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Home My WebLink AboutBLD2009-00111 0UILDING PERMIT APPLICASJN MLRA09 00eview 095 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00111 Received Date: 4/9/2009 SITE ADDRESS: 372 RHODODENDRON LN BRINNON, 98320 OWNER: DAVE RALPH PHONE: (253)606-6987 RHONDA RALPH PO BOX 147 BRINNON WA 98320 SUBDIVISION: Block: Lot: TX631 PARCEL NUMBER: 502151017 Section: 15 Township: 25 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION BULKHEAD EXTENSION TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 22,500.00 ADD'L: HEAT TYPE: 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: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Z 13 10 1 \ ` Type Amount Paid By: Date: Receipt: Approved/Date Permit $363.25 KAS 04/09/09 105649 fp" P R v E Plan Check $236.11 KAS 04/09/09 105649 State Building Code $4.50 KAS 04/09/09 105649 MAY H- 2009 Total: $603.86 Jefferson County Plannint &Building Department Jefferson County Building •sion Permit Null: Applicant: BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: 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 FINAL INSPECTION \ FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD09-00111 1.) THE APPLICANT SHALL COMPLY WITH THE RECOMMENDATIONS OUTLINED ON PAGE 2 OF THE GEOTECHNICAL REPORT PREPARED BY NTI DATED MARCH 12, 2009, REGARDING PLANTING OF NATIVE DROUGHT-TOLERANT LOW GROWING VEGETATION IN THE FILL SOIL BEHIND THE BULKHEAD. 2.) A Geotechnical Report prepared by NTI dated March 12, 2009 was submitted in conjunction with this application. The report assessed the results of the recent landslide event, addressed the stability of the geologic hazard area and made recommendations for stabilizing the bluff. 3.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated. Should buffer disturbance occur during construction, the Unified Development Code (UDC)Administrator shall require replanting with native vegetation. No alterations shall be made to the Landslide Hazard Area or its associated buffer without prior authorization by the UDC Administrator. 4.) Prior to and during approved construction activities, the perimeter of the landslide hazard area buffer shall be marked with a temporary sign. The sign shall be placed in such a manner that it can be directly observed from the construction area. The sign shall contain the following statement: "Landslide Hazard Area and Buffer- Do not Remove or Alter Existing Vegetation." 5.) All construction activities shall not encroach upon the landslide hazard buffer. This includes the storage or preparation of materials. 6.) The applicant shall permanently separate the boundary of the Landslide Hazard Area Buffer from the remainder of the subject property through installing logs, trees, a hedge row, or any other prominent physical marking approved by the UDC Administrator. 7.) 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. 8.) 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. 9.) Prior to commencing development activity, proponent is responsible for informing the Washington Department of Fish and Wildlife (WDFW) in order for WDFW to determine whether this action is subject to the Washington State Hydraulic Code (Chapter 220-10 WAC). Hydraulic Project Approval (HPA) is required for all hydraulic projects, which are defined as construction or performance of other work that will use, divert, obstruct, or change the natural flow or bed of any of the salt or fresh waters of the state. 10.) In addition to Jefferson County permit conditions, the project proponent shall comply with all conditions set forth by the Washington Department of Fish and Wildlife through Hydraulic Project Approval. • riJEFFERSOrr •,,,h. DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street.per{ kik, -.4,� 360/379-4450 • 76 send•bVashington 98368 .4451 Fax • www.cojefferson.wa.us/commdevelopment Master Permit APR 2G .. Application Project Description(include separate sheets as � C 1-r; MLA: C>`� f? �1�' neaessary 1 Tax Parcel Number. U ''�^ S i Owl a o Site Address and/or Directions to Pro Property Size: cresquare feet) party: Property Owner(s)of Record: Telephone: �5.��CCU a'> , Mailing Address. � � Fax:-�,�� ---��,• email: __._. Applicant/Agent(if different from owner): 6 Telephone: .--- ""�� Mailing Address: --- Fax: email: -- !!!wW t kind of Permit?