HomeMy WebLinkAboutBLD2005-00625 CERTIFICATE OF OCCUPANCY
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
Carl Smith, Director/Building Official
PERMIT #: BLD05-00625
SITE ADDRESS: 4943 SR20 Issue Date: 10/20/2005
PORT TOWNSEND, 98368 Final Date: 5/30/2013
APPLICANT: ROBERT P LANDIS PHONE: 360-385-3352
CYNTHIA L GRUYE
4943 STATE ROUTE 20
PORT TOWNSEND WA 98368-9701
SUBDIVISION: Block: Lot: TX 1+
PARCEL NUMBER: 901054004 Section: 5 Township: 29 N Range: 01 W
PROJECT DESCRIPTION: INTERIOR REMODEL & ADDITION TO SFR - PERMIT CANCELLED DUE TO
NON-PYMNT UNDER AMNESTY PROG
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2003
EDITION.
OCCUPANCY GROUP: R-3
TYPE OF CONSTRUCTION: 5N
SPRINKLER SYSTEM yes no
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 5/30/2013
\\tidemark\data\forms\F_BLD_Occupancy.rpt 5/30/2013
JILDING PERMIT APPLICA1IN MRLAO5 0eview 0pe582
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00625 Received Date: 9/27/2005
SITE ADDRESS: 4943 SR20
PORT TOWNSEND, 98368
OWNER: ROBERT P LANDIS PHONE: 360-385-3352
CYNTHIA L GRUYE
4943 STATE ROUTE 20
PORT TOWNSEND WA 983689701
SUBDIVISION: Block: Lot: T 1+
PARCEL NUMBER: 901054004 Section: 5 Township: 29 N Range: 01 W
CONTRACTOR: KIMBALL & LANDIS LLC PHONE: (360)385-4915
151 FREDRICK ST
PORT TOWNSEND WA 98368
Contractor's License KIMBALL996D3 Expires 3/25/2004
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP INTERIER REMODEL & ADDITION TO SFR 1
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ADD MAIN: 416
VALUATION 40,000.00 ADD'L: HEAT TYPE: WOD
CODE EDITION: 2003 HEAT BASE: HEAT TYPE: EEE
OCCUPANCY: R-3 UNHEATED: # OF STORIES:
OCCUPANCY:
CONST TYPE: 5N OTHER: 40 SHORELINE:
CONST TYPE: GARAGE: SETBACK: 130
DECK: BANK HEIGHT: 90
SEWAGE DISPOSAL: CON
WATER SYSTEM: PWELL
BEDROOMS: BATHROOMS:
Exist: 2 Exist: 1
Prop: 2 Prop: 1
Total: 2 Total: 2
Routing Date:
Type Amount Paid Bv: Date: Receipt: Approved/Date
State Building Code $4.50 SLE 09/27/05 76695 APPROVED
Plan Check $352.79 SLE 09/27/05 76695
Permit $542.75 SLE 09/27/05 73695 OT Cli 2 j 2005
Total: $900.04
Bu erson y Planning
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4110
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00625 Received Date 09/27/2005
SITE ADDRESS: 4943 SR20 Issue Date 10/20/2005
PORT TOWNSEND, 98368
APPLICANT: ROBERT P LANDIS PHONE: 360-385-3352
CYNTHIA L GRUYE
4943 STATE ROUTE 20
PORT TOWNSEND WA 98368-9701
SUBDIVISION: Block: Lot: T 1+
PARCEL NUMBER: 901054004 Section: 5 Township: 29 N Range: 01 W
CONTRACTOR: KIMBALL & LANDIS LLC PHONE: (360)385-4915
151 FREDRICK ST
PORT TOWNSEND WA 98368
Contractor's License: KIMBALL996D3 Expires: 3/25/2006
PROJECT DESCRIPTION: INTERIOR REMODEL&ADDITION TO SFR
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBAC KS:
UFFER:
Footing:)- 10-,20-o5
Foundation: , Ni ii4u- 140i-0 u,'s Pc514- PLAIJ Cr-'1) Tw-U) i0-zp ►�
Stormwater FINAL Approval:
Underground Plumbing:
Underground Insulation:
Shear Wall :
Sheathing:
Framing: k3,v -k,�..2A-'t5S c
Plumbing:
Propane Tank/ Lines:
Insulation:?_/,;w L. m5
Sheetrock:
Septic Sytem Final Approval (If not on sewer):
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval:
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
SPECIAL CONDITIONS FOR CCE t BLD05-00625
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 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.) 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.
7.) 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.
8.) The applicant shall fully adhere to all conditions and requirements of the eagle habitat
management plan signed by the applicant on October 10, 2002.
9.) As per the approved Eagle Plan signed by the applicant on October 10, 2002, the
applicant shall retain all known perch trees and conifers >/=24 inches diameter at breast
height (d.b.h.). The applicant shall also retain >/=50% of pre-clearing or pre-construction
conifer stand with diameter distributions representative of the original stand (>6 feet tall).
Windowing and low limbing of trees is acceptable provided no more than 30% of the live
crown is removed.
10.) 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.
11.) 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.
12.) MANDATORY MEASURES 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.
13.) 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.
14.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP)
Elements#1 through #12 of the Department of Ecology's Stormwater Management
Manual for Western Washington 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.
15.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
16.) 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).
17.) Pre-existing legal lots of record less than one acre in size in Rural Residential districts are
subject to the stormwater requirements in UDC Section 6.7 and must meet the"Area of
Impervious Surface Coverage"to the maximum extent practicable as determined by the
Administrator." Lot coverage is defined as amount of impervious surface, which includes
rooftops, driveways, concrete, etc.
18.) The building height is not to exceed 35 feet.
19.) 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.
20.) 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.
21.) Setback from SR 20 right-of-way is no less than 50 ft., side and rear setbacks are no less
than 5 ft. If an environmentally sensitive area (ESA) is present, then the more restrictive
setback shall apply.
22.) The standard setback for residential structures, including common appurtenant structures
such as garages and workshops, shall be thirty(30) feet or one (1) foot for each foot of
bank height, whichever is greater. This setback shall be measured from the bank's edge
when the bank's height exceeds 10 feet. When the bank's height is less than 10 feet, the
setback shall be measured from the ordinary high water mark. The setback shall not
exceed 100 feet.
I:\F_BLD_Permit_Buildng.rpt 10/29/19
�.,'" 0
06. JEFFERSCOUNTY •
ti 14a DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street • Port Townsend -Washington 98368
360/379-4450 • 360/379-4451 Fax
�gS,-IiING(O� www.co.jefferson.wa.us/commdevelopment
Master Permit Application
MLA: c5 .-5 c;.�
Project] escription(inclu. ., ,
de separate sheets as necessary):
Rc.,,,,,,L., Q._
Tax Parcel Property
Number: 9 0 105�•(-00C� Size: $95 C .V. (acres/square feet)
Site Address and/or Directions to Property: 4•-I q4 3 S K. 20 Pool' ToTOW tk.S WC,i VA- cl r6(
oliv
Property Owner(s)of Record: YYC)belni- 3 CI yt to L.atc(,t S
Telephone:3(Ot1—` S— 3'6 2- Fax: email: LtInithilta.e pt
Mailing Address: tiq y. 3 S W. 2.0 Port- -[-per As. t t A..114- SYg v
Applicant/Agent(if different from owner):
Telephone: Fax:
email:
Mailing Address:
What kind of Permit?(Check each bo -
'l Building ('} t k ' f V • (Minor, Major or Reasonable Economic Use)
❑ Demolition Permit [ T. i i nal Use[C(a), C(d),or C]**
Single Family () ❑ t) nary"D"or Unnamed Use Classification
❑Garage Attached/Detached !! 1 I SEP 2 7 ❑ '.' Use(Essential Public Facilities)**
❑ Manufactured Home i 2 ❑ o ry Line Adjustment
❑ Modular [] .hod ,lat**
❑Commercial* — •-----------El ;indinc6 Site Plan**
❑Change of Use ❑ Long Flat**
0 Address ❑ Roa&Approach----•.-- •..._____._..._-gplanndd 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)* 0 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 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 al 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 a d right rlf entry to Jefferson County and its employees,representatives or agents for the sole purpose of application
review and any required later i sons.14ccess and right of entry to this property shall be requested and shall occur only during regular business
hours.
Signature: �3�--` c. -i.,_,.._F._�-�
�° '...�C3 Date: / 2- O
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 '1 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 i liance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-t sferable re nsib f ty for adhering to and complying with the ESA. The Applicant has read this disclaimef and signs and dates it below.
Signature: r-, -
�S. Date: .
if ? // 0/
G:\PemiltCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
•
• 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 responsibility of the General Contractor for the proposed project.
Signature: Date:
,fiENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
� . c �I V\ 4 LuvIN us, (; s) ) $D1 -- -7- (34,0)
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
6 New Wood Existing: I ❑ Sewer
Addition ❑ Steel Proposed: 41.i. Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: _ 2 Height: Individual System
❑ Repair ❑ Masonry 90 S P Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: - Setback: '3K Private well ❑ Two Party
Type of Heat:
Pro pond-:---
01 �/� Tidal: Z. 130 Name of System:
!/ t
cc 4
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 X Above ground Tank eySiSi-ive Size of Propane Tank:
f_l Heat Stove Cook Stove El Woodstove ❑ Fireplae Insert ❑ 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
Main Floor _ _ i r'onsistency Review: �.
llama 4-1 S9 ' Pi, --r -:LA.
2Nu Floor _ :�c ,
C.
Lv t
3f0 Floor IP LiA6,GL: f it E
Mezzanine: 41) ZiT7
0 Ce `_„rf.JJ iHeated Basement Stat Unheated Basement I Pot Water Review fee .
Other Unheated 911/Rd Approach fee:
F .01 fry()
Garage/Carport TOTAL: $ C 1 L ;" -
Decks Receipt Number: ri i I'q
Other ,...L��e,` -, i4.j -i C,�} -t Cash/Check Number: `-' If
_.z
i 1 it fi. r t
ESTIMATED COSTIREQUIRED) Date: {• ,I )I+
*Fair market value of all labor and materials foundation to finish f r3 7+ vd'
r._ ;� Initials: tn;
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
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