HomeMy WebLinkAboutBLD2009-00066 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 #: BLD09-00066
SITE ADDRESS: 12 BLUEBERRY HILL RD Issue Date: 04/13/2009
PORT LUDLOW, 98365 Final Date: 9/14/2009
APPLICANT: SHIRLEY J ADKINS PHONE: (360) 683-1011
30 MANTLE RD
SEQUIM WA 98382-8806
SUBDIVISION: Block: Lot: T1194
PARCEL NUMBER: 821334058 Section: 33 Township: 28 N Range: 01 E
PROJECT DESCRIPTION: NEW MANUFUCTURED HOME
SERIAL 09L36432XU
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING
CODE 2006 EDITION.
OCCUPANCY GROUP:
TYPE OF CONSTRUCTION:
SPRINKLER SYSTEM yes Cno
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 9/14/2009
I:\F_BLD_Occupa ncy.rpt 10/29/19
MLA09-00083
0UILDING PERMIT APPLICADN Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD09-00066 Received Date: 3/3/2009
SITE ADDRESS: 12 BLUEBERRY HILL RD
PORT LUDLOW, 98365
OWNER: SHIRLEY J ADKINS PHONE: (360) 683-1011
30 MANTLE RD
SEQUIM WA 98382-8806
SUBDIVISION: Block: Lot: T119+
PARCEL NUMBER: 821334058 Section: 33 Township: 28 N Range: 01 E
CONTRACTOR: SOUTH SHORE CONSTRUCTION PHONE: (360) 275-0818
230 E HILLSIDE DR
BELFAIR WA 98528
Contractor's License SOUTHSC016NL Expires 3/13/2010
REPRESENTATIVE: MARK SHINGLEDECKER PHONE: (360)479-4663
5620 KITSAP WAY (360) 479-4630
BREMERTON WA 98312
PROJECT DESCRIPTION NEW MANUFUCTURED HOME
TYPE OF WORK MOB SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 68,164.00 ADD'L: HEAT TYPE: EEE
CODE EDITION: 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: PUD
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: 2 Prop: 2
Total: 2 Total: 2
Routing Date: I
(3
Type Amount Paid By: Date: Receipt:Manufactured Homes $213.00 K APPftraAS 03/03/09 105513 V CU
Potable Water Application $62.00 KAS 03/03/09 105513
Total: $275.00 APR
etterson County Plannint
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•
MANUFA URED/MOBILE HOME INSTAATION PEiRMv IT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD09-00066 Received Date: 3/3/2009
SITE ADDRESS: 12 BLUEBERRY HILL RD Issue Date: 4/13/2009
PORT LUDLOW, 98365
APPLICANT: SHIRLEY J ADKINS
30 MANTLE RD
SEQUIM WA 98382-8806
SUBDIVISION: Block: Lot: T1194
PARCEL#: 821334058 Section: 33 Township: 28 N Range: 01 E
CONTRACTOR/ SOUTH SHORE CONSTRUCTION PHONE: (360) 275-0818
DEALER 230 E HILLSIDE DR
BELFAIR WA 98528
(360) 275-6256
Contractor's License SOUTHSC016NL Expires 3/13/2010
PROJECT DESCRIPTION: NEW MANUFUCTURED HOME
MAKE: LIBERTY YEAR: 2009 SIZE: 56 X 26.6
Directions SEE MAP QUEST DIRECTIONS AND MAP IN FILE
To Site:
THIS PERMIT IS VAUD FOR ONE YEAR..
THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR.,
CALL IN F D INSPECTIONS THAT APP OUR PROJECT.
o�
tbacks/Fo (CONTINUOUS FOOTIN SL PADS USED): I► (°'
Stormwater FINAL Approval:
Blocking/Plumbing:.../1-1-617)? (6_
Propane Tank/Lines
Zoning Final Approval:
Septic System Final Approval (If not on sewer):.
Road Approach Final Approval:
Final/Skirting/Vents/Porches/Steps: 11`-/ U ( 6
HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION
THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED
BUILDING INSPECTION HOT-LINE 37944M.
HOT-LINE AVAILABLE 24 HOURS A DAY
SPECIAL CONDITIONS APPLY-SEE REVERSE
To Schedule inspections, call
(360)379-4455 by 3:00 PM prior
day.
NOTE: Monday inspections by
•
3:00 PM prior Thursday.
SPECIAL CONDITIONS CASE •LD09-00066 •
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.) CONSTRUCTION ENTRANCES SHALL BE STABILIZED WHEREVER TRAFFIC WILL
BE LEAVING A CONSTRUCTION SITE AND TRAVELING ON PAVED ROADS OR
OTHER PAVED AREAS WITHIN 1,000 FEET OF THE SITE.
THE ENTRANCE SHALL BE CONSTRUCTED ON A FIRM COMPACTED SUBGRADE.
QUARRY SPALLS (OR HOG FUEL) SHALL BE ADDED IF THE PAD IS NO LONGER IN
ACCORDANCE WITH THE SPECIFICATIONS. (BMP C105, 2005 DOE STORMWATER
MANUAL).
ANY SEDIMENT THAT IS TRACKED ONTO PAVEMENT SHALL BE REMOVED BY
SHOVELING OR STREET SWEEPING. THE SEDIMENT COLLECTED BY SWEEPING
SHALL BE REMOVED OR STABILIZED ON STIE.
ANY QUARRY SPALLS THAT ARE LOOSENED FROM THE PAD, WHICH END UP ON
THE ROADWAY SHALL BE REMOVED IMMEDIATELY.
UPON PROJECT COMPLETION AND SITE STABILIZATION, ALL CONSTRUCTION
ACCESSES INTENDED AS PERMANENT ACCESS FOR MAINTENANCE SHALL BE
PERMANENTLY STABILIZED.
3.) PRIOR TO OCCUPANCY & BUILDING FINAL - FINAL APPROVAL OF SEPTIC
SEP08-00055 IS REQUIRED. MUST MEET ALL CONDITIONS OF SEPTIC PERMIT.
4.) The application was reviewed by the Jefferson County Department of Community
Development staff on April 6, 2009 for the potential presence of Environmentally Sensitive
Areas (ESAs) under the provisions of the Unified Development Code (UDC). After an
initial Geographic Information Systems mapping review and an investigative site
inspection, the following ESAs were confirmed to be present on the subject property:
unstable shoreline slope stability; SUSC aquifer recharge area; high risk SIPZ.
5.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological
formations that allow percolation of the surface water into the soils and the underlying
zone of saturation. Aquifers are geologic formations that contain sufficient saturated
permeable material to yield significant quantities of water to wells and springs. Aquifers
serve as the source of drinking water within most of the rural portions of Jefferson County.
6.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions
that promote rapid infiltration of recharge waters to groundwater aquifers.
7.) Geologically Hazardous Areas in Jefferson County are characterized by slope, soil type,
geologic material, and groundwater that may combine to create problems with slope
stability, erosion, and water quality during and after construction or during natural events
such as earthquakes or severe rainstorms.
8.) Marine shorelines and islanOre susceptible to a condition that is knowrllseawater
intrusion. Seawater intrusion is a condition in which the saltwater/freshwater interface in
an aquifer moves inland so that wells drilled on upland areas cannot obtain freshwater
suitable for public consumption without significant additional treatment and cost.
Maintaining a stable balance in the saltwater/freshwater interface is primarily a function of
the rate of aquifer recharge (primarily through rainfall) and the rate of groundwater
withdrawals (primarily through wells). The Washington Department of Ecology is the
agency with statutory authority to regulate groundwater withdrawal for individual wells in
Jefferson County. New development, redevelopment, and land use activities on islands
and in close proximity to marine shorelines in particular should be developed in such a
manner to maximize aquifer recharge and maintain the saltwater/freshwater balance to
the maximum extent possible by infiltrating stormwater runoff so that it recharges the
aquifer.
9.) The parcel is located within a High Risk SIPZ (seawater intrusion protection zone)
according to the County GIS map. There are mandatory measures identified in the
Jefferson County Seawater Intrusion Policy (Resolution 44-22, effective September 23,
2002) that apply to well drilling proposals and building permit applications on existing lots
of record.
A High Risk SIPZ is defined as: areas within 1,000 feet of a groundwater source with a
history of chloride analyses above 200 milligrams per liter (mg/L).
10.) 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.
11.) The property owner shall comply with Water Conservation Measures (per list maintained
by the UDC Administrator).
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.) The applicant is proposing to create or add 1974 square feet of impervious surface and
1866 square feet of land disturbing activities. JCC 18.30.060 and 18.30.070 require your
proposal comply with Minimum Requirement#2 (Construction Stormwater Pollution
Prevention) of the Department of Ecology Stormwater Management Manual for Western
Washington 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.
14.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP)
Elements#1 through #12 of the Department of Ecology's Stormwater Management
Manual for Western Washington 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.
15.) Jefferson County determined that this proposal is categorically exempt from review under
the State Environmental Policy Act (SEPA) pursuant to WAC 197-11-800(1)(b)(i).
16.) The site plan as submitted with the manufactured home & decks building permit
applications on March 3, 2009 has been reviewed for consistency under the UDC, and
has been approved by Jefferson County Department of Community Development. Any
modifications, changes, and/or additions to the stamped, approved site plan dated April 6,
2009 shall be resubmitted for review and approval by Jefferson County Department of
Community Development.
17.) This approval is for a manufactured home and decks only. Any future permits on this site
are subject to review for consistency with applicable codes and ordinances and does not
preclude review and conditions which may be placed on future permits.
18.) The parcel has been designated as RR 1:5 under the Jefferson County Comprehensive
Land Use Map effective August 28, 1998.
19.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
20.) Not more than 2 unlicensed Soles shall be stored on any lot unless totaS.reened
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.
21.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
22.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
23.) The building height is not to exceed 35 feet.
24.) Minimum setback from Blueberry Hill Road right-of-way shall be 20 feet. Minimum
setback to Teal Lake Road right-of-way shall be 20 feet. Minimum south and east
property line setbacks shall be 5 feet.
25.) 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.
26.) 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.
27.) An address of 12 Blueberry Hill Road, Port Ludlow has been assigned to the parcel.
Blueberry Hill Road is private (P19).
28.) The parcel is served by the Bywater Bay public water system (ID No. 02043).
29.) A boundary line adjustment was finaled on November 16, 2007. A septic permit
(SEP08-0055) was approved on May 15, 2008. A building permit(BLD09-0067 for decks)
will be issued with the manufactured home permit. A septic permit (SEP93-0447)was
cancelled on November 19, 1993. A well (USR08-0028) must be decommissioned prior to
final.
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'�4�4 cO JEFFERSOWOUNTY •
ti ' DEPARTMENT OF COMMUNIr PE,VELOPMENT
14
621 Sheridan Street • Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
q p� www.co.jefferson wa.us/commdev lopm n
1
2
Master Permit Application MLA: Da-8.5
Project Description(include separate sheets as necessai)r' E
Tax Parcel Number: ` Z9_,7�� 7�j� Property Size: t 7 J (acres/square feet)
Site Address and/or Directions to p C
Property: y Vh lr4 v_�1
2 -: _(-_—_ !I r7:, \A t LL, 'tZ D � _-.,,_„,._ C npi ,,i a tif-,
Property Owner(s)of Record: S 1R-L.Ec Ac — r•-1 -
Telephone: L 3 • 1c:A\ Fax: email:
Mailing Address: -2., i t"'‘"t-1.T "Re=v-'r-� jtr.,.‘ v.Ia 98 y-_
Applicant/Agent(if different from owner): t'rlgVZ\C— SO ti,.t(... 0 r .)CC (ZT.i(E k r—L-S )
Telephone:%*LI , 4-1� L 2> Fax:-2- s3.4-t--1 44-3 C email:{v f2C,ft(? Cit-
Mailing Address: 9,62.c3 \ 4T e Ls,n---, ,, Tel N,.fia q -L cow, ,LCeln
What kind of Permit?(Check each box that applies
❑Building 0 Critical Areas Stewardship Plan
❑ Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use)
0 Single Family 0 Garage Attached/Detached ❑ 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 ❑ Boundary Line Adjustment
❑ Address 0 Road Approach ❑ Short Plat**
❑ Home Business ❑ Cottage Industry 0 Bincling Site Plan**
❑ Propane ❑ Long Plat**
❑ Sign ❑ Planned Rural Residential Development(PRRD)/Amendments**
❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration**
❑Stormwater Management ❑ 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 ❑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:
DESIGNATION OF AGENT
I hereby designate NI 4� SN 11-1L-¢ 4-et.. to act as my agent in matters relating to this applicationio7 for permit(s).
OWNER SIGNATURE� ��J �� Date: -9- (,/7
By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of
his,her or 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, indemni and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and
expenses which may in any w ue gainst Jefferson County as a result of or in consequence of the granting of this permit.
I further agree to prov e a ' and rjdht of a try to Jefferson County and its employees, representatives or agents for the sole purpose of application
review and any re " spe ons. affs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the appli the or a want prior notice. ,-?
Signature: Date: �`'7
The action or actions Applicant-with dertake as a result of the issuance of this pen-nit may negatively impact upon one or more threatened or
endangered species a d.ct5uld le to'a potential"take"of an endangered species as those terms are defined in the federal law known as the
"Endangered Spec)e "or',''S -"Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this
permit has been i dl,not olate t .ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your
action(s)even if I co Tian ith the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transf espo i i' r adhering to.and complying with the ESA. The Applicant has read this dis an aryd date -below.
Signature: - 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:1•- 1� {�, FAX:
� SF 0-t Cc L7r%.j( LG•,J Z1s —catiV Lx( )*".--C c-co
MAILING ADDRESS: 2?y�j tit ie 'p(L 7C.a_ ' 7�+1- 1-5T
L.
CONTRACTOR'S LICENSE -11-3---14zat/t. L. c1 .'tZ� WAINS ^^
NUMBER: Jl'�5c,a,�.l,`„ NUMBER (26 �
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Pro' ct Type: Fra Type: Bathrooms: Shoreline: Type of Sewage Disposal:
New Wood Existing: ❑ Sewer
II Addition ❑ Steel Proposed: `Z Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: '2_ Height: Individual System G
❑ Repair 0 Masonry SEP Permit# On" )5
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well 0 Two Party
Type of Heat: Proposed: ❑ Public
r--J Total: N e of System:
j'�W!a-TZ3ti
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 i 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 For Office Use Only Amount Revision
Main Floor Heated EH BId App Review: 13
2ntl Floor Heated Consistency Review:
a15.00
Other Heated Base fee:
a► -5. M
Mezzanine Additional Section:
Heated Basement i_.,,:) r � 1' t `,�' Plan Check fee:
Unheated Basement �(�,� State Surcharge fee: _
Other Unheated f — �° Pot Water Review fee:
(00 .00
Garage/Carport ,r.t: r n t,.I l l}; ,1 SUBTOTAL
,.., : u, 5gq.ao
Decks 911/Rd Approach fee:
Other TOTAL: $ ,5 99. W
Receipt Number: /05 5 73
Cash/Check Number: 907 /
^ESTIMATED COST(REQUIRED) Date: _ (��
•Fair market value of all labor and materials foundation to finish
Initials:
d
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
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