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HomeMy WebLinkAboutBLD2007-00349 • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD07-00349 Received Date: 6/26/2007 SITE ADDRESS: 307 GARDEN CLUB RD Issue Date 7/24/2007 NORDLAND, 98358 Expiration Date 7/24/2008 OWNER: WARREN D SHEFFIELD PHONE: (206) 902-1916 DEBORAH L SHEFFIELD 3033 38TH AVE W SEATTLE WA 98199-2512 SUBDIVISION: Block: Lot: 6+ PARCEL NUMBER: 921043001 Section: 4 Township: 29 N Range: 01 E CONTRACTOR: JDG CONSTRUCTION INC PHONE: 360-385-3287 JOHN GIESER PO BOX 2073 PORT TOWNSEND WA 98368 Contractor's License JDGCOI*044BJ Expires 11/14/2007 PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE (1100 SQ FT DECKS) (998 SQ FT COVERED WALKWAY) _AL-1,0416-(2)420-erAt-PRGMNE_TANKS--W 9 kl? pe(L � •� ., d TYPE OF WORK RES SQUARE FOOTAGE: -111(0.) TYPE OF IMP NEW MAIN: 3,036 VALUATION 342,308.00 ADD'L: HEAT TYPE: RAD CODE EDITION: 2003 HEAT BASE: HEAT TYPE: PRO OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: 880 SHORELINE: CONST TYPE: DECK: 2,098 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PWELL Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $2,354.55 KAS 06/26/07 91331 Exist: Exist: Plan Check $1,530.46 KAS 06/26/07 91331 Prop: 2 Prop: 3 State Building Code $4.50 KAS 06/26/07 91331 Total: 2 Total: 3 Potable Water Application $58.00 KAS 06/26/07 91331 Total: $3,947.51 Directions to Site: HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. HOT LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS APPLY -SEE ATTATCHED Jefferson County Building Dion Permit Nu*: BLD07-00349 Applicant: SHEFFIELD 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 ,a'I'67 Erosion Control ,) -i,.e. -7 f�.,,,, 3 f: Foundation Footing -67 MAIL,E�,nrlJ*�OO 02 w Footing DrainsC Itii, - i --0-7 i Foundation Stem Wall OBlei "A DK Underground Plumbing �� Under Floor Framing l V)3_D7 : Straps(hold downs) F/ o/oB 1 Ext. Shear Wall Nailing -,I c� I `l \-1bJ5(r oiol 2-(ct- 5(A _ Rough-in Plumbing .l•kC( c,C 4 Framing F .1-, i u ? 'Koor: 1.)ti,1.N. (�i it. q,t Do , Blocking 2- - 1 o 0 Airseal Zr--- 655' C .c Insulation:Walls Ole-� 8 Al' Okleco�doi Jp 1Au D PT M .S'theses, Floors c 7i -l�1 Insulation: Ceiling SO-4`164( j--,L I / Int. Shear Wall Nailing No0-A o1`r SV�C viAt- S `f-Vc_ Wallboard Nailing ( , J Gas Line: Interior Gas Line: Exterior '/ A )74(___ Propane Tank Heat/Chimney Clearance S z, s #it O Drywell/Alt Drainage Ll Z40? 0 — Address Posted LI/ /* ` C. 2/q, w t, Farad hire. s 1,s isc24 `I 1 K 1 vt � Frist4,rnrt Gag-MA—• 4 13/off FINAL INSPECTION 3` „Qq. ,{�'� FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD07-00349 1.) PRIOR TO OCCUPANCY& BUILDING FINAL INSPECTION -- FINAL APPROVAL OF SEPTIC SEP07-154 IS REQUIRED. MUST COMPLY WITH ALL PERMIT CONDITIONS, STATE AND LOCAL CODE. 2.) 10' SEPARATION REQUIRED BETWEEN A WATER LINE AND ALL PORTIONS OF THE ONSITE SEWAGE SYSTEM; EFFLUENT TRANSPORT LINE, TANKS, TREATMENT AND DISPOSAL COMPONENTS. 3.) MUST COLLECT AND DIVERT ALL SOURCES OF DRAINAGE AWAY FROM SEPTIC TANK, RESERVE & DRAINFIELD. 4.) PRIOR TO BUILDING FINAL AN EVALUATION OF THE EXISTING SYSTEM, (.9( p1�yr- An I in SEP04-278, MUST BE COMPLETED AND SUBMITTED TO JCPH. t 1o\tal �-o`6© 5.) The application was reviewed by the Jefferson County Department of Community Development staff on July 20, 2007 for the potential presence of Environmentally Sensitive Areas (ESAs) under the provisions of the Unified Development Code (UDC). After an initial Geographic Information Systems mapping review and an investigative site inspection, the following ESAs were confirmed to be present on the subject property: Category III Wetlands, Special Aquifer Recharge Protection Area, Coastal and At Risk Seawater Intrusion Protrection Zones (SIPZ). 