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HomeMy WebLinkAboutBLD2008-004271 !UILDING PERMIT APPLICATIONML vy 423 Review T Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00427 Received Date: 9/25/2008 SITE ADDRESS: 123 KINGFISHER PL PORT HADLOCK, 98339 OWNER: MICHAEL C THOMPSON PHONE: 360-774-2163 STEPHANI THOMPSON 1331 OLD EAGLEMOUNT RD PORT TOWNSEND WA 98368 IRONDALE AC TRACTS SUBDIVISION: Block: Lot: D PARCEL NUMBER: 962700026 Section: 13 Township: 29 N Range: 01 W CONTRACTOR: TERHUNE CUSTOM HOMES INC PHONE: (360) 697-7000 PO BOX 97 POULSBO WA 98370 Contractor's License TERHUCH984MA Expires 7/1/2010 REPRESENTATIVE: TERHUNE CUSTOM HOMES PHONE: (360) 697-7500 PO BOX 97 POULSBO WA 98370 PROJECT DESCRIPTIOt NEW SFR W/DAYLIGHT BASEMENT AND ATTACHED GARAGE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,200 VALUATION 244,134.00 ADD'L: 934 HEAT TYPE: HTP CODE EDITION: 2006 HEAT BASE: 166 HEAT TYPE: WOD OCCUPANCY: R-3 UNHEATED: # OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: 572 SHORELINE: CONST TYPE: DECK: 332 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PUD BEDROOMS: BATHROOMS: Exist: Exist: Prop: 3 Prop: 3 Total: 3 Total: 3 Routing Date: 10 Type Amount Paid Bv: Date: Receipt: Approved/Date Permit $1,805.75 KAS 09/25/08 102715 APPROVED Plan Check $1,173.74 KAS 09/25/08 102715 State Building Code $4.50 KAS 09/25/08 102715 Potable Water Application $59.00 KAS 09/25/08 102715 OCT 3,' 2008 Total: $3,042.99 Jefferson County Planning & Building Department • • CONDITIONS for Building Permit# :BLD08-00427 1.) A Stormwater and Drainage and Erosion Control 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. 2.) 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. BMP C103, MARK CLEARING LIMITS MARK CLEARING LIMITS. 2005 DOE Manual BMP C103 High Visibility Plastic or Metal Fencing - SEE ATTACHED SHEET FOR DESIGN AND INSTALLATION SPECIFICATIONS. BMP C105, ESTABLISH CONST. ACCESS ESTABLISH CONSTRUCTION ACCESS 2005 DOE Manual BMP C105 Stabilized Construction Entrance - SEE ATTACHED SHEET FOR DESIGN AND INSTALLATION SPECIFICATIONS. BMP C233, SILT FENCE INSTALL SEDIMENT CONTROLS - SILT FENCE 2005 DOE Manual BMP C233 Silt Fence - SEE ATTACHED SHEET FOR DESIGN AND INSTALLATION SPECIFICATIONS. BMP C120,121 - STABILIZE SOIL STABILIZE SOILS 2005 DOE Manual BMPs C120 , C121 - SEE ATTACHED SHEETS FOR DESIGN AND INSTALLATION SPECIFICATIONS. BMP C120, C201 - PROTECT SLOPES PROTECT SLOPES 2005 DOE Manual BMP C120 temporary and permanent seeding &201 Mulching - SEE ATTACHED SHEETS FOR DESIGN AND INSTALLATION SPECIFICATIONS. BMP C151 - CONTROL POLLUTANTS 2005 DOE Manual BMP C151 - Concrete Handling - SEE ATTACHED SHEETS FOR DESIGN AND INSTALLATION SPECIFICATIONS MANAGE THE PROJECT Maintain BMP's as prescribed in individual attached sheets MAINTENANCE STANDARDS 3.) SHALL BE INSTALLED DOWNVE OF THE CLEARING/PROPOSED REtNCE TO PROTECT THE WETLAND B FER (SEE ATTACHED SITE PLAN) PRIO 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. 4.) GUTTERS TO DOWNSPOUTS TO SPLASHBLOCK SHOULD BE SUFFICIENT FOR STORMWATER DISPERSION. A MAXIMUM OF 700 SQUARE FEET OF ROOF AREA MY DRAIN TO EACH SPLASHBLOCK.. 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. 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. 5.) THE ROAD APPROACH PERMIT(RAP07-00154) 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. 6.) A setback of 100-feet, measured perpendicularly from the wetland edge, shall be permanently maintained as a buffer. No filling, grading, clearing, or other alteration of the wetland or its buffer is allowed. 7.) Buffer perimeters shall be marked with temporary signs at an interval of one per parcel or every one hundred (100) feet, whichever is less. Signs shall contain the following statement: "Wetland & Stream & Buffer- Do Not Remove or Alter Existing Vegetation." 8.) A permanent physical separation along the upland boundary of the wetland buffer and stream buffer area shall be installed and permanently maintained. Such separation can include installing logs, trees, a hedgerow, or any other prominent physical marking approved by the UDC Administrator. 9.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 10.) Not more than 2 unlicensed vehie shall be stored on any lot unless totally silikned 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 automobile 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 requirements 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. 11.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 12.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 13.) The building height is not to exceed 35 feet. 14.) Building Setback from Kingfisher Place right-of-way is no less than 20 ft., Front yard setback (eastern) is no less than 20 ft. Left side setback (southern) is no less that 30 feet . Rear(western) setback is not less than 5 ft. If an environmentally sensitive area (ESA) is present, then the more restrictive setback shall apply. 15.) 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. 16.) 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. 17.) Water lines must be located a minimum of 10' from all septic system components. Jefferson County Building Lion Permit Nu•r: BLD08-00427 Applicant: THOMPSON BI$hLDING PERMIT INSPECTION APPROVALS Npplicable 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 it/II/et)/et) Building Setback from Kingfisher Place right-of-way is no less than 20 l l ft., Front yard setback(eastern) is no less than 20 ft. Left side setback (southern) is no less that 30 feet. Rear(western)setback is not less than 5 ft. If an environmentally sensitive area(ESA) is present,then the more restrictive setback shall apply. Wetland buffer of 100 ft from edge of delineated wetland. StL� FeN^e /a35-rKre.-L-En /l//r,C'c�si Erosion Control Stormwater Plan Submitted-A SILT FENCE& STRAW ON EXPOSED SOIL. SHALL BE INSTALLED DOWNSLOPE OF THE CLEARING/PROPOSED RESIDENCE TO PROTECT THE WETLAND BUFFER(SEE ATTACHED SITE PLAN) 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. Foundation Footing 0//7/4,5 Footing Drains ;ilii Foundation Stem Wall e>e�l It'3 Underground Plumbing / Under Floor Framing ,/22/°0 Straps(hold downs) Ext. Shear Wall Nailing ///5/c Rough-in Plumbing 4jo Framing //Z-7/0gt Blocking /let/o 9 Airseal // /61 l Insulation:Walls 5-IO� • Insulation: Floors 2 l g f o'1 Insulation: Ceiling Int. Shear Wall Nailing 2AWO �/ 05 5 O - Wallboard Nailing �%��L J / �/�y/�9 GasiinP• Interior has I ine• Fxtedor Ut,nimney Clearance Drywell/Alt Drainage SPLASHBLOCKS/GUTTERS -fiC nL" / s1"-EA 1 z/q/o8 GUTTERS TO DOWNSPOUTS TO SPLASHBLOCK FOR STORM WATER DISPERSION INTO THE WETLAND BUFFER. NO PORTION OF THE OUTLET OR TIGHTLINE SHALL EXTEND INTO THE WETLAND BUFFER. A MAXIMUM OF 700 SQUARE FEET OF ROOF AREA MY DRAIN TO EACH SPLASHBLOCK.. 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. 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. Address Posted ` G {— FINAL INSPECTION 1 01 n D-V 51v b.c rre,- -p nor -Iv F1 tied FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR Oct. 27. 2008 10:46AM Terhune Custom Homes • • • No, 0824 P. 4 re: RECE VED JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT + �'f 20a8 }v - -ftmek- ,4 621 Sheridan Street•Port Townsend• Washington 98368 360/379-4450 .360/379-4451 Fax ffhiStIiN hftp://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE Mtn PROJECT/APPLICANT time: IU,L .\! Please answer all of the following questions to the best of your applicant may choose to either incorporate the elements into the general plot plan for the Master Land Use A question calls for pplication ti a site map, the submit separate stormwater site plan map. Applicat}on or to submit a Project Overview 1. Describe the proposed developed conditions of the site. indicate position and relative size of proposed improvements on the site map. ari ).AU' _ . a OPt • ►asp Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. S i e, . . 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. • 4. Describe the existing oils. Indicate soil type on the site map. r- C t� ' Ja— mic 5. Describe the existing site hydrology(i.e.,drainage;behavior of water on the site—above,below,and on the ground). In e existing stormwater drainage to and from the site .n the site map. g si dip, if applicable,and Indicate acreage of each, p Depict separate drainage basins on the site map, if , • • 40 VA.lam .• .�..� . -+ [ •-,Ct Yv� 12* +� 6. Describe any excess levels of noise generated by the proposed use or activity. av ORMWATER PLAN stomwatta Sti9rianWrrplaze-rev.1G12009 I Stormwater BMP's OCT 2008 JEFFERsOti •bRhi Required e� JEFFERSON COUNT _ DEPT.OF ITYDEV SIGNATURE:: ./((� C Oct. 27. 2008 10:47AM Terhune Custom Homes No, 0829 P. 5 • • 7. Describe significant geographic features and critical areas (Le., environmentally sensitive areas such as wetlands, streams, steep slopes,etc.)on the site. Indicate location on the site map. c -a / `1--R_ yv 6'' �` `*r r-,CN441.e.t 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 eAk-?.-t s tom-,r.�9�1rer b-s� GI VIA 5 k'a 14. _ ' . Permanent Stornxwater Control Plan This portion of the Stormwater Site Plan consists of the selection and installation of the appropriate stormwater control DMPs 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 pprvlous surfaces to verify that the thresholds for treatment facilities and flow control facilities are not exceeded. 9. Describe the developed site hydrology,as proposed, indicate whether stormwater will be fully dispersed(i.e.,per 8MP T5.30 in the Manual)or,it not,what types of stormwater flow control will be utilized for the site or specific threshold discharge areas within the site. Locate those facilities on the site plan and differentiate proposed facilities from existing facilities. (tt t-LA, 4 ..i 1j�L4C./ r.0Y'S-e-- `►,�t+.c Y'C�a,+{r, -' rlt �/� -�C /y .� A S re1r' S-P.,f '` �.-c.9 �� At, LQ5A �,� �w'�`+ �Q IF , • 10. If M 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.] ►vim,. '.t-VV �-4- / . ...kyi\H T 11. Describe the performance goals and standards applicable to the project. 12. Descnbe the flow control system. R E E I V I4:I( ) • APPROV • t 14 , i LOOT2003 .,tormvrster site plan terrOata-ray.1 CA2p03 JEFFER ONTY COUNDEV DEPT.OF COM 4E `�� SIGNATURE: _/ ���(pppppp I Jam_ • Oct. 27. 2008 10:47AM Terhune Custom Homes No. 0829 P. 6 13. Describe the water quality system. . • u�y . aiAJiI.l-arr. A at • 14. Describe the conveyance system analysis and design. — — .V • i = n 15. Describe the source of fill material,physical characteristics of till material,and deposition of excess material, 004.0 en/ E'_ 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 Uniform Building Code. p of the 17. Describe the proposed surfacing material. Z-ale,_ o3.32-tAn 18• Describe methods for restoration of the site. `f LLL-P c�`-� 19. An Operation and Maintenance Manual is required for each flow control and treatment facil' ty. [This is normaluired for large'projects only and only those for which facilities are required to control flow or treat runoff.] if Included,l strthe Manuals here. a w, • - r. G/V\ w 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. Imps I-1 OF {�(1) OCT 2 72008 stocrtrvCershep!intenplefe—rev.Y6r7/20QA ! �l'llU � UWtY t int CANUG1 JEFFERSON COt1 DEPT.OF COM NITY ll PlV .NBC S1GNr1TURE: �.X a Oct. 27. 2008 10:48AM Terhune Custom Homes No. 0829 P. 7 . . CONSTRUCTION STORMWATEPt 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 respons ,le 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 wilt 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. 4 Y^z � �1 _ `ca�vN- '2 • 2. Establish Construction Access. C.c-t. - ► v car v--e.ua P 0_, r0CAC-. c ..u.1 r\ ��Y�iaEr�tra 1;�v•, Iank q ,�� 4 y } py-2.21-1124-►'v, p },. 'fY r n . A-- O €- ve^2,rz y . ` rQ pr e-C CX Y V e_ . zo es to ex_ / rrx.�-e..Q �rnr rn a Pa . - , V, ,U. ,-� nce .►� ti,�r vort,� 3. Control Flow Rates. ri YSQc Y-x _ e.r r�aic r ?V G ()1,01- L Ey\-k{k..trl..e . C r NZ kr'„LN rt pe_.r 4. Install Sediment Controls. • Te.1.e._ .r e tom , rk.0 t tab' vvp r6•9.f-ri-c r ap Lc*:-- 9 st we -✓� V-kr^.rv-t&L c lkr_ w,-- 41/4--f co. inc-1 c—x LA .t Ezri-ri_.P!Z ror.�c�Yj�o �tCa v_ trtr r� (e2P �P _v1A in-ra ,�Qh , �C7 5. iiize Soils. }, \'1 ►c- �r'L/�1' u� G`r-Aj��C� t__ v 1 ✓ tO B. Protect Topes. 7. Protect Drain inlets. r a—. • Vr. . A. • _ tftr tt r r GQ,C_. * 1 STORMWATER PLAN j I ) 2003 —rsc�oorr�AWr dE iCY�Ui +��U�YY1 OCO Lik c L� ��ff JEFFERSON TY DEPT.OF C`4.7V1UNI"�41Ey' 1(2 Oct. 27. 2008 10:48AM Terhune Custom Homes No. 0824 P. 8 • • 12 Required Elements—Construction SWPPP r ffpui 0 8. Stabilize Channels and Outlets. • 9. Control Pollutants. • CILad— to Gt ia_ 1t}. Control Oe-Watering(the act of um in ��� nt P P g groundwater or stormwater away rem an active construction site). 11. Maintain Best Management Practices(BMPs). -Zi � 12. Manage the Project. joieca— .��Ih�.. y t�� 1rn its 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas,roads). L b. Description of the downstream drainage path Leading from the site to the receiving body of water(minimum distance of 400 yards). S. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. .� .. •_ if _ � I ` 7 normwatata'tepranterrosla-rw.76ry/d003 2 OCT2 2008 .iEFFERSON COUNTY ��r JEFFERSON CO S l r� a✓0�� �9 I (r ail DEPT.OF COM I7 SIGNATURE .Imy. DE 1�;" l Oct. 27. 2008 10:48AM Terhune Custom Homes No, 0829 P. 9 • • • b. Description of special requirements for working In or rear environmentally sensitive areas. • ( N1S-�t I.h t, t - 1 +/l„C C o Sa-r,r ll.r 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the Characteristics of the on-site soils(e.g.,erodibiity,settleabirty,permeability,depth,texture,soil structure). Se L '.C-teN _.. b. Constructio haling. a. Cons coons uence N 7 A b. Constar on basing(if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). T E C E rTrq !. Provide a proposed construction schedule. 1L f NCiNt Fij2.A,S.1rl, ptjj ) �-t� 2-00`� OCT 2 7 2C08 !!. Wet Season Construction Activities. a. Proposed wet season construction activities. T- - - .xfirt N 1;1-0 1Y lip f 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. :mot c.( n Y11 t1N4A_p 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. c. Waterways. ``; d. Runoff/Storrnwater Detention Calculations lb V: ' A RP AN 200$ sotmxaterstta;gal tar:data-rev.151/20C3 �r A� (� `, T 1D JEFFFF �[�i 1SOS �I� 1 JEFFERSON COTr e S1nGNATIOJRro/ # 'nYDEy i (�,EN Oct. 27. 2008 10:49AM Terhune Custom Homes No. 0829 P. 11 • • � 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-bullts")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. --2 -0-7 ER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES,IF NEEDED: RFCETVED 1�T 2 7 20Q8 JEffL1�>5'U,' jrijpiiY iICD p pMli # • f • lEEEERS6E COUNTY Deb APPROVED i' STORMWATER PLAN !,11 200' stormwater sits plan tarpl e—rsv.1N1P493 12 JEFFERSON COUNTY DEPT.OF CONN4UN1TY DIVE SIGNATIIRF ��� / 0 BUILDER STATEMENT • l The signer of this stat ment does hereby certify that they are ttie Owners of the parcel referenced erein,that they are notticensed ontractors and that they will be assumi the responsibility of the General Coptfactor for the proposed project, Signature: = Date: i. --- GENERAL CONTRACTO _. PHONE: FAX: .0 i U.k.1 C ADP/1 -P >\I k 1 f_:) ins-t-t log tji-1_ ,S60 MAILING ADDRESS: P -) •-6UX-C7 l 'L--�.Ca )C)rf r /Vkl :C. 1 CONTRACTOR'S LICENSE t' l�� E IIVAINS E_.yy\,`1 NUMBER: TS2r 4\C1ZLk(Nr AR Lek.cu ttine.'_tl.et(A-eV 1A.i.t.ne.L..L`tt rv\ ARCHITECT/ENGINEER: --;(.( ITV` (. • PiziODls—( ) EAX ) ‘'OYV J.i\lt MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: •horeline: Type of Sewage Disposal: I New Wood Existing: _ ❑ Sewer ❑ Addition ❑ Steel Proposed: 2.'/Z Ba ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Z y z Heig : 131 Individual System ❑ Repair ,M o ry i f IT fl' SEP Permit# ❑ Demolition JI -Other: - 0 d'rooms: Water Supply: Existing: Setb. k: ❑ Private well El Two Party Type of at: Proposed: ❑ Public t 31,(AA-- SEP 2 5 2fUf, Total: Name of System:J If this. a Commercial P 'ect m tt i win Num e of Park' g pa s C6 "'!� I I{ kbpos d. mber of Par ' Spa Ni e of o pan s(i d es wne ,ten nts, mplgye s,a rr nt Pr os I 0 pa y: IBC p f con tru ion: II yo hav Foo rvice. s / o If thi is a ropane Tank and/or Appliance Insta lation permit,mark all it below t at apply: i U de round'fa Hbov qr d Tam Si pf Propane nk:_� I H at S v i Co Sto ‘"Ws•dst vo A(eplace miser t Hot Water Ta k i P,ellet Love Other Is this appliance being installed in: tnufactuPed/Mobile Horn ? Yes / o ' �_! 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 EH Bld App Review: tZOO 110 gyp: QD 2"0 Floor Heated a'" t Consistency Review: C 139 cl 39.94 157.00 Other Heated' Base fee: 1805. 805. J C Mezzanine Additional Section: Heated Basement - ' `' Fi'lan Check fee: '' (c(c b073 7 1 17 5.-14 Unheated Basement State Surcharge fee: q .5a Other Unheated Pot Water Review fee: 95.00 Garage/Carport SUBTOTAL Si 1 .G 111, /4.567 3 a>5. (1 q Decks 911/Rd Approach fee: C'u�'OxeCi - o'2-- - $15.% R A-P 0 1- 144--- ----_ Other ,c317 de__ �^ cn 2oO -j r-/)4 TOTAL: $ 3J305G�G� t tt Receipt Number: ID Ri j,3 Cash/Check Number: 1(� ESTIMATED COST(REQUIRED) Date:Th 9,NA g •Fair market value of all labor and materials fou Lion to fini 2 I 1"42-s f - o4 E 154 Initials: C G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc 7�,. g0N cot, JEFFERSON �JNTY 1 11 it , �7 , W ' \_ `�A DEPARTMENT OF COMMUNITY DEVELOPMENT o 621 Sheridan Street• Port Townsend •Washington 98368 r'rp 2 J 2U0u 360/379-4450 • 360/379-4451 Fax �' p'� www.co.jefferson.wa.us/commdevelopment �`�HINp� �[ S COLI UC Master Permit Application L : �-� ,D' Project Description(include separate sheets as necessary): C'CrY3IT. Lu t- Off. 2 5 i L-4cdc;u, L�1A t- lCf.�rAvtt 31- w/a,+ irt,i 0-A,,rczciQ Tax Parcel Number: '\(,,2_,- 16 ^0 6 Property Size: (acres/square feet) Site Address and/or Directions to Property: Z f tSh�.r •P o ae, PC1 1+1ui -k.-, L )P1 `l 3-'i 3c--1 Property Owner(s)o ecord:ll'\A_ir_P 4 Q 1ri irlt -lino vvxp C VI Telephone: 's=0-2-11`a`2-1 3 2- Fax: email: b Mailing Address: 133( .Gt q,.ekt xC,.L P-Cit\t • i ")( 4- 1 LL:1:4'"\ce-bA, W 1A clZ. 30g Applicant/Agent(if different from owner):'TQ r A.u.,r'1Q.: ('U5--,-t7 iOv ' (VW S Telephone: `-, ..-,c ( '11-'lOCX) Fax: .,0 L-ic-ci-1 EI.)O email: Mailing Address: 17.n• 1x 4-Al PdL; bc-, u„)0 C 3-)0 What kind of Permit?(Check each box that applies >puilding 0 Critical Areas Stewardship Plan ❑ Demolition Permit __.�, 0 Variance(Minor, Major or Reasonable Economic Use) Xi Single Family I Garage(ttache)Detached 0 Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home 0 Modular 0 Discretionary"D"or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use 0 Boundary Line Adjustment ❑ Address 0 Road Approach 0 Short Plat** ❑ Home Business 0 Cottage Industry 0 Binding Site Plan** 0 Long Plat** ❑ Sign 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration** ,I Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** ❑Temporary Use 0 Shoreline Management Variance ❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment *May require a Pre-Application Conference ❑Tree Vegetation Request **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 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 County in writing at the time of the a • i e or she wants prior notice. � 1 Signature - T tttOA -1 ZL Date: E -`C) 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-transfe le ' 'lity for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. ISignature: Date: `( 1-1-e-Y2 G:\PemmitCenter\###FORMS###\DAD FORMS\Master Permit Application 5-29-08.doc 30.-0" 7-10" 5'-6" 16'-8" Patio TBD r rid I Provide Landing kid v I(-_. 6'x6'10' sl/gl/dr a, ;._,l a I .„']'-Sef:-149- f— \ • n a '114 N I earance cim.Q r —41 q u— �w D �° l O " • 1 1 sl i 7 , sI- : I 0 0 _ n 1 0 110C , i+ �' a .- n o O 0 < w Y / d„ g $ 5. m fi (D (/ 4 3I mw OD n ct m � _�C. x'- I w.J ra o! + O n - C� +- o_ 1 o J u x O I ZI• o x m �1 i p o CD ® , m 0 I.. i a Q I 3 a'e • -1 ' O ►,I' c I I , . o c CD E opr (D O Down is sbP:. 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