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HomeMy WebLinkAboutBLD2006-00735 BUILDING PERMIIT APPLICA N MRAO-006694 eview Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00735 Received Date: 12/29/2006 SITE ADDRESS: 313 MARGARET ST PORT LUDLOW, 98365 OWNER: PETER B CHUNG PHONE: (206) 794-7383 KIMBERLY Y CHUNG 6507 155TH AVE SE BELLEVUE WA 98006 SUBDIVISION: Block: Lot: 4+ PARCEL NUMBER: 821333006 Section: 33 Township: 28 N Range: 01 E CONTRACTOR: GRICE CORPORATION PHONE: (360) 895-3155 PO BOX 2218 PORT ORCHARD WA 98366 Contractor's License GRICEC*044BQ Expires 11/27/2008 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NEW SFR W/ATTACHED GARAGE ALSO A/G 500 GAL PROPANE TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,570 VALUATION 265,548.00 ADD'L: 922 HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: PRO OCCUPANCY: R 3 UNHEATED: # OF STORIES: 2 OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: 540 SHORELINE: CONST TYPE: DECK: 1,250 SETBACK: 62 BANK HEIGHT: 4 SEWAGE DISPOSAL: CON WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: 3 Prop: 3 Total: 3 Total: 3 Routing Date: 12 i 29 JO& Type Amount Paid By: Date: Receipt: AF11iVEE Permit $1,923.35 KAS 12/29/06 87109 �+� Plan Check $1,250.18 KAS 12/29/06 87109 FEB 2007 State Building Code $4.50 KAS 12/29/06 87109 Potable Water Application $55.00 KAS 12/29/06 87109 Jefferson County Planning Total: $3,233.03 &Building Department Jefferson County Building Divi In Permit NumbeIBLD06-00735 Applicant: CHUNG BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: 2003 International Building Codes To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection. Requests received after 7:00 AM will not be scheduled for that day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Setbacks Erosion Control g/7/07 Foundation Footing �/2- Z1 0 7 pc„/ cocorre- oe)CC, Footing Drains Foundation Stem Wall 3/5/67 RUnderground Plumbing Straps(hold downs) #t4/07 6 0.111tR161,-- trte,01Pc d,e Ext. Shear Wall Nailing 41241a R ErrE,et a7!' ge l b 515 0 lL(cd pp4.11 6,19 Rough-in Plumbing 5,14/4 7 S�-wF,e, itiAlre"2 Evrs ri/,D/tv J , .I�ME?l�C z Jfi�7EK Framing �, / K Blocking _y`/` / ' I Airseal / �/� ' /' 0�. Insulation:Walls 0/(:)-7 I, Insulation: Floors 0/4-17 Insulation: Ceilingt7/6/‘ ..% ' /94 Int. Shear Wall Nailing �' il/ Wallboard Nailing 4/07 nki JvGas Line: Interior !s1� PiGT Ga�cExr�susia.� UNDE,� S4L�� a` ,� /,k �.ust�r �N CnsiNc I I (r 1 f Gas Line: Exterior /NSPEcria,u dui n P,�bc To CcvsiC. 1 6/very A k Propane Tank Heat/Chimney Clearance SAr7 // P i< Drywell/Alt Drainage Address Posted /*7 fii 4Z-I FINAL INSPECTION ?/J/7 A _ /‹. -a'r--01,,Cti1 FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • CONDITIONS for Building Permit# :BLD06-00735 1.) NO 2-MAN ROCKS SHALL BE PLACED CLOSER THAN 30 FT. FROM THE ORDINARY HIGH WATER MARK(OHWM). 2.) The application was reviewed by the Jefferson County Department of Community Development staff on January 5, 2007 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, the following ESAs were confirmed to be present on the subject property: Suburban Shoreline Designation, Salt marsh, Wetlands, Seismic Hazard Area, Coastal Seawater Intrusion Protection Zone (SIPZ), Shoreline Slope Stability-- modified and stable. 3.) Geologically Hazardous Areas in Jefferson County are characterized by slope, soil type, geologic material, and groundwater that may combine to create problems with slope stability, erosion, and water quality during and after construction or during natural events such as earthquakes or severe rainstorms. 