HomeMy WebLinkAbout BLD2006-00041 *JILDING PERMIT APPLICAT N ML vT
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Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD06-00041 Received Date: 1/31/2006
SITE ADDRESS: CRESSEY LN
PORT LUDLOW, 98365
OWNER: THOMAS E JOHNSON PHONE: 360-774-1274
JENELL S JOHNSON
62 GARDEN CLUB RD
NORDLAND WA 983589610 PORT LUDLOW NO 1
SUBDIVISION: Block: Lot: 39
PARCEL NUMBER: 990400139 Section: 9 Township: 28 N Range: 01 E
CONTRACTOR: NORDLAND CONSTRUCTION CO INC PHONE: (360)385-1247
62 GARDEN CLUB RD
NORDLAND WA 98358
Contractor's License NORDLCN953NT Expires 8/30/2007
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION NSFR W/ATT GARAGE - A/G 120 GAL PROP TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,800
VALUATION 225,000.00 ADD'L: HEAT TYPE: PRO
CODE EDITION: 2003
OCCUPANCY: R-3 HEAT BASE: HEAT TYPE: N'�i., . PAm P
OCCUPANCY: UNHEATED: 1,300 #OF STORIES:
CONST TYPE: 5N OTHER: SHORELINE:
CONST TYPE: GARAGE: 400 SETBACK:
DECK: 500 BANK HEIGHT:
SEWAGE DISPOSAL: SEW
WATER SYSTEM: PUD
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 3 Prop: 2
Total: 3 Total: 2
Routing Date:
Type Amount Paid By: Date: Receipt: APPROVEr
Approved/Date
Permit $1,693.75 LYK 01/30/06 79035 Plan Check $1,100.62 LYK 01/30/06 79035
State Building Code $4.50 LYK 01/30/06 79035 APR 7 2006
Potable Water Application $55.00 LYK 01/30/06 79035
Jefferson County Planning
Total: $2,853.87 & 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 #: BLD06-00041 Received Date 01/30/2006
SITE ADDRESS: 90 CRESSEY LN
PORT LUDLOW, 98365 Issue Date 04/7/2006
APPLICANT: THOMAS E JOHNSON
JENELL S JOHNSON PHONE: 360-774-1274
62 GARDEN CLUB RD
NORDLAND WA 983589610
SUBDIVISION: PORT LUDLOW NO 1
PARCEL NUMBER: 990400139 Block: Lot: 39
Section: 9 _ Township: 28 N Range: 01 E
CONTRACTOR: NORDLAND CONSTRUCTION CO INC
62 GARDEN CLUB RD PHONE: (360)385-1247
NORDLAND WA 98358
Contractor's License: NORDLCN953NT Expires: 8/30/2007
PROJECT DESCRIPTION: NSFR W/ATT GARAGE -A/G 120 GAL PROP TANK
CALL IN FOR THE REQUIRED INSPF.CTIOliV THAT APPLY TO YOUR PROJECT.
SETBACKS: /),( c/711 N.;
UFFER: A(' 0141,
",„)
Footing: �A- -
liok
Foundation: /9 i ��n
Stormwater FINAL Approval:
Underground Plumbing: I airriffeiYfTarJ�
Underground Insulati�{'s 7 / '
Shear Wall : eklr� rL`itms ( VDUX iq,A1 «.1APPL ,Ner,
Sheathing: f���
Framing:
Plumbing: Qx .077,47 ,0
Propane Tank/Lines: / / "
Insulation: Cr- t„� r- ->
`o VT i/z�tir
Sheetrock: Z
Septic Sytem Final App val MUST be ob(t1ø )
ned before final f str ure can be attempted.
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval: i, (1/Z0 it, 7 PZI
HEALTH DEPARTMENT AND PUBLIC WORKS APPROV L REQUI D 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 t BLD06-00041
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 45%. 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 Cressey Lane right-of-way shall be 20 feet. Minimum side and
rear yard setbacks shall be 5 feet.
10.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
11.) Per MPR Code Section 3.17, Accessory Dwelling Units (ADU's) shall not be allowed in the
MPR-SF zone.
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ti <\', rC DEPARTMENT OF COMMUNITY DEVELOPMENT i 0
621 Sheridan Street•Port Townsend •Washington 98368 . .
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STORMWATER SITE PLAN
SUBMITTAL TEMP - -
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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.
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Project Overview »,r ..1 1/44444‘4.41 4 AAd / Pa27' Lud1.0 Lr1
1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the
site p. Iu i iv/ice / L e i-r.r Gh Io A T(kiei.e_ 1-AA-Uri 14v1St-
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Existing Conditions Summary
2. Describe the existing topography. Indicate contours on the site map. (C,C-C_Cce.Y.
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3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
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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
applicable,and indicate acreage of each. l E 1•
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6. Describe any excess levels of noise ene ed¢v the sed use or activity
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SAiliS / Iva71.-6-1 ..v.i' / SfiTiailWATER PLAN at
Stormwat S !1' �� y i 4• JAlit'
Require FEE"! 2 1 2006 -
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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.
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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.).
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Permanent Stonnwater Control Plan
This portion of the Stormwater Site Plan consists of the selection and installation of the appropriate stormwater col trot tSMKS`
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.
9. 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 sto 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.]
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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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13. Describe the water quality system. k/:
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14. Describe the conveyance system analysis and design.
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15. Describe the source of fill material,physical characteristics of fill material, and deposition of excess material.
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16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code.
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17. Describe the proposed surfacing material.
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18. Describe methods for restoration of the site.
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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.
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20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan.
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.
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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. (�r<c f_'`y ff�57..
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2. Establish Construction Access.
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3. Control Flow Rates.
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4. Install Sediment Controls.
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5- Stabilize Soils.
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6. Protect Slopes.
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7. Protect Drain Inlets. (�aG(, e k t/I/4
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12 Required Elements—Construction SWPPP(continued)
8. Stabilize Channels and Outlets.
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9. Control Pollutants.
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10. Control De-Watering(the act of pumping groundwater or stormwater away from an active constrrsiction site).
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11. Maintain Best Management Practices(BMPs).
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12. Manage the Project.
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2. Adjacent Areas.
a. Description of the adjacent areas that may ibe-4ttected-.by-site-distur8ance e.g., streams, lakes, wetlands, residential
areas, roads). Ze2,S e/J L. l7":✓ x,, ',,ft;
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b. Description of the downstream drainage path leading from the site o the re in b f r(minimum distance of 400
yards). ( �J / H e L y
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3. Environmentally Sensitive Areas.
a. Description of environmentally sensitise areas that are on or adjacent to the site.
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b. Description of special requirements for working in or near environmentally sensitive areas.
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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. p
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a. Construction sequence �T - - r--r rc.PJr-1 h g./Nf
C. 1—Efir arr/ .t%rt A3.L!i- 1 PA/l-( ./'J "; / 6pF/er- Sj.7;A ,r 11`.�,t V r _[1G1�'Ic
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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).
Provide a proposed construction schedule. _
•
II. Wet Season Construction Activities.
`1 a. Proposed wet season construction activities.'c
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b. Proposed wet season construction activities for environmentally sensitive areas.
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7. Financial/Ownership Responsibilities.
a. Identify the property owner responsible for the�tiatiertothohds and/or otter . I securities.
b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impacts.
8. Engineering Calculations. Provide Design Calculations no a_ if epplicab)e
a. Sediment Ponds/Traps.
b. Diversions.
c. Waterways. s , , )0
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d. Runoff/Stormwater Detention Calculations
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• •
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 stomiwater 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 affe property.
/11(fill-60-1, ik7441/4 .- 0 6,
(LANDOWNER OR AUTHOR!ZED REPRESENTATIVE SIGNATURE) ~
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THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
I
JAN 3 0 200E
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BUILDER STATEMENT
_
The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,tha they re censed contractors an)that
they will be'assuming.the responsibility of the General Contractor for the proposed project. �
Signature vk"h.r� 5i„, �/ Date: j'`C�! 6' e�
A Me-
/ GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAx:
/-_J}`'�_- AJO/ZA h14,V6 e�,y,sYReAc-r'Ui,/ ,4/ .XntC (36 ) '77y -17'� ( 44 ) i - s10Z-
MAILING ADDRESS: F z / A_P/ A/ ci �'t fi\ EMAIL: ,
WAINS
CONTRACTOR'S LICENSE C ` / �rJr� v, I�W�LL 1�/70�t LJ Al s'n/,, C�' n
NUMBER: AJC(:b L.c- J 3 `� NUMBER
9.53 �� NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAx: ( )
MAILING ADDRESS: EMAIL
Pro' ct Type: cryle Type: Bathrooms: Shoreline: Typ f Sewage Disposal:
New Wood Existing: CVSewer
[1 Addition ❑ Steel Proposed: / Bank Height: ❑ Community System
[I Alteration/Remodel ❑ Concrete Total: --i- ❑ Individual System
❑ Repair ❑ Masonry .�� SEP Permit#
[.7 Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: '4 ( ublic
Total /� Name of System: v`y/'[P!G
ha[7eR S eh/eK
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 Apptiance�tgstallation permit, mark all items below that apply:
❑ Underground Tank ❑ Above group ,k)/ ze of Propane Tank:
I I Heat Stove ❑ Cook to i Li 0o stov ❑ Fireplace Insert ❑ Hot Water Tank ❑ Pellet Stove ❑ Other
t.
