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HomeMy WebLinkAboutBLD2007-00586 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 #: BLD07-00586 SITE ADDRESS: 14 LEWIS AVE Issue Date: 02/11/2008 PORT TOWNSEND, 98368 Final Date: 7/9/2008 APPLICANT: LEE 0 ADAMS PHONE: (360) 808-0242 CAROL A ADAMS 14 LEWIS AVE PORT TOWNSEND WA 98368 SUBDIVISION: IRONDALE Block: Lot: PARCEL NUMBER: 962110201 Section: 34 Township: 30 N Range: 01 W PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2006 EDITION. OCCUPANCY GROUP: R-3 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM yes no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 7/9/2008 I:\F_BLD_Occupancy.rpt 10/29/19 ItILDING PERMIT APPLICATTN ML Review Ty Ty 625 pe: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00586 Received Date: 11/20/2007 SITE ADDRESS: 14 LEWIS AVE PORT TOWNSEND, 98368 OWNER: LEE 0 ADAMS PHONE: (360) 808-0242 CAROL A ADAMS 14 LEWIS AVE PORT TOWNSEND WA 98368 IRONDALE SUBDIVISION: Block: 102 Lot: 5-10 PARCEL NUMBER: 962110201 Section: 34 Township: 30 N Range: 01 W CONTRACTOR: HI-LINE HOMES PHONE: 11306 62ND AVE E PUYALLUP WA 98373 Contractor's License HILINH`981BT Expires 2/10/2008 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI NEW SFR W/ATTACHED GARAGE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,716 VALUATION 175,076.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: 484 SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PUD BEDROOMS: BATHROOMS: Exist: Exist: Prop: 3 Prop: 2 Total: 3 Total: 2 Routing Date: \ 21I0'1 Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,419.35 KAS 11/20/07 95475 APIDRcJf Plan Check $922.58 KAS 11/20/07 95475 Fr State Building Code $4.50 KAS 11/20/07 95475 Potable Water Application $58.00 KAS 11/20/07 95475 FEB ' I 20i►2 Total: $2,404.43 Jefferson County Plannint &Building Department • Jefferson County Building Division Permit Num. BLD07-00586 Applicant: ADAMS 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 � STRIA./ (--iNKFIOUSE FOUNDATION SHALL BE A MINIMUM OF 10 FEET ON THE NORTH AND WEST PROPERTY LINES. Erosion Control SEE CONDITION 2 FOR SILT FENCE REQUIREMENTS. Foundation Footing ?-2'91 v1� Footing Drains • Foundation Stem Wall Underground Plumbing Under Floor Framing Straps(hold downs) • I77 Y o7 ` r Ext. Shear Wall Nailing j o Rough-in Plumbing 4 7, M Framing vt -L or Blocking �l Airseal Insulation:Walls 4/30/48 d,k faviD� Z&RTiFeAre- �Fiu�1c. 4f5o76B Insulation:Floors Insulation:Ceiling Int.Shear Wall Nailing albs Wallboard Nailing y)c f' Gas Line: Interior Gas Line: Exterior Propane Tank Heat/Chimney Clearance Drywell/Alt Drainage 3 SEE CONDITION I FOR DRYWELL REQUIREMENTS. 3 dfr /Lo//e8 DRYWE ,L ARE-REQUIRE14,144PAVF4,14 NEED TO BE AA. MINIMUM OF 10 FEET FROM PROPOSED HOUSE AND PROPERTY LINES. Address Posted FINAL INSPECTION ci FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED TLIIC DCCIIAIT IC\/AI Ir Ct\O "IOC VCAG • ._ CONDITIONS for Building Permit# :BLD07-00586 1.) SECTION 3.1.1, 2005 DOE STORMWATER MANUAL DRYWELL BOTTOMS MUST BE A MINIMUM OF 1 FOOT ABOVE SEASONAL HIGH GROUNDWATER LEVEL OR IMPERMEABLE SOIL LAYERS. EACH DRYWELL MAY SERVE UP TO 1000 SQUARE FEET OF IMPERVIOUS SURFACE FOR EITHER MEDIUM SANDS OR COARSE SANDS. TYPICALLY DRYWELLS ARE 48 INCHES IN DIAMETER (MINIMUM)AND HAVE A DEPTH OF 5 FEET (4 FEET OF GRAVEL AND 1 FOOT OF SUITABLE COVER MATERIAL). FILTER FABRIC (GEOTEXTILE) MUST BE PLACED ON TOP OF THE DRAIN ROCK AND ON TRENCH OR DRYWELL SIDES PRIOR TO BACKFILLING. SPACING BETWEEN DRYWELLS MUST BE A MINIMUM OF 4 FEET. DOWNSPOUT INFILTRATION DRYWELLS MUST NOT BE BUILT ON SLOPES GREATER THAN 25%. ALL INFILTRATION SYSTEMS SHOULD BE AT LEAST 10 FEET FROM ANY STRUCTURE, PROPERTY LINE, OR SENSITIVE AREA. DRYWELL MUST BE DOWNGRADIENT OF THE DRAINFIELD UNLESS THE SITE TOPOGRAPHY CLEARLY PROHIBITS SUBSURFACE FLOWS FROM INTERSECTING THE DRAINFIELD. 2.) A SILT FENCE SHALL BE INSTALLED ON THE SOUTH SIDE OF THE PROPOSED RESIDENCE TO PROTECT THE DRAINFIELD AREA PRIOR TO ANY LAND DISTURBING ACTIVITY. THE MINIMUM HEIGHT OF THE TOP OF SILT FENCE SHALL BE 2 FEET AND THE MAXIMUM HEIGHT SHALL BE 2 1/2 FEET ABOVE THE ORIGINAL GROUND SURFACE. THE SILT FENCE SHALL BE BURIED IN A TRENCH TO A MINIMUM DEPTH OF 5 INCHES BELOW THE GROUND SURFACE. THE TRENCH SHALL BE BACKFILLED AND THE SOIL TAMPED IN PLACE OVER THE BURIED PORTION OF THE SILT FENCE, SUCH THAT NO FLOW CAN PASS BENEATH THE FENCE AND SCOURING CAN NOT OCCUR. ANY DAMAGE TO THE SILT FENCE SHALL BE REPAIRED IMMEDIATELY. SEDIMENT DEPOSITS SHALL EITHER BE REMOVED WHEN THE DEPOSIT REACHES APPROXIMATELY ONE-THIRD THE HEIGHT OF THE SILT FENCE, OR A SECOND SILT FENCE SHALL BE INSTALLED. 3.) 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. 4.) 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. • 0 5.) 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. 6.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 7.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 8.) 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. 9.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 10.) Minimum setbacks from Prospect Avenue right-of-way and Tenth Avenue right-of-way shall be 10 feet. Minimum south and east property setbacks shall be 5 feet. (Road reductions were admnistratively approved. See letter dated November 7, 2007 in file). 11.) 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. 12.) 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. 13.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 14.) The building height is not to exceed 35 feet. 15.) The road approach permit(RAP07-00163) must be inspected and finaled by the Jefferson County Department of Public Works prior to the final inspection/certificate of occupancy of this residence. Contact Terry Duff, Department of Public Works at 360-385-9159 for the final road approach inspection. .N • • ()G &.ISy ° JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street Port Townsend, WA 98368 Al Scalf, Director November 7, 2007 Lee&Carol Adams 14 Lewis Ave Port Townsend WA 98368 RE: Request for front yard setback reductions from 10th Ave and Prospect Ave on Parcel Number 962110201. Mr. and Mrs. Adams: This letter is being sent to you as the landowner of parcel number 962110201 in response your request for a setback reduction from 20 feet to 10 feet from 10th Ave right of way and from 20 feet to 10 feet from Prospect Ave right of way in order to accommodate maximizing backyard native vegetation, and to provide a greater setback between new home and structures on adjacent property. Findings: • Jefferson County Code 18.30.050 note 6 for Table 6 allows that"The administrator may reduce the minimum road setbacks if the strict application of such setback would render a legal lot of record unbuildable under the provisions of this code."' • Jefferson County department of Public Works commented on 11/2/2007 in part as follows: "Public Works has found no advantage to any roadway to reduce the setback from the right of way. The following information is being provided in response to your request for comments: The sections of Prospect Ave. and 10th Ave. as platted within Irondale No. 4 are unopened rights of way. Access to the parcel is through a section of Prospect Ave. as it runs adjacent to Lots 1-6 of Block 102 within the Plat and as permitted under RAP07-00163. 10th Ave. is not being used as access to any lots within this plat at this time. Other access is available to adjoining parcels through existing platted streets." The administrator reviewed your request and Public Works comments on 7/11/2007 and determined that the setbacks from Prospect Ave and 10th Ave right of ways on parcel number 962110201 may be reduced to 10 feet to accommodate building plans. This determination is based on Jefferson County Code and policy as it stands today, and is not a vesting response. Should the Jefferson County Code or policy change, this determination may no longer apply. Building permit approval will vest these setback reductions. You will need to address the requirement for two off street parking spaces on the parcel. If you have any questions or concerns, please contact me at(360) 379-4450. Sin ely, 411,P 600. / // Cara Leckenby Assistant Planner, Jefferson Count DC. cc: Terry Duff, Jefferson County Public Works Building Permits/Inspections Development Review Division Long Range Planning (360) 379-4450 E Mail: ascalf@co.jefferson.wa.us FAX: (360) 379-4451 • • 17116 sq ft Home ..,... STANDARD ORIENTATION .!; ,, -;,...i • 3 BEDROOMS • 2 BATHS • OPEN LIVING ROOM , 1-1----‘1", rgrom • HIGH VAULTED CEILINGS ' le,&,. A I , ,:, 414"'.:4"' ,..;;': ' ,' o•,' . , •‘,,• • SPACIOUS BEDROOMS i, HiL 1NE H 0 M E S vvvvvv. H i Li ne Homes.com BUILT ON YOUR SITE u 2007 f'c.111E79ig COHN BCD ..iii 74 —0" 1_..— .- , 7 :o , _ 1 I E--1_1 UTIL DINING KITCHEN LC)-i..)..) -IBATH ROOM ! i l'\11'9" x 134" i •- -\ MASTER 111" x 109" ! BEDROOM - - 15 x 14' GARAGE 22' x 22' 1 1--- ----I VAULT LINE I --J I _L WIC ' 9 9'9" x 57 A L1 V t--------- ol . BATH LIVING ROOM i 194" x 203" BEDROOM' BEDROOM 2 3 ENTR`rr) 11 x 12 10 7 115" x 1210" I . 1 , . II i CL')' CL :---J N. cr) cr) ..-E .o.) 1:-.. o.. o @ Artist conceptual drawings.Builder reserves the right to change plans,specifications&prices without notice.Plan number is approx.living square feet. 1 • • , . f, ir. iI iLi vj t I _.1 jJJRE� ]�� SON )1' IrNiq,� c° JEFFERSON,140: 621 Sheridan Street • Pwnsenld..Wasrliinq d1443 6t� j '' B �I�, � O 360/379-4450 • 360/379-4451 Fax "°' x �o � i1� a �7N http://www.co.Jefferson.wa.us/commclevelopment/ f STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# a - c 3 PROJECT/APPLICANT NAME: Le e()L ' .Y'Y VV\S 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 j 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 sk map. .e - o� \31 .3 q 37 S, F E. w r. Q- . . .-.0._ -�t-w v— C-c`s-)N c �- t� I S Lie o__ Z., 1', , �„ o-- _ a bi �.>\ V o�_c�- L.�. . 1 2 \:' cv- s . _ w •�._� Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the size map. 1 f ; `i-'.Q-�'-\ 3\-s-�ci _ (c J\ss C9- z 1.- Q_Y`- \U ',,J cam , ` Q. ---04. ,2.3, U-D 6:-...,..\-- 0--b_9-3-_,—.) A ....y..9_p__--, (3.- b_.,\J„..3-Al.._,, 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. _J,._7- 7 .f•lJ O 71.�-QAr 03--3--Q.- ,l .K•r..Q.SJ'.. Q._ e4C A 4--" 0.)..... J J 4. Describe the existing soils. Indicate soil typ on the site map. C o ��.. \1 .A�-A ..A V \ i--©Q , \ . _ ,/, 4 1 ---0. .-Q.. VIA L.. . .•.-t--4. �0--'--- AS--p� CN.-- S 6 4`- 3.-- h l su_..YY) ����--)\(.,r.: . 5. Describe the existing site hydrology(i.e.,drain,age;behavior of water n hf a 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 applicable,a d indicate acreageof each. s. 1 t w J'i--cam NCt.><h C a c'h A C r\ 6 ' ' cv 1 �_+ar.a s. . t 6. Describe any excess levels f noise generated by the proposed us oracti' ' .. o .• ' 0 VED --No-1/4_- Q.,�r-.ty\ -c -v`.. t--•\C`-c----'1-.A STORMWATER PLAN tormw Requir d DEC 1 8 2007 1EFFER 04 C'. NTY storrnwater site pan template—rev.10/1/2003 DEPT.OF C• • .' b VE PMENT SIGNATURE I7 l:• ,-., . 4 • 1 7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, steep slopes etc.)on the site Indicate locationILL_e_t cl t C1-+nnh site _� `� --a-- -Q_ ..� •1-k. �'�.. .a-Q ,'_.�� 4)a--- ---Q-Ack,, U 8. Describe the general vicinity of the site, including adjacent land uses and structures, utilities, roads,and sensitive/critical areas (streams, etlands,lakes,steep slopes,et -----V _)..2_, - '\.1 \.).,_,I-41.)1Q-k...)-0 O-Voc0 iv Ch-)Q-Q. , 4--- 5 Qs„...z....y-n_. ) , -1),_ i-k_ R �c 0 v,.-s �.Q om .}• C'�-C91 �� E?/ at./ ,' U Jf .9-U-� op.$)cis .d/ — " �- �� 'J ._ @ rJ, -To -a--o." `t- Permanent Stormwater Control Plan Q 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. g. Describe the developed site hydrology, as proposed. Indicate whether stormwater will be fully dispersed (i.e., per reMI' 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 the site pla nd differentiate proposed facilities from existing facilities. WQ. c-4-) UM. \- 3 e3.\ 1-,-,z_33 -1 t _Q--_ t o Cii '\_r _J\r,---4-6_, ,A ,tro-6 d,_x_-e,s , c.D....i2-. j1...'0...&o._ f U0--t.> 4 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.] 1 c ✓fir-A-k-_L_) /3 4 JV---.it-4 c 4.. 11. Describe the perfo nce wals and standards ap licable to the project. 7 r,*.,,,,,. 0,9 LP .f 12. rpescri the flow contropl system. ' r 6 a) cn l I,U C400 4-_-e C� c�o-cJvYl 7} ',in,* ,�jM C� ..,a..._ _b _ p ( c-t. r1 ' :n kJ: It 't/ i.t lr\ ''1 DEC 1 7 2007 ; stormwater site plan template—rev.10/1/2003 I 75:ITY 6 LD'r-P '1 1ELOPiAENT • 110 13. Describe the water quality system.,, p �L l2)C� -� (1J lJ� .).�O_c)6 uo DJ1 p , 1 14. Describe the conve an e system y y em anal sis and design. • ✓1—R t R- � Cr—) C-t e-i 5Mv-&w \ Li-)Li-) cs. � di(i.,1.c- ./VV\ t_A-Q_ q etA ...pf2-0._.:+eL d c),^,-04,_ Lcz--tu / `�vc� 15. D Ascribe the spurce of fill ma rial,physical haracterist' s of fill material,and deposition of excess m terial. b„,..,.....6,v, $1 ,. c�-tti c4� S f 0.1, . (aQ c i i • , `CL i () ji. I t)o r-4- 11-4-1 c,c;p-Lia ..a....6 ,4,....) , 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. ll 7 '7 l - 17. Describe the proposed surfacing material. 3Al ' ,mil=u_,-e._. q A-'o'c'-e-P c�)-)w-k-Q- . (4-c',)-9- - 034. -I-0 0-�-1` 18. Describe methods for restoration of the 5493. ya- w t,2.� ��►- i C"-k.. em-Y�- Al ��- V a-- �--� t -41 4- o -1-- L f ....)y\ o_Zi-_-AJ-Q__ 6 Le3A_ci_.. 1 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. (V/A- 20. List here and incl de any spec'l reports or sxu laws conducted to repave the tormwaterSite Ian. n -to (2-10-k.im u......) tx.)(:- .1.- C-crt.)-4,---tki fizia._.) ) 0-4- c)41.-t":- 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 restriction here.lis i±-m d- �LD P- V 2. +0 _4N @ 0-- -0 c 4—c1L * 0 it.—C.A. c3 } iur- ', DEC 17 2007 1 i stornmater site plan template—rev.10/1/2003 _i 7 012 TY L' = `r -±:b'ELOPMENT • REC.rvEL. NOV 2 0 2007 CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN (SWPPP) ����j�11ff n('(� � > i C h' (t4N�h The Construction SWPPP addresses sediment and erosion control during construction. The BMPs in l + . e e 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. "r4X < 9 , c 3E Ir v cYN, (N‘' `1> ///-)6, 2. Establish Construction Access. (e.._ t- (;) ( RosPEc.T . 3. Control Flow Rates. Fes ,I , t-I‘by l~" s av£s tIEe-v sLl61 - s , C, I- p , 4- ✓i\U,Le-N wt E_ 4. Install Sediment Controls. S7WAvd go, (rv,.1,1 CA 5. Stabilize Soils. (Pit, : • i >C /04.CC-SS a r7 6. Protect Slopes. Jo ,S1oy'c. S / Si '1 E. 15 V- --y LE✓EL 7. Protect Drain Inlets. /1.)t7 /3 rAi^) Iru I DEC 1 7 2007 ;tom stormwater site plan template—rev.10/1/2003 " _ ' v LIPMENT 12 Required Elements-Construction SWPPP(continued) h v D 6 0 LU I 8. Stabilize Channels and Outlets. -- JEFFERSON C88i'JT` 0-CD 9. Control Pollutants. / ..e to f 710 /II i 4 i w1 tit h1 ex ok �e._r.,-.ti e_ok ulD , -1rl" E USE OP N \l ULD t t.l- IA t,1-0 S t rt t__ it-a 1t E c L_E A l...)f\--, ...x..p, 76 Q.-s R - -7 -\ \ o t,-) S \`t E ' 6•?-. c 4_5 1 -. S u.Sr '�v,E�..I i tc col--S.� e_`.t ci f O iv, 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). /At., o(l c.i . G-cx r e- /— r ,rt-Le-/-etied 11. Maintain Best Management Practices (BMPs)./"i , Ri /2 4_.\.. -J e v-i 4 // .(-3 !''7 /D s ,e5 0, f r 1 y ot_y di i"E.>v‘,,.1 e� Te ,.Y . C 6 .' -4-e,I s f"k•cr....1 ry 0-4,t... i*n s 'Ia./F s/( a -4 )1......e., 12. Manage the Project. L.)n r k C' bSe- / 63 % Ft, ea,. 1-rc-��2 S Ste, b s a_. of L.l i I_4- i c-.S , o I Su rt Pr,o)C-Z4 k4S /►fi ri: vtA.a w.. I or,f elc f. 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential A areas, roads). ---) H --r)g-k.V � Lt.)) 1...1- --V> S- QuT I1N P.Nsp ACEMi 'T'o P 'PrIV 70 ()vL t.. L t)N A- 3 O ' P_0c t,..)A y 1-14 Ni- A& N El)E e c4- -� 7 __ i Y \1 �E `�E%ELDPE. ` y coutt--- ki. OwNE;Zs AR- Awl * IL) P f EEF ir\AE 1.Yt'. b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). A/ 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. /A )r , , I'' 'TA . 11 \') Ltz-, ,-.)1 i i IDEC 1 7 2007 stomnvater site plan template—rev.1 Q 12003 r(i t `._. P�Y • • iLy b. Description of special requirements for working in or near environmentally sensitive areas. A) _ N O V 2 0 2c07 JEFFEEN COUNTY OCD 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils (e.g.,erodibi'ty,settleability,permeability, de th texture,soil Pstructure). fa) � � -�.- `6 b 5. Construction Phasing. Constructionseq ence 31 b. Construction phasing(if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Providea proposed nstruction hedule. Sf�lEQ�P L '03scw'�� F��t ) evOF ( 1A3 d C= 1b0 e �NS`c �FE` rnR� 02) rilvlS/f �LoO� '` P i►`V' P12-1LTT� IL Wet Season onstruction Activities. L A1`� iQ S ia, ,t`• (f(t\f..y '09j a. Proposed wet season construction activities. b. Proposed wet season construction activities for environmentally sensitive areas. 7. Financial/Ownership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. Z‘sy Uwt FS LLB \Naa Niv,s 6sI ►-,c,-rt-,sv �I�},CEf k=i�QtY�F�S ��r✓S �tLr�� 1- ow�LS b. Describe bonds and/or other evidence of financial responsibility for liab ty associated with erosion and sedimentation impacts. Pt:�SO l,t.f `-/ 8. Engineering Calculations. Provide Design Calculations on a separate heet for the following, if applicable. a. Sediment Ponds/Traps. b. Diversions. c. Waterways. d. Runoff/Stormwater Detention Calculations , , — --,+, • .1! DEC 1 7 2007 � � _ l stormwater site plan template-rev.10/12003 ' i.'1t 1 Obi 110 Pa, r e-e,L - .9 6 ,7/if ,Z O ( al V__Piv 1\S, ---4-- P(Oeefl Li , ,: , , . , t. I; �� DEC 17 2007 � �� i. °1--4.ii?t,'IEIN31-911 -rlf. 1:1 ' ,� 4. L� 1T # .44 j 5 ro— _ • 0 7 - 0 5 G 8�o --„ lb - 1.7"4 • 4 84' - 4, , .7:# 4.to,_ 73)-- . . - t j be.• rn i n morn ' rt,' ' • now. , �N F \ a , • - 30�M,' Ad•o 4, .f . M. 5I +- • 1 .. lors ''• I . rr,i*nl+r h srat,. 7 �pte 2,i .I , I ,1. ) D A.b r - g w 1- 4. Stormwa a B 'iril, ,, _ - . Require a �111 p `IP tot q . K . sa M.. . PPROVE I0t ,d I • - J SITE PLAN I ar t ck, DEC82007 _ _ _ _ • n DEPT.OF •./ • ' SIGNATUR : i a L 'l/ - '' , S ` 4 z_ 0. .5 - O cc.,, Area l� Le,,J1 s AUE- i !\\it /01-, To ,0,t52Y1ot , oa cle348 . ���SON cO JEFFERSO UNTY • ti ,1404, DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax ���,HING`,•O3 www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: C - (6 Project Description(include separate sheets as necessary): . '`-^� C. C) 01 2_'AN F Tax Parcel ..,. , Property Number: �,; „ i",,)! Size: / ,, `` L..) , (acres s uare feet ' Site Address and/or Directions to Property: i y /fi P)Vt. ` ' j t= r Property Owner(s)of Record: L 'E "A- CP „ ._ C Telephone: ., 20 g )2 0 y ) Fax: r� email: Mailing Address: 19 LE uk.a; °> Pc li l-'7- k U.,-.-.1i-.L.z=t"-'(') {st-)1\ ', .,x.,: 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) ❑ Demolition Permit 0 Conditional Use[C(a), C(d),or C]** I Single Family Garage _Attached Detached ❑ Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)** 0 Commercial* 0 Boundary Line Adjustment ❑ Change of Use 0 Short Plat** r 0 Address 0 Road Approach 0 Binding Site Plan** t ❑ Home Business 0 Cottagelndustry 0 Long Plat** ❑ Propane 0 Planned Rural Residential Development(PRRD)/Amendments** ❑ Sign 0 Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions** Stormwater Management ❑Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination (SPAAD)* El Shoreline Management Variance ❑ Temporary Use 0 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 0 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 to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or it's knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and 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 application that he or she wants prior notice. Signature: _ , t e'', ' R't �. ..d.- .-Date: r i- 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 actions)-ekTn if you are in corn, lance i ,the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual andg non transferable respo 'bi���Or her ing to and complying with the ESA. The Applicant has read this disclaimer and signs and date below. Si nature: �` (1 �,�nv� 1�� \ -Q �.,,. Date: A U 'U G:\PermitCenter\###FORMS###\DR n Ff1RMS\M,, tPrPr.r.,,h a.,.,li..,,a 11 1n oW A-- . 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: \---\\. LI r) . 0mE ( ) ( ) MAILING ADDRESS: \\'�Q b (, 01, \--EVE C , EMAIL: CONTRACTOR'S LICENSE ,: '), . F ,.a ` '- ` _ WAINS NUMBER: 0.0-01�rlii j/l H i'l L ,.3 " NUMBER \At1./N4 ' g83t::: ARCHITECT/ENGINEER: \ evl f.� `L-�& P (} PHONE ( ) $yb./gy9 FAX:( ) MAILING ADDRESS: Ld S S�FV•fi,r LAf�-E. Pak c:. CI q3o\ EMAIL Project Type: Frame Type: t Bathrooms: Shoreline: Type of Sewage Disposal: New IX Wood Existing: ❑ Sewer Addition ❑ Steel Proposed: , . Bank 0 Community System ❑ Alteration/Remodel 0 Concrete Total: He�Ig „ A Individual System O Repair ❑ Masonry 1�� SEP Permit# O Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well 0 Two Party Type of Heat: Proposed: \� } ,Public F L ` Total: 3 _ Name of System:Y v,----) 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 1 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 e'Us- e 1. wi,.' . . . °�'-,:u.) k t`si... a... it 41„4 :,..y. 4. Main Floor Heated `�11 #"` F-I Bid App Review: / c S. 2nd Floor Heated Consistency Review: (p Other Heated tomx . Base fee: 141q. 5 t' 1 Mezzanine - S Additional Section: Heated Basement Plan Check fee: Unheated Basement � z - State Surcharge fee Other Unheated 'F'7.-TgAt4, 7 Pot Water Review fee: coGarage/Carport" ` SUBTOTAL Decks O { 4,u• « 9 1/Rd Ap roa h f Other : ` TOTAL: $ OF,',. .';'. 1 Receipt Number: 951415 w Cash/Check Number: . ESTIMATED COST(REQUIRED) M5 p- l Date: 1 2d I •Fair market value of all labor and materials found ion to final? 0-7 zvo 1'- RO v Initials: ' G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc