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HomeMy WebLinkAboutBLD2009-00264 S UILDING PERMIT APPLICAIMN B RD09-00eview p264 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00264 Received Date: 8/6/2009 SITE ADDRESS: MAPLE DR PORT TOWNSEND, 98368 OWNER: NILS K ANDERSON PHONE: 425-413-9628 LAURIE LR ANDERSON 24206 SE 248TH ST MAPLE VALLEY WA 980388235 CAPE GEORGE VILLAGE DIV 4 SUBDIVISION: Block: Lot: 21 PARCEL NUMBER: 940800021 Section: 13 Township: 30 N Range: 02 W CONTRACTOR: VIKING FENCE CO PHONE: (360)373-7918 3015 STATE HWY 3 BREMERTON WA 98312-5015 Contractor's License VI KINFC159JC Expires 8/23/2010 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NEW 8' FENCE TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 2,343.00 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 Routing Date: —� Type Amount Paid By: Date: Receipt: APPRV1EJEI.DPermit $0.00 LYK 08/06/09 Plan Check $0.00 LYK 08/06/09 AUG di- 2009 State Building Code $0.00 LYK 08/06/09 Total: $0.00 Jefferson County Planning &Building Department Jefferson County Building ision Permit Wilk: BLD09-00264 Applicant: ANDERSON 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 clays 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 / , For P ate 14-1 Post Holes Framing FINAL INSPECTION 7 Ito FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR III III r4� oN co JEFFERSON COUNTY ,''v ' eApi DEPARTMENT OF COMMUNITY DEVELOPMENT '' ` `4 621 Sheridan Street• Port Townsend •Washington 98368 �.. w 360/379-4450 • 360/379-4451 Fax ww.co.jefferson.wa.us/commdevelopment Cs Master Permit Application MLA: kl 0 (Y\Ade C.F`fA Project Description(include separate sheets as necessary): /, O n SUd7� 8 0-- Adtl Ccd c� cs/teede.)r... ref?C< , t (A (,- 10h_j/ iorv/a`'� 4,!-,_e`- Tax Parcel Number: ?el(7 :5700 0 --/ Property Size: LY/ C©c) SI A, (ewes/square feet) Site Address and/or Directions to Property: 3 A) /Lc C c✓z./ lot bhl 1C'Ykko-,-- ?at Ta de.,,/1 t J A /06ye Geoi vl Mz /of -: Ls k fn 4/o(e_, Property Owner(s)of Record: It-Ctwri-f 4 Ai % S' Dei Telephone: `-f '1 /3 9 Ce c}i'Fax: email:L A cL gig e A � 6. Mailing Address:r9c/, S'0(0 LC ,D1 z/dam t< ( / Mezio&� G/eal ec,/ I L)Y 9d�4O`-ss> ,Jer" Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies 0 Lot or Road Segregation •7 (4Building -4)/ let Fe � . 0 Critical Areas Stewardship Plan ° ❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Single Family 0 Garage Attached/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** ❑ Propane 0 Long Plat** ❑ Sign 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration** 0 Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** 0 Temporary Use 0 Shoreline Management Variance 0 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 0 Tree Vegetation Request **Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal, if known: vb/ ;: e't /12 ')ij /46D ,/ /, • DESIGNATION OF AGENT/ I hereby designate it I l--/ 1&-.El---' to eet-ss-mi,Lagertt in matters relating to this application for permit(s). OWNER SIGNATUt Y .�-� J-c—p--� Date: ,/ ' `j 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 application that he or she wants prior notice. ( Signatures.- .._ ,lie". ,.1 ..1-1--� Date: ;C.- (275: 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-transferable responsibility for adhering to and complying with the ESA. The Applicant has read this 'discla er and signs and dates it below. Signature: e_ �' [ .��� Date: _/Jvy .� ' 6 • • 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 the General Contractor for the proposed proje . G, SignatuGZZi � -t^ 5� Date: , -s -/l 0 I i.` PHONE: AX: >? Ftf/ r t Co rc-ni.eYfvAA, .moo) '-?'n-S? 7-2 & O397-OO// MAILING ADDRESS: -. O/s' s1zC„fr // J I '3 EMAIL: tj 0( gO(Z -leo 7 jAV CONTRACTOR'S LICENSE Q-�� ✓~Oj.e� 7 �� / ki 1i 7172/ a WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: _ Height: ❑ Individual System ❑ Repair ❑ Masonry — SEP Permit#____________ I ❑ Demolition ❑ Other: Bedrooms: Water Supply: _ Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: ❑ Public Total: 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 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 1 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: 2nd Floor Heated Consistency Review: Other Heated Base fee: �3. `lc� Mezzanine Additional Section: O`✓ Heated Basement Plan Check fee: r I I Unheated Basement ' State Surcharge fee: ,, Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL l LI I • 26 Decks 911/Rd Approach fee: the �r--1 C t_ ( g P. 11 l C't , TOTAL: $ I LI I O� CC.(' ,/-1 (at_s a C tiez, Receipt Number: S/ acL T� tCAC Cash/Check Number: ESTIMATED COST(REQUIRED)c..a 3 ii,3 00 Date: •Fair market value of all labor and materials foundationL to finish (,/t%4-i,-sj FeiAC.L Cchyi,..c<.l c.. Initials: • 0 �; l 1 ,SON L,O �c''� /vo k . ln7 L / (� �w JEFFERSON COUNTY �i.�• k' DEPARTMENT OF COMMUNITY DEVELOPMENT V P, / .."( 4-- 14 ,. 621 Sheridan Street • Port Townsend • Washington 98368 J $S tO 360/379-4450 • 360/379-4451 Fax Oi' J2.t7�J �l 81N0 http://www.co.jefferson.wa.us/commdevelopment/ /QcLcM f (fir e r_ Stormwater Calculation Worksheet 6 ' k`J (/`21et . ..7) MLA# 'P � �^ PROJECT/APPLICANT NAME: / tljj (14c- (—R „AIka6,-.rcv7 DETERMINING STORMWATER MANAGEMENT REQUIREMENTS: This stormwater calculation worksheet should be completed first to classify the proposal as"small,""medium,"or"large." The size determines whether a Stormwater Site Plan is required in conjunction with a stand-alone stormwater management permit application, building permit application, or other land use approval application that involves stormwater review. The basic information will also be helpful for completing a Stormwater Site Plan, if required. PARCEL SIZE(I.E., SITE) Size of parcel 0 acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet /3)Goo sq/ft (Of CS" /D U 7 ( 3 C.) Land-disturbing activity is any activity that results in movement of earth, or a change in the existing soil cover (both vegetative and non-vegetative) and/or the existing soil topography. Land disturbing activities include, but are not limited to clearing, grading, filling, excavation, and compaction associated with stabilization of structures and road construction. Native vegetation is vegetation comprised on plant species, other than noxious weeds,that are indigenous to the coastal region of the Pacific Northwest and which reasonably could have been expected to naturally occur on the site. Examples include species such as Douglas fir,western hemlock,western red cedar, alder, big-leaf maple, and vine maple; shrubs such as willow, elderberry,salmonberry, and salal; herbaceous plants such as sword fern, foam flower, and fireweed. LAND DISTURBING ACTIVITY, CONVERSION OF NATIVE VEGETATION,AND VOLUME OF CUT/FILL Calculate the total area to be cleared, graded,filled, I Answer the following two questions related to excavated, and/or compacted for proposed development conversion of native vegetation: project. Include in this calculation the area to be cleared for: 6 & -(f p IC ere0c� n Does the project convert 34 acres or more of Construction site for structures T tic.(Z- Aft native vegetation to lawn or I ndscaped areas? Drainfield,septic tank, etc. sq/ft Circle: No Well, utilities, etc. sq/ft Does the project co v rt 2'/2 acres or more of native vegetation t asture? Driveway, parking, roads, etc.___------'' sq/ft Circle: Ye No Lawn, landscaping, etc. sq/ft Other compacted surface, etc. — ' sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance 0 sq/ft Cut d Fill U (cu/yd) [over] • • Impervious surface is a hard surface that either prevents or retards the entry of water into the soil mantle as under natural conditions prior to development. A hard surface area which causes water to run off the surface in greater quantities or at an increased rate of flow from the flow present under natural conditions prior to development. Common impervious surfaces include, but are not limited to roof tops, walkways, patios, driveways, parking lots or storage areas, concrete or asphalt paving, gravel roads, packed earthen materials, and oiled, macadam or other surfaces which similarly impede the natural infiltration of stormwater. STORMWATER CALULATIONS—IMPERVIOUS SURFACE NEW EXISTING Structures(all roof area) /i CJ/ti sq/ft Structures(all roof area) /i4P' - sq/ft r% Sidewalks et sq/ft Sidewalks sq/ft Patios C� sq/ft Patios sq/ft Solid Decks `r sq/ft Solid Decks `` sq/ft (without infiltration below) (without infiltration below) f << Driveway, parking, roads,etc sq/ft Driveway, parking, roads, etc sq/ft r. Other r sq/ft Other `' sq/ft Total New sq/ft Total Existing sq/ft TOTAL NEW+TOTAL EXISTING* sq/ft "This amount will be used to check total lot coverage. The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT v. REDEVELOPMENT Divide the total existing impervious surface above by the size of the parcel and convert to a percentage: 0 % Does the site have 35%or more of existing impervious surface? Circle: Yes FURTHER INSTRUCTIONS: If the answer is yes, the proposal is considered redevelopment and the attached Figure 2 should be used to determine the applicable Minimum Requirements. If the answer is no, the proposal is considered new development and the attached Figure 1 should be used. At this juncture, the applicant should refer to the applicable Flow Chart to determine the Minimum Requirements for stormwater management. DCD staff will help verify the classification of the project and the application requirements. For proponents of "small" projects who must comply only with Minimum Requirement #2—Construction Stormwater Pollution Prevention--an additional submittal is not required. The proponent is responsible for employing the 12 Elements to control erosion and prevent sediment and other pollutants from leaving the site during the construction phase of the project. Pick up the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet. Proponents of"medium" projects—those that must meet only Minimum Requirements #1 through #5—and for "large" projects—those that must meet all 10 Minimum Requirements—are required to submit a Stormwater Site Plan. DCD has prepared a submittal template of a Stormwater Site Plan, principally for rural residential projects. Complete the template in the Stormwater Site Plan Instructions and Submittal Template or prepare a Stormwater Site Plan using the step-by-step guidance in the Stormwater Management Manual. APPLICANT SIGNATURE By signing the Stormwater Calculation 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. // Z'.' 4 �G� / s GOWNE AUTHORIZED REPRESENTATIVE SIGNATURE) (DA E)!, FOR OFFICE USEONLY. ' SMALL MEDIUM LARGE REDEVELOPMENT Stormwater Site Plan: Yes No stoonwate,talc worksheet-RE_V. 11/3/2008 2 R `�� gill/lll/ N. 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