HomeMy WebLinkAboutBLD2006-00148 ILDING PERMIT APPLICAN MLA06-00145ReviewType: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD06-00148 Received Date: 3/29/2006
SITE ADDRESS: 500 CHERRY AVE
CHIMACUM, 98325
OWNER: JASON J WOODS PHONE: 360-732-0880
ROBIN WOODS
500 CHERRY AVE
CHIMACUM WA 983258727
SUBDIVISION: Block: Lot: T 45
PARCEL NUMBER: 901101033 Section: 10 Township: 29 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP NSFR RfrYL A k-X.1o\ rnF�
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 2,852
VALUATION 279,572.00 ADD'L: HEAT TYPE: EEE
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: # OF STORIES:
OCCUPANCY: OTHER: 1,016
CONST TYPE: 5N GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: PUD
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 3 Prop: 2
Total: 3 Total: 2
Routing Date:
Type Amount Paid Bv: Date: Receipt: Approved/Date
Permit $2,001.75 LYK 03/29/06 80878 E
Plan Check $1,301.14 LYK 03/29/06 80878 (_ 2006
State Building Code $4.50 LYK 03/29/06 80878 APR aco
Total: $3,307.39 Jeffersur County Pianninu
�;gu�ldiny 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 #: BLD06-00148 Received Date 03/29/2006
SITE ADDRESS: 500 CHERRY AVE Issue Date 04/26/2006
CHIMACUM, 98325
APPLICANT: JASON J WOODS PHONE: 360-732-0880
ROBIN WOODS
500 CHERRY AVE
CHIMACUM WA 983258727
SUBDIVISION: Block: Lot: T 45
PARCEL NUMBER: 901101033 Section: 10 Township: 29 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: NEW SFR REPLACING MFH
CALL IN FOR THE REQUIRED INSPE TION THAT APPLY TO YOUR PROJECT.
SETBACKS: f-)k e,/%s r_)z
UFFER: L1 -7 R k /,,j am if
Footing: QX 40 04i I
Foundation: ! (o'i Ob
Stormwater/FINAL Approval:
Underground Plumbing:
Underground Insulati n:
Shear Wall : O/r( 8 /oL
Sheathing: ,--"
T-19Framing: 4,,,� , V „` 5-0L � -7;14:0
Plumbing: 1
Propane Tank/ Lines: /1V o/(9z.?,29-06
Insulation:
Sheetrock:
Septic Sytem Final Approval MUST be obtained before final of structure can be attempted.
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval , \ ?
HEALTH DEPARTMENT ND 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 A BLD06-00148
1.) 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.
2.) 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.
3.) 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.
4.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
5.) 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).
6.) The building height is not to exceed 35 feet.
7.) Minimum setback from Cherry Avenue and Anderson Lake Road rights-of-ways shall be
20 feet. Minimum side yard setbacks shall be 5 feet.
8.) 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.
9.) 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.
0
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.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
12.) At such time that access from Cherry Avenue is abandoned, a road approach permit and
address will be required from the Jefferson County Department of Public Works for the
access off of Anderson Lake Road.
I:\F_BLD_Perm it_Build ng.rpt 10/29/1999
o1v cow JEFFERS.COUNTY •
��
k N DEPARTMENT OF COMMUNITY DEVELOPMENT
�' ` '� 621 Sheridan Street • Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
, s. Ko0 www.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA: CSC=- 1115
Project Description (include separate sheets as necessary): 4 l
Velf4 J" ,,,'k 1--y" i .tea +L —1.49-I"r`"
Property
Tax Parcel Number: 961 — in I 0 ? Size: 5 Rc S (acres/square feet)
Site Address and/or Directions to Property: SOO r �,I".f'r t 4 ANK h;I.
Property Owner(s)of Record: ' _.r v. :; v C.� � ". �,
Telephone: ` 73a. ""0,Ct c 0 Fax: (.o b — 32 y -f'l(1 email: - f. v. .--:4„; e[ c"rr C,CC%',
Mailing Address: rt r, .^ r-I.a_ ",-f=�, t f - ,,-.. (
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies)
0 Building ❑ Variance (Minor, Major or Reasonable Economia.Os`fI`
il j
fi Demolition Permit ❑ Conditional Use[C(a),C(d),or C)**
N Single Family ❑ Discretionary"D"or Unnamed Use Classification
❑ Garage Attached/Detached ❑ Special Use(Essential Public Facilities)**
n 4 f"-1^❑ 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**
0 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
0 Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment
❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment
0 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 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 apd right of entry to this property shall be requested and shall occur only during regular business
hours.
Signature: C7,/ ,t«,?f1 ( r !. .. J
Date: .""'.per-e--0tra
The action or actions Applica ill 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.Tie Applicant acknowledges that he,she or it holds individual and non-
transferable resp sibility for adheri to d complying 'th the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature `" _ Date: ¶ ',-^F
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc
• 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 the Gen al Contractor for the proposed project.
Signature: J Date: 3 --ac —0
i
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
MAILING ADDRESS: `j500 04. EMAIL:
CONTRACTOR'S LICENSE Gj'i ;!,-+ate-V/). (444 � ; ;;1.5" WAINS
NUMBER: a f NUMBER
ARCHITECT/ENGINEER: H P ft .5.f jt/ " PHONE (360 ) L y, -,;,4- FAX: (36c') 4j,43 ._ ?ni)
MAILING ADDRESS: .7 1 1,-,. to 9;;7V.C2 EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
5 New C3' Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: r,. Bank Height: `�❑ Community System
❑ Alteration/Remodel 0 Concrete Total: -' /J J ,Individual S tem
❑ Repair ❑ Masonry !�/� SEP Permit# ff ' �-1
❑ Demolition 0 Other: Bedrooms: Water Supply:
Existing: Setback: [I Private well ❑ Two Party
Type of Heat: Proposed:Total: f�/!7}- 0 Public
1� • :y ,,.�,_,: 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 C1 Above ground Tank Size of Propane Tank:
❑ Heat Stove I I Cook Stove ❑ Woodstove i 1 Fireplace Insert [1 Hot Water Tank ❑ Pellet Stove 0 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 (95uEH Bld App Review:r.1 C
2n°Floor Heated Consistency Review:
Other Heated Base fee: {/l-�oo t
l , '75
Mezzanine Additional Section:
Heated Basement Plan Check fee: 1601 I1}_
Unheated Basement State Surcharge fee: L\
Other Unheated Pot Water Review fee: � V
Tf()VC 11 I A D.Mc,-V* Rt\ACl(j>9soe44-
Garage/Carport SUBTOTAL G
.39
Decks 911/Rd Approach fee: ctt 3A t 111
Other. TOTAL: $
J I
i
Receipt Number: ',6 C 1
Cash/Check Number: a D%
ESTIMATED COST(REQUIRED) Date: 3' rl!
•Fair market value of all labor and materials foundation i J1�J0 ` Initials: 1diti
/ f � = : f51�, e�
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Ap ' ation 12-30-05.doc.-
• I
gON _ ty (`i..
c JEFFERSON COUNTY L.�.�,1 �� D
DEPARTMENT OF COMMUNITY DEVELOPMENT ' rn
621 Sheridan Street • Port Townsend • Washington 98368
360/379-4450 • 360/379-4451 Fax r; ,.
t , is
``'� Nd`1 http://www.co.Jefferson.wa.us/commdevelopment/ tt.r �ttcfr;p �„. r `0
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# OV I 6PROJECT/APPLICANT NAME: v-TGL6evy‘ A.)4 Re jj." 1
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.
Project Overview
1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the
site map.
(1 r r v . +ate_ 4 IL} - ,-oz ___ /ycty _ _. clauat
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Existing Conditions Summary
2. Describe the existing topography. Indicate contours on the site map.
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3. Describe the existing vegetation. Indicate native vegetation areas on the site map. rnun- ..of vi%��
4. Describe the existing soils. Indicate soil type on the site map_
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.
(lei . Qir+L� L' U Vey pe,41
APPROVED
6. Describe any excess levels of noise generated by the proposed use or activity: STORM WATER PLAN
APR 7 2006
P
Storr�wa e 1EFFER OUN Y
DEPT.OF Y DEV O ENT
stormwater site plan template—rev.10/1/2003 Requlr SIGtiATIiR
• •
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.
o-AJL
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.).
Permanent Stormwater Control Plan
This portion of the Stormwater Site Plan consists of the selection and installation.of the appropriate stormwater control BMPs
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.
g. 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.
10. If the project requires the use of stormwater treatment facilities, describe the types of stormwater 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.]
11. Describe the performance goals and standards applicable to the project.
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12. Describe the flow control sys#em.I
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stormwater site plan template—rev.1d1/2003
6
•
13. Describe the water quality system.
Ind..._
14. Describe the conveyance system analysis and design.
15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material.
16. Proposed methods of placement and compaction consistent: with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code.
17. Describe the proposed surfacing material. 1 � is ; (- �( , -,T(�
4,/ cam �`� j ''`j ��'�_ 1 � / �(� +1
18. Describe methods for restoration of the site.
•1+
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.
rt7 ypt.
20. List here and include any special reports or studies conducted I:o prepare the Stormwater Site Plan.
/ki1
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.
/1.74
stormwater site plan template—rev.10/1/2003 7
• •
•
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.
I
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2. Establish Construction Access.
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.
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stormwater site plan template—rev.10/1/2003 8
• 1110
12 Required Elements—Construction SWPPP(continue:)
8. Stabilize Channels and Outlets.
>01 1
9. Control Pollutants.
/2/A,
10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site).
4./
.
11. Maintain Best Management Practices( MPs).
4/4
12. Manage the Project.
2. Adjacent Areas.
a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential
areas, roads).
RCE.. k,, TANI jr)
b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards). ;.
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3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that an on or adjacent to the site.
(22)11''
stormwater site plan template—rev.10/1/2003
9
0► • .
b. Description of special requirements for working in or near environmentally sensitive areas.
414
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).
/1/1
5. Construction Phasing.
a. Construction sequence
g/iA
b. Construction phasing(if proposed)
6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
I. Provide a proposed construction schedule. /7
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II. Wet Season Construction Activi ies.
a. Proposed wet season construction activities.
` f,9.
b. Proposed wet season const tion activities for environmentally sensitive areas.
14
7. Financial/Ownership Responsibilities. ' "f% 1 ~3,`3 \ ° 1
�l Y_ i 1'( li. 1 T� IF 1[)
a. Identify the property owner responsible for the initiation of bonds and/or other fi ancial securities.
b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impacts. ;'rq
/71(:4 ,h1
8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following, if applicable.
a. Sediment Ponds/Traps.
b. Diversions. 'f
c. Waterways. �(J 1
d. Runoff/Stormwater Detention Calculations
stormwater site plan template—rev.10/1/2003 10
• •
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 stormwater 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 affected property.
(LAN NER OR HORIZED REPRESENTATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
.
[1
12 stormwater site plan template—rev.10/1/2003
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