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BLD2008-00055
• • 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 Al Scalf, Buildiing Official PERMIT #: BLD08-00055 SITE ADDRESS: 183 WAMPUM POINT RD Issue Date: 07/30/2008 QUILCENE, 98376 Final Date: 1/5/2011 APPLICANT: CLAUDIA G SHERMAN PHONE: 206-276-6220 LAWRENCE D SHERMAN 18544 NE 19TH PL BELLEVUE WA 98008-3324 SUBDIVISION: Block: Lot: T 45+ PARCEL NUMBER: 701194027 Section: 19 Township: 27 N Range: 01 W PROJECT DESCRIPTION: NEW 2 STORY SHOP W/ SATELLITE BDRM & BATHROOM (HTD) & A/G 55 GAL PROP 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 1/5/2011 I:\F_BLD_Occupancy.rpt 10/29/19 - AMMO al Jefferson County Building Dion Permit Numb!`: BLD08-00055 Applicant: SHERMAN 4 BUILDING PERMIT INSPECTION APPROVALS \pplicable 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 Cam_E• t�- - ri'-571(tt h(-Yt S 1: L- 1 LT FiVeg INSI ILLI P 9fr3,101 Foundation Footing Q g /fi /j�' P Footing Drains Foundation Stem Wall 9/yg/Qg ��/ & op";it) i9l< 11/20.5 AL Under Floor Framing 31,�-1b`( e ` • 00Q O 3a(x Straps(hold downs) Ext. Shear Wall Nailing q:0/—01 pb Rough-in Plumbing c()-) 3-;--fU / Framing Airseal Insulation: Walls Insulation: Floors Insulation: Ceiling Wallboard Nailing —� — I Drywell/Alt Drainage b I Address Posted rFINAL INSPECTION I.,S iI 91—/ FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR 2 BUILDING PERMIT APPLICATION MR evie ToType: : I ?`1 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00055 Received Date: 2/11/2008 SITE ADDRESS: 183 WAMPUM POINT RD QUILCENE, 98376 OWNER: CLAUDIA G SHERMAN PHONE: 206-276-6220 LAWRENCE D SHERMAN 18544 NE 19TH PL BELLEVUE WA 980083324 SUBDIVISION: Block: Lot: T 45+ PARCEL NUMBER: 701194027 Section: 19 Township: 27 N Range: 01 W CONTRACTOR: GIFFORD CONSTRUCTION COMPANY PHONE: 253-405-7994 PO BOX 2744 GIG HARBOR WA 98335 Contractor's License GIFFOOC977KF Expires 5/6/2009 REPRESENTATIVE: GRETCHEN REYNOLDS PHONE: (253) 862-1255A 3058 S 200TH (253) 862-1443 SEATAC WA 98198 PROJECT DESCRIPTIOP NEW 2 STORY SHOP W/ SATELLITE BDRM & BATHROOM (HTD) & A/G 55 GAL PROP TANK TYPE OF WORK GAR _ SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 416 VALUATION 75,000.00 ADD'L: 416 HEAT TYPE: PRO CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: SHORELINE: GARA0 CONST TYPE: DECKLE 800 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 REVISION Prop: 1 Prop: 1 ADDITIONAL SQ FT Total: 1 Total: 1 OR VALUATION Routing Date: PLEASE DESTROY PREVIOUS BLD REPORT Type Amount Paid By: Date: Receipt: Approved/Date Permit $307.25 LYK 02/11/08 95914 Plan Check $199.71 LYK 02/11/08 95914 State Building Code $4.50 LYK 02/11/08 95914 Plan Check $71.00 LYK 03/09/09 105557 Renewal $213.00 KAS 07/13/09 108758 Permit $511.50 LYK 02/22/10 1'3901 3an1 Total: $1,629.44 • • CONDITIONS for Building Permit# :BLD08-00055 1.) DESIGN CRITERIA FOR SPLASHBLOCKS: A VEGETATED FLOWPATH OF AT LEAST 50 FEET SHOULD BE MAINTAINED BETWEEN THE DISCHARGE POINT AND ANY PROPERTY LINE, STRUCTURE, STEEP SLOPE, STREAM, WETLAND, LAKE, OR OTHER IMPERVIOUS SURFACE. SENSITIVE AREA BUFFERS MAY COUNT TOWARD FLOWPATH LENGTHS. A MAXIMUM OF 700 SQUARE FEET OF ROOF AREA MAY DRAIN TO EACH SPLASHBLOCK. A SPLASHBLOCK OR A PAD OF CRUSHED ROCK (2 FEET WIDE BY 3 FEET LONG BY 6 INCHES DEEP) SHOULD BE PLACED AT EACH DOWNSPOUT DISCHARGE POINT. NO EROSION OR FLOODING OF DOWNSTREAM PROPERTIES MAY RESULT. FOR SITES WITH SEPTIC SYSTEMS, THE DISCHARGE POINT MUST BE DOWNSLOPE OF THE PRIMARY AND RESERVE DRAINFILED AREAS. 2.) A SILT FENCE SHALL BE INSTALLED 30 FEET LANDWARD OF THE TOP OF THE SHORELINE BANK 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.) PRIOR TO OCCUPANCY & BUILDING FINAL - FINAL APPROVAL OF SEPTIC SEP07-265 & SEP99-60 IS REQUIRED. MUST MEET ALL CONDITIONS OF SEPTIC PERMIT. 4.) ANY PORTION OF TRANSPORT LINE UNDER A DRIVEN \NAY IS TO BE SLEEVED/CASED OR EQUIVALENT. 5.) 10' SEPARATION REQUIRED BETWEEN A WATER LINE AND ALL PORTIONS OF THE ONSITE SEWAGE SYSTEM; EFFLUENT TRANSPORT LINE, TANKS, TREATMENT AND DISPOSAL COMPONENTS. 6.) 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. 7.) VOLUNTARY MEASURES OF C•TAL &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. 8.) 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. 9.) 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. 10.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 11.) All construction activities shall not encroach upon the shoreline 30-foot buffer. This includes the storage or preparation of materials. 12.) 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. 13.) 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. 14.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 15.) Not more than 2 unlicensed vehi.shall be stored on any lot unless totally sc ed 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. 16.) 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. 17.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 18.) Minimum setback from Wampum Point Road right-of-way shall be 20 feet. Minimum north and south property setbacks shall be 5 feet. Minimum setback from shoreline top of bank shall be 30 feet. 19.) 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. 20.) 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. 21.) The building height is not to exceed 35 feet. NC� � �9 • III (LEAK .E)ci je,./r* , tiq\ JEFFERSON COUNTY 11`.. ' DEPARTMENT OF COMMUNITY DEVELOPMENT f J JUL 14 2008 ), 621 Sheridan Street• Port Townsend•Washington 98368 II •Lr ' - TNC' . http://www.co.je•ffe son.a.s/commdevelopment/ JEFFERSON379-4451 Fax COUNTY DEPT.OF COMMUNITY DEVELOPMENT STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# 0 ;) 73- PROJECT/APPLICANT NAME: : k cif 141 Gi'.Ll 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 storrnwater site plan map. Project Overview 1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the �Jsite map. t/ l I A-C-F.'. q ii <' c�3 i'1'I d cCf /a V `1 G 0'1 c ('1 r`S 1 to L.% I. +G. k ot4 S,Qo, ti_ a G i2 t''1 Ir C 1 4 (Pity* vv e LJ �//C�6 v v-o c, it.c_4 N ou-t e a L; di t o t2 4. 7t'v q c_+' l,6 x 2- 5 f-i c � f 1,°Y>; kkt e ` `, I--c Vet e P_ Gnu ( (di h- a Lea( k-4lc .1 S Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. 1L-e I fivc t� CIO- al ei�"{',4 04_ e0 1,S t-v4 c t- I a t^ CJ1 ( •3 o r �fJ`12Ci 1C -f_ VOIAA p s,-' prTt*/ kO( vela l'i,i61 LA:Ct ((. /6 I bat,K keilicf--oil ..� VOk,--f- 7iy a4- ve10 3. Describe the existing vegetation. Indicate native vegetatiof areas on the site map.Cott( c e✓ ; _cs ivS 6(1 /6 f (06k-elk?v-I t•�c E4=1.5"k— Qu r I o_ekc>_ /2e c/ a LA cI A Ira 5 5 a 4, f i--c Ip‹ ,--d-. b -1-0 e e IA l va U-,T u kit-c j°f-, A ctcl a t I / h l-e7a ')th/'- CI)a 11 . 4. Describe the a sting soils. Indicate soil type on the site map. 7 e pope, f-Y i s /ad,Wr a ktal 5 7teveck 9 ret Vet 4 -4J e l I •y-eco v As ALA KO+ tt�oitk`l'ev bzdify,C,(C iN JVil(L 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 applicable,and indicate acreage of each. I 1- Site iS Ve_.t'y f/41-- w ; 411 ov-Li ck / ! j`1. viS( c-l; a o 4-4+ 1 `f 0 ; i1 U P.a 1-6 Le�. - rc=te,k to'v' ✓n c_, i of b c,oei/( Pho c 5r, -A GIotiSio, a_h.J `i'iV& i' 1,,6 t,,J4 ,, 1-to,' w v-ettI, r (' G kS6 [M !Pt O ( enilPG'+/nv'. r4' cuaeev' ail tz--LG,k4- i4? toktdA 4VCijv1S L.,A 6. Describe any excess levels of noise generated by the proposed use or activity: I -.Z ckyS TIV.f. I164 4 .s wta[(4L4c-i_. -5 l'K Q 5 t^ f(.; IX ;Q 1� ? ►' Cca / /b v o/✓( 'C 6bi S • r�(!' 7o " noe 1cf << 5it t, , c , OvED STORMWATER PLAN stormwater site plan template des—rev.10/12/2003 JUL 14 2008 5 Stormwater : l �te� ��1 „� . ..�1 1EFFER O y Requi • DEPT.OF CO ' : E E i T SIGNATURE. • . • 7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, -7steep slopes,etc.)on the site. Indicate location on the site map. ! ,7 0 / Su-- -12 a-" K' `b q c C ` o t;t7 iiite) V 7/e n Mel iw 2(( a y �i .1 �t, t IL�it bar Et rep-ed o' vas 4 r ,�: ,�_. to C�`tti E�.c Y S ��czttc ��a�-�•:� c2 r cet 1 q / �-t�11 t C l'� 's h `11 y ( v t/c.cl LI; eP i ate_ tr cc1M f l o t, a i.uu t( be, I<t-- 4 `c 3. 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.). o iA . VDt a1,c ` e Z` 5 ir�C�dtC gi6k C1,4 S i S. (-et it tc1-1-k rot t-ge)cc irtc hS ` irty''o4sL, n t,-V6' 10 r 1- t et,6l , i ei 5'<r t(J tcc /&i ci I /S EA R'- `ti _ f' NO `5+1V A v'15 cat- t..v¢.±1a-k ci5 Pj a �a -r, ct��� be +tt eZt~ 2c� a 5 vto -Fed �a <5 Q�,����e (��r . _�1v�P ��<_-}- 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. 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. TAe rel10 !t©k5e haaS 5i /g ' n V0t6 a .�+- . { °�'e .5 ')v-A E:SS'€c1 kis (t5 5 /*et i t 7CC' P ��t�ted �:..� i•�v©4'. 7'�e hatt-� t,�r ll hczv� 5e/a5h blc�:l65 a(.d SO' V j lac ...F/�tti �'a 5 CK"-eKdik5 -vew, P 5c 4-t, r ic,51'ev-k + 2_ ko+-' ii�� � fdter� CnlrKc� _6 - jutt56 i-o i_ •C-(0c..3 prti'�� e x .1,,t1I i '--o {--kQ So-1 w45'- 0..kS 1 3 e5 �rRS hncv1 0l't Si f e p(at,. Tile .5icrq e stted wr l� Vlauf / /'j 10. If the project requires the use of stormwater treatment facilities,describe the pes of stormwater o C r- atmd nt accli`i vt 5 (�1� for use on the site. Locate these facilities on the site plan and differentiate opes od faclies from treatment facilities proposed normally for"large"projects or projects that involve the potential for dispersion of contaminants.] existing facilities. [This is 11. Describe the performance oals and standards applicable to the project. t r1 11 el l l lG, 4- Oh 4:N; ,V /6 Li c.f 0 4-'ro( , nCi l/19 Jet ir[t C rig-is t-r c 7 eq.") At‘5 i to• 12. Describe the flow control system, --'}i,fS �, /a3 Ci b/aCJC CcL Li 1 l ,� �cfi VeGAv'e' �dL�l at,[t �'a�`t rS �tYC�Gt +— .. eg`f'Gt 7�o u:et t. A- GJr° 7' 5 i d,° c,„ . la"l-. itG etIrr. cD Lito , e1 en k i .t`e T p/ct v,. stormwater site plan template.doc—rev-10/12/2003 6 III • 13. Describe the water duality system. G. t i,,e `` '�I've I�Jt1 t �. t'�l '{��' t 5 �-�et� � ail v�.►tid Lid. vt.o V q,(k-eC=4' (Jtlt. �lC/5f/lt5 (cLti1 s}`dri+ W 'V4 yke it; ,accs�� t:tI( F,4� c'rct5t"v�c e� 5 i fr' r� vt L T; f lC cl- r°S�-S► fin �,�, tr ct Z -.3 } r (,3 t I b directed a d y /©1.s Vo ©ice lc c.,4-6 L, CrrPt s�-vc&CA-t°LA. o.c.. v.z. licd/ot c Lo,l i i i LJeel• t2 ill, 1et�er et~ -- 14. Describe the conveyance system analysis and design. 4 cii../ poyct- ,r TAe ci Ow.1,itie'4,, 11 11i. ( b Aiv'c'_C`f 8 $-O v Jr -cci-,. d 4, L es°t; Mete' 4 pl‘ic,_,A,r1,1- c,r ',5f-V-ue+1 tie5 gqVie stkv,cgc°S t lI remuai per 04< 0/e a c( re �rA. gv�v <j vYc S t-- T e �v c c vt>f Y�cat o t-- S� ft' t�rf�!� t�C f1�l�l`/ q�� C:.0«5 rlZe.`)�lC k 4 5 1- It . d wib/C t-Z2- . 15. Describe the source of fill material,phfsical characteristics of fill material,anc deposition of excess material. 5 t 4-9 tS (evc / a ci ha 4-t1v4_ ( tlz t l�rti g ttC1 l � tt ]� , Mc 'Hi sd/ / rdy be f/acej 65 <1ee _c ,pe MfAla ii A,1dc p,tr '1 k t" I VAk .5 ►reI 461r Civtve aLAr-( ti cr.,(0tc Y vd_5 acal it C: c1. 101 C. Gti v �� ,, Kg +© 1r� 16. Proposed methods of placement and compaction con�antwith the applicable el standards on Appendix li pt Fi 4 Uniform Building Code. Chapter 33 of the G►-a.il2I L0,11 i)e 'ie c d as f Scv-t �� it., 1S !„.. sec/Qv (Occ s 6v.- �m, ocict0 a rod, erp Y,rs�t.� �ecC55 t5 toy tA, � „at .I y 64.8 c4- t w c,.u-. p I-. �.) a ti� S ruck( d ti�a-(-- be ct ec l 17. Descn the proposed surfacing material. 0 cn'- t.r1 i i (. r t'u y j _ "I' C � / `of � 5 to (1 a�tT C 5/O t. 0 eC tk. . v-4`re I ri in V e lti 4y t^tl 4 !-t C;C* t'1 i Oa o ru 1A- p 4 c�tti�. Gi 18. Describe methods for restoration of he site. . 314' 41/hil41q ( /aft 5coM9.5 a Vd CA.> t.oLSri 1 VFes-6 ve 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, , 4 �l 20. List here and include any special reports or sxudies conducted to prepare the Stormwater Site Plan. 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. �I f- /\'0l'C �Aft tA,i iri i ti S -1- t cu.,, - Ca1 l 1,- s",armwater site plan template.doe—rev.10112/24•3 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 Clearing Limits. 1.}P. 4. I ' t V 1 I(C ec p ti ' ' I / itC 2. Establish Construction Access ex/s 745 . GLi) 141 14 frr-t PO l t �d is Met/���-f t he CIc ►� � �ol' � Q ,L iI �5rvtic `�-to.1 veto cl�s cam, it 5 5 re 3. Control Flow Rates. �/ /J / �J U et t vu' na ft,Vct 4 l y // q /c1 f3 0,r / ro,)ec-t hPP a r� I I / y ,r cc�c1 ham,r1 t�l s ct frv, f�-- dr 5 [�{?Q far26ti// Sctte ' ccr' (oV V 4. Install Sediment Controls. nn (jGl_r e k( S tt ('r Y'lr0bt.kr� Sf 14,16 rR y VO tt 41 1i v '►r . 5. Stabilize Soils. cl aXC till)5 6. Protect Slopes. S loft 0P2 (-1‘)e5 ¢ S / Jc oif- Pre r<v,(_, 6'1 ve461, r"Aa i ( toe d,15`j��t'�z �. 7. Protect Drain Inlets. r q 7— fro?virtu/ stormwater site plan templata.doc—rev.10/12/2003 8 • . 12 Required Elements-Construction SWPPP(continued) 8. Stabilize Channels and Outlets. ' I VJ G C �tict Lit 11C 1 S O1 0-C`- - (A-1 1 ( 1 V je y+�'A a C c E i fY G(r 6 t. -- iCe` r t Li t 4 oC- L ea &CI-. It�,�,, � tAi 1 he re cf,,c( Frio V 0 cv.s-1- v 9. Control gollutants. hvl5/b✓1 (10, c) ( «av�(c.- Itl es Lot 11 1e)a ot.iNA !'0. Gam Noe v-ePfii 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). 101- (rrg 1 v d / 1 f"r f�, Vey I P ve / at et_to V3e f� koRci t tti.J-d V t I ty.oe,j vt,u41 _,14 -i---5i c 04- /0'• 11. Maintain Best Management Practices(BMPs).; C . '..A fit ' CLe. • ♦' r r 'rtc Lt • I '! Vt. V G� ♦ y t • ua �Ll 5 r-6P filet 144.0 vt t yL 12. Manage the Project Lott( o �.�1�2 v ( (me mot^ tom �i I 110.0 �Y-e���►t - a + a j/ --Ft iP5 ct tit to , Cyrt/ 5 f 1-4.. 7� e'14 4 rt t-e e f vl ' c5-' (LP/ 4 5re( t 5 c 7/<$ M�.� 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). TA e Cp ct r (c e64 c e7c, /S l�/O e S 7`e G 21g 715 ai,t /o r-dam. a- ( a c, +Li Y'C v-5>��e. --i t o 3i cv . a v 5 rot 5 tee, sJ ,? /S ftxc i f S be 1ztleeit roa 5 0 act r 1 1,itvefr - G n t4".1"iv r b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). /kJo S�reGut 5 or LJ .11a 11t 9 t' ert. , lcctrte ii—r Lj CO d 4 J 5 In H (6 Yt.rf 'r" tin wk., 5 f vei( 61.-1 G t~ L toe et cc ec 3. Environmentally Sensitive Areas. a. Description of environmentally se,jsitive areas that are ion or adjacent to the site. tt.t ce ` 1.6ety tiocS sbrmwater site plan template.doc—rev.10/12/2003 9 • • b. Description of special require ents for worldng in or near environmentally sensitive areas.s �6 v s.0 i't C c�2 I I ' / j f`.i."_liC/r/e) Cl-i--z%c t r c;� fl e, et,e S/ �e L ez io J r� I it` .--f`-. --1- c r Gtri S 1- 6-t.Ir 12eri J4 61 J 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?trructure). OA eVC 5I C r't 1 v0 to( 6 i•1-S yi,a<�,,,9, 4 1. J it---, /5 / v, ' 4 Lt. C- Ll 5. Construction Phasing. a. Construction sequence c U r / y o O • vt k L ,%*A- b. Construction phasing(if proposed) S�,-��`�c,s ertr Sltic>� �" , 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Provide a proposed construction scule. ) ) P ' t t- e-ok 5`tr u c i cti-t /S i i ti-ef (^ ,,tt t 1e e;.. �t-1 o ,, II. e Piac r /'i2i'J I, (! v- 11, 10 a ( , Oc , C'D, Wet Season Construction Activities. C-6 its.+6�Ct-- We Y r5t,6f (3e- f O J> a. Proposed wet season construction d activities. 1 `� '055/ b I e p/ac itte,L 61.E Mg 4 / b' ko N-.0/C_..)c)! /(.6 P.a.- /�J�f4. l�6 � b. Proposed wet season construction qctivities for environmentally sensitive areas. Aioserkokszci 7. Financial/Ownership Responsibilities. a. Identify the property owner responsible for the initiation of ds and/or other financial securities. Q Gi s r�Df4Ce Q Oar! ) . ..✓Nt-4 6 b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. b. Diversions. c. Waterways. d. Runoff/Stormwater Detention Calculations Vciketi 01 frf .ram. 5t it LA stormwater site Wan template.dw-rev.10/12I2003 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 hformation that explains and supports the faaav„for the change. Final Corrected Plan Submittal If the project included construction of conveyance systems,treatmert 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 applicantlowner 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, 7,_ / 7 _-0 (LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: storm ter site plan template.doc—rev.10/12/2003 12 7i.�,SON cam&,. JEFFERSOFs )UNTY W ' ,�.3 DEPARTMENT OF COMMUNITY DEVELOPMENT TT .�`' `� 621 Sheridan Street • Port Townsend •Washington,)9 -Vi_ct. 360/379-4450 • 360/379-4451 Fax • Is NOO� www.co.jefferson.wa.us/commdevelopmert FEB 11 2U09 Master Permit Application rr�1 ,,i, ._ Proje t Description (include sep rate sshhheeets necessary): ssary): �irc;Cft : f'%11�E, <, „ �� Tax Pa el nn Property Number: `l01 `I�1�-- 07-7 Size: / , ! u-/4/� �( (acres/square feet) Site Address and/or Directions to Property: 1ce3 n arr f dtn± 6)tki ( C2r L( 0 9g 7 Property Owner(s)of Rdcord: Telephone: -—a -. ;�74� (� ax: email: ri,.. ,.(.'ml- LZ (ns1, r, Mailing Address: 14j` t-(.j N 2... rft - c_ Applicant/Agent(if different from owner): 6reklitppl •,' /ice j Telephone: ZO( S-53-ISZJ Fax: ZS�- e i ,'It Mailing Address: �S3 5. ���. - uoilgp C � emaillq'yy1J� �jL(,(�J/11$r7,� What kind of Permit?(Check each box that applies o (/ ❑Building A 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit 0/'a �4a.dt 0 Conditional Use[C(a), C(d),or C]** .0 Single Family B'Ctarge Attached/ r 0 Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home ❑ Modular ❑Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment ❑ Change of Use 0 Short Plat** ❑ Address 0 Road Approach 0 Binding Site Plan** ❑ Home Business 0 Cottagelndustry 0 Long Plat** ❑ Propane 0 Planned Rural Residential Development(PRRD)/Amendments** ❑ Sign 0 Plat Vacation/Alteration** 0 Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management 0 Shoreline Management Substantial Development** 0 Site Plan Approval Advance Determination (SPAAD)* 0 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 2 �w /LotiZti--�d Date: lS to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE 1 f"- ' ^+�^-,t� _ / v �-I a01--/ 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 applon that e r she wants prior notice. Signature: Date: ! / 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 are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transf$rable r nsibility for adhering to and complying with the ESA. The Applicant has read this disclai r and signs and dates it below. Signature: r Date: 2//7 G:\PennitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc • BUILDER STATEMENT 0 The signer of this statement doe edify tat they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be asprh n the resp I i' f G ral Contractor for the proposed project Signature: 7 Date: / 2/'''i GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: t'a14 ,rr5 ()krm ('196517-0 , ( ) '51 'D 1 ( ) $5) 1 TJ MAILING ADDRESS: EMAIL:�.i Y g.�rowis/,� nisi), Cffin CONTRACTOR'S LICENSE WAIN /� �"^ NUMBER: �U -��0&`(•77 k'F NUMBER ARCHITECT/ENGINEER: TiviriQ„,r(avid t4 14c. PHONE ( 9.5j37 '73s ?(5 ) MAILING ADDRESS: 1F7►~ EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: Z.New la Wood isting: ❑ Sewer Li Addition ❑ Steel Pro ed: Bank i ❑ Community System ❑ Alteration/Remodel ❑ Concrete al: Height: (IJ ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# 07-6C;?-44'5 ❑ Demolition ❑ Other: Brooms: Water Supply: Exis • Setback: C -Private well ❑ Two Party Type of Heat:.. i M4 Proposed: 5�'"�"j]� (�.',L ❑ Public •()Ol I i\� Total: 7 Name of System: • If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: `-- Proposed: N.------. 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 I No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: , . a I Underground Tank �'� r bove ground Tank Size of Propane Tank: i ("')'l� &Heat Stove I Cook Stove i Woodstove i Fireplace Insert I Hot Water Tank i Pellet Strive 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 Use Only Amount Revision Main Floor Heated - Q 7_b EH BId App Review: 4164 / t.-0/ I-{Gc R- f i.--10 i - 2nd Floor Heated [ ) d) S , Consistency Review: 1�� ' 1,3 Mein c. (4- id Other Heated Base fee: jQ• 12 , ---/ � i ' I Mezzanine Additional Section: Heated Basement Plan Check fee: ici I Ciq I .-IT Unheated Basement State Surcharge fee: A Other Unheated Pot Water Review fee: �/ �( �:j(.-) I VLSI(n Garage/Carport SUBTOTAL �l (1 , (/ q q Decks .. 911/Rd Approach fee: Lice, W _ `�r�` CaY(2(43d. Prt..h :,l,i,_ �, L 1 toy -)1nj - -} O xOther �1.�1:4�9f it Iq 1 ,00 TOTAL: $511 Ai co `3 -� ` v Receipt Number: j "_ 1u0`n `72 Cash/Check Number: ` Ci ESTIMATED COST(REQUIRED --- --...__.,--- Date: ( , •Fair marfc ue of all labor materials foundatio fim l• —]�� / r1^,I,-n-�-)� Initials: >j t (To �1 V G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc Fri \ m 23 I n 0da r o x _ rrt "- c.►J E ♦�- {{ S� � r P I l O_ -G n c� �- _. c .c 3 1 T- 1-- o w p �, WI , f_ p `� C7� V • SD© w � c o ' I cm k 3 , is' °� r .z 3s c) cow il_ t, 3a 1 n F 7U G -_ �` i s -- N Z. 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