4.) Among the native conifer species which may be used in buffers or for re-vegetation include, but are not limited to: Grand Fir(Aibes grandis), Sitka Spruce (Picea Sitchensis), Shore Pine (Pinus Contorta), Douglas Fir(Pseudotsuga Menziesii), Western Red Cedar (Thuja Plicata), and Western Hemlock (Tsuga Heterophylla). Among native tree species which may be used includes: Vine Maple (Acer Circinatum), Big-Leaf Maple (Acer Macrophyllum), Red Alder(Alnus Rubra), Pacific Madrone (Arbutus Menziesii), Quaking Aspen (Populus Tremula), Black Cottonwood (Populus Trichocarpa), Bitter Cherry (Prunus Emarginata), Oregon White Oak (Quercus Garryana), Cascara (Rhamnus Purshiana), Pacific Willow (Saliz Lasiandra), and Scouler's Willow (Saliz Scouleriana). Among the native shrub species which may be used are: Sevice-Berry(Amalanchier Alnifolia), Red Osier Dogwood (Cornus Stolonifera) Salal (Gaultheria Shallon), Ocean Spray (Holodiscus Discolor), Indian Plum (Oemlaria Cerasiformis), Pacific Ninebark (Physocarpus Capitus), Red Flowering Currant (Ribes Sanguineum), Wild Rose (Rosa Nutkana), Swamp Rose (Rosa Pisocarpa), Willows (Salix ssp.), Red Elderberry (Sam bucus Racemosa), Snowberry (Symphoricarpos Albus), Evergreen Huckleberry (Vaccinium Ovatum), Red Huckleberry(Vaccinium Parvifolium). 5.) Marine shorelines and islands are susceptible to a condition that is known as seawater intrusion. Seawater intrusion is a condition in which the saltwater/freshwater interface in an aquifer moves inland so that wells drilled on upland areas cannot obtain freshwater suitable for public consumption without significant additional treatment and cost. Maintaining a stable balance in the saltwater/freshwater interface is primarily a function of the rate of aquifer recharge (primarily through rainfall) and the rate of groundwater withdrawals (primarily through wells). The Washington Department of Ecology is the agency with statutory authority to regulate groundwater withdrawal for individual wells in Jefferson County. New development, redevelopment, and land use activities on islands and in close proximity to marine shorelines in particular should be developed in such a manner to maximize aquifer recharge and maintain the saltwater/freshwater balance to the maximum extent possible by infiltrating stormwater runoff so that it recharges the aquifer. 6.) The parcel is located within a coastal SIPZ (seawater intrusion protection zone) according to the County GIS map. There are voluntary and mandatory measures identified in the Jefferson County Seawater Intrusion Policy (Resolution 44-22, effective September 23, 2002) that apply to well drilling proposals and building permit applications on existing lots of record. A Coastal SIPZ is defined as: all islands and area within one-quarter mile of marine shoreline, but no history of chloride concentration above 100 mg/L in groundwater sources within 1000 feet. 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 COAL &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 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. 11.) The applicant is proposing to create or add 4,200 square feet of impervious surface and 6,000 square feet of land disturbing activities. JCC 18.30.060 and 18.30.070 require the project applicant submit a stormwater plan meeting Minimum Requirements#1 through #5 of the Department of Ecology Stormwater Management Manual for Western Washington. The stormwater plan shall address measures to control stormwater, erosion and sediment during construction and shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 12.) A Stormwater 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. 13.) 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). 14.) The revised site plan as submitted on January 18, 2007 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 February 8, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 15.) This approval is for a 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. 16.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 17.) Not more than 2 unlicensed vehicicall be stored on any lot unless totally scrd 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. 18.) Setback from Margaret St. right-of-way is no less than 20 ft., side setbacks are no less than 5 ft. Setback from the shoreline is no less than 30 ft. from the Ordinary High Water Mark (OHWM). If an environmentally sensitive area (ESA) is present, then the more restrictive setback shall apply. 19.) The OHWM is where the presence and action of waters are so common and usual, and so long continued in all ordinary years, as to mark upon the soil a character distinct from that of the abutting upland in respect to vegetation. This is commonly referred to as the "Line of Vegetation". 20.) The Development Review Division finds that this proposal is consistent with Shoreline Master Program JCC 18.25.090 (5), which exempts the "construction by an owner, lessee, or contract purchaser of a single-family residence [in shoreline jurisdiction]for the owner's or owner's family's use..."from the substantial development permit (SDP) requirements under certain provisions. Exemptions from the substantial development permit requirements do not exempt a proposed development from compliance with the applicable policies and standards of the Shoreline Master Program or other applicable Federal, State, or local permit or license requirements. 21.) 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. 22.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 23.) The building height is not to exceed 35 feet. 24.) Stormwater shall be retained and infiltrated on site. The owner shall control all sedimentation and erosion on the property. 25.) This is a legal nonconforming parcel designated as Rural Residential 1:5 under the Jefferson County Comprehensive Plan Land Use Map effective August 28, 1998. 26.) This parcel is served by an individual private well. 27.) A septic permit (SEP06-00294)was approved November 2, 2006 for a capacity of 480 gallons per day. 28.) A Site Plan Approval Advanced Determination (SPAAD)was approved on July 14, 2005. Case#ZONO3-00028. 29.) Margaret St. (C514209) is a county local access road. A road approach (RAP03-00101) was withdrawn. Public Works determined the access for this parcel is located on the private road portion of Margaret St. An address of 313 Margaret St. has been assigned to the parcel. 30.) A minimum of two (2) on-site parking spaces is required for the single-family residence. 31.) A Wetland Delineation Report dated July 2001 prepared by Dixie Llewellin of Olympic Wetland Resources, Inc was submitted in conjunction with the SPAAD (ZONO3-00028) application to delineate and establish the wetland edge . 32.) Class I and Class III wetlands are assigned a protective buffer of 150 feet and 50 feet respectively. Buffers are measured perpendicular to the delineated wetland edge. All buildings fall within the buffer of the Class I wetland. All associated buffers for the Class III fresh water wetland lie within the buffers of the Class I estuarine wetland. 33.) Buffer perimeters shall be marked with temporary signs at an interval of one per parcel or every one hundred (100) feet, whichever is less. Signs shall contain the following statement: "Wetland & Buffer- Do Not Remove or Alter Existing Vegetation." 34.) A permanent physical separation a*the upland boundary of the wetland buffea shall be installed and permanently maintained. Such separation can include installing logs, trees, a hedgerow, or any other prominent physical marking approved by the UDC Administrator. 35.) A flood elevation certificate prepared by Arnold Wood dated May 21, 2003 was submitted with the SPAAD (ZONO3-00028) application. The elevation certificate and survey demonstrate the building site is in Zone C (out of the flood hazard area). 36.) Jefferson County GIS mapping indicates this parcel is within the Natural Shoreline Designation. A letter from the Jefferson County Dept. of Community Development Director dated May 16, 2001 regarding a neighboring parcel to the west(parcel# 821324009) states in part, "we find that the parcel better fits the definition for Suburban (Section 4.104) than Natural (Section 4.102). Therefore, for the purposes of development review under the Master Program, the subject parcel shall be considered Suburban." A copy of the letter can be found in MLA06-00694.) Staff determined that based on this letter and the surrounding development parcel 821333006 is also within the Suburban shoreline designation. 060PRt: VED STORMWATER PLAN tii*. °C%, JEFFERSON COUNTY FEB - 8 MO7 1 DEPARTMENT OF COMMUNITY DEVELOP ENT ,�, 621 Sheridan Street • Port Townsend • Washingto 9849 JEFFE UN 360/379-4450 .360/379-4451 Fax s, ;vA1 t�R:• ��` http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# l%�. u ; ; i PROJECT/APPJCANT NAME: PeAt,„{,_ a.1.11-, 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. rh CO3e4t,A.ck 0. utOO 56 Seal -.twk1-s S1.0wc-e/ on ow) v X Z EJG4C 5r4-G 1 7b f1'l 44 £; Gr.isad Pock- zr..d j Pam(uc w.// be_ a.,sox QrJ WiI 4:v4_ -4400 a- I c+rervi vus se.-fe C e iP vig 0, Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the" site/map. / �t �j �J Iv Y t i- .6.T W. .v--A.- 'rn+.� on Sdu ,ySif 4 444 L�.6v O i N air . /n o go A 'f t Piv fp'/f Imo✓' (�t/�'j, ' ,ii A f IMJ'S DYL J I.PI h,ermsrv,. 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. % / di II .1" a, • ./L.4. �i �1 - 6rG7lf a4 e. N' '!to A 9C' (.! grwrh. 4. Describe the existing soils. Indicate soil type o the site map. 5.,� C�sr6a sawd.C7/ Rs Sep,-41 j'y so,s Aryl/ c,s /44 el l,J PeZGy/ . 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. 1- 5/ - A 9�0-DJ �,,o,, , �.� jP >4 ►I h It" 'lug.. 4 . 2/v/A---6 441 ef i '-S 11 il PG IT fh c•/ i'1o// AA) 6. Describe any excess levels of noise generated by the proposed use or activity: JEFFERSON COUNTY UCP .. a ter see plan template-rev.,a✓1rzooe JEF� OSUI1 L"UUNI10 V 5 • • 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 L, e'C � / rGwS On 4t,5 pPr, � ✓ [) ZSU -F eiof SI,",t,L4c.. £te31 v15ru�h Parr Of p . Goss a- W of( 5 onu ,ate id ai" Peq - ke 6, , . 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.). / / �ti. °5 hood Co►t , 35� 4 Wk5i` at --trtz. Prep tx'.S4- Z fAi-es 4'S t.) d Oo a,GId did 4%-y- >�- -7u- ,✓ Gt r� /- . A C'_,rbci ,�cic.- _ f iimil..ti a wts r A j21451r3 1L 45 Q, PM/e- 6tal en i 0' 4'46- Oc eive—ita air f ir 64,1614-1 6,nvio, iveArA 44-1--- , 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 Ian and differentiate proposed facilities from existing facilities. di/ sue-.►, 4K.f�- 1l,, q Ala d�S�.4,4,u"/ ., Tt-s , >,9 2.1 P-tr� L r 7'h--' 0 f / I) ?- !h 3- 1-e- Tom. l.0 o I•ti p�v ° L'L . C ctu•r, ,1:oo4 C.dd( 6-e 7 -Z 1.,,4 a- 54,0 ,AI.. J b•s. Ym f€,€ee r 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 jor dispersion of cont/amin nts.) 1.y /J c_. �tJ_7 iv, it)i y'Go k fi44 b1Cc ,174se- a�Yl 4 tt ,S, n plot 11. Describe the performa e goals and standards applicable to the project. We-- 1 w k h fApo cr-, -� ,/. e....... Air-.-,-- ro, vve......aitt.- /�Ze�d- c 1 :ep � k/ Z¢ - �;�' w# t he. 27. 7IIvi -4ej v' s {�� 12. Describe Die f18w control system. / /6_ i�Gi-� w-�r% J�.r _ ci.-5.,4,,,,L - Ak�J ,..e G/6#0.5 �-r-e ?, / _ '14,5 01 A.alt 14w 1 l c ,r sw i . JA1% 1 Q ewe t' stormwater site qan template-rev.I WI/2003 ,i EEHISllll, 1;1,10Nlr ,i CI E 6 • • 13. Describe the water u lity system. ,t . 7L , 5 J Pa/ w, ,ram . Wc4, rem 4A, x 1. v# S-hrn, (A)<*kkk.— i- c✓eGl L : f GIF�Nr► P'µdGr-5-. 4.-rij /'cJI - G2el► ytel ze- 14. Describe the -conveyance analysis and design. S �'►� _ - vk,G rY�w � k✓ & 11�^� A sip oar, c/ ~' f Pi - �7 e 5 4SC.2 err 4 . y 15. Describe the source of fill material,physical characteristic of fill material,and deposition of excess material. 741-4-1- w j( A ? .oli " 1' s,/ /5 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. /! / / cix,/ r„v/ eswi s%/t 6244.5 ,ec Y.rir�,-$ pia.;✓�/lam' sT��cl�, r�x. r.� 4 P Gr- s j.tf 7 .w A C13e-r.