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HomeMy WebLinkAboutBLD2005-00349 OUILDING PERMIT APPLICA#N ML vTy 332 Reiewiewy�: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00349 Received Date: 5/31/2005 SITE ADDRESS: 4973A DABOB RD QUILCENE, 98376 OWNER: MARK REITZ PHONE: 360-385-6882 TERRY REITZ 353 E ARDEN ST PORT HADLOCK WA 98339 SUBDIVISION: Block: Lot: T 4+ PARCEL NUMBER: 701053004 Section: 5 Township: 27 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: • PROJECT DESCRIPTIOr WEAVING STUDIO, MAiNTWOR & PORT - 2ND FLOOR 1480s.f. MUSIC-ROOM TYPE OF WORK RES SQUARE FOOTAG200 irffRa /1,1'✓ L TYPE OF IMP / NE 1� MAIN: -3 000- LPG- /o ce`D /4Ije VALUATION •• " ADD'L: 3,000 HEAT TYPE: --R,4B-- CODE EDITION: 20. HEAT BASE: HEAT TYPE: OCCUPANCY. UNHEATED: # OF STORIES: / OCCUPANCY: OTHER: CONST TYPE: —13 GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: . Exist: Prop: 0 Prop: 2 Total: 0 Total: 2 Routing Date: :P/1/6 Type Amount Paid Bv: Date: Receipt: Rroi Permit ." $3,414.25 BAC 05/31/05 73302 DEC30 2005 Plan Check $2,219.26 BAC 05/31/05 73302 State Building Code $4.50 BAC 05/31/05 73302 Jefferson County Planning Total: $5,638.01 & Building Department 1 • • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD05-00349 Received Date 05/31/2005 SITE ADDRESS: 4973A DABOB RD Issue Date 12/29/2005 QUILCENE, 98376 APPLICANT: MARK REITZ PHONE: 360-385-6882 TERRY REITZ 353 E ARDEN ST PORT HADLOCK WA 98339 SUBDIVISION: Block: Lot: T 4+ PARCEL NUMBER: 701053004 Section: 5 Township: 27 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: WEAVING STUDIO CALL IN FOR THE QUIR INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: 2//6 TW . LiN,LPei o%✓rsyt. UFFER: .5"-- 4/.? 4 Footing: A10")4 .2 3 Foundation: Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: Shear Wall : Sheathing: Framing: . 0K e,-t ,1 (`-7 - (0v ADU DK 3J/3/D7f Plumbing: OX S B/7 Propane Tank/Lines: /or le +?,Q,),' . 'k 4/5 en Insulation: Off( 3/,1<3/7 A ft1fl2S dK 03/07# Sheetrock: 11(Df MIA Z 2 0 1 Septic Sytem Final Approval If t on sewer): Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: 'X4T--10 7 HEALTH DEPARTMENT D 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 C• A BLD05-00349 • 1.) The identified Fish and Wildlife Habitat Area (Type 3 Stream), shall maintain a vegetative buffer setback of 100-feet. The setback shall be measured horizontally from the Ordinary High Water Mark (OHWM) to the proposed development. 2.) All construction activities shall not encroach upon the stream buffer. This includes the storage or preparation of materials. 3.) An additional setback of five (5) feet is required from the edge of the stream buffer area to the proposed home weaving studio/music room. 4.) A permanent physical separation along the boundary of the stream buffer area shall be installed and permanently maintained. Such separation can include installing logs, trees, a hedgerow, or any other prominent physical marking approved by the UDC Administrator. 5.) Stream buffer perimeters shall be marked with temporary signs at an interval of one per parcel or every one hundred (100) feet, whichever is less. Signs shall be in place prior to and during construction activities. The signs shall contain the following statement: "Buffer - Do Not Remove or Alter Existing Vegetation." 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 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. 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.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 11.) The building height is not to exceed 35 feet. 12.) Minimum setback from Dabob Road right-of-way is 20 feet. Minimum setback from Lone Star Road right-of-way is 20 feet. Minimum side and rear setbacks are 5 feet. Minimum setback from the Type-3 stream is 105 feet(100 feet stream buffer plus 5 feet side yard setback). Minimum setback from the neighboring property zoned CF 1:80 is 250 feet. 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. 15.) The cottage industry shall be operated by at least one full-time, bona fide resident in a single-family residence of the parcel on which the proposed use is being requested. 16.) The cottage industry may not employ more than four(4) persons on the site at any one time who reside off the subject property. 17.) This is a cottage industry home weaving studio for wholesale only. No customer shall visit site. Any business requiring customers to visit the site shall provide adequate on-site parking spaces, in addition to one (1) for each full-time equivalent employee who reside off the subject property, and two (2) for the owners of the property. All parking spaces shall meet the standards of Section 6.10. 18.) All structures and outside activities shall be so located or screened from adjacent properties to avoid disturbance through glare, noise, dirt or other nuisances or hazards. 19.) All activity related to the conduct of the business or industry, except for activities related to the growing and storing of plants, shall be conducted within an enclosed structure or be sufficiently screened from view of adjacent residences. 20.) All cottage industry activities shall be sufficiently screened from view of adjacent residences, using site location, topography, landscaping, fencing, the retention of native vegetation, or a combination thereof necessary to meet the Type A screening requirements of Section 6.13. 21.) Traffic generated by the cottage industry shall not exceed the level of service adopted for the public roadway which accesses the use, nor generate significant traffic in excess of that normally generated by typical uses found within the particular district. 22.) No business may provide drive-through service. 23.) Cottage industries shall be limited in their hours of operation. No business on-site customer service shall be conducted before 8:00 a.m. or after 8:00 p.m., Monday through Friday, and before 9:00 a.m. or after 6:00 p.m., Saturday and Sunday. 24.) The granting of the proposed cottage industry use shall not constitute a rezone. No expansions of approved cottage industries are permitted, except as specified in Section 3.6.12 concerning the Remote Rural overlay districts. 25.) No exterior display of goods for sale shall be allowed. 26.) The cottage enterprise is an accessory use to the residential use of a dwelling unit, and the residential function of the buildings and property shall be maintained. 27.) Any new structure constructed to accommodate the cottage industry shall be limited in scale so that it is in character with neighboring properties. In no case shall more than five thousand (5,000) square feet of total building area on the property be devoted to the cottage industry. 28.) No more than one (1) sign is allowed, consistent with the sign standards in Section 6.15 of this UDC. 29.) No on-site direct retail sales of products not produced on-site are allowed, except for items collected, traded and occasionally sold by hobbyists, such as coins, stamps and antiques, and their accessories. 30.) Minimum parcel size shall be one (1) acre gross site area. 31.) No use shall be made of equipment or material which produces unreasonable vibration, noise, dust, smoke, odor, or electrical interference to the detriment of the quiet use and enjoyment of adjoining and surrounding property. Any after-hours business activities shall not have noise impacts discernable beyond the property boundaries. 32.) Not more than one (1) cottage industry shall be allowed in or on the same premises. 33.) The illumination of signs shall be shaded, shielded, or directed so as not to adversely affect surrounding properties or public and private rights-of-way or create a hazard or nuisance to the traveling public, or to surrounding properties. 34.) No sign or part thereof shall consist of rotating, revolving, or moving parts; consist of banners, streamers, or spinners; or involve flashing, blinking, or alternating lights. 35.) The total square foot of the sign shall not exceed 32 square feet per business. 36.) Only one side of a double-faced sign shall be counted when determining total square footage. The square footage of the sign shall be calculated by the outside dimensions necessary to frame the information displayed. 37.) There shall be no more than one (1) on-premise free standing or projecting signs or combination thereof. 38.) Signs attached to or painted against the structure to which it relates shall not be computed as part of the overall total square footage or number. 39.) All signs shall be continuously maintained. Signs that present a hazard shall be subject to abatement. 40.) Free-standing signs shall include measures to restrict vehicles from passing beneath them. 41.) Signs shall be incorporated into the landscaping of the site when landscaping is provided. 42.) The Jefferson County Building Official should be contacted to determine whether or not a building permit is required for the sign. 43.) A minimum of two (2) parking spaces are required for the cottage industry or 1 parking space per 2 employees. A minimum of two (2) on-site parking spaces are required for the single family residence. A minimum of one (1) handicap parking space is required. 44.) All parking surfaces shall be provided with an all-weathered surface. 45.) All parking spaces shall be provided with wheel stops, striping or similar measures. 46.) The handicap parkng space shall be a minimum of 13 feet wide and be properly signed in accordance with the Washington State Regulations for barrier-free facilities (WAC 51-10). 47.) The permitted cottage industry shall not grow beyond the scale permitted for such activities. Should the cottage industry grows beyond the limits, it must move to a location designated for commercial or industrial uses. 48.) Based on septic system capacity the commercial activity proposed for the building served by this permit is approved for a maximum of 4 employees and the 2 home residents, 6 persons total. No use by the public other than employees is approved. I:\F_B LD_Perm it_Bu ildng.rpt 10/29/1999 JsoSEND PI RII 411PI OR7 T o�-- City of Port Townsend >°gyp _' °`��, �,0. I I Fire Department a is?,�� �o [fl-_' !°I " 1 Office of the Consulting Fire Code Official for Jefferson County u� 1 9 1256 Lawrence Street,Port Townsend,WA 98368 WAS (360)344-4607 Email: asstfirechief@ci.port-townsend.wa.us Fax: (360)344-4604 PLAN REVIEW MEMORANDUM TO: Stan Southworth, Plans Reviewer,Jefferson County Department of Community Development FR: Tom Aumock,Asst. Fire Chief, and Consulting Fire Code Official to Jefferson CoulaT44.44.4-01.--- DT: 21 November 2005 RE: BLD05-00349,Weaving Studio,Parcel#701053004,Reitz CC: Fire Chief This department is in receipt of a plan revision for the above-referenced proposal from your office. The above-reference proposal was reviewed by this department relative to the International Fire Code [I.F.C.], 2003 Edition, and the Jefferson County Coordinated Water System Plan, and Jefferson County Department of Community Development,Fire Code Official policy. Findings &Determinations: Ct 1. The proposal was reviewed as etwe- ory fixed occupancy with 3,200 square feet of total fire area of a Group F-1 occupancy with a 7 co s io classification[s]; and, 2. Fire flow and fire hydrant review r this osal is derived from the requirements of the Jefferson County Coordinated Water System Plan, and Jefferson County Department of Community Development, Fire Code Official policy. a. No fire hydrants are available for this project; and, b. The fire area calculation is 3,200 square feet [without area separation wall]; and, c. Fire flow requirement based upon the, fire area determination including provision a. above, and the proposed construction classification for this proposal [Type I]: 500 gallons per minute by minimum default sustainable for two [2] hours; and, d. Fire flow delivery can only be met by Fire District pumper capacity from tender operation, allowable under NFPA 1142, at a maximum of 500 gpm; and, Please advise the applicant that unless there is an occupancy separation requirement, that this proposal does not require an area separation wall, as proposed in the plan. 0.5 hours time was consumed in the review of this proposal It is the administrative determination of this department that the proposal be approved subject to the aforesaid requirements of the International Fire Code and NFPA standards. C:\Documents and Settings\toma.COUNIY\Desktop\Tom's Cabinet\Jefferson Co.Plan Review\Jeferson County Plan Review\Reitz BLD05-349 Weaving Studio Ill.doc 11/21/05 I.S.COIRE FLOW CALCULATION WORK ET Building Permit Number 05- OD3¢9 Proponent Location - Fire District 45.amoveut/ Parcel Number -7-0/D -3 D 24 Fire Area Calculation (A] Base c3,zp0 SF Overhangs _.-- SF Square Ft. Total 13:Z,OO • I.B.C. Construction Type 1 • I.S.O. Construction Coefficient [C] p,(o ▪ Total Fire Flow from ISO Formula: 18 C[A] 05 =[F]-/+H% 18041 5 Zoo ]°.5=Base Fire Flow GPM[F] Base Fire Flow GPM f 7/ Debits or Credits (H] • I.S.O. Occupancy Hazard Low [-25%] n High [+25%] Adj. GPM A09- I.S.O. Exposures Debit or Credit Distance/Type Debit/Credit% <30'add 20% North 31-60'add 15% South 61-100 add 10% East 101-150 add 5% West >150'subtract 25% Total Debit or Credit [Max. Credit @ 25%] % Adj. GPM ,v/,d • Sprinklers Credit n deduct 0.75% Multiply by 0.25 Adj. GPM k/iqr Q One-Hour Construction Credit n deduct 0.25% Multiply by 0.75 Adj. GPM N,a • Area Separation Credit Calculation Largest Internal Fire Area:Adjusted Fire Flow • Factored to SF: 1 gpm • Maximum Fire Area Separation Calculation Square Feet • Required Total Fire Flow Requrement [But not less than 500 GPM] Required GPM Lf25 d - Proponent Design Change Credits Type Percentage Exposure Ti Sprinklers Ti One-Hour Construction n Area Separation n Other n Total Adj. GPM I N/ Plans Examiner Date // ..2//p Fire Flow Worksheet 11/21/2005 PERMIT # 11113 °) ° JEFFERSON COUNTY ��c;cTY DCD L11:111)11 . „ 1A DE PARTMENTOF COMMUNITY DEVELOPMENT MAY31 2Q�5 621SheridanStreet • PortTownsend • ashington 98368 r 360/379-4450 • 360/379-4451 Fax __ _. G' http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# `, ' 'l `9 PROJECT/APPLICANT NAME: M it h I J E1 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. 1 / }IJ 1// /� p✓ r^ 44, (t: `h Y , 6-C ( ,'Yt,1 C f v.C,. , A,`. I v) frc ✓1 4-K `> t'l C7 [_- /e6x t ej e: v e, ? • Existing Conditions Summary 2. Describe t e existing topography. Indicate contours on the site map. 5�� 5l7-1 Ati= r= ) - 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. 0 WO() 2fl . A.41 ; 74.. - 4. Describe the existing soils. Indic to soil type on the site map. c4Wlt k/ ( —I� 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 acreage of each. 6. Describe any excess levels of noise generated by the proposed use or activity: APPROVED STORMWATER PLAN Storm /a is JUL 1 2 2005 stormwater site plan template-rev.10/1/2003 Require JEFFERSON UN 5 DEPT.OF C , ' ' WI I P. EN SIGNATURE 7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, steep slopes, etc.)on thy site. Indicate 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 slopes,etc.). s re 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. 9. 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 thesefacilities` on the site plan and differentiate proposed f(a/cilities from existing facilities. 2�}�7ZJi sev! p,-.6 1 r. kn f I & ter i t/ d t �+ "•'c m't, �r��Lam. Ft � r J 30 / G' e 10. If the project requires the use of stormwater 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.] I 11. Describe the performance goals and standards applicable to the project. • 12. Describe the flow control system. --� Ili .._ MAY 3 1 j ! 2005 • • • W/A- jth• vu 6 stormwater site plan template—rev.10/1/2003 13. Describe the water quality system. / IN' , ,.,� i L:_ 14. Describe the conveyance system analysis and design. E N/fir c , M AY 3 1 Def5 L ' li_ ___---1 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. t M iii 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform fi '_ Building Code. ii-- — .. 17. Desc�rii the proposed surfacing material. !Y 18. Describe methods for restoration of the site. N' P 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. N to- 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. Afill 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. /IA . stomiwater 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 the template that follows must be installed on the ground during all construction phases of the project. The proponent is responsible for 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 Clearing Limits. v+ 10 viA t t 0 s `. 2. Establish Construction Access. / J, 4( ::s '1( Cx '• 5Tr q j/i ✓j. >rf` Tr4tj gtvt 3. Control Fiow Rates / / 4. Install SSe^�diment Controls. / f { ) Iee-5 Lit e (A C. 4 if 5. Stabilize Sops. 6. Protect Slopes. • MAY 3 1 2005 7. Protect Drain Inlets. 8 stormwater site plan template—rev.10/1/2003 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. t{( , • /y/4- 9. Control Pollutants. 10. Control/ De-Watering(the act of pumping groundwater or stormwater away from an active construction site). u �Y 11. Maintain Best Manag ment Practice (BMPs). �f 11 e `S/1 Gc/t (1 C C e-r' t:s!�1 �t , l?j" G'i( t' �fr y 4-"I.( C ti vt ? e'j�[ r,.s t a 12. Manage the Project. !! tit y��`[� Ci r� ..'� �`�F-.. 143f�r. e+z t j k� f t1„) /1e,k,- ` Sr 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential area roads). 4 b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). <'f9:.R 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. sJo 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). tom e c�'L a � (11 !''P 1/1r_- p v C?/e frt.. er ,::1 I:; Gr, c 5. Construction Phasing. a. Construction sequence , ) ✓"'/.a�t .-� �f L' f <1-✓- .rr(Gt :-f r'"t 1.')Gt 1�' t+et fin","..K",..''/a ; J PI u f :F!e, t (Ir1 S t^tc. Ec vc c. b. Construction phasing(if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Providei � a proposed construction sc edule. �1k V'c.. li Lr' I;. jY"� CAv'r eg ivi 1-7/ II. Wet Season Construction Activities. a. Proposed wet season construction activities. d.JI ' b. Proposed wet season construction activities for environmentally sensitive areas. 7. Financial/Ownership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. /A �h-,- OFT' . b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. IV/` ) MAY J 2005 i..1 b. Diversions. c. Waterways. d. Runoff/Stormwater Detention Calculations 1. ''iyH�_tstt stormwater site plan template—rev.1 W12003 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 be submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised 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 SW PPP worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected pro erty. (LANDOW R OR AUTHORIZED R ESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: l 1 - i MAY 31 2005 ' 12 stormwater site plan template—rev.10/1/2003 i , orrco JEFFERSON �,JUNTY' DEPARTMENT OF COMMUNITY DEVELOrTon MEN 621 Sheridan Street• Port Townsend 98368 MAY 3 r' 360/379-4450 • 360/379-4451 Fax I i �i;'15 ;`� p www.co.jefferson.wa.us/commdevelopment 1____ �` . S�i!INp� ( ----_� t_i I Master Permit Application MtA - j- ._._ At Project Description(include separate sheets as necessary): 7 Cr ° Tax Parcel Property 7Gars Number: / 0I - 0 5 3 `-0 0 ISize: 2 J&/ /00 / (acres/square feet) Site Address and/or Directions to Property: til 7'S 007 0C if(// Lacl i le Property Owner(s)of Record: -c 1 G is f Telephone: -360 3 Q5 l� YZ- Fax: email: (-c'fo"1441 i/cS 6 cafe.57.4.," Mailing Address: 357,3 15 , 6 gl) C---.is/ CT,y it,f He a(c,:.1s/ t,41- c `_53 7 r(0 iti 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 C]** ❑ Single Family ❑ Discretionary"D"or Unnamed Use Classification ❑Garage Attached/Detached ❑ Special Use(Essential Public Facilities)** ❑ Manufactured Home ❑ Boundary Line Adjustment Cl Modular ❑ Short Plat** ❑ Commercial* ❑ Binding Site Plan** [I Change of Use ❑ Long Plat** ❑Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRDyAmendments** kPropane ❑ Plat Vacation/Alteration** Li 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 Li Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment L] 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 Acce and right of entry to this property shall be requested and shall occur only during regular business hours. c /y _—Li L -- Signature: Date: —Uj 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 the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-tra sffrabe resp srbi• for ad ring to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: t C%v' L `✓ Date: 5 -t_( 0 5` G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc 0 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 r sponsi ility of a General Contractor for the proposed project. Signature: }T7 C-th Date: 5 ` Li 'L') GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: Lm. 7 MAILING ADDRESS: EMAIL: !f A� 3 1 �nnr ill I I CONTRACTOR'S LICENSE WAINS , i WY Lr7tlJ NUMBER: NUMBER f ARCHITECT/ENGINEER: PHONE ( ` ) ' FAX ( ) MAILING ADDRESS: EMAIL---• - - ___ ._�_...__. ._. _ Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: X New X. Wood Existing: — CI Sewer ❑ Addition ❑ Steel Proposed: _ Bank ❑ Community System ❑ Alteration/Remodel 0 Concrete Total: a _ Height: Ix.,Individual System O Repair 0 Masonry SEP Permit# 7S-O/6A O Demolition 0 Other: Bedrooms: Water Supply: Existing: Setback: X Private well ❑ Two Party Type of Heat: Proposed: LI ❑ Public Total: —v'— Name of System: If this is a Commercial Project you must answer the following: q Number of Parking Spaces: Current: Proposed: ! Number of ADA Parking Spaces: I / Number of occupants(includes owners,tenants,employees,etc) Current Proposed 6(1. - ,,e4- --s 2 e,L,t,/� 1e- 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 g,Above ground Tank Size of Propane Tank: i'.,ZG 6:x- / ❑ Heat Stove ❑ Cook Stove ❑ Woodstove I 1 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 Current Proposed _ Amount Main Floor Consistency Review: 3C3C70 4S VI Gi. cc, 2m)Floor 3 3 �� -Base fee: (;8mfo : 4-Iq ) 3n°Floor ' Additional Section: Mezzanine: Plan Check fee: Heated Basement State Surcharge fee: Unheated Basement Pot Water Review fee: r, YroovyttivIilk VIM O'k-110\ Other Unheated 911/Rd Approach fee: csi_+t Re u�," �I L PLATE-- I`� Garage/Carport TOTAL $ C Decks Receipt Number: 1 1 l 0 Other Cash/Check Number: r %DU, ESTIMATED COST(REQUIRED) Date: , .Fair market value of all labor and materials foundation to finish = r) t J 1. 1 6CO/0CX) ' .� >> �1 0 (�� ,els, li G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc , \ , I; 7 r ' II -— , � , 15 1 DAB 0 B R D, v._. _,_ ____w.,_..._--- ------- \ 20'-0' NATURAL VEGETATION BUFFER a..- c. — " -/20'/- ,, n W A W W 4 �r:S (EXISTING) Z J OQ \ J r [t^ = T W Lai In a H X N 0 a. 0VX SU XCUv ff d i 0 % J 1 U Z a J Xchew 0 I I ¢ vNG I. J r JZ , ..:.: .,RESERVE LI amr(o ¢. DRAIN A FIELD.) 12'-0'I" / z iir• TLa a W ro F- (EXISTING) / Cn La W \ i sr) A� IX _St/444W EPTI • A/G 120 GAL O !Alt ¢ CMGS R. PROPANE TAN • 0p CDC I 2 1�/^' I' /��)/� /I�yy� (coTQ, -) CIXIST) I ty1 2 3 W Y '/”4'L .: {r a N 1 ¢ / 123' ,� 1�t. b �c)9 ¢ 1AI //�.�, Pi �`� — tip + � Strait :� �� 105' SETBA FR. u too' t / ( t l' �i2 p/�+.75 W ! DN CraL, • • TYPE 4 STREAM <S `rT 11,0 44, W REVISED SITE P AN Z dated 1I5DO►. J , Has been APPROVED —K-- L., by JEFFERSO O a DEFT. CO EVE \ S1ONATUDF stormwa �S \ Require EXISTING DOMESTIC WELL. / 100' ,( 75' 0' ip' too PROPERTY LINE PERMIT # B,R 332'-9 1/4' 0 5 — 9 0 3 4 JEFFERSON COUNTY r SITS L \ SCALE: 1"= 75'— 0" REITZ WEAVING STUDI❑ 4973 DABLJB DR. SHT 1 QUILCENE, WA. 98376 DRAWN BY: MARK REITZ (360) 385 6882 DATE: 9/26/05 TAX — 701-053-004 i r APP" 411, oz 0 n w 0 0 El I\ Vill -13 41- o 7> o n o FT-1 0 OOIUI I' s �a _ 4 ; __--. 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