Loading...
HomeMy WebLinkAboutBLD2006-00345 RILDING PERMIT APPLICATPN MLLA0600327 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00345 Received Date: 6/15/2006 SITE ADDRESS: 3501 OAK BAY RD PORT HADLOCK, 98339 OWNER: RENEE LINNABARY PHONE: 206-979-1646 3501 OAK BAY RD PORT HADLOCK WA 983399729 SUBDIVISION: Block: Lot: T1054 PARCEL NUMBER: 921191005 Section: 19 Township: 29 N Range: 01 E CONTRACTOR: WARREN ENTERPRISES PHONE: (360)732-7487 PO BOX 626 CHIMACUM WA 98325 Contractor's License WARREE*947BR Expires 1/19/2008 REPRESENTATIVE: TAMARA HALLIGAN PHONE: (360) 385-2628 PO BOX 862 PORT TOWNSEND WA 98368 PROJECT DESCRIPTIOr NEW DETACHED GARAGE TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 2,400 VALUATION 233,038.00 ADD'L: 200 HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: 70 BANK HEIGHT: 70 SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 0 Prop: 0 Total: 0 Total: 0 Routing Date: d)01ED (011(0 OD Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,744.15 LYK 06/15/06 83556 Plan Check $1,133.70 LYK 06/15/06 83556 Ar' ) v r State Building Code $4.50 LYK 06/15/06 83556 JUL 2-I 2006 Total: $2,882.35 Jefferson County Planning & Building Department • • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD06-00345 Received Date 06/15/2006 SITE ADDRESS: 3501 OAK BAY RD Issue Date 07/26/2006 PORT HADLOCK, 98339 APPLICANT: RENEE LINNABARY PHONE: 206-979-1646 3501 OAK BAY RD PORT HADLOCK WA 983399729 SUBDIVISION: Block: Lot: T105+ PARCEL NUMBER: 921191005 Section: 19 Township: 29 N Range: 01 E CONTRACTOR: WARREN ENTERPRISES PHONE: (360)732-7487 PO BOX 626 CHIMACUM WA 98325 Contractor's License: WARREE*947BR Expires: 01/19/2008 PROJECT DESCRIPTION: NEW DETACHED GARAGE CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: UFFER: Footing: Foundation: Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: Shear Wall : Sheathing: Framing: Plumbing: Propane Tank/ Lines: Insulation: Sheetrock: Septic Sytem Final Approval MUST be obtained before final of structure can be attempted. Road Approach Final Approval: Zoning Final Approval: //�� 1 Final/Occupancy Approval: e 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 • SPECIAL CONDITIONS FOR CAM BLD06-00345 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.) 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. 3.) 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. 4.) 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. 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 property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 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.) 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. • 9.) Outdoor residential storage shallTe maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 10.) 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). 11.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 12.) Minimum setback from Oak Bay Road right-of-way shall be 30 feet. Minimum side yard setbacks shall 5 feet. Minimum setback from shoreline top of bank is 70 feet. (Proposed garage, relocation of carport and SFR addition are located further landward behind the house and to the south of the house). 13.) 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. 14.) 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. 15.) The building height is not to exceed 35 feet. 16.) Residential developers and individual builders shall be required to preserve shoreline vegetation and reduce the associated risk of erosion during construction and any future activity which may impact the stability of the shoreline. I:\F_BLD_Perm it_Bu ild ng.rpt 10/29/1999 III ----A -,- A--,14, vcAk-sz_, r., C(sNoNL) : VIe- 000 f- 1 ro r1 sON a t 3 p Qc 8 1.0 °t, JEFFERSON COUNTY 0 u 0 3 5 1 ►`a.Q DEPARTMENT OF COMMUNITY DEVELOPMENT E, . , '~ 621 Sheridan Street • Port Townsend •Washington 98368 �E�R�O� COUNTY BCD _es ,.O 360/379-4450 • 360/379-4451 Fax NO`�! http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# CYO---3�-/ PROJECT/APPLICANT NAME: JUDSoii f RGINGU LJPJIBARY 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. Perry i-t */ — g�MOOEL /57-/1v& /i' U C 'EXTEND 1.1 V/Nce AERL 0 xC/5r/No C P�,er ( te1170,1 f' PM17It2 - Ma tic IXisr/No, SNP ,P ADD ivEw $gEt-7E4-,e1Y r *i'ustc Piep11r-03 ` NEW si-lop frpma ALL Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. I_aw Six PE To lot 13PcNI- ABcVT Soy F E:T F/201,1 SH0gE 5EE SITE Pt..i\N * 6E.orE6_NN1c:AL 4 r -T .13Y 5TE- N P, MogrA 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. EVE EEJ Tg!✓ S AT Te f at- L.cy , cL Ag/Nce / r rt-dC M I VPL E , . 4. Describe the existing soils. Indicate soil type on the site map. SOIL_ UNPENEATN4 THE PPoPoSaI 3UI Li)INC-, Sire (ziiSISr OF A PAQK BgotUN C AY .5)L.T WTI HATER 7.'- 6?/_AC.1AL "Ft LL 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. WATT✓12 USAI?JS NANgALLY _ TDWil- D5 f3eA-C{-I SoME ( 'OUN L �EPAGE rg-oM SIDE OF ft1LL. _ 72 t&iPepS -ref a-F « F-r. 6. Describe any excess levels of noise generated by the prgqppoo�� ��yyo No E.XcE e71`7e t _ t`1[fir � D � i, ti'j STORM WATER PLAN Stormw3ter :AA r M Required PuN 3 0 2006 1 i I stormwater site plan template—rev.10/1/2003 1EFFERSO 0 TY --- 5 DEPT.OF CO, I : /.L ME T SIGNATURE: 1 • S 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. MO PeP ATe 4 it STET P s,vof 5 Aga M t cif Tv DUST% 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.). NE108130PIN& rFoPeg--1 eS HAVE IMlLA (o1QPITIOn1 IJ iTE-t f 6Us S Locarl; t"7 AT" t'o op s( /)Pe- 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. ALL S-ogNIWAT -rZ-01,1 `--i F=UGTUPS INlLL -fir,0 T!_!KiE1D (DV ° TIFt 5Ar\ 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.] n <E- QUI2 1 11. Describe the performance goals and standards applicable to the project. 12. Describe the flow control system. • 1 = t - i - f t• I 4fitLUI UN COUNTY UC6 stormwater site plan template—rev.10/1/2003 t 6 • • !RMIT # BED 034 5 13. Describe the water quality system. w L-� WA-t- ,1fktttliSON COUNTY DCD 14. Describe the conveyance system analysis and design. TI�HTLINC VAT -POM 6uT TE PS 6NCH pRAiws TU PIP QVE �N� SAtJJ 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. N i ..L 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. 12 PE U1LpINC7 51�-E TTv f3&flyINCB G� 1 roPcolL -*PAP ATL A--?O Sf"T1= 17. Describe the proposed surfacing material. 60I2J V AT Vgl `J V\/A'("; NflTUVA- VE&TA T !Oh. kiDScAPiNC. 18. Describe methods for restoration of the site. MATUVAL LAMDSCAP v 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. d J fi g 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. 5Ee cosore . Ivl cA L Fe'FcRT `(' 12). Mod'-ram. 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. sE.FTtc PETmIr i ' stormwater site plan template—rev.1 W1/2003 7j • • 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. M,� U./ I T'1� (��to S j),14c0e7 412E14 1,1NES AT F3UILD/Nc. 5/TES 2. Establish Construction Access. ST/ PIEIV,cWAy 3. Control Flow Rates. 855 o7EY TILE SILT FE(ES dN 4. Install Sediment Controls. jN( Su?Mce WHT RUM) fF DU g t NC' (OINs rUcTl0►J 514ALC. SE DleeL7fTJ To- mED -rH Lot L€1 3712A1N40e ?IF) WF-FlCH Die,ec7` TH SUN a F- DOWN 6Nr� T F.- 1c c*4 1CW 5. Stabilize Soils. 6. Protect Slopes. �o ►JOT PPMOVE ANC" CX(STI kKo VFfae TION iJ sTt sty p S 7. Protect Drain Inlets. /'°� PEROT .545 Affitatt LEVY KO storrnwater site plan template—rev.10/1/2003 8 R�IlT # BLD 034 5 12 Required Elements—Construction SWPPP(continued) ,1i.f o Liiduli 8. Stabilize Channels and Outlets. Pc=cD61 1 ( NsT/ LL1TION or. 4 At-Ate � Fc�(-X p /s. I NAY) Di ea cr j—© > Z D F t3ER C . f w I'k � Ex(sri ry )I ,4eF> -LkSTl;N 17 '-A l ICJ 9. Control Pollutants. N/,e- 10. Control De-Watering(the act of pumping groundwater or stomiwater away from an active construction site). 1rf-IE sirL" IS Sc_OFeP NO / I-( THAT PUMF!•'J vJ J' T 1 e� QUIR i 11. Maintain Best Management Practices(BMPs). 12. Manage the Project. "165 CAFTAJki TD 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas,roads). Arx ENT A-P- s A . _ SIMILyai 4tJD JW AEI tot V E `:7" AF b. Description of the downstream drainage path leading 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. NO a-1Av11-6NMEJTILtY wSiTRiE geeA-5 JUN 1 5 ).006 stormwater site plan template—rev.10/1/2003 9 • b. Description of special requirements for working in or near environmentally sensitive areas. 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). �6ME 511 C0HT pn1:7I N60 5. Construction Phasing. a. Construction sequence Move H - 43U1LP A-Dr) 4T1ONJ - UIL S tO1=7' b. Construction phasing if pro osed) 11(1 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). Provide a proposed construction schedule. C13 r'J Sl UCT I / -) I Iv J U LY II. Wet Season Construction Activities. a. Proposed wet season construction activities. I NT ► � f2- w o- b. Proposed wet season construction activities for environmentally sensitive areas. 7. Financial/Ownership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. JU1:7SOi , LINNA$Ag.Y b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. N/Pc-- b. Diversions. N//A- c. Waterways. N/EA- d. Runoff/Stormwater Detention Calculations Cho l a -Fr" S7 n1 F Wlog-Tfl- stormwaler site plan template—rev.10/1/2003 J[FFEt1uUN LUiNTV AC[1 ,o • 4 • 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. • (LANDOWNER OR AUTHORIZED REPRESENTATIV IGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: PERMIT # BLD o 34 JEFFERSON COUNTY CD stormwater site plan template—rev.10/1/2003 12 SIN � rP i1 \ rik6. JEFFERSINCOUNTY • — " DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 JUN 1 5 2006 .. S, 360/379-4450 • 360/379-4451 Fax �gIii-NCO3 www.co.jefferson.wa.us/commdevelopment _00MENT Master Permit Application MLA: ( - 3-17 Project Description (include separate sheets as necessary): N+v►J 14OQD F MW EP (),4- &i .. Q Property �,t^3 Tax Parcel Number: -1 2 I) 9 1 60 5 Size: I. 55— ((acres/�quare feet) Site Address and/or Directions to Property: 3501 OAK- SAY ROAD l'o4T HA DLock, UI Property Owner(s)of Record: J U P50 N f gt.N EE L]N N.A-$Ap1 Telephone: /•2OCo - • /(o*& Fax: email: Renee.Linnaba l ti6). Mailing Address: iitTlE. Ali ianceCy)e hie Cd vn Applicant/Agent(if different from owner): Te fnA pi HA, _i M N, 74 gCl IT-Er- Telephone: sj(p0 - 3/3 •2(a2E5 Fax: MA—_ email: Ala I1;430110o15 N�1S.11 2 Mailing Address: P.O. 13a)( B(a PQ T TO IA/NSNND, WA' ' 3 ,3 J 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 xGarage 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* 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: '?A'?' NiDESIGNATION OF AGENT I hereby designate p A- IrL id' ; N to act as my agent in matters relating o thi application for permit(s). OWNER SIGNATURE / ,2/, Date! By signing this applicat n form,the ow r/a ent attests thathinformation pr ovided p ovided 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 of entry to this property shall be requested and shall occur only during regular business hours. 77(ieSignature: Date: & 'Za -Q(a 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 responsi lity for adhering to and co yingyith the ESA. The Applicant has read this disclaimer and pgns and dates it below. Signature: 6 •D(- . 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 cdntractrs and that� o they will be assuming the responsibility of the General Contractor for the proposed project. ; I Signature: /`'/,Q- Date: (( to GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: riAgg � NT >�PI21 SAS ( =o) > 3 2 ��S 7 ( = . MAILING ADDRESS: F?D t 0 6)( GO Z EMAIL: — -- — CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: -FA MA PA- I t A.�6)�N m1?a1 5r6Ve(E1„wJ., r PHONE (moo) 386 ..26�FAX: ( ._, MAILING ADDRESS: p 0 o� fP(6,2 tvhlw�rl IG 'I'uraDO1- EMAIL kaIIiG>)Diel�4 QLIyy1�(/c "� '- Project Type: i'� Frame Type: Bathrooms: Shoreline: Type Of Sewage Disposal: [/' New WI' Wood Existing: ❑ Sewer 0 Addition ❑ Steel Proposed: Bank Height: ❑ Community System Alteration/Remodel ❑ Concrete Total: .— Etindividual System I 1 Repair CI Masonry SEP Permit# L1 Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: v'Private well ❑ Two Party Type of Heat: Proposed: Li Public Total: ,L) Name of System: Vie' If this is a Commercial Project you must answer the following: Is -- 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: 1_. Underground Tank ❑ Above ground Tank Size of Propane Tank: LI Heat Stove I] Cook Stove ❑ Woodstove i 1 Fireplace Insert [7 Hot Water Tank [1 Pellet Stove [1 Other Is this appliance beina installed in a Manufactured/Mohilp 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 Z.f3 1 t 2 EH Bld App Review: ___ _— 2nd Floor Heated Consistency Review: brnc D I ,(12A0 Other Heated Base fee: (7 r, 1 5 Mezzanine Additional Section: l__. Heated Basement Plan Check fee: 1t ?) z70 Unheated Basement State Surcharge fee: J�--• Other Unheated Pot Water Review fee: • Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL: o. - Receipt Number: -65-`5- b ,3 Cash/Check Number: 16 Q ESTIMATED COST(REQUIRED) -Date: h ` ---_6 to •Fair market value of all labor and materials fou o-finistf— L N Initials: G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc • /. 401--0' / SI Gil / ® ou i_ou / 5_op ' 4�ou/ d o° f S_ u FINISH FINISH MNISH t._J0° a,.H,0 ,61n14°:),RED. rJ • o / ICI 0 P III s, D � � 1 J; ; - r -_ % p = i. c m z Z 2 73 tr c +l IN II 44 rn • C4 / 0 I� O v�vl C� L ] < - kri fr m 'a 11 HIL-,I !kii --.' - — = - 1- �-11?p of c o vt m �.�,, 7a - i p ' ,rim m 6 �� g,n p q\c - � N � $ m . .� — { � c,a _ -. b N,¶ . ,71 - jo-O�� Lo-o N i JO!O II , 6 THEW Gel,FAG_E"- ffaMARA_ HALLIGANI GARf_aGE ___�'1�/S; --Ir SHEET FOR — PvRcHITEcr Fort r'eRMT- G7i4•;-- o frinl N _ RENE LIMN? BARS' �IUPsa po- fox S<o2 ,11 350 �2P<K" BAY RoP p. PoRT TOhINSEND, Imo` PORT =HAPLacK, 44ASHINGoTaN 9,933'1 3Coo 385 2G28 of c4 II V O 0 1 , 1 _ at.:1/44 illAsr F2441:::, t qt171 ,,s4 tg m =m ca, m 7 A ill m '0 g t ruz.1 > m- in c.„ 1(7.5.;11oey D -,-5 510E1-ARO ''''" iZ -1 1 _ ET_EfesC SETA C,'S - ---.------- ,,. I 1 - ___ — W i3 = \ '`'`'s ,..- a '',9 i'Cz 5;'• )-(' ;II m Ali Z.'. ______ ki •,1 g7.4 P ; r i.i ----- /Id' 7 Ill 10 g .5 •00' -4, sao, • s., — lit e la\c°-1 ,...:n 111 5 I i ,I . li-44),4..J. - K! F r ' e /t• 4 '.%'• r I Y:-,-- '-`-'—'2' '4 -R, • I 50 > r A-73r-- -1.4-73c--- 1; 1S 7 7._ t 21T --- lia m 7_ 1 7g 73 k11 I g MI > I il ve T iTI 2 , rn _1 01 71* -a- z t r'a I' I 1"C2,4 ! ,I ----------------------- -• I _ / ....,,._ • , ,.3 /Ai a t,"•....,..‘ / 0.. i\ °- iiiiha., i.,1402"41114ift EL:Ito' 0\t • ..'1 cl z cn-_ I „1 1 varilviirra a 11: • , , -.-- ' ••= . ..., t 1 -tm .1.>, 11 I . '--, z-11 -,T.--5z),-,-. I .: .......•.1 , %. ' 'Z/ I '. ' Z 0 ,...„ .... 1 : R , 71 rnl 1ft,,% =,-r . ' . \ , 9 r T---T,4-__ 1 1 0 11 l'I'''urn T -6 O-g: 4-14-a ). z -2 70 7, Oa 73 ..., - - t t- , -- , ---Z 'crE T u -in_i lia 4... --/-7;4--- :pis_ Di -- , 00 II rnz vr) i/ I •- r c' tn . . _,, 1/1 E ., -, ., cn 1:_-7 -,, r m, -0 n 1 T Aak, C ril i le)' I 71 70 ( ?, /fr 5 - 1-11. 71 E 1r 1-- al T?' I ,.., , .J p, ,__,. , 1 r, o< cr 0 gi - I . 111.11_T, z > 73.,jegco. IgITEN P .A 17,m 1 uyiti_cT x 2 z. r ni_ Z 7c ii.0-I r '61F-A › 0- 1 Ff\m z WI 73 in 7 -4 ,,-1.4 l'rii G1 otm (- t'tj3 .1- 73 ;11- 0 -1) z4 11) In 0 -I 2 0- i---• ,-,1 In),. 6 m m l'.. i, gt,c) Ti 1,. (- .1.1 z.. 3?-_A r, 0 M -.'3.Z' rn .4_1; -II r M c-4 G) i' tl l44'17 t& 5\' '-1 ;s r - 0•T 17 .- _ z. ,-.„ g• 4. -x_ , CA ResiDeTQ-c , etki:::151rioNI;GoAgte166,aeft Or TA h-rAizA HALLI6Aril - SITE . FLANI ) SHEET Fe,P, gffsiDNI.TIA.L Das 16 ri /3) pelzym ir c,,/4.C7(4 0 cri— r:0 paX i y co 2 rli JuPs5N----+ F HE ps i_IHNI3Ag• I "P PeRT roHN551,0, WA, PoR 7 L.-LA:DI...al-I, wASI-Ht- Tet-I 418,3e#5 3epo 38s 2(..2e, OF p C..... , ,'' - \ ril ...•ri 73 Cn al o z„„.01 ••,-1 \ \ (Do \4\\ C sa g (.. =4. * CA 00 : CD 0 c- -•-•9:43 iv 9.4- low ='',' • --Zim Z C', III 4.--- - ,11r,-IlIP co Cri p:j c= cD *•-,,, \ - •9 = CP,1 ...Wiwill °1:1 (") = CCP 1 i---15711 „ \ i"° —4 , ir— __ •,..s. .„, OIL o p IV .1< '.."- I= - i CD > 4 Z til 0-, , x 2 1 • • November 19, 2007 Lisa Keller Permit Technician Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 RE: Permit BLD06-00345 Dear Ms. Keller: This letter is in response to your notice regarding the building permit expiration. At this time, I wish to cancel the permit for the garage. Pursuant to our conversation this morning, I understand that all other matters pertaining to the permit have been satisfied. Thank you. Sinc- -ly, R•nee Li‘/t74. 3' 11 Oak Bay Road Port Hadlock, WA 98339 E CEI[ - D NOV 2 6 2007