HomeMy WebLinkAboutBLD2005-00685 tUILDING PERMIT APPLICAION MLA05-00642
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00685 Received Date: 11/1/2005
SITE ADDRESS: 850 BLACK BEAR RD
PORT TOWNSEND, 98368
OWNER: TIM SNIDER PHONE: 360-385-0669
MAUREEN R SNIDER
1777 HOLCOMB ST
PORT TOWNSEND WA 98368 STEBURG SHORT PLAT
SUBDIVISION: Block: Lot: 2
PARCEL NUMBER: 001294025 Section: 29 Township: 30 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI NEW DECK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP DEK MAIN:
VALUATION 2,828.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: # OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: 120 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: PUD
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 0 Prop: 0
Total: 0 Total: 0
Routing Date:
l f 3(45 vp_e)
Type Amount Paid By: Date: Receipt: A�r�¢fD��/
Plan Check $54.11 SLE 10/31/05 77188 �� ff ��,,JJ ��//
Permit $83.25 SLE 10/31/05 77188 JAN d7 2006
State Building Code $4.50 SLE 10/31/05 77188
Total: $141.86 Jefferson County Planning
& Building Department
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BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00685 Received Date 10/31/2005
SITE ADDRESS: 850 BLACK BEAR RD Issue Date 01/27/2006
PORT TOWNSEND, 98368
APPLICANT: TIM SNIDER PHONE: 360-385-0669
MAUREEN R SNIDER
1777 HOLCOMB ST
PORT TOWNSEND WA 98368
SUBDIVISION: STEBURG SHORT PLAT Block: Lot: 2
PARCEL NUMBER: 001294025 Section: 29 Township: 30 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: NEW DECK
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS:
UFFER:
Footing:
Foundation:
Stormwater FINAL Approval:
Underground Plumbing:
Underground Insulation:
Shear Wall :
Sheathing:
Framing:
Plumbing: 11
Propane Tank/ Lines:
Insulation:
Sheetrock:
Septic Sytem Final Approval (If not on sewer):
Road Approach Final Approval:
Zoning Final Approval:
'Final/Occupancy Approval: OV. (1-(5-Lk vvA4Air
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 CAE BLD05-00685
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.) 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.
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.) Setback from Black Bear Rd. right-of-way is no less than 20 ft., setback from the private
easement(south) right-of-way is no less than 20 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.
10.) Stormwater shall be retained and infiltrated on site. The owner shall control all
sedimentation and erosion on the property.
I:\F_BLD_Permit_Buildng.rpt 10/29/1999
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r4 ON OOP JEFFERS.COUNTY �1 �
DEPARTMENT OF COMMUNITY DEVELOPMENT
` `4 621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
qS, A‘O� www.co.jefferson.wa.us/commdevelopment
HIND
Master Permit Application MLA: O 5"`- ¢2_„
Project Description(include separate sheets as necessary):
Tax Parcel C Property
t
Number: ) "-0 Z5 Size: (acres/square feet)
Site Address and/or Directions to Property: e S C) 'L4 G� (� I�.(-t •j
Property Owner(s)of Record: {'l (f�^F'
Telephone: 1 O C, / Fax: email: _
Mailing Address: ( � ��o�. �1'l �� 7( ��fZ i j.%tAA. N.I r /� �YS?6 e
Applicant/Agent(if di rent from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies)
Building
❑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
0 Garage Attached/Detached 0 Special Use(Essential Public Facilities)**
❑ Manufactured Home 0 Boundary Line Adjustment
❑ Modular ❑ Short Plat**
0 Commercial* 0 Binding Site Plan**
❑ Change of Use ❑ Long PlatLi **
Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments**
[I 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 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 required later inspections.Access and right of entry to this property shall be requested and shall occur only during regular business
hours.
k Signature: Date:
�— _ �t' GJ f, 5
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 lake"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 responsi ' „for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and da tes it below.
Signature: ��� Date: C.
r G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
N.
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: ?( v "� 0 ,
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAx:
( ) ( )
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:
g New P iVood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: Bank ❑ Community System
❑ Alteration/Remodel 0 Concrete Total: Height: 0 Individual System
0 Repair ❑ Masonry SEP Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: ❑ Public
Total: Name of System:
If this is a Commercial Proiect 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:
Li 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: ti•00
2m'Floor Base fee: 63.25'
3
ro Floor Additional Section:
Mezzanine: Plan Check fee: s(,j., k
Heated Basement State Surcharge fee: CA l
Unheated Basement Pot Water Review fee: . ---
Other Unheated 911/Rd Approach fee:
1c5Ct 11/4J6
Garage/Carport TOTAL: $ ,CIO. SI,
Decks l .44D1 Receipt Number: '?l IV
.� Cash/Check Number:
Other ... 41.C3
ESTIMATED COST(REQUIRED) Date: ) , ,
•Fair market value of al I-bor and materials foundation to finish l
Initials:
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc