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HomeMy WebLinkAboutBLD2007-00497 CERTIFICATE OF OCCUPANCY Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 (800) 831-2678 PERMIT #: BLD07-00497 SITE ADDRESS: 1342 E MARROWSTONE RD Issue Date: 11/8/2007 NORDLAND, 98358 Final Date: 9/15/2008 APPLICANT: MELVIN H LAKE TRUSTEE PHONE: KAREN J LAKE TRUSTEE 12665 SE 240TH ST KENT WA 98031-5034 SUBDIVISION: OLSON & HAMBLETON'S Block: Lot: PARCEL NUMBER: 977700062 Section: 4 Township: 29 N Range: 01 E PROJECT DESCRIPTION: ADDITION, REMODEL AND RESTORATION ALSO A/G 200 GAL PROPANE TANK THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2006 EDITION. OCCUPANCY GROUP: TYPE OF CONSTRUCTION: SPRINKLER SYSTEM yes no] THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 9/15/2008 I:\F_BLD_Occupancy.rpt 10/29/19 Ii ILDING PERMIT APPLICATIN MLA07-00523 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00497 Received Date: 9/6/2007 SITE ADDRESS: 1342 E MARROWSTONE RD NORDLAND, 98358 OWNER: MELVIN H LAKE TRUSTEE PHONE: KAREN J LAKE TRUSTEE 12665 SE 240TH ST KENT WA 98031-5034 OLSON & HAMBLETON'S SUBDIVISION: Block: Lot: TR38- PARCEL NUMBER: 977700062 Section: 4 Township: 29 N Range: 01 E CONTRACTOR: ?C••\.YC\CI t 5z 6Ckt 3ICj ' COY13\ PHONE: (360)(137- 13 -{LI c)1--kc3 cY�ImCq:�,mw� rr`63aa5 Contractor's License NORDLCN953NT Expires 8/30/2009 REPRESENTATIVE: HENRY M SOUZA PHONE: (360) 379-8338 DESIGNS BY SOUZA INC (360) 379-9136 164 SWANSON PROJECT DESCRIPTIOF ADDITION, REMODEL AND RESTORATION ALSO A/G 200 GAL PROPANE TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: 198 VALUATION 229,000.00 ADD'L: HEAT TYPE: CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: 86 SETBACK: 227 BANK HEIGHT: 100 SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: 2 Exist: 3 Prop: 0 Prop: 0 Total: 2 Total: 3 Routing Date: Ulirlir7 Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,716.15 KAS 09/06/07 93139 APPROVED Plan Check $1,115.50 KAS 09/06/07 93139 State Building Code $4.50 KAS 09/06/07 93139 NOVD 2007 Potable Water Application $63.00 KAS 09/06/07 93139 Total: $2,899.15 Jefferson County Planning & Building Department Jefferson County Building Divan Permit Numb.BLD07-00497 Applicant: LAKE TRUSTEE BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2006 International Building Codes To schedule inspections,call (360)379-4455 no later than 7:00 AM the day of the inspection. Requests received after 7:00 AM will not be scheduled for that day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Setbacks Erosion Control Foundation Footing //,G/Gg 6/e/eee Q// '011 Footing Drains 0/A Foundation Stem Wall //Z=/Ug gri Underground Plumbing Under Floor Framing //54018 Straps(hold downs) / 3�I o& Al &fl`"14e64— LEtl -R_£EDd ROD FRL?M Ekit e# 3 Pot.o Dowtsc 310-1 / Ext. Shear Wall Nailing 3/J0/0$ pry Rough in Plumbing 3/3f/ob /ZL OK Framing Blocking 3/3/b De_ Airseal �� Oe aK Insulation: Walls y -7/06 Qk Insulation: Floors l Insulation: Ceiling C 6 /IJC�?7� Int. Shear Wall Nailing K(7:310d' r"I= Wallboard Nailing z V( Gas Line: Interior -7 204 UZ— J.jf fa P at 1k q3 — 1 (� Gas Line: Exterior 7 Lg/bt ✓ �p R-L�©i Propane Tank , /` Heat/Chimney Clearance ofr ///,/► / e rif. I�'EG7 ��t1 Drywell/Alt Drainage EX/Sr Address Posted �io* FINAL INSPECTION 3 L/t 7 d ,o)e --(;)0:a-/ FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD07-00497 1.) The application was reviewed by the Jefferson County Department of Community Development staff on September 7, 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: conservancy shoreline designation; eagle; seismic; landslide hazard area 3; SARPA& SUSC aquifer recharge area; coastal SIPZ. 2.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological formations that allow percolation of the surface water into the soils and the underlying zone of saturation. Aquifers are geologic formations that contain sufficient saturated permeable material to yield significant quantities of water to wells and springs. Aquifers serve as the source of drinking water within most of the rural portions of Jefferson County. 3.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 4.) Critical Aquifer Recharge Areas are defined as Seawater Intrusion Areas, and Special Aquifer Recharge Protection Areas and the following land uses located within Susceptible Aquifer Recharge Areas (1)All Industrial Land Uses (2)All Commercial Uses (3)All Rural Residential Land Uses requiring a Discretionary Use or Conditional Use Permit(4)All Rural Residential Land Uses with nonconforming uses that would otherwise require a Discretionary Use or Conditional Use Permit(5) Unsewered Planned Rural Residential Developments (6) Unsewered residential development with gross densities greater than one unit per acre. All of the above listed uses shall be subject to the applicable requirements and standards of the Jefferson County Unified Development Code. 5.) 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. 6.) 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. 7.) 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. 8.) A vegetative buffer of 30-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. 9.) 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. 10.) Prior to and during approved consOion activities, the perimeter of the landslicipazard 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." 11.) All construction activities shall not encroach upon the landslide hazard area buffer. This includes the storage or preparation of materials. 12.) 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. 13.) 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. 14.) 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. 15.) The applicant shall fully adhere to all conditions and requirements of the eagle habitat management plan signed by WDFW on May 4, 2007 and the landowner on May 11, 2007. 16.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 17.) The applicant is proposing to create or add 210 square feet of impervious surface and 200 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.) 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. 19.) 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. 20.) 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). 21.) The site plan as submitted with the building permit application on September 6, 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 November 8, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 22.) The parcel has been designated as RR 1:5 under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. 23.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 24.) Not more than 2 unlicensed vehicliOnall be stored on any lot unless totally scrod 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. 25.) The building height is not to exceed 35 feet. 26.) 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. 27.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 28.) 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. 29.) 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. 30.) Minimum setback from East Marrowstone Road right-of-way and any ingress/egress easement rights-of-ways shall be 20 feet. Minimum side yard setbacks shall be 5 feet. Minimum setback from the top of the shoreline bank is 118 feet as depicted submitted site plan. Development is occurring 210 feet landward of the ordinary high water mark. 31.) An address of 1342 East Marrowstone Road, Nordland has been assigned to the parcel. East Marrowstone Road is a county local access (C593909). The parcel actual access is via a private easement off of East Marrowstone Road. 32.) The parcel was created through the Olson & Hambleton's Addition Subdivision on December 12, 1906. No AFN available. 33.) A septic permit(SEP91-0549) was finaled on July 25, 1991 and is now filed with SEP07-0122 that was approved on May 3, 2007. A building permit (BLD91-0295) for storm damage repair was finaled on May 28, 1991. 34.) Potable was is provided via private well and established at time of single family residence in 1938 as identified in the Jefferson County Assessor's records. • • IM � g JEFFERSON COUNTY SEP - 6 2O ? ti y '..4 DEPARTMENT OF COMMUNITY DEVELOPMENT 6360/37921 Sheridan-4450 Street360/379-4451 w Fax 3 iV • Port Tonsend • Washington 98368 JEFFEHSON COUNTY 0CD . $INO http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# 0 1 - 5a. PROJECT/APPLICANT NAME: Lthicy 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. tit s T'Gi e-©N of T10 S o�' .ITS j s LAi ) f. SC t.i25, P b-fl - 14)14 r1_ O o Lor✓i,s+l i3 s in vt t1 4- ( f m- t illr Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. SL't.) ixe--007D Tye erz44,tiL 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. 4. Describe the existing soils. Indicate soil type on the site map. C 0 S Vi Z-e141hi 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 si:e map. Depict separate drainage basins on the site map, if applicable, and indicate acreage of each. CPS A4m 1 aLac - fv r 6. Describe any excess levels of noise generated by the proposed use or acivity: APPROVED L; ✓ L- GGNS�itr�i7/a�J f AkAla. ' ' kl(4fl&MWATER PLAN NOV - 82007 Stormw• stortnwatersiteplantemplate.doc—rev.10/12/2003e AisN JEFFERS O NT s Require. dtkifil.•. .• DEPT.Of D: F.L P SIGNATUR : • • 7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, steep slopes, etc.)on the site. Indicate location on the site map, 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.). '&6 ga- 0 Ow o r"'i- emo I- 0-24.-- RR/1144.4—rieF'opezr 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 verity that the thresholds for treatment facilities and flow control facilities are not exceeded. g. Describe the developed site hydrology, as proposed. Indicate whether stormwater will be fully dispersed (i.e., per BMP T5.30 in the Manual)or, if not, what types of stormwater flow control will be utilized for the site or specific threshold discharge areas within the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. £ JT'4 /1-DUr - kn L /S .I ' T '/u) 51 . /// IM 10. If the project requires the use of stormwater treatment facilities, describe the types of stormwater treatment facilities proposed for use on the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. [This is normally for"large"projects or projects that involve the potential for dispersion of contaminants.] OF 11. Describe the performance goals and standards applicable to the project. Mic 12. Describe the flow control system. to' � 'tom ate 1"7I SEP - 6 2007 4 = D stormwater site plan template.doc—rev.10/12/2003 6 • 13. Describe the water quality system•. 14. Describe the conveyance system analysis and design. P14- 15. Describe the source of fill material, physical characteristics of fill material, and deposition of excess material. 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. 17. Describe the proposed surfacing material. 18. Describe methods for restoration of the site. 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. 1 / 4 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. ilk 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. SEP - 6 2P07 d Cb stormwater site plan template.doc—rev.10/12/2003 d t ,.libW Ty UU+ 'v �i p�y\1 �j D 7 c�. • • CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN(SWPPP) The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the template that follows must be installed on the ground during all construction phases of the project. The proponent is responsible for preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential development. SECTION I—CONSTRUCTION SWPPP NARRATIVE 1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or will be addressed. Identify the type and location of BMPs used to satisfy the required element. If an element is not applicable to the proposal,justify in writing. Descriptions of the 12 Elements are found at section 2.5.2 of the Manual(beginning on page 2-15). 12 Required Elements—Construction SWPPP 1. Mark Clearing Limits. 001 Bap / /TX/ill I 2. Establish Construction Access. 3. Control Flow Rates. 4. Install Sediment Controls. 5. Stabilize Soils. 6. Protect Slopes. 1 ) 7. Protect Drain Inlets. SEP - 6 2007 i�T e arra� ikRt ;'iu„ �: i9Sr.1! JuLl stormwater site plan template doe—rev.10/12/2003 8 • • Construction Storm Water Pollution Prevent ����� � Best Managed Practices SEP - 6 2007 1. Mark Clearing Limits °Lk Li i, By minimizing the limits of clearing on the site, a builder can minimize storm water runoff and provide effective control of pollution. 2. Establish Construction Access Much of the sediment that leaves a construction site does soon the wheels of delivery and construction vehicles that drive off a project site. Construction access must be limited to a single location and a properly constructed Stabilized Construction Entrance (BMP C105)should be included on the site. 3. Control Flow Rates Storm water that leaves a project site unimpeded may exceed the capacity of the existing storm water control facilities downstream and may contain sediment that may be deposited as the velocity of the runoff decreases. Storm water protection on a construction site should include measures to control the flow rate of runoff from the site. This can be done by installing a Sediment Trap(BMP C240)or other measure that will impede the flow of water off a construction site. 4. Install Sediment Controls In addition to limiting the rate of storm water flow off a construction site, measures should be put in place to treat the runoff and remove sediment. Limiting of the cleared area (Element 1)will assist in this effort, but there will be exposed soils that may move with the runoff. Suggested BMPs for controlling sediment include Straw Bale Barriers (BMPC230), Brush Barrier(BMP C231), Gravel Filter Berm (BMP C232), and Silt Fence (BMP C233). Installation of a Sediment Trap (Element 3) is an additional sediment control feature. 5. Stabilize Soils An additional measure that can minimize sediment transport in runoff is to stabilize soils on the site with mulch or some other covering. This will limit the amount of soil that is exposed to rainfall, thus limiting the sediment that could potentially leave the site. BMPs that could be used for this include Mulching (BMP C121), Nets and Blankets (BMP C122), and Plastic Covering (BMP C123). During periods of dry weather dust can become a problem and sediment could be transported from the site in high winds. BMP C140 Dust Control should be followed to limit loss of soils in windy conditions. 6. Protect Slopes If the cleared area includes slopes of 3:1 (Horizontal: Vertical) or steeper, the slopes should be protected to limit runoff. If the slopes are not protected, rills and gullies may form, transporting sediment to the lower elevations and potentially off the construction site. The slopes should be graded to minimize erosion and runoff at the downstream end of the slopes, and runoff should be collected and treated. The following BMPs could be used Surface Roughening (BMP C130), Interceptor Dike and Swale (BMP C200), and Pipe Slope Drains (BMP C204). 7. Protect Drain Inlets Runoff from urban construction sites often discharges into existing storm water collection systems.Water enters the collection system through drain inlets. If there are drain inlets downstream of a construction site, they should be protected using BMP C220 Storm Drain Inlet Protection. • • 8. Stabilize Channels and Outlets Any temporary on-site channels or ditches that are used to control runoff should be stabilized to prevent erosion in the channel. BMP C202 Channel Lining and BMP C209 Outlet Protection should be used. 9. Control Pollutants The best way to control pollution is to limit the source of pollution. Construction debris should be maintained in a safe location. Vehicle maintenance on the construction site should be minimized and any spill should be promptly cleaned up. Concrete spillage should be kept to a minimum and cleaning of the concrete trucks after they have unloaded should be done in an area that will not drain off site(see BMP C151 Concrete Handling). 10. Control Dewatering In some cases, excavation for the foundation or below ground structures will encounter ground water. This water must be removed (dewatered)from the excavation. Discharge of this ground water must be treated in a manner that will not cause damage downstream due to flow rates or added pollution. There are no specific BMP identified for this activity, but the water should be handled with care to assure that soils or other pollutants are not added to this flow. 11. Maintain BMPs Installation of the appropriate BMPs is not adequate to completely control storm water runoff. The BMPs that have been installed on the project must be inspected and maintained during the duration of the construction project. In addition, the temporary controls that were installed for construction should be removed within 30 days of completion of the work. Typically, once construction has been completed, the temporary facilities are not maintained, and by removing the facilities, it will ensure that these won't fail and discharge water or sediment that had been previously trapped or contained. 12. Manage the Project Management of a project has four aspects: 1. Phasing construction to prevent transportation of runoff and sediment, 2. Limiting the work during seasons where large amounts of rainfall could be anticipated, 3. Coordination with Utilities and other Contractors, and 4. Inspection and Monitoring. All of these for aspects are important and must be followed to ensure a project that will have minimal impact on the environment. Volume II of the Manual contains additional BMPs that could be used on-site. The applicant is encouraged to review the Manual to see if other BMPs may be applicable to, or more useful on, a particular site. IR CFIIV ,D SEP - 6 2007 'JEffEfS iC1J � Pi00 • • 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. RECEIVED SEP - 6 2007 9. Control Pollutants. "FFEFfill CHM OCI1 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). 11. Maintain Best Management Practices(BMPs). 12. Manage the Project. 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). / ' /7 b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. Volis S , .1740/00 '- fir geir ij / ,/z stormwater site plan template doc—rev.10/12/2003 9 • ! b. Description of special requirements for working in or near environmentally sensitive areas. 7,7 6# /1 rc. u ft / Sot L 1f 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils(e.g., erodibility, settleability, permeability, depth,texture, soil structure). d#4741- GO,I 61C-- /s L4 ) ` 1e 4: l /l G/ 4 i tf be.....5. Construction Phasing. a. Construction sequence p" / 44Oi•', t iP,, /Jc!/7l' b. Const ction phasing(if proposed) sP 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). 11� G I. Provide a proposed construction schedule. .. 'A) /65r25g— - 112/ 5 II. Wet Season Construction Activities. a. Proposed wet season construction activities. Li b. Prop sed wet season construction activities for environmentally sensitive areas. SEP - 6 2007 7. Financial/Ownership Responsibilities. JUFE$IS;r)9 A UNTY IICO a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. N , b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. r 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following, if applicable. a. Sediment Ponds/Traps. b. Diversions. /1)71- c. Waterways. d. Runoff/Stormwater Detention Calculations stormwater site plan template.doc—rev.10/12/2003 10 • 0 Stormwater Site Plan Changes If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan, the proposed revisions shall be submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised drawings showing any structural changes, and any other supporting information that explains and supports the reason for the change. Final Corrected Plan Submittal If the project included construction of conveyance systems, treatment facilities, flow control facilities, or structural source control BMPs (not standard on-site stormwater management BMPs), the applicant shall submit a final corrected plan ("as-builts")when the project is completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as constructed. APPLICANT SIGNATURE By signing the Construction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected property. (LA DOWNER OR AUT ORIZE EPRESENT IVE SIGNATURE) (DATE) G W THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: If VF SEP - 6 2007 1 r 7' h' 'b'n S u'.n-:�' . I L uInYDAD stormwater site plan template.doc—rev.10/12/2003 12 , • • Asa y F---� I I I I D$/s 9.a I u G G, . Iul LLLJJJ ' EXIST'6 LIVING © I AIR HANDLER r� •.1 G.� N CRAWL SPACE — Tt m 3'ox3o Tg. i X — 1111 I I I I �_ �° 1 I I I / I I I I 1 ..`"�; /--GELS LINE CHANGE rS EXISTS - ( ' I �I.y ADDITION DEN �J EXIST6 • EXISTSO OI KITCHEN 1 ,l° HALL O CPOST IN WALL .-- TO FTS o 3'-T" 2-II" 3'-6" 3'-0" I _� / 0 II 3oxe'e f m EXISTS ,-, I IDUTI\ 3'4 \. BATH OO I 4/oxe/n GOATS \ t 2,2'd V. in WINDOW ABOVE L__1 , ii_,,,, ,5'-10" , \ FIREPLACE SEE ELEV / / I TOILET w, ___� 4 \ BATH MASTER SUITE I lWALK-IN - a �4 U 7 r — in SOAKING TUB I I \ \ v Yex'/e / 1 s/ox% AUXILIARY / 2'-q" / 5'-3" / C'nV ID 4'-5,V2" I i I I'_I" g'_g. / 20'-0" / 13'-I I' 25'-"1' c•J 11114,1PJ .F-i.°02 fL.vj& x • I =-: REMOVE 2 REMOVE EXIST REMOVE EXIST. WIDOW �a WINDOW h IIto III _ g _Lzrr r� .4�° — lC Th 3 t II 0 0 b y II x Q 0 -I Z7� IIr__T 6$ u1 F IIII II r, < UL__11 et 4LE • I I I I I I I 1 �I II II 11 L .I Jr Iu J JL 11 F 1 r 1L nl I III I b In �I h //‘ III I -i L 7� � IIL -- 3 rn $ w X I I I I I/ \I I � I N III L iy .i J 11 U3 III rr�/ II cf, N II b Cra imommuummillimmummummorimemeenmougaiwimmommanimilsimmenumairmit 06111D 'OP `' Cifti,F I �-0 1 , �e4� JEFFERSO Ui�7Y �, t\ ,.3 DEPARTMENT OF COMMUNITY DEVELOPMENT 4 "1 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax .ysiNGo www.co.jefferson.wa.us/commdevelopment Master Permit Application SEP - 6 2007 MLA: 0 `/-- 5 ' Project Description,(include separate sheets as necessary): Tax Parcel Property Number: 7 7e) 642- Size: 3z 7? 5 (acres/square feet) Site Address and/or Directions to Property: --,—.--' Property Owner(s)of Record: /«taA/ t /2460,t,) i/dr,a Telephone: Fax: email: Mailing Address: j 24' '5— 56: & ..t- Al',iT c.,,,;4 °f i4,3r' Applicant/Agent(if different from owner): /9 ot) 47 S't i s 2i ,Az Telephone: 3�rG �� �34c1 Fax: '3(e0 979 6j 13 S„, email: heilfy kc il.iS3jr 3t c„3c.c 4,,..r Mailing Address:_/(., O .C.,ve9JSO•s% 1•1 J y'j j k? What kind of Permit?(Check each box that applies :uilding ❑Variance (Minor, Major or Reasonable Economic Use) ❑ Demolition Permit 0 Conditional Use[C(a),C(d),or Cj** ❑ Single Family 0 Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)** ❑ Commercial* ❑ Boundary Line Adjustment ❑ Change of Use 0 Short Plat** ❑ Address 0 Road Approach 0 Binding Site Plan** ❑ Home Business ❑ Cottagelndustry 0 Long Plat** ❑Propane ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑Sign 0 Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** ❑Stormwater Management ❑Shoreline Management Substantial Development** ❑Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Variance ❑Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium Cl 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 /--iiiVA37 60110A to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE 4,L4 a,,{ `iJ 1 A k 4 ; Date: /i 7/C 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 al 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 req ired later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the appr on that he or s wants prior notice. Signature: /� Date: [ /U 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 yo are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transf ra le responsibility f dhering to and complying with the ESA. The Applicant has read this disclaim r an signs and dates it below. Signature: f L, Date: //� G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc . BUILDER STATEMENT -r ' 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: N/;t1/14di0 G'G ..S74ec & ('c)) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New A_Wood Existing: 0 Sewer ❑ Addition ❑ Steel Proposed: U Bank 0 Community System Alteration/Remodel 0 Concrete Total: _5 Hei ht::i ..Individual System ❑ Repair ❑ Masonry fN SEP Permit# O Demolition 0 Other: Bedrooms: .0 Water Supply: Existing: Setback Private well 0 Two Party Type of Heat: Proposed: y Public /b€tY11,C/ Total: — Z 7/ l ,vame 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 .ermit mark all items below that a..I : i Underground Tank Above ground Tank j Size of Propane Tank: 7 .k) fr9G I Heat Stove I 0000kStoove T Woods ove i Fireplace Insert Hot Water TaniT)i Pellet Stove i Other Is this appliance einq 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. 3f� � Square Footage Current Proposed r ; i.9 .se ;, y . ' „ -. P i �� �,.?��..,�1moiunt vJsl n„ �l .� Main Floor Heated r ".=��''x, `' .EH Bld App Review: 2nd Floor Heated �{r"v y Consistency Review: ` .. , `7.e. f .�3 .CT) Other Heated Base fee: Mezzanine �yr`y .t,. Additional Section: _,____ IT Heated Basement C1 - 200 � " Plan Check fee: C1" � �x vigil 1II ). c�( Unheated Basement i.''`,10 State Surcharge fee: /' G Other Unheated Pot Water Review fee: ci Da Garage/Carport,., % 4 7 tAtrytilV SUBTOTAL G' C G Decks el';, Ti17147, 911/Rd Approach fee: sF c )(15k Ini Cr sx ) Other :s 1.�4 ^ i TOTAL: $ ,,' -, 2 , t J T Vt 3 l Receipt Number: ( 12)q f Cash/Check Number: `s J : ESTIMATED-COST(REQUIRED) (( 7 3 -�� Date: .../ Fair market value of all labor and nnaterials foundation tb nish ' C(' () / 22 OD:) Initials: (z. G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc I \ 5.o'pi_ Craw I� 1 \ r IIR Ij Co 1 \ e ^7 I —1 I� ` \ o c \ 1\ C7-2 'cap :.:1 '7 II 11111 1 ( r— �________ I) r— b '\ O \ U i r — 1 / _\- 1/ \\ \ \ Z 4 \ \ .., I 1 1 \ II \ � \ 1 i' 1 L g k , \ I \\ \ I -'MIN. \. a /1 /1=7e I i/ V a T v 0.0, , ,. i li \\\i ems' lij;i rli`!,, \ 9-g t • I •!' ,r� it - - :II" ...., --'4 E SD \ I i . ,..,. i___ ,, 3, , ., 15-- --77 _. ,, , 1k f'.„, ,, , Y / . A/ •,,, <01.41 P- 9 m JJZLLIIII Y / \ 6 9 o el o \ / O C � �, \ / tri 'AA / 1 ot O \ / ""./— 11:.'s ._P / 00 l \ / 0 r''' '.. "`'-'c',A v ,,,,,,,,,. � .. \\)/ o"5r..l , ,- :1 i � c LAKE REMODEL -a m z qo •. „, 1 '7 A 41 z 1342 EAST MARROWSTONE RD. w Z N 360 3 s3`3fr NORDLAND, WASHINGTON 98358 O O N v O O v