HomeMy WebLinkAboutBLD2005-00662 •UILDING PERMIT APPLICA1SN MRLA05 006617
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00662 Received Date: 10/18/2005
SITE ADDRESS: DENA LN
Type: I
CHIMACUM, 98325
OWNER: CRAIG VANNESS PHONE: 360-531-0952
2096 ANDERSON LAKE RD
CHIMACUM WA 98365
BISHOP HEIGHTS DIV II
SUBDIVISION: Block: Lot: 6
PARCEL NUMBER: 933500006 Section: 35 Township: 29 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOr NEW SFR W/ ATTACHED GARAGE
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,585
VALUATION 130,000.00 ADD'L: HEAT TYPE: HTP
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: # OF STORIES: 1
OCCUPANCY: OTHER:
CONST TYPE: 5N SHORELINE:
GARAGE: 624
CONST TYPE: SETBACK:
DECK: 452
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: PWELL
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 3 Prop: 2
Total: 3 Total: 2
Routing Date: \ ‘5\1 7-:;"
Type Amount Paid By: Date: Receipt: Approved/Date
State Building Code $4.50 SLE 10/18/05 77135
Potable Water Application $53.00 SLE 10/18/05 77135 APPROVED
Plan Check $755.14 SLE 10/18/05 77135
Permit $1,161.75 SLE 10/18/05 77135 DEC I) 2005
Total: $1,974.39 Jefferson County Planning
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CERTIFICATE OF OCCUPANCY
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451 (800) 831-2678
PERMIT #: BLD05-00662
SITE ADDRESS: 113 DENA LN Issue Date: 12/1/2005
CHIMACUM, 98325 Final Date: 5/10/2006
APPLICANT: CRAIG VANNESS PHONE:
2096 ANDERSON LAKE RD
3CHIMACUMg 51 Ug52WA 98365
SUBDIVISION: BISHOP HEIGHTS DIV II Block: Lot: 6+
PARCEL NUMBER: 933500006 Section: 35 Township: 29 N Range: 01 W
PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE
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 5/10/2006
CiNs2_CX. /i/O
Building Official Signature __. Date
I:\F_BLD_Occupancy.rpt 10/29/19
BUILDING PERMIT•
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00662 Received Date 10/18/2005
SITE ADDRESS: 113 DENA LN Issue Date 12/1/2005
CHIMACUM, 98325
APPLICANT: CRAIG VANNESS PHONE: 360-531-0952
2096 ANDERSON LAKE RD
CHIMACUM WA 98365
SUBDIVISION: BISHOP HEIGHTS DIV II Block: Lot: 6+
PARCEL NUMBER: 933500006 Section: 35 Township: 29 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE
CALL IN FOR THE EQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS: P.--?,--(_05
UFFER:
Footing. 2 ..2.s— LKi:-. -6-9-c- i- .•7 v
Found tion: L. 0,..-13-0f5
Stormwater INAL Approval:
Underground Plumbing:
Underground Insulation:
Shear Wall : Exr DIC i/zD/O,G114'
Sheathing:
Framing: (/A/c t,Fi J -5-r5 a2 !", [.,c- /i'"9-6
Plumbing:
Propane/lank/ Lines: Q� �3dr'�k, y��q�,
Insulation:C"—c_ L� J r//
Sheetrock:/1 omei••c f 3 D,(,
Septic Sytem Final App oval ( f of on sewer):
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval: OK - ar elo S�/G v
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
Ilr
SPECIAL CONDITIONS FOR C E A BLD05-00662
1.) 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.
2.) A Stormwater Site Plan has been submitted and approved by the Department of
Community Development. Once the subject permit has been issued the applicant shall
fully implement the provisions of the submitted plan and contact the Jefferson County
Department of Community Development to arrange a schedule to inspect the property for
plan compliance. A Certificate of Occupancy will not be issued until the Department
verifies plan compliance. No clearing for roadways or utilities shall occur on the project
site until clearing necessary for the installation of temporary sedimentation and erosion
control measures have been completed.
3.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
4.) 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).
5.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
6.) The building height is not to exceed 35 feet.
7.) 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.
8.) 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.
9.) Minimum setback from Dena Lane and Kevin Lane rights-of-ways shall be 20 feet.
Minimum side yard setbacks shall be 5 feet.
10.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
I:\F_BLD_Permit_Buildng.rpt 10/29/19
4,�¢So1v co�� JEFFERSOIbUNTYIII
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street • Port Townse astiI isor 98 8 .�
360/379-4450 • 360/379-4451 Fax , t 1
.qs, o www.co.jefferson.wa.us/commdeve¢p r
i ,
OCT 1 8 200 !Master Permit Application kA,R J; O�- 11
1
Project Description(include separate sheets as necessary):
1\)1;--LJ S=t,K-,1-tom t-Pt``ILI{ '\Ci3 I a1kt ! `RPGi-t ri 4ArR14C./ rW
,Tax Parcel
Number: , ._ ., ; ,_, Size: (acres/square feet)
Site Address and/or Directions to Property:
Property Owner(s)of Record: ►?,^. -:::_ <` , 1 (- 'I i t 't ] ' _ — 4 tvl lgP,'tp, \. A ,_0 e c$
Telephone: ' (.,r> h j. '.) ' L} %, Fax: email:
Mailing Address: --..(7.-_)c,' , ., _ , , t.- t� 0 ',, -- _ 4, ...) c.
i Applicant/Agent(if different from owner):
1Telephone: Fax: email:
Mailing Address:_
___t
What kind of Permit?(Check each box that applies)
❑ Building U Variance(Minor,Major or Reasonable Economic Use)
❑ Demolition Permit ❑ C,dnditional Use[C(a), C(d),or C]**
)itSingle Family 0 Discretionary"D"or Unnamed Use Classification
..Garage edy Detached ❑ 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(PRRD)/Amendments**
❑ Propane ❑ Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions**
❑ Stormwater Management 0 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 **R•.uires a Pre-A..lication 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 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 r uired later inspections.Access and right of entry to this property shall be requested and shall occur only during regular business
hours. r_...-
Signature: i'!, ) 7
_ Date: :/ C-- l % ._.
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-transfeble responsibility for adhering to and complying with the ESA. The Applicant has read this di ai er and signs and dates it below.
Signature: ��. . ---•-,
�` C, Date: j �� `�C f
G:\PennitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
• OWNER BUILDER3TATEMENT •
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. �t—
r7
Signature: ' ' ,.s ice' '`7 ,--- Date: , _.f D 1 ?
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTORS LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX: ( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
X New Wood Existing: ❑ Sewer
Addition ❑ Steel Proposed: Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: Z Height: K Individual Syst m
❑ Repair ❑ Masonry SEP Permit# V-- S D
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ' Private well ❑ Two Party
Type of Heat: Proposed: ❑ Public
Total: 1 Name of System:
N CZ.r-;, i-V N ?
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 ❑ Cook Stove ❑ Woodstove ❑ Fireplace 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 ( ._- Consistency Review:
'i D L� /0Mo
2 °Floor Base fee: , '1
'
1c�1 .`7�
,
ro
3 Floor Additiene -
f+yj tV
-P --fl--N ,_.
Mezzanine: P ee4 ' ' : i4
Heated Basement S' a urch f : 8 2005
r.•� -'I. so
Unheated Basement Pot Water Review fee: @ `
1 O
Other Unheated 911/Rd Approach fee: -• - , )
Garage/Carport I �q
10 `a /9,h0 3'V TOTAL: $ a act}, " 1
Decks
A-5? t 0 t1,53.(14 Receipt Number: 11 1 l�Jj
Other - -` 0. Cash/Check Number: u f I
ESTIMATED COST(REQUIRED) Date: 10
6 ('0
•Fair arket value of all r and materials foundation to finish
Initials:
,..i 0 s-Air-**/ crfC)C.-J(1.-D
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
JRMI! # BiO
•
05 - 0662 _
QN ° JEFFER ^�` C Ct, S7-7\,
SON COUNTY
,: DEPARTMENT OF COMMUNITY DEVELOPMENT OCT 1 8 2005 E". a
621 Sheridan Street • Port Townsend •Washington 98368
10 360/379-4450 • 360/379-4451 Fax 1
http://www.cojefferson.wa.us/commdevelopnnent/
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# O ,J` Co 1 PROJECT/APPLICANT NAME a.\\C111.v V P \) t V S 5-
Please answer all of the following questions to the best of your ability. Where the question calls for depiction on a site map, the
applicant may choose to either incorporate the elements into the general plot plan for the Master Land Use Application or to submit a
separate stormwater site plan map.
Project Overview
1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the
site map. "
) I--10 S i- (,)s '` J Pre
ry
Existing Conditions Summary
2. Dfiscribe the existing topography. Indicate contours on the site map.
1 J L� � `- c- Lot-�a'' �* iz...s "� '. , y am,. t ' .' ' S t k L b \)
3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
7 /?►2 c S r- DCOSC'_ 12)(7- fi�RVS f- -
4. Describe the existing soils. Indicate soil type on the site map.
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5. Describe the existing site hydrology(i.e., drainage;behavior of water on the site—above,below, and on the ground). Indicate
existing stormwater drainage to and from the site on the site map. Depict separate drainage basins on the site map, if
Dkaa Iicable,and indicate acreage of each.
6. Describe any excess levels of noise generated by the proposed use or activity: AP PRO V ED
KT. LL S s=. W STORMWATER PLAN
OCT 252005
Stormwa a P'
Requir JEFFERSON
stormwater site plan template—rev.10✓12003 DEPT.OF N P 5
SIGNATUR_:
• •
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7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams,
steep slopes,etc.)on the site. Indicate location on the site map.
8. Describe the general vicinity of the site,including adjacent land uses and structures,utilities, roads,and sensitive/critical areas
(streams,wetlands,lakes,steep slopes,etc.). p
Permanent Stormwater Control Plan
This portion of the Stormwater Site Plan consists of the selection and installation of the appropriate stormwater control BMPs
and facilities to remain in place after construction of the project is completed.
"Medium" size projects are required to have the totals calculated of all impervious surfaces, pollution-generating impervious
surfaces, and pollution-generating pervious surfaces to verify that the thresholds for treatment facilities and flow control
facilities are not exceeded.
g. Describe the developed site hydrology, as proposed. Indicate whether stormwater will be fully dispersed (i.e., per BMP T5.30
in the Manual)or, if not,what types of stormwater flow control will be utilized for the site or specific threshold discharge areas
within the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities
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10. If the project requires the use of stormwater treatment facilities,describe the types of stormwater treatment facilities proposed
for use on the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. [This is
normally for large"projects or projects that involve the potential for dispersion of contaminants.]
11. Describe the performance goals and standards applicable to the project.
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12. Describe the flow control system,
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OCT- 1 8 21105
storrnw4tgr the plan templaie;'-rev.10/1/2003 6
• • •
13. Describe the water quality system. ((" ! ""1
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_ I OCT 18 1UU5 vJ
14. Describe the conveyance system analysis and design.
444-
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15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material.
i 4C.K ► itLL N Wr
16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code.
17. Describe the proposed surfacing material. _
18. Describe methods for restoration of the site.
19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for
"large"projects only and only those for which facilities are required to control flow or treat runoff.] If included,list the Manuals
here.
1f '
20. List here and include any special` reports or studies conducted to prepare the Stormwater Site Plan.
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21. List other necessary permits and approvals as required by other regulatory agencies. If those permits or approvals include
conditions that affect the drainage plan or contain more restrictive drainage-related requirements,describe those conditions or
restrictions here.
storrmvater site plan template—rev.10/1/2003 7
• •
CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN(SWPPP)
The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the
template that follows must be installed on the ground during all construction phases of the project. The proponent is responsible for
preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater
Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential
development.
SECTION I—CONSTRUCTION SWPPP NARRATIVE
1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or
will be addressed. Identify the type and location of BMPs used to satisfy the required element. If an element is not applicable
to the proposal,justify in writing. Descriptions of the 12 Elements are found at section 2.5.2 of the Manual(beginning on page
2-15).
12 Required Elements—Construction SWPPP
1. Mark Clearing Limits.
2. Establish Construction Acc
DLv eNa .XY-S T I:VJC,
3. Control Flow Rates.
I--1;50=4-- �� �R ioff FoR
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4. Install Sediment Controls.
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5. Stabilize Soils.
6. Protect Slopes.
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7. Protect Drain Inlets. L ( ,n�
,
! OCT 1 8 2005 l •i
stormwater site plan template—rev.10/1/20 03 8
• •
12 Required Elements—Construction SWPPP(continued)
8. Stabilize Channels and Outlets. j 1
1 OCT 1 8 2005
9. Control Pollutants.
K P ?Roi C LC Pt C5V Pi' /
10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site).
p0 k1r-i s--c r�
11. Maintain Best Management Practices(BMPs).
Moti‘itrOk %` or <-r— DAirt.Y
12. Manage the Project.
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2. Adjacent Areas.
a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential
areas,roads).
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b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards).
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3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
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stormwater site plan template—rev.10/12003
9
•
b. Description of special requirements for working in or near environmentally sensitive areas.
-1/
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4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site
soils(e.g.,erodibility,settleability,permeability,depth,texture,soil structure).
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5. Construction Phasing.
a. Construction sequence
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b. Construction phasing(if proposed)
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6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
I. Provide a proposed construction schedule. / {�
IV r �
II. Wet Season Construction Activities.
a. Proposed wet season construction activities. iv
b. Proposed wet season
�coonstruction activities for environmentally sensitive areas.
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7. Financial/Ownership Responsibilities.
a. Identify the property wner responsible for the ini'ation of bonds and/or other financial securities.
C�Rkrc t/Au 0 0:s s.
b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impacts. IV
8. Engineering Calculations. Provide Design Calculations on a separate sheet for the follo•vi rif-applieablc. ---�
a. Sediment Ponds/Traps. . _LP 7__ !r'' r: 11
b. Diversions.
c. Waterways. -•
d. Runoff/Stormwater Detention Calculations I 1 OCT 1 8 203 1'�J
i
1
stormwater site plan template—rev.10'1/2003 10
• •
Stormwater Site Plan Changes
If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan,the proposed revisions shall be
submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised
drawings showing any structural changes,and any other supporting information that explains and supports the reason for the change.
Final Corrected Plan Submittal
If the project included construction of conveyance systems,treatment facilities,flow control facilities, or structural source control BMPs
(not standard on-site stormwater management BMPs),the applicant shall submit a final corrected plan ("as-builts')when the project is
completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as
constructed.
APPLICANT SIGNATURE
By signing the Construction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and
correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all
owners of the affected property.
(LANDOWN AUTHORIZED REPRESENTATIVE SIGNATURE) (dA'7()
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
15 •
�0) OCT 1 8 2005 t
12 stormwater site plan template—rev.10/1/2003
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