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HomeMy WebLinkAboutBLD2005-00382 • BUILDING PERMIT • Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD05-00382 Received Date 06/10/2005 SITE ADDRESS: 411 OLD ANDERSON LAKE RD Issue Date 07/14/2005 CHIMACUM, 98325 APPLICANT: GERALD C GUSTAFSON PHONE: 360-732-4840 MARILYN J GUSTAFSON PO BOX 673 CHIMACUM WA 98325-0673 SUBDIVISION: Block: Lot: T 38+ PARCEL NUMBER: 901104015 Section: 10 Township: 29 N Range: 01 W CONTRACTOR: TOWN & COUNTRY POST & FRAME PHONE: 425-743-1555 16521 HWY 99 SUITE B LYNNWOOD WA 98037-3161 Contractor's License: TOWNCPF099LT Expires: V§ OEj660 PROJECT DESCRIPTION: ADDITION TO EXISTING POLE GARAGE CALL IN FOR THE QUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: 1b Y o�' UFFER: Footing: /4 a4y-D5 Foundation: Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: Shear Wall : Sheathin • Framing: I I-Q -c ---' Plumbin : Propane Tank/ Lines: Insulation: Sheetrock: Septic Sytem Final Approval (If not on sewer): Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: I I-9 -elks 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 CA•A BLD05-00382 • 1.) 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. 2.) The identified Fish and Wildlife Habitat Area (Type 5 Stream), shall maintain a vegetative buffer setback of 50 feet. The setback shall be measured horizontally from the Ordinary High Water Mark (OHWM) to the proposed pole garage addition. 3.) An additional setback of five (5) feet is required from the edge of the stream buffer area to the proposed pole garage addition. 4.) A permanent physical separation along the boundary of the 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.) 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.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 8.) 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). 9.) Maximum lot coverage is not to exceed 25(Yo. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 10.) The building height is not to exceed 35 feet. 11.) Minimum setback from Old Anderson Lake Road right-of-way shall be 5 feet. Minimum side and rear yard setbacks shall be 5 feet. 12.) 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. 13.) 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. I:\F_BLD_Permit_Buildng.rpt 10/29/19 °BUILDING PERMIT APPLICION MRLA05 0eview 0pe35I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00382 Received Date: 6/10/2005 SITE ADDRESS: 411 OLD ANDERSON LAKE RD CHIMACUM, 98325 OWNER: GERALD C GUSTAFSON PHONE: 360-732-4840 MARILYN J GUSTAFSON PO BOX 673 CHIMACUM WA 98325-0673 SUBDIVISION: Block: Lot: T 38+ PARCEL NUMBER: 901104015 Section: 10 Township: 29 N Range: 01 W CONTRACTOR: TOWN & COUNTRY POST & FRAME PHONE: 425-743-1555 16521 HWY 99 SUITE B LYNNWOOD WA 98037-3161 Contractor's License TOWNCPF099LT Expires 6/30/2007 • REPRESENTATIVE: PHONE: • PROJECT DESCRIPTIOr ADDITION TO EXISTING POLE GARAGE TYPE OF WORK GAR • SQUARE FOOTAGE: TYPE OF IMP ADD MAIN: VALUATION 12,437.00 ADD'L: HEAT TYPE: CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYRE: SHORELINE: GARAGE: 576 CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: _ _ WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing J Date:/_ //S— V n F _ • I/ vC Type Amount Paid Bv: Date: Receipt: H/4 rga.