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BLD2007-00034
CERTIFICATE OF OCCUPANCY Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 Carl Smith, Director/Building Official PERMIT #: BLD07-00034 SITE ADDRESS: 2290 ANDERSON LAKE RD Issue Date: 02/20/2007 CHIMACUM, 98325 Final Date: 11/26/2013 APPLICANT: RAE ANN VAN TROJEN PHONE: 360-732-5051 2290 ANDERSON LAKE RD CHIMACUM WA 98325-8765 SUBDIVISION: RUSSELL SHORT PLAT Block: Lot: PARCEL NUMBER: 901104021 Section: 10 Township: 29 N Range: 01 W PROJECT DESCRIPTION: NEW POLE BUILDING - NO HEAT, NO PLUMBING THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2003 EDITION. OCCUPANCY GROUP: TYPE OF CONSTRUCTION: SPRINKLER SYSTEM yes no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 11/26/2013 \\tidemark\data\forms\F_BLD_Occupancy.rpt 12/17/2013 RILDING PERMIT APPLICATI MLA Revieeww Type: 42 ype: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00034 Received Date: 2/2/2007 SITE ADDRESS: 2290 ANDERSON LAKE RD CHIMACUM, 98325 OWNER: RAE ANN VAN TROJEN PHONE: 360-732-5051 2290 ANDERSON LAKE RD CHIMACUM WA 983258765 RUSSELL SHORT PLAT SUBDIVISION: Block: Lot: 2 PARCEL NUMBER: 901104021 Section: 10 Township: 29 N Range: 01 W CONTRACTOR: M &W BUILDING SUPPLY PHONE: (800)547-1714 PO BOX 220 CANBY OR 97013 Contractor's License MWBUISCC61K5 Expires 7/25/2008 REPRESENTATIVE: WILLIAM FAULK PHONE: 360-732-5051 ANDERSON LAKE ROAD CHIMACUM WA PROJECT DESCRIPTIOr NEW POLE BUILDING - NO HEAT, NO PLUMBING TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 23,000.00 ADD'L: HEAT TYPE CODE EDITION: 2003 OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: OTHER: CONST TYPE: GARAGE: 1,728 SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PUD BEDROOMS: BATHROOMS: Exist: Exist: Prop: 0 Prop: 0 Total: 0 Total: 0 Routing Date: q(:: // 10-6_, Type Amount Paid By: Date: Receipt: �ved/Date AIRc 'JEED Permit $421.55 CJZ 02/02/07 87310 Plan Check $274.01 CJZ 02/02/07 87310 State Building Code $4.50 CJZ 02/02/07 87310 FEB 2001 Total: $700.06 Jams �i a • Jefferson County Building Division Permit Number: BLD07-00034 Applicant: VAN TROJEN BUILDING PERMIT INSPECTION APPROVALS applicable 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 1/41:"V/ Post Holes r7, 7M Framing 9C- I�f 07 Address Posted 0/67 FINAL INSPECTION I t-ZS--'3 FINAL INSPECTIO MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR V A CJ5 t9-� • • CONDITIONS for Building Permit# :BLD07-00034 1.) NO PLUMBING REVIEWED OR APPROVED. 2.) The application was reviewed by the Jefferson County Department of Community Development staff on February 20, 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 and an investigative site inspection, the following ESAs were confirmed to be present on the subject property: Eagle; landslide hazard area 1; SARPA& SUSC aquifer. recharge area. 3.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological formations that allow percolation of the surface water into the soils and the underlying zone of saturation. Aquifers are geologic formations that contain sufficient saturated permeable material to yield significant quantities of water to wells and springs. Aquifers serve as the source of drinking water within most of the rural portions of Jefferson County. 4.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 5.) Critical Aquifer Recharge Areas are defined as Seawater Intrusion Areas, and Special Aquifer Recharge Protection Areas and the following land uses located within Susceptible Aquifer Recharge Areas (1)All Industrial Land Uses (2)All Commercial Uses (3)All Rural Residential Land Uses requiring a Discretionary Use or Conditional Use Permit(4)All Rural Residential Land Uses with nonconforming uses that would otherwise require a Discretionary Use or Conditional Use Permit (5) Unsewered Planned Rural Residential Developments (6) Unsewered residential development with gross densities greater than one unit per acre. All of the above listed uses shall be subject to the applicable requirements and standards of the Jefferson County Unified Development Code. 6.) 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. 7.) The applicant is proposing to create or add 1900 square feet of impervious surface and 2173 square feet of land disturbing activities. JCC 18.30.060 and 18.30.070 require your proposal comply with Minimum Requirement#2 (Construction Stormwater Pollution Prevention) of the Department of Ecology 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. 8.) 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. 9.) 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). 10.) The site plan as submitted with the building permit application on February 2, 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 20, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 11.) This approval is for an unplumbed,unheated pole building 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. 12.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 13.) Not more than 2 unlicensed vehic•hall be stored on any lot unless totally so/liked 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. 14.) Minimum setback from Anderson Lake Road right-of-way shall be 20 feet. Minimum side and rear yard setbacks shall be 5 feet. 15.) 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. 16.) 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. 17.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 18.) The building height is not to exceed 35 feet. 19.) The lot was created through the Russell Short Plat on August 19, 1991 under AFN 342869. 20.) The parcel has been designated as RR 1:5 under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. 21.) An address of 2290 Anderson Lake Road, Chimacum has been assigned to the parcel. Anderson Lake Road is a county minor collector(C523408). 22.) A septic permit (SEP90-0343) was fnaled on April 10, 1991. An EES was completed on March 27, 2006. A buidling permit(BLD06-0516) for a manufactured home replacement was approved on October 7, 2006. 23.) The parcel is relatively flat. It appears the county GIS mapping that shows the landslide hazard area 1 is in the neighborhood of the intersection of Old Anderson Lake Road and Anderson Lake Road. 24.) The proposal was not sent to WDFW for potential impacts to Eagle's as the proposal is greater than 2800 feet from the nest near Anderson Lake. �I —� 164 [__[ V [ I 64 f: l- l l , , DQ —J -J , il I P.- �\ * CY V/ I ,4, W V/ Z Z N Z Z F D Q N 7 3 red 74k 00 tY W 7 Oa 7' J o t0 N a _ w a oo_ o U : W - U- W M WL. il0I J S OO O N w S O • Q (O W m 1 Z(O .�i N d 0 (O CC H� Q X OD CO I O W(Q,N ` W " <3 0 IN T �f I �--11 —f—� r�-171 I fl , my INF 641— — -� 0 lei Z II 0ZW 7o WoN I Q 0O 4k ,� O `�Cv JJ a Id 07 = 06 OCD z / r UP WO0OD. X O JS N NJ J W J 7 m � a N �/� • Q � (0oa 0 hyJ 7 c r IL 1 �Ii U 1. ( I. I, , L _ _1 UA b -I ��i — — -� 0 O.' o w a -CO� 3� zo o" z N • ° �� U a\ N 0 m wN WY J3 �W N H0. U _ tD7 :rt. w� N� zm oD K I� a� C�2C 4, I 1-� 1r-rL F� 1 I \ di MI-1 641— -)----4 ci of = 0 z .} .- J Q (Ni m Q 0. 7 ®(I) a 2 to 2 -0II Z iO O I J� I CVN X11 7N - x O. I. 0 l (...__1 f ( (D4 ( ('—1= L_, D4 J =J j< / I . / i ..B I ..0-.z L ..0—.z t. y o—,z I eL iF ' �� • ON L, • 4�' O& JEFFERSON COUNTY a 'N V DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax 4`S1YING� j mm www.co efferson.wa.us/codevelopment Master Permit Application MLA: Project D Iption(include separate s eets as necessary): F / . (ram �t-Q-1CA GCS. .110 l?Frt`�i 17©�_Y " ' '?CLaz ./TaPacel ' / py Number: ctO` l 0 y 0 Z , V Size: (acresquare feet) Site Address and/or Directions to P dperfy: 2a?0 ArL_____ae rso In (.;,,k , •(l nnc�e.�c.(4,.(vt et-.Property,Qwner(s)of Record: A IN r . VGA-•7r1D,t e Telephone: 1:340 ` 1'1—$o'5( Fax: email:ZIC4rnoiaaAIDS a ,#r fe(n%' A Mailing Address: Applicant/Ap..e�nt(if different from owner): ILL._( µ. a. L,} Telephone: (�60, 7 3'`5o5( •fF9,c:.Ci4r"' SZ.(^?'/17 7 email: L/Qiwt QNgis/D S e..b�y o n f'G Mailing Address: /�.2.,e) CtPIC Crsos, L (2 C:.6,1N-,c...C,„_wl. coo... 6 r What kind of Permit?