HomeMy WebLinkAboutBLD2005-00192 SILDING PERMIT APPLICA1N MLA05-00181
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00192 Received Date: 3/30/2005
SITE ADDRESS: 187 SEATTLE DR
PORT LUDLOW, 98365
OWNER: CRISTIN RASMUSSEN PHONE:
34 CUL DE SAC
PORT HADLOCK WA 98339
360-379-0979
SUBDIVISION: TRAILS END 4TH ADDITION Block: 1 Lot: 6
PARCEL NUMBER: 950200104 Section: 16 Township: 27 N Range: 01 E
CONTRACTOR: BAUMAN MASONRY PHONE: 360-509-3973
35 BLUE MOUNTAIN RD
CHIMACUM WA 98325-9772
Contractor's License BAUMAM*004C5 Expires 2/22/2007
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP DECKS
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP DEK MAIN:
VALUATION 1,414.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: 60 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: BRIDGEHVN
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total:
Routing Date: 3w 1w
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $54.00 BAC 03/30/05 71763 A l 1 O V E L.
Plan Check. $35.10 BAC 03/30/05 71763
State Building Code $4.50 BAC 03/30/05 71763 APR 1 9 2005
Total: $93.60 Jefferson County Planning
&Building Department
71.1 (J n
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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 #: BLD05-00192 Received Date 03/30/2005
SITE ADDRESS: 187 SEATTLE DR Issue Date 04/19/2005
PORT LUDLOW, 98365
APPLICANT: CRISTIN RASMUSSEN PHONE: 360-379-0979
34 CUL DE SAC
PORT HADLOCK WA 98339
SUBDIVISION: TRAILS END 4TH ADDITION Block: 1 Lot: 6+
PARCEL NUMBER: 950200104 Section: 16 Township: 27 N Range: 01 E
CONTRACTOR: BAUMAN MASONRY PHONE: 360-509-3973
35 BLUE MOUNTAIN RD
CHIMACUM WA 98325-9772
Contractor's License: BAUMAM*004C5 Expires: 2/22/2007
PROJECT DESCRIPTION: DECKS
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS: ex E/fir
UFFER: /JA
Footing: Ot: 0/2 er
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: i // r>j,
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
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SPECIAL CONDITIONS APPLY - SEE REVERSE
SPECIAL CONDITIONS FOR CA BLD05-00192
1.) 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.
2.) MANDATORY MEASURES OF HIGH 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.
3.) MANDATORY MEASURES FOR HIGH RISK 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 requirements:
a.Variance from Chapter 173 WAC standards granted by Ecology per WAC 173-160-106
for a new groundwater well within 100 feet of a sea-salt water intrusion area per WAC
173-160-171 (i.e., within 100 feet of a groundwater source showing chloride
concentrations above 200mg/L or within 100 feet of the marine shoreline); or for an
existing or proposed groundwater well not subject to an Ecology variance, applicant must
provide evidence through a hydrogeologic assessment(relevant components of an
Aquifer Recharge Area Report per UDC 3.6.10.e) of a reasonable probability that the
subject aquifer will not be degraded by the proposed use of well.
b. Installation of a flow meter.
c. On-going well monitoring for chloride concentration.
d. Submittal of flow and chloride data to the County per monitoring program.
3. If public water is unavailable, a qualifying alternative system may be used as proof of
potable water.
4.) The property owner shall comply with Water Conservation Measures (per list maintained
by the UDC Administrator).
5.) Stormwater shall be retained and infiltrated on site. The owner shall control all
sedimentation and erosion on the property.
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 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.
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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.) 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
ImpeNious 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.
11.) The building height is not to exceed 35 feet. •
12.) Setback from Seattle Dr. right-of-way is no less than 20 ft., 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.
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.
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I:\F_B LD_Perm it_Bu ildng.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 responsibility of the General Contractor for the proposed project.
rf
Signature: i '1, ii: /12 rt.ti. Date: // t, - `?
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
MAILING ADDRESS: '-:`:;-- 11 7 ` ici / :` EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: `
d'i _i ': i (`(-,LAC_ NUMBER
ARCHITECT/ENGINEER: PHONE ( ) PAX( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
9' New E1' Wood Existing: ❑ Sewer
0 Addition ❑ Steel Proposed: Bank 0 Community System
0 Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System
0 Repair ❑ Masonry SEP Permit#
❑ Demolition 0 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 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:
0 Underground Tank ❑ Above ground Tank Size of Propane Tank:
❑ Heat Stove ❑ Cook Stove ❑ Woodstove 0 Fireplace Insert 0 Hot Water Tank 0 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 v,:
Current Proposed Amount
Main Floor Consistency Review:
2NU Floor Base fee: F
J
i______
3f0 Floor Additional Section:
Mezzanine: Plan Check fee. -
Heated Basement State Surcharge fee:
Unheated Basement Pot Water Review fee:
Other Unheated 911/Rd Approach fee:
Garage/Carport
TOTAL $ CI 3 te 6
Decks ^ �A 1
6.
>5 Receipt Number: 17673
Other , Cash/Check:Number:
ESTIMATED COST(REQUIRED) Date:
N
•Fair market value of all labor and materials foundation to finish `
/D�' � el Initials: MAR 3 0 2(- <<
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
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���`5ON cow JEFFERSOI OUNTY •
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax r" `!;�
I 3 Q 1i;r:
p� www.co.jefferson.wa.us/commdevelopment
1`shilNOtC
Master Permit Application MLA: C 1 g1
Pro•1 t Description(include separate sheets as necessary):
Tax Parcel _ Property
Number: C.1`.,3(: ,[;t, I C. Size: Y" y (acres/square feet)
Site Address and/or Directions to Property: j ;; C� (,_1 �� < A
Property Owner(s)of Record: ( v '- �l [/l C' `>
Telephone: '/'- Fax: email:
Mailing Address: :3 ('. ,) 1 `x';--1 .i'T�. "lc r
0
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies)
U Building ❑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 ❑ 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
❑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:
t/ , DESIGNATION OF AGENT
Ihereby designate t�%`% t..V ,1 '3 t(ir""� to act as my agent in matters relating to this application for permit(s).
(7/ -yy
OWNER SIGNATUREI_ '2KL{���t?� �. — Date: //,J+.tee,J < l G G<=j
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. 1 �
Signature: iU✓` fin. Date: ►Y;;..r;,j„ •t ]) - Jt
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 responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: L:._b (_._ Y 1 Date:
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc