HomeMy WebLinkAboutBLD2006-00057 GILDING Revviewiew Ty PERMIT APPLICAAN ML Ty052
pe:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD06-00057 Received Date: 2/10/2006
SITE ADDRESS: SR 20
PORT TOWNSEND, 98368
OWNER: MALAMUTE ASSOCIATES LLC PHONE: 360-379-9040
422 DISCOVERY RIDGE RD
PORT TOWNSEND WA 98368909
MOUNTAIN VIEW VISTA
SUBDIVISION: Block: Lot: 4
PARCEL NUMBER: 974600004 Section: 8 Township: 29 N Range: 01 W
CONTRACTOR: JERRY LINDSEY EXCAVATING PHONE: 360-385-1076
1865 W UNCAS RD
PORT TOWNSEND WA 98368
Contractor's License JERRYL962QR Expires 11/19/2006
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI` NEW 270' RETAINING ROCK WALL
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 5,500.00 ADD'L: HEAT TYPE:
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY:
OCCUPANCY: UNHEATED: # OF STORIES:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 0 Prop: 0
Total: 0 Total: 0
Routing Date:
I/ 5(ocoi
Type Amount Paid By: Date: Receipt: roved/Date
��Permit $125.25 LYK 02/10/06 79104 R O Y E P
Plan Check $81.42 LYK 02/10/06 79104
State Building Code $4.50 LYK 02/10/06 79104 APR 3 2006
Total: $211.17 Jefferson County Planning
&Building Department
'.... . e-L-L
t', - '�rt t�#
BUILDING PERMIT•
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD06-00057 Received Date 02/10/2006
SITE ADDRESS: SR 20 Issue Date 04/3/2006
PORT TOWNSEND, 98368
APPLICANT: MALAMUTE ASSOCIATES LLC PHONE: 360-379-9040
422 DISCOVERY RIDGE RD
PORT TOWNSEND WA 983689091
SUBDIVISION: MOUNTAIN VIEW VISTA Block: Lot: 4
PARCEL NUMBER: 974600004 Section: 8 Township: 29 N Range: 01 W
CONTRACTOR: JERRY LINDSEY EXCAVATING PHONE: 360-385-1076
1865 W UNCAS RD
PORT TOWNSEND WA 98368
Contractor's License: JERRYL962QR Expires: 11/9/2006
PROJECT DESCRIPTION: NEW 270' RETAINING ROCK WALL
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:
Propane Tank/ Lines:
Insulation:
Sheetrock:
Septic Sytem Final Approval MUST be obtained before final of structure can be attempted.
Road Approach Final Approval:
Zoning Final Approval: t
Final/Occupancy Approval: `/ c/F 0�j /.L,//.,-+1� /cy i7
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 t BLD06-00057
1.) Any further development and permit approval will require a soils compaction report from a
licensed Geologist or Engineer for the building site. The soils compaction report shall be
submitted with the building application.
2.) A Geotechnical Report date September 1997 and prepared by Shannon &Wilson Inc.
was submitted in conjunction with a long plat(SUB97-00007) that has recievied final
approval. The report addressed the stability of the geologic hazard area. A setback of 30
feet shall be measured perpendicularly from the top or toe of the geologic hazard to the
any proposed.
3.) 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.
4.) 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."
5.) All construction activities shall not encroach upon the buffer. This includes the storage or
preparation of materials.
6.) 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.
7.) A setback of 50 feet for the Class II wetland and a setback of 25 feet for the Class Ill
wetland, measured perpendicularly from the wetland edge, shall be permanently
maintained as a buffer. No filling, grading, clearing, or other alteration of the wetland or its
buffer is allowed.
8.) Buffer perimeters shall be marked with temporary signs at an interval of one per parcel or
every one hundred (100) feet, whichever is less. Signs shall contain the following
statement: "Wetland & Buffer- Do Not Remove or Alter Existing Vegetation."
9.) A permanent physical separation along the upland boundary of the wetland buffer area
shall be installed and permanently maintained. Such separation can include installing
logs, trees, a hedgerow, or any other prominent physical marking approved by the UDC
Administrator.
10.) 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_B LD_Perm it_Bu ildng.rpt 10/29/1999
• 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 assugli r ponsibility of the General Contractor for the proposed project.