6.) Environmentally Sensitive Wetland Delineation and Classification Report was submitted in conjunction with the application to address the wetland. 7.) 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. 8.) 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. 9.) Wetland 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. 10.) 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 (Salix lasiandra), and Scouler's Willow (Salix 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). 11.) Marine shorelines and islands susceptible to a condition that is known asSwater 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. 12.) The parcel is located within a coastal SIPZ (seawater intrusion protection zone) according to the County GIS map. There are voluntary and mandatory measures identified in the Jefferson County Seawater Intrusion Policy(Resolution 44-22, effective September 23, 2002) that apply to well drilling proposals and building permit applications on existing lots of record. A Coastal SIPZ is defined as: all islands and area within one-quarter mile of marine shoreline, but no history of chloride concentration above 100 mg/L in groundwater sources within 1000 feet. 13.) The parcel is located within an At Risk SIPZ (seawater intrusion protection zone) according to the County GIS map. There are voluntary and mandatory measures identified in the Jefferson County Seawater Intrusion Policy (Resolution 44-22, effective September 23, 2002) that apply to well drilling proposals and building permit applications on existing lots of record. An At Risk SIPZ is defined as: areas within 1,000 feet of a groundwater source with a history of chloride analyses between 100 mg/L and 200 mg/L (milligrams per liter). 14.) A setback of 50-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. 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 contain the following statement: "Wetland & Buffer- Do Not Remove or Alter Existing Vegetation." 16.) A permanent physical separation along the upland boundary of the wetland 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. 17.) 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. 18.) 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. 19.) VOLUNTARY MEASURES OF •STAL &AT RISK SIPZ: • Water conservation measures: 1. Roof and other intercepted precipitation shall be routed to on-site detention ponds and/or other approved means and allowed to be released to the soil slowly. 2. Water collected from Storm water and roof catchments may be used for watering lawns and gardens. Unless catchment water has been treated to meet drinking water standards, there shall be no cross connections allowed between the potable supply and impounded water. 3. Water withdrawn from wells on each property shall not be used for watering of lawns and/or gardens. 4. Ground water withdrawn from each property shall be restricted to a rate of three (3) gallons per minute. 5. Installation of water conserving fixtures such as low flow toilets, faucets and shower restrictors and other water saving plumbing fixtures. 6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation). Please NOTE that the above listed measures are not intended to be exhaustive, but rather is intended to be illustrative of the types of water conservation measures. 20.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: 1. Installation of a flow meter. 2. On-going well monitoring for chloride concentration. 3. Submittal of monitoring data to County. 21.) MANDATORY MEASURES FOR COASTAL SIPZ: 1. For proof of potable water on a building permit application, applicant must utilize DOH-approved public water system if available. 2. If public water is unavailable, a qualifying alternative system may be used as proof of potable water or an individual well may be used as proof of potable water subject to the following requirement: a. Chloride concentration of a laboratory-certified well water sample submitted with building permit application. 3. If public water is unavailable, a qualifying alternative system may be used as proof of potable water. 22.) MANDATORY MEASURES FOR AN AT 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. Chloride concentration of a laboratory-certified well water sample submitted with building permit application. 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. 23.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 24.) A flow meter shall be installed prior to final sign off of the building permit. 25.) 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. 26.) The applicant is proposing to create or add 7112 square feet of impervious surface and 9862 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. 27.) A Stormwater Slte Plan for a me n project has been submitted and approvy 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. 28.) 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). 29.) The site plan as submitted with the building permit application on June 26, 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 July 20, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 30.) 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. 31.) The parcel has been designated as Rural Residential 1:5 under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. 32.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 33.) 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. 34.) A minimum of four(4) on-site parking spaces shall be provided for the single family residence and the accessory dwelling unit. 35.) The building height is not to exceed 35 feet. 36.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 37.) 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. 38.) Minimum setback from Flagler Rd right-of-way is 30 ft. Minimum setback from the edge of the 60-ft wide ingress, egress and utilities easement is 20 ft. Minimum side yard setback is 5 ft. Environmentally Sensitive Areas further impact setback. 39.) Development Review staff conducted a site visit of the parcel July 18, 2006. The road easement with road construction was constructed on wetland. The easement appears to be a old logging road to access adjacent parcel. 40.) A boundary line adjustment(SUB04-00021)was finally on January 19, 2005. A septic permit(SEP04-00278) was finaled on November 7, 2005 for a system of 360 gpd. A Site Plan Approval Advance Determination (SPAAD)was issued on November 13, 2006. 41.) The site is accessed via a private easement from Garden Club Rd. A road approach permit (RAP02-00221) was finaled on October 17, 2002. An address of 307 Garden Club Rd has been assigned to the parcel. itiT _ • ,f #1 )) 4w' fa` co � JEFFERSON COUNTY f ' ; - DEPARTMENT OF COMMUNITY DEVELOPMENT JU�� 6 df .-, `'4 621 Sheridan Street• Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax �q S, p www.co.jefferson.wa.us/commdevelopment j )$' [t 'I OND 011,1) Master Permit Application MLA: 1 C' -C) Project Description(include separate sheets as necess ): N�hl 'PlvP T IZE ((7el4GE ( t3EpRooM) A v ('M A E Tax Parcel -Z 4 D 43 0 0 Property 5 Number: Size: (acres/ a* Site Address and/or Directions to Prnnarty: . 64/14gr2 fELLEAKbPsD NO Kt2 ,ADNtPt WA of 83 5ej Property Owner(s)of Record: 'VD 0& AN P 9 5(E 5 tE FFl ELO Telephone: 206 ' 902• IT 1' Fax: — email:G1She.X-Ff e.[cte loyths4A.'r" Mailing Address: 3.033 'N /tAr • WVST t SE1kT T L I W Jk q g l 91 neuro.corn Applicant/Agent(if different from owner): R(Grt/'C.[z,P i3tR(J Telephone: 3 6 D• 371• .13690 Fax: email: Y(chard,@ rl ehet-rd t✓j Mailing Address: 7111 TAIL-OR ??iT To W Ns v , �A q S 36S Arch( C.ks.COM What kind of Permit?(Check each box that applies Building , '.'/ ❑Variance(Minor, Major or Reasonable Economic Use) 1' ❑ Demolition Permit A -ZLC-1R• ❑ Conditional Use[C(a),C(d),or C]** NI Single Family j"Garage Attached/hoed C] Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular El Special Use(Essential Public Facilities)** ❑ Commercial* C] Boundary Line Adjustment ❑ Change of Use ❑ Short Plat** El Address 0 Road Approach 0 Binding Site Plan** ❑ Home Business 0 Cottagelndustry ❑ Long Plat*' Propane ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑Sign C] Plat Vacation/Alteration** ❑Allowed"Yes" Use Consistency Analysis C]Shoreline Master Program Exemption/Permit Revisions** 0 Stormwater Management 0 Shoreline Management Substantial Development** ❑Site Plan Approval Advance Determination(SPAAD)* C] Shoreline Management Variance ❑Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* C]Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium ❑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: DESIGNATION OF AGENT I hereby designate J.t vi ' ` to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Ll� l Date: (.p/, /r�.-' By signing this applicati• 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 attorneys 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 an red later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the appli a'on that or he a pnor notice. /' / Signature: he 1 Date: e/1L / a� 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 7are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfresp ility r a ing to and complying with the ESA. The Applicant has read this disimgrand sigr�and dates it below. Signature: ( Date: (/( �U (/(�7 C:\Documents and Settings\caral\Local Settings\Temporary Internet Files\OLK86\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: _ Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: .161-4s V. Lvi sER Jdlo DONS OCfIONJ (3bo) 385 . 32g7 ( ) MAILING ADDRESS: P ,• ( 2073 ?. *•./WA 1 % )EMAIL: CONTRACTOR'S LICENSWAINS E NUMBER: 1 J D v CO 1 —015i NUMBER ARCHITECT/ENGINEER: fICAARD enao Ago ATEUT5 PHONE ( ) 311.Soji FAX:(NA)371. $329' MAILING ADDRESS: -TN 7'itt4 LO R 'FT. )WA 1`b 360 EMAIL Yt Gh 6-rd t V i at Ax4 tr &rthA ( S.'.d111 Project Type: l Frame Type: Bathrooms: Shoreline: Type of Sewa6e Disposal: ➢Q New D( Wood Existing: _ — t.1 Sewer Li Addition ❑ Steel Proposed: _`3 _ Bank L Community System ❑ Alteration/Remodel ❑ Concrete Total: _Y%? Hight X Individual System 01- 7 f ❑ Repair /❑ Masonry /Wit SEP Permit# O/ /,-i'- ❑ Demolition /v ❑ Other: Bedrooms: Water Supply: Type of Heat: V.. Existing: Setback: X Private well ❑ Two Party Proposed: 2 I] Public t ' -j)112 ({` , Total: 2 r�//t Name of System: If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No If this is a ro ane Tank and/or A liance Installation rmit mark below that a I : 4� . ❑Underground Tank Above groun Propane Tank: 2 12a L�slr t-. �\ ❑Heat Stove Pf Cook Stove 0 Woodstove pifFir ce Insert of Water I anK 0 Pellet Stove ❑Other Is this a liance bein installed in a Manufa red/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 3 CR I t 42 I.--, 'EH Bld App Review: 1 rQce'i 2ntl Floor Heated Consistency Review: :-% u% Other Heated 11 4-41 p,& r,1E4 A ! Base fee: -/ , j j Mezzanine z �yi� Additional Section: _____�—. Heated Basement jj 4 Plan Check fee: l' . J ,aUnheated Basement °I State Surcharge fee: " Other Unheated Pot Water Review fee: of ('l., Garage/Carport �III l SUBTOTAL 31 880 iia)3 Decks I&O 25.q Z}CC 9 d Approach fee: 1 F— .) c.t Other Z. Zc TOTAL: $ DI Coves W%kLKwAV �i ��, ., Receipt Number: c I �`J I _._---•---- Cash/Check Number: ESTIMATED COST(REQUIRED) . .t Z )ate: / ��/`1/ .Fair market value of all labor and materials fou dation to finish l.l' C:\Documents and Settings\caral\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc • • 5C)N REA'EWFj ) �" ° , JEFFERSON COUNTY i n - tl DEPARTMENT OF COMMUNITY DEVELOPMENT ,�,., 621 Sheridan Street • Port Townsend •Washington 98368 jEf FEH�'��VI�U�1N1 V II flIi 0 360/379-4450 • 360/379-4451 Fax I)J I� �, IN_ , ' http://www.co.jefferson.wa.us/comrndevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# ffl" YOU PROJECT/APPLICANT NAME: rt EL D 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 a.. . ti qx r n M 1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the site map. Carr 1,06 cri rn t - s Site- ewe, , �e t { A u f -h,ud Hopi y `-iid� a Vine It t, at a-- Rao, �i! n Q �,p� 8V1 ES B tLII DD``// � cT` Existing Conditions ummary � vY 2. I- cribe the existing topography. Indicate contours n the she map. '� o I Ahla r 1 lo W&M- I town 4-0 I ' 3. tscribe i e e 'sting ve.etation. Indic. e native ve'etatio. areas o the site map. lam, / 1!A . .1..A / if • I 11 �6 d AP. �J ,� M I/1 ' `j��/ /4./ rillAi1 .'?^_'SIii./i #J.!IV; • l 4. Describe the existing soils. Indica a soil pe on the site ap. �t V t t. I,OA a I/ �'1 t O Ng-, V 'I1h�i 5 ti/f `�m, C-- 2 t E P�r� d- 1,u, 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 ap lic le,and indicate acreage Q each._ 0 5 �t u� o . APPROVED STORMWATER PL 6. Describe any excess levels of noise generated by the proposed use or activity: Ike' 2D al I I - JEFFERSON Cps j 4- Se �,'tt-t,.. -� 0-es i) ' 1 Y1: Y�^G� DEFT 1 .a1MUN µ r i i SIGNATUR Y � !1 Y Rv r -F,T 0iSpe✓ , 1(.e.pi ct P S c ------_.,.._._ stormwater site plan template-rev.10'1/2003 5 III • 7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, steep slopes, e the tsiit�e.. Indicate( location �o�n0the site map.J y�� .Ln\ VV C� l wd (7 r l, (o 1�Vrt-tJ� t Q t r^uribreA7611/2- Iola 8. Describe the general vicinity of the site, including adjacent land uses and structures, utilities, roads, and sensitive/critical areas treams,wetlands,lak s,steep slopes,etc.) uw� Gurdik ON ` . ° -11A A'rnd e t � t i tam► utd �r 6i wV ` ` 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. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. 1 os-oil eiftg, _ck Cm uo 011 tvi t( KA st f`Cam, e wider/AmMil/NIA- tillunr v will Io& ct teJed a,l 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 f large"projects or projects that involve the potential for dispersion of contaminants.] h7A 11. Describe the erf rmanc goals and standards applicable to th project. -lb t r G�CsfeAre, R eck rOd Qwf�� c ivil/4 w a ri dq- Ov' ' & . 12. Describe the flow control system. -Tr U roo-f CO tW,4-vvt {-o b w0,(pkAA rff 01-404-001 • REATAVIA,i11 ) J N 2 6 :..`;:,7 IEFFEN10 11[Mlirl' stormwater site plan template—rev.10/1/2003 6 • • 0 13. Describe the wat quality system. vii 14. Describe the co veyance system analysis and design. t/ a 15. Describe the source of fill materia physical characteristic of fill mate ial,and deposition of excess material. r M� I physical &y. ra NA)1 4. wc`f .. car w s or- 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform B ilding Code -' it ')11 1 196 4initAtte>teel tO 10 70 lY 1 VUW Wt JOWt Hil (Ac(V lie i qi 7 U 13G 33t 3. 17. Describe the proposed urfacing material. CN(U� aa 3/1-u 18. Describe methods for restoration of �Igite.All VI f Ail t� i �1 6r• It ,�p�- .X 1`• Pit` 644 1 Asturbe spa cfu In 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. q CL-- 20. List here and include any special reportseppo or studies conducted to rep re the Stormwater Site Plan. fit✓ cn^, ,,'l �i� �D S 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. Co ) 046 ank4 / lilletkitl ?eAquiii (.1d(. Co. L rerui t(J2 sim CO. ) \F,4&\1_41\kiyii ) stormwater site plan template—rev.10/1/2003 IN`'PAUPOD 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 C aring Limits. CAY) j Val( be- mcvike,d w rhn s-a as Ltd ' .rvatitors . 2. EstaViish Construction Access. ) OUP U Q-CG°L5s Wt I( be- V l G� xt Y ev . 3. Control Flow mil'l�Ow Rates. ml �d 1(i �( ,a444) �W%Y,CIAN, 6W CbU 1 t Wl ' t(Qtffi1Y1 • 4. Install ediment Controls. �Ti- i 61rl DWI J(l trr rO U tvU►1 5. Stabilize Soils. e ave n \S �n (Nor-e/vi-/ Uvlepc� l vv6 6. Protect Slopes. kfC '4t 2 ti0 ' ,^^ 1 V� � Cf(�G • 7. Protect Drain Inlets. I it) 2 6 ' ; 7 IEff��SU�►�UU�I�V�1r�� stormwater site plan template—rev.10/1/2003 8 • I 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Chan els and Out 1UVI O t : 0S FD is We r 9. Control Poll ants. 10. Contr I e-W tering(the ct of pumpin groundwater r st w er away from an activ construction site). 11. Maintai Best Management Practices(BMPs). tini.%w riYe7 (— icy . 12. Manage t e Protect. fri � rwl a#O►' s "OF `iGki2 LAJW be_, 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). g e O Cud(fidt) &hi__ 55DI • b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). .)11.t Otge (S-rdr fa-10C etAA9-. 3. Environmentally Sensitive Areas. a. Description pf ryt Afert�eyn,,vironmenta sensitive are/a4 that are on or adjacent tot e site. lF(,ER� b_ R � C3 EfffI�blln .�IIIIIIIdaIi:i stormwater site plan template—rev.10/12003 9 . • b. Descri ofecjslreme trt s for rking ir ,npar Zonme tally se sitive areas. �1�;11J-- Y1U ���>�� 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils(e.g.,erodi TIit�y,settleability,permeability,depth,texture,soil structure). 5. Construction Phasing. a. Constpuction sequencecw.A ten ^ -v t( FAA O it ' b. Construction phasing(if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. tovi proposed gons ruction Ehedule. 4 i r rl,^ ^4G�b II. Wet Season Construction Activities. a. Propose wets aso0 construction activitieVA .,�S �02, �.D�Qv b. Propose wet season construction activities for environmentally sensitive areas. 7. Financial/Ownership Responsibilities. a. Identify the property ow er r ib,le for the ini ia,tio belds,and/or other financial securities. bV rkt ply! b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. I^ MA 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the followin ,if applicable. a. Sediment Ponds/Traps. l v(� Q �q��`� VIII) b. Diversions. W ) 1 J' c. Waterways. d. Runoff/Stormwater Detention Calculations E 9*, 2 273 lEfffliSONCMIIN10,11 stormwater site plan template—rev.10/1/2003 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 owner of the affected property. 61� �� (LANDOWNER OR AUTHORIZ D REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: a Ervi60 4T 2G2 7 Eff1tI (JI\:oUNIYOCD stormwater site plan template—rev.10/1/2003 12 oer - -4--T . - . - r-rn cN �f -sue (P -0 Z -U �p � O � iN� I c c:, � � 1�1 rri � III O � � ni ! -c > rnd 70 Cp 0 rn /4 > _ a CI , rn n I II N _Et TT r _I --acr n o d n l it zu) z - .. OZ /• iv? . ig N. . I N ;4 _ _ cr I � r Ns N aNN' v 41, 0;1> v s a� kit O ril I a ,Q0(1) O I \ I IE I rc di Z tv 1 I. i 3. • I , = 11 III ti. 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