HomeMy WebLinkAboutBLD2005-00718 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#: BLD05-00718
SITE ADDRESS: 185-A BLUE HILL CT Issue Date: 03/7/2006
PORT TOWNSEND, 98368 Final Date: 11/1/2013
APPLICANT: MARGARET ENGLE PHONE: 360-344-2049
DAVID ENGLE
185 BLUE HILL CT
PORT TOWNSEND WA 98368-9208
SUBDIVISION: DISCOVERY RIDGE DIV III Block: Lot:
PARCEL NUMBER: 001195111 Section: 19 Township: 30 N Range: 01 W
PROJECT DESCRIPTION: DETACHED GARAGE - NO HEAT NO PLUMBING - REVISION, NEW
OWNERS ADDING CARPORT TO DETACHED GARAGE
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2003
EDITION.
OCCUPANCY GROUP:
TYPE OF CONSTRUCTION:
SPRINKLER SYSTEM yes no
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 11/1/2013
\\tidemark\data\forms\F_BLD_Occupancy.rpt 11/18/2013
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00718 Received Date: 11/16/2005
SITE ADDRESS: 185-A BLUE HILL CT Issue Date 3/7/2006
PORT TOWNSEND, 98368 Expiration Date 3/7/2007
OWNER: MARGARET ENGLE PHONE: 360-344-2049
DAVID ENGLE
185 BLUE HILL CT
PORT TOWNSEND WA 98368-9208 DISCOVERY RIDGE DIV III
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 001195111 Section: 19 Township: 30 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: DETACHED GARAGE - NO HEAT NO PLUMBING - REVISION, NEW
OWNERS ADDING CARPORT TO DETACHED GARAGE
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 0
VALUATION 40,000.00 ADD'L: 0 HEAT TYPE:
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES: 1
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: 1,104 SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CMY
WATER SYSTEM: PUD Type Amount Paid By: Date: Receipt:
BEDROOMS: BATHROOMS: State Building Code $4.50 SLE 11/16/05 77420
Exist: 0 Exist: 0 Permit $542.75 SLE 11/16/05 77420
Prop: 0 Prop: 0 Plan Check $352.79 SLE 11/16/05 77420
Total: 0 Total: 0 Potable Water Application $53.00 PRB 11/18/05 77427
Renewal-2013 $228.00 MKF2 03/29/13 140174
Permit $195.25 JLA 05/16/13 142091
Plan Check $202.92 JLA 05/16/13 142091
State Building Code $4.50 JLA 05/16/13 142091
Potable Water Appl cation $156.00 JLA 05/16/13 142091
Total: $1,739.71
Directions to Site:
MLA05-00671
.UILDING PERMIT APPLIC . .ON Review Type:I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00718 Received Date: 11/16/2005
SITE ADDRESS: 185-A BLUE HILL CT
PORT TOWNSEND, 98368
OWNER: ROCKWELL SORENSON PHONE: 360-344-4326
CANDACE L SORENSON
185 BLUE HILL CT
PORT TOWNSEND WA 983689208 DISCOVERY RIDGE DIV III
SUBDIVISION: Block: Lot: 3
PARCEL NUMBER: 001195111 Section: 19 Township: 30 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP DETACHED GARAGE & SAT OQsat !� 0
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 0
VALUATION 40,000.00 ADD'L: 387v TEAT TYPE: PRO
CODE EDITION: 2003 HEAT BASE: f HEAT TYPE:
OCCUPANCY: UNHEATED: # OF STORIES: 2
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
SHORELINE:
CONST TYPE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL: CMY
WATER SYSTEM: PUD
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0 /
Prop: �•" Prop: y
Total: .1 Total: /1
Routing Date: / -i
f os fR)
Type Amount Paid Bv: Date: Receipt: A rtv r
State Building Code $4.50 SLE 11/16/05 77420
Permit $542.75 SLE 11/16/05 77420 MAR 7 2006
Plan Check $352.79 SLE 11/16/05 77420 !after8on County?laming
Total: $900.04
).j;IS•I iiu 9901E11)?0.
--tAy`c.tea. .
•
orr cob. JEFFERSON COUNTY I l I
` ,�,�j DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax NOV 6 z��5
46‘ N tp www.co.jefferson.wa.us/commdevelopment
Master Permit Application ( ;�� (� MLA:
Project Description(include separate sheets as necessary): • (-TU4EN
Garage w/ ]tvn epa abV. SA .t Qe0mA-13 74 �-rL_ „euT` s•
Tax Parcel Property
Number: OOl lay 1%1 Size: 2122OO ,P (acres/square feet)
Site Address and/or Directions to Property: 14;5 " h }}j1l C1- pdi--rbv~ALI.j'*
Property Owner(s)of Record: Rock L aae 5orenso*A
Telephone: 3bo•344.432.b Fax: email:
Mailing Address: 195 Blue Ih•tt C1" , Port-lownserd IV✓\ q%364)
Applicant/Agent(if different from owner): FLAW 5andalil
Telephone: 20b• 543.' 3 QJ Fax: 20b•143.1501 email: peke (a sanclallYmorte.coll
Mailing Address: 4d64 bbo3 9tevbrt" L`jeamee 98lot
Whiat kind of Permit?(Check each box that applies)
u Building u Variance(Minor,Major or Reasonable Economic Use)
u Demolition Permit u Conditional Use[C(a),C(d),or C]**
✓Single Family u Discretionary"D"or Unnamed Use Classification
eGarage Attached Detached u Special Use(Essential Public Facilities)**
i Manufactured Home u Boundary Line Adjustment
i Modular u Short Plat**
Li Commercial* u Binding Site Plan**
u Change of Use u Long Plat**
_i Address i Road Approach a Planned Rural Residential Development(PRRD)/Amendments**
u Propane u Plat Vacation/Alteration**
u Allowed"Yes"Use Consistency Analysis u Shoreline Master Program Exemption/Permit Revisions**
u Stormwater Management u Shoreline Management Substantial Development**
u Site Plan Approval Advance Determination(SPAAD)* u Shoreline Management Variance
u Temporary Use a Comprehensive Plan/UDC/Land Use District Map Amendment
u Wireless Telecommunication* u 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. 1 (
Signature: / �"/e t j CV/te,c ,._t_ Date: ////S-��s
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-trans cable responsibility for adhering to and complying with the ESA. The Applicant has read this disc) imerr,nd si�d dates it below.
Signature: If-� ;'!�-� C�`}� Date: ,�7//\ v.1
C:\Documents and Settings\mochil\Desktop\Master Permit Application 7-8-04.doc
S •
OWNER BUILDER STATEMENT '--''
7
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:
1 6 2005 .
f
1 i
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: t FAX: i
MAILING ADDRESS: EMAIL: +.., _
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER ,�..``��
ARCHITECT/ENGINEER: RItlr la'� /AIVI1 i , - PHONE (2v ) 3.g57$ FAX:(-L.06 )543.7504
MAILING ADDRESS: 60 e . III 'P mot EMAIL ,•,li., Q e {ym1A1°•WA
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
re New i 'Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: 1 Bank R 1ommunity System
O Alteration/Remodel ❑ Concrete Total: I Height: ❑ Individual System
❑ Repair 0 Masonry SEP Permit#
Demolition ❑ Other: Bedrooms: 1 Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: I ❑ Public
—f Total: I Name of System:
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:
i Underground Tank i Above ground Tank Size of Propane Tank:
i Heat Stove i Cook Stove i Woodstove i Fireplace Insert i Hot Water Tank i Pellet Stove i 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 properly
lines,tank location and size,distances from the propane tank it,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:
2Nu Floor Besse fee: 54z'-�S-
Wl f 2t>3:
3`d Floor Additional Section: .,.
Mezzanine: Plan Check fee: 3 5z.ici
Heated Basement State Surcharge fee: 4
Unheated Basement Pot Water Review fee:
Other Unheated 911/Rd Approach fee:
Garage/Carport r?6 ch 1357(..3 TOTAL: $ Ct54-0`-t.
Decks Receipt Number:
17f'
Cash/Check Number: lt�
Other �Tq 7
ESTIMATED COST(REQUIRED) • "Date: f(f*rs bS
.Fair market value of all( anrLmateri l . ,'dation to finish 1( I
oW� Initials:
)
C:\Documents and Settings\mochil\Desktop\Master P.•.'t Applcati - .doc 4 5 y s 1-9"A t.l¢d No) t1*t
14'0NrGj1, j *-Lo N_OLIQC
III •
com JEFFERSON COUNTY l--_.,.. — - rDEPARTMENT OF COMMUNITY DEVELOPI4ET 1 7 �(�06 621 Sheridan Street • Port Townsend • WasTiington 9836t360/379-4450 • 360/379-4451 Fax
www.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA: Cl (41
Project Description(include separate sheets as necessary):
A deed 2 car gsraee
Tax Parcel ` 1 q5 ,`� Property
Number: Size: V I ebe ) SF (acres/square feet)
Site Address and/or Directions to Property: j(6g $ham Fh1l O•t* , Pori-To„y ,ViA
Property Owner(s)of Record: Rockwett o Can au Swanson
Telephone: 360•544 •4321, Fax:
email:
Mailing Address: 1,65 F3Jyg Hilt Ct Ft.. •Tcyfiw ul wA• Qt36eb
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
Vtat kind of Permit?(Check each box that applies)
eeBuilding Li Variance(Minor,Major or Reasonable Economic Use)
Demolition Permit a Conditional Use[C(a),C(d),or Cj**
Single Family a Discretionary"D"or Unnamed Use Classification
Garage Attached/Detached a Special Use(Essential Public Facilities)**
u Manufactured Home a Boundary Line Adjustment
u Modular a Short Plat**
Commercial* Binding Site Plan**
Change of Use ❑ Long Plat**
u Address i Road Approach a Planned Rural Residential Development(PRRD)/Amendments**
u Propane a Plat Vacation/Alteration**
._i Allowed"Yes"Use Consistency Analysis Shoreline Master Program Exemption/Permit Revisions**
Li Stormwater Management Li Shoreline Management Substantial Development**
Site Plan Approval Advance Determination(SPAAD)* Shoreline Management Variance
Temporary Use a Comprehensive Plan/UDC/Land Use District Map Amendment
Wireless Telecommunication* Jefferson County Shoreline Master Program Amendment
Forest Practices Act/Release of Six-Year Moratorium i
*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 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:_ 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 and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: Date:
C:\Documents and Settings\mochil\Desktop\Master Permit Application 7-8-04.doc
1
JAN 1 7 2006 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:
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:
/New ❑Wood Existing: ❑ Sewer
Addition Li Steel Proposed: Bank ❑ Community System
• Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System
Ci. Repair ❑ Masonry SEP Permit#
i Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well Ci Two Party
Type of Heat: Proposed: Li Public
Total: Name of System: I
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:
I Underground Tank I Above ground Tank Size of Propane Tank:
I H• eat Stove I Cook Stove I Woodstove I Fireplace Insert I Hot Water Tank I Pellet Stove I 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 4� .„'.-
Main Floor ': r
- C:C.� itri--
2NU Floor Base fee:
3fd Floor Additional Section:
Mezzanine: Plan Check fee:
Heated Basement State Surcharge fee:
Unheated Basement Pot Water Review fee:
Other Unheated 911/Rd Approach fee:
Garage/Carport e C.
r716 s,_ TOTAL: $ 1 2 C-, t;-
Decks Receipt Number: 1 S°(`e I
Other Cash/Check Number: rt
ESTIMATED COST(REQUIRED) Date: �( �,( �
.Fair market value of all labor and materials foundation to finish V 111[.J'�K '
Initials: C--.
C:\Documents and Settings\mochil\Desktop\Master Permit Application 7-8-04.doc
•
SPECIAL CONDITIONS FOR .1 SE # BLD05-00718
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.) 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.) Minimum setback from Blue Hill Ct right-of-way is 20 ft. Minimum side and rear setbacks
are 5 ft. Environmentally sensitive areas further impace setbacks.
12.) 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.
I:\F_BLD_Permit_Buildng.rpt 10/29/1999
CONDITIONS for Building Permit#• 00718
D05- S
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.) The revised site plan as submitted on January 17, 2006 has been reviewed for
consistency under the UDC, and has been approved by Jefferson County Department of
Community Development. Any modifications, changes, and/or additions to the stamped,
approved site plan dated January 31, 2006 shall be resubmitted for review and approval
by Jefferson County Department of Community Development.
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) 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).
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.) Minimum setback from Blue Hill Ct right-of-way is 20 ft. Minimum side and rear setbacks
are 5 ft. Environmentally sensitive areas further impace setbacks.
• S
13.) 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.
\\tiriemark\riata\fnrmc\F RI fl Parmit Rlrin rnt 7/11/71111
��g�orr co�� JEFFERSON COUNTY 1 L
L-4 . 1-3 DEPARTMENT OF COMMUNITY DEVELOPMENT
ti 1:-.-, 1
� "'\\� 621 Sheridan Street • Port Townsend • Washington 98368 ���;'..` 1 !. 2013
�y O 360/379-4450 • 360/379-4451 Fax J
`� ING` http://www.co.jefferson.wa.us/commdevelopment/ I `J
JEFFERSON COUNTY
" T Or COMMUNITY DEVELOPMENT
Stormwater Calculation Worksheet
MLA# PROJECT/APPLICANT NAME: r r 3 _. k' 6 0- '44-5Z__.
DETERMINING STORMWATER MANAGEMENT REQUIREMENTS: This stormwater calculation worksheet should be completed first
to classify the proposal as "small,""medium," or"large." The size determines whether a Stormwater Site Plan is required in conjunction
with a stand-alone stormwater management permit application, building permit application, or other land use approval application that
involves stormwater review. The basic information will also be helpful for completing a Stormwater Site Plan, if required.
PARCEL SIZE(I.E., SITE)
Size of parcel /S acres An acre contains 43,560 square feet. Multiply the acreage by this figure.
Size of parcel in square feet .t 11j $D 0 sq/ft
Land-disturbing activity is any activity that results in movement of earth, or a change in the existing soil cover (both vegetative and
non-vegetative) and/or the existing soil topography. Land disturbing activities include, but are not limited to clearing, grading, filling,
excavation, and compaction associated with stabilization of structures and road construction.
Native vegetation is vegetation comprised on plant species, other than noxious weeds, that are indigenous to the coastal region of the
Pacific Northwest and which reasonably could have been expected to naturally occur on the site. Examples include species such as
Douglas fir, western hemlock,western red cedar, alder, big-leaf maple, and vine maple; shrubs such as willow, elderberry, salmonberry,
and salal; herbaceous plants such as sword fern, foam flower, and fireweed.
LAND DISTURBING ACTIVITY, CONVERSION OF NATIVE VEGETATION,AND VOLUME OF CUT/FILL
Calculate the total area to be cleared, graded,filled, Answer the following two questions related to
excavated, and/or compacted for proposed development conversion of native vegetation:
project. Include in this calculation the area to be cleared for:
Does the project convert 3/4 acres or more of
Construction site for structures 1, 00 U sq/ft native vegetation to lawn or landscaped areas?
Drainfield, septic tank, etc. sq/ft Circle: Yes cD
Well, utilities, etc. 0 sq/ft Does the project convert 2 1/2 acres or more of
native vegetation to pasture?
Driveway, parking,roads, etc. e sq/ft
Circle: Yes
Lawn, landscaping, etc. & sq/ft
Other compacted surface, etc. sq/ft Indicate Total Volumes of Proposed:
Total Land Disturbance 11 bO `' sq/ft Cut Fill (cu/yd)
[over]
stormwater calc worksheet Rev 9-9-2010—REV 9/9/2010 1
Impervious surface is a hard surface that either prevents or retards the entry of water into the soil mantle as under natural conditions
prior to development. A hard surface area which causes water to run off the surface in greater quantities or at an increased rate of flow
from the flow present under natural conditions prior to development. Common impervious surfaces include, but are not limited to roof
tops, walkways, patios, driveways, parking lots or storage areas, concrete or asphalt paving, gravel roads, packed earthen materials,
and oiled, macadam or other surfaces which similarly impede the natural infiltration of stormwater.
STORMWATER CALULATIONS—IMPERVIOUS SURFACE
NEW EXISTING
Structures (all roof area) Ii DOY sq/ft Structures (all roof area) 3i 040 sq/ft
Sidewalks D sq/ft Sidewalks 0 sq/ft
Patios sq/ft Patios 0 sq/ft
Solid Decks sq/ft Solid Decks C) sq/ft
(without infiltration below) (without infiltration below)
Driveway, parking, roads, etc 0 sq/ft Driveway, parking, roads, etc U sq/ft
i
Other 0 sq/ft Other (5 x .` \ sq/ft
Total New ), 'L/ _sq/ft Total Existing sq/ft
TOTAL NEW+TOTAL EXISTING* sq/ft
*This amount will be used BY STAFF to check total lot coverage.
The following questions will help determine whether the proposed project is considered development or redevelopment.
DEVELOPMENT v. REDEVELOPMENT
Divide the total existing impervious surface above by the size of the parcel and convert to a percentage: , 01 %
Does the site have 35% or more of existing impervious surface? Circle: Yes (Nci)
FURTHER INSTRUCTIONS: If the answer is yes, the proposal is considered redevelopment and the attached Figure 2 should be
used to determine the applicable Minimum Requirements. If the answer is no, the proposal is considered new development and the
attached Figure 1 should be used. At this juncture, the applicant should refer to the applicable Flow Chart to determine the Minimum
Requirements for stormwater management. DCD staff will help verify the classification of the project and the application requirements.
For proponents of "small" projects who must comply only with Minimum Requirement #2—Construction Stormwater Pollution
Prevention—an additional submittal is not required. The proponent is responsible for employing the 12 Elements to control erosion and
prevent sediment and other pollutants from leaving the site during the construction phase of the project. Pick up the Construction
Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet. Proponents of"medium" projects—those
that must meet only Minimum Requirements #1 through #5—and for "large" projects—those that must meet all 10 Minimum
Requirements—are required to submit a Stormwater Site Plan. DCD has prepared a submittal template of a Stormwater Site Plan,
principally for rural residential projects. Complete the template in the Stormwater Site Plan Instructions and Submittal Template or
prepare a Stormwater Site Plan using the step-by-step guidance in the Stormwater Management Manual.
APPLICANT SIGNATURE
By signing the Stormwater Calculation 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.
e/ '5/1•5 / Si' 3
(LANDOWNER OR AUT RIZED REPRESENTA VE SIGNATURE) (DATE)
FOR OFFICE USE ONLY
SMALL MEDIUM LARGE REDEVELOPMENT Stormwater Site Plan: Yes No
1 stormwater calc worksheet Rev 9-9-2010—REV 9/9/2010 2
� ,gON ° JEFFERS ! COUNTY IP c).-D LD 05- 1 1 K
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14' DEPARTMENT OF COMMUNITY DEVELOPMENT gems,_,)
`4 621 Sheridan Street • Port Townsend • Washington 98368
360/379-4450 • 360/379-4451 Faxq www.co.jefferson.wa.us/commdevelopment
S Na
Master Permit Application MLA:
Project Description(include separate sheets as necessary):
et
Tax Parcel Number: p I S I i Property Size: Al �,ff oo ScQ` \f (acres/square feet)
Site Address and/or Directions to Property:
Property Owner(s)of Record: at lE n , ( 6
Telephone: 3(uO 3 J1 ' a49 Fax: _ .� email: ( sctrtcjle_a Me .Com
Mailing Address: 135 Blue_ lit 1( �� Pc - •f Len t14 , It1A 4?36v
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies 0 Lot or Road Segregation
❑Building 0 Critical Areas Stewardship Plan
❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use)
Single Family Garage Attached Detache 0 Conditional Use[C(a), C(d),or C]**
❑ Manufactured Home Modular 0 Discretionary"D"or Unnamed Use Classification
❑ Commercial* 0 Special Use(Essential Public Facilities)**
Change of Use 0 Boundary Line Adjustment
0 Address _ 0 Road Approach 0 Short Plat**
❑ Home Business ❑Cottage Industry 0 Binding Site Plan** S C I E O V L
0 Propane ❑ Long Plat**El
sign • 0 Planned Rural Resided I :velopment(PRRD)/Amen• - s**
❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteratior <,
❑ Stormwater Management ❑ Shoreline Master Proggalm Exemption/Permit Revisions
❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management§ul stantial Development**
❑ Temporary Use 0 Shoreline Management`4Aarta ce
❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Uggt-$i tM pYAmendmenl
❑ Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Ml eecegrigitaillVbYltteFtt t
*May require a Pre-Application Conference 0 Tree Vegetation Request
**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 its 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. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the application that he or she wants prior notice.
Signature: -7/7tGt—edeL-.4_C. e/arCe Date: 6 J/v// .7
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. / ` Date: 5'fj/�J`/3
,,7", ..__•_,__.__\uuucnonrc++u++\\-1o`cr,r,N,c\\ r..__..�non=c._, ..,\n.o_...__n__:. n__,'__.:__c nn no a__
•
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:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PI-ZONE: 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:
New X Wood Existing: ❑ Sewer
❑ Addition
❑ Steel Proposed: 0 Bank ❑ Community System
O Alteration/Remodel ❑ Concrete Total: C..7 Height: 0 Individual System
O Repair ❑ Masonry — SEP Permit# -
• Demolition ❑ Other: Bedrooms: Water Supply:
Existing: - Setback: ❑ Private well 0 Two Party
Type of Heat: Proposed: U ❑ Public
Total:
novlt-
Name of System:
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:
1 Underground Tank 1 Above ground Tank Size of Propane Tank:
i Heat Stove 1 Cook Stove 1 Woodstove 1 Fireplace Insert i Hot Water Tank 1 Pellet Stove i 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 Current Proposed -For Office Use Only _ Amount Revision
Main Floor Heated EH Bld App Review: o
2`d Floor Heated Consistency Review:
1Le o
Other Heated Base fee: V°kS ZS
Mezzanine Additional Section:
12,E -q,Z-
Heated Basement Plan Check fee: 1 lv- 00 y
Unheated Basement State Surcharge fee: `
50
Other Unheated. Pot Water Review fee: —_.
Garag Carpo SUBTOTAL
52 IQ o 3
Decks 911/Rd Approach fee:
COther TOTAL: $ Co 39-�11
Receipt Number:
Cash/Check Number:
ESTIMATED COST(REQUIRED) Date:
•Fair market value of all labor and materials foundation to finish
. 00 0 Initials:
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