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HomeMy WebLinkAboutBLD2005-00716 • • 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#: BLD05-00716 SITE ADDRESS: 140 GYBE HO RD Issue Date: 01/27/2006 NORDLAND, 98358 Final Date: 9/24/2007 APPLICANT: NANCY E HERT PHONE: 360-774-0681 PO BOX 212 NORDLAND WA 98358 SUBDIVISION: ROBERT SPERRY SHORT PLAT Block: Lot: 3+ PARCEL NUMBER: 921081027 Section: 8 Township: 29 N Range: 01 E PROJECT DESCRIPTION: NSFR W/ATT GARAGE & 120 GAL A/G PROPANE 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 1no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 9/24/2007 FredSlUt-G., 13Dildin9 0 i c l /&S/Cfl Building Official Signature 4c (^ Q'' Date I:\F_BLD_Occupancy.rpt 10/29/19 ("BUILDING PERMIT APPLICON MLA05-666 Review Type:I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00716 Received Date: 11/14/2005 SITE ADDRESS: 140 GYBE HO RD NORDLAND, 98358 OWNER: NANCY E HERT PHONE: 360-774-0681 PO BOX 212 NORDLAND WA 98358 ROBERT SPERRY SHORT PLAT SUBDIVISION: Block: Lot: 3+ PARCEL NUMBER: 921081027 Section: 8 Township: 29 N Range: 01 E CONTRACTOR: OWNER BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI` NSFR W/ATT GARAGE & 120 GAL A/G PROPANE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION 120,000.00 MAIN: 822 CODE EDITION: 2003 ADD'L: 200 HEAT TYPE: PRO OCCUPANCY: R-3 HEAT BASE: t HEAT TYPE: EEE OCCUPANCY: UNHEATED: # OF STORIES: 2 CONST TYPE: 5N OTHER: GARAGE: 616 SHORELINE: CONST TYPE: SETBACK: DECK: Aer BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: 2WELL BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 1 Prop: 1 Total: 1 Total: 1 Routing Date: Li ( l& (oc 'i Type Amount Paid Bv: Date: Receipt: p;ro v d/Pat-r/c r. Permit $1,105.75 SLE 11/14/05 77412 V V L. Plan Check $718.74 SLE 11/14/05 77412 JAN R1 2006 State Building Code $4.50 SLE 11/14/05 77412 Potable Water Application $53.00 SLE 11/14/05 77412 Jefferson County Planning & Building Department Total: $1,881.99 • • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD05-00716 Received Date 11/14/2005 SITE ADDRESS: 140 GYBE HO RD Issue Date 01/27/2006 NORDLAND, 98358 APPLICANT: NANCY E HERT PHONE: 360-774-0681 PO BOX 212 NORDLAND WA 98358 SUBDIVISION: ROBERT SPERRY SHORT PLAT Block: Lot: 3+ PARCEL NUMBER: 921081027 Section: 8 Township: 29 N Range: 01 E CONTRACTOR: OWNER BUILDER PHONE: PROJECT DESCRIPTION: NSFR W/ATT GARAGE & 120 GAL A/G PROPANE CALL IN FOR THE REQUIRED INSPEC IONS THAT APPLY TO YOUR PROJECT. SETBACKS:e.,J,L Sn-i _ UFFER: 04 S'f7J 0 45119 Footing: 6 - ' / 7-0-6 FS Foundation: k_.744 Stormwater FINAL Approval: 9/.10-(/-- Underground Plumbing: Underground Insulation: Shear Wall : 6jct /IJAiLwt of /%,oi At Sheathing: ,'//©-(/`OG Framing: 1'S%.U,..K- ,h; t=ilwi.Ab �_ --Cv Plumbing:;), Qv- , /i TG (2 !3 , Propane Tank/Lines: `iuTBeeraz_ Zrvirs f�sAJZL .0e f/7/7 Insulation: 1'y ict-Ototy „,,vz,c Ira DK '/r A-7 Sheetrock. , -4 �5--07 Septic Sytem Final Approval (If not on sewer): Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: ,- -r 112ARRTASET 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 CASE # BLD05-00716 • 1.) 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. 2.) 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 flcw 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. 3.) MANDATORY MEASURES FOR COASTAL SIPZ: 1. For proof of potable water on a building permit applica:ion, 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. 4.) In addition to all voluntary and mandatory actions associated with the applicable SIPZ as described above, the following measures apply to all development proposals on Marrowstone Island that include groundwater withdrawal: (A)Voluntary Actions. (I)Installation of times together with new well pump installations to enable pump use limitation to low demand times. (B)Mandatory Actions. (I)The use of a well proposed as proof of potable water for a new building permit shall be conditioned through the building permit such that enrollment in a county-sponsored monitoring program is required, including periodic submittal of flow and chloride data as determined by the county. (II)Installation of a source-totalizing meter(flow). (III)Installation of a variable speed pump, controllable'rom the surface, in order to enable reduction of withdrawal rate, as may be necessary. (IV)Installation of a 1,000-gallon minimum storage tank that shall conform to the ANSI/NSF standard 61. 5.) 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. IP6.) A Stormwater Plan has been submitted and approved bythe Department p ent of fully ty Development. Once the sub ject 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. 7.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 8.) 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). 9.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 10.) The building height is not to exceed 35 feet. 11.) 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. 12.) 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. 13.) Minimum setback from the edge of Gybe Ho Rd right-of-way is 20 ft. Minimum setback from SR 116 right-of-way shall be 30 ft. Minimum side and rear setbacks are 5 ft. 14.) A minimum of two (2) on-site parking spaces is required for the single-family residence. 15.) Stormwater shall be retained and infiltrated on site. The owner shall control all sedimentation and erosion on the property. 16.) All residences constructed on the lots within this short subdivision shall install water-conserving fixtures such as low flow toilets, faucets and shower restrictors, and other water saving plumbing fixtures. 17.) 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 Stormwater 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. I:\F_BLD_Permit_Buildng.rpt 10/29/1999 ,..i tic, JEFFERSON C TY 0 ! I'',! TrI DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street •• Port Townsend •Washington 98368 . i ` NOV 1 4 2005 `s 4j 360/379-4450 • 360/379-4451 Fax ._.. �•qs,kIN��O� www.co.jefferson.wa.us/commdevelopment _, Master Permit Application , r'T MLA: 05-` - Project Description(include separate sheets as necessary): Tax Parcel _ Property l a 1`c ''" 4-// es �' ht o, - -" - , ,r a— Number: 2 / ( $ / 6 7Size: 3- 6 (acres/square feet) Site Address and/or Directions to Property: f'/(} (- y be_ 14: Rcey,dl , A/7., l—A I cs,t, C"l v T A Property Owner(s)of Record: A/2 N c.1 {-/ FR 7 Telephone:3 tL' -. `7'7 y-- C' rL ?j Fax: email: Mailing Address: p. 6 , r>>, A' ,;-1 LA /t ,t v-(-I /o... ta.4, IA;A 7 &'._ 3 .`,-3' Applicant/Agent(if different 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 Cj** ji4•Single Famil ❑ Discretionary"D"or Unnamed Use Classification Garage ttachecf!/Detached ❑ Special Use(Essential Public Facilities)** ❑ Manufactured Home ❑ Boundary Line Adjustment ❑ Modular ❑ Short Plat** El Commercial* ❑ Binding Site Plan** ❑ Change of Use ❑ Long Plat** Cl Address CI Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments*" ji4'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)* ❑ 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 '- l b e--'L -.ti '1 I hereby designate ;f ti r.�,.�,. I)r be- -` 6&- e '., ,(, . �-� 1 j:Uc 01 to act as my agent in matters relating to this application for permit(s). '��' OWNER SIGNATURE —'J Date: /! ,- / y 1 C s— 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. Signature: 6A,___C1__..-L f) /> 4. ---- Date: /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-transferable responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: /f et".'�. Date: / 0/.2 S-: /r,.,�— G:\PermitCenter\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: � cs�7 --��,. 5- qt.60 Date: /0 ---1 , -- (_;: 4 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: __ ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE NOV 1 4 20t'J i ? WAINS NUMBER: 1 NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX: ( ) MAILING ADDRESS: _ EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: '' New jg Wood Existing: -c ❑ Sewer ri Addition ❑ Steel Proposed: i Bank 0 Community System ❑ Alteration/Remodel ❑ Concrete Total: I Height: ca Individual System ❑ Repair 0 Masonry n t 'k SEP Permit# G' r-,q 3 s->.- ❑ Bedrooms:Demolition ❑ Other: Water Supply:4 ri i a Srie a �� Existing: e- Setback: ❑ Private well tic Two Party Type of Heat: Proposed: I 0 Public P(7) r►p.'rvr.e. Total: } �—�—�- Name of System: eto(Ar,z W0-(1 tree.h e r: 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: O Underground Tank 2k Above ground Tank Size of Propane Tank: I 7,4 n Heat Stove f=1 Cook Stove 0 Woodstove Ga F/ireplace Insert 0 Hot Water Tank 0 Pellet Stove 0 Other Is this appliance being installed in a Manufactured!Mobile Home? Yes AM 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 - t' Consistency Review: - s4104. Act 00 2""Floor t3 O%. ase fee: ( 1®5• S 3`°Floor Additional Section: -- Mezzanine: Plan Check fee: .7(F.'14- Heated Basement State Surcharge fee: 4scD Unheated Basement 5(4 Pot Water Review fee: S7.60 Other Unheated 1-4-0-cdred, 0 911/Rd Approach fee: 9�ti Poa*4 , .1 tg3.3q .LS-I'( (J ""—�- Garage/Carport s. TOTAL: $ �y li ( t' 0.54•t� 14)4. qq Decks Receipt Number: 11l' Other ��� _Sash/Check Number: ZO 5__-- ESTIMATED COST(REQUIRED) Date: t(/ 'T`A 1O5 •Fair market value of all labor a • tionjo finish 1 ( • �5I3. Initials: ee7 G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc rr- I ITE i i I _..Pu�fP )AIO(o l( NATURAL I+AMBER �� 1 i c.�wtiu�� Y�cu�I CNIT T - -H A F IN I . o� SGur 7� I DQ�v&wq�y I r� i i NOKTH. APPROVED SITE PLAN JAN 2 0E ai 7EFfE S UN''�jJgg DEFT. OF UYiBFt not TIe5�HT1f4�E ro Pk-\YLI HT -- -_ I 5�nc EASEMR�h" I �yx izo A5 I o I - r E_ -j +Z762 MaUND --- J I12D p I p�� iooi Pu..tP) _-- I 1 I - I — �ELL NEI�I+ T IaE CUCrAW -PIF'ELIUEG4bEKENTDEAI&.) - EP�E p 3o lf�RFA lY uAto aos5-rA IC.E 7�/2(SEE DE!"A fL, 0 =120' �D /SCHA26E Hl w�/ F,Yilt,l kn4Al0 �— PERMIT # BID I"- 120,0 � I NagTj f+ ►-) E -ram I L_ P,e�,F-cEL -* e921-oeI-o2-7 � o � � N n N N U- Lu m >J Q5 w �la m V °L � Q Q Z fu � 3 N�RTI� pp LI 6