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BLD2006-00405
BUILDING PERMIT• Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD06-00405 Received Date 07/14/2006 SITE ADDRESS: 42 GROVES WAY Issue Date 09/19/2006 PORT LUDLOW, 98365 APPLICANT: DANIEL R NIBLOCK PHONE: 206-634-0628 4011 FREMONT AVE N aaR -aRo SEATTLE WA 981037739 SUBDIVISION: THORNDYKE BAY SHORT PLAT#3 Block: Lot: 2 PARCEL NUMBER: 721194011 Section: 19 Township: 27 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: NSFR W/ UNHTD BASEMENT CALL IN FOR THE REQUIRED INSPECTIONSHAT APPLY TO YOUR PROJECT. SETBACKS: Ok �j22- o4 UFFER: /2/ g5/2 / 4 yy v Footing: L2K 472.02‘ j' Foundation: Dk 9/204 Stormwater FINAL Approval: Underground Plumbing: OK /%o,/oC Underground Insulatio : Shear Wall : Lxr /u STRAPS OL 3/i7`7 00/ Sheathing: Framing: Z/ o ,r $itlE r e p,2/el TO yor i9 I Plumbing: 0 Propane Tank/ Lines: Insulation: AtS L OE' 6/24ro7 A/LS Ot G u e7 Well0 Sheetrock: OK 7/Qf07 Septic Sytem Final Appr va M T be obtained before final of structure can be attempted. Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: 0jk( $/ O/D7 HEALTH DEPARTMENT AND PUBLIC WORKS APP VAL 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 BUILDING PERMIT APPLICATIONReview M T0393 Type: I Jefferson County Department: of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00405 Received Date: 7/14/2006 SITE ADDRESS: 42 GROVES WAY PORT LUDLOW, 98365 OWNER: DANIEL R NIBLOCK PHONE: 206-634-0628 4011 FREMONT AVE N SEATTLE WA 981037739 THORNDYKE BAY SHORT PLAT#3 SUBDIVISION: Block: Lot: 2 PARCEL NUMBER: 721194011 Section: 19 Township: 27 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NSFR W/ UNHTD BASEMENT TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 960 VALUATION 128,666.00 ADD'L: 576 HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: 960 # OF STORIES: OCCUPANCY: CONST TYPE: 5N OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: 628 BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PWELL "- BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 3 Prop: 2 Total: 3 Total: Routing Date: rill q IO6 Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,156.15 LYK 07/14/06 83825 APP} Plan Check $751.50 LYK 07/14/06 83825 State Building Code $4.50 LYK 07/14/06 83825 SEP i'i 2006 Potable Water Application $55.00 LYK 07/14/06 83825 Jefferson County Planning Total: $1,967.15 &Building Department SPECIAL CONDITIONS FOR CASP BLD06-00405 1.) A vegetative buffer of 30-feet shall be permanently maintained from the top or edge of the Landslide Hazard Area. All buffers shall be measured perpendicularly from the top of the Landslide Hazard Area. 2.) A Geotechnical Report dated June 16, 2006 and amended on September 6, 2006 prepared by Quadra Engineering was submitted in conjunction with this application. The report addressed the stability of the geologic hazard area. A setback of 100-feet for structures and 50-feet for septic system shall be measured perpendicularly from the top or toe of the geologic hazard. 3.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated. Should buffer disturbance occur during construction, the Unified Development Code (UDC)Administrator shall require replanting with native vegetation. No alterations shall be made to the Landslide Hazard Area or its associated buffer without prior authorization by the UDC Administrator. 4.) Prior to and during approved construction activities, the perimeter of the landslide hazard area buffer shall be marked with a temporary sign. The sign shall be placed in such a manner that it can be directly observed from the construction area. The sign shall contain the following statement: "Landslide Hazard Area and Buffer- Do not Remove or Alter Existing Vegetation." 5.) All construction activities shall not encroach upon the landslide hazard area buffer. This includes the storage or preparation of materials. 6.) The applicant shall permanently separate the boundary of the Landslide Hazard Area Buffer from the remainder of the subject property through installing logs, trees, a hedge row, or any other prominent physical marking approved by the UDC Administrator. 7.) 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. 8.) 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. 9.) 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. 10.) MANDATORY MEASURES FOPOASTAL 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. 11.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 12.) 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. 13.) A Drainage and Geotechnical Review Plan prepared by Quadra Engineering revised date September 6, 2006 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. 14.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 15.) Not more than 2 unlicensed vehicles shall be stored on any lot 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 Chapter 18.30 JCC. Outdoor storage of 3 or more junk motor vehicles is prohibited except in those districts where specified as an autormobile wrecking yard or junk (or salvage) yard and allowed as a permitted use in Table 3-1 or Chapter 18.18 JCC, and such storage shall meet the requriements of JCC 18.20.100, Automobile wrecking yards and junk (or salvage) yards. In no case, shall any such junk motor vehicles be stored in a critical area. 16.) Minimum setback from the edge of the private easement right-of-way shall be 20 feet. Minimum east and north property line setbacks shall be 5 feet. Minimum setback from top of bank to proposed structure shall be 100 feet and 50 feet from top of bank to septic drainfield per geotechnical report. 17.) 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. 18.) 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. 19.) The building height is not to exceed 35 feet. 20.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 21.) PRIOR TO FINAL BUILDING OCCUPANCY, PROPONENT SHALL SUBMIT A WRITTEN LETTER FROM HAROLD ANDERSON, P.E. QUADRA ENGINEERING STATING THAT THE STRUCTURE, EARTHWORK, AND STORMWATER FACILITIES HAVE BEEN CONSTRUCTED IN ACCORDANCE WITH THE"DRAINAGE AND GEOTECHNICAL REVIEW" REVISED DATE SEPTEMBER 7, 2006. 22.) APPLICANT/CONTRACTOR SHALL CONTACT HAROLD ANDERSON, P.E!UADRA ENGINEERING FOR FOLLOW-UP INSPECTIONS ONCE FOUNDATION EXCAVATION IS COMPLETE TO OBSERVE AND IDENTIFY ANY UNUSUALLY SOFT AREAS. SUCH ©� AREAS SHALL BE OVER-EXCAVATED AS DIRECTED BY THE ENGINEER AND FILLED AS DESCRIBED IN THE "DRAINAGE and GEOTECHNICAL REVIEW." FOLLOW-UP INSPECTIONS CONDUCTED BY HAROLD ANDERSON SHALL BE IN >Q.ce_'" g� WRITTING AND SUBMITTED TO FRED SLOTA, BUILDING OFFICIAL. 23.) THE LANDSLIDE HAZARD AREA BUFFER SHALL BE PROMINENTLY AND , PERMANENTLY DELINEATED WITH 6"x 6" LANDSCAPE TIMBERS LAID F END-TO-END (OR EQUIVALENT DELINEATION). NC) WORK SHALL BE PERMITTED IN THE BUFFER. SIGNAGE STATING "LANDSLIDE HAZARD AREA& BUFFER - NO WORK PERMITTED IN THIS AREA" SHALL BE DISPLAYED DURING CONSTRUCTION ACTIVITY. 24.) APPLICANT SHALL RESTRICT RECREATIONAL AND CASUAL USE OF BLUFF AND BUFFER AS MUCH AS PRACTICAL. 25.) APPLICANT SHALL MONITOR/REPAIR ALL SURFACE: EROSION AND SLOPE DAMAGE. 26.) OWNER SHALL INSPECT AND REPAIR ANY RIVULETS THAT MAY APPEAR IN THE BUFFER ON A YEARLY BASIS. IMMEDIATELY REPAIR ANY CONCENTRATED STORMWATER FLOWS AND DISPERSE THE FLOWS TO AS BROAD AN AREA AS POSSIBLE. UTILIZE LEAST INVASIVE EQUIPMENT POSSIBLE (I.E. HAND TOOLS) TO MINIMIZE SOIL COMPACTION. 27.) APPLICANT SHALL AVOID DESTRUCTIVE THINNING OF TREES AND UNDERSTORY. 28.) APPLICANT SHALL MAINTAIN AND PROMOTE GROWTH OF TREES AND UNDERSTORY WITHIN THE BUFFER. I:\F_BLD_Permit_Buildng.rpt 10/29/1999 �.s, ON co JEFFER.J COUNTY • RECEIVED � � W �,� ,�.� DEPARTMENT OF COMMUNITY DEVELOPMENT F' 4\ �' '� 621 Sheridan Street • Port Townsend • Washington 98368 , , 360/379-4450 • 360/379-4451 Fax JUL , 4 L;ub 1,, eop� � www.co.jefferson.wa.us/commdevelopment Master Permit Application MLEFE NI: ,• J oie Project Description (include separate sheets as necessary): i -`.i' r. h rta` .r perty Tax Parcel Number: Z. ) / 9 Cr/ 0 / / Pros Size: (acres/square feet) Site Address and/or Directions to Property: '/�' ( ,�. ,%,: - �t-t Property Owner(s)of Record: r Telephone: `? - - 6- Fax: _ email: ,1„1 t I„, 64,-1, Mailing Address: Wit) Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit? (Check each box that applies) ! ilding Li Variance (Minor, Major or Reasonable Economic Use) C1 Demolition Permit ❑ Conditional Use[C(a),C(d),or C]** rpi ingle 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 I I 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* ❑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 its employees, representatives or agents for the sole purpose of application review and any required later inspections Access and right of ent to this property shall be requested and shall occur only during regular business hours. ____6_,„/L Signatur f = "�'-4` , / G Date: �/ V & 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 issu ' not violat he ESA. Any individual,group or ency can file a lawsuit on behalf of an endangered species regarding your action(s) even if are in complian wit e Jefferson Cou develop nt code.The Applicant acknowledges that he,she or it holds in ividual and. non- trans rable respons• ility or ring t co ying wit ti SA. The Applicant has read this disclaimer n d da s' ;b w. Sig ture: yeti (,. Date: • ermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc • BUILDER STATEMENT ill 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. Signatur : r__ '/=-4 12 _ Date: 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: If New f Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank Height: ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Z . Individual System ❑ Repair ❑ Masonry SEP Permit# , 1 043-OC ,LO • Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: f I Private well I t Two Party Type of Heat: Proposed: n 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: l l Underground Tank ❑ Above ground Tank Size of Propane Tank: I I Heat Stove I I Cook Stove Woodstove I I Fireplace Insert ❑ Hot Water Tank Li Pellet Stove I I 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 (zatia:VO EH Bld App Review: 65 C30 2nd Floor Heated 37(v01 ZS Consistency Review: I 6J Other Heated Base fee: 115(a •15 Mezzanine Additional Section: ,.--. Heated Basement Plan Check fee: Unheated Baserrlent c2 / 13.5:13(co State Surcharge fee: •50 Othertinheated Pot Water Review fee: (�1,� Garage/Carport SUBTOTAL "�V I Decks /.�q 14gp 14(a 911/Rd Approach fee: / ' Other TOTAL: $a LD Receipt Number: 231/4352, Cash/Check Number: ESTIMATED COST(REQUIRED) I 1 g(pi4p Date: .Fair market value of all labor and materials foundatio nuns„ 00° 0 CY Initials: r G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc ....._ Cik, r-r-% --r , -r-1 .a • . - !?I- a3/(1_1 r)--;-.. t. ,.._22:...44., GI_ ---...---.. .., .. :-mt: ttl ... 9L-514 31-5344 4 4 At....44.14 41_-7 I/2! ;,:,..- ,---= • ct* e' iii 4; * 19(--- IsA LITI L. 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'' 7 ,5,?,C).s..-/........;-f<' 4 I 7 •0 O i��j' c� O F� /A 300 - a * tl o C �l t _ d -- ,,U •p- 10 4,4 __ ... 54 mimmil t. t 41, Gi z 77...:___---------ci- n1 )� / �d��I o �9y��F �ro( y .00 -go y -osC rn ntir 1‘ / c, rig 3I 4No Thl \ $110 fr. �d06, j �� c) ,./ y r� C_) , , 1_0 A ( /Z V' /, • t t 0 i / ��\ 1 0 1 �_� i� r= 9/6/06 REVISION: ADDED 50" SETBACK FROM TOB TO DRAINF7ELD; REVISED O c-tt=3 L` U) HOME SIZE; ADDED WELL AS-BUILT LOCATION; REVISED SWMF SIZE ;:� PrePared for: DANIEL NIBLOCK c.,:-..%{) QDDQNIBL0CK RESIDENCE 612 HEWITT AVENUE d BREMERTON, WA 98337 GROVES WAY, ENGINEERING, INC. .1DRAINAGE & EROSION CONTROL PLAN PHOFAX: (206) 632-112280 P.O. BOX 2356 TEL: (360) 683-7019 SITE PLAN 240 W. CEDAR STREET FAX: (360) 683-7087 `DRAWN: MZ DESIGNED: MZ CHECKED: JMW SEQUIN, WA 98382 quadroOolypen.com .IDATE:12/02/05 JOB No: 05-85 SCALE: AS NOTED SHEET: 1 of 2 J