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Home My WebLink AboutBLD2006-00160 0 • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD06-00160 Received Date 04/4/2006 SITE ADDRESS: 2011 OLD GARDINER RD Issue Date 05/3/2006 SEQUIM, 98382 APPLICANT: PHILLIP M CECERE PHONE: 360-681-4255 JACQUELINE M CECERE 60 MANTLE RD SEQUIM WA 98382 SUBDIVISION: Block: Lot: T 56+ PARCEL NUMBER: 002341035 Section: 34 Township: 30 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: NSFR & DECK(S) CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: UFFER: 0 s• (_ •O(0 cY----AV'3— Footing: fl�lovN0 (c,.A pliUIS 1 - . h, Foundation: Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: Shear Wall : Sheathing: C., A/4(1 NHS& -f3,9 3 7/ Les� �,/� /Framing:IJj�/�lfs�t ADZ sDI' 1-1 Plumbing: i0/ g��/GILG 6 l Propane Tan /Lines: Insulation: line 5690t- ( 4 u/a ..00.1t-L.4.,ya.1-2.2.-.m` .A-ttic, zti 2'3 (! Agin& Sheetrock: r-a'"C�C ��d`� L'IV eF oe( rz-3O Septic Sytem Final Approval MUST be obtained before final of structure can be attempted. Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: 1, (-2 ']-0C 4 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 WILDING PERMIT APPLICA MLA06-00156 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00160 Received Date: 4/4/2006 SITE ADDRESS: 2011 OLD GARDINER RD SEQUIM, 98382 OWNER: PHILLIP M CECERE PHONE: 360-681-4255 JACQUELINE M CECERE 60 MANTLE RD SEQUIM WA 98382 SUBDIVISION: Block: Lot: T 56+ PARCEL NUMBER: 002341035 Section: 34 Township: 30 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr NSFR & DECK(S) TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 816 VALUATION 54,117.00 ADD'L: HEAT TYPE: EEE CODE EDITION. 2003 HEAT BASE: HEAT TYPE: WOD OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: 36 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: OTHER BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 1 Prop: 1 Total: 1 Total: 1 Routing Date: ti Type Amount Paid By: Date: Receipt: kpproved/Date Permit $678.75 LYK 04/04/06 80943 2006 Plan Check $441.19 LYK 04/04/06 80943 MA 3 State Building Code $4.50 LYK 04/04/06 80943 Jefferson 1.ounty Planning Potable Water Application $55.00 LYK 04/04/06 80943 &Building Department Total: $1,179.44 CARLA 1 ?irnerb-A IF / • YO,tiZ • / Y/;7 / .8,Y Y )1' - 71-3" / TO-2 xYO YO ,Z x YO ,5g 1- �V V 0 3 N , � N \ a J : I 1\3? 3-2 rn 0 . &.,c7/ w 2'-2" e ""-,r' ,y CI', o QQ c11 ® X \\\ N -v"x 6; 1 � /4 l \ /Z YO ,� I �/ 1 3'41" / 5'--2" Z /.8-'9 x.9: - Ai� n� O Se.,v,+� ' allYl� ,� � � _ ___-__._ c V w.) I co CA) li e ` w 0 /1 \‘ ri‹e_,x 4 *4>\t t.„ 00_ A•tl. 7. \\ w Q - ! 9-- - G _ (31 w 0 (� o ci); ! 1 " -k 1 - I v � CO E�SON 0 ttt 1 00 a Stiff N N r�IPLl�4'L N ilL11.11.11 \-1. \ 5-0 x2-/ 6 - ' / 6'-9" " '-6" / 6'-9" / / 24' " / APR - 4 2006 1 --., SPECIAL CONDITIONS FOR CAI A BLD06-00160 • 1.) To help prevent seawater from intruding landward into underground aquifers, all new development activity on Marrowstone Island, Indian Island and within 1/4 mile of any marine shoreline shall be required to infiltrate all stormwater runoff onsite. 2.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: Water conservation measures: 1. Roof and other intercepted precipitation shall be routed to on-site detention ponds and/or other approved means and allowed to be released to the soil slowly. 2. Water collected from Storm water and roof catchments may be used for watering lawns and gardens. Unless catchment water has been treated to meet drinking water standards, there shall be no cross connections allowed between the potable supply and impounded water. 3. Water withdrawn from wells on each property shall not be used for watering of lawns and/or gardens. 4. Ground water withdrawn from each property shall be restricted to a rate of three (3) gallons per minute. 5. Installation of water conserving fixtures such as low flow toilets, faucets and shower restrictors and other water saving plumbing fixtures. 6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation). Please NOTE that the above listed measures are not intended to be exhaustive, but rather is intended to be illustrative of the types of water conservation measures. 3.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: 1. Installation of a flow meter. 2. On-going well monitoring for chloride concentration. 3. Submittal of monitoring data to County. 4.) MANDATORY MEASURES FOR COASTAL SIPZ: 1. For proof of potable water on a building permit application, applicant must utilize DOH-approved public water system if available. 