HomeMy WebLinkAboutBLD2005-00553 BUILDING PERMIT APPLICAN B RDOe 00553
Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00553 Received Date: 8/25/2005
SITE ADDRESS: 53 N WILLISON AVE
PORT TOWNSEND, 98368
OWNER: MICHELLE CRAY PHONE:
PO BOX 720
PORT HADLOCK WA 983390720
IRON DALE
SUBDIVISION: Block: 114 Lot: 33-37
PARCEL NUMBER: 962111406 Section: 34 Township: 30 N Range: 01 W
CONTRACTOR: PHONE:
PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI NEW ATTACHED GARAGE BY BREEZE WAY
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 9,000.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: # OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: SHORELINE:
GARAGE: 672
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON _
WATER SYSTEM: PUD
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total:
Routing Date:
8 91, 05
Type Amount Paid By: Date: Receipt: Approved/Date
State Building Code $4.50 SLE 08/25/05 76557 A P P R c V E E
Plan Check $108.71 SLE 08/25/05 76557
Permit $167.25 SLE 08/25/05 76557 SEP 1 4 2005
Total: $280.46
Iefferso ounty Planning
& g'i di epartment
_ • el
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00553 Received Date 08/25/2005
SITE ADDRESS: 53 N WILLISON AVE Issue Date 09/13/2005
PORT TOWNSEND, 98368
APPLICANT: MICHELLE CRAY PHONE: 385-9624
PO BOX 720
PORT HADLOCK WA 983390720
SUBDIVISION: IRONDALE Block: 114 Lot: 33-37
PARCEL NUMBER: 962111406 Section: 34 Township: 30 N Range: 01 W
CONTRACTOR:
PROJECT DESCRIPTION: NEW ATTACHED GARAGE BY BREEZE WAY
CALL IN FOR TH EQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS.
UFFER:
Footing: 4Jl�wo9/q,o! Y7-7&- /D- ?-a(r" .--SC,
Founds on: �! -SO—OS
Stormwat FINAL Approval:
Underground Plumbing:
Underground Insulation:
Shear Wall :
Sheathin / /
Framing: • �
Plurnbi ' :
Propane Tank/Lines:
Insulation:
Sheetrock:
Septic Sytem Final Approval (If not on sewer):
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval: Ok -final $ i4/ 7
HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRE 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
i
SPECIAL CONDITIONS FOR APSE # BLD05-00553
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.) 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.
3.) 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.
4.) 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.
5.) 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.
6.) The property owner shall comply with Water Conservation Measures (per list maintained
by the UDC Administrator).
7.) 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.
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) unlic ed 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.) 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.) Minimum setback from North Willison Avenue right-of-way shall be 20 feet. Minimum side
and rear yard setbacks shall be 5 feet.
I:\F_BLD_Permit_Buildng.rpt 10/29/19
0 OWNER BUILDER STATEMENTIII
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 assume the responsibility of the General Contractor for the proposed project.
Signature: LAI ` Ck_e✓i 1-k_ (tA. (A/ii� Date: __ i1 043
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
( ) ( )
MAILING ADDRESS: ClEMAIL:
CONTRACTOR'S LICENSE
\L. WAINS
NUMBER: r,,,_....:-\\„
1.---1 J _ NUMBER
ARCHITECT/ENGINEER: V PHONE ( ) FAX: ( )
MAILING ADDRESS: EMAIL
Project Type: F me Type: Bathrooms: Shoreline: Type of Sewage Disposal:
❑ New Wood Existing: 0 Sewer
1 Addition ❑ Steel Proposed: �� Bank ❑ Community System
0 Alteration/Remodel ❑ Concrete Total: _ Heigh i, Individual System
❑ Repair ❑ Masonry SEP Permit# j --T 17
Bedrooms: Supply:
i 1 Demolition 0 Other: ', Water
Existing: n\a N Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: '"_ _� Public
L.)A) i4QQA—-t) Total: _ me of System: -s,. l
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:
n Underground Tank 0 Above ground Tank Size of Propane Tank:
❑ Heat Stove ❑ Cook Stove Li Woodstove Cl 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 Poi Office Use Only
Current Proposed Amount _
Main Floor Consistency Review: A �
2Nu Floor Base fee: )� , 1,a 5 ,1g
3rd Floor Additional Section: U!
Mezzanine: Plan Check fee: ill a Al / OS. 11 ( 2
Heated Basement State Surcharge fee: _=_ I.
0 I.OC)
Unheated Basement Pot Water Review fee:
Other Unheated 911/Rd Approach fee: Y
Garage/Carport f
X
-) TOTAL: $ 3` OI . o
Decks /�-`
'�
O� v�' Receipt Number: '1 64 5 51
Other Fes.__ I�Ig Number_ESTIMATED C SI (REQUIRED) E ! Q.4'Cas1iICheck
' Date: 1' J °G�
'Fair market v of all labor and materials foun.ation to finish �! Z -1 J
7 lc, ✓ �� � 5 z��5
I . . C ,), ------:
G:\PermitC er\Fe is•• -e N.•• \Master Permit Application 7-8-04.doc
wA.u_Q. tlesi1 •,r\O0:c.a a o
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goN co& JEFFERSON 41UNTY_ III
' 1 DEPARTMENT OF COMMUNITY DEVELOPMENT
I"' •' `� 621 Sheridan Street • Port Townsend •Washington:98368
360/379-4450 • 360/379-4451 Fax
qs,1-11N�� www.co.jefferson.wa.us/commdrAppTsit,,),,,c
Master Permit Application 1 MLA: (J5
Project Description(include separatejsheets as necessary): _�_ •
__�_�_"cN
, 1 j9 L/ �.e fit tt: L,'(,,Vri- --1f'
Tax Parcel L Property
Number: 1 Co 7, - ` \ \ - 0 Size: ' (� e 7 c, SQ (acres/square feet)
Site Address and/or Directions to Property: ,� ,, <2
p ►ty= 5`' AlN in) t l{I�Clil ,���; '�t;;Y--�... ��,�t1_c.�.R.�'� 4�� N. ��3(.1>s
Property Owner(s)of Record: Mi I.lr1 e i t P rV c?irk.
Telephone: 3 (iv 2 t- — jO)1 —i 311 Fax: email: ili1 S /Y irk Lg c% (try.,LA I*
Mailing Address: VD ..FL,ys 12c 0 6A Loc c . tV '1 G33'7 aE-E-
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What 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]**
❑ Single Family ❑ Discretionary"D"or Unnamed Use Classification
Garage Attached/Detached ❑ Special Use(Essential Public Facilities)**
❑ Manufactured Home ❑ Boundary Line Adjustment
❑ Modular ❑ Short Plat**
❑Commercial* ❑ Binding Site Plan**
❑ Change of Use ❑ Long Plat**
❑Address H 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**
❑ 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 /� /� q to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE,./V lil'V I..� l_���C��/� Date: j / !..1 i' i. `-
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 inspections.Access and right of entry to this property shall be requested and shall occur only during regular business
hours. q /�
Signature: \(V Xv'K t C-- Lti 1 /-i ‘.Date:
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 you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transferable responsibility for adhering to an complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: IVA(/t'.'i(t'C., (IA/ /7 Date: L?; r= l — r)5
cli
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
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