HomeMy WebLinkAboutBLD2005-00297 •UJLDING PERMIT APPLICA MLA05-0288
JN Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD05-00297 Received Date: 5/9/2005
SITE ADDRESS: 660 PINECREST DR
PORT TOWNSEND, 98368
OWNER: EDWARD HARMON
1240 W SIMS WAY#20 PHONE: 360 774 1077
PORT TOWNSEND WA 98368
SUBDIVISION: KALA POINT#7
Block: Lot: 399
PARCEL NUMBER: 965000259
Section: 27 Township: 30 N Range: 01 W
CONTRACTOR: OWNER/BUILDER
PHONE:
REPRESENTATIVE:
PHONE
PROJECT DESCRIPTIOP NEW SFR W/ATTACHED GARAGE &
A/G 120 GALLON PROPANE TANK
TYPE OF WORK RES SQUARE FOOTAGE
TYPE OF IMP NEW
VALUATION 212,049.00 MAIN: 954
ADD'L: 1,110 HEAT TYPE: EEE
CODE EDITION: 2003
HEAT BASE: HEAT TYPE: PRO
OCCUPANCY: R_3
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: 5N OTHER:
CONST TYPE: GARAGE: 484 SHORELINE:
DECK: 240 SETBACK:
SEWAGE DISPOSAL: CON BANK HEIGHT:
WATER SYSTEM: PUD
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: 3 Prop: 3
Total: 3 Total: 3
1Routinq Date: (o /c
ype Amount Paid By: Date: Receipt:
'ermit Approved/Date
$1,620.95 BAC 05/09/05 73110 APPROVED
'Ian Check $1,053.62 BAC 05/09/05 73110
tate Building Code $4.50 BAC 05/09/05 73110
)table Water Application $53.00 BAC 05/09/05 73110 SUN 2 1 2005
Total: $2,732 07 Jeffers C my Planning
& 8 lid' apartment
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BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
s. (360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00297 Received Date 05/9/2005
SITE ADDRESS: 660 PINECREST DR Issue Date 06/21/2005
PORT TOWNSEND, 98368
APPLICANT: EDWARD HARMON PHONE: 360-774-1077
1240 W SIMS WAY#20
• PORT TOWNSEND WA 98368
SUBDIVISION: KALA POINT#7 Block: Lot: 399
PARCEL NUMBER: 965000259 Section: 27 Township: 30 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE &
A/G 120 GALLON PROPANE TANK
CALL IN FOR THE REQUIRED IN ECTIs , THAT APPLY TO YOUR PROJECT.
SE[BACKS: DJ( 8/7S
UFFER: 7X 8//l'3 j
Footing: ,fie Ali
7A5651,4
Foundation: PE i.A4Pr=i- f;k4P41104 (Alas Dk ez-5/4S
Storrnwater FINAL Approval:
Underground Plumbing:
Underground Insul io
• Shear Wall • N.4//7 >/-36"eV"'
Sheathing/ 1-30-- / —
Framing: ((((((///////Ak. years l'�an,s //oL pPlumbing: //
Propane Tank/ Lines: _kr 9 ! d
5 !`O Insulation: IlQ f Like l _S/61 -DS we-cs
Sheetrock:
Septic Sytem Final Approval (If not on sewer):
Road Approach Final Approval: •
Zoning Final Approval:
Final/Occupancy Approval: . 41410(0
HEALTH DEPARTMENT A(ND 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 CS A BLD05-00297
1.) Critidal 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.
2.) 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.
3.) A Stormwater Site Plan has been submitted and approved by the Department of
Cormunity Development. Once the subject permit has been issued the applicant shall
fullyimplement 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
verities 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.
4.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
5.) 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
sucks unlicensed or inoperable vehiclesbe stored in an Environmentally Sensitive Area
(ESA).
6.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
7.) The.building height is not to exceed 35 feet.
8.) Minimum setback from Pinecrest Drive right-of-way shall be 20 feet. Minimum side and
rear:yard setbacks shall be 5 feet.
9.) 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.
10.) 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.
11.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
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, JEFFERSON COUNTY 1
R 444:. ' DEPARTMENT OF COMMUNITY DEVELOPMENT
4 621 Sheridan Street • Port Townsend • Washington 98368 MAY2005
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360/379-4450 • 360/379-4451 Fax
http://www.co.jefferson.wa.us/commdevelopment/
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STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# Cc; -.2 PROJECT/APPLICANT NAME: 1/ q / /14/ —l2f/t/ _
Please answer all of the following questions to the best of your ability. Where the question calls for depiction on a site map, the
applicant may choose to either incorporate the elements into the general plot plan for the Master Land Use Application or to submit a
separate stormwater site plan map.
Project Overview
1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the
site map. p /
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Existing Conditions Summary
2. Describe thwxisting opography. Indicate contours on the site_ .
3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
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4. Describe the existing soils. Indi ate soil type on the sit map.
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5. Describe the existing site hydrology(i.e., drainage;behavior of water on the site—above, below,and on the ground). Indicate
existing stormwater drainage to and from the site on the site map. Depict separate drainage basins on the site map, if
applicable,and indicate acr age of each.
6. Describe any excess level lie generated by the proposed use or activity: APPROVED
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STORMWATER PLAN
Stormwate 1S
JUN 2 0 2005
stormwater site plan template—rev.10/1/2003
Require JEFFERSO 0 TY
DEPT.OF C' . DE :LOP E T
SIGNATURE.
7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams,
steep slopes,etc.)on th sit . I icate location on the site map.
8. Describe the general vicinity of the site,including adjacent land uses and structures, utilities, roads,and sensitive/critical areas
(streams,wetlands,lakes,steep lopes,etc.).
Permanent Stormwater Control Plan
This portion of the Stormwater Site Plan consists of the selection and installation of the appropriate stormwater control BMPs
and facilities to remain in place after construction of the project is completed.
"Medium" size projects are required to have the totals calculated of all impervious surfaces, pollution-generating impervious
surfaces, and pollution-generating pervious surfaces to verify that the thresholds for treatment facilities and flow control
facilities are not exceeded.
g. Describe the developed site hydrology, as proposed. Indicate whether stormwater will be fully dispersed(i.e., per BMP T5.30
in the Manual)or, if not,what types of stormwater flow control will be utilized for the site or specific threshold discharge areas
within the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities.
10. If the project requires the use of stomiwater treatment facilities,describe the types of stormwater treatment facilities proposed
for use on the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. [This is
normally for large"projects or projects that involve the potential for dispersion of contaminants.]
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11. Describe the performs a goals and sta9dards applicable to theproject.
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12. Describe the flow control stem.
AB Ay a 2005
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stormwater site plan template—rev.10/1/2003 6
10_
13. Describe the water quality system.
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14. Describe the conveyance syst m analysis and design.
15. Describe the source of fill material,physical characteristics of fill material, deposition
n of excess material.
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16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code (ii
17. Describe the proposed surfacing material
oray.e I- QA) (_11Ziue to
18. Describe methods forestoration�ofth'jQ sit .� �t�
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19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for
large"projects only and only those for which facilities are required to control flow or treat runoff.] If included,list the Manuals
here. A.
20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan.
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21. List other necessary permits and approvals as required by other regulatory agencies. If those permits or approvals include
conditions that affect the drainage plan or contain more restrictive drainage-related requirements,describe those conditions or
restrictions here. —
6—
stormwater site plan template—rev.10/1/2003 7
CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN(SWPPP)
The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in t'
template that follows must be installed on the ground during all construction phases of the project. The proponent is responsible fu.
preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater
Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential
development.
SECTION I—CONSTRUCTION SWPPP NARRATIVE
1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or
will.be addressed. Identify the type and location of BMPs used to satisfy the required element. If an element is not applicable
to the proposal,justify in writing. Descriptions of the 12 Elements are found at section 2.5.2 of the Manual(beginning on page
2-15).
12 Required Elements—Construction SWPPP
1. Mark Cle ring Limits.
2. Establish Construction Access.
nc_ce_V-;
3. Control Flow Rates.
4. Install Sediment Controls.
122 stet" 7/1-e-Se,4-`I'e .Ze4_s Aftiftet-
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5. Stabilize Soils. 41
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6. Protect Slopes. jAy' - 9 2005
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7. Protect Drain Inlets. n.
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stormwater site plan template—rev.1 W1/2003 8
1011- 12 Required Elements—Construction SWPPP(continued)
8. Stabilize Cha n Is and Outlets.
MAY - 9 2005
9. Control P Ilutants. •
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10. Control D e[
Watering(the act of pumping groundwater or stormwater away from an active construction site).
11. Mai "nest Management Practices(BMPs).
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12. Manage the Project.
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2. Adjacent Areas.
a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential
areas,roads)
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b. Description of the wnstream drainage path leading from the site to the receiving body of water(minimum distance of 400
N.
yards). h._
3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
stormwater site plan template—rev.10/1/2003
9
b. Description of special requirements for working in or near environmentally sensitive areas. I
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4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site
soils(e.g.,erodibility,settleability,permeability,depth,texture,soil structure).
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5. Construction Phasing.
a. Construction segue e
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b. Construction phasing(if proposed)
6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
I. Provide a proos construction schedule.
II. Wet Season Construction Activities.
a. Proposed wet eason construction activities.
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b. Proposed wet se son construction activities for environmentally sensitive arelWAY — 9 2005
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7. Financial/Ownership Responsibilities.
a. Identify the property ow r responsible for the initiation of bonds and/or other financial securities.
fr—
b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impacts.
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8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. -
a. Sediment Ponds/Traps.
b. Diversions.
c. Waterways.
d. Runoff/Stormwater Detention Calculations
storrnwater site plan template—rev.10/1/2003 10
Stormwater Site Plan Changes
If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan, the proposed revisions shall I
submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revises,
drawings showing any structural changes,and any other supporting information that explains and supports the reason for the change.
Final Corrected Plan Submittal
If the project included construction of conveyance systems,treatment facilities,flow control facilities,or structural source control BMPs
(not standard on-site stormwater management BMPs),the applicant shall submit a final corrected plan ("as-builts")when the project is
completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as
constructed.
APPLICANT SIGNATURE
By signing the Construction S PPP worksheet, I as the applicant/owner attest that the information provided herein is true and
correct to the best of my k edge. I also certify that this application is being made with the full knowledge and consent of all
owners of the ected rty.
( ER 0 ED REPRESENTATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
MAY - 9 2005 \Li
jEFFEFiSGN COUNTY
Irr Di ELOPMENT
stormwater site plan template—rev.10/12003 12
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zi:-0 ON co JEFFERSONIUNTY •� - 1
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' DEPARTMENT OF COMMUNITY DEVELOPMENT ' = ~
621 Sheridan Street • Port Townsend •Washington 98368 •
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Q. 'P 360/379-4450 • 360/379-4451 Fax i i j s MAY ` 9 2005
�, iiiNG'�O www.co.jefferson.wa.us/commdevelopment j' I
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Master Permit Application MLA:I . c".r-.
Project Description(include separate sheets as necessary):
Tax Parcel rProperty
Number. 1 ° 0 4)'5-
Size: ,Lig /1•71:2_00 0. (acres/square feet)
Site Address and/or Directions to Property: 660 / •iiii Ci' -o f "7 3'
Property Owner(s)of Record: an ,. 0 4
Telephone: . •O r — O " Fax: email: ._ � I"t--
Mailing Address: - h• rt„/,�,,Y>i / e"" •
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies)
i -Building ❑Variance(Minor, Major or Reasonable Economic Use)
❑ Demolition Permit ❑ Conditional Use[C(a),C(d),or C]**
*Single -:••. �� ❑ Discretionary"D"or Unnamed Use Classification
Garage -•`�l L it'/Detached ❑ Special Use(Essential Public Facilities)**
Al Manufacture. Home ❑ Boundary Line Adjustment
❑ Modular ❑ Short Plat**
❑Commercial* ❑ Binding Site Plan**
I I Change of Use ❑ Long Plat**
❑Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRDyAmendments**
If-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 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 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 e try to Jefferson County and its employees,representatives or agents for the sole purpose of application
review and any required later ns ctions.A and right of entry to this property shall be requested and shall occur only during regular business
hours. - _
Signature: '&If/ ---- Date: ' z ��'�
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 lake"of an endangered species as those terms are defined in the federal law known as the
"Endangered Species Act"or"ESA."Jefferson Cou• makes no assurances to the applicant that the actions that will be undertaken because this
permit has been issued will not violate the ESA. •• individual,group or agency can file a lawsuit on behalf of an endangered species regarding your
action(s)even if you are in , pli-•ce wi a I e -fferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transferable =a a sibi. f. .d •ri . to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: .Ai �, t__ Date: '- 2 ._e
er
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04-doc
iii OWNER BUILDER STATEMENT •
The signer of this statement does hereby ce 'fy thatiey are the Owners of the parcel referenced herein,that they are not licensed contractors and that
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assumin res liGeneralContractor for the proposed projec: �` ,�j �li/�,, Date: /�C6
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: i p .HONE: FAx
_. `; 11 I t 't ( ) ( )
MAILING ADDRESS: [`;-- ;! 1 EMAIL:
CONTRACTOR'S LICENSE MAY - 9 2005 I , , + %MAINS
NUMBER: ' NUMBER
ARCHITECT/ENGINEER: SHONE ( ) FAX:( )
MAILING ADDRESS: i s r t , , ,
1'` 1 MI F' I;, T r f'-t f ti'`t -I,1 MAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
.
New K Wood Existing: _ D Sewer
Addition 0 Steel Proposed: 1, ' Bank 0 Community System
O Alteration/Remodel ❑ Concrete Total: Z. S Height:
[it.Individual System
❑ Repair ❑ Masonry SEP Permit#
O Demolition 0 Other: Bedrooms: Water Supply:
Existing: Setback: 0 Private well ❑ Two Party
Type/of.Heat: Proposed: 3 �. Public
C ctv°,r: Total: 3 Name of System: t.
''' Ce,( r 1-t. ��p. I I�(.v (,t2 CL
I 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 X Above ground Tank Size of Propane Tank: / 0 t. q-LC e,*U
i l Heat Stove ❑ Cook Stove ❑ Woodstove 1)4..Fireplace Insert 0 Hot Water Tank ❑ Pellei Stove 0 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
ines, tank location and size,distances from the propane tank to all property lines,buildings and septic system components,
ncluding the reserve area. _.
Square Footage -For Office Use Only
Current Proposed Amount
ain Floor imi i s65.j0 Consistency Review: 4
i ---‘.
u Floor Base fee:
1 ! 1C LOCI1411 1I!Oao: �5
Floor Additional Section:
zanine: Plan Check fee: / 053.
r 3 (Da
led Basement State Surcharge fee: ' Cj(
,ated Basement Pot Water Review fee: e
Unheated 911/Rd Approach fee: VOIe, "
e/Carport ' j
1 % 111401. TOTAL: $ p� $ ' 5 . t7 t
)y 6 �� Receipt Number: 7 7) (t �,
Cc/, 04°l ashlCheck Number 1
►TED COST(REQUIRED) I e— �!
ket value of all
labor and materials foundation to O finish ��
.1 13 O I c Initials. t
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iter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc