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Home My WebLink AboutBLD2010-00064 • • DEMOLITION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD10-00064 Received Date 3/9/2010 SITE ADDRESS: 6431 SR20 Issue Date 3/10/2010 PORT TOWNSEND, 98368 APPLICANT: PORT OF PORT TOWNSEND PHONE: 360-385-0656 PO BOX 1180 PORT TOWNSEND WA 98368-0980 TX 94 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001332017 Section: 33 Township: 30N Range: 01W CONTRACTOR: OWNER/BUILDER PHONE: OWNER, PORT OF PORT TOWNSEND PHONE: 360-385-0656 if different: PO BOX 1180 PORT TOWNSEND WA 98368-0980 PROJECT DESCRIPTION: DEMO SFR -TRAINING BURN FOR EAST JEFFERSON FIRE & Directions RESCUE To Site: THIS PERMIT IS VALID FOR ONE YEAR AND IS NOT RENEWABLE. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 3/10/2011. REQUIRED INSPECTION: Final proval: BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. SPECIAL CONDITIONS APPLY - SEE REVERSE HOT LINE AVAILABLE 24 HOURS A DAY BLD10-00064 ELDING PERMIT APPLICATIO Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD10-00064 Received Date: 3/9/2010 SITE ADDRESS: 6431 SR20 PORT TOWNSEND, 98368 OWNER: PORT OF PORT TOWNSEND PHONE: 360-385-0656 PO BOX 1180 PORT TOWNSEND WA 98368-0980 SUBDIVISION: Block: Lot: TX 94 PARCEL NUMBER: 001332017 Section: 33 Township: 30 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: JIM PIVARNIK PHONE: 385-0656 PO BOX 1180 PORT TOWNSEND WA 98368 PROJECT DESCRIPTIOI DEMO SFR -TRAINING BURN FOR EAST JEFFERSON FIRE & RESCUE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP DEM VALUATION MAIN: CODE EDITION: 2006 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid Bv:--Date: Receipt: Approved/Date Permit $0.00 LYK 03/09/10 APPROVED State Building Code $0.00 LYK 03/09/10 Total: $0.00 MAR 201U Jefferson County Planning &Building Department • SPECIAL CONDITIONS FOR CASE#BLD10-00064: 1.) SEPTIC SYSTEM NOT VESTED FOR FUTURE USE. SHOULD SEPTIC SYSTEM BE DECOMMISSIONED, DOCUMENTATION AND VERIFICATION BY JEFFERSON COUNTY HEALTH DEPARTMENT IS REQUIRED. ALL AREAS APPROVED FOR SEPTIC SYSTEM USE ARE TO BE COMPLETELY PROTECTED FROM VEHICULAR TRAFFIC OR MECHANICAL DISTURBANCE. NO EVALUATION HAS BEEN COMPLETED. THIS APPROVAL FOR DEMOLISHING THE RESIDENCE DOES NOT ENSIRE FUTURE BUILDING APPROVAL. ANY FUTURE ON-SITE SEWAGE SYSTEM SHALL MEET CODE IN EFFECT AT THE TIME OF APPLICATION. I:\F_BLD_Permit_Propane.rpt 10/29/19 4��,goN c0r, JEFFERSON CTY a at ' \,,, DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax �S, N0�0'� www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: ; j r i; Project Description(include separate sheets as necessary): _/c 4 4')? / sC. 'L'v E -T .v 4).4% Tax Parcel Number: rJ 0/3 D! Property Size: /0 (acres/square feet) Site Address and/or Directions to Property: y3? �' ' 20 0 Jele /oui,cf_ moo G, i w 1(5',3 Property Owners)of Record: 7 'e7 d-'4. ' ). -f 7—e, GvV6:74.1p Telephone:36 `:,.__ '•5 6‘.S(-„ Fax:3/D- S 3y' ,_.) email: k. u✓ Mailing Address: ?� Q //8(� f, „�� ,�I 9,, _36 • �'�?,) Applicant/A ent(if different from owner): Telephone: —0 6 // f� Fax:c ;0—386—-;3C-106 email: Mailing Address: smwe Whi..kind of Permit?(Check each box that applies ❑Lot or Road Segregation Buildi 0 Critical Areas Stewardship Plan emolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) ❑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 0 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** ❑ 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 ❑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 anv reuired later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the cation tha ants prior notice. Signature:, Date: _//0//0 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 disclaimer and signs and dates it below. Signature: Date: G:\PermitCenter\###FORMS###\DRD FORMS\Current 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: F GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER NUMBER: PHONE•( '. ) . FAX:( ) ARCHITECT/ENGINEER: MAILING ADDRESS: EMAIL F�e Type: Bathrooms: Shoreline: Type of Sewage Disposal: Project Type: t Wood Existing: ❑ Sewer ❑ New n ❑ Steel Proposed: Bank ❑ Community System ❑ Alterati ❑ Alteration/Remodel CI Concrete Total: _ Height: ❑ Individual Systemt❑ airii ❑ Masonry SEP Permit# emolton ❑ Other: Bedrooms: Water Supply:: Existing: Setback: ❑ Pri -well ❑ Two Party Proposed: ubiic Type of Heat: Total: Name of System:t 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(indudes 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: 1 Heat Stove 1 Cook Stove i Woodstove 1 Fireplace Insert 1 Hot Water Tank 1 Pellet Stove 1 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: 2"d Floor Heated Consistency Review: Other Heated Base fee: Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL: $ Receipt Number: Cash/Check Number: ESTIMATED COST(REQUIRED) Date: .Fair market value of all labor and materials foundation to finish Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc • . k4:¢,$oN c.0611. .06� JEFFERSON COUNTY ti -4 DEPARTMENT OF COMMUNITY DEVELOPMENT _ 621 Sheridan Street • Port Townsend •Washington 98368 O) 360/379-4450 • 360/379-4451 Fax �`sBlNcs`S http://www.co.jefferson.wa.us/commdevelopment/ Stormwater Calculation Worksheet MLA# PROJECT/APPLICANT NAME: o•Of c.we'N .C-/- 6>fr'K�dr..4q 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 