#. ,e, ;Ck- is 17. Describe the proposed surfacing materi I. 57Y ,� «4� / 4-- i "x /moo spc-6 - ' s r tgn f P ( Prt 42 c;n L 18. Describe methods forrestoration of the site. Cirj C 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. /414- 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. A, 0 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. ,Ssit,-,-(,,Vo (4— 6ii-AA. [-W RfIN( 1-b#JA 144P " JAN I -8 2tffl' 1��E��S'UIVGUUNIr UC1 stomnvarer site pan template-rev.10n/2003 7 • • 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. NU 6-Yew/ " D !n ia-/ c4,4 Cyfrf/ I 56d4 le-i rri+ 2. Establish Construction Acc ss. nn Xf. Z0 J (1- 5 + ,L wvt-C/ • 3. Control Flow Rates.A-4144/}" PrJv�{rE� 'v Glaybst✓�-s AsN or, 5o4e lr 5� � 5,//" 4. Instal)pediment Controls. / L L I ote- 5. Stabilize Soils. 10 4 5 Neel 6. Protect S opes. r/e--v.a 1 1— , aJ' s/o7,e_-- o,-, � l4"‘IS7. ProtecUt rain Inlets. ` ,, C14'IN F11) :VT y,l i 1 i stormwater sae plan'tinplate—rev.1012003 I H+HiS 1;UUN 1t iJ CIS e ♦ • • 12 Required Elements--Construction SWPPP(continued) 8. Stabilize Channels and Outlets. Oath h 9. Control Pollutants. / ov 5, Sp. z.e cry. �wJ vfi # tt-rnevt.r i dla 4S, Ott o%1 frin 5HIS 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). r t.> OA+ (41 ,ld •A )t,�` �rz. N e•S"f may. 11. Maintain Best Ipna9erryant Pr�}etices(BM,P�s) / A) t! 4-1- p i S 04-Ti /�F t I(b Y�f�f7i.,' frail/� //...A /A Si"�e 7, I�'�i,��.fir i 5 Pam Af $A/f_t4, �,� a,! 4, tr 12. Manage th Project. �� � 641 �� wilt 44 09 ,e. 1,S 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas,roads). �y�F i f/ f [ l // /� r--1 Y_ inev) 1 I T:,s EW ✓X u 1l C �b44*-A�4 . /4114/ ' 54if-(4A& j„"tI,C'lc--' - 4,4,r42'i/u4r b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). / /�1 // f //J 1 ) L/ / //0-44, �5 l�r�Gr / s JA /6�R'.G/��-'��e-1,,K�//,/am�`�- l-(PI cl�l 4,,,4I 44e-r 4 1 -1-Ave-vr `-r- li �7IL 7 /!! /tom A�C1,,,tf, 3. Environmentally Sensitive Areas. a.", Description of envir nmen ally sensitive areas that are on or adjacent to the site.e J v 4 Jam. RECEWE1J) JEFitilJtinG UNI1 Ut 1 stonm',ater site pan template-rev.1friQ003 9 • • b. Description of special requirements for working in or near environmentally sensitive areas. 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils(e.g.,erodibility,settleability,permeability,depth,texture,soil stru ure). rJp►ti` �h-S�P�yj S•�c .�'. � r 5 a S�u��� 4'1-� c tf ��,�h1 k- Ate 4/cn}./yn"i— 44- Veto 1- 4- /�tJL_ G6'1kJ1 2-N«a.— 3vtd .) `, A Gl. Y�'V`�'t-C.�'w V/II�Il"rf i�l t9(4i)'� � l/{11/.[ �'Y E7Wk /.7it�0(1,1-��L 5. Construction Phasing. a. Construction sequence / f � U b. Construction phasing(if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Provide a roposec1construction schedule. 5r All act; 6 0:2 ✓t-ram,, stli�6�/.� Lnzk�� o t� 44 A:77-r�,_ f=/- S (a.«cX/PI4$vII,s� ( 1�tL- ) L�F%U 4 'A �� 3 .vt� G/Yl.. II. Wet Season Construction Activities. a. Proposed wet season construction activities. // /,(r4.1H b. Proposed wet season construction activities for environmentally sensitive areas. 7. FinancialOwnership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. , ' b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. f , r e�StMIX f-e0erjl`1 S , J it-�,- 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the foIlo iR if applicable. a. Sediment Ponds/Traps. b. Diversions. c. Waterways. d. Runoff/Stormwater Detention Calculations JAN 1 8 ZUU d JEFFEilSO CUUNir COB stom vrater site plan template—rev.10/12003 10 • 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 REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: ►R I CEIV7f E)) JAN 1 8 1007 JEff HSUIV GUUNIy UCI! $tom>wrater efe pan template-rev.11Y1/2003 12 ON • • I �! (zi� r1lel� \\f 1�rI1 �f e ca6. JEFFERSON COUNTY a DEPARTMENT OF COMMUNITY DEVELOPMENT ' ' `4 I 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450• 360/379-4451 Fax *ktING www.cojefferson.wa.us/commdevelopment I UINIV 0C�l j ��lit�S,,!!U l,l! Master Permit Application MLA: On - bgrl Project Description(include separate sheets as necessary): (Aft. �-P4 vre 5 � c 1, ► ,1i fee) I,.,/frtivAll CtiAlt"c c.