�l t�d�ate _ q Permit $237.25 BAC 06/11/05 73359 iL \�/A Plan Check $154.22 BAC 06/11/05 73359 JUL 1 4 2005 State Building Code $4.50 BAC 06/11/05 73359 Total: $395.97 e.rson County Planning ui : ' i •'. tment :CIAL/iiiri ri,g0N c°6 JEFFERSON COINTY 0 ' `� DEPARTMENT OF COMMUNITY h14I 621 Sheridan Street • PortTownsend •Wasngton 98368�q O'. www.co.jefferson.wa.us/commdeyOlopr&ntOf'` SINGS. Master Permit Application I MLA: Project Description(include separate sheets as necessary): A �-{(j�0 Tax Parcel Property ` / , ;;i ., '.;". r• ;l Number: ? --Mil-O/ Size: Ay/ • !4i..• s,, (acres/square feet) Site Address and/or Directions to Pro rty: �/j—�(j� .� � �('e • ;, 10 ; Property Owner(s)of Record: w O) / - t. 5 Gt,,c +c,-ri;y Ir^ 1- -` j Telephone: r 73 -- ,,+r__1 22 j�, Fax: email • : t-... t Mailing Address:A 0,t ©X 6J 73 r ch)r )a( vm i Applicant/Agent(if different from owner): c 0 5-- x }�o�) �` Telephone: 4i2.6-Jy -]SSS. Fax: 92 - 7V/2-/ 6 7/ email: aovNis efw+a6i il}, Cap Mailing Address: 5vt-r-e C (( 51I (-},,,,,i qq 1 L),,nw cococl \ i A SO3 7 h t kind of Permit? (Check each box that applies) uilding ❑Variance(Minor,Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a), C(d),or C]** ❑ Sjngle Family _ CI Discretionary"D'or Unnamed Use Classification arage Attached/Detached Alit•}�c%1 �2`I ; vt 11 Special Use(Essential Public Facilities)** ❑ Manufactured Home -------- yY •---__._. ❑ 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** ❑ Stormwater Management ❑ Shoreline Management Substantial Development** 0 Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance ❑Temporary Use 0 Comprehensive Plan/UDC/Land Use District Mar " -,ndment ❑Wireless Telecommunication* ❑ Jefferson County Shoreline Master Program Ame_.'ament 0 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 hefeby designa+A\ is -, ;• �;,- ' to act as mny agent in matters relating to this application for pg_rmit(s). OWNER SIGNATURE --.2 !/ L +ry.. Date: � � � By signing this application f , e owner gent att sts,that the information provided herein,and in any attachments,is true and correct to the best of his,her or it s knowledge.�Cny ' falsehood or any omission of a material tact 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 entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required lat • spe 'ons, and right of entry to this property shall be requested and shall occur only during regular business hours. _ Signature: Date: �L! vim. The action or actions Appf nt ' e 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 corn ' with the J rson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable res ' i dheri o an mplying with the ESA. The Applicant has read this disclaimer and signs and datesbelow. Signature: �� Date: �i —� G:\PertutCenter\FORI4WDRD FORMS\Mas Permit Application 7-8-04.doc OWNER BUILDER STATEMENT ' The signer of this statement does hereby certify Ilkley are the Owners of the parcel referenced herein.they are not licensed contractors and that they will be-assuming the respo • ility of the General Contractor for the proposed project. ;' nature: N Date: no5 'GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: �Dwn (owl /Qt i- I a wiz- ( yts ) 7 c3_)5SS ((its 7V L-I 1 C!/ i MAILING ADDRESS: Svili-Y-/C. )b 5 7 ) -w e 9 EMAIL: do 4 15 t9 ' e r rvt a b;/f, (-ow)-..- CONTRACTOR'S LICENSE L y y'1 rt is.,o 6 c� I.!. A- U 'y y30 3 7 WAINS NUMBER: -I-D wM C )7 F D 9c1/-J- NUMBER ARCHITECT/ENGINEER: '7-5F Tom,„_ pot,i4it// PHONE ('-/25 )7y3-105 FAX:( ) Oi MAILING ADDRESS: S rvt,[_ G S Cott. L.} Ems. AO 4 '': Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New 0 Wood Existing: 0 Sewer ❑ Addition 0 Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel 0 Concrete _ otal: Height: 0 Individual System O Repair 0 Masonry SEP Permit# O Demolition lif Other. Bedroo Water Supply: poc-I- -- Existing: Setback: ❑ Private well 0 Two Party Type of He t: Proposed: 0 Public /V' 4 otal: 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: 0 Underground Tank 0 Above ground Tank Size of Propane Tank: ❑ Heat Stove ❑ Cook Stove 0 Woodstove ❑ Fireplace Insert 0 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 , . Current Proposed Amount 4 ,, •., Main Floor + Consistency RevievV: a • , 2""Floor Base fee: " :'� 5 , ' 31.d Floor Additional Section: . ,," , a •A b Mezzanine: Plan Check:fee: r Heated Basement State Surcharge fee: Unheated Basement Pot Water Review'fee „" ; 4s* '' R,, Other Unheated s1t/Rd Approach fee , } ��od 51b 4 (0 TOTAL: $ "" '' ,: , Decks - F ?N 5 rs , Receipt Number. �'T", .. P Other Cash/Check Number~ {:�'x; ` . '° F .�'i STIMATED COST(REQUIRED) Date: c `` `� C '4 1 . it market value of all labor and materials foundation to finish r Initials: r a ;4 + ;t4 • . a G:\Per nitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc 1 tag. • a...•• -Allr� ,c -- -___ IOWIl lX Country! Suite C•16521 Highway 99•Lynnwood,WA 98037.3161 PI se Check After Doing Site Plan: ❑Septic and drain(ield �Loi size brow North Arrow in Circle ------ --- '7- Everett:(425)258-4171 Puyallup:(253)840-9552property dimensions ewer lines ❑Elevation of property - 'FRAM BUILDINGS Administrative Headquarters: (425)743-1555 Existing buildings etbacks of proposed&existing buildings L I Bodies of wafer ' , �PERMA GILT FAX: (425)742.4378 Toll Free: 1-800-824-9552 Proposed building Main road with name ❑Floorplan Contractor's Lic.p:TOWNCPF099LT t Easements Access to proposed building O Slopes&Con(o s(5'increments) (12) (,•• 1 r• r 'j,0. ty:Our Future Depends On It.'" L / ;t I t�' Job Name: 4.(, --"y��--1,.��/� Job Site Address: ��l• 6 d j1i2c?y.k,r p,tJ !/- (, c•I • 1 tt, ��/J O - �l i Legal Description: // .ra',` Tax Account: l \ ��'i/h �r�/Y7 /1/c Z-"'c/ � i �ri/liu�' fig,%�r _ _,> ,>. rye,-t/ S x/tA`i T — _L,1T- Xz,f! • =I 1 Q y O • >,1 2 r ( 0 CJI m C", I —♦ ___, - �% -�i�%!/�' c�/`T ��'� �f-�l iiJir�/lam = W MCI ✓ �,-7 l����? e>‘----) Z% 0 tom. -5i9T,'r'%J/l/e44'.- '' O x//T/,-t'C /J2i! e- - /At/6= l 7e i 2 z>i..,',2r2) ,�/2! ?/f//v ' pia i tn«a r . ea 0 I, ;;ta, . • III \ i . , ,' -• , ,a 1, ) , %I, ! • 6- ge 6 .-i/%49 i {, • '-,, i rl yq, ,t V I I -,t., t'L cUXii,✓G • YA' } ip �Irl e ? .- i 41) (/-* Id l�L / l f1 ...__i -t-/'" \ ------ 20/c X i.C'- - - - - — two, _.1- � i l�r • N — l //i'l N- r N CD 0 n v N^ 0 ro r— aiE • :\'o G' �d n i. r J U N 1 0 2005 CD N -- -'' Dui,o -1 , o r i t I +�, PLETE SITE PLANT i'C t•lr !stas Cwi`rr and approved the location of the building,on tion the building to the North,and verifies that all White-Customer Copy White-Office Copy low-Accounting ?ull 0 l;I,show;w 'his drawing in the correct ocaU l'� l� �„ L�o.., LEAD# y 'R SIGN•TURF ,)'I I„ ©1995 Parma-Bill Industries FR-34 12/04 re-tit l!J W