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Home My WebLink AboutBLD2005-00143 ItUILDING PERMIT APPLICAC MLA05 00143 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00143 Received Date: 3/10/2005 SITE ADDRESS: 21 DEER HOLLOW RD PORT LUDLOW, 98365 OWNER: NORTH SOUND # 1 LMTD PARTNERSHI PHONE: 206-786-5714 K CROSS-W SOUND DEVELOP 321 HIGHSCHOOL RD NE#265 BAINBRIDGE ISLAND WA 98110 SUBDIVISION: SOUTH BAY#1 Block: Lot: 31 PARCEL NUMBER: 995500031 Section: 21 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 Contractor's License WESTSSD966R2 Expires 12/22/2006 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr NEW SFR W/ATTACHED GARAGE & A/G 120 GALLON PROPANE TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,950 VALUATION 215,000.00 ADD'L: HEAT TYPE: HTP CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: # OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N SHORELINE: CONST TYPE: GARAGE: 594 SETBACK: DECK: 204 BANK HEIGHT: SEWAGEDISPOSAL: SEW WATER SYSTEM: LUDLOW BEDROOMS: BATHROOMS: Exist: Exist: Prop: 3` Prop: 2 Total: 3' Total: 2 Routing Date //o /v Type Amount Paid By: Date: Receipt: Approved/Date Permit ' $1,643.35 BAC 03/10/05 71619 APPROVED Plan Check $1,068.18 BAC 03/10/05 71619 State Building Code $4.50 BAC 03/10/05 71619 MAR 3 1 2005 Potable Water Application $53.00 BAC 03/10/05 71619 Jefferson County Planning Total: $2,769.03 &Building Department \141111r . , .. S '.ce-41,,..,k • ic,O 21 rJ06Z I - , 83 _ n / ; , S`% till rtot tam_-A f,- - i \ ,,,_ (4-- 0 , , NI A A Y �,I ; ; j I .... ;--- _______________44i I�II \\\ \\(2 \ I v \ \• \% ,,_ i ( _ __` rII i �v TIT' ;: 1z1 Ole. v >v 1 • / "s----'90e... , ‘• / ('' ......i...--14 \CA /• Q \ `,.l J ` `� 1 / `-- ..... \`.\ -/ -- 1°/d .ram �'��• 1`h �<<k sOa .S a J� f APPROVED SITE PLAN -- �! MA,t 1 2OO5 - . _ 07 oil JEFFERSON O Ty DE T.OF CO I D ELOP' ENT SIG ATUR , L 3 1 Storrawater S Required tltl; ;vy,or,r, So mil. G.‘.) -tt l 5e'�L<<icf- Ts,e_ 7/ 9 ci sSo 00 3 I Mar+L, So.-., P11 i C,wit, Pc,4 .tC., Ei -� INmf'f- E o,.-..J /Der e/oe.,-�.,d c f '',-, !I-.'_,r,,/ �7 '\I Le 1,- -c O'C�li#on 00 CERTIFICATE OF OCCUPANCY Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 (800) 831-2678 PERMIT #: BLD05-00143 SITE ADDRESS: 21 DEER HOLLOW RD Issue Date: 03/31/2005 PORT LUDLOW, 98365 Final Date: 9/4/2008 APPLICANT: NORTH SOUND# 1 PHONE: 206-786-5714 PO BOX 2745 GIG HARBOR WA 98335-4745 SUBDIVISION: SOUTH BAY#1 Block: Lot: PARCEL NUMBER: 995500031 Section: 21 Township: 28 N Range: 01 E PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE & A/G 120 GALLON PROPANE TANK THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2003 EDITION. OCCUPANCY GROUP: R-3 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM yes no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 9/4/2008 I:\F_BLD_Occupancy.rpt 10/29/19 6 BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD05-00143 Received Date 03/10/2005 SITE ADDRESS: 21 DEER HOLLOW RD Issue Date 03/31/2005 PORT LUDLOW, 98365 APPLICANT: NORTH SOUND# 1 LMTD PARTNERSHIP PHONE: 206-786-5714 K CROSS-W SOUND DEVELOP 321 HIGHSCHOOL RD NE#265 BAINBRIDGE ISLAND WA 98110 SUBDIVISION: SOUTH BAY#1 Block: Lot: 31 PARCEL NUMBER: 995500031 Section: 21 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 Contractor's License: WESTSSD966R2 Expires: 12/22/2006 PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE& A/G 120 GALLON PROPANE TANK CALL IN FOR THE REQUIRE IN PELT ONS THAT APPLY TO YOUR PROJECT. SETBACKS::,// 4 7 14 OS UFFER: Nd Footing: .e,k V2.60 45. !J eD !04S ,4/- Foundation:O7— - --TL ~ uuerrFzc f 2AMwe 1k G/6/0a Stormwater FINAL Approval: OK 7/.i/t'6 Underground Plumbing: k/A Underground Insulation: /)/A Shear Wall : Vvi5E7 76 ,k -L Iui Itc,p Pp'? PuC/uEEalicw Sheathing: Framing:' (1(/ n, Plumbing:7 ( ( lfr6 Propane Ta k/Lines: 7 Insulation: Lv2 rt,(J L 5 4. 4uL7FD C611-14.05 0,_ 7/i5/00 Sheetrock: 0,t4. 57/i/ c8 ,;� /oi :5i4AAF /i2 “ o k 7/i1/1l Septic Sytem Final Approval (I not on sewer): Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: iX nr L;[, A�0`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 CM A BLD05-00143 1.) A vegetative buffer of 30-feet shall be permanently maintained from the top or edge of the Landslide Hazard Area. All buffers shall be measured perpendicularly from the top of the Landslide Hazard Area. 2.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated. Should buffer disturbance occur during construction, the Unified Development Code (UDC)Administrator shall require replanting with native vegetation. No alterations shall be made to the Landslide Hazard Area or its associated buffer without prior authorization by the UDC Administrator. 3.) Prior to and during approved construction activities, the perimeter of the landslide hazard area buffer shall be marked with a temporary sign. The sign shall be placed in such a manner that it can be directly observed from the construction area. The sign shall contain the following statement: "Landslide Hazard Area and Buffer- Do not Remove or Alter Existing Vegetation." 4.) All construction activities shall not encroach upon the landslide hazard area buffer. This includes the storage or preparation of materials. 5.) The applicant shall permanently separate the boundary of the Landslide Hazard Area Buffer from the remainder of the subject property through installing logs, trees, a hedge row, or any other prominent physical marking approved 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 Stormwater Narrative 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. 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 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 Deer Hollow Road and Highland Drive rights-of-ways shall be 20 feet. Minimum side and rear yard setbacks shall be 5 feet. If and ESA is present, then the more stricter 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.) Based on Section 3.107 of the Port Ludlow Code, accessory dwelling units shall not be allowed in the MPR-SF zone. • 16.) A minimum of two (2) on-site perking spaces shall be provided for the single family residence. • • I:\F_BLD_Perm it_Bu ildng.rpt 10/29/19 1 • 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 responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: 1044 A5 J- c- (34., r~p0C XSic-.) (2XC ) 786 -5-2/V (20 47 ) sss -I of 3 MAILING ADDRESS:3.v / .,L Ili 4 / /tp iv-c Ar.2..Gs-- 4., L..,.J5,E /�-of 1/.q . GI,5'//0 CONTRACTOR'S LICENSE LL WAINS NUMBER: �,eJT s$0 ci(Oto 2Z NUMBER ARCHITECT/ENGINEER:N\�S tl Atte n e Es41,...at. G L,S', PHONE (3& )2S',-8?8Z FAX:( ) MAILING ADDRESS: P.d,0 e,z 14 SV W,,5s j,..,. 41,9 3 ty(0,. EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: $i New Wood Existing: _ Af Sewer ❑ Addition ❑ Steel Proposed: _ 2 Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: _Z Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: 3 ki Public El..,-,c (r4-0-1p) Total: _3 Name of SysteT o ly,w h./..�c /. hr-sl.ce-.c' 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 X Above ground Tank Size of Propane Tank: /L e" ❑ Heat Stove ❑ Cook Stove 0 Woodstove 't/Fireplace Insert 0 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 Offic 'Use Only .� ., , y4 :ei Current Proposed Amount ',_ lz m�s *, .f Main Floor v a ;Onsistency Review: {4;:+ ', � i ,n" art b 2""Floor l Base fee: } , ivA 3r0 Floor N4. :Additional Section: Mezzanine: Plan Check fee: Heated Basement State Surcharge fee: , d Unheated Basement Pot Water Review fee: ;. 1 NA- Other Other Unheated Hid- 911/Rd Approach fee: ` ,,. _" Garage/Carport �7 s-9 L., IA oeg TOTAL: $ ,4a`" " g Q Decks l - ) r Z o y l g eeeipt Number. 42 \ z Other r---t 'ash/Check Number: ,ti ' '` ESTIMAT µREQUIRED) Date:/ IQ ` 05 .Fair et val a bor a aterials foundation to finish Z I S,U O tJ Initials: G:\PemritCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc T (:, inc �� -- ON--:_,NIfJEFFERSON JNTY • ' DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington qms 360/379-4450 • 360/379-4451 Fax Iv.r, 1 20Ti 0215 4q 0 www.co.jefferson.wa.us/commdevelopment SNGrS Master Permit Application MLA: Q 5-- Project Description(include separate sheets asj,ecessary): Tax Parcel Property Number: 'V S-S 000 3 I Size: . Z4 v C I o.(4SV) (acres/square feet) Site Address and/or Directions to Property: 2 I Deter- 1do.\1 et./ a Property Owner(s)of Record: N6 - S o4-,r2 i:tr L.•,•.•1e1 I'w I n..S L,/ (Kw t„ C.m.cf tiau,.,.sp,-„ Gig( (1.,L) Telephone: 204.- ?86-S '/ Fax: Zcto- SSS-/o/3 email: Mailing Address:%£Vs/ c.v..4) /7z,clopry,..,,� 12.I Hr5 4.r(Aoo/ /c.ri i i .2 ion' &,".t r.J v -LVV•-1 IVIti - 5 //p Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What 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]** fRiSingle Family ❑ Discretionary"D"or Unnamed Use Classification gGarage Attached/Detached ❑ Special Use(Essential Public Facilities)** El Manufactured Home ❑ Boundary Line Adjustment ❑ Modular ❑ Short Plat** ❑Commercial* ❑ Binding Site Plan-* ❑Change of Use ❑ Long Plat** ❑Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRDyAmendments** I'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 Key 4,,Ct-oci k,-F tu4s,f-1 Ili pic/ te4t as my agent in matters relating to this application for permit(s). OWNER SIGNATURE —1 '— J/�/ ,�/� 62-[.A--J / �11,..„--- Date: I- 05- 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: /�T� Date: _ U —� 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 terns 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: , y — / r '4. -- Date: 3—/U-a S G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc