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HomeMy WebLinkAboutBLD2005-00530 •UILDING PERMIT APPLICA )N MLLA05 00492 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00530 Received Date: 8/18/2005 SITE ADDRESS: 143 NICHOLSMITH LN BRINNON, 98320 OWNER: STEPHEN PETRICK PHONE: 360-796-0239 CHERYL D PETRICK PO BOX 426 BRINNON WA 983200426 SUBDIVISION: Block: Lot: T 32 PARCEL NUMBER: 602231008 Section: 23 Township: 26 N Range: 02 W CONTRACTOR: SOUND BUILDING SYSTEMS PHONE: (360)437-1219 3546 THORNDYKE RD PORT LUDLOW WA 98365-8229 Contractor's License SOUNDBS027NM Expires 8/19/2006 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOt NEW POLE BUILDING NO PLUMBING/ NO HEAT TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 11,592.00 ADD'L: HEAT TYPE: CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: U 1 UNHEATED: # OF STORIES: OCCUPANCY: CONST TYPE: 5N OTHER: SHORELINE: CONST TYPE: GARAGE: 720 SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: 0 Prop: 0 Total: 0 Total: 0 Routing Date' g 0 Type Amount Paid By: Date: Receipt: Approved/Date Permit $209.25 SLE 08/17/05 76291 APPROVED Plan Check $136.01 SLE 08/17/05 76291 State Building Code $4.50 SLE 08/17/05 76291 SEP 1 4 2005 Total: $349.76 Jefferson County Planning Buil ' D artment FOit F eo A BUILDING PERMIT• Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD05-00530 Received Date 08/18/2005 SITE ADDRESS: 143 NICHOLSMITH LN Issue Date 09/13/2005 BRINNON, 98320 APPLICANT: STEPHEN PETRICK PHONE: 360-796-0239 CHERYL D PETRICK PO BOX 426 BRINNON WA 983200426 SUBDIVISION: Block: Lot: T 32 PARCEL NUMBER: 602231008 Section: 23 Township: 26 N Range: 02 W CONTRACTOR: SOUND BUILDING SYSTEMS PHONE: (360)437-1219 3546 THORNDYKE RD PORT LUDLOW WA 98365-8229 360-437-1218 Contractor's License: SOUNDBS027NM Expires: 8/19/2006 PROJECT DESCRIPTION: NEW POLE BUILDING NO PLUMBING/ NO HEAT CALL IN FOR THE QUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS. lD-,./6-as UFFER: Footing:/D -o2(e-0 Foundation: Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: Shear Wall : Sheathing: Framing: Plumbing: Propane Tank/ Lines: Insulation: Sheetrock: Septic Sytem Final Approval (If not on sewer): Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: O- it 2 Z 4— j 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 likSPECIAL CONDITIONS FOR E A BLD05-00530 • 1.) A vegetative buffer of 30-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. 2.) 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. 3.) 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." 4.) All construction activities shall not encroach upon the landslide hazard area 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. 10.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). i • 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.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 13.) 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). 14.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 15.) The building height is not to exceed 35 feet. 16.) 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. 17.) 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. 18.) Minimum setback from Nicholsmith Lane right-of-way shall be 20 feet. Minimum side and rear yard setbacks shall be 5 feet. If an ESA is present, then the more stricter setbacks shall apply. I:\F_BLD_Permit_Buildng.rpt 10/29/19 • OWNER BUILDER STATEMENT . i 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 1 they will be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: -- AUG 17 2005 1 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: 3oun4 liuiltlin , 5yitema Ih - _ ( 360) 937- 1.1 i.I ( - 4,[,) '13 } 1-27 ._ MAILING ADDRESS: ,j y yic Ma,-foci yk F_ Read — EMAIL: CONTRACTOR'S LICENSE Po, f 1-.ad10., 0'1- 74's(rs WAINS NUMBER: S O I.t A/0 13 S 0.• 7 NM NUMBER ARCHITECT/ENGINEER: PHONE ( .5 c'.S ) X* t 7 J i FAX:(s e,3 )s a'9• )7 a 6Y A II((ince knSinereins 5 7 MAILING ADDRESS: a-7co/4a,'kr-Y Sfi, elf:Sfc. EMAIL A Saie:.t , UR q 73 01 Project Type: Type: Bathrooms: Shoreline: Type of Sewa ge Disposal: �New Frame Existing: ElSewer O Addition 0 Steel Proposed: Bank ❑ Community System 0 Alteration/Remodel 0 Concrete Total: _ Height E(Individual System ❑ Repair 0 Masonry Bedrooms: SEP Permit# i.I 2---- 0 Demolition 0 OtherWater Supply: Existing: Setback: Eir Private well 0 Two Party Type of Heat Proposed: ❑ Public Total' -- — Name of System: If this is a Commercial Protect 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,marls all Items below that apply: ❑ Underground Tank ❑ Above ground Tank Size of Propane Tank: O Heat Stove 0 Cook Stove O Woodstove O Fireplace Insert ❑ Hot Water Tank 0 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 ce(I _s o 5,- -3 "..t ..;. s .. p$• R ; Current Proposed t, z` ,f. . j, t i •LST.,,i.<ri �S7M1..' �� a 4 � 'ae'�j.R' Main Floor �,�a H t . 7 `+�',y t y, s.. 1'" r-4„� `.chi Y ;. µ ,t8' 4 -� . ., try: .. 2 Floor s < 7• 7'� Y .�„ -' r �_ ` -fvs ;4 3f°Floor , z �a , f- ' t•'. 'a7e-otio 1 �'t o_.;1 a• x.h .•,t S` -,e a itt -_ , tic: Mezzanine: i , 'tan Chock fee -;,, , t ,} 3 .I' _ w? IT IC _`Y++ 4'tr y . `� ?'} 'Y- � �fir' - F. .., 9. Z« Heated Basement //1Y • c ', - ? ' ,' ° � b Y i =t'`•. Unheated Basement z, 7, i,k.- :P� .� ' y !Xi-''-'. ek. ?? F ." `'>� Win= " - 't.+!: i ., ..:fir ; �Y", - Other Unheated `�• t` • h "�� �+,� K..- � ` ... 7 i4.7 st anti' ..� t Garage/Carport ,` . ra� .�3 k s F 1 N 1 1 ...+T f tw fifa;., . ` ,.. . ...,{ y:gyp`' Decksa �r ¢ s s , .. Other - r • �, F r 4 1 : a-, d -.2.- -` •, v.Y$ 0.-- 2 '?1 r Other Z S Nun o b w .ti s croc Y tit ' -,' 7" • ESTIMATED COST(REQUIRED) 10, g 0(o ' t+4 *Fair market value of all labor and materials foundation to finish � .�{ .z; :s"t• ▪ `" G:\PermitCentet\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc 40 FS'Ai` °14. cb� JEFFERSON*1NrL_ _ " `.. DEPARTMENT OF COMMUNITY DEVELOPMENT `4 621 Sheridan Street• Port Townsend•Washington 9668 360/379-4450. 360/379-4451 Fax www.co.jefferson.wa.us/commdeve relit- 2005 y +s op Master Permit Application . M ANT , ©5LA: Project Description(include separate sheets as necessary): rrt,ic e 1 ard'X,ji')c/a' pelt- Va, SGGrd_je farats� Tax Parcel J Property Number: 3 I U 0 Size: t r3 1 /) .-j (acmes/ quare feet) Site Address and/or Directions to Property: l y 3 >t',c k o 1`,.r. 't h L.0 t o Ar r n r at Property Owner(s)of Record: Steve. Pa fi r)c k Telephone: 3 - i,,- o I Fax: email: Mailing Address: 13 0 6 ox y , 8r-, .,,, ,v. vim 1 Ff 3 2 0 Applicant/Agent(If different from owner): Telephone: Fax email: Mailing Address: What kind of Permit?(Check each box that applies) l(Building ❑Variance(Minor,Major or Reasonable Economic Use) 0 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)** D Manufactured Home ❑Boundary Line Adjustment 0 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 ❑Shoreline Master Program Exemption/Permit Revisions** ❑Stormwater Management ❑Shoreline Management Substantial Development** 0 Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance 0 Temporary Use ❑Comprehensive Plan/UDC/Land Use District Map Amendment 0 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 A CA-N r> - 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 fad 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.iudoments.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 late inspections.Access and right of entry to this property shall be requested and shall occur only during regular business Signature: , �' 4- I Date: - The action or actions Applicant will undertake as a result of the icc,rance 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 compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and ion-tra nsf�rablff re9ponsibilitypr adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: / -r i' Date: G:\PcrmitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc .111MONIP\ . ? ...t I•k) It W .--.- 1'). - ........... ,t 44 . %c • -F1?)D \,.._ , \ \--- ,.... ........_ .....„. ..,),,..._ t T L,51-1.1 f 1.7 d: 7 , rN (s ' Vt;• :cr..N < ,,,,, ‘ --. =,''-' *--r...kc..\----.. <A 1:2' Z.. Vk V ,UF.•0 \,. .."-:-'"; 0 • , 9 1 001 0 s' i in ,r\ if --‘i -,•:.:"."2, . 401. ulo N. f‘t . ',•...giy; 1:41,4 if6 . • I ‘‘14 Z: \• ..P L'''';', • ‘VtietV e. ' , 4 Si •...i „.. 02 \in , SNk 0 tk 111/4) ----- ,---- N‘j 2. t\ili 1- ,.. 0 4 \; lk •.,3, sk y) L. 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