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HomeMy WebLinkAboutBLD2007-00186 OUILDING PERMIT APPLICA•N MRA07N00213 Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00186 Received Date: 5/1/2007 SITE ADDRESS: 119W CENTER RD QUILCENE, 98376 OWNER: MARTIN PENHALLEGON PHONE: 425-821-4880 LINDA PENHALLEGON 2S-^ 2 Z- ' P`f 6340 NE 125TH ST KIRKLAND WA 980345737 SUBDIVISION: Block: Lot: PARCEL NUMBER: 701061007 Section: 6 Township: 27 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NSFR W/ ATT GARAGE & A/G 120 GAL PROP TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 896 VALUATION 105,533.00 ADD'L: 400 HEAT TYPE: HTP CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: CONST TYPE: 5N OTHER: SHORELINE: CONST TYPE: GARAGE: 720 SETBACK: DECK: 168 BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: OTHER BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 2 Prop: 2 Total: 2 Total: 2 Routing Date: -----,• .._._h =L-Th- if Pri '----------- Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,027.35 LYK 05/01/07 89921 APPROVED Plan Check $667.78 LYK 05/01/07 89921 State Building Code $4.50 LYK 05/01/07 89921 JUN 5 2007 Potable Water Application $58.00 LYK 05/01/07 89921 Total: $1,757.63 Jefferson County Planning & Building Department 0 r Jefferson County Building Division Permit Number: BLD07-00186 Applicant: PENHALLEGON 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 IL? (EF.k!&#J Foundation Footing 7/2-4/0 1 Dk Footing Drains • Foundation Stem Wall f,,ne7 *. Underground Plumbing 'r Under Floor Framing 23,01 /i0 to tic- /4-1-1--'c i. Straps(hold downs) 9/3/dr g,y �i Ext. Shear Wall Nailing 12 /13 O7 Lop Rough-in Plumbing M' dk- Framing gl Df- Ad., DK 7 Blocking 3/61- ' D/L Airseal 4/7/o g' D u Insulation: Walls N/!t/00 , Ak Insulation: Floors # //t/.0& �L bX Insulation: Ceiling �//3/4g U'V DK Int. Shear Wall Nailing � Wallboard Nailing *0,�/� 0� eirth �' Gas Line: Interior 9/3/p8 4/ dK Gas Line: Exterior 493/d8 10,V aK Propane Tank i 3/Dg 4/ U/-‹ Heat/Chimney Clearance W5/029 okj Drywell/Alt Drainage IITi4 0 /7cNtCtmc QK 4 4 o7 �' Y 9 4 / I / T)Rl'�F�-Ok A/14�IOT,' Address Posted /�s%`� "`��� FINAL INSPECTION 2 V'?!? e.fYi a- __cem r 0 FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD07-00186 1.) The application was reviewed by the Jefferson County Department of Community Development staff on June 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 and an investigative site inspection, the following ESAs were confirmed to be present on the subject property: Type 3 and 5 Streams and Wetlands. 2.) A Habitat Management Plan and Wetland Report, with an enhancement plan was completed by Landau Associates dated February 3, 2004 and was submitted in conjunction with the condition use permit (ZON04-00010) application to address the buffers for the streams and wetlands impacted by timber removal in May 2003. The proposed single family residence with attached garage is further away from the streams and wetland areas. 