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HomeMy WebLinkAboutBLD2007-00116 B ILDING PERMIT APPLICATI* MLA07-00145 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00116 Received Date: 3/20/2007 SITE ADDRESS: MOUNTAIN VISTA CT OWNER: GLENN NORCROSS PHONE: 828 57TH ST PORT TOWNSEND WA 983681203 WOODLAND HILLS#2 PHASE 1 DIV SUBDIVISION: Block: Lot: PARCEL NUMBER: 999900127 Section: 27 Township: 30 N Range: 01 W CONTRACTOR: PACIFICA PHONE: 360-297-9778 OLD PORT GAMBLE MILLSITE PORT GAMBLE WA 98364 Contractor's License PACIFCL951OT Expires 9/30/2007 REPRESENTATIVE: SAM BERRY PHONE: 206-940-0564 8598 BELLE HILL RD BAINBRIDGE ISLAND WA 98110 PROJECT DESCRIPTIOI' NEW FOUNDATION ONLY FOR RELOCATION OF EXISTING SFR 1794 SQ FT TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 46,644.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2003 OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: PUD BEDROOMS: BATHROOMS: Exist: Exist: Prop: 3 Prop: 2 Total: 3 Total: 2 Routing Date:3p//07 Type Amount Paid Bv: Date: Receipt: Approved/Date Permit $613.45 CJZ 03/20/07 89595 APPROVED Plan Check $398.74 CJZ 03/20/07 89595 State Building Code $4.50 CJZ 03/20/07 89595 APR ICt 2007 Potable Water Application $58.00 CJZ 03/20/07 89595 Total: $1,074.69 Jefferson County PlanA1ng &Beate Department Jefferson County Building Divisi# Permit Number: 0307-00116 Applicant; BERRY 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 / �`3/e Foundation Footing /II,-ret fejr Crs6" re BEr ,eEvtet ' k"1 4 ku ,0.,,IJAu� V3 C:1 Perbtiere,e ecx rn uu s t ti,r6� rt�.s ChoL y Footing Drains �/ ' 1X17 Foundation Stem Wall 7 1 Z_7 , �n g a5 o(e-- Rough-in Plumbing (7 . 0-4) VA°5 w Framing ` R Insulation: Floors )2-011 FINAL INSPECTION It..<<_1 FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD07-00116 1.) The application was reviewed by the Jefferson County Department of Community Development staff on April 19, 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: SARPA aquifer recharge area. 2.) 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. 3.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 4.) 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. 5.) 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. 6.) The applicant is proposing to create or add 3419 square feet of impervious surface and 4409 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. 7.) 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. 8.) 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). 9.) The site plan as submitted with the building permit application on March 20, 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 April 19, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 10.) This approval is for a foundation only for relocation of an existing house and a detached garage 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. 11.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 12.) Not more than 2 unlicensed vehicles stile stored on any lot unless totally screens 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. 13.) Minimum setback from Mountain Vista Court right-of-way shall be 20 feet. Minimum west side and rear yard setbacks shall be 5 feet. Minimum east yard setback shall be 10 feet due to 10 foot wide utility easement per recorded plat. 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.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 17.) The building height is not to exceed 35 feet. 18.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 19.) The parcel has been designated as RR 1:10 under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. 20.) An address of 74 Mountain Vista Court, Port Townsend has been assigned to the lot. Mountain Vista Court is a county local access road (C682009). 21.) A road approach permit (RAP07-0036) will be issued with the permits. A building permit (BLD07-0117) for a detached garage will be issued with the foundation only permit. A septic permit (SEP07-0107)was issued on April 3, 2007. 22.) This parcel was created through Woodland Hills No. 2, Phase 1 Division 2 subdivision under AFN 469869 on May 19, 2003. A Correction to this subdivision was recorded on July 1, 2003 under AFN 471849. 23.) The subject property is located in the proximity of the Jefferson County International Airport (JCIA). The JCIA is a public, general aviation airport with a hard surfaced 3,000-foot, 12,500-pound weight bearing capacity runway. JCIA experiences frequent landings and take-offs. Structures located in the proximity to the airport will, to varying degrees, be subject to noise and vibration from aircraft during take-off, landing and approach activities 24.) THE ROAD APPROACH PERMIT (RAP07-0036) MUST BE INSPECTED AND FINALLED BY THE JEFFERSON COUNTY DEPARTMENT OF PUBLIC WORKS PRIOR TO THE FINAL INSPECTION/CERTIFICATE OF OCCUPANCY OF THIS RESIDENCE. CONTACT TERRY DUFF AT THE DEPARTMENT OF PUBLIC WORKS AT 360-385-9159 FOR THE FINAL ROAD APPROACH INSPECTION. • ID Pacifica Corporation Sam Berry Woodland House Project SWPPP Plan CONSTRUCTION & PERMANENT STORM WA.TERJ'OL_LUILOJ4 PREVENTION PLANS �_ ? ` ' '''' � PROJECT: 2 Sam Berry Woodland House: ___ 1 Foundation & New 2 car garage permits � , - -NT CONTRACTOR: Pacifica LLC: PREVENTION OF ENVIRONMENTAL POLLUTION AND PRESERVATION OF PUBLIC NATURAL RESOURCES: During the life of the project, Pacifica will make all reasonable effort to comply with the provisions of federal, state and local statutes, ordinances and regulations pertaining to the prevention of storm water pollution & erosion, and maintain the preservation of public natural resources. SWPPP/ WATER QUALITY PLAN: A. Pacifica will take all reasonable precautions to comply with city ordinances, state, and federal laws and other regulations or rules applicable to water pollution occurring in waters of the state. These efforts include but are not limited to: 1. Marking Clearing Limits. Clearing limits will be marked in the field prior to the work in accordance with the limits shown on the attached site plans. Pacifica will take precautions to ensure that the amount of surface area of erodible earth material exposed at one time by clearing and grubbing, excavation, borrow or fill within the Project area not exceed +/- 5,000 square feet without prior approval by the CESL and Project Manager. 2. Establish Construction Access. Construction access will be in the location of the future driveway to limit the disturbance of the site as shown on the attached site plan per BMP C240. 3. Control Flow Rates. Flow rates for all surface and ground water will be as stated in paragraph's B & F of this plan, but primarily by the following for the Woodland site as necessary: a) Restrict flow and allow settlement by Building dams, settling basins, energy dissipaters, and other measures, to control downstream flows. This is simply achieved on such a large undisturbed site of 4.15 acres. b) Providing ditches, berms, culverts, and other measures to control surface water; c) . Controlling underground water found during construction; or d) Covering or otherwise protecting slopes until permanent erosion-control measures are working. • • Pacifica Corporation Sans Berry Woodland House Project SWPPP Plan 4. Install Sediment Controls. Pacifica will institute all necessary and reasonable measures to perform such temporary work as may be necessary to effectively control water pollution, erosion, and related damage within the Project site or that might be necessary at work areas located outside the Project site. These outside areas may include, but are not limited to, equipment, material and other storage sites. When temporary control facilities or measures are no longer needed, they will be removed and the areas restored or finished. Sediment controls will be as stated in this plan, but primarily by the following for the Woodland site as follows: a) Diversion of Storm Water: Catch basin protection and silt fence will be installed as shown on the plans using the storm drainage products specified. Storm water will be diverted around the Project to prevent pickup of silt. This may be accomplished by pumping; improvising ditches; lining channels or by placing metal,plastic or concrete gravity pipe; constructing ditches, berms, culverts, etc., to control surface water; or constructing dams, settling basins, or energy • dissipaters to control down-stream flows. b) Intercepting Ground Water: Surfacing ground water will be intercepted and routed around the construction site to prevent silt erosion by the use of gravel trenches, French drain tiles, well points, or interceptor ditch. Pacifica will provide reasonable means of controlling underground water that may be encountered during the work. Catch basin protection and silt fence will be installed as shown on the plans using an appropriate storm drainage product. c) Turbid Water Treatment Before Discharge: Determination of turbidity in surface waters will be at the discretion of the governing authority; for Lake Class Receiving Waters,turbidity shall not exceed 5 NTU(Nephelometric Turbidity Units) over background conditions; for Class AA and Class A Waters, turbidity shall not exceed 5 NTU over background turbidity when the background turbidity is 50 NTU or less, or have more than a 10 percent increase in turbidity when the background turbidity is more than 50 NTU; for other classes of waters, refer to WAC 173-201-045 and WAC 173-201A-030. 1. The term turbidity means the optical property of sample demonstrating the scattering and absorption of light caused by suspended material as • expressed in Nephelometric Turbidity Units and measured with a calibrated turbidimeter. 2. Discharges to a state waterway caused by aggregate washing, drainage from aggregate pit sites, and stockpiles or dewatering of pits and ----, excavations will not increase the existing turbidity of the receiving waters. 3. Turbid water from the Project Site may be treated as necessary before being discharged into stream or other state waters to limit turbidity to acceptable levels. Turbidity may be removed by the use of lagoons or holding ponds, settling basins, overflow weir,polymer water treatment, discharging to ground surface, by percolation, evaporation or by passing r) !��� ' try i through gravel, sand or fiber filters. • • Pacifica Corporation Sam Berry Woodland House Project SWPPP Plan d) Temporary Erosion Control: Temporary erosion control will be exercised by minimizing exposed areas and slopes until permanent measures are effective. Catch basin protection and silt fence per BMP C233 will be installed on the down hill side of any open excavation. Plastic/polyethylene sheet covering will be placed over exposed ground areas to protect from rain erosion when necessary. Other alternative methods for erosion control under certain situations may be required to include netting, mulching with binder, and seeding. Should rutting and erosion occur the Contractor will be responsible for restoring damaged areas and for cleanup of eroded material including that in ditches, catch basins, manholes, and culverts and other pipes. Temporary water pollution, erosion, and sedimentation control work will comply with the Department of Ecology's Construction Storm Water Requirements Manual State Best Management Practices, and that may be proposed by Pacifica and/or approved by Sam Berry, CESL. This temporary work is intended to provide prevention, control, and abatement of water pollution/erosion/sedimentation within the limits of the Project, and to minimize damage to the work, adjacent property, streams, and other bodies of water. e) Vehicle and Equipment Washing: If water is used for washing vehicles and equipment, it will not be allowed to enter storm drains, streams or other state waters unless separation of petroleum products, fresh concrete products or other deleterious material is accomplished prior to discharge. f) Oil and Chemical Storage and Handling: Handling and storage of oil and chemicals will not take place adjacent to waterways. The storage will be made in tanks and barrels with secondary containment provided under the dispensing area. Shut-off nozzles will be provided on hoses. Should an oil or chemical spill occur, Pacifica will make the notification in accordance with the agency notifications above. g) Sewage: No known sanitary sewer line is present at this site. If one is encountered and repair or relocation work is required, Pacifica may be required to provide blocking and sealing of the sanitary sewer line on an emergency basis. h) Sawcutting, Planing, and Grinding By-Products: Pacifica will take special precautions to ensure that no concrete, asphalt, concrete by-products, or asphalt by-products from, or used in, the saw-cutting, grinding, or planing of asphalt cement or cement concrete pavements, sidewalks, curbs, etc. are discharged into any storm drain or surface water system. Such discharge is prohibited by the p,p } Department of Ecology. �' tN '``s �� l 'i) Gutters and other Surface Drainage Channels: All construction, demolition, and ; land-clearing waste and by-product entering gutters and other pavement surface MAR 2 0 2097 j 1✓' drainage channels will be prevented from entering any inlet, catch basin, or other drainage structure or feature. Material will be removed from drainage channels on ,Y • a regular basis. If necessary, temporary filters or filter materials will be placed in DEVEELOP?.1ENT drainage channels to prevent the passage of material. 5. Stabilize Soils & Protect Slopes. Pacifica will institute all necessary and reasonable measures to perform such temporary work as may be necessary to effectively stabilize soils& • • Pacifica Corporation Sam Berry Woodland House Project SWPPP Plan protect slopes. Slopes at the site are minimal and do not exceed 3:1, and due to the size of the 4.15 acre site, stable soils should be easily be maintained. Stabilization of soils will be maintained primarily by the following actions for the Woodland site as follows: a. If the work is suspended for an extended time, Pacifica will make every effort to control erosion, pollution, sedimentation, and run-off during shutdown utilizing temporary erosion and sediment control measures as previously stated in the plan above. b. Limited areas of excavation: the construction access will be locates such that the permanent driveway will be in the same location. Pacifica will take precautions to ensure that the amount of surface area of erodible earth material exposed at one time by clearing and grubbing, excavation, borrow or fill within the Project area not exceed 5,000 square feet without appropriate TESC in place. The vast majority(+/- 97%) of the site's plentiful vegetation will be undisturbed to control erosion& sedimentation. c. Exposed soils will be covered with an impervious membrane per BMP C 123 prior to any precipitous weather event that may compromise the stability of exposed soil. Covering or otherwise protecting slopes will occur until permanent erosion-control measures are working. BMP C140 will be utilized for dust control. d. Diversion of Storm Water: Pacifica will provide for the flow of all watercourses, including but not limited to streams, ditches, sewers, and drains intercepted during the progress of the work. Pacifica will install ditches, berms, build dams, settling basins, energy dissipaters, and/or other measures, to control downstream flows; All necessary erosion control measures to protect the site as stated in the "sediment controls" section will be maintained to maintain the stability of the soils on the site. e. Pacifica will operate and maintain the environmentally safe removal and disposal of water from the various parts of the work as required. When discharge of water from the site is subject to approval of any federal, state or local agency, Pacifica will be responsible for obtaining such approval before commencing any pumping or de- watering operation. The contractor will responsibly remove and dispose of surplus water, mud, silt, slicking, or other run-offs pumped from excavations or resulting from sluicing or pavement cleaning or other operations. 6. Drain Inlet Protection. Pacifica will utilize BMP C220 storm drain inlet protection as necessary to protect any inlets present,however it appears there is a surface runoff system installed in Woodland Hills#2 phase 1 so they may not be necessary: a a ,� • b' • els& Outlets: BMP C209 will be utilized as outlet protection. 1 -- 8. onrroli Polltants: Construction debris will be confined to an impermeable area where possible or disposed of in a debris dumpster for disposal. Concrete cleanup areas will be in MAR 2 0 i86eird 'th BMP C 151, cleaned up off site, and/or unloaded in an area of no drainage potenti4l. 9. ' tering: Ground water exploration has occurred on site and none was found to a depth of 6'. he site is on a high hill with a south facing slope& is very dry. Dewatering methods if necessary will be utilized as stated in the previous section addressing TESC measures for this project. • • Pacifica Corporation Sam Berry Woodland House Project SWPPP Plan 10. Maintain BMP's: No TESC material will be removed until permanent erosion control is established on the site or 30 days after completion of the work, whichever is later. BMP's will be maintained during construction. 11. "Manage the Project": Construction phasing and project scheduling during the summer months will assist in maintaining effective erosion control measures on the site. The project will commence immediately upon receipt of permits and anticipated to be complete by July. Inspection, monitoring, and coordination appropriate to the effective control of the work will occur as it is fundamental to the success of any construction project(as a side note -this does not need to be explained to contractors). 12. Permanent Storm water Control: Permanent storm water control for the Lot 27 site is provided via the permanent storm water control system infrastructure already provided for the Woodland Hills#2 Phase 1 planned development. Permanent storm water controls for Lot 27 will consist primarily of infiltration(97%of the site undisturbed& vegetated, and water collection and distribution from impermeable area to the Woodland Hills#2 Phase 1 storm water system via gutters, downspouts, and plastic piping for distribution to the in accordance with BMP's, code requirements, 03' IBC and Jefferson county code requirements. See attached site plans for details. B. Pacifica will institute all reasonable measures to comply with the water quality criteria required by the Washington Department of Ecology and regulations of: 1. The Washington State Department of Fish and Wildlife. 2. Those federal statutes on oil spills enacted under the federal Water Pollution Control Act Amendments of 1972 (a copy of which may be obtained from the U.S. Environmental Protection Agency). 3. The water quality standards of the State of Washington as set forth in Chapter 173-201A WAC. 4. Any local statutes, regulations, ordinances, or rules, which stipulate the various types of discharge prohibited in public sewer systems or any drainage ditch in the local jurisdiction. D. State statutes on water pollution covering liability of the Contractor, penalty for violation, liability and damages for injury or death of fish, animals or vegetation are set forth in Chapter 90.48 RCW. Some though not all, of the rules set forth by various state departments are summarized below. 1. State Department of Fish and Wildlife: In doing the work Pacifica will institute all reasonable measures to: a. Not degrade water quality in a way that would harm fish. (The Washington State ;; *er Quality Regulations will serve as water quality criteria for the work.) ) _f_ — `--- --�b�—?Release into a flowing stream or open water any fish stranded by the work. MAR 2 0 Q"'' 'Replant--as required, stream bank or shoreline areas if the work has disturbed the 'vegetative cover--to similar conditions as existed prior to performing the work. "Y • • Pacifica Corporation Sani Berry Woodland House Project SWPPP Plan d. Provide an open water channel at the lowest level of any isolated pothole remaining when the work is complete. e. Protect fish by preventing harmful siltation on the bed or bottom of any body of water. f. Not block stream flow or fish passage. g. Keep equipment out of any flowing stream or other body of water(except as the Contract may permit). h. Not remove gravel or other bottom material from within the high-water flow . channel bed of any stream nor from the bottom of any other body of water(except as the Contract may permit). i. Dispose of any Project-generated debris beyond high-water flows. 2. State Department of Ecology: In doing the work, Pacifica will: a. Obtain a waste discharge permit from the Department of Ecology before: i. Washing aggregate, and ii. Discharging water into a ground or surface waterway from pit sites or excavations when the water contains turbidity, silt, or foreign materials. b. Control drainage and erosion to minimize the pollution of any waterway where possible and necessary. c. Dispose of all toxicants (including creosote, oil, cement, concrete, and water used to wash Equipment) in ways that will prevent them from entering state waters. d. Dispose of Project-generated debris, overburden, and other waste materials in ways that will prevent them from entering state waters. CONTACTS /NOTIFICATIONS RELATIVE TO ACTIVITIES: Pacifica LLC (Pacifica) will plan and schedule its work activities to conform to approvals,reviews, and other conditions of the Contract documents. Primary contact phone numbers are: CESL, Sam Berry 206-940-0564 (cell). Pacifica Project Manager, David Berry 360-297-5636 (office), 206-940-2529 (cell). Certified Erosion and Sedimentation Lead(CESL) Sam Berry and/or David Berry,will initiate the following notifications required for spills or discharges: 1. Sanitary Sewer Spills: Jefferson County DCD (360) 379-4450 ,�' s' H+I Oil; zardous Materials, or other Contaminant Spill or Discharge: !.J �� a. *Vhen spilled into a body of water, the following agencies: MAR 2 0 2'J , ,^--,r ' 1 i. Port Townsend U.S. Coast Guard office (360) 385-3070 to Y ' ii. Department of Ecology(425) 649-7000 J td'c 4.OP�'r"r N�r __ iii. Jefferson County Emergency Management(360) 385-3831 Ext. 529 • Pacifica Corporation Sam Berry Woodland House Project SWPPP Plan b. When spilled into a storm drain or sewer, the following agencies: i. Jefferson County DCD (360) 379-4450 ii. Department of Ecology(425) 649-7000 c. When spilled other than into a body of water, storm drain, or sewer: i. EPA (206) 553-1263 ii. Department of Ecology(425) 649-7000 **, L41,', 2 0 • • ..,SON 1^4 JEFFERSON COUNTY ,. DEPARTMENT OF COMMUNITY DEVELOPMENT 0 621 Sheridan Street • Port Townsend • Washington 98368 - l SWI�:yt:�� O 360/379-4450 • 360/379-4451 Fax Y �yJIY� i:1;ir1 http://www.co.jefferson.wa.us/com mdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# 0 _ 1 PROJECT/APPLICANT NAME: Pleasecant answer . W qp, appli may chooseallof tothe either incorporatefollowingquestions theto elementsthebest intoof theyour generaabilityl plothere plan forthe the uestion Mastercalls Landfor Use Applicationdepictionona orsite to ma submitthe 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. ``'' 5:fc �.A 9,lc ci�er'S 1, 1rcc4"4 (�_ 1.)",ts7-�r 0 / 40.I Pecks- cited..t'1 5 LO��r'I L� ( .3`( S 419,-) 51 v 1- .c, • ` c9 r�f S.1-e Set i 0,5 Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the ste map. <tc. D(c:Hs 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. swell ((sloes (4 l� l✓�+! d:C,, 510,4[,/ A-4 r0„-k5, r'zzS� 4. Describe the existing soils. Indicate soil type on the site map.(:0 /J ,l3 ACC $ y c:�o►q¢ W/ 5bn�u G v�C ! ✓1e41...s . kt st. 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. �� fr fu,A} o 4r'ri it) Lx:s4-,,5 Lj)vtr J J'1r.�cr MD✓� :,� V`S jw L+, 'E -- a j32c r5 54-0 r ot r�1`,.tif� ;s t d/ed n n 1'4 n-1r..;l7 v. :t o•� her }Lc •tc, w+ car 14:r-c — a-D re. wrLi.� Q,.VI � ti 6. Describe any excess levels of noise generated by the proposed use or activity: APPROVED .47r`a (.x•1Si{r✓ca '` XrP,)"44.,/1' 4- ' ✓S'X?RMWATER PLAN APR 1 0 2007 Stormwater B Require ,EFFER CO TY stormwater site plan template—rev.10/1/2003 DEPT.Of NI Y D. E PM s r SIGNATUR : • • / 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. n.L'1 e - 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.). �p SRC i; (1At&r Ct TFe4:474 i f>�-r PO.rt 7)...A6'e,Ad )-t.t L ;1-1 t,D oval ft: is 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. d1/4:5/" t rs t!/f 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.] II Ar 11. Describe the performance goals and standards applic ble to the project. 12. Describe the flow control system. e P (sx f; .i a r-rs loKiagietiiiefpleiteenhite rev.ioninoa.To ►r} 6 • I 13. Describe the water quality system. 7 ;r i ' l _ ry^ ^�" 14. Describe the conveyance system analysis and design. LAY-1147 Tel vtod- , tIS i`1v1(Cr. 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. "A4%/f)4ej vtc..vv _ 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. 17. Describe the proposed surfacing material. 9 rot v t� el i`>.e wk lctl ) 4eic arm . 18. Describe methods for restoration of the site. -,acw £v4t r.s p<- SwPPP f(AK 61 berJA.1s;sr, le5;e :14s o {��1-29,i it, - <:I:1-rt+( if it. t 1r�.../ciAti t Jed-e-r 'o.l#s f. 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. 1Jlif /-14.;f `2cod e,/, 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. N/l4. 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. al 1 stomtwater site plan template—rev.10/1/2003 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. // )\-)4,0"-41; 2. Establish Construction Access. 3. Control Flow Rates. 4. Install Sediment Controls. 5. Stabilize Soils. 6. Protect Slopes. 7. Protect Drain Inlets. stormwater site plan template—rev.10✓1/2003 6 i • 12 Required Elements—Construction SWPPP(continued) i `r 8. Stabilize Channels and Outlets. ;; 9. Control Pollutants. 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). 11. Maintain Best Management Practices(BMPs). 12. Manage the Project. 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). N op. b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). ` ,�,//� C Avvrd- il4G� / lil.�nl�:n °r;5rlG, 15 J ti ►tan •mac yL►bon `'/tQt rd G4;.,1 rt A 4i.:.� re al:r:. ti©di or e t.c 0,1 71-rc-51k55'vy 0 ✓,c;1ti6 r-5 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. INIMO • stormwater site plan template—rev.10/1/2003 9 4 411, • b. Description of pecial requirements for working in or near environmentally sensitive areas. ©n e 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,settleabili ,permeability,depth,texture,soil structure). a.1e 5. Construction Phasing. a. Construction sequence 1 i6 6 it, F X-e-0e4-R"^ Co (40 4-1,+L _i4-5 40`1)e vl4 I L rt 5' 144,:ie) 400L11�d Q1/f L�.f r�+'-'t,5c 47•+ S 14 c' C1rlt � �n -t + 14NO6 b. Construction phasing(if proposed) t + 1/' 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). Provide a proposed construction schedule. ✓tee o rC Ap' ' is , ?'4 3dit7 tSi". II. Wet Season Construction Activities. a. Proposed, wets son construction activities. �c �br►n o C'• 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 nd/or other financial securities. t,Jl,�Lr W ker,,f- ( ✓:rr ;s *L. s ? b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. k ` 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following if applicable. a. Sediment Ponds/Traps. jCt S "� dti (a,`- s A-46 jiZet b. Diversions. {ro-a r uer c. Waterways. d. Runoff/Stormwater Detention Calculations 10 stormwater site plan template—rev.10/12003 . • 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. e 7)1 4107 (UWOOWNFR,OR AUTHORIZED REPRESENTATIV GNATURE) D'ATV,)_ THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: •,\ ) • .cy‘ stop water site plan template—rev.10/1/2003 4. 12 4? k'w i'`Y�'0111;-.x,LIO ..b,- - wi$'-''' ' .:N Yr` a,'r"' �. A �,� JEFFERSO �NTY -- ` DEPARTMENT OF COMMUNITY DEVELOPMENT 1. 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax �; o www.co.jefferson.wa.us/commdevelopment �7Na --_ I Master Permit Application MLA: 'n'O -1 - V6� Project De$cription(Includi separate sheets as necessary): { .L:L-' -�;�✓w �U^ 1 �o r (^C,I vc:-w�'�s� C'�`'''�,,.ti'ri')� `0,��c, *a 01.i t lec-(v Tax Parcel -Property lLj f�-�, Number: ``1"I'1y co 121 Size: Lt•�J (acres/square feet) Site Address and/or Directions to Property: ��7 1H i L. ov► W� iay►d �l�%✓�C!►*�rN:r�a' . 1.07" 27) L)90aL4d J:.1S * 2_ pirIse1. t- ..,, peric r:d9c j L NA Ma•44a,'. VV, G#V Lortf. 7 Property Owners)of Record: <.".., 'Rte.-7 Telephone: CC") )-0‘-q-1)--05-0 Fax: email: S.kri►QGc:‘.aS4ofp•t:,,,,., Mailing Address: 85'f E&l ic. ¢-(;li re/• t g.:4 ite- TSIa,,�11 4: Ko I t'> Applicant/Agent(if different from owner): ,.,, Gr-r'i Telephone: Fax: email: Mailing Address: What kind of Pe rt?(Check_ L`each box that applies gBuilding — a...44X 0:1 paw►%-t- 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit 0 Conditional Use[C(a), C(d),or CI** IXSingle Family 0 Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment ❑ Change of Use ❑ Short Plat** ❑ Address 0 Road Approach 0 Binding Site Plan** ❑ Home Business ❑ Cottagelndustry 0 Long Plat** 0 Propane 0 Planned Rural Residential Development(PRRD)/Amendments** 0 Sign 0 Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** ❑Stormwater Management ❑ Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Variance ❑Temporary Use 0 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 0 Tree Vegetaion Request *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: 0 ' DESIGNATION OF AGENT I hereby designate tj to actmatters relating to this application for permit(s). OWNER SIGNATURE t�A as my agent in 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. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application that he or she wants prior notice. pi �„-,�:�fc n,.�Ji�t 1-• �-- •`4" �� .f Signature: "--' '—S". Date: ?PP 7 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 responsibility for adherjn to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: ' , -�-.-/- 'I t r Date: 7J l /.).) G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc 0 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: Pi 4 Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: �ali. i cA_ 1,--L(.- 3( o ) A') 15 r a (A0 ) 19 7--,j( (;, MAILING ADDRESS: po ?oy- 2,47 , po/'9L 6^,,.4,1{ 4i cy EMAIL: CONTRACTOR'Sj LICENSE WAINS - NUMBER: Pw c-.- CL. tip-7 NUMBER NfrT . ARCHITECT/ENGINEER: PIA-- , PHONE ( ) FAX: ( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New )(Wood Existing: a Li Sewer ❑ Addition ❑ Steel Proposed: Bank Li Community System '(RD . 1 iq) ❑ Alteration/Remodel 0 Concrete Total: �_ Heigtlt: ❑ Individual S em b`/ N"" "^ '/"'K NNl �cpl,< a . ❑ Repair ❑ Masonry I SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: fia r&w4t 40,9 -t3dw,,,+n Existing: 3 Setback: 0 Private well ❑ Two Party Type of Heat: '"'`" �`�`" Proposed: it Public rj .c- t-,,,erwie-t Total: 3 WM- Name of System: If this is a Commercial Project you must(answer the following: Number of Parking Spaces: Current: r"1� 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: i Underground Tank *icAbove ground Tank Size of Propane Tank: is C yti i Heat Stove Cook Stove i Woodstove )6ireplace Insert I Hot Water Tank i Pellet Stove 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 t 61�` 4� / A� EH Bld App Review: (D^ OD 2"0 Floor Heated i ) Consistency Review: kn ).op ______, _..._ Other Heated Base fee: G2 13 . 45 Mezzanine Additional Section: —J — Heated Basement Plan Check ;- 2�S (11 K J 1 Unheated Basement '- - a e Surcharge fee: 4 Other Unheated Pot Water Review fee: q,- OD Garage/Carport SUBTOTAL �c� l,3 36 Decks / 911/ Approach fee: \SD CO Other c TOTAL: $ 141x.loci 0eceipt Number: \ __ �� A�, sh/Check Number: a.l rig ESTIMATED COST(REQUIRED) Date: 1 �9t� .Fair market value of all labor and materials fou .t to ,,%, 3fi�a 4 ?L` Initials: olor n G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc I - 1 I-on , 79 X M 70 2 ta. ° ... --4 7I 411 m ma z — • .4 m , < -9 a> o m 7 7 m Ti rr -13 rn — 6 rn r- C Oo c U 3> --- H --I z 5 c) 4 . e Z Z 2 r. 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