Is this appliance being installed in a Manufac ure /Mobfte-PtO ne? 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 r H Bld App Review:
1 te) IlkY �. r, I
2nd Floor Heated i; L
Cor$1stecy R_iew __..__ G
II i
Other Heated Base fee:
-- JAN 3 0 2006 i _ j �- G j `�j
Mezzanine Additional Section:
1r —
Heated Basement Plan Check fee: l
Unheated Basement State Surcharge fee:
�, 1 S LIY•CD - LI SO'
Other Unheated Pot Water Review fee:
qD.00
Garage/Carport SUBTOTAL
Lief: �j �`c- 1. ri
Decks �[ , ^' 1 i ��r.- 911/Rd Approach f� eel 1 .
Other C t
TOTAL: $ .3 i 6)5. S I
Receipt Number: l►6 1VV/•;/i
Cash/Check Number: I
ESTIMATED COST c I
•Fair market value of all labor and materials foundation to finish , 1 I G�;;
k -i_i_cooc)2 Initials:
``II
G:\Permit'Cein z\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc
¢goN oQ�� JEFFERS. COUNTY •
,kiro
DEPARTMENT OF COMMUNITY.DEVELOPMENL i
621 Sheridan Street • Fort Townsend •..:Washing 0366
360/379-4450 • 360/379-4451 Fax
rs. www.co.jefferson.wa.us/commdevelopment
JAN 3 0 2006
Master Permit Application MLA: C,
Project Description (include separate sheets as necessary): _ /Y�C,� S I' i t/}!(," 'frsv W-7 &AA405
/;&-c, i✓'/ti'l Sliw) LR4-s'eA1 cz/T'
Property Sr-
Tax Parcel Number: f76) 11 60 /. Size: �(SC S (acres/square feet)
Site Address and/or Directions to Property: L1/i 4e- &F,: GA i i ' y k7' t' '4",e'efc2 - 7 F`i j/ c/a
Property Owner(s)of Record: -`7/Jo/'/ ;Ye t j eLL ci,k1
Telephone: 7('r) - 17 - [Z-7 Fax: }CMG - 2'71 - 5)v'Y email: `j N /1.5V,6,;,'t
Mailing Address: 6`L AZb—ei . a vt8 1L064/0 #yA) CJY 3 $
Applicant/Agent(if different from owner): �'� /VC,R Q i) Cc: 577?ncTGAl X/'�(/ C
Telephone: Fax: email:
Mailing Address: AJ G l'O
Wh t kind of Permit? (Check each box that applies)
. Building 0 Variance (Minor, Major or Reasonable Economic Use)
❑ De�molition Permit 0 Conditional Use[C(a), C(d),or C]**
B'�Single Fa 0 Discretionary"D"or Unnamed Use Classification
b'Garagcr-Attache etached ❑ Special Use(Essential Public Facilities)**
❑ Manufacture Home 0 Boundary Line Adjustment
❑ Modular 0 Short Plat**
❑ Commercial* ❑ Binding Site Plan**
D Change of Use 0 Long Plat**
0 Address [1 Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments**
3-15ropane 0 Plat Vacation/Alteration**
❑ Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions**
O Stormwater Management 0 Shoreline Management Substantial Development**
O Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Variance
❑ Temporary Use D Comprehensive Plan/UDC/Land Use District Map Amendment
0 Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment
O 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:
.�, / t DESIGNATION OF AGENT
I hereby designate //1�M�s J /U G iV to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE prr7)-iVL.--- (Ji; Date: I "Z — Q€
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. g
Signature: ,//l7 �w(�� (4i� 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 rgspensibility for adhering to and omplying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: c Date: / ' 2b —Dag
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc