HomeMy WebLinkAboutBLD2006-00397 • •
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD06-00397 Received Date 07/13/2006
SITE ADDRESS: 204 GARDEN CLUB RD Issue Date 08/10/2006
NORDLAND, 98358 3 S5"5
APPLICANT: LISA GILLEY PHONE: 360 385 6r820
CHRISTOPHER CHASErytsts3
204 GARDEN CLUB RD
NORDLAND WA 983589685
SUBDIVISION: Block: Lot: T 43
PARCEL NUMBER: 921092020 Section: 9 Township: 29 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: NSFR W/A/G 250 GAL PROP TANK
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS: ( S-L3-O(4, 1•//)
UFFER: g Ir wfr
Footing: 61,_ e- Z-3 - 1,-1/4 r--s /ii spit-4,4 levr Ncs dK 9/i3/44 p
Foundation:A dj //D9 8'-3/-0E
Stormwater FINAL Approval: Kter NC DQA,L - Orcu** Ok 05/04
Underground Plumbing: Ok 4//3/of V
Underground Insulation: D 13/O4 /
Shear Wall : 0,//7.4" O�
Sheathing:
Framing: , . 2/414,7A ��
itioh&_ St kv►ce DIY 0�47i
Plumbing: 4YPeduie J,u6S pk 9/i3/4LAi 414LYrEROIL-PpoPAA16 L1uES 6k V3d/G!f
Propane Tank/ Lines: DIC wu q 15 -V 1-16-rce--(-2-2-7
Insulation: (d)K y��./i�; rf' Jtq� C�,L 2/c./e 7
Sheetrock:
Septic Sytem Final Approval MUST be obtained before final of structure can be attempted.
Road Approach Final Approval:
Zoning Final Approval: r,
Final/Occupancy Approval:jr�_�2�-O'7
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
ItILDING PERMIT APPLICATI MLA06-00387
�N Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD06-00397 Received Date: 7/13/2006
SITE ADDRESS: 204 GARDEN CLUB RD
NORDLAND, 98358 3 pG JSbo2
OWNER: LISA GILLEY PHONE:360-038c5$$26
CHRISTOPHER CHASE
204 GARDEN CLUB RD
NORDLAND WA 983589685
SUBDIVISION: Block: Lot: T 43
PARCEL NUMBER: 921092020 Section: 9 Township: 29 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP NSFR W/A/G 250 GAL PROP TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 872
VALUATION 140,000.00 ADD'L: 480 HEAT TYPE: PRO
CODE EDITION: 2003 HEAT BASE: HEAT TYPE: RAD
OCCUPANCY: R-3 UNHEATED: 1,000 #OF STORIES:
OCCUPANCY: OTHER: 180
CONST TYPE: 5N GARAGE: SHORELINE:
CONST TYPE: DECK: 552 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: PWELL
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 2 Prop: 2
Total: 2 Total: 2
Routing Date: TF_.fJ cr
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $1,217.75 LYK 07/13/06 83771
Plan Check $791.54 LYK 07/13/06 83771 APPRO%/EED
State Building Code $4.50 LYK 07/13/06 83771
Potable Water Application $55.00 LYK 07/13/06 83771 AUG l0 siii
Total: $2,068.79 Jefferson County Warm
& Building Department
•
SPECIAL CONDITIONS FOR CASE BLD06-00397 •
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 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.
6.) The property owner shall comply with Water Conservation Measures (per list maintained
by the UDC Administrator).
7.) A flow meter shall be installed prior to final sign off of the building permit.
8.) 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.
9.) 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.
10.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
•
11.) 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).
12.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
13.) Minimum setback from the edge of the ingress/egress easement shall be 20 ft. Minimum
side and rear setbacks are 5 ft.
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.) A minimum of two (2) on-site parking spaces are required for the single family residence.
I:\F_BLD_Permit_Buildng.rpt 10/29/19
¢sort co
-- \ - .1 7u., - ;
, � JEFFERSO OUNTY a �' u°_—
co--, DEPARTMENT OF COMMUNITY DEVELOPMENT
` ` 621 Sheridan Street • Port Townsend •Washington 9 au 1
360/379-4450 • 360/379-4451 Fax Uri` 3 a
�•q�, 0� www.co.jefferson.wa.us/commdevelopinent
1
Master Permit Application `"--et'
M .( -3 21
'MLA: :��a '
Project Description (include separate sheets as necessary
1Jt,vu cov►$YU�h c5 0 r ‘,, ..St�,, it- - - G,ivut V(' �tCI 1-� all 57 AC V etvG2 �.
Tax Parcel 9 i /�� / /'�, C
Number: z 1 l/� �LJ��J Property ize: / I lac
t Size: 5 OatS 2 11-,,Y0 I (acres/square feet)
Site Address and/or Directions to Property:J � �t�e .-ef CA uN
Property Owner(s)of Record: Z./Siq 6). LLe-7, Civ-'L h (2. ..-
Telephone: l = 3 5- t3 2'`) Fax: email:
Mailing Address: 2.oq Oft0-A4a^ CI N,"5 t r .kt✓e- A- g17i g
Applicant/Agent(if different from owner): Oco�.-�eF_— is
Telephone: Fax:
email:
Mailing Address:
What kind of Permit?(Check each box that applies)
;((Building LI Variance(Minor, Major or Reasonable Economic Use)
Li Demolition Permit U Conditional Use[C(a),C(d),or C]**
`Single Family ❑ Discretionary"D"or Unnamed Use Classification
[I Garage Attached/Detached 0 Special Use(Essential Public Facilities)**
C7 Manufactured Home [l Boundary Line Adjustment
[l Modular [l Short Plat**
[1 Commercial* ❑ Binding Site Plan**
[1 Change of Use ❑ Long Plat**
❑Address ❑ Road Approach [l Planned Rural Residential Development(PRRD)/Amendments**
*propane ❑ Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions**
L1 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* CI 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 attomey's fees and
expenses which may in any way accrue against Jeffers County as a result of or in consequence of the granting of this permit.
I further agree to provide access and right of entry o' erson County d its employees,representatives or agents for the sole purpose of application
review and any required later inspections.Access an right of entry to is property shall be requested and shall occur only during regular business
::;ure: iL /
\
[� '� 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. 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 ff rson County development code.The Applicant acknowledges that he,she or it holds individual
and non-trans able responsibility for a heri t and corn lying with the ESA The Applicant has read this dis ' er an sig and dates it below.
Signature: SGl .(
Date: I '
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
• OWNER BUILDER STATEMENT •
The signer of this statement doe h reby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be assurning,jhe res ibility of the General Contr�ac
cto
�r for_the proposed project.
Signature: `/l�w�✓ /j 7(SC Est VJ2� Date: 1 Z'LJC,
l
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 LI Wood Existing: ❑ Sewer
Addition ❑ Steel Proposed: Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: Height: '`Individual System
❑ Repair ❑ Masonry SEP Permit# 06-oC'k ZJ
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: - Setback: [_� Private well i i Two Party
type of Heat< 5teejtA�( Proposed: L Public
iit)? �
- Total: Z Name of System:
'30k . 7 g�dAA.)rf'z5 'PetrvA5
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 T nk and/or Appliance Installation permit,mark all items below that apply:
❑ Underground Tank Above ground Tank Size of Propane Tank: `)() Gi
❑ Heat Stove [1 Cook Stove L1 Woodstove Li Fireplace Insert XHot Water Tank ❑ Pellet Stove LI Other
Is this appliance being installed in a Manufactured/Mobile Home? Yes /0
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 For Office Use Only n
Current Proposed` N'.• - I` • ))
Main Floor !�-t �,f� Consistency Review: t
2""Floor ] j Do ly a1.1 G Base fee: i l rl
1. o , 1
3f°Floor Additional Section: .Q.- -i—
Mezzanine: IA id- 180 i(, ,41 C Plan Check fee: ()� !( G,G1
Heated Basement t I State Surcharge fee: `.� SC)
Unheated Basement F 00O i'5.,,,�� Pot Water Review fee: q 0
Other Unheated Iv 911/Rd Approach fee: _._ y,
Garage/Carport TOTAL: $ Q I ,1 9
Decks 5 Receipt Number: 3 ,i
Other 1 l 3�� o�(yCash/Check Number:61. I- tQ8�O/
ESTIMATED COST(REQUIRED),, Date: �� 3/ MT 1 3 2006
•Fair market value of all labor and materiel .�s foundation to finish 1 `��
r' I f ., Initials: 26 i
G:\PemvtCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
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