3.) Jefferson County has determined that the use of real property for agriculture and forestry operations is a high priority and favored use in the county. The county will not consider to be a nuisance those inconveniences or discomforts arising from such operations, if such operations are consistent with commonly accepted best management practices in compliance with local, state, and federal laws. If your real property includes or is within five hundred (500) feet of real property designated as Rural Residential 1:10 or 1:20, Rural Industrial, Rural Commercial, Agriculture, or Forestry, you may be subject to inconveniences or discomforts arising from such farming and forestry operations, including but not limited to noise, tree removal, odors, flies, fumes, dust, smoke, the operation of farm and forestry machinery during any 24-hour period, the storage and disposal or manure, and the application of permitted fertilizers and permitted pesticides. One or more of these inconveniences may occur as a result of agricultural and forestry operations which are in conformance with existing laws and regulations. 4.) A Type 5 Stream (Fish and Wildlife Habitat Area) has been identified on the subject property. The stream will require a setback of 50-feet. The setback shall be measured horizontally from the Ordinary High Water Mark (OHWM). Fish and Wildlife Habitat Areas shall also have Buffers and Building Setbacks established. 5.) A Type 3 Stream (Fish and Wildlife Habitat Area) has been identified on the subject property. The stream will require a setback of 100-feet. The setback shall be measured horizontally from the Ordinary High Water Mark (OHWM). Fish and Wildlife Habitat Areas shall also have Buffers and Building Setbacks established. 6.) Buffers are areas that shall be maintained in their natural condition, however, minor pruning or alteration of vegetation may be permitted as long as the function and character of the buffer are not diminished. 7.) 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 (Sambucus Racemosa), Snowberry (Symphoricarpos Albus), Evergreen Huckleberry (Vaccinium Ovatum), Red Huckleberry (Vaccinium Parvifolium). 8.) A setback of 100-feet, measured perpendicularly from the wetland edge, shall be permanently maintained as a buffer. No filling, grading, clearing, or other alteration of the wetland or its buffer is allowed. 9.) 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." 10.) A permanent physical separatiorilIng the upland boundary of the wetland b•area 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. 11.) The identified Fish and Wildlife Habitat Area (Type 5 Stream), shall maintain a vegetative buffer setback of 50 feet. The setback shall be measured horizontally from the Ordinary High Water Mark (OHWM) to the single family residence. 12.) The identified Fish and Wildlife Habitat Area (Type 3 Stream), shall maintain a vegetative buffer setback of 100 feet. The setback shall be measured horizontally from the Ordinary High Water Mark (OHWM) to the single family residence. 13.) An additional setback of five (5) feet is required from the edge of the buffer area to the proposed single family residence. 14.) A permanent physical separation along the boundary of the buffer area 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. 15.) 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 be in place prior to and during construction activities. The signs shall contain the following statement: "Buffer- Do Not Remove or Alter Existing Vegetation." 16.) 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. 17.) The applicant is proposing to create or add 4632 square feet of impervious surface and 9300 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. 18.) 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. 19.) 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). 20.) The site plan as submitted with the building permit application on May 1, 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 June 5, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 21.) 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. 22.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 23.) Not more than 2 unlicensed vehicles shall be stored on any lot unless totally screened from view of neighboring dwellings and rights-of-way. Such screening shall meet all applicable performance and development standards specific to the district in which the storage is kept, and shall be in keeping with the character of the area. Screening shall meet the requirements of Chapter 18.30 JCC. Outdoor storage of 3 or more junk motor vehicles is prohibited except in those districts where specified as an autormobile wrecking yard or junk (or salvage) yard and allowed as a permitted use in Table 3-1 or Chapter 18.18 JCC, and such storage shall meet the requriements of JCC 18.20.100, Automobile wrecking yards and junk (or salvage) yards. In no case, shall any such junk motor vehicles be stored in a critical area. 24.) Exterior lighting for residential us.hall not exceed twenty feet(20') in heightln the finished grade, excepting when such lighting is an integral part of a building or structure. Ground level lighting is encouraged. 25.) 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. 26.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 27.) The building height is not to exceed 35 feet. 28.) Minimum setback from Center Rd right-of-way is 30 ft. Minimum setback from the western parcel boundary (adjacent land designated Commercial Forest) is 250 feet. Minimum side yard setbacks are 5 ft. 29.) Approximately 27.5 acres of this property is designated Rural Residential 1 dwelling per 20 acres and 2.5 acres of this property is designated 1 dwelling unit per 5 acres by the Jefferson County Comprehensive Plan adopted August 28, 1998. 30.) A pre-application conference (PRE04-00002) was held on January 14, 2004 for the animal shelter. A conditional administrative permit (ZON04-00010) for the animal shelter was finaled on March 4, 2004. The property was logged through FPA 2605356 by the previous owner, a Conversion Option Harvest Plan and an application to lift the 6 year moratorium (FPA04-00001) was finaled on March 4, 2004. A commercial remodel (BLD04-00338) was issued on September 14, 2004. 31.) A septic permit (SEP06-00184) was approved on May 2, 2007. 32.) Center Rd (C931507) is a major collector road. The road approach is existing and an address of 11900 Center Rd has been assigned to the parcel. 33.) A minimum of two (2) on-site parking spaces are required for the single family residence. Xt .1ON cx, JEFFERSON COUNTY • � 4��t DEPARTMENT OF COMMUNITY DEVELOPMENT : .1*,,t10. 4 621 Sheridan Street • Port Townsend•Washington 98368 ... NAY 0 1 20J7 _ 360/379-4450 •360/379-4451 Fax http://www.co.jefferson,wa.us/comrndevelopment/ STORMWATER SITE OCI PLAN SUBMITTAL T� MLA# 0- 021 2) PROJECT/APPUCANT NAME: ei2,11 h Gt. l I 0✓- - 11701041007 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. / Tath �51t.� C.unSI s73 o Ca Zy':5.f-� uvc� u5 b.2.�,� �. �'�y ,(7 .� fiL—i:41 �5 /hive, 1 { t3erh�..c --Ak--5,1r"ti �d afahy .vr ct.f pt davr- 5 Oo / •� I S Obi SI w/ Ai�.D 1J` eo✓.C.�sz.,/ ?.-ei itic.sy if-dr'i ve Qct d-d /c�yy-fn9 i-cic<a� .1z t, ..1- fylvi:,� 1, a u t- 7yn.ting Condition Summary 5,}��+ 2. Describe the existing topography. Indicate contours on the site map. the sIke Czi1 Si S�s 0 7. t/7 ro111 wy At. 1 j 5 (-Anil') 1.-.. AtyA i0o.rti n P 43 e ) 4 zs -c 9-/ 0 --e- -t, •7'kt s , s Aar42. 7 f-e, ©-F' 75ke.- IP to,-#'047 `vim.,, a <5 ✓u eetAb2 S a. A '411.-1-1- v-P 34S Pr 3. Describe the exi ting vegetation. Indicate native vegetation areas on the site map. t Site_7 e_ /ta 5 i•a_C. r-/ g-a .� lc� / 5'u i kr 0 ra frt.- 7'?- e--e- s y rs / . < usC%S Y1 t.444: 2,i-A J�-'e#liQiviS /y:ci- 4. Describe ttre existing soils. Indicate soil type on the site map; Pl al- AEI j .-,2.9K c=ti-d P1 i vi . AlOaq Ai 0 d 570, I s /7o v-t l 0 rii co-ed -I S- .- pn ' /.LC./i/ r l s - '1z:vi, i/ - Bi-i O vi .-Paa, S i a-C O S--G'- -rii .S'1,mac.-' 4-^ ! k2 0-7 4 Y 6-R i--e- c 171`- / S f i/nce r r e:VIA-i I c. -e, 5. Describe the existing site hydrology(i.e.,drainage;behavior of water on the site above,below,and orf the ground). Indicate existing stormwater drainage to and from the site on the site map. Depict separate drainage basins on the site map, if ap licable,and i dicate acreage of each. _ - �'r f..� t v. -i e-:. Van 0-('7 ,51i tA- ..c,,y, 2 i--�. vc2 l vt l X yi «- 5-fi-.1feC ty) 01,1 S i -E'_ -,-_ �� -hams -`r` ► z . I "7%7 " 4 to f J 5 O / -AL- dii3 i fir/77 114- The_ .5 t't-z Al ers /b.D_.-ev, S p A 1'- 1 r 4�„ Grp‘,1 �s 1"1-t 0,A)yi t7- -7,t�- s 1 vfrr�, 6. Describe any excess levels of noia.ganamlorl by thR pmpusad use or activity: Gci o r tiAR O is-�4_ rn Mp- e- Ys s 5 /6 .. '3RMW g1 A S i5 C4. 6-Ie l i x-`-i �RMWATER PL JUN — 5 2001 p • .4 stormwater site plan template-rev.10/1/2003 —�...� .A', "5 JEFFERSON COUNTY DEPT.OF C MMUNITY DE LOP FE' '�• CO Y SIGNATURE: DEP . 1F t• ' ELO' �.'T Sr ATU' ���•�� • f lL 11 s'2_ 7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands,streams, steep slopes,etc.)on the lite. Indicate location on the site map. .� /4- '1,7 0--e_ 3 ¶ •7&/p-e- 5 S �Y-Q 1 LA t 1 a sS 0 W` rs. . A I �(�3p� �, �l _/,� . 1).4 a ll�I.e W P ...ppv pis a�- r e c t yam .�.- /l /ass 40 °� f f •� 41ex-e # c 77.4vv7 O-P,Noczei Wait G-c_ '5/0,-e_s ,, G- c�.,tv X1(1 / 1/ 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.). ` vv vt S�5 ct ✓..cr J2-4 tix-'tom 3+ u ✓- f ju-t W o v- -qv&I+, ,+ � ue•-.tee /z rid eu-i o� �w-�, 2z-// w�/�/6 ,-t'/ ii •4t.ems e `fit C.�-t 1W"i/ R�iE.'s'f t Ira a kl"5 -to 7/lX_ �5 7L 'GC VQ u v..i f 1- j 0 I ► -5 1) MnvVC-►n Cva ()/. us i 1 c. d VC(1*0 140 /)GzAO /36(.y • 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. 9. 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. Locat these facilities on a site plan and differentiate proposed facilities from existing facilities. �/ Cu v ! rna j © 'i of / /f1 a 5 Jio--�.1 jeVi cii ali oakvt4 v.e 'a•r5 Q If/t etlu✓e e-/ 11 w-1.9�Gc44 v ✓ N7O D-vc v I s a/ " /Najd✓117o 7 j�XQ Get. '/ pq/a✓�¢ttS v'7I, L.e Go t0 1 e sS Q'rtc.�y-Ll aic S, Gay . (— d 5'1"91.Q - 'I/ t��s,c GO, i a-,I" pia- c;!�d r�✓�fi teio H 7 Zs�,1 5 slj Va-1, e ?� s- -h c d71/44J ce -.•S Q At s ifs v n//� 1[L h -c/e. .1 C $oI 10. If the project requires the use of stormwater treatment facilities,describe the types of stomiwater 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 9r projects that involve the potenlial for dispersion o contaminants.] (-c y c6u.0.-i t, -� l 5 % r t ►-►2 ►- 1l t s Prof , el rCvl n�r(r .9�t � ea-‘6 a S�Lc v.:4s t c.,a 1) h-e„ I- A.. + 71`) 71.A.L.r 4 c,c-P1�-�'-/"' t3'< 5', l s r, i�v, I i I rh p 6'0-'.� i n �+rt�ct?',. I►✓I`k 'f h 4- 7 ro:i 9 lfilA 'r;/*t .I v›,. d `F !''t�r,✓t o 47,z h ct- ( -�'✓ a/�v! CP► ' tL( ✓✓-�tri '- 5-1 ITe-tic.1 n a-N JcCf /S c9 C e.✓I y © ti 11. Describe the performanc�e-oals and standards applicable to the project.//C1 h•C �f' .i-F�G /1 tt.e-lf' !!(.�JL• i'i cod-; -e4241 /r1 (..4 vtl� .;cam iiLi /!-1 S41-, awca y 116 4,cx47 y, AS� IV,CY—/ Ct✓�1 d f�C� t I l 19-e 1�-����`'t►'� `� . -/o✓n i'n c64,7' k *,e 7f 2-c U 1 cc^4 6f,c 12. Describe the flow control system. f�crs V-e- /o4r.7 rut: : 'f'i /je. tz5 d" "/) -51G lj_ /"..t iu`> 0-+0q' / cA.-..f2a5 %ie 1+Pit.4t:0i.‘ . Smt.v G1ct i .nN .l K c / 0ii IruGl�-��t1 _5 ci rfa c ;�E•�f. -v c v, I I �i-� c�'`i I--_,�?4) C!/,..>? U :.) 7470, LA.), l/ r 1 .1 t't.� P1 a f e /low n� �- `v- /i r #_, l 4-.-��'f;a vi t r< r-e- fJs 1 G/ c c-A cz s' stormwater site plan template-rev.10/1/2003 6 litkni\V Pa) • • MAY 0 2 7 13. Describe the wateruality system. 1 Ni} / t,(�.�L�S v . a 4'w/a `i P/ frvi' A 1E5 �►�Stu v. U1 Li b-k c -rr .a Q vsu-- ' Qi 5 t-/,2 d'Q ct V 6,-)e-ACI, .041515 - 14. Describe the conveyance system analysis and design. r't V1+Lt,✓y C Y(UR-y, h C�.t� t, • a ' 1=2-Z "5 2 •`I > i ) ''w �, � �%lrc._/ s'S y'u f n a -=#' CAI r �Q/� e /-`' s ii /- c d C7,1 -e j CY-.,^ c/ -plc ► s to tavt .i ' a P16C5 /7r sc.h�x - vim., 15. Describe the source of fill material,physical aracteristics of fill materiiII,and deposition of e�� �s material.l. .L ( rytd✓'y� 3 v i j it Ca l�'t 5'r I--� 5 4Ga clart.C+Jc�cA` C_,L�t rite LA'./1 S i ri i lit al />7 �1a . t- a-f 4' h _ o s��Fe (s., + 15 /r c.'id-/cc4 cx s I 7 -e_+.c,,11 5‘„r IS, 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. Atny (lls ��-: )1 1,�._ M I vi 0-F 2 ��¢- o ,ass p/C� c is C y'1,ez_ - 7 het ctc C.0 v-Gecte, 17. Describe the proposed surfacing materials j 5 r mart a tl I k 0,15- k 5 Q t 15 t d Y/ve- c&cz j- cg.4,7' V-12425 cv t'11 6.e 5tt Gra-5/.0-, eock., 18. Descnbe methods for recto tion of flip s'e. dt ' v A CL Y`geet'S ._ /a 5- /0 Y 7 bi.t w i I ( u 5. -- ;�� dii4( a4i 't�-� 3 J dv-t✓ir / �lit✓�/ 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. 20. List here and.i clude any special reports or studies conducted to prepare the Stormwater Site Plan. 47k 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. c;.u feL4144 j- stommater site plan template—rev.10/1/2003 CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN(S , ;�\ 1""1 S' j..• •; 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 pi-oponent 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 -L.srt t � • 1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or wilt 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. C'/-P ✓ vi; /,.n, f3 6-4 ` . i'hcrs� /pa-s "e GO-n i 4554 s 3 I b>lisr et 4® 7,5 , -.ez ss P{,u-, 2 u-/ // /1 u 4-- - `45:- 2—S 2. Establish Construction Acce /y s- / ., /� knit- 7 4� �V- , GL- G...�s•S'5 W I I I V l-�i{/ / 5 µ'ion e_ CQ as-5 LA,Slat, -�o r / i' (.A,11 t c4 i S d✓ ..Q o f LO fttsf%rtq /314' spa ilc I Ii 1 c-dcleW y 4,3 h.g./p n -A-c/ avt 3. Control Flow Rates. sr e /tic Arco ,Is -i viy coi-14 i-v l 4y i7 IX"LISA' / n f-c '3 yQ zoi �j c=1 �cz s �c;A (A/ �'f�-, Z cz E�,�..e �l sc r y� �°(Pt . C\ *r v�� d tz el-4"-el S /1-2 T��¢iL� C� ✓.-z 6j2.1 ,t7 ✓tee ✓✓ 2� , (vyt - pcs' -e- 5'� -2 Z'hy 3 -v ) 4. Install Sediment Controls. j f .� t o en- f .1-7-6 is C..ee sr s �f-r►-�j 0 SJ ,a-II A/i s c--/ /J c1`�1 al ea b�(v t.+Z,✓ Z S "'"G /&1 S' //.v-1 c.177L /.77:1-tehn / 1" 5 Sha t-U t1,� m `�v— t // b-i- irt 5. Stabilize Soils. f s: i41/ab .- . 5-0 t I s �• 11 L-.e.- it r a S t -e ?vets. -2-c rti ill 1vt /d-e - s' 74 5i(rd,/, ss / /So • 6. Protect Slopes. v as` S Gg bpi G i' - i/ . Ar-ems •,7 i T ��.s 2U r 4—// av -qS c..", / - ' - cc' 7. Pr test Drain Inlets. c e i it /vt 0 14 `5' stormwater site plan template—rev.10/1/2003 8 • • R ECE1VE il )' 12 Required Elements-Construction SWPPP(continued) Rr \' I. n27 8. Stabilize Channels and Outlets., �c ,f c! l5+ietg 6-LiNw' r$' (/- I✓iif 57 -4iIia t.ut .'f earl.csi l rI"'t.kvs ,/ .tttliSIO 1111111 _IL 9. Control Pollutants. I j vn 1 Imo- S /J/c.rk- Li-, ikt rc,Cit0rr cc/, I i h.2 pi-fr-sh/-JJd / ,Ooa.5 9 rZz s�.-a 5 /-ram c?' s1/ -',f- /)�i e$cf.Q'v 1)t�2- &!pia Qeit - t� cA ti7 Gt' " -0-v �i'.s7 c,,, 67-65•1' /j Q-t �tr p s LA-//// 6 . u.f; /1 ,/ d/n 7 5".(2415.17 e ex s. , 10. Control De-Watering(the act of pumping groundwater o stormwater awa from active construction site). lt'b ,., -�.vc.�.1�t.i P-. I �� �-h 1.-i,I&..cd an 11. Maintain m est Manage nt Practices(BM s). 5 41 P 5 (it-► I I w ti I 1 -d ea th 1 IA 1-yL,c- 0-r- - a try U fr `l • .,-r2r s .sa5' --e. ---51" 4/t 5 .0,../, ArTIMMIPIAMBEE v r S I a 5 1:7_2 C-isvt q fh.-rt a/ • w- it--a-Co rn In-r-e-I w'. : ,--, 5 0.4►4d7-o- ti I G� 6.z I .v 1 i4.a S 12. Wage the Project. t f b-2 a-5 ' Yho� -a- 'f yv4e�MP-s i4,1L J .-i4 f' h.. (7,6,'r �t� +f�4-1 f it,�...:f.-� 0 -P -1 •5. ' l.4r j i`// h.r_ ilia vt t Gil i a' t.c_par vs s�`7 ,6,,,6,, d-i1fc3�'1�-"- 5.!o Le A."' 1 t1 vi}' Co >^ S "u- �c CYr�t e1'J0 i1 v 1- 1 in ,0d,cc sus' p ci c 5`�� -vi vi I i4-t t .cam, 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands; residential areas,roads). �_ 5 a.- �1cyr� 3 f yps���®s s 'n - c d cv tic,/ -re &''' :S t# , -5;f� c1Z/r�71h s in ili ese -L`-.2-5 , b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yam). . of-4-7 1 ' 14 I` �` , h a r n - 1 �- 6 r" 5"A `1�`'4 'S lb' �4:2 1 -"' l0�'i 4 iCt,ii CP ,.`k., ! rr i 5 - 4 2 xi-, ' 5`6 t..-1 c�"r ems; i+.a r--sr DCL 0+h 3. Environmentally Sensitive Areas. a. D ription of environmentally sensitive areas th t are on or adjacentto the site. 7/�'-� 7`" c r ' D '1� t,c.J f7�r�rr cz s.� s t -5 i t stormwater site plan template—rev.10/1/2003 9 RECEIVF!u b. Description of special requirements for working in or n ar environmentally sensitive area . ' i ' ,y k�� �� (-(.'. )/ £1R C:�} r 0 tt -5 r_. ,_-C' (sJ:s1-f/ 4 C.,s(sl, 'j` -0-ce ytc av14'' !/F-'tv- harf r5 R-'5Ott,-. ItG aF -,25-'e 5 aj1,. /r9+'4- r9 E 4t5 /4ii3/,O 5-cd_ 44 ° T► +. rra. 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils(e. .,erodibir ,settleability,permeability,depth,texture,soil structure). .52.�'O S/n✓. / 5Su raS_ ria4a Id '-L 4 0 r^ifiaA CA-n 5 u /55'64-0-S r'-e-ict i. i ��' "'--.� d 1 t i I f"ct'SS S h��-, - -f2 b It 5 ti.e� �.s-/� q �& �I /114Leeri/Z T�56 P plat! , - • 5. Construction Phasing. a. Construction sequence Q S hx_ke. ,6a-r--,4.e.,,-s C s7tt-. /► ►k,+-5 42 COpt.sue. 7"E5c_p. Q C Pia.i4- 6,42-ss ' I+ ri'loAy htei --e+.s j.12-5 L I riA 7re-5-5' 0 6-ra,/.. i' '.a. d b. Construction phasing(if proposed)) PO 5- jv:Z a✓-bras "1 pka-5 5',. PC) 5 t 5. ‹t.e-..4., It7 6-ram ,Act- .� /e/o/ 1 7k 51zt k'-o-5 y-acz_k5 /dr'L 517--i lacy s -t ✓-,2-5 . .-S 3 — tea 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Provide a proposed construction chedule.. 5'--&.rhto r_itri o vim.,( - b rK-5A t► , /P01vt e4Ar. I ,t r a d v� 0- /B 5 i-, s- /sue y -- J'u.h-L r �j' / ll. Wet Season Construction Activities. / a. Proposed wet season construction activities. I A fair -c-f-pa- .-1 ,/a_n rl-�-� - a-�hp/.tq T AO usf-h WI, 0 04_ b. Proposed wet season construction activities for environmentally sensitive areas. /no,i- . 7. Financial/Ownership Responsibilities. a. Identify Cheep property owner responsible for the initiation of bonds and/or other financial securities. it1 b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts./ _ 8. Engineering Calculations. Provide DesigpCalculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. b. Diversions. /¢ c. Waterways. / ' d. Runoff/Stormwater Detention Calculations de,"1/1 stomrwater 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 pro 2s%b1- (LANDOWNER OR AUTHORIZED REPRESENTA SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES,IF NEEDED: • • � -' Ail • • • • stomHvater site plan template—tev.10/12Ub3 , 12 • • • RF4CE1VED 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 Constructs er Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, part' � � ;al development. �1ti° SECTION I-CONSTRUCTION SWPPP NARRATIVE 1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or wilt 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 wilting. Descriptions of the 12 Elements are found at section 2.52 of the Manual(beginning on page 2-15). - 12 Required Elements-Construction SWPPP 1. Mark Clearing Li Al -t/ //41,7 ' -r co w. I/ /. s ✓/ / z c,, (.G/ -P-,/,'�''l ` 2. Establish Construction ccess. t Sr ( i,"-e Ga''67 51; 3. Control Flow Rates. ,( �,/ ,[� /i f/7,/ 7/7~ 0 `f f-lSrt 3"Y:.c c% 'tD u�`y �i-L'r 1 a�l: CC rt S 4t C p n.s"fYu- -+- f r.ch �10{.1, 7IN &in Alt-S7r lI-1400/ 4v c — c 5f- ', / widh ha - - d1 r�ri-> mot 4. Install Sediment Controls. 5. Stabilize Soils. ,d , .s�oiTi#v �1/r ,4cY-'C. Ja,./ IA,( t I /0 day f O • 6. Prot Slopes. ' 7. Protect Drain Inlets. 777-e et /Lb GP/1'�i ay'J 7j / stormwater site plan template—rev.10V12003 8 (------ jDEEPARETRMSENTiesoN co� OUN �E"+ iiti g�y OF COMMUNITY DEVELOPM \, 4 ` 621 Sheridan Street• Port Townsend•Washington 98368 360/379-4450. 360/379-4451 Fax �.Q /p� www.co.jefferson.wa.us/commdeveloprnent i• f° $ �rS Master Permit Application MY , DI— , "Q al Project Description(include separate sheets as necessary): 1Y SW Le7 vc 5 tki..c.4- 6 S,6 5,F• If t).ssL- -I- :' t $F ci A Tax Parcel Property -f, �.�_ Number: 70/0 6 /0 O 7 Size: 3 0 (5, (acres/square feet) Site Address and/or Directions to Property: //99t)0 C. i/(. P• 4d Property Owner(s)of Record: /S'(Z Ir .,- f Llrejcz /22-et 11c-1 1-e ." Telephone: wK• 4-25--8 1-7,2-0/4 Fax: 42 5--& 7-5-0 c;4 Cif t�s.J�YS,�' email: I�1¢'v y��& Mailing Address: 6 3 4-0 / -. !2_S'fr-"5j" ) '<i✓ Ci-h ?Fj cf ; CZO• 'u 3 Applicant/Agent(if different from owner): frif Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) ❑Building I Variance(Minor,Major or Reasonable Economic Use) El Demolition Permit ❑Conditional Use[C(a),C(d),or C]** Single Famil Discretionary"D"or Unnamed Use Classification Garag= Attached Detached OSpecial Use(Essential Public Facilities)** 0 Manufa r-• "ome °Boundary Line Adjustment d Modular °Short Plat** 0 Commercial* ❑Binding Site Plan-- 0 Change of Use °Long Plat** ddress I Road Approach °Planned Rural Residential Development(PRRD)/Amendments** Propane °Plat Vacation/Alteration** lowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions*'` OStormwater Management QShoreline Management Substantial Development** ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance OTemporary Use 0 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: �vilyz..__ DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or it's knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and it.employees,representatives or agents for the sole purpose of application review and any required later insp ' s. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the appli 1 at h nts p n Signature: & Date: 4/ I 'V 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 complian iith the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable respon ' dhering and complyin ' the ESA. The Applicant has read this disrlai/nerpn signs and dates it below. Signature: /,�/� Date: / 7 D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc • BUILDER STATEMENT • The signer of this statement does he eby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming the re pon ' i' of eneral Contractor for the proposed proje Signature: ////Ct'. / — Date: l I D 7 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTAI I FR: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX( ) MAILING ADDRESS: EMAIL Pr ject Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: New Wood Existing: 0 Sewer ❑ Addition CI Steel Proposed: Bank 0 Community System ❑ Alteration/Remodel 0 Concrete Total: 2 Hei Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition 0 Other Bedrooms: Water Supply: Existing: U Setback: 0 Private well Q Two Party Typg of Heat Proposed: 7-- public p '-1 j /' - ,� Total: l- / ' Name of System 780 9 ` ! Ps9--,„1 ter`( i -' If this is a Commercial Proiect 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: ❑Underground Tank L.'Above ground Tank Size of Propane Tank: /.7- C ❑Heat Stove di4Cook Stove ❑Woodstove ❑Fireplace Insert a Hot Water Tank In 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. Square Footage Current Proposed For Office Use Only Amount Revision Main Floor Heated 696 Dr 5 11%S':'4 EH Bld App Review tz 2AO Floor Healed ao F) 1 at Zia 1 I i Consistency Review: j 6' Other Heated Base fee: Mezzanine Additional Section: ------- Heated 0 Basement Plan Check fee: , Si Unheated Basement 0 State Surcharge fee: � Other Unheated O Pot Wafter Review fee: 03 L Garage/Carport 72.0 O' I(`Oil ) 'k) SUBTOTAL Decks /66,L,' ail .'7(o 911/Rd Approach fee: _ Other TOTAL: $Do-I 2, Imo,_ -, ,..... Receipt Number: sqq,' I ___________. Cash/Check Number: �_ 13.. ESTIMATED COST(REQUIRED) Cl.„ • Date:.Fair market value of all labor and materials fouedation to finish i /�mil.'1 P7 s 0 I)J Initials: 7�---111 `�-, D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc }p,ay • • . ..y, q, . , . .., . . 2 .,A•.,iir.,-,,,,LF 1 : ‘ ,$) e ,,, . . • g! ,,zi- P:41;;iz,1"-"'p'' -itt."'`‘11''.-4%;-;i---7....4411: . --'I - -,,.. • iv-, n1 1iill tlb+' � ice,/ �,w attjtfl� � � /2 6" 3�6• io'-o" 1„, •6_0+i� ' ® �tw1�y.14/ O /'k © fiblA\1ti44 4, VA� .;04 I>„ • • . 0 i"\,.,' 1 ) 1 p Lii ;i1 r. b I.o a nry ^— . - . ^: 0 . Fu c ,fit • 3. VS _� „ . 2 rr•, fir_ 2'-O 2 / 7'ou ` _ /_6., 3Lp,� 7e 6., / 4_prt , / 8 )f / 6 6" i f___.. .. , Cs., •• WQ', 1` . , t.--'t.,! ,, 7,......, ITf a „. , z, ,.. • i .,, , ..., It , G 61. ,. 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(Nr cn . ,_t ,f , till7 411 .EXISTING METAL BLDG.HAS GUTTERS AND ALL BLDG.RUNOFF NOTES:1.DIRECT ALL RUNOFF TO SHEET FLOW TO BUFFER 2.INSTALL INFILTRATION TRENCH AT OUTLET OF lift., ..0' rallik.....% INFTHEILsTRATEITE ISSDmTODGERDOUND. 1?)al 3.s. Ir'Ell, , fsi.,2.'" ',/e,7411_,„i : CENTRAL TYPE 3 ANDIBOTH DRAINTO TYPEO 2S6Us:BA INS SUB-BASINS, ' f) --.. /I. \ . ;A •11,7.zir-y ••, Olt. r STREAM LOCATIONS,WELTAND LOCATIONS AND THEIR BUFFERS - PONDS.POND TO HAVE A ROCK OVERFLOW SPILLWAY. 3.INSTALL BRUSH BARRIERS IN DITCH LINES TO IA FILTER RUNOFF. / VIII( it ,.i.„ $ na •, .k. ,,,, ARE APPROXIMATE BASED ON FIELD RECON AND MEASUREMENT 1 1,1 trit;tlitha 1.1 . . 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