Signature: k L �-�,,% • Date: Z, /Q , 0 (a
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: �. FAX:
MAILING ADDRESS: / EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: I�i s i ,_'S, 2 ���r r h PHONE (3 c/o ) ytv c1if Z e FAX:(3�-, ) S 7 74,
MAILING ADDRESS: qv(4,0 J/ - /' EMAIL Aim 7
CL�r c�z�'/Lh � rl .S'c•,�z, 2c� ife�,� f�C+' �n .L, a, j47,1- -c'ha it1�'"'1l'
Project Type: Frame Type: I Bathrooms:cj 4 3;D Shoreline: Type of Sage Disposal:
❑ New ❑ Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: Bank Height: ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: ❑ Individual System
❑ 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 Project you must answer the following:
Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces:
Number of occupants(includes owners,tenants,employees,etc) Current Proposed
IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No
If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply:
❑ Underground Tank ❑ Above ground Tank Size of Propane Tank:
❑ Heat Stove ❑ Cook Stove ❑ Woodstove ❑ Fireplace Insert ❑ Hot Water Tank ❑ Pellet Stove ❑ Other
Is this appliance being installed in a Manufactured/Mobile Home? Yes / No
When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property
lines, tank location and size, distant rco4(( . .. . 9.. all property lines,buildings and septic system components,
including the reserve area. C 1
,it'd 'f . #`2° -s``' 'C - 'MC "-' {- x x•'s < t T,; 'r, �0 7
Square Footage _ Current Proposed �: r ce Use ��` ,- _-' 7'. , r „ _. �. .''t4 ,r;
Main Floor Heated
E. t 'a i , EH Bid App Review:
2n°Floor Heated r. Consistency Review:
Other Heated JEFFERS€ �` ( ,i ease fee: r.
c
I .-( .) t-(J
Mezzanine Additional Section:
`
Heated Basement X� Bra" Plan Check fee:
Unheated Basement s State Surcharge fee:
- (.
Other Unheated 'i_' :` `" Pot Water Review fee:
Garage/Carport .' it,V . SUBTOTAL
:.•:.,:,_,,,,q„.,,,„ . ..„:„
4-
c1 ii-
Decks g .� 911/Rd Approach fee:
Other ,•. +,
TOTAL: $ ii ,Aci 1~-)
Receipt Number:
r1 9 (U 4-
Cash/Check Number:
ESTIMATED COST(REQUIRED) Date:
•Fair market value of all labor and materials foundation to finish `( I (i( .
��'GI Initials:
G:\PermitCenter'(FORMS\DRD FORMS\Master Permit Application 12-30-05.doc
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'C4 il. CO JEFFERS COUNTY
t� 41
DEPARTM
„, ,� EWOF COMMUNITY DEV F*M 11114,1 �A, I
ti � r � 1__! �;
621 Sheridan Street • Port Townsend • ashington 98368 `-"-
360/379-4450 • 360/379-4451 Fax
4qs' ,iTING .C$ www.co.jefferson.wa.us/commdevelopmentFER 1 ig
Master Permit Application
tifffERSON MLA: -- , J'
Project Description (include separate sheets as n cessa ):
• ��� '�
C ?0 jvi:/C / r' . k.) /1.Li_Z__
Tax Parcel Number: , Pros ze '/
(: C 4-C.._ (acres/square feet)
Site Address and/or Directions to Property: 2--4{ 1- z-/ / r1,7 j,r,,;i1t Zliq i,
Property Owner(s)of Record: / .'l /,i''cat, 41';o c ,;7 ;- , U h
Telephone: '7b6; r 7‘-1 l `1c, �-i0 Fax: 3 �, ��� -�� �; email: c f31, 1,/, , cJ_4/ci-I r`,n,;/.c, .
Mailing Address: `f a Z //;i c 4 • '.z/L IC, c---c_ k:zi, / -'t .c�, s,,,.( L: 7 cl-V 7�..;
Applicant/Agent(if different from owner) /
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies)
❑'Building [I Variance (Minor, Major or Reasonable Economic Use)
❑ Demolition Permit ❑ Conditional Use[C(a), C(d),or C]**
❑ Single Family 0 Discretionary"D"or Unnamed Use Classification
❑ Garage Attached/Detached ❑ Special Use (Essential Public Facilities)**
❑ Manufactured Home ❑ Boundary Line Adjustment
❑ Modular ❑ Short Plat**
❑ Commercial* ❑ Binding Site Plan**
❑ Change of Use ❑ Long Plat**
❑Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments**
❑ 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 t;// C/-/-'1r-25 l /',2 4(, t j�_ Date: c f P ' 6)
C��
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 in ' ctions.Access and right of entry to this property shall be requested and shall occur only during regular business
hours. j
Signature: //"/ '�a l% . Date: c / ' C; C,
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 respoogsiblity for a ermg to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: Ai _ /
-fie'✓ Date: 2 %/7 C74 '
G:\PennitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc
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