HomeMy WebLinkAboutBLD2006-00231 0220
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UILDING PERMIT APPLICA1 IuN Review MLA06-0A06-0Type:l
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD06-00231 Received Date: 5/3/2006
SITE ADDRESS: 4671 CENTER RD
CHIMACUM, 98325
OWNER: TIMOTHY F HAMMOND PHONE: 360-732-0643
STACEY SOUZA
4671 CENTER RD
CHIMACUM WA 983259758 JOHNSTON SHORT PLAT
SUBDIVISION: Block: Lot: 4+
PARCEL NUMBER: 801034021 Section: 3 Township: 28 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION NEW ATT UNHTD GARAGE WI PLMB & HTD MUD ROOM - NO PLMB
TYPE OF WORK GAR SQUARE FOOTAGE: 7t tx\ b(31c�6
TYPE OF IMP NEW f
VALUATION -5Z807.00 MAIN: 174
CODE EDITION: 2003 ADD'L: HEAT TYPE:
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER:
GARAGE: SHORELINE:
CONST TYPE: 3 -N 1,43 Il� SETBACK:
DECK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM: PWELL
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 0 Prop: 0
Total: 0 Total: 0
Routing Date:
L- ,i}
Type Amount Paid Bv: Date: Receipt: .
Permit A .._ 1 °OV E I'
$664.75 LYK 05/03/06 81147
Plan Check $432.09 LYK 05/03/06 81147
State Building Code $4.50 LYK 05/03/06 81147 MAY a 2006
Total: $1,101.34 Jefferson County Planning
Cam \& Building Department
ent
SPECIAL CONDITIONS FOR CASE # BLD06-00231
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.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
3.) 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).
4.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
5.) There is 20 foot setback requirement from the edge of the access easement, which is
located near the northwest corner of the property. There is a 5 foot side and rear setback
from property lines.
6.) The building height is not to exceed 35 feet.
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�gON c0 Ca)� 6 JEFFERSON COUNTY
1.4 DEPARTMENT OF COMMUNITY DEVELOPMENT
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621 Sheridan Street• Port Townsend •Washington 98368
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STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# PROJECT/APPLICANT NAME: l /10 1" /2/77(J)
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.
Existing Conditions Summary
2. Describe the existing topography. Indicate contours on the site map.
3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
6-441.4its.)
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.
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6. Describe any excess levels of noise generated by the proposed use or activity:
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stormwater site plan template.doc—rev.10/12/2003 MAY 3 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.
--V74
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 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.
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.
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.
12. Describe the flow control system.
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13. Describe the water quality system.
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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.
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. /
/
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.
MAY 3
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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.
2. Establish Construction Access.
3. Control Flow Rates.
4. Install Sediment Controls.
5. Stabilize Soils.
6. Protect Slopes.
7. Protect Drain Inlets.
stormwater site plan template.doc—rev.10/12/2003
MAY 3 1 2006 s
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12 Required Elements—Construction SWPPP(continued)
8. Stabilize Channels and Outlets.
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9. Control Pollutants.
10. Control De-Watering(the act of pumping groun water or stormwater away from an active construction site).
11. Maintain Best Management Practices(BMPs).
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).
b. Description of the downstream drainage path lei ding from the site to the receiving body of water(minimum distance of 400
yards).
3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
MAY 3 1 2006
atormwater site plan template.doc—rev.10/12/2003 9
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b. Description of special requirements for working in or near environmentally sensitive areas.
4
4. Erosion Problem Areas. Description of potential rosion problems on site in the context of the characteristics of the on-site
soils(e.g.,erodibility,settleability,permeability,dept ,texture,soil structure).
5. Construction Phasing.
a. Construction sequence
b. Construction phasing(if proposed)
6. Construction Schedule. Wet season is Octobe 1 through April 30(page 2-21 of the Manual).
I. Provide a proposed construction sch:.ule.
II. Wet Season Construction Activities.
a. Proposed wet season constructio activities.
b. Proposed wet season constructio activities for environmentally sensitive areas.
7. Financial/Ownership Responsibilities.
a. Identify the property owner responsible for he initiation of bonds and/or other financial securities.
b. Describe bonds and/or other evidence of fi ancial responsibility for liability associated with erosion and sedimentation
impacts.
8. Engineering Calculations. Provide Design Calculati.ns on a separate sheet for the following,if applicable.
a. Sediment Ponds/Traps.
b. Diversions.
c. Waterways.
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 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 signin the Construction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and
correct t he best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all
owners the affected propert .
5-o 1 (T) (C)
L NDOWNER OR AUT IZ REPRES TIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
MAY 3 1 2006
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JEFFERA COUNTY
,2` DEPARTMENT OF COMMUNITY DEVELOPMENT i f i r `fir
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621 Sheridan Street • Port Townsend •Washington 98368 r
360/379-4450 • 360/379-4451 Fax i
�qs0� www.co.jefferson.wa.us/commdevelopment ! MAY — 3 2006 i
Master Permit Application MLA: Q(0- c aQ
Project Description (include separate sheets as necessary): 1ii J 1% K,,i ri 5',ov,<1 kil iiyi do .)�M
>✓ Cl(<,s---o,c_`L C2 C �A 1 c� � A IT is, G1 � �10 �o l-AD .S / fr Wo /<,c/id 3
J Property
Tax Parcel Number: r Q l-)')7- O 2k Size: 5. C) ( a quare feet)
Site Address and/or Directions to Property: ''1(i;-i-1 (�eu\-keic 1�(y - I C k1t0n(.x.e,i wl Lt bk
Property Owner(s)of Record: \tyikoi- LA 4 a ,v�ty\n��v( a tx(-t `2,i-rxc,e.,( ��t(-2.-A.,Telephone:j( �3- 3-3 2. - 6(0' Fax: email:
Mailing Address: (c 1 & kA—hZr ,GCk.c°I, 0 kikV.ICic_�L.V .1 r.S(L 9`71 3 2 S
Applicant/Agent(if different from owner): t1 16;-
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies)
D Building ❑ Variance(Minor, Major or Reasonable Economic Use)
D Demolition Permit ❑ Conditional Use[C(a),C(d),or C]**
t] Single Family • ❑ Discretionary"D"or Unnamed Use Classification
$.Garage (Attache/Detached ❑ Special Use(Essential Public Facilities)**
0 Manufactured Home ❑ Boundary Line Adjustment
❑ Modular 0 Short Plat**
❑ Commercial* ❑ Binding Site Plan**
❑ Change of Use ❑ Long Plat**
❑Address 0 Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments**
17 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
D Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment
❑Wireless Telecommunication* 0 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).
1
OWNER SIGNATU� i _ - -- Date: 3, ii.o e
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 ccrue against Jefferson County as a result of or in consequence of the granting of this permit.
I further agree to provide and right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application
review and any require la ' spections.Access and right of entry to this property shall be requested and shall occur only during regular business
hours.
Signature:
Date: ". //- O
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 SA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit
has been issued will not v. ,•a the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding
9 P 9 g your action(s)
even if you are in compl'., e with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-
transferable respensib /for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: I q J Date: 0'• //-04-
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc
wBUILDER STATEMENT •
The signer of this statement d ereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be assuming the re o sibility of the General Contractor for the proposed project.
Signature:----7 Date: 3- cf_ Dt
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:
A New Wood Existing: ❑ Sewer
1. Addition 0 Steel Proposed: Bank Height: ❑ Community System
❑ Alteration/Remodel 0 Concrete Total: -L - A. Individual System
O Repair 0 Masonry - SEP Permit#
❑ Demolition 0 Other: Bedrooms: Water Supply:
Existing: Setback: Private well U Two Party
Ty e 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:
I Underground Tank [] Above ground Tank Size of Propane Tank:
n Heat Stove Li Cook Stove n Woodstove ❑ Fireplace Insert ❑ Hot Water Tank 0 Pellet Stove LI 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 Propoaed For Office Use Only Amount Revision
Main Floor Heated 114- to2 EH Bld App Review: �)
i5 .
22 Floor Heated Consistency Review: tc�3 CO5 I ,
Other Heated Base fee: / 64• i5 -i5 S
Mezzanine Additional Section:
Heated Basement Plan Check fee: ,+( 5Q bei ^�
Unheated Basement State Surcharge fee: 4.`� 5
Other Unheated Pot Water Review fee:
Garage/Carport ; A 2 SUBTOTAL ��
3, .: - a31q•
Decks- : 911/Rd Approach fee:` '' � ,
`a►SA ►riG
Other TOTAL: $ I 3I ) .34=
Receipt Number: VIL1- 7
nn �.a,- Cash/Check Number: 51
a 1
ESTIMATED COST_j(REQUIRED) i (.-�1 Date) `,may
.Fair market value of all labor and materials foundation to s t /// V�
Initials: ` r--T
C '' t,j, -1 ea 6} pi' . ., ...--••••"".- ..>.
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc
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Designs by:off HAMMOND16 ADDITION
SwansonAve Port Townsend,Washington 9036e 4671 Center road
Voice(360)379-0339 Fax(300)379-132-1327 henryedesipnabysoo.com
J Chimacum,Washington 98325