HomeMy WebLinkAboutBLD2009-00073 BUILDING PERMIT APPLICAON ML Revviewiew T Tyy 086
pe: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD09-00073 Received Date: 3/16/2009
SITE ADDRESS: 84 CLEVELAND ST
PORT HADLOCK, 98339
OWNER: KATSIKAPES HEFELY NANCY L PHONE: 360-385-7407
PO BOX 128
PORT HADLOCK WA 98339-0128
PORTAGE VIEW SHORT PLAT .73AC
SUBDIVISION: Block: Lot: 3
PARCEL NUMBER: 962700112 Section: 7 Township: 29 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOt ENCLOSE EXISTING DECK TO HTD SPACE
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ALT MAIN: 287
VALUATION 29,260.00 ADD'L: HEAT TYPE: EEE
CODE EDITION: 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: 3 Exist: 2
Prop: 0 Prop: 0
Total: 3 Total: .3-
CRouting Date:
—1 to-c
Type Amount Paid— y: Date: Receipt: Approved/Date
Permit $441.75 LYK 03/16/09 105563 APPROVED
Plan Check $287.14 LYK 03/16/09 105563
State Building Code $4.50 LYK 03/16/09 105563 MAY 52009
Total: $733.39 Jefferson County Planning
& Building Department
Jefferson County Building [Sion Permit Nu ,r: BLD09-00073
Applicant: KATIEHEFELY NANCY L
BUILDING PERMIT INSPECTION APPROVALS applicable Code: 06 Intenati nal 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 �/� O Minimum setback from Cleveland Street right-of-way�r�ht-of-way shall be 20 feet.
Minimum side yard setbacks shall be 5 feet. Minimum setback from
Foundation Footing
top of shoreline bank shall be 33 feet.
Footing Drains i
Foundation Stem Wall —It.—cf
Straps(hold downs)
Ext. Shear Wall Nailing `7 2;7-D 9
Framing
Airseal ' K� " ��" OR
Insulation: Floors _(1_
11
Insulation: Floors
Insulation: Ceiling _((— D t
Wallboard Nailing )s---
-tb-oq
Heat/Chimney Clearance
Free-standing Stove
Address Posted
�+ LLSic-iz e Tb t
Cold 417 191/Lo-c. 40 0
FINAL INSPECTION •?
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
•CONDITIONS for Building Permit# :BLD09-00073
1.) 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.
2.) HOLD - Prior to final approval of this permit the corrections/modifications of the drainfield
serving this property must be completed and inspected by Health Department staff.
3.) HOLD - Prior to final approval of this building project the septic system repair permitted
under SEP07-152 must be finaled/completed and all conditions met.
4.) 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.
5.) The property owner shall comply with Water Conservation Measures (per list maintained
by the UDC Administrator).
6.) 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.
7.) 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.
8.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
9.) Not more than 2 unlicensed vehS shall be stored on any lot unless totally ned
from view of neighboring dwellings and rights-of-way. Such screening shall mee 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.
10.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
11.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
12.) The building height is not to exceed 35 feet.
13.) Minimum setback from Cleveland Street right-of-way shall be 20 feet. Minimum side yard
setbacks shall be 5 feet. Minimum setback from top of shoreline bank shall be 33 feet.
14.) 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.
15.) 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.
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.
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��¢,SOlY O JEFFERSON COUNTY
ti ,* DEPARTMENT OF COMMUNITY DEVELOPMENT
., `� 621 Sheridan Street • Port Townsend •Washington 98368
,`y 360/379-4450 • 360/379-4451 Fax
- , N��O www.co.jefferson.wa.us/commdevelopment
MAR 16 2009
Master Permit Application MLA: •-gam
Project Description(include separate sheets as necessary):
Tax Parcel 962 700 112 Property
Number: Size: 41-.73 acres
(acres/square feet)
Site Address and/or Directions to Property: 84 Cleveland Street-Port Hadlock, WA 98339
Property Owner(s)of Record: Nancy Hefely-Katsikapes
Telephone:(360) 385-7407 Fax
Mailing Address:
PO Box 128 Port Hadlock,WA 98339 email:
Applicant/Agent(if different from owner):
Telephone: Fax:
email:
Mailing Address:
What kind of Permit?(Check each box that applies
lBuilding ❑Variance(Minor, Major or Reasonable Economic Use)
❑ Demolition Permit ❑Conditional Use[C(a), C(d),or C]**❑Single Family ❑Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification
❑ Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)**
❑ Commercial* ❑ Boundary Line Adjustment
El Change of Use ❑Short Plat**
❑ Address 0 Road Approach ❑ Binding Site Plan**
❑Home Business ❑Cottagelndustry 0 Long Plat**
❑Propane 0 Planned Rural Residential Development(PRRD)/Amendments**
❑ Sign 0 Plat Vacation/Alteration**
❑Allowed"Yes" Use Consistency Analysis El Shoreline Master Program Exemption/Permit Revisions**
❑Stormwater Management ❑ Shoreline Management Substantial Development**
❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance
❑Temporary Use ❑Comprehensive Plan/UDC/Land Use District Map Amendment
❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment
❑ Forest Practices Act/Release of Six-Year Moratorium ❑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:
I hereby designate l/' /gyp �'/ DESIGNATION OF AGENT
yam..—. t.(/ -fl/h"�J�� to act as my gent in matters relating to this application for permit(s).
OWNER SIGNATURE 177/1 �" ..47,,��_�% q
/��� Date: �f///
By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,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 applicationhe packetof
may result in this permit being null and void.
I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and
expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit.
I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application
review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the application that he or she nts prior notice.
Signature: Date: �//07
The action or actions Ap licant 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-tra able responsibili for a he,ri to and co I ing with the ESA. The Applicant has read this disclaimer and s'gns and dates it below.
Signature:
Date: y/yZ . °9'
C:\Documents and Settings\carat\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.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 ass um ing the responsibility of the General Contractor for the proposed project.
Signature: L-, ' Date: 3 G/ '
PHONE: FAx:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: ( )
( )
EMAIL:
MAILING ADDRESS:
CONTRACTOR'S LICENSE WAINSNUMBER
NUMBER:
PHONE ( ) FAxc( )
ARCHITECT/ENGINEER:
EMAIL
MAILING ADDRESS:
Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
Project Type: V Wood Existing: ❑ Sewer
❑ New Proposed: 0 Bank ,7 Community System
• Addition ❑ Steel❑ Alteration/Remodel ❑ Height:Concrete Total: ❑ Individual System
+/-30' SEP Permit#07-152
❑ Repairmo ❑ Masonryther: Bedrooms: Water Supply:
❑ Demolition Other: Existing: Setback: ❑ Private well l Two Party
Proposed: p V Public
Type of Heat: Total: Name of System:
existing
If this is a Commercial Project you must answer the following: Number of ADA Parking Spaces:
Number of Parking Spaces: Current: Proposed:
Number of occupants(includes owners,tenants,employees,etc) Current Proposed
Type Occupancy:
IBC T e 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:
❑Underground Tank ❑Above ground Tank
Size of Propane Tank:
❑Heat Stove ❑Cook Stove 0 Woodstove 0 Fireplace Insert 0 Hot Water Tank 0 Pellet Stove 0 Other
Is this appliance being installed in a Manufactured I 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 1 Current Proposed For Office Use Only
Amount Revision
Main Floor Heated 2100+ 2.1Z5C .(16 EH Bid App Review: r j3
2F7
2rd Floor Heated Consistency Review: L 1 3
Other Heated Base fee: 11 4 1 '1 s
Mezzanine Aela Ion:31�1 , X tq p `/I
Heated Basement Plan Check fee: n •t+
Unheated Basement •
State Surcharge fee: CD
Other Unheated Pot Water Review fee:
r.` A
Garage/Carport SUBTOTAL
151(n,
Decks 911/Rd Approach fee: X onl
Other TOTAL: $ 151er, 3c
Receipt Number: 1 be
Cash/Check Number:
ESTIMATED COST(REQUIRED) Date: Ib
.Fair market value of all labor and materials foundation to finish Initials: -.� I
2S, pl`)c'
C:\Documents and Settings\carat\Local Settings\Temporary Internet Files\OLK86\ faster Permit Application 12-19-2006.doc
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o1v Qa
�� DEPARTMENT OF COMMUNITY DEVELOPMENT
rMAR i 6 2009
�y 621 Sheridan Street • Port Townsend • Washington 98368
q„. NG�O 360/379-4450 . 360/379-4451 Fax
http://www.co.jefferson.wa.us/commdevelopment/
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
IMLA# -S-(0 PROJECT/APPLICANT NAME: MINN RJ CftLEy 1(---,VT5 I OWES
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. 7/1.P pry po-c/ l/dl//ho YI 15 2 o $i a/ /,c /ll/ /kif'l c .
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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.
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4. Describe the existing soils. Indicate soil type on the site map. v�J �?U
1 he flft fo/ /5 re '7o)CP y qra ve//y 706 m o-/S% f/op,5u ¢-
7/d&P marsh er) fhs fa- trr/ porb6n 4 /h to fs ,
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.
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APPROVED
6. Describe any excess levels of noise_generated by the proposed.use or activity:
�6 Qe%// �a n� STORMwATER PLAN
15 '(fio/,/ ,/S� /ll be' 9�/2v/�kcl �fl/' bvr _//r/
_ , C\ APR - 6 2009
Stornuva ii**4
. iRequire ' IP JEFFER 0 •U
DEPT.OFC•,' 'ti 19, E �PMENT
tormwater site plan template—rev.10/21/2008 SIGNATUR �,
i • 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. Indicatet location on the site map. r1 �`
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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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imp-e✓rn cal—et wr(et el Sh6// Pe giaCtitcl.
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.]VK f7D /0122p0 W</ rip✓✓-7 c.) 4l'/(//J7(5
11. Describe the performance goals and standards applicable to the project.
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12. Describe the w control system.
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stormwater site plan temptftecrev.1d/21s/2008 6
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13. Describe the water ciNality sy t m.
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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.
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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.
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18. Describe methods for restoration of the site.
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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 acid 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.
r/0!ii
MAR 16 2009
stormwater site plan template—rev.10/21/2008
7
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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 Volume II Section 3.2.3 of the Manual (beginning
on page 3-7).
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.
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4. Install Sediment Controls.
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5. Stabilize Soils. /
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6. Pr tect Slppes.
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Slop 15 not- << p�K/- o{ J,o�
111 lri i'o Vol?C, 5174 // pt/r7C1 Ivl 1)H (/i Sf�rk�cl
7. Protect Drain Inlets.
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tormwater site plan template—rev.10/21/2008 8
411) •
12 Required Elements-Construction SWPPP(continued)
8. Stabilize Channels and Outlets.
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9. Control Pollutants.
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10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site).
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11. Maintain Best Management Practices(BMPs). r
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12. Manage the Project.
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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—rev.10/21/2008
9
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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5.5. Construction Phasing.
a. Construction sequence
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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.
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IL Wet Season Construction Activities.
a. Proposed wet season construction activities.
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b. Proposed wet season construction activities for environmentally sensitive areas.
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7. Financial/Ownership Responsibilities.
a. Identify the property owner responsible for the initiation of bonds and/or other financial securities.
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 Calculations on a separate sheet for the following, if applicable. ne </gr//C7C�
a. Sediment Ponds/Traps.
b. Diversions.
c. Waterways.
d. Runoff/Stormwater Detention Calculations
stormwater site plan template—rev.10/21/2008
10
411 •
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 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.
3 • 9
(LANDOWNER HO ZED REPRESENTA VE SIGNATURE (DA E)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
MAR 1 6 2009
•
stormwater site plan template—rev.1021/2008
12
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