HomeMy WebLinkAboutBLD2005-00158 •UILDING PERMIT APPLICA*N MLA05-00155
Review
Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00158 Received Date: 3/15/2005
SITE ADDRESS: 72 S STROMBERG AVE
PORT TOWNSEND, 98368
OWNER: JOHN BARTH PHONE: 360-301-3626
DIXIE L BARTH
PO BOX 1937
PORT TOWNSEND WA 98368-0065
SUBDIVISION: IRONDALE Block: 145 Lot: 27-30
PARCEL NUMBER: 962114504 Section: 35 Township: 30 N Range: 01 W
CONTRACTOR: M &W BUILDING SUPPLY PHONE: (800)547-1714
PO BOX 220
CANBY OR 97013
Contractor's License MWBUISCO61K5 Expires 7/1/2006
REPRESENTATIVE PHONE:
PROJECT DESCRIPTIOP NEW POLE BUILDING/GARAG6/..)
wy-EQA n-Th--64cA ory\
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,440
VALUATION 33,941.00 ADD'L: HEAT TYPE:
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total:
Routing Date: )
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $482.15 BAC 03/15/05 71628 /� P PROVED
Plan Check $313.40 BAC 03/15/05 71628 /�
State Building Code $4.50 BAC 03/15/05 71628 JUN 1 6 2R05
Total: $800.05
offer County Planning
& B di ge ment
• •
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00158 Received Date 03/15/2005
SITE ADDRESS: 72 S STROMBERG AVE Issue Date 06/16/2005
PORT TOWNSEND, 98368
APPLICANT: JOHN BARTH PHONE: 360-301-3626
DIXIE L BARTH
PO BOX 1937
PORT TOWNSEND WA 98368-0065
SUBDIVISION: IRONDALE Block: 145 Lot: 27-30
PARCEL NUMBER: 962114504 Section: 35 Township: 30 N Range: 01 W
CONTRACTOR: M &W BUILDING SUPPLY PHONE: (800)547-1714
PO BOX 220
CANBY OR 97013
Contractor's License: MWBUISCO61K5 Expires: 7/1/2006
PROJECT DESCRIPTION: NEW POLE BUILDING/GARAGE -foundation insulation - R-10
perimeter
CALL IN FOR THE REQUIRED INSPECTIONS THAT PP TO YOUR PROJECT.
SETBACKS: OX iv/C'oh �arr5 B 4.0
UFFER: io/s4
Footing: Dk Pod 44c 12.815,
Foundation:
Stormwater FINAL Approval:
Underground Plumbing:
Underground Insulation:
Shear Wall :
Sheathing:
Framing: O& dir)i- 1-13-14
Plumbing:
Propane Tank/ Lines:
Insulation:
Sheetrock:
Septic Sytem Final Approval (If not on sewer):
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval: ei(-41- 41/n.J / 13/45
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 C PE A BLD05-00158
1.) Sewer transport line must be min of 2' from foundation of garage
2.) S. Stromberg Ave. (P492) is a private road. A road approach (RAP04-00201)was issued
and an address of 72 S. Stromberg Ave. has been assigned to the parcel. CONTACT
TERRY DUFF AT 360-385-9159 FOR FINAL INSPECTION OF ROAD APPROACH
PRIOR TO FINAL BUILDING INSPECTION.
3.) Stormwater shall be retained and infiltrated on site. The owner shall control all
sedimentation and erosion on the property.
4.) Critical Aquifer Recharge Areas may require special protection measures to mitigate water
quality degradation. The submitted proposal does not require additional aquifer
protection measures. However, during construction the project shall follow the Best
Management Practices (BMPs) and facility design standards as identified and defined in
the Stormwater Management Manual for the Puget Sound Basin.
5.) 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.
6.) 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.
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.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP)
Elements#1 through #12 of the Department of Ecology's Stormwater Management
Manual for Western Washington 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.
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.) Pre-existing legal lots of record less than one acre in size in Rural Residential districts are
subject to the stormwater requirements in UDC Section 6.7 and must meet the"Area of
Impervious Surface Coverage"to the maximum extent practicable as determined by the
Administrator." Lot coverage is defined as amount of impervious surface, which includes
rooftops, driveways, concrete, etc.
12.) The building height is not to exceed 35 feet.
13.) The minimum setback from S. Stromberg Ave. right of way is 20 ft. The minimum setback
from Victory Avenue right of way is 20 ft. The setback from the north and south property
lines is a minimum of 5 ft. If an environmentally sensitive area (ESA) is present, then the
more restrictive setback shall apply.
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.) 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.
•
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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 will be assuming the responsibility of the General Contractor for the proposed project.
Signature: Date:
GENERAL CONTRACTOR OR MANyFACTURED HOME INSTALLER: PHONE: FAX:
i
///2 L3 Au, ld/,-,/ '). .2i7s-s //w e` .(5"G3):tee3 15— (55.3VL� 7/0.
MAILING ADDRESS: C> AJ iiy 0 R 6_ ti 7(l/ .� EMAIL:
CONTRACTOR'S LICENSE J, ccXP 7, WAINS
NUMBER: '2 ` J /�J 2C/Ui5<,D 6,fA- _ NUMBER
ARCHITECT/ENGINEER: /),,u// !/� ii �5 4/ PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
New Wood Existing: _ ❑ Sewer
❑ Addition 0 Steel Proposed: Bank ❑ Community System
O Alteration/Remodel 0 Concrete Total: _ C ) Height: ❑ Individual System
O Repair ❑ Masonry SEP Permit#� f—/yr)
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well 0 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:
❑ Underground Tank ❑ Above ground Tank Size of Propane Tank:
Cl Heat Stove ❑ Cook Stove Li 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 For Only
Current Proposed Amount
Main Floerlo� `"r, 2 3 �46.E• nsistency Review: 4"
2'"t'Floor ' ) J( r Base fee: ' ' , tj f r04 q(5
vs, a :
..,
3`°Floor a34 t' Additional Section; _ l f
Mezzanine: �
Plan Check fee: �s.etl A/\ (off
313 . �T V
Heated Basement State Surcharge fee: 1 0
Unheated Basement Pot Water Review fee:
Other Unheated 911/Rd Approach fee: 12r4
Garage/Carport
TOTAL: $ Q 19
� 0
Decks L1J
Receipt Number: 17 / (to2 Y
Other Cash/Check Number: 500
ESTIMATED COST(REQUIRED) Date: / -t•Fair market value of all labor and materials foundation to finisha
f a�mi 3 0 0 initials.
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G: emvtCenter FO S\DRD FO Mastst er Pem�it Application 7-8-04.8oc
4�,gsON e06. JEFFERSON.UNTY •
4 ' DEPARTMENT OF COMMUNITY DEVELOPMENT
''d 621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
�q �, O/ www.co.jefferson.wa.us/commdevelopment
INS.
Master Permit Application MLA: o5-\55
Project Description(include separate sheets as nece ary):7
X 3 O ;Y,/&9 /tie - / /; ,/el,,v/' 7 -r..str''
Tax Parcel 2t,,g//a-5"O i .. P,(operty /
Number: y[o, /j 0 ( Size: j
/'�%G� ,`� {0 0 �..�(acr�es//s/qua/re feet)
Site Address and/or Directions to Property: S , S -7,,/y/A c4 r / j�T /D ek_m1v�/AI /J, -
Property Owner(s)of Record: c h)./). .: J. S /),a'/C )3,t3W i7
Telephone: ' '� ;. . ,Sx: //t) ".1,. email: A/0/v c2
Mailing Address: 1-'() Y ' 7) f GHQ 1- l()C,L; 1`.Sc?.C' -JAL F '3'6 g
Applicant/Agent(if different from owner): / /
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies)
p'Building CI Variance(Minor, Major or Reasonable Economic Use)
❑ Demolition Permit ❑ Conditional Use[C(a),C(d),or C]**
❑ Single Family r- c ❑ Discretionary"D"or Unnamed Use Classification
t9 Garage Attached Detached ) CI Special Use(Essential Public Facilities)**
❑ Manufactured Home .1 ❑ Boundary Line Adjustment
❑ Modular ❑ Short Plat**
❑ Commercial* ❑ Binding Site Plan**
❑Change of Use ❑ Long Plat**
❑Address ❑ 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
F]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,4he 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 arpd any uired later inspections.Access d ri t of entry to this property shall be requested and shall occur only during regular business
hours.
Signature'---- ` J , .. Date: `�
The action o(a¢fions 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 individ al,group or agency can file a lawsuit on behalf of an endangered species regarding your
action(s)even if you are in complian with the J erson my development code.The Applicant acknowledges that he,she or it holds individual
and non-transferab r niili adhe' o n ying with the ESA. The Applicant has read this disclaimer and.signs and dates it below.
Signature: 6 -� Date: 3//. //) 3
G:\Permitteriter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc /