HomeMy WebLinkAboutBLD2006-00344 PUILDING PERMIT APPLICATIN MLA Review
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Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD06-00344 Received Date: 6/15/2006
SITE ADDRESS: 310 SANDY SHORE RD
CHIMACUM, 98325
OWNER: GENE C KROTKE PHONE: 360-379-6617
GLENDA J KROTKE
PO BOX 1950
PORT TOWNSEND WA 983680066
SUBDIVISION: Block: Lot: +
PARCEL NUMBER: 801103005 Section: 10 Township: 28 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION DEMO EXISTING SFR
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP DEM
VALUATION MAIN:
CODE EDITION: 2003 ADD'L: HEAT TYPE:
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total:
Rout q D te:
(Olt !n(r)
Type Amount Paid By: Date: Receipt: Approved/Da
Permit $51.00 LYK 06/15/06 83548 L~ 4 �`�� -W C
ID
State Building Code $4.50 LYK 06/15/06 83548 JUL bf 2006
Total: $55.50 Jefferson County Planning
& Building Department
eUxy'r l �N:JL1
• •
DEMOLITION PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD06-00344 Received Date 6/15/2006
SITE ADDRESS: 310 SANDY SHORE RD Issue Date 7/14/2006
CHIMACUM, 98325
APPLICANT: GENE C KROTKE PHONE: 360-379-6617
GLENDA J KROTKE
PO BOX 1950
PORT TOWNSEND WA 983680066 +
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 801103005 Section: 10 Township: 28N Range: 01W
CONTRACTOR: OWNER/BUILDER PHONE:
OWNER, GENE C KROTKE PHONE: 360-379-6617
if different: GLENDA J KROTKE
PO BOX 1950
PORT TOWNSEND WA 983680066
PROJECT DESCRIPTION: DEMO EXISTING SFR
THIS PERMIT IS VALID FOR ONE YEAR AND IS NOT RENEWABLE.
THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR.
THE EXPIRATION DATE IS 7/14/2007.
REQUIRED INSPECTION:
FinalAppro �et if
�'� ?o►- -�iha�� ( i7/DLO r
BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9:00 a.m. -4:30 p.m.
SPECIAL CONDITIONS APPLY - SEE REVERSE
HOT LINE AVAILABLE 24 HOURS A DAY
• •
SPECIAL CONDITIONS FOR CASE#BLD06-00344:
1.) The application was reviewed by the Jefferson County Department of Community
Development staff on June 19, 2006 for the potential presence of Environmentally
Sensitive Areas (ESAs) under the provisions of the Unified Development Code (UDC).
After an initial Geographic Information Systems mapping review and an investigative site
inspection, the following ESAs were confirmed to be present on the subject property:
SUSC aquifer recharge area; rural forest lands.
2.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological
formations that allow percolation of the surface water into the soils and the underlying
zone of saturation. Aquifers are geologic formations that contain sufficient saturated
permeable material to yield significant quantities of water to wells and springs. Aquifers
serve as the source of drinking water within most of the rural portions of Jefferson
County.
3.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions
that promote rapid infiltration of recharge waters to groundwater aquifers.
4.) Jefferson County has determined that the use of real property for agriculture and forestry
operations is a high priority and favored use in the county. The county will not consider to
be a nuisance those inconveniences or discomforts arising from such operations, if such
operations are consistent with commonly accepted best management practices in
compliance with local, state, and federal laws. If your real property includes or is within
five hundred (500)feet of real property designated as Rural Residential 1:10 or 1:20,
Rural Industrial, Rural Commercial, Agriculture, or Forestry, you may be subject to
inconveniences or discomforts arising from such farming and forestry operations,
including but not limited to noise, tree removal, odors, flies, fumes, dust, smoke, the
operation of farm and forestry machinery during any 24-hour period, the storage and
disposal or manure, and the application of permitted fertilizers and permitted pesticides.
One or more of these inconveniences may occur as a result of agricultural and forestry
operations which are in conformance with existing laws and regulations.
5.) 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.
6.) The applicant is proposing to demolish a single family residence and is not proposing any
impervious surface at this time. The house to be demolished is approximately 2535
square feet.
7.) 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.
8.) Jefferson County determined that this proposal is categorically exempt from review under
the State Environmental Policy Act (SEPA) pursuant to WAC 197-11-800(1)(b)(i).