---, Tax Parcel Property Number: �`. �� � Size: I3 Y (acres/square feet) Site Address and/or Directions to Property: ` g '7r (_.tab' • CANT, Property Owner(s)of Record:` eAcAr CAnu,n Telephone: 2496, 1 ar4- '7363 Fa Lac)(1O '.cati 3 email: Q('.nto%0.@ S+.t?t✓L Mailing Address: (i50'- Vi"-;1 1�4, f1; t L,9,p- ktiAAA , - CS00(0 V Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) fiBuilding ❑Variance(Minor,Major or Reasonable Economic Use) ej Demolition Permit ❑Conditional Use[C(a),C(d),or C]** a-SIngle Fami y ❑Discretionary"D"or Unnamed Use Classification Garage ac /Detached OSpecial Use(Essential Public Facilities)** ❑Manufactu?tsb Home °Bounds Line ry Adjustment C]Modular °Short Plat** ❑Commercial* °Binding Site Plan** El Change of Use °Long Plat** Q Address i Road Approach °Planned Rural Residential Development(PRRD)/Amendments** 14 Propane ❑Plat Vacation/Alteration** DAllowed"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 wayjcorvelgainst Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide �o-ss and rig At of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and requir-. later inspectiti . Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of t appli - '.n that he or a.•Wants prior notice. / Signa re: ��_� �r Date: 7 Z O 6, The action or ,41:"s Applicant will u •ertake as esult of the issuance of this permit may negatively impact upon one or more threatened or endangered pecies and could lead t. -pa ential"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 mpliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-trans le res ty for adhering to and complying with the ESA. The Applicant has read this disclaim r a�signs and dates it below. Signature: ---" Date: /?-I c/p L D:\PetmitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc • • BUILDER STATEMENT I 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: i 1-i-E C( ,p • (34o)3y0 . 295I) e 0 )70-F86/ MAILING ADDRESS: RQ 2,,fl X. ZL'g Pert ohr lA)0 C)193 EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: 61e.T c e C- 0 4Y e ti NUMBER ARCHITECT/ENGINEER: -V.A.i1 liDe5 1n / PHONE (41r) j,7, 2 3 FAX:( ) MAILING ADDRESS: 2'+2 �Y/ f EMAIL Pr jest Type: Fr me Type: Bathrooms: Shoreline: Type of Sewage Disposal: ▪ New al. Wood Existing: 0 Sewer Cl Addition 0 Steel Proposed: 3 Bank 0 Community System ❑ Alteration/Remodel 0 Concrete Total: (j Hr Kindividual System ❑ Repair 0 Masonry SEP Permit#.5ge O(i-ZC Y e)t-A ❑ Demolition 0 Other: Bedrooms: Water Supply: Existing: Setback: i$ Private well 0 Two Party Type of Heat: Proposed: / 0 Public RA-LEd At Total: �2 Name of System: 0 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 amly: C] A��, Underground Tank S' )'Above ground Tank Size of Propane Tank: t ❑Heat Stove (Stook Stove 0 Woodstove - ireplace Insert L -Hot Water Tank ❑ Pellet Stove Other ^;,•ti& • 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 Current Proposed For Office Use Only Amount Revision Main Floor Heated 1 EH Bld App Review: ° 2nd Floor Heated �I Consistency Review: qti �a 1�35. 1 53.c Other Heated Base fee: I c3. Mezzanine +R J4.,�� l A 1 \ Ell ) Additional Section: Heated Basement Plan Check fee: N 'a50• M Unheated Basement L y State Surcharge fee: i/' `50 Other Unheated , Pot Water Review fee: ` r� Garage/Carport IEFI- iSON 1I1II.INIY t1(U) SUBTOTAL go.G 0 co - Decks 911/Rd Approach fee: r' (('�tt�� �Ci S�-r - Other `dart 61014) k7i�v ac L C 5D TOTAL: $ �1 vo.° Receipt Number: 5Ci I ©d Cash/Check Number: (044 7 ESTIMATED COST(REQUIRED) Date: kb .Fair market value of all labor and materiels-foundation to finish l _ __ ')00 000 QA/ 5t548 26 Initials: / D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc 40.I-oli I I •dl t "a .;. 0 -• j ,�-- - , 1d ,1 30 y1 t i,`? • ,e N -d w a ` is m S sLo Yg"%FT• I T.1......, —Lo___., �M I i `' co Nz N k l' o a I 1-A- 21--) N 6 1 yp 4. 0 v °o .;. 11 o I P ' ' N � Wom �� II ® N(j• • rpvimm 1= IG� I; p - .1%- - A F IP-1 In�l� �+ac�—��r-������r-, I. 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