.
stormwater site plan template-rev.10/1/2003
7
I
CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN(SWPPP)
The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the
template that follows must be installed on the ground during all construction phases of the project. The proponent is responsible for
preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater
Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential
development.
SECTION I—CONSTRUCTION SWPPP NARRATIVE
1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or
will be addressed. Identify the type and location of BMPs used to satisfy the required element. If an element is not applicable
to the proposal,justify in writing. Descriptions of the 12 Elements are found at section 2.5.2 of the Manual(beginning on page
2-15).
12 Required Elements—Construction SWPPP
1. Mark Clearing Limits.
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2. Establis Construction Access.
3. Control Flow Rates.
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4. Install Sediment Controls.
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5 Stabilize Soils.
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6. Protect Slopes.
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7 Protect Drain Inlets. j
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8 storrnwater site plan template—rev.10/1/2003 _
•
12 Required Elements—Construction SWPPP(continued)
Stabilize Channels and Outlets.
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Control Pollutants.
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•
1 . Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site).
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11. intain pest Management Practices(BMPs).
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12./Ma{�age the)Project.
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2. Adjacent Areas.
a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential
areas, roads).
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b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards).
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3. Environmentally Sensitive Areas.
a. pescripition of envirorlmen ally sensitive areas that are on or adi% nt to the site.
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stormwater site plan template—rev.10/12003 9
r fib. 5criPtion of pecial equir a is for working in or near environmentally sensitive are .er„...,....2
10 0-11- t-,...»i I ,PNWT p ifer_ ifr7 oe- A ear--
4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site
soils
/(e. .,erodibility,settleability,permeability,depth,texture,soil structure).
41-
5. Construction Phasing.
a. Construction sequence
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b. Construction phasing(if proposed)
6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
I. Provide a pro sed nstry+ction schedule.
II. Wet Season Construction Activities.
a. Proposed wet season construction activities.
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/ b. Proposed wet season construction activities for environmentally sensitive areas.
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7. FinanciaVOwnership Responsibilities.
a. Identify the property owner responsible for the initi 'on of bonds and/or other financial securities.
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b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
pacts.
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8. Engineering Calculations. Provide Design Calcula pns on a separate sheet for the following,if applicable. Ilkt M__
a. Sediment Ponds/Traps. _�. - ---- i
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b. Diversions. f
c. Waterways. MAR I 1 2n75 1'
d. Runoff/Stormwater Detention Calculations
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stormwater site plan template—rev.10V1/2003 10
Stormwater Site Plan Changes
If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan,the proposed revisions shall be
submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised
drawings showing any structural changes,and any other supporting information that explains and supports the reason for the change.
Final Corrected Plan Submittal
If the project included construction of conveyance systems,treatment facilities,flow control facilities, or structural source control BMPs
(not standard on-site stormwater management BMPs),the applicant shall submit a final corrected plan ("as-builts")when the project is
completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as
constructed.
APPLICANT SIGNATURE
By signing the Construction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and
correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all
owners of the affected property.
.3 70..5-"—-----
IZED REPRESENTATIVE SIGNATURE) (DAT
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
I
i MAR 1 1 2005
stormwater site plan template—rev.10/1/2003 12
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IdRO CT' HESS FAMILY HOM MO BRICAYSOC‘P
Designed and Drafted by: /0//5/61 R. ':-.0 3 jki/05" tc: '
t.;..r
TOR SITE ONLY/ (no moil to this addressj --I-
LARRY L. HESS
PO Box 951
0 Fig LARRY L. cf CAROLYN HE55
11
il; • 720 NO NAME RD„PT LUDLOW, WA
CHIMACUM, WA 98325 -4 fli." M HM 206-579-5159 CELL
360-732-6818 HM 206-679-5159 CELL 360-732-6
PARCEL NO. 821063013