9.) The site plan as submitted with the building permit application on June 15, 2006 has been
reviewed for consistency under the UDC, and has been approved by Jefferson County
Department of Community Development. Any modifications, changes, and/or additions to
the stamped, approved site plan dated June 19, 2006 shall be resubmitted for review and
approval by Jefferson County Department of Community Development.
10.) This approval is to demolish an existing single family residence only. Any future permits
on this site are subject to review for consistency with applicable codes and ordinances
and does not preclude review and conditions which may be placed on future permits.
11.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
• i
12.) 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).
13.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
14.) 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.
15.) 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.
16.) The building height is not to exceed 35 feet.
17.) The parcel has been designated as RR 1:20 under the Jefferson County Comprehensive
Land Use Map effective August 28, 1998.
18.) An address of 310 Sandy Shore Road, Chimacum has been assigned to the parcel.
Sandy Shore Road is a county local access (C502909).
19.) On June 15, 2006 the UDC Administrator granted a reduction to 15 feet to the adjacent
rural forest land that typically requires a setback of 100 feet.
20.) A septic permit (SEP81-0108)was finaled on June 25, 1981. A building permit
(BLD81-0005)for a single family residence had a NTT issued on it on October 28, 1994
for failure to finalize the building permit. A building permit (BLD06-0124)to demolish a
shed was finaled on April 28, 2006. A building permit(BLD06-0307)for a pole building
will be issued at a later date.
21.) APPROVAL OF THIS BUILDING PERMIT TO DEMOLISH THE EXISTING SINGLE
FAMILY RESIDENCE DOES NOT VEST FOR USE OF THE EXISTING SEPTIC
SYSTEM. AN EVALUATION OF THE EXISTNG SYSTEM (EES)AND DESIGNATION
OF A RESERVE DRAINFIELD AREA IS REQUIRED PRIOR TO ANY FURTHER
APPROVAL OF BUILDING PERMITS FOR NEW STRUCTURES ON THIS PARCEL.
22.) Minimum setback from Sandy Shore Road right-of-way shall be 20 feet. Minimum
setbacks from north property boundary (adjacent rural forest lands) shall be 100 feet.
Minimum south property boundary setbacks shall be 5 feet. Minimum west property
setback shall be 15 feet based on approval of an administrative rural forest lands setback
by the UDC Administrator on June 15, 2006.
I:\F_BLD_Permit_Propane.rpt 10/29/19c
06/12/2006 15:17 FAX 360 491 I8 ORCAA • a 001
PEf1MIT# _ 1 - — GIOx E y E
APPRovEo_.. _ ..-
CONDITIONALLYAPPROVED_ : J U N 1 2 2006
NOT APPROVED
FOR COMPLIANCE WrtH O RCA A
ORCAA R UL TION 1 _
it to ( I •ftmRsox•0,84*-
Notification of Demolition Permit
It is unlawful for any person to cause or allow the demolition(or major renovation)of any structure unless all asbestos-
containing materials have been removed from the area to be demolished. Work shall not commence on an asbestos protect
or demolition unless the owner or operator has obtained written approval from ORCAA. A written application for a
demolition shall include a certification that there is no known asbestos-containing material remaining in the area of the
structure,
Project Site Address: I0 1'�f CI ! r
ft o RE- �c��. .--•
�-- County: -.5c FtRSotcf
City: CJI(tek 11_C-0 PI State: LA/A 1 Zip: ?S3 2.5
Starting Date: - p-- 4--1-t4 h L . <9.0O,& Completion Date: 12-7U 11 e 2 ? ' OCi 7
*(There is a 10 working day advance notification period from receipt of permit application)
edt 3or -'311oc
Property Owner:_ i N'e 1<ftt f E Telephone: ( ) - 7 4—LC(7 Fax:
Mailing Address: f. O. 73 ex 750
City:_ IPcRt. 7e "P.•.r SC:Ard State: \e.f r4 Zi p:_n36S
Demolition Contractor: .3 A rs.t 1. __9S A£a+sir State License#:
Mailing Address:
City: State: _ Zip:
Contact Person: a Lr rc Q 36asisrC .1KR tR6-Telephone: 3L1"r ,71t9-(pU17 Fax:
NO
Demolition by Wrecking or Dismantling? ($25.00 fee)check#53 4 2,
Training Fire Demolition? (If yes,attach fire department request for training fire)
Y Renovation,Alteration, Remodeling,Maintenance,or other Construction?
L'' Asbestos found or suspected*
*An ORCAA"Notice of Intent to Remove or Encapsulate Asbestos"'form and appropriate fcc must be submitted prior to any asbestos
removal work. Asbestos removal projects involving demolition must be preformed by a Certified Asbestos Contractor and all friable or
potentially friable asbestos must be removed before any demolition begins. Refer to ORCAA Regulation I Article 14 for additional
requirements that may apply.
►- Asbestos Survey Completed by
ABERA Certified Inspector
Certification#. •- Otti 2.
This approved permit must Enclose$25 Certification of the Asbestos Survey must
be available at the job site Processing Fee accompany this form
2940$Limited Lane NW,Olympia,Washington 98502 -
360-586-1044 * 800-422-5623 4' fax 360491-6308
homepage;www.orraaorg • email;info2iorcaa.org
Rev,07/11/02
J U N 1 2006 CK. NO, w
__ __ DATE -1 -�
„ONO . JEFFERSOUNTY •
,\„ _ DEPARTMENT OF COMMUNITY DEVELOPMENT `
621 Sheridan Street • Port Townsend •Washington 98368 ,1!) `----— —
360/379-4450 • 360/379-4451 Fax
NI”. 0 www.co.jefferson.wa.us/commdevelopment JUN 1 5 ZOOS
f Master Permit Application/ MLA:- 0(6—�)
t`i,
Project Description(include sepatat sheets as necessary):
T U
�f.1t_ Ly1C *3ldti- ,0Nd 1L(V' f cAtdotcrt
Tax Parcel Number: ''s u r I � r Property 5 ` S
C ,3 — �,, ((`��_`p / Size: C IZ�� � r (acres/square feet)
Site Address and/or Directions to Property: 3 i () Sri N c ,S C,bk.:: Rci Cit t tv't t,I C r.i fek
Property Owner(s)of Record: G-L_r`f(.7 4- G lc ck4 ({i.2(3t t(ci
Telephone: —3 7 7 - i,z, I '7 Fax: email:
Mailing Address: P. C',- 11jei< l I.J CJ re;.'2"f' "Tr c. Ai s `Ai CI
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies)
❑ Bui ding ❑Variance(Minor,Major or Reasonable Economic Use)
emolition Permit ❑ Conditional Use[C(a), C(d),or C]**
❑ Single Family ❑ Discretionary"D"or Unnamed Use Classification
0 Garage Attached/Detached ❑ Special Use(Essential Public Facilities)**
❑ Manufactured Home ❑ Boundary Line Adjustment
❑ Modular 0 Short Plat**
❑ Commercial* ❑ Binding Site Plan**
❑ Change of Use 0 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)* 0 Shoreline Management Variance
0 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).
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 r:s employees, representatives or agents for the sole purpose of application
review and any required later inspections.Access and right of entry to this p operty shall be requested and shall occur only during regular business
hours.
•
Signature: tibc.�. � Date: it'?--I0 Cie"
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 assurance;.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 res nsibility for adhering to and co ying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: �� �' ] Date: (C> _ I0 C �-,
g r / , 1
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: Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
(lVA ( ) ( )
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: ❑ Sewer
❑ Addition ❑ Steel Proposed: Bank Height: ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: 0 Individual System
❑ Repair 0 Masonry SEP Permit# _
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well 0 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 0 Above ground Tank Size of Propane Tank:
I I Heat Stove ❑ Cook Stove ❑ Woodstove Ii 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,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 a 4„
Main Floor Heated EH BId App Review: 65 .eb
26a Floor Heated Consistency Review: i 33
Other Heated Base fee:
Mezzanine Additional Section:
Heated Basement Plan Check fee:
Unheated Basement State Surcharge fee:
Other Unheated Pot Water Review fee:
Garage/Carport SUBTOTAL a--8
Decks 911/Rd Approach fee:
Other TOTAL: $ 4,50
Receipt Number: — O �
Cash/Check Number: 55 i/
ESTIMATED COST(REQUIRED) Date: ( � /�
�.�
•Fair market value of all labor and materials foundation to finish l0
Initials:
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc
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