HomeMy WebLinkAboutBLD2005-00197 •
BUILDING PERMIT APPLICAON MLLA05 00192
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00197 Received Date: 3/30/2005
SITE ADDRESS: ADELMA BEACH RD
PORT TOWNSEND, 98368
OWNER: MATTHEW S HENERY PHONE: 360-379-1318
TARA L HENERY
1705 14TH ST
PORT TOWNSEND WA 98368-8200
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 001324079 Section: 32 Township: 30 N Range: 01 W
CONTRACTOR: LITTLE & LITTLE CONSTRUCTION PHONE: (360)385-5606
2009 4TH STREET
PORT TOWNSEND WA 98368
Contractor's License LITTLLC157C5 Expires 2/28/2007
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOr NEW SFR &
A/G 500 GALLON PROPANE TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,688
VALUATION 600,000.00 ADD'L: 2,722 HEAT TYPE: RAD
CODE EDITION: 2003 HEAT BASE: HEAT TYPE: PRO
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: SHORELINE:
CONST TYPE: DECK: 888 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: OSS
WATER SYSTEM: PUD
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: 4 Prop: 4
Total: 4 Total: 4
Routing Date: ! / O3 L 2
Type • Amount Paid Bv: Date: Receipt: Approved/Dat
Permit $3,708.75 BAC 03/30/05 71762
APPF�O EL
Plan Check $2,410.69 BAC 03/30/05 71762
State Building Code $4.50 BAC 03/30/05 71762 JUN 1 7 2005
Potable Water Application $53.00 BAC 03/30/05 71762 "efferson County Planning
Total: $6,176.94 & B • • epartment
Fat_ Fercb•
• • BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
•
(360)379-4450 FAX (360)379-4451
PERMIT#: BLD05-001 97 Received Date 03/30/2005
SITE ADDRESS: 287 ADELMA BEACH RD Issue Date 06/17/2005
PORT TOWNSEND, 98368
APPLICANT: MATTHEW S HENERY PHONE: 360-379-1318
TARA L HENERY
1705 14TH ST
PORT TOWNSEND WA 98368-8200
SUBDIVISION: Block: Lot: TXG2
PARCEL NUMBER: 001324079 Section: 32 Township: 30 N Range: 01 W
CONTRACTOR: LITTLE & LITTLE CONSTRUCTION PHONE: (360)385-5606
2009 4TH STREET
PORT TOWNSEND WA 98368
Contractor's License: LITTLLC157C5 Expires: 2/28/2007
PROJECT DESCRIPTION: NEW SFR &
A/G 500 GALLON PROPANE TANK
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS:
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: &Waited
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 CA A BLD05-00197 •
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.) 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.
3.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ:
1. Installation of a flow meter.
2. On-going well monitoring for chloride concentration.
3. Submittal of monitoring data to County.
4.) 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.
5.) 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.
6.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
7.) 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).
8.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
9.) The building height is not to exceed 35 feet.
10.) Minimum setback from Adelma Beach Rd right-of-way is 20 ft. Minimum side and rear
setbacks are 5 ft.
11.) 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.
12.) 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.
13.) A minimum of two (2) on-site parking spaces are required for the single family residence.
14.) A stormwater plan for a medium project 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.
I:\F_BLD_Permit_Buildng.rpt 10/29/19
• •
. 4` ON cow JEFFERSON COUNTY 1
4 t DEPARTMENT OF COMMUNITY DEVELOPMENT
"' '` ,=- ,...4 621 Sheridan Street•• Port Townsend •• Washington 983 .
360/379-4450 • 360/379-4451 Fax MAN 2 �11J
q O www.co.jefferson.wa.us/commdevelopment
SONG`S
Master Permit Application MLA: 0,5` I la
Project Description(include separate sheets as necessary):
1Je w Go 64 yu c.A".\,,._. o 1r c.. S.\ .31.�. F (y (es:6-Ce H.c.�.
Tax Parcel Property
Number: C Q 3 2.44 O'1 °t Size: (acres/square feet)
Site Address and/or Directions to Property: Arte lt.Y,h. iSe-e.. l.i. 14.4
Property Owner(s)of Record: MA 444.44 w .i. Tie ea.. L}C H 4 •r v
Telephone: 3(00 '371- l3j/$ Fax: email:
Mailing Address: rier)S" (Wif't% 154- PO r4" 11>4.4•1.4.1.44r46.4.
Applicant/Agent(if different from owner): 4.,iirkI.C. r 1..i'W'l4.,,. C "t6+vU(.ars'o....... C.ALI A L-ail,..)
Telephone:3(I0' 345$'ar(oc,(e Fax: 3/00 3o 5 73 5 email:ftt .y a 1:14•}(c - I:+444.e.,...
Mailing Address:2. c,1 'f+ - S f- -pO r-f 7-664,,n'a,4,10us t,
What kind of Permit?(Check each box that applies)
Building I I Variance(Minor,Major or Reasonable Economic Use)
I i Demolition Permit i i Conditional Use[C(a),C(d),or C]**
Single Family 1 I Discretionary"D"or Unnamed Use Classification
i 1 Garage Attached/Detached i I Special Use(Essential Public Facilities)*"
i_I Manufactured Home i I Boundary Line Adjustment
U Modular IJ Short Plat'*
I I Commercial* U Binding Site Plan**
i I Change of Use Li Long Plat**
Address i Road Approach Li Planned Rural Residential Development(PRRD)/Amendments**
Propane U Plat Vacation/Alteration**
U Allowed"Yes"Use Consistency Analysis Li Shoreline Master Program Exemption/Permit Revisions**
U Stormwater Management U Shoreline Management Substantial Development**
U Site Plan Approval Advance Determination(SPAAD)* U Shoreline Management Variance
U Temporary Use U Comprehensive Plan/UDC/Land Use District Map Amendment
U Wireless Telecommunication* U Jefferson County Shoreline Master Program Amendment
LI Forest Practices Act/Release of Six-Year Moratorium
*May require a Pm—Application Conference **Requires a Pm-Application Conference
Please identify any other local,state or federal permits required for this proposal, if known:
DESIGNATION OF AGENT
I hereby designate Ll +14 . to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATUR Date: 5 ' Z 1 1,::.s-
,
By signing this app'ccation fo , e 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 and any required la er inspections Access and right of entry to this property shall be requested and shall occur only during regular business
hours. L * __
SnatuDate: 2
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-tran rable re nsibility fo�dt to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature:, IC�!`1-�� l/Y b1V Date: 03Til f/dtS—
C:\Documents and Settings\mochil\Desktop\Master Permit Application 7-8-04.doc
• •
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.
MAR Q -
Signature:
Date: "`t,
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
t'l4.+ -l•-- -t (04 - GotA.16f1A0G u+-.. _ (3Go) Ass oe. (3‘o)-Uss-97s3
MAILING ADDRESS: Zoo ot ffik• 5+ 7 t�A EMAIL: atjiK a 1`44,It,. I i 1,41..fir..
CONTRACTOR'S LICENSE WAINS
NUMBER: / 7"TT'ta-G is 7 c, _ NUMBER
ARCHITECT/ENGINEER: �►'+' PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
New )(Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: Height: `Individual System
❑ Repair ❑ Masonry SEP Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: LI Private well a Two Party
a of Heat: Proposed:
Ty i i Public
'��i - 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:
i o Ta - ve round Tank --.Size of' .. -- . k: ,SCaG�
eat Stove Cook Stov I Woodstove I Fireplace Inss rt Hot Water Ta . I Pellet Stove I Other o►la.✓'
Is this appliance being installed in a Manufactt�reciJ_Mabrte Home. es / 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
Current Proposed Amount
Main Floor !`'' t bUv 151 Ia95 44onsistency Review:
fO
2N°Floor 1 4v1sis t5( 44Base fee: 3 r1ox I..
3rd Floor dditional Section:
s to 3'-f 151, 15 I-'� ...___. _---.
Mezzanine: Plan Check fee: '0. i l
�{�
Heated Basement / State Surcharge fee: I
Unheated Basement / Pot Water Review fee:
Other Unheated / 911/Rd Approach fee: l -A-
Garage/Carport
TOTAL: $ 6 t-4 O l, 91
Decks
g D ( ceipt Number: q/ 70
Other f l,,A(JCash/Check Number: i
ESTIMATED COST(REQUIRED) Date: ��?� �
.Fair market value of all labor and materials foundation to finish ..0
/_a,/ cx?Q ..--) Initials:
C: ents and Settings\mochil D aster Permit Application 7-8-04.doc MAR`R 2 9 203
_ ADELMA BECH RD BLD05-197 _
HENERY
Approvals Req'd Prior
to Final Inspection
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SEP
RAP
ZON
SIPZ
DPW _