HomeMy WebLinkAboutBLD2005-00274 MLA05-00263
BUILDING PERMIT APPLICATIN Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00274 Received Date: 5/3/2005
SITE ADDRESS: 162 DUSTY RD
BRINNON, 98320
OWNER: JEROME FITZGERALD PHONE: 208-886-2756
440 N 375 W
SHOSHONE ID 83352-5146
SUBDIVISION: Block: Lot: T21
PARCEL NUMBER: 502104037 Section: 10 Township: 25 N Range: 02 W
CONTRACTOR: OWNER/BUILDER
PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION NEW DETACHED GARAGE
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 936
VALUATION 33,375.00 ADD'L: 432 HEAT TYPE: UH
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: # OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: SHORELINE:
GARA0
CONST TYPE: DECKLE 48 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: -0 Prop: 0
Total: 0 Total: 0
Routing Date 9 of
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Type Amount Paid Bv: Date: Receipt:Permit $482.15 BAC 05/03/05 72971 � rantLs+"
Plan Check $313.40 BAC 05/03/05 72971
State Building Code $4.50 BAC 05/03/05 72971 JUL 6 2005
Total: $800.05 efferson County Planning
'apartment
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00274 Received Date 05/3/2005
SITE ADDRESS: 162 DUSTY RD Issue Date 07/26/2005
BRINNON, 98320
APPLICANT: JEROME FITZGERALD PHONE: 208-886-2756
440 N 375 W
SHOSHONE ID 83352-5146
SUBDIVISION: Block: Lot: T21
PARCEL NUMBER: 502104037 Section: 10 Township: 25 N Range: 02 W
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: NEW DETACHED GARAGE
CALL IN FOR THE REQUTE /INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS` Of S
UFFER:
Footing: $ 3S-' G•J/c ..a)(
Foundation:
StormwatiFlNAL Approval: 40/1/ 5//J/A
Underground Plumbing:
9 9
Underground Insulation:
Shear Wall : �',�r 4'H6--AR_ L[JALc.S OK � 4L ft
Sheathing:
Framing: 06L 3—2g—4:
Plumbing:
Propane Tank/ Lines:
Insulation:
Sheetrock:
Septic Sytem Final Approval (If not on sewer):
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval: jl
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 CA t BLD05-00274
1.) 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.
2.) 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."
3.) A vegetative buffer of 15-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.
4.) All construction activities shall not encroach upon the 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.) 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.
7.) 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.
8.) 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.
9.) 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.
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10.) As stated in the geotechnical report dated July 7, 2005 prepared by Allen L. art
Engineering Geologist, "All runoff from roofs, patios, driveway and parking areas, and
similar hard surfaced areas should be intercepted and directed away from slopes and to
appropriate disposal areas. The free flow of water over the terrace fill slope face should
not be allowed due to the potential for erosion and slope damage".
11.) 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.
12.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP)
Elements#1 through #12 of the Department of Ecology's Stormwater Management
Manual for Western Washington 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.
13.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
14.) 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).
15.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
16.) The building height is not to exceed 35 feet.
17.) Setback from Dusty Rd. right-of-way is no less than 20 ft., setback from Hwy. 101
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.
18.) The applicant/owner shall follow all recommendations as stated in the geotechnical report
dated July 7, 2005 prepared by Allen L. Hart Engineering Geologist.
I:\F_BLD_Permit_Buildngspt 10/29/19
"w4` 'i cOr,� JEFFERSON CCOITY •
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street • Port Townsend •Washington 98368 ,
360/379-4450 • 360/379-4451 Fax
Qq r3 www.co.jefferson.wa.us/commdevelopment
"VINO MAY - 3 2005 �
Master Permit Application MLA: C/ 5 - (.0 , J
. _
Project Description(include fq
arate heets a .necessary):
N'e-c,.-/ Ci (_,L� - ki 1 C("ic �----- tA;h 1 e... 7 -e. —moo /C...q...s.-I
//)
Tax Parcel f-- n �/ Property i
Number: .D C.)tat- - / 6t — 0 .2 Size: <, '( ,e_S (acres/square feet)
Site Address and/or Directions to Property: I ( d2 D e' + )d ,
Property Owner(s)of Record: 7 1 -�irc�v. r';'t- �l esr[f<4..'Z.L$'"' ' Z Telephone: ` — `.2,S_ Fax: email:
Mailing Address: t"/Y(' /1/ 3'7 6 L / $ .g Drys, . i ..Z ): 3" 5 .S"e
Applicant/Agent(if different from owner): <'L k' nk.J.:•.3
Telephone: 7 Cl t — /Y 2 5f Fax: email:
Mailing Address: 2 (;--C) -,f G)4 ("e- 1�,_ ,'i,.-t 0 c-, .47.4tf �'R.3 L2
What kind of Permit?(Check each box that applies)
El 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 Hom ❑ 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 0 Shoreline Master Program Exemption/Permit Revisions**
❑ Stormwater Management El 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 at to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE 't^- `- j Date: — 2_�— 5—
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 and any required later inspe ' ns.A--cess and right of entry to this property shall be requested and shall occur only during regular business
hours. J _
Signature: •-'�— .f Date: 2 7 — CD 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 lake"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-th Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transf rable responsibili or fiering t and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: Date: ? — 7 —
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
• OWNER BUILDER STATEMENT •
The signer of this statement does here • that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be assuming the res i 'f the G eral Contractor for the proposed project.
Signature:(9 '~ Date: `! •— Ur S
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms.
.._•„ Shoreline: Type of Sewage Disposal:
New )st,Wood Existing: ❑ Sewer
❑ Addition 0 Steel P sed: Bank 0 Community System
❑ Alteration/Remodel 0 Concrete r Total: Height: ❑ Individual System -7
❑ Repair ❑ Masonry SEP Permit# U d
O Demolition ❑ Other: 'edrooms: Water Supply:
y:
Nsting: Setback: A. Private well ❑ Two Party
Type of Heat: Praposed_y ❑ Public
h D h Total: �J 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:
❑ Underground Tank ❑ Above ground Tank Size of Propane Tank:
❑ Heat Stove ❑ Cook Stove ❑ Woodstove LI Fireplace Insert ❑ Hot Water Tank ❑ Pellet 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
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 3 r -__ Consistency Review: co
2Nu Floor — r 1 j C ��i%•1�
Base fee: , . 1.1 Ol L
3`d Floor Additional Section: t
Mezzanine: Plan Check fee:
Heated Basement State Surcharge fee: 1 ,50
Unheated Basement Pot Water Review fee: -
Other Unheated w/ � C; 911/Rd Approach fee: , ., C t oi
L01 t�
Garage/Carry ��� ��.� TOTAL: $
�4(� r/ �%� 6 a 1 4 CV_ CAS
? h a o v- tga il Receipt-Number. \ q a q
Otiiec � _ 5 1 Cash/Check Number:
ESTIMATED COST(REQUIRED) Date MAY .. 3 ��� /
•Fair market value of all labor and materials foundation to finish �,
(-5) CO e0� Q... Initials:
G:\PermitCenter\FORMS\DRD FORMS\Master Pert Ap ca' n 7-8-04.doc
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