HomeMy WebLinkAboutBLD2008-00375 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#: BEDOE3600375
SITE ADDRESS: 657A WILDWOOD RD EXT Issue Date: 10/29/2008
QUILCENE, 98376 Final Date: 2/11/2009
APPLICANT: WILLIAM L BIERY PHONE: 360-765-0975
NANCY R BIERY
PO BOX 486
QUILCENE WA 983760486
SUBDIVISION: Block: Lot: TX 52
PARCEL NUMBER: 702142001 Section: 14 Township: 27 N Range: 02 W
PROJECT DESCRIPTION: NEW MODULAR ADU W/A/G 250 GAL PROP TANK
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 2/11/2009
I:\F_BLD_Occupancy.rpt 10/29/19
•UILDING PERMIT APPLICA N ML ReviewTy 391
Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00375 Received Date: 8/20/2008
SITE ADDRESS: 657 WILDWOOD RD EXT
QUILCENE, 98376
OWNER: WILLIAM L BIERY PHONE: 360-765-0975
NANCY R BIERY
PO BOX 486
QUILCENE WA 983760486
SUBDIVISION: Block: Lot: TX 52
PARCEL NUMBER: 702142001 Section: 14 Township: 27 N Range: 02 W
CONTRACTOR: SEAHOME SERVICES, INC PHONE: (360)765-3749
7425 THORNDYKE RD
QUILCENE WA 98376
Contractor's License SEAHOSI077KS Expires 11/30/2009
REPRESENTATIVE: GREG BARRON PHONE: 360-765-3749
7425 THORNDYKE RD 360-765-4551
QUILCENE WA 98376
PROJECT DESCRIPTIOP NEW ADU W/A/G 250 GAL PROP TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ADU MAIN: 660
VALUATION 175,000.00 ADD'L: HEAT TYPE: PRO
CODE EDITION: 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: SHORELINE:
CONST TYPE: DECK: 200 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: PWELL
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 1 Prop: 1
Total: 1 Total: 1
Routing Date:
Type Amount Paid 4: Date: Receipt: Approved/Date
Permit $1,413.75 LYK 08/20/08 100739 APPROVE[
State Building Code $4.50 LYK 08/20/08 100739
Potable Water Application $59.00 LYK 08/20/08 100739 OCTc 2008
Plan Check $918.93 LYK 08/20/08 100739
Jefferson County Planning
Total: $2,396.18 & Building Department
Jefferson County Building •ision Permit Nuier: BLD08-00375
Applicant: BIERY
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
Foundation Footing 0/ dg perimeter footings
Foundation Footing deck footings
Foundation Stem Wall ; y_og
Under Floor Framing and interior footings
Straps(hold downs) L ,� _�r 4( j' and anchorbolts
Ext. Shear Wall Nailing nailing to mudsill and all attachments to foundation
Framing Z/ii td. decks: ramps, stairs,guards, handrails,
Insulation: Floors �, �� 6 mil also
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Gas Line: Exterior Z l/ C9 /,1
Propane Tank / / q' �/ , /?
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FINAL INSPECTION 7///frq AI
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FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
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CONDITIONS for Building Permit# :BLD08-00375
1.) Health approval based on the condition that a 10'water sewer separation is REQUIRED at
the residence, and when the sewer crosses the water line elsewhere the crossing be
constructed per Nathan Cleaver crossing detail design dated 10/23/08
2.) An additional setback of five (5) feet is required from the edge of the buffer area to the
proposed ADU.
3.) The building height is not to exceed 35 feet.
4.) Southern Property Boundary setback is 55' per Geo Tech Report&Approval of Variance
from Rural Forest on 10/8/08.
Western, Eastern & Northern Property Boundary Setback meet UDC Requirements.
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0", ;`? ► ' i, corm IQNlTY DEVELOPMENT AUG 2 0 2 C08
4. ', , 621 Sheridan Street • Port Townsend • Washington 98368
vlo OHO 360/379-4450 • 360/379-4451 Fax JEffERSON COUNTY OCD
YIN http://www.co.jefferson.wa.us/commdevelopment/
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# C ` J 1 ( PROJECT/APPLICANT NAME:
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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.
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Existing Conditions Summary
2. Describe the existing topography. Indicate contours on the site map.
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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.
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.
6. Describe any excess levels of noise generated by the proposed use or activity:
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stormwater site plan template.doc—rev.10/12/2003 5
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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 ma
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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.).
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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.
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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.]
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11. Describe the performance goals and standards applicable to the project.
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12. Describe the flow control system. , ,r f,r-c
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stormwater site plan template.doc—rev.10/12/2003 aQ&11ffraSi CLAP
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13. Describe the water quality system.
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14. Describe the conveyance system analysis and design.
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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.
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17. Describe the proposed surfacing material.
18. Describe methods for restoration of the site.ra
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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.
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20. List here and include any special reports or studies 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.
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stormwater site plan template.doc—rev.10/12l2003 JL�fE�SUN COON[ 7
JEFFE SON CON DC t BCD
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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.
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2. Establish Construction Access.
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3. Control Flow Rates.
4. Install Sediment Controls.
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5. Stabilize Soils.
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6. Protect Slopes. 4
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7. j Protect Drain Inlets. j
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stormwater site plan template.doc—rev.10/12/2003 tt i,V011 uu 8
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12 Required Elements—Construction SWPPP(continued) F CE1ry )
8. Stabilize Channels and Outlets.
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9. Control Pollutants. JEFFUlSUN COUNTY DAD
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10. Control De-Watering (the act of pumping groundwater or stormwater away from an active construction site).
11. Maintain Best Management Practices(BMPs).
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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).
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b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards).
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3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
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stormwater site plan template.doc—rev.10/12/2003
9
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b. Description of special requirements for working in or near environmentally sensitive areas.
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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).
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5. Construction Phasing.
a. Construction sequence r oZ
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b. Construction phasing(if proposed)
6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
Provide a proposed
/construction schedule. L
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II. Wet Season Construction Activities.
a. Proposed wet season construction activities.
b. Proposed wet season construction activities for environmentally sensitive areas.
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7. Financial/Ownership Responsibilities.
a. Identif the property ow er responsible for the initiation of bonds and/or other financial securities.
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b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impacts.
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8. Engineering Calculations. Provide Design Calr,ulations on a separate sheet for the following, if applicable.
a. Sediment Ponds/Traps. /I.4.
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b. Diversions. f
c. Waterways. A.1/*-
d. Runoff/Stormwater Detention Calculations
..L1��1'������� IAA/stormw ater site plan template.doc—rev.10/12/2003 Y 10
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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 Constructio PPP worksheet, I as the applicant/owner attest that the information provided herein is true and
correct to the st of m n% ledge. I also certify that this application is being made with the full knowledge and consent of all
owners of ected o •rty. iiii/og
(LANDO OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
F,CE!V1ED
AUG 2 0 2008
JEFFERSON COUNTY ULU
atERIBStA LiiiINif fiCb
stormwater site plan template.doc—rev.10/12/2003 12
k,�4,,``'sON CO�� JEFFERSONOUNTY I f u
W \� DEPARTMENT OF COMMUNITY DEVELOPMENT
t' o 1-C 621 Sheridan Street • Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
.qS, ��p www.co.jefferson.wa.us/commdevelopment
HIN
Master Permit Application MLA: CS '3 9
Project Description(include separate sheets as necessa
4 c J uo vi-h % pq,v2 * noioR L iVc?-,O.-e---0
Tax Parcel Number: '7 Q a I C.-o. 0 0 / Property Size: Vs,3 "7 (acres/square feet)
•
Site Address and/or Directions to Property:
(, S ---) (A)i /clwa0 ci p J
Property Owner(s)of Record: PiernfC C. WGk, , , Lt/JLLd y3A4 s1 /4,j c y $BAR
Telephone: -7(3 "- C 1 Fax: /If email:
Mailing Address: ,0 , I x yg-(, Qom;'� � l lA j�- '76 3 24
Applicant/Agent(i different from owner): Gj'"",_c /3'(roeJ
Telephone:76S-- 3`1`7 ci Fax:
email:
Mailing Address: j 6 V /G ._,`&_o<-ce i_ we t?S .7L
What kind of Permit?(Check each box that applies
iuilding 0 Critical Areas Stewardship Plan
❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use)
❑ Single Family 0 Garage Attached/Detached ❑ Conditional Use[C(a), C(d),or C)
❑ Manufactured Home odular ° R+Tl ' i[q 1
❑ Commercial* � 0Discretionary"D"or Unnamed Use s,I Ion•-� l ,
0 Special Use(Essential Public Facilities}**
0 Change of Use 0 Boundary Line Adjustment
Address 0 Road Approach ❑Short Plat** AUG 2 0 2008
❑ ome Business ❑Cottage Industry ❑ Binding Site Plan**
Propane 0 Long Plat**
0 Sign 0 Planned Rural Residential Developr►
0 Allowed"Yes"Use Consistency Analysis El Plat Vacation/Alteration** �� Li
0 Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions**
0 Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development**
❑Temporary Use ❑Shoreline Management Variance
❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment
❑ Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment
*May require a Pre—Application Conference 0 Tree Vegetation Request
**Requires a Pre-Application Conference
Please identify any other local,state or federal permits required for this proposal, if known:
f DESIGNATION OF AGENT
I hereby designate U to act as my agent in matters relating t 's application for permit(s).
OWNER SIGNATUR Date: ICN
By signing this application form,the owner/agent attests th the information provided herein,and in any attachments,is true and correct to the best of
his,her or its 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 Cou y in writing at the
time of the a he or sh prior notice.Signature: Date: g _ . p�V3
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 complian w the Jefferson County development code.The Applicant acknowledges that he,she or't holds individual
and non-trap :';,77/
, nsci, t laim rin to and complying with the ESA. The Applicant has read this disc r�arad signsrand ges it below.
Signature: /i L J J
Date:
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
• 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:
, - di ram S e ev�c.._c-s (6 76S--37 `7, ( )
MAILING ADDRESS: -7y7S 11br y£ QJ F j��,,te-t ` EMAIL:
CONTRACTOR'S LICENSE � WAINS
NUMBER: _41" 5-�CD-7-)'`- r T NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: • EMAIL
' Project Type: Frame Type: Bathrooms: Shor Tine: Type of Sewage Disposal:
X New Ne( _Wood Existing: yU 40,- i i Sewer
❑ Addition ❑ Steel Proposed: / Ban I I Community System
.❑ Alteration/Remodel ❑ Concrete Total: / Height: N.-individual System
❑ Repair ❑ Masonry SEP Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: 0 Setback: kr—Private well I I Two Party
Type of Heat: Proposed: 0 Public
0- L Total: / _ t _ Name of System:
If this is a Commercial Project you must answer the following:
Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces:
Number of occupants(includes owners,tenants,employees,etc) Current Proposed
IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No
If this is a Propane Tank and/or A••liance Installation permit,mark all items below that apply:
i Under,round Tank .bove ground Tank Size of Prapane_Tank: Q SO
- Heat Stove i Cook Stove i Woodstove i Fireplace Insert �ot Water Tank i Pellet Stove i Other
Is t is 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 /-t �, l EH Bld App Review: r
2 °Floor Heated Consistency Review: cJ
Other Heated Base fee: `l
Mezzanine Additional Section:
Heated Basement Plan Check fee: q ` C 3
Unheated Basement State Surcharge fee:
f 5C
Other Unheated Pot Water Review fee: 0 r CO
Garage/Carport SUBTOTAL
Decks -/> U �, k_1(4^ 911/Rd Approach fee: \
Other C/ TOTAL: $,1 V i{I . ( I
•
Receipt Number:
Cash/Check Number:
ESTIMATED COST(REQUIRED)__ - ,_ Date: ,� -
�(
•Fair market value of alilabor and materials foundation to finish,, S-`)D_.-.
S10 O Initials: i
r D
G:\PcrmitCentcr\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
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