2. If public water is unavailable, a qualifying alternative system may be used as proof of potable water or an individual well may be used as proof of potable water subject to the following requirement: a. Chloride concentration of a laboratory-certified well water sample submitted with building permit application. 3. If public water is unavailable, a qualifying alternative system may be used as proof of potable water. 5.) MANDATORY MEASURES FOR AN AT RISK SIPZ: 1. For proof of potable water on a building permit application, applicant must utilize DOH-approved public water system if available. 2. If public water is unavailable, a qualifying alternative system may be used as proof of potable water or an individual well may be used as proof of potable water subject to the following requirements: a. Chloride concentration of a laboratory-certified well water sample submitted with building permit application. b. Installation of a flow meter. c. On-going well monitoring for chloride concentration. d. Submittal of flow and chloride data to the County per monitoring program. 3. If public water is unavailable, a qualifying alternative system may be used as proof of potable water. 6.) 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. 7.) 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. 8.) Outdoor residential storage shaITbe maintained in an orderly manner and shaTS 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.) Minimum setbacks from Old Gardiner Rd right-of0way and Bachelor Rd right-of-way shall be 20 ft. Minimum side and raer setbacks shall be 5 ft. 12.) The building height is not to exceed 35 feet. 13.) A minimum of two (2) on-site parking spaces are required for the single family residence. I:\F_BLD_Permit_Buildng.rpt 10/29/1999 r .. s- ., ��,v' , co63 JEFFERSS COUNTY • W DEPARTMENT OF COM tJ ITY D VELC PM NT '. , '� $41-.0 621 Sheridan Street • Pprf Ti pcpnrf ••Washing 6gf 360/379-4450 • 360/379-4451Fax �qS p� www.co.jefferson.wa.us%comnldev iment . Master Permit Application - -_-- MLA: Uco Project Description (include separ to sheets as ne ssary): Si#-C-< aIT I cSie.(:sie*'6' Tax Parcel Number: G - 3 L' >/C ' a Pros ze • ' el(- .4 C (acres/square feet) Site Address and/or Directions to P o erty: 3.p / I 0 l'C-f 6rGk !`u ./" kr4 . ,,Gy. ,,,4., ; ', Property Owner(s)of Record: 11 c4 Cc; e, -,- Telehone: .26 C L-'`'0 ( ,. '' ' : z^''' "'� P � Fax: � � ; �, •; ; t email: Mailing Address: 'o ' , , / ? ,,.1 Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) /Building ❑ Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a),C(d),or C]** '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 C1 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 0 Wireless Telecommunication* 0 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 re ired Ia r 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 resPp r rlit` y for adher(ng to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: r / ""'._..`........`"...'.".-ti_ g I { _„,,,� Date: �.�� 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 assumin t re ponsiibil�ity off the General Contractor for the proposed project. Signature: l Date: 3 /, . e/j( • 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: 0 Sewer ❑ Addition 1i Steel Proposed: i Bank Height: ❑ Community System ❑ Alteration/Remodel L 1 Concrete Total: 8 ,.2'lndividual System ❑ Repair ❑ Masonry SEP Permit# .'r• /_.0.'ei ❑ Demolition Cl Other: Bedrooms: Water Supply: Existing: 0 Setback: L 1 Private well U Two Party Type of Fie ` . Proposed: i ,k Public ((�� W e . Total: I Name of System: Y oaf • 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 11 Above ground Tank Size of Propane Tank: ❑ Heat Stove ❑ Cook Stove , Noodstove i 1 Fireplace Insert ❑ Hot Water Tank [1 Pellet Stove I7 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 6 0,/ 5.5. f ,, ` H Bld App Review: C0 2nd Floor Heated Consistency Review: 5 DO Other Heated 0 Base fee: r 1 fy • Mezzanine V Additional Section: �j• 15 Heated Basement C Plan Check fee: Z,j ' \ n Unheated Basement State Surcharge fee: L\ Other Unheated 0 Pot Water Review fee: Ck0 r tl Garage/Carport 1 SUBTOTAL t Decks 911/Rd Approach fee: Other /�► TOTAL: $ i Li bd LIL V Receipt Number: 943 'esCash/Check Number: 11-4 ESTIMATED COST(REQUIRED) Date: •Fair market va ue of all labor and materials fours ation to finish"— - ' --•—_, 14 IC(p 5C/d oG 511_I1.W}� als: L, - G:\PermitCenter\FORMS\DRD FORMS\Master Permit pplication 12-30-05.doc ; y.,5- I . 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