(Check each box that applies) Ogiailding ❑Variance(Minor, Major or Reasonable Economic Use) i Demolition Permit °Conditional Use[C(a),C(d),or C]** Single Family ❑Discretionary"D"or Unnamed Use Classification Garage Attached/Detached °Special Use(Essential Public Facilities)** °Manufactured Home °Boundary Line Adjustment Cf Modular °Short Plat** Q Commercial* °Binding Site Plan** Q Change of Use °Long Plat** 0 Address i Road Approach °Planned Rural Residential Development(PRRD)/Amendments** R Propane ❑Plat Vacation/Alteration** DAllowed"Yes"Use Consistency Analysis ['Shoreline Master Program Exemption/Permit Revisions** OStormwater Management ❑Shoreline Management Substantial Development** OSite Plan Approval Advance Determination(SPAAD)* ['Shoreline Management Variance DTemporary Use °Comprehensive Plan/UDC/Land Use District Map Amendment OWireless Telecommunication* °Jefferson County Shoreline Master Program Amendment OForest 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: UU DESIGNATION OF AGENT I hereby designate CO( fG... tea. �-4.a.u. .4.1.,, to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE 1 CIi' RJ'►IS_„ Date: /e/z 4-00 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. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the appli ion that he or she wants prior Ir notice. / Signature: 4, ' �-+ - Date: A?!Z.5/2.664 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 lake"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 ypu are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-tran feerr ble res onsibili or adhe•ing to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. iv Signature /, " //.2j;W?\-N Date: 10 • o5-7^1)4 D:\PemutCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc • • BUILDER STATEMENT The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL.CONTRACTOR OR MANUFACTURED HO INSTALLER: PHONE: FAX: in" 4.1.0 ' Le i3(.1-acc ,Vvg S (. /2 63.7600 ($03)_2 G G-Z/bZ MAILING ADDRESS: pip% LW ` 22476 5 Hull 7?8 EMAIL: CONTRACTOR'S LICENSE C.O.,n b j . o r.R 7.1 3 WAINS NUMBrk: �C.ri#, `//q50 NUMBER ARCHIT CF/EN,INEER: ;:. "Nrefil cyst g N,ec4cog, PHONE ( ) FAX:( ) I(lAiLING DDBE S: , 2.700 ,'4 or- pa' a• •?:^4 l cANt O T71 el ,; P�roject Type: €Fr 1'�rpe:4' " ' Bair"oo I -Sh'r l' e• ' jl iet`of Sew' age Disposal: ' New - Wood batting! Q,F ❑'Sewer IYM" ' • ❑' Addition , 0 Steel Proposed: Bank . ❑ ommunity System, ❑ Alteration/Remodel ❑ Concrete Total: Height: dividual Syr ❑ Repair 0 Masonry SE Permit# ,j( Redrod s: ; ❑ Demolition El Other: r u••ly,•, E°itistirfg:�'f p&fie, Setback: ri t- '/'=l 'El Two Party Type of Heat:`> Proposed: igkPublic t..)One..- 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: ci Underground Tank 0 Above ground Tank Size of Propane Tank: 0 Heat Stove ❑Cook Stove 0 Woodstove ❑Fireplace Insert Cl Hot Water Tank Cl Pellet Stove p 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. E.S4 gI Ze)I 0(Q Square Footage Current Proposed For Office Use Only Amount Revision Main Floor Heated EH Bld App Review: to a cn 2°°Floor Heated Consistency Review: ' 53 Other Heated Base fee: zi-a f. SS Mezzanine Additional Section: Heated Basement Plan Check fee: 7d , 0 1 Unheated Basement State Surcharge fee: 4-Sd Other Unheated Pot Water Review fee: • Garage/Carport I -7 2-arCi�ao•g�� SUBTOTAL /} •O� Decks �1-t1Rd Approach fee: "I (1-5l 11 Other TOTAL: $ gal No Receipt Number: Cash/Check Number: ESTIMATED COST(REQUIRED) Date: .Fair market value of all` a labor and materiAs fo r aJion to finish ©fir c/ Initials: D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc • • . • :7! - 1• I • I - C:=Cw f �, e I 8?y� ��a J 1 t C3a CD _ COLI- h+i j u_ a IL S t� [� co w'� �o I I 1 .. • 1 �, O ��r`JJ 411 )1 , m I 1 I I I • �i I i i 1 1 • 1 i T i • • : ' . : - -.. le? -I i' .- ". !- - I I_.1; ... J, ___.4.; _.1 I ( j I ! I 1 ; I I I -i. ' 1 1 j I ! I , I 1 I 1 I I �( T t ! I. 1 I I_ I ' I 1 .. . I I 1. ._ I I. I_ { 11 j 1 I I j I , N • I I I I I • L.. 1 I I 1 i I _._ __ INT j I I1 ..\.. 1 / • 1 I 1 i - --- __. __-l. 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