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HomeMy WebLinkAboutBLD2005-00328 tUILDING PERMIT APPLICATIN MRLA05 00313 eview Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00328 Received Date: 5/24/2005 SITE ADDRESS: 532 PENNEY CREEK RD QUILCENE, 98376 OWNER: TIMOTHY M VAN BERKOM PHONE: 532 PENNY CREEK RD QUILCENE WA 98376 SUBDIVISION: Block: Lot: T7+ PARCEL NUMBER: 702224016 Section: 22 Township: 27 N Range: 02 W CONTRACTOR: REALITY HOMES INC PHONE: (253)926-6330 1308 ALEXANDER AVE E FIFE WA 98424 Contractor's License REALIH1984CN Expires 2/15/2006 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NEW SFR W/ATTACHED GARAGE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,049 VALUATION 170,142.00 ADD'L: 720 HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: 494 SHORELINE: CONST TYPE:. DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: 3 Prop: 3 Total: 3 Total: 3 Routing Date: ( / ' 1 J I(4-1 /0`� '�/__ Type Amount Paid Bv: Date: Receipt: Approved/Date State Building Code $4.50 RAC 05/24/05 73098 Potable Water Application $53.00 RAC 05/24/05 73098 APPROVE Permit $1,391.35 RAC 05/24/05 73098 AUG - 2 2005 Plan Check $904.38 RAC 05/24/05 73098 Total: $2,353.23 Jeff u y Plannine. & ildi artment • F62 A • • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD05-00328 Received Date 05/24/2005 SITE ADDRESS: 532 PENNEY CREEK RD Issue Date 08/2/2005 QUILCENE, 98376 APPLICANT: TIMOTHY M VAN BERKOM PHONE: 532 PENNY CREEK RD QUILCENE WA 98376 SUBDIVISION: Block: Lot: T7+ PARCEL NUMBER: 702224016 Section: 22 Township: 27 N Range: 02 W CONTRACTOR: REALITY HOMES INC PHONE: (253)926-6330 1308 ALEXANDER AVE E FIFE WA 98424 (253) 926-8515 Contractor's License: REALIHI984CN Expires: 2/15/2006 PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: ©jj_ Lo-1 o,"�" UFFER: Footing:( 10`to s � Foundation: Ok /9/5 .5,- Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: Shear Wall : Sheathing: icArdtN /,27-0.6 Framing: DA Vs.2 a Al Plumbing: Q&< 3/b/06G, Propane Tank/ Lines: Insulation: AR 5' F,9 4: 3,27Az. Ote. wvrku13 4 - -Csb(PO. :.(4 SheetrockvI L /`f�' Septic Sytem Fir1 I A proval (If not on sewer): Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval:, (L)-? 3 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 CASE t BLD05-00328 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.) 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. 7.) The applicant shall fully adhere to all conditions and requirements of the eagle habitat management plan signed on August 1, 2005 by WDFW and applicant. 8.) 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. 9.) A Stormwater Site 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. 10.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 11.) 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). 12.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 13.) The building height is not to exceed 35 feet. 14.) Minimum setback from Penny Creek Road right-of-way shall be 20 feet. Minimum side and rear yard setbacks shall be 5 feet. If an ESA is present, then the more stricter setback(s) shall apply. . 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. 16.) 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. 17.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. I:\F_BLD_Permit_Buildng.rpt 10/29/19 �gSonr oor, JEFFERSO OUNTY • Wt ' A DEPARTMENT OF COMMUNITY DEVELOPMENT 1-' ` `'4 621 Sheridan§tree[--Port-Town n 98368 360/379-4450�• 360/379-4451 Fax I`�HING1IO www.co.jefferpon.wp:us/commdevelopment Master Permit Application p`" ' !j!)`� MLA (-\r� � ' r; Project Description(include separate sheets as necessary): 5 i 4 "1 CI)6L r s' Tax Parcel Property Number: 702224016 Size: 4, 7 [arts/square feet) Site Address and/or Directions to Property: 532 P nnu Caeek Road PropertyOwner(s)of Record: "-Lmo2ky and Lee Ann Van 7?enkom Telephone: 360 76 5 4083 Fax:3 6 0 76 5 33 91 email: Mailing Address: 532 perxzy ,,zeok ,zvad /1viec art e, ll4 9R37c 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 CI** tSingle Fan" ❑ Discretionary"D"or Unnamed Use Classification Garage ttached Detached ❑ Special Use(Essential Public Facilities)** ❑ Manufactured ome ❑ Boundary Line Adjustment ❑ Modular ❑Short Plat** ❑Commercial* ❑ Binding Site Plan** ❑ Change of Use ❑ Long Plat** ❑Address ❑ Road Approach 0 Planned Rural Residential Development(PRRD)/Amendments** ❑ Propane ❑ Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** 0 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 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 attorneys 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.Akers and right of entry to this property shall be requested and shall occur only during regular business hours. .� . o Signature:: ,.,, .-_�-.Tv,. /t / i, tiv(''� ,.��--=3.-1,-c..: Date: ,i(, j • - 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 Date: t' G:\PermitCenter\FORMS\DRD FORMS\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. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: Rea7-LLy /ionze 1308 fitexande-. live f-7 ( 253) 926 6330 ( 253) 926 8515 MAILING ADDRESS: EMAIL: CONTRACTORS LICENSE REf4LI111984CN WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: 7308 Siexande2 7lie. 6. f LLe, 1J,4 .E 98424 Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: p New E Wood Existing: _ ❑ Sewer ❑ Addition ❑ Steel Proposed: _C. 5 - Bank 0 Community System ❑ Alteration/Remodel 0 Concrete Total: 2. Height: W Individual System ❑ Repair 0 Masonry 8EP Permit# 9 7-0 2 6 5 ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: RI Private well 0 Two Party Type of Heat: Proposed: 3 0 Public , . Total: 3 Name of System: / HLI LLI% S 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: ❑ Heat Stove ❑ Cook Stove 0 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 Amount � a: Current ( Proposed Main Floor I G nsistency Review- _ 1048. 5 613 �77 "° // ^ Base�f;ee: ' C) 2 Floor 7 20 (0 1,t 5 33 I _-- 1 •i 3"'Floor Addi onal Section: k• !AA. 1 ,I€ s Mezzanine: Plan to fee: . C 20 f i A'` i 4 2()9" f t P Jo Heated Basement Sta , rge.fee: I Sua � c-ac Unheated Basement P�ot:Water Review fee: Other Unheated 911I d Approach fee: ,. L. - IA Garage/Carport [,. 4 9 3. 5 II " TOTAL: $ 0 A•34o3 Decks Rec ipt Number: ='i I %, _ '� '�Qr 1L1r� Other ash/Check Number: • ESTIMATED COST(REQUIR D) Date: -,,i , r *Fair market value of all labor andiaterials foundation to finish k' 5Lx; Initials: '"j k G:\Per mitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc