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HomeMy WebLinkAboutBLD2007-00320 S UILDING PERMIT APPLICASN MLLA07N003336 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00320 Received Date: 6/15/2007 SITE ADDRESS: 135 LIP LIP LN NORDLAND, 98358 OWNER: PETER M BAFFARO PHONE: 425-743-7286 MARY M BAFFARO 6528 148TH PL SW EDMONDS WA 980264019 SUBDIVISION: Block: Lot: T 39 PARCEL NUMBER: 921094025 Section: 9 Township: Range: CONTRACTOR: WALTENBAUGH CONSTRUCTION CO PHONE: (360)385-6105 40-A SETON RD PORT TOWNSEND WA 98368 Contractor's License WALTECC012BA Expires 1/1/2008 REPRESENTATIVE: WALTENBAUGH CONSTRUCTION CO INC PHONE: (360) 385-6105 40-A SETON RD PORT TOWNSEND WA 98368 PROJECT DESCRIPTIOI NSFR W/ ATT GARAGE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,868 VALUATION 490,000.00 ADD'L: 895 HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 OCCUPANCY: UNHEATED: # OF STORIES: CONST TYPE: 5N OTHER: SHORELINE: CONST TYPE: GARAGE: 576 SETBACK: DECK: 1,036 BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: ATHROOMS: Exist: 0 " Exist: 0 Prop: /a °1/41c Prop: 3 Total: X a- Total: 3 Routing Da e: _ rd c 1 Type Amount Paid By: Date: Receipt: Approved/Date Permit $3,177.75 LYK 06/15/07 91235 APPROVED Plan Check $2,065.54 LYK 06/15/07 91235 State Building Code $4.50 LYK 06/15/07 91235 SEP ,9 /2007 Potable Water Application $58.00 LYK 06/15/07 91235 Total: $5,305.79 Jefferson County Planning & Building Department Jefferson County Building D•sion Permit NuS: BLD07-00320 Applicant: BAFFARO 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 0--16-b? ^FP7 Erosion Control Foundation Footing to i -r' Footing Drains Foundation Stem Wall `l,1 Underground Plumbing H/ 7 A ( 4L x& AeCA a(, , 07767, Under Floor Framing i_11.�_O-7 w" Q Straps(hold downs) 7/0 S f Ext. Shear Wall Nailing i_ct _n 8 Fi t-� � W IS t" `it( Rough-in Plumbing .07,, Ai r;PRa> Framing .3(.2-4* Blocking 3/7/�.0 `,( Airseal 7�I . Insulation: Walls 3� 03 d�— Insulation: Floors // Jis Insulation: Ceiling 06/`OB Int. Shear Wall Nailing P-VA Wallboard Nailing / y/OB Gas Line: Interior kVA Gas Line: Exterior N/A Propane Tank N,A Heat/Chimney Clearance Drywell/Alt Drainage Address Posted 02#6 FINAL INSPECTION q/ ae 43&r FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD07-00320 1.) PRIOR TO OCCUPANCY& BUILDING FINAL INSPECTION FINAL APPROVAL OF vontic1 SEPTIC SEP07-202 IS REQUIRED. ql2 2.) A 5' SETBACK SHALL BE MAINTAINED FROM THE SEPTIC TANK TO ANY DOWNSLOPE FOOTING, CURTAIN OR INTERCEPTOR DRAIN OR DRAINAGE DITCH. 3.) The application was reviewed by the Jefferson County Department of Community Development staff on July 25, 2007 for the potential presence of Environmentally Sensitive Areas (ESAs) under the provisions of the Unified Development Code (UDC). After an initial Geographic Information Systems mapping review, the following ESAs were confirmed to be present on the subject property: Shoreline Designation -Conservancy, Shoreline Slope Stability-- Unstable Recent Landslide (toward shoreline) and Stable (toward Lip Lip Lane), Fish &Wildlife Habitat--Cliffs & Bluffs, Seismic Hazard Area, Landslide Hazard Area-- High, Erosion Hazard Area, Special Aquifer Recharge Protection Area (SARPA), Susceptible Aquifer Recharge Area (SUSC), Seawater Intrusion Protection Zone(SIPZ) -- High Risk. 4.) A Geotechnical Report dated September 7, 2006 prepared by NTI Engineering and Surveying was submitted with the application to address the geological hazards on this parcel. A Well Hydrogeologic Assessment dated September 6, 2007 prepared by Aspect Consulting was submitted in conjunction with this application to address the potential for seawater intrusion. 5.) 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. 6.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 7.) 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. 8.) 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. 9.) Marine shorelines and islands are susceptible to a condition that is known as seawater intrusion. Seawater intrusion is a condition in which the saltwater/freshwater interface in an aquifer moves inland so that wells drilled on upland areas cannot obtain freshwater suitable for public consumption without significant additional treatment and cost. Maintaining a stable balance in the saltwater/freshwater interface is primarily a function of the rate of aquifer recharge (primarily through rainfall) and the rate of groundwater withdrawals (primarily through wells). The Washington Department of Ecology is the agency with statutory authority to regulate groundwater withdrawal for individual wells in Jefferson County. New development, redevelopment, and land use activities on islands and in close proximity to marine shorelines in particular should be developed in such a manner to maximize aquifer recharge and maintain the saltwater/freshwater balance to the maximum extent possible by infiltrating stormwater runoff so that it recharges the aquifer. 10.) The parcel is located within a Hiisk SIPZ (seawater intrusion protection zj according to the County GIS map. There are mandatory measures identified in the Jefferson County Seawater Intrusion Policy(Resolution 44-22, effective September 23, 2002) that apply to well drilling proposals and building permit applications on existing lots of record. A High Risk SIPZ is defined as: areas within 1,000 feet of a groundwater source with a history of chloride analyses above 200 milligrams per liter (mg/L). 11.) A vegetative buffer of 70-feet shall be permanently maintained from the top or edge of the Landslide Hazard Area. All buffers shall be measured perpendicularly from the top of the Landslide Hazard Area. 12.) A Geotechnical Report was submitted in conjunction with this application. The report addressed the stability of the geologic hazard area. A setback of 70-feet shall be measured perpendicularly from the top or toe of the geologic hazard to the proposed residential development. 13.) PRIOR TO FINAL BUILDING OCCUPANCY, PROPONENT SHALL SUBMIT A WRITTEN V LETTER FROM THE GEOLOGIST WHO PREPARED THE GEOTECHNICAL REPORT ht, DATED SEPTEMBER 7, 2006 STATING THAT THE STRUCTURE AND/OR FACILITIES AD° HAVE BEEN CONSTRUCTED IN CONFORMANCE WITH THE REQUIREMENTS OF THE "GEOTECHNICAL REPORT." THE LETTER SHALL BE STAMPED BY THE LICENSED GEOLOGIST/ENGINEER. 14.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated. Should buffer disturbance occur during construction, the Unified Development Code (UDC) Administrator shall require replanting with native vegetation. No alterations shall be made to the Landslide Hazard Area or its associated buffer without prior authorization by the UDC Administrator. 15.) Prior to and during approved construction activities, the perimeter of the landslide hazard area buffer shall be marked with a temporary sign. The sign shall be placed in such a manner that it can be directly observed from the construction area. The sign shall contain the following statement: "Landslide Hazard Area and Buffer- Do not Remove or Alter Existing Vegetation." 16.) All construction activities shall not encroach upon the 70-ft buffer. This includes the storage or preparation of materials. 17.) The applicant shall permanently separate the boundary of the Landslide Hazard Area Buffer from the remainder of the subject property through installing logs, trees, a hedge row, or any other prominent physical marking approved by the UDC Administrator. 18.) 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. 19.) To help prevent seawater from intruding landward into underground aquifers, all new development activity on Marrowstone Island, Indian Island and within 1/4 mile of any marine shoreline shall be required to infiltrate all stormwater runoff onsite. 20.) MANDATORY MEASURES OF HIGH RISK SIPZ: Water conservation measures: 1. Roof and other intercepted precipitation shall be routed to on-site detention ponds and/or other approved means and allowed to be released to the soil slowly. 2. Water collected from Storm water and roof catchments may be used for watering lawns and gardens. Unless catchment water has been treated to meet drinking water standards, there shall be no cross connections allowed between the potable supply and impounded water. 3. Water withdrawn from wells on each property shall not be used for watering of lawns and/or gardens. 4. Ground water withdrawn from each property shall be restricted to a rate of three (3) gallons per minute. 5. Installation of water conserving fixtures such as low flow toilets, faucets and shower restrictors and other water saving plumbing fixtures. 6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation). Please NOTE that the above listed measures are not intended to be exhaustive, but rather is intended to be illustrative of the types of water conservation measures. 21.) MANDATORY MEASURES FOF3H RISK SIPZ: • 1. For proof of potable water on a building permit application, applicant must utilize DOH-approved public water system if available. 2. If public water is unavailable, a qualifying alternative system may be used as proof of potable water or an individual well may be used as proof of potable water subject to the following requirements: a. Variance from Chapter 173 WAC standards granted by Ecology per WAC 173-160-106 for a new groundwater well within 100 feet of a sea-salt water intrusion area per WAC 173-160-171 (i.e., within 100 feet of a groundwater source showing chloride concentrations above 200mg/L or within 100 feet of the marine shoreline); or for an existing or proposed groundwater well not subject to an Ecology variance, applicant must provide evidence through a hydrogeologic assessment(relevant components of an Aquifer Recharge Area Report per UDC 3.6.10.e) of a reasonable probability that the subject aquifer will not be degraded by the proposed use of well. b. Installation of a flow meter. c. On-going well monitoring for chloride concentration. d. Submittal of flow and chloride data to the County per monitoring program. 3. If public water is unavailable, a qualifying alternative system may be used as proof of potable water. 22.) IN ADDITION TO ALL VOLUNTARY AND MANDATORY ACTIONS ASSOCIATED WITH THE APPLICABLE SIPZ AS DESCRIBED ABOVE, THE FOLLOWING MEASURES APPLY TO ALL DEVELOPMENT PROPOSALS ON MARROWSTONE ISLAND THAT INCLUDE GROUNDWATER WITHDRAWAL: (A)VOLUNTARY ACTIONS. (I)INSTALLATION OF TIMES TOGETHER WITH NEW WELL PUMP INSTALLATIONS TO ENABLE PUMP USE LIMITATION TO LOW DEMAND TIMES. (B)MANDATORY ACTIONS. (I)THE USE OF A WELL PROPOSED AS PROOF OF POTABLE WATER FOR A NEW BUILDING PERMIT SHALL BE CONDITIONED THROUGH THE BUILDING PERMIT SUCH THAT ENROLLMENT IN A COUNTY-SPONSORED MONITORING PROGRAM IS REQUIRED, INCLUDING PERIODIC SUBMITTAL OF FLOW AND CHLORIDE DATA AS DETERMINED BY THE COUNTY.(II)INSTALLATION OF A SOURCE-TOTALIZING METER (FLOW). K'A I, (III)INSTALLATION OF A VARIABLE SPEED PUMP, CONTROLLABLE FROM HE SURFACE, IN ORDER TO ENABLE REDUCTION OF WITHDRAWAL RATE, AS MAY BE NECESSARY. (IV)INSTALLATION OF A 1,000-GALLON MINIMUM STORAGE TANK THAT SHALL CONFORM TO THE ANSI/NSF STANDARD 61. 23.) The project shall adhere to the Best Management Practices (BMPs) to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 24.) The applicant is proposing to create or add 3,540 square feet of impervious surface and 5,080 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. 25.) PRIOR TO FINAL BUILDING OCCUPANCY, PROPONENT SHALL SUBMIT A WRITTEN LETTER FROM NTI ENGINEERING STATING THAT THE STORMWATER FACILITY b HAS BEEN CONSTRUCTED IN ACCORDANCE WITH THE REQUIREMENTS OF THE Qb "REVIEW OF STORMWATER PLAN" LETTER DATED SEPTEMBER 11, 2007 AS alb SIGNED BY BILL PAYTON, LEG OF NTI ENGINEERING & SURVEYING, INC. 26.) 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). 27.) The revised site plan as submittEll, September 14, 2007 has been reviewe. 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 September 14, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 28.) This approval is for a single-family residence with attached 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. 29.) The parcel has been designated as RR 1:5 under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. 30.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 31.) 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. 32.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 33.) The building height is not to exceed 35 feet. 34.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 35.) 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. 36.) Setback from Lip Lip Lane right-of-way is no less than 20 ft., side and rear setbacks are no less than 5 ft., the minimum setback to shoreline bluff is 70 ft. If an environmentally sensitive area (ESA) is present, then the more restrictive setback shall apply. 37.) PRIOR TO SCHEDULING THE FIRST BUILDING INSPECTION THE GEOLOGIST/ENGINEER SHALL STAKE THE 70 FT. BUILDING SETBACK LINE. 38.) The proposal was reviewed for consistency with the Shoreline Management Master Program Section (JCC 18.25.090 (5)) and found to be consistent. The proposal is (1) a single family residence, (2) does not exceed 35 feet in height, (3) does not involve over-water construction and is located landward of the OHWM, and (4) meets or exceeds all required setbacks as set forth in said SMMP. 39.) The proponent shall notify the Jefferson County Department of Community Development at (360) 379-4450 forty-eight (48) hours prior to commencing construction in order to allow monitoring and ensure compliance with permit conditions. 40.) This project meets or exceeds all performance standards listed under the Shoreline Management Master Program (JCC 18.25.410)with the exception of the shoreline setback which has been addressed in the finding above. 41.) The proposal was reviewed for consistency with the Shoreline Management Master Program Section (JCC 18.25.090 (5)) and found to be consistent. The proposal is (1) a single family residence, (2) does not exceed 35 feet in height, (3) does not involve over-water construction and is located landward of the OHWM, and (4) meets or exceeds all required setbacks as set forth in said SMMP. 42.) The Development Review Division finds that this proposal is consistent with Shoreline Master Program JCC 18.25.090 (5), which exempts the "construction by an owner, lessee, or contract purchaser of a single-family residence [in shoreline jurisdiction] for the owner's or owner's family's use..."from the substantial development permit(SDP) requirements under certain provisions. Exemptions from the substantial development permit requirements do not exempt a proposed development from compliance with the applicable policies and standards of the Shoreline Master Program or other applicable Federal, State, or local permit or license requirements. 43.) Construction shall be in substanOompliance with the site plan submitted or•ptember 14, 2007 as it exists now or is hereafter amended by Jefferson County and/or the Washington Department of Ecology. 44.) Residential developers and individual builders shall be required to preserve shoreline vegetation and reduce the associated risk of erosion during construction and any future activity which may impact the stability of the shoreline. 45.) EXCAVATION, GRADING AND EARTHWORK CONSTRUCTION SHALL ONLY BE ALLOWED FROM APRIL 1ST TO NOVEMBER 1ST, UNLESS THE APPLICANT DEMONSTRATES THAT SUCH ACTIVITIES WOULD NOT RESULT IN IMPACTS OT THE STEEP SLOPE. 46.) The project shall comply with all Sclusions and Recommendations found in• Geotechnical Report prepared by NTI Engineering and Surveying dated September 7, 2006. The copy of the geotechnical report can be found in MLA07-00336 filed in the Jefferson County Department of Community Development. In part, the report states: The bluff at the subject property is actively being eroded as evidenced by the recent sliding on the bluff face, and future sliding should be expected. Typically, bluff erosion and sliding are more common in the winter and spring due to increased rainfall, higher tides and winter storms. It is impossible to predict when a slide will occur or how much the bluff will recede. Average rates of bluff recession for this area have been suggested to be on the order of 6"to 8" per year. However, several feet of bluff could be lost during one event. Based upon our investigation, and the possible average rate of recession of approximately 8" per year, we recommend that the building setback from the top of the bluff be at least the 1:1 setback specified in the Jefferson County Shoreline Management Master Program, which in this case is 70'. Assuming that the 8"/year rate is accurate (and it may not be), then in a typical 60 year economic life of a home, the bluff might recede 40' and be within 30' of the home. Since there is no way to accurately predict the bluff erosion rate, an increased setback may be more beneficial for long term asset planning. The following recommendations should be considered with regards to the proposal: 1. It will be necessary to maintain ground cover in order to reduce erosion from surface runoff. Any bare areas that develop, on the bluff or on the upland, should be revegetated if possible. Native deep-rooted low growing vegetation that requires little or no irrigation would be the most beneficial. Please consult the enclosed publications for further information. It should be noted however that vegetation establishment on the steep eroding bluff soils may not be possible. 2. Vegetation on the bluff face provides stabilization to the bluff face soils and helps remove water from the soil. Existing established vegetation should be left in as natural state as possible. As far as pruning for a better view, minor thinning and pruning should be done in such a way that minimizes disturbance to the soil and root zone and that insures the continued health of the vegetation. Trees on the bluff or along the top of the bluff that are in danger of falling over should be evaluated for possible removal. Because if a large tree does fall over, the wrenching out of the large root mass can cause damage to the bluff and adjacent vegetation. If trees are removed, the trunks should be left in place so the root mass can continue to provide stabilization to the soil. A tree expert could provide valuable consultation in this matter should the need arise. 3. Maintenance/repairs to the beach access path would probably not significantly increase bluff stability as long as they were performed to the normal standards of care associate with this environment. 4. Tree limbs, lawn clippings, etc. should not be thrown over the bluff because these piles have a tendency to damage/kill the underlying vegetation which in turn increases the erosion potential of the bluff soils. These piles also add unnecessary weight to the bluff soils, especially when saturated with water. 5. Heavy irrigation or other activities that would contribute large quantities of water to the soil should be avoided. 6. Surface water should not be allowed to flow over the face of the bluff as an uncontrolled or concentrated flow and cause erosion of the bluff face. This can be controlled with vegetation and using berms or swales to direct runoff to a drainage system. Please see the attached DOE publications for more information on this subject. 7. Surface runoff from hard surfaces such as roofs, driveways, walkways and patios should be controlled and routed to a drainage control system such that surface water discharge to adjacent properties does not exceed predevelopment conditions. 8. Silt fences or other sediment control devices may be needed during construction such that sedimentation to adjacent properties does not significantly exceed predevelopment conditions. • • 9. Drainage control devices should be maintained in good working order and inspected at least once a year. 10. NTI can develop an engineered drainage, sediment and erosion control plan for this project if desired. 11. The septic drainfield should also be located away from the bluff and behind the recommended building setback line. For further information please review the three publications . . . published by the Washington State Department of Ecology (DOE) entitled: "Slope Stabilization and Erosion Control Using Vegetation", "Vegetation Management: A Guide for Puget Sound Bluff Property Owners" and "Surface Water and Groundwater on Coastal Bluffs". These publications can also be viewed on the DOE website at http://www.ecy.wa.gov/biblio/sea.html under the 1993 and 1994 year heading. The DOE website also contains additional useful information regarding slope stability and site development; this reference is highly recommended." 47.) A Hold Harmless Indemnification Covenant was recorded September 27, 2007 under AFN 527722 with the Jefferson County Auditor for the purpose of indemnifying the county against all liability for building a residence and septic system in close proximity to a landslide hazard area. 48.) Bluff-Coastal Zone Atlas of Washington-Nonvegetated steep to moderate slopes of varying substrate. Bluffs often serve as buffer between developed uplands and wetlands at their base creating important strips of coastal habitat. 49.) The project shall comply with ALL recommendations and conclusions found in the Hydrogeologic Assessment prepared by Aspect Consulting dated September 6, 2007 including but not limited to: 1) Pumping should not exceed a rate of 3 gpm due to the mandatory water conservation measures required for wells completed in High Risk SIPZs. 2) Not more than 400 gallons per day should be pumped from the Baffaro well. 3)All stormwater is required to be infiltrated on-site. It is recommended that the infiltration should be directed in an area between the well and the sea, which will further protect the aquifer from seawater intrusion. A copy of the this report can be found in the file for MLA07-00336 which can be found at the Jefferson County Department of Community Development. 50.) 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N �� y _________________—_=______=____- zF �Z @$Z1 O JOpp o ftz � lC -OP, R. ti a ^� 30-0• Z3 42.E i 4,4 2 cn PROPOSED RESIDENCE FOR: 2 1..i ��� J C H DESIGNS 2 2 m BAFFARO'S � J H}(p PO BOX 12381,EVERETT WA 98206 0 0 o z +� TEL.(425) 359-5678 m 200 7-06-06 10:35 3603/92/3/» 425 446 586/ N 2 f 2 SON WA (F 4 :1 i?? c0G JEFFERS"COUNTY •' '`� ' \ ,rta DEPARTMENT OF COMMUNITY DEVELOPMENT '"S ,y -. "4 621 Sheridan Street •• Port Townsend••Washington 98368 II qg` j 5 Inv 360/379-4450. 360/379-4451 Fax www.co.Jefferson.wa.us/commdevelopment �'SBINO ` ' Master Permit Application MIA k Project Description(include separate sheets as necessary): . ��" �� newt ,irr &c ki I +�totl L4 &►u44J 1-0, IGt ..�lt✓e, Tax Parcel 'Property �7Number: QZIOqLDa� Size: �• a- O_ ) age creslsquare feet) Site Address and/or Directions to Property: ]35 Up " e- , tJord (a.ihd wA ( s35$ Property Owner(s)of Record: - M A-V:3 S - f A-Ir o Telephone: L a-5- 1'4 3- G� Fax: 1 email: Mailing Address: (p 5 t� Pict,cb"�` PI & )) { Vv,•.z�t S WA cl d 7-6 . Applicant/Agent(if different from owner): 1 1 h J�,1,S`lt1AC ,45,•l C r I Y . • Telephone: W0.0 3�5""(0 cS Fax: ~ 1q �t1 - 3� email: Sa.D{{W 041 ly 4;40'1 f,'(' Mailing Address: 3I. 141.0 A 10 la r X, ►-'o r+TD"wvt Se.ir,d ttQA 41% What kind of Permit?(Check each x that applies 3uilding 0 Variance(Minor,Major or Reasonable Economic Use) 0 Demolition Permit 0 Conditional Use[C(a),C(d),or C]' Single Family arage ttache Detached ❑Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular Cl Special Use(Essential Public Facilities)" Ll Commercial' 0 Boundary Line Adjustment Change of Use 0 Short Plat'" LI Address 0 Road Approach I.I Binding Site Plan" ❑Home Business ❑Cottagelndustry Li Long Plat" ❑Propane ❑Planned Rural Residential Development(PRRD)/Amendmen s" ❑Sign 0 Plat Vacation/Alteration" 0 Allowed"Yes"Use Consistency Analysis 1-1 Shoreline Master Program Exemption/Permit Revisions Stormwater Management 0 Shoreline Management Substantial Development" 0 Site Plan Approval Advance Determination(SPAAD)* LI Shoreline Management Variance 111 Temporary Use ❑Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication" FI Jefferson County Shoreline Master Program Amendment ❑Forest Practices Act/Release of Six-Year Moratorium 11 Tree Vegetaion Request May require a Pre—Application Conference _ "'Requires a Pre-Application Conference Please kfentify any other local,state or federal permits required for this proposal, If known: OES)O T19N OF AGENT I hereby designate II �ct as my agent in matters relating to this application for pennit(s). ---7> OWNERSIGNATIJRE -%3 ..-- -- ` , Date: >% - 4 C 7 . By signing this application form,the owner/agent attests that -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 et the time of the application that he or she wants prior notice. - .7 Signature:'------ - "" ,... jam.- . Date, _ `c -`.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 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 you are in corppllance with the Jefferson County development code,The Applicant acknowledges that he,she or it holds individual and non-transferable responsibility for adhering Wand comprgg with the ESA. The Applicant has read this disclaimer and signs and dates it below. -!; � ✓JS Signature' -Zj` -.r. Date 4> — ".L.1 r::\r)treumena,and k'nings\coral\Itxal Scui,t}N\l rmporary Internet I'iletN\01,KllG\Merle r Pcnnit Appliceion 12-19-20(K,duc 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 HOME INSTALLER: PHONE: FAX: WW EWDV••, Ct1/.� 1 vt calo) 33S-to I t5 31. -a'73� MAILING ADDRESS: 321?OJiL µQ,y-Q, PI. rb14T6P_reawit-EMAIL: aot cock Oy .hp�- CONTRACTOR'S LICENSE WAINS limps NUMBER: \JALTeCLDI Llibi l NUMBER (00I�116 ..q31 ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: X New Wood Existing: _ _ ❑ Sewer ii Addition ❑ Steel Proposed: _1 _ Bank ❑ Community System r.i Alteration/Remodel ❑ Concrete Total: _3— Height: %Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: — Setback: A Private well ❑ Two Party Type of Heat: Proposed: a ❑ Public 4f1Q tom.` • _,Total: Name of System: Wreck Avr If this is a Commercial Project you must answer the following: WI A 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 °Above ground Tank Size of Propane Tank: ❑Heat Stove 0 Cook Stove 0 Woodstove 0 Fireplace Insert 0 Hot Water Tank 0 Pellet Stove 0 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 l Q 1 1p'�4 c�Sl-i EH Bld App Review , D "b 2nd Floor Heated pq G b2 iS3`d�Consistency Review: i< 5� Other Heated V II J Base fee: Mezzanine iyiefitional X ii: k ��-7 % Heated Basement Plan Check fee: OCYS 51-1 Unheated Basement State Surcharge fee: 50 Other Unheated Pot Water Review fee:l w �� Garage/Carport si ^ I a516.3Z SUBTOTAL Q rn Decks j )l 1612i-F8 911/Rd Approach fee: ` (`F) Othe 35 a i ' '2 JIC TOTAL: �` I� • �� Receipt Number: ►D,5 1 � Cash/Check Number: ,01 • Y ES1tIMATED C• - ' L D) Date: r Q .Fair m.. - ,. •_ • . labor and m. -dals foundation to finish .^' /I iir I 40 1 D 00. 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