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HomeMy WebLinkAboutBLD2007-00476 • DEMOLITION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD07-00476 Received Date 8/28/2007 SITE ADDRESS: 111 LINDSEY LN Issue Date 10/16/2007 PORT TOWNSEND, 98368 APPLICANT: RJ ERMINTHALER PHONE: 360-385-3942 SALLY LOVELL 2023 E SIMS WAY#224 PORT TOWNSEND WA 983686905 3 SUBDIVISION: LINDSEY SHORT PLAT Block: Lot: PARCEL NUMBER: 001074016 Section: 7 Township: 30N Range: 01W CONTRACTOR: KOZELISKY'S HOME SERVICE INC PHONE: 360-385-3215 1112 S JACOB MILLER RD PORT TOWNSEND WA 98368 Contractor's License KOZELHS027C3 Expires 1/6/2009 OWNER, RJ ERMINTHALER PHONE: 360-385-3942 if different: SALLY LOVELL 2023 E SIMS WAY#224 PORT TOWNSEND WA 983686905 PROJECT DESCRIPTION: DEMO EXISTING M/H Directions SEE DIRECTIONS& MAP IN FILE To Site: THIS PERMIT IS VALID FOR ONE YEAR AND IS NOT RENEWABLE. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 10/16/2008. REQUIRED INSPECTION: FinalApproval: 2. `Jt 11 CA BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. SPECIAL CONDITIONS APPLY - SEE REVERSE HOT LINE AVAILABLE 24 HOURS A DAY •UILDING PERMIT APPLICA fiDN MLA O-004495 iew Type:i Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00476 Received Date: 8/28/2007 SITE ADDRESS: 111 LINDSEY LN PORT TOWNSEND, 98368 OWNER: RJ ERMINTHALER PHONE: 360-385-3942 SALLY LOVELL 2023 E SIMS WAY#224 PORT TOWNSEND WA 983686905 LINDSEY SHORT PLAT SUBDIVISION: Block: Lot: 3 PARCEL NUMBER: 001074016 Section: 7 Township: 30 N Range: 01 W CONTRACTOR: KOZELISKY'S HOME SERVICE INC PHONE: 360-385-3215 1112 S JACOB MILLER RD PORT TOWNSEND WA 98368 Contractor's License KOZELHS027C3 Expires 1/6/2009 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP DEMO EXISTING M/H TYPE OF WORK MOB SQUARE FOOTAGE: TYPE OF IMP DEM MAIN: VALUATION ADD'L: HEAT TYPE: CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: 1 Exist: 2 Prop: 0 Prop: 0 Total: 0 Total: 0 Routing Date: ''— a2.310(-7 Type Amoun al Bv: Date: Receipt: Approved/Date Permit $51.00 LYK 08/28/07 93031 APPROVED State Building Code $4.50 LYK 08/28/07 93031 Total: $55.50 OCT '(p au Jefferson County Planning & Building Department • • SPECIAL CONDITIONS FOR CASE#BLD07-00476: • 1.) No plumbing has been reviewed or approved for this project by Jefferson County Public Health. Additional requirements may apply if plumbing is proposed. 2.) The application was reviewed by the Jefferson County Department of Community Development staff on October 15, 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: Susceptible Aquifer Recharge Protection Area. 3.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological formations that allow percolation of the surface water into the soils and the underlying zone of saturation. Aquifers are geologic formations that contain sufficient saturated permeable material to yield significant quantities of water to wells and springs. Aquifers serve as the source of drinking water within most of the rural portions of Jefferson County. 4.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 5.) 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. 6.) The applicant is proposing to create or add 1,200 square feet of impervious surface and 1,500 square feet of land disturbing activities. JCC 18.30.060 and 18.30.070 require your proposal comply with Minimum Requirement#2 (Construction Stormwater Pollution Prevention) of the Department of Ecology Stormwater Management Manual for Western Washington to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 7.) 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. 8.) Jefferson County determined that this proposal is categorically exempt from review under the State Environmental Policy Act (SEPA) pursuant to WAC 197-11-800(1)(b)(i). 9.) The site plan as submitted with the Building Permit application on August 28, 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 October 15, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 10.) This approval is for a Demolition of an existing Manufactured Home only. Any future permits on this site are subject to review for consistency with applicable codes and ordinances and does not preclude review and conditions which may be placed on future permits. 11.) The parcel has been designated as Rural Residential 1:10 under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. 12.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 13.) Not more than 2 unlicensed 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. 14.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 15.) The building height is not to exceed 35 feet. • • 16.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 17.) Lindsey Lane (P190) is a private local access road. An address of 111 Lindsey Lane has been assigned to the parcel. 18.) An asbestos survey was completed for ORCAA by Alan Olson with Now Environmental Services, Inc. 19.) Building Setback from Lindsey Lane right-of-way is no less than 20 ft., side and rear setbacks are no less than 5 ft. If an environmentally sensitive area (ESA) is present, then the more restrictive setback shall apply. I:\F_BLD_Permit_Propane.rpt 10/29/19 1 : 7. • ' I : 1 • • • I i • ' : i ,,S. -' r• , • . i• • ' 4 : ; rff'• i . . -I- 7 ' : ::::- --4-- -t f,----} -t- : - t- : • ! -4 7- 7, 7- : • f. -; - -7 -r -.7 -7 ' 4- , ; - 4 i L l•- - -7. i f • i .7. ' : ; i 7.- : ; . r . ! : 7 ! i ! , : , , : • t ' • '; 0 -)f-1 • 7 --:- "-^' - . 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'"r'� NOT APPROVED ()RCM _ FOR COMPLIANCE WITH % ORCAA / BY: EGU,t,Kiru�l/5 #4,.., fRfiRSdN•M AS ,r_ Notification of Demolition Permit SEP 2 $ an17 It is unlawful for any person to cause or allow the demolition (or major renovation) of any structure unless all asbestos- containing materials have been removed from the area to be demolished. Work shall not commence eat ad asbestos project or demolition unless the owner or operator has obtained written approval from ORCAA. A written application for a demolition shall include a certification that there is no known asbestos-containing material remaining in the area of the structure. Project Site Address: 1`k L r45e .1L te\e- County: Te-R-rf, ^, City: P©i-T IownsQ,lp( State: GO A- Zin: RR 3 G' Starting Date: 1-�o felu.(l _�e,)t ((_, 2L)07 Completion Date: I *(There is a 10 working day advance notification period from receipt of permit application) Property Owner: CoM,6 (-')v'e-(( Telephone: 360-3R$-361 14 2 Fax: Mailing Address: .20a_3 EE SIivts Way 4.22Lf City: Pore Taw AsevtcQ State: WA Zip:9836S Demolition Contractor: t<ozetisiCy'S tibme Senn ce_Inc- State License#: Kozel_ h S 0 27 C 3 Mailing Address: [k 1'2- s, Taco(o Ati l le- d • City: Po r-t Townsera State: W -- Zip:9g%8 Contact Person: T imi e bY. TO S II Telephone: 3 60-385- 3 21.5 Fax: 360-385 32_15 YES NO Demolition by Wrecking or Dismantling? ($25.00 fee)check# %7 X. Training Fire Demolition? (If yes,attach fire department request for training fire) v Reno-v-ation, Alteration, Remodeling, Maintenance, or other Construction? Asbestos found or suspected* *An ORCAA"Notice of Intent to Remove or Encapsulate Asbestos"form,9nd appropriate fee must be submitted prior to any asbestos removal work. Asbestos removal projects involving demolition must be preformed by a Certified Asbestos Contractor and all friable or potentially friable asbestos must be removed before any demolition begins. Refer to ORCAA Regulation 1 Article 14 for additional requirements that may apply. Asbestos Survey Completed by AHERA Certified Inspector /(ar OlSoh /Voti Fnv\aronmet-tr` . .Qrvit.e5IvtC, Certification#. ASS -N E S- 0-7- C)(B This approved permit must Enclose$25 Certification of the Asbestos Survey must be available at the job site Processing Fee accompany this form iiiP A I 'I B Limited Lane NW,Olympia,Washington 98502 0 ;(1---- �,\! t('/Itl ia 86-1044 * 800422-5623 * fax 360491-6308 a p epage:www.orcaa.org * email: info(cdorcaa.org IekO / /OZ l/— J DATE______�' . IliA 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 R: PHONE: FAX: Ju;rn'Z KO Ze:Ci SKL (3 0)3g5- 3215 ( ) MAILING ADDRESS: 1 (( -2- 5, 3-acdbmi tie rg 1 �� EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: WA-INS O62 NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: i ❑ Sewer ❑ Addition ❑ Steel Proposed: :ank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: ',eight: K Individual System ❑ Repair ❑ Masonry SEP Permit# X Demolition g Other: Bedrooms: Water Supply: 'I Qt.(le,f- Existing: 2- Se •:ck: IX Private well II Two Party Type of Heat: Proposed: ❑ Public Total: Name of System: If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: Proposed:_ Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: i Underground Tank i Above ground Tank Size of Propane Tank: i Heat Stove i Cook Stove i Woodstove i Fireplace Insert i Hot Water Tank i Pellet Stove i Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines, tank location and size,distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. Square Footage Current Proposed For.Office Us .:..6. r :,• r.!Wt .;.. , evrstoj,, ,,„,4 Main Floor Heated EH Bld App Review: IV 2nd Floor Heated Consistency Review: 1O 1.0/ .711 Other Heated Base fee: `JAI .. Mezzanine 4. .. Additional Section: Heated Basement Plan Check fee: Unheated Basement i State Surcharge fee: r•-1' Other Unheated - Pot Water Review fee: I n Garage/Carport SUBTOTAL F-J -(._--.; ap Decks 911/Rd Approach fee: _ Other ( 3 0a) TOTAL: $ e-i .x Receipt Number: Ci i Cash/Check Number: y . C j23 ESTIMATED COST(REQUIRED) Date: •Fair market value of all labor and materials foundation to finish 28\07 Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc k�� � +. 06 JEEFER O•OUNTY • DEPARTMENT OF COMMUNITY DEVELOPMENT, v `� 621 Sheridan Street • Port Townsd JIsshingtorr 98361 360/379-4450 • 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopa `347NO 2 8 2007 Master Permit Application t��} ' MLA: 0a'7'' -1 Project Description(include separate sheets as necessary): JE•FtRSUN COUNTY i OCI�`' ne4m � t c-rt C c� U I C� ' 'L t r Tax Parcel /( Property Number: 001 Q 744 C ( (o. Size: 3 et-r e S (acres/square feet) Site Address and/or Directions to Property: ( ( L,+lass L<t ne, c s t Se me Property Owner(s)of Record: So t it V?1c l rii valitak-F r Telephone: `3 5--361 t-(2 �1 Fax: email: Mailing Address: A -3 E. SIrr'S irv/t'/ 11-2214 ?err 'Tdc4h5evit; w4 q83 i Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑Building 0 Variance(Minor, Major or Reasonable Economic Use) vit Demolition Permit ❑ Conditional Use[C(a), C(d),or C]'" ❑ Single Family ❑ Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment ❑ Change of Use ❑Short Plat** ❑ Address ❑ Road Approach ❑ Binding Site Plan** ❑ Home Business 0 Cottagelndustry 0 Long Plat** ❑ Propane ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑ Sign ❑ Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management 0 Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance ❑ Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium ❑ 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 a%nit Ql Ic b'' ii.SK.`'1 to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE 1 A[ra Date: jI 3 10 7 By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his, her or it's knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the applic ' nithat to ors _a'nt,, rior notice. Signature: �'LI[I/ Date: �`/13167 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 in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable espo ibility adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: 1 =)(6i1 Date: 41 l G.\PermitCenter\###FC)RMC###\Tian FCIRMC\ 10.in onni a....