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Home My WebLink AboutBLD2006-00156 • BUILDING PERMIT • Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD06-00156 Received Date 04/3/2006 SITE ADDRESS: 659 WILDWOOD RD EXT Issue Date 04/28/2006 QUILCENE, 98376 APPLICANT: JACK R SELVIDGE PHONE: (360)860-1136 SHANNON L SELVIDGE PO BOX 543 QUILCENE WA 983760543 SUBDIVISION: Block: Lot: + PARCEL NUMBER: 702142002 Section: 14 Township: 27 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: EXIST SHOP CONVERT TO SFR&ADD 280 SQ FT UNHTD PATIO CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBAC KS: UFFER: Footing: Foundation: Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: Shear Wall : Sheathing: Framing:s /c22 Pio-de Pm-- 0-06 . Plumbing: met 0-bb Fa Propane Tank/ Lines: (IIG-a ir1; 1 V p Insulation:�p‘, t, 4 -tea , '4 Sheetrock: oL f'Q7 Septic Sytem Final Approval MUST be obtained before final of structure can be attempted. Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: 2' .c r C 1> ( /3/Q6 ift HEALTH DEPARTMENT AND PUBLIC WOR S APPRO AL 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 !UILDING PERMIT APPLICA1N MLLA06-00150 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00156 Received Date: 4/3/2006 SITE ADDRESS: 659 WILDWOOD RD EXT QUILCENE, 98376 OWNER: JACK R SELVIDGE PHONE: (360)860-1136 SHANNON L SELVIDGE PO BOX 543 QUILCENE WA 983760543 SUBDIVISION: Block: Lot: PARCEL NUMBER: 702142002 Section: 14 Township: 27 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE PHONE: PROJECT DESCRIPTIOI' EXIST SHOP CONVERT TO SFR &ADD 280 SQ FT UNHTD PATIO TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,244 VALUATION 87,808.00 ADD'L: HEAT TYPE: WOD CODE EDITION: 2003 HEAT BASE: HEAT TYPE: PRO OCCUPANCY: R-3 OCCUPANCY: UNHEATED: #OF STORIES: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: 280 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 1 Prop: 2 Total: 1 Total: 2 Routing Date: 1 /5/0G CC5) Type Amount Paid Bv: Date: Receipt: RCp ro GV Er Permit $909.75 LYK 04/03/06 80955 2006 Plan Check $591.34 LYK 04/03/06 80955 APR2 State Building Code $4.50 LYK 04/03/06 80955 Jefferson County Planning Potable Water Application $55.00 LYK 04/03/06 80955 &Building Department Total: $1,560.59 Ci9 • SPECIAL CONDITIONS FOR CAt BLD06-00156 1.) This application for a SFR uses 240gpd of the 480gpd available for this septic system. This leaves 240gpd (2 Bdr) for future use. 240gpd min per res. 2.) 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. 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.) The identified Fish and Wildlife Habitat Area (Type 5 Stream), shall maintain a vegetative buffer setback of 50 feet. The setback shall be measured horizontally from the Ordinary High Water Mark (OHWM) to the Single Family Residence. 8.) An additional setback of five (5) feet is required from the edge of the buffer area to the proposed Single Family Residence. 9.) A permanent physical separation along the boundary of the 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.) 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 be in place prior to and during construction activities. The signs shall contain the following statement: "Buffer- Do Not Remove or Alter Existing Vegetation." 11.) 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. 12.) The building height is not to exceed 35 feet. 13.) Minimum setback from the western parcel boundary adjacent to designated Rural Forest Land 1:40 is 100 feet. Minimum setback from the northern and southern parcel boundaries is 20 feet. Minimum setback from the eastern parcel boundary is 5 feet. 14.) Maximum lot coverage is not to exceed 10%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 15.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 16.) A minimum of two (2) on-site parking spaces is required for the single family residence. I:\F_BLD_Perm it_Bu ildng.rpt 10/29/1999 4,4�4`SON cO JEFFER COUNTY • W �� DEPARTMENT OF COMMUNITY DEVELOPMENT ~' 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax qs 411‘10 ° www.co.jefferson.wa.us/commdevelopment APR 3 2006 Master Permit Application ` MIA: 0 (if - \`Do Project Description (include separate sheets as necessary): _„ :, ENILi ( U K!iEFTE-J1 ' Mo L` '\-(-)t /TNTQ 511vcLE.. TflMti..Y RE. E-INCY 1 PDC)'N. `6c3 Ssi''1-ENCLO GO PATIO - Property Tax Parcel Number: i 06.- h A - O(� Size: ` )-1 e 0 (acres/square feet) Site Address and/or Directions to Property: (05 O,, L1,) \ L..J cm Z 1 ;j, U I L C E t t 2. . Property Owner(s)of Record: "XAC `,-, A f h COI E'`E.LV i cc;E. Telephone: )(roa- (U,0 . \\34-1 crL,Mci Fax: \.loN L email: t.,4;� Mailing Address: (J ''-", Er,,,,' `".` " C' 0,`;QQW Q, Applicant/Agent(if different from owner): N A- Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) IA Building ❑ Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a), C(d),or C]** IX Single Family ❑ 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 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: 5 tiZ`�cc Date: ') �, The action or ac ons 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 responsi ility for hering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: c` Date: y1aloC3 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 of the General Contractor for the proposed project. Signature: t sr_. rn Date: 4/�C� GENERAL CONT"•CTOR OR MANUFFAAC_TURED 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 j Wood Existing: }-, ❑ Sewer X. Addition ❑ Steel Proposed: I.3 Bank Height: ❑ Community System [:id., Alteration/Remodel ❑ Concrete Total: ,i Individual System ❑ Repair ❑ Masonry SEP Permit# See oS o0A1 ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: Gq, Private well [I Two Party Type of Heat: Proposed: yp ❑ Public C.MCxa o/ Pro fAtNQ. Total: Name of System: AKf5 `4, 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 U Above ground Tank Size of Propane Tank: -;t c c: t.i Heat Stove p Cook Stove [] Woodstove [1 Fireplace Insert V Hot Water Tank ❑ Pit Stove ri 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 —T ,n1, 1p, `,U EH Bld App Review: .. ,,1.1 '4 c`A 0 T.,,V,ik4:.- lc Y�`M-^%tK k��l l I -)0A � (Z r) _ 2"�Floor Heated �� I� I Consistency Review: j �Y Other Heated Base fee: C� j C r _ ( . t RA . Mezzanine Additional Section: bi-I-1, Heated Basement Plan Check fee: it-)9 ( :34 N+4_ Unheated Basement State Surcharge fee: /-�1' cS�? RA " Other Unheated Odd( i(o tr E t c, (� Pot Water Review fee: C- -� ;t i (`;.{<\\Yc s. ,. ca)i ``4.3 1. C C`, Garage/C�rport SUBTOTAL c—C) Decks 9 1/Rd Approach fee: - 1-11 '+ i-_-_. �k1=�!t try � R r ` -Ct Other ' 547 T;. l _ TOTAL: $ i 13__ 5$frl _I- Receipt Number: SO- 1 tP1 Caail L'k Number 30U ESTIMATED COST(REQUIRED) Date: �l •Fair market value of all labor and materials foundation to finish .'T '1 '31 tJ(� Initials: �11 `� rXC` oa� C1cl C'r G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc --......M111111111111111.1111111111111.M . . • _._ _,..._....1 lt 111. 1 7 •-1 , 1 , A 1 ,. ., ., _ . , -,f • i 1 1 , I:- -,-, -T . t , 1 , , 1. . ... . _ . , 4 _L , I 1 I W ail 1 KY.'C C6 I , - 1 , 11 , , i _ , 1 , 1 ______. _i___. ,.. _ , , . -4 1 . 1 . s.. 1 H et 1 1 I 1 ..-""" I--r - ,IIVO , 1 I li ..---" ' ', -I-- -4- . rri- 1- 1- iL . _____ --- '' .. - , ---''.-----, 1 , i---- , !II ! --} ! : ......i ...... 1 4:TT1-1 .. 1 1--- „! ! 1 l , r --+ 1- , Iain-I , _c. 1 _cl 1 , I -41 1 i k/N 1 ,0 1 . ' : , . 1 1 1 1 , ...--- , 0 ' 1 1 ....C- I \01! 1 •I I . 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