(Check each box that applies ilding ❑ Demolition Permit 0 Critical Areas Stewardship Plan ❑Single Family ❑Garage 0 Variance(Minor,Major or Reason ❑ Manufactured Home 0 Modular Attar/Detached 0 Conditional Use C a able Economic Use) ❑ Commercial* 0 Discretionaryt ( )'na or Cj"* ❑ Change of Use "D"or Unnamed Use Classification ❑ Address 0 Special Use(Essential Public Facilities)** ------- ❑Road Approach0 Boundary Line Adjustment ❑ Home Business �y-- 0 Short Sitet 0 Cottage Ind 0 Binding .. ❑Sign 0 Long lat* Plan ❑Allowed'Yee Use Consistency Analysis ❑Planned Rural Residential Development PRRD ❑StoRnwater Management ❑Plat �acation/Alteration** ( YAmendments*" ❑Site Plan Approval Advance Determination(SPAAp)* 0 Shoreline Master P • ❑Temporary Use ❑Shoreline Management Substantial Exemption/Permit Developmentnvisions"* ❑Wireless Telecommunication* 0 Shoreline Ma agement "* ❑Forest Practices Act/Release of Six-Year MoratoriumManagement Variance *May require a Pre—Application e i of S 0 Jefferson CountyaPlan/UDC/Land Shoreline a Use District Map Amendment Conference 0 Tree Vegetation Master Program Amendment Please Identity any other local,state or federal Request •FR • h s a �. cation Conference permits required for this proposal,if known: I hereby designate_ F,{ / DESIGNATION OF AGENT to act as my agent in matters relating to this application for permits) OWNER SIGNATURE _.01111t-:-/ By signing this application form,the owner/agent a Date: - 0 Bhiy,her or its knowledge.ledge, Anymaterial falsehood attests that the Information provided herein,and ..,is may result in this cod or any omission of a material fact made byany attachments,Permit being null and void. the owner/agent with respect true and correct to the beste of I further agree to save,indemnify Pit to this application Packet NY and harmless Jefferson County expenses welch av in any way accrue hold ha Jefferson Conn as a against t an or a ud ments, I further agreeCounty ,1 9 court costs,reasonable attorneys to access and right of entryconsequence of the granting 1/ fees and review and any o provide ter ins to Jefferson County and its employees, ng of for Permit it time of the applicatio, she w-s. Staffs access and right of entry representatives or agents for the sole he o she w: F ,,. wiq be assumed unless the applicant interns the County ioapplication Signature: writing at the �� The action or actions Applicant will undertake as _ Date: L/ Li The nd atinspecies could wad no a undertake potential result of the issuance of this permit may .... or endanger"Endangeed and or lea 'Jeffersonlake"of an endangered species as those to negatively impact upon one or more known as the Permit has been Speciese will notCounty makes no assurances to the tuts are defined is the federal lawundertaken ene a permiactiont )even N you ere violate e ESA. Any indivktual,group or agency cante that the behalf of an will be undertaken because this and non-transferable Applicant on behalf d e chat he,she inky r adhering Jefferson County development code.The acknowledges that he regarding Signature: ng plying with the ESA. The APPant ackn ,she or it holds individual your (�� Applicant has read this disclaimer aig l rd dates it below. Date: G:\PermirCenter\###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 Ncensed contractors and that they will be ass responsibility of the General Contractor for the proposed prujed. Signature: assuming/Se "-f( L., -1) J Date: ‘ 7c:// 9 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE Fax:( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S$JCENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) Fax:( ) MAILING ADDRESS: EMAIL Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: Project Type: ❑ Wood0 Sewer 5 New Existing: Addition 0 Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Height:� ❑ Individual System `7� SEP Permit# ❑ Repair. 0 Mason Water Supply: ❑ Demolition )Ij Other. F?G_ Bedrooms: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat Proposed: 0 Public Total: Name of System: 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 IBC Occupancy: IBC Type of construction: W l you have Food Service? Yes I No If this is a Propane Tank andlor 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 I Mobile Home? Yes I No When applying for a permit to install a propane tank you must also submit a site plan showingand thee buildings, lines,tank location and she,distances from the propane tank to all property es,buildings � system ents, including the reserve area. Square Footage 1 Current Review: Main Floor Heated EH Bid A ----- 21x1 Floor Heated I Iii1 C r Consistency Review: Other Heated Base fee: / a 3 Mezzanine APR Additional Section: IC LL_.. Heated Basement Plan Check fee:Pr ' l 1 ' CC� ((� Unheated Basement / L11S 1 • 'State Surcharge fee: 14 j ` 5Other Unheated Pot Water Review fee: "t Garage/Carport SUBTOTAL �j I j Decks 911/Rd Approach fee: pal Other TOTAL: $ Q /(� . b Receipt Number: l 05(C4 _1 Cash/Check Number. 3 q U' ESTIMATED COST REQUIRED) Date: 0 .Fair marks of all labor—and materials foundation to finishInitials: L G:\Perrr+atCenter\###FORMS###\DRD FORMS\Master Penmt Application 5-29-0S.doc 1 ciN . 1,,,„, , rh)N r. o ,N.:-,,,L44 't \,_,_,,, . . ,0;36 ____________--- \I ' ---.. . '-‘ -4FO-\-....,>,, , , '' Fl. i ---..'''\\\ \.• 1 -NI \ N - -o . N , , \ &t, \ 4" \\\ o 11 x� _ +," O \k\ �\\\ V 11 165.00'