HomeMy WebLinkAboutBLD2005-00418 f.
BUILDING PERMIT APPLICAfON MRAOWO� - :I
Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00418 Received Date: 6/23/2005
SITE ADDRESS: 140 CLEVELAND ST
PORT HADLOCK, 98339
OWNER: KATHRYN G SEDLAK PHONE: 360 302-0156
6505 NE FIR ST
SUQUAMISH WA 983929777
IRONDALE AC TRACTS
SUBDIVISION: Block: Lot: T 22+
PARCEL NUMBER: 962700096 Section: 7 Township: 29 N Range: 01 E
CONTRACTOR: OLYMPIC RIDGE INC PHONE: 360-302-0156
15940 LINDSEY LANE
POULSBO WA 98370
Contractor's License OLYMPRI986NA Expires 8/1/2006
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI NEW SFR W/ATT GARAGE
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 878
VALUATION 150,000.00 ADD'L: 234 HEAT TYPE: EEE
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: # OF STORIES: 2
OCCUPANCY:
OTHER:
CONST TYPE: 5N SHORELINE:
GARAGE: 367
CONST TYPE: SETBACK:
DECK: 100
BANK HEIGHT:
SEWAGE DISPOSAL: OSS
WATER SYSTEM: PUD
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 1 Prop: 2
Total: 1 Total: 2
Routing Date:
Type Amount Paid Bv: Date: Receipt: At 4 rovel&V E l)
Potable Water Application $53.00 INT 06/23/05 73401
State Building Code $4.50 INT 06/23/05 73401 MAY It) 2006
Plan Check $827.94 INT 06/23/05 73401 Jefferson County Planning
Permit $1,273.75 INT 06/23/05 73401 & Building Department
Total: $2,159.19 CAQQl a�
• •
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00418 Received Date 06/23/2005
SITE ADDRESS: 140 CLEVELAND ST Issue Date 05/10/2006
PORT HADLOCK, 98339
APPLICANT: KATHRYN G SEDLAK PHONE: 360 302-0156
6505 NE FIR ST
SUQUAMISH WA 983929777
SUBDIVISION: IRONDALE AC TRACTS Block: Lot: T 22+
PARCEL NUMBER: 962700096 Section: 7 Township: 29 N Range: 01 E
CONTRACTOR: OLYMPIC RIDGE INC PHONE: 360-302-0156
15940 LINDSEY LANE
POULSBO WA 98370
Contractor's License: OLYMPR1986NA Expires: 8/1/2006
PROJECT DESCRIPTION: NEW SFR W/ATT GARAGE
CALL IN FOR THE RE UIRED INSPECTIONS THAT APPLY TO F7 P JECT.
SETBACKS: �4IU/ ?7 Ti
C
UFFER:
Footing: j}/[ ��/D��
Foundation: O`C ,62///44
Stormwater FINAL Approval: //Lsfri.AuE QK chs/a4A
Underground Plumbing: itimeeboe r</A,q -ii pk /3/4/90/
Underground Insulation: 91)
Shear Wall : Dk 7" ctL OCII
Sheathing:
Framing: 2)4y/6.46 1 R&/', ►tE z''Qaar&s i 6.)VEILrn ) A,
4.4TbeC4. 5ksa. s i5/�
Plumbing: 0k .S�0 /
Propane Tank/ Lines:
Insulation: /�/Q. 6k 3/5/6dc a< �'�7®/0.6
il)
Sheetrock:
Septic Sytem Final Approval MUST be obtained before final of structure can be attempted.
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval: Dt( - i'r G,��J 13/3 4
HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUI ED 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 # BLD05-00418 •
1.) 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.
2.) 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.
3.) 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.
4.) 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.
5.) The property owner shall comply with Water Conservation Measures (per list maintained
by the UDC Administrator).
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%. 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 Cleveland Street right-of-way shall be 20 feet. Mini side yard
setbacks shall be 5 feet. The proposed residence is 27 feet from top of medium bank.
The proposed house is utilizing the shoreline averaging setback per JCC Section
18.25.410(4)(j)(i)which states that"where there are existing dwellings within 300 feet on
either side of the proposed building site, the etback shall be thw average setback of those
dwellings". To the north is an existing residence that is approximately 50 feet away from
the proposed foundation and to the south is an existing residence that is approximately 88
feet away.
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.
14.) Residential developers and individual builders shall be required to preserve shoreline
vegetation and reduce the associated risk of erosion during construction and any future
activity which may impact the stability of the shoreline.
15.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
16.) Prior to final approval of the residence the onsite sewage system must be pump tested by
the Environmental Health Division.
17.) The existing well on the property shall be properly abandoned by a licensed well driller
prior to final approval of the residence. Documentation shall be provided to the Health
Department.
I:\F_BLD_Permit_Buildng.rpt 10/29/1999
/ ON cob\ JEFFERSON CSNTY •
r1 ` 4 DEPARTMENT OF COMMUNITY DEVELOPMENT
R 621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
� •PAa* )
�ySO� www.co.jefferson.wa.us/commdevelopment JUN 3 2
Master Permit Application MLA: u 5--3g2 ,
Project Description(include separate sheets as necessary): ,t' / �_�,__..
CU
Tax Parcel (� Property y
Number: `L I.
. )oo0Ci G Size: , On c ,(acres/square feet)
Site Address and/or Directions to Pro, I d f t.LLD1 n Cr
Property Owner(s)of Record: IC �_ �. , rr but
Telephone: 06 0- ?fl `0(4-6 Fax: £Q j `--NLe C/40) email: ---(,)'—
Mailing Address: /J'y Le ...,..,_A� C42i... &Vcf/ C.Ja, .,{J)U
Applicant/Agent(if different from owner): •. r: `44 t° /„.,.,� <'z .r .r
Telephone: 76 G, `�Q.1 C2/P6 Fax: o — ci —
email:
Mailing Address: /• —9(;.fir L(c,. %ry ( ;14.4 �',<4 .
What kin of Permit?(Check each box that applies)
❑ Buil ' ❑Variance(Minor,Major or Reasonable Economic Use)
olition Permit ❑ Conditional Use[C(a), C(d),or C]**
Jngle Family ❑ Discretionary"D"or Unnamed Use Classification
Ig'Garage Attached/Detached 0 Special Use(Essential Public Facilities)**
❑Manufactured Home ❑ Boundary Line Adjustment
❑ Modular ❑ Short Plat**
❑ Commercial* ❑ Binding Site Plan**
❑ Change of Use ❑ Long Plat**
❑Address ❑ Road Approach 0 Planned Rural Residential Development(PRRDyAmendments**
❑ Propane 0 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* 0 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 j., ' . '14,,,,,, to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE ji i1's r—a c./��JRie e��_. Date: (v/'/L//U
5
By signing this application fonn,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of
his,her or ifs 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 pro de access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application
review and any red later inspections.Access and right of entry to this property shall be requested and shall occur only during regular business
hours. n .
Signature: ' i Lam Date: 67/9 f(..)S
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 y" are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transf• ..le res ' ty for ad eeng to and complying with the ESA. The Applicant has read this disclaimer nd signs and dates it below.
Signature: 24 Z, ��
-C
Date: 6C��fj�--
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
•
OWNER BUILDER STATEMENT •
The signer of this statement ereby ' that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be assuming 'bility of General Contractor for the proposed project
Signature: Date: 6/3 �f
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
C' /L�y,o°��� / - ) ??a2--r74 i ( )
MAILING AVSDRI / y) ! 61 �,r:� A-,,,,,,,,_: ,„, w.?„v _
CONTRACTOR'S LICENSE i sc�y
WINS
NUMBER: wee e,')i/�1V�iZarCl ,/(`� NUMBER
ARCHITECT/ENGINEER: L ../ PHONE ( ) FAX ( )
MAILING ADDRESS: EMAIL
Pro ype: Fra perfype: Bathrooms: Shoreline: Type of Sewage Disp
osal:
posal:
New ood Existing: ^ — ❑ Sewer
❑ Addition ❑ Steel Proposed: 2 Bank 0�Community System
❑ Alteration/Remodel ❑ Concrete Total: Z Height: Individual System
❑ Repair ❑ Masonry —o , SEP Permit# S j`7
❑ Demolition 0 Other. Bedrooms: Water Supply.
Existing: 0 Setback: ❑ ate well 0 Two Party
Type of Heat: Proposed: / Public
Total: _i___ 6 C ' Name of System: 4.4..iaNi
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 0 Cook Stove IDWoodstove 0 Fireplace Insert 0 Hot Water Tank ❑ Pellet Stove 0 Other
Is this appliance being installed in a Manufactured I 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 Foir'C ce Use`O my: ,. 1Yr ,- 4s`. a °` "'i
Current Proposed a n.. o ' ' ; "�� sf ��f ,
Main Floor ^�/ �'y+r�) � � Consistency Review s s
4t Jxy .t {'4�lq f � rt n�T
2 Floor a ' a' �7A.: , r' F •a z
3`"Floor olt 5 ,
?a,� it
Mezzanine: . •.:,.-,q ,,
•
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atHeated Basemen
Unheated Basement W '`: i,r ;t t „, + ‘, ` �-
., t,
Other Unheated �` '. $ ' Q,gn• , i .t, r Gs� . X `# -'" b
Garage/Carport r� �6� s • , °`sn
0_ wnber� ." �' "4 �, t
r !
Other 00 � rr 'r , 4.. �`"�� � ' m
Li
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ESTIMATED COST - r Dad
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*Fair market val ... foundaliar b finish r Viz„ ,� ``
•� e� r'-y�Y�
Initials 0'.,',....Yr ' q :ib i a
... ...'art,. 1. ,Y '?,, R _
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