HomeMy WebLinkAboutBLD2005-00160 tILDING PERMIT APPLICA•N ML v
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Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00160 Received Date: 3/17/2005
SITE ADDRESS: 635 SR20
PORT TOWNSEND, 98368
OWNER: ROBERT G WALLACE PHONE: 360-385-7038
KRISTIN WOLFRAM
1930 CLAY ST
PORT TOWNSEND WA 98368-6916
SUBDIVISION: NOVAK SHORT PLAT Block: Lot: 3
PARCEL NUMBER: 902243037 Section: 24 Township: 29 N Range: 02 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI` DETACHED CARPORT
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 6,955.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 2003
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: # OF STORIES:
OTHER:
CONST TYPE: GARAGE: 432 SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total:
r
Routing Date: .
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l) //
Type Amount Paid Bv: Date: Receipt: proved/Date
Permit $139.25 BAC 03/17/05 71720 APPRr \JE[
Plan Check $90.52 BAC 03/17/05 71720
State Building Code $4.50 BAC 03/17/05 71720 MAY 1 8 2005
Total: $234.27 Jefferson County Planning
& '.il.' Department
,l�- I Ti FofL-
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BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00160 Received Date 03/17/2005
SITE ADDRESS: 635 SR20 Issue Date 05/18/2005
PORT TOWNSEND, 98368
APPLICANT: ROBERT G WALLACE PHONE: 360-385-7038
KRISTIN WOLFRAM
1930 CLAY ST
PORT TOWNSEND WA 98368-6916
SUBDIVISION: NOVAK SHORT PLAT Block: Lot: 3
PARCEL NUMBER: 902243037 Section: 24 Township: 29 N Range: 02 W
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: DETACHED CARPORT
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBAC KS:
UFFER:
Footing:
Foundation:
Stormwater FINAL Approval:
Underground Plumbing:
Underground Insulation:
Shear Wall :
Sheathing:
Framing:
Plumbing:
Propane Tank/ Lines:
Insulation:
Sheetrock:
Septic Sytem Final Approval (If not on sewer):
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval: eianeLtie4,
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
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SPECIAL CONDITIONS FOR CAI t BLD05-00160
1.) Foundation must meet 10' min. setback to septic system and reserve area per SEP99-285
2.) 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.
3.) 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.
4.) 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."
5.) All construction activities shall not encroach upon the buffer. This includes the storage or
preparation of materials.
6.) 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.
7.) 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.
8.) To help prevent seawater from intruding landward into underground aquifers, all new
development activity on Marrowstone Island, Indian Island and within 1/4 mile of any
marine shoreline shall be required to infiltrate all stormwater runoff onsite.
9.) The identified Fish and Wildlife Habitat Area (Type 4 Stream), shall maintain a vegetative
buffer setback of 100 feet. The setback shall be measured horizontally from the Ordinary
High Water Mark (OHWM) to the detached carport.
10.) An additional setback of five (5) feet is required from the edge of the buffer area to the
proposed detached carport.
11.) A permanent physical separation along the boundary of the 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.
12.) 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 be in place prior to and
during construction activities. The signs shall contain the following statement: "Buffer- Do
Not Remove or Alter Existing Vegetation."
13.). 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.
14.) VOLUNTARY MEASURES OPOASTAL &AT RISK SIPZ:
1. Installation of a flow meter.
2. On-going well monitoring for chloride concentration.
3. Submittal of monitoring data to County.
15.) 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.
16.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
17.) 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).
18.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
19.) The building height is not to exceed 35 feet.
20.) Minimum setback from SR 20 is 50 feet. Minimum setback to Fairmount Rd is 20 feet.
Minimum side setbacks are 5 feet.
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. iforr c��4'� JEFFERSON NTY •
4 ,1 DEPARTMENT OF COMMON DEVELOPMENT
I. 621 Sheridan Street• Port T nsenc •Washingtonir t
' ' 360/379-4450 • 360/379-44 F ��- G 5_' L i t°-0
��O www.Co.jefferson.wa.us/com dev lopment I ;
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411Y �I 3 i 1
MAR 1 7 2005 ''
Master Permit Application MLA: OJ ) 1
Project Description(include separate sheets as necessary): I
Tax Parcel Property
Number: ''� —2 1'3 --67 /� Size: 3, "7 (acre square feet)
Site Address and/or Directions to Property: 6 S /j/(6W 4 i j 2 D ?dl ; I MC.7 A)se A)___b
Property Owner(s)of Record: /?O S F-R)- G r 7,(,7lj-GG4 G E - / AV,c;/ j D`*R4 if
Telephone: 360 3PS 74.7 S Fax: email: kw",RAP SS�, rt'Uf/C,,641.1
Mailing Address: /930 C74.4p Pe 7O1tro.k5 -U› u'.4 gjA34. 8
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 0 Conditional Use[C(a),C(d),or C]**
❑Single Family 0 Discretionary"D"or Unnamed Use Classification
*Garage Attached Detached <-4RiiP/ ❑ Special Use(Essential Public Facilities)*"
❑Manufactured Home ❑ Boundary Line Adjustment
❑Modular 0 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
❑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 '•1 .1* 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 1
hours.and any requi ater i pe ons.Acc ss an right of entry to this property shall be requested and shall occur only during regular business
Signature: Date: -5-4 --, 'S
The action or actions Applicant will undertake as a result of the issuance of this permit maynegatively impact 9 Y� P act 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 e in comps ce with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transf I/�'espgffsi . f dherin o and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: / E// 9 E/�� c fret `� lGZ1��_ Date: S —7, -- 41.E
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
*OWNER BUILDER STATEMENT
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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 « ibility of General Contractor for the proposed project_
Signature: /l a ul,`I % /Qi7ti. Date: ,`j (S ^G-'S
GENERAL CONTRACTOR OR MANUFACTURED HOWINSTALLER:k i r itPHONE: FAX:
( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTORS LICENSE \WINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
New X Wood Existing: ❑ Sewer
❑ Addition II Steel Proposed: Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: ?C Height: `Individual System
❑ Repair ❑ Masonry SEP Permit# ??^2e)S
❑ Demolition ❑ Other. Bedrooms: Water Supply:
Existing: Setback: X Private well ❑ Two Party
Type of Heat: Proposed: ❑ Public
Total: Name of System:
e, —
If this is a Commercial Proiectyou must answer the following:
Number of Parting 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 0 Above ground Tank Size of Propane Tank:
❑ Heat Stove ❑ Cook Stove ❑ 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 Office Use Only x ; tii ,e+ ,- °`
Current Proposed . r= t `,, t ''�'
Main Floor `Co Revie*: '�.'; r �'a`a ti
�`: i
2Nu Floor r "Be f - ;:; ''* . > t x
Ee: t
3ro Floor L 4 ection: , . r : 4 ? ,n yr
n + y SA y.
�j t A � �
Mezzanine: `. ,' • ee: .«s�
- ¢¢ma�,�yy �t
Heated Basement �pJ 5x
Unheated Basement Puf ;•. ar ie04i. } '.W 4. ;, 5;
Other Unheated L A n'
Garage/Carport 7:'' - TOTAL $
Decks Number
a h�, a-c)
kt
{
Other ` �'
'Casfl1 Number F •
>..,:1'.
ESTIMATED COST(REQUIRED) -, t. 3 ' ` ,x
•Fair market vol of all labor and materials foundation to finish f ti • 77 7••• , ,..-,.A.,.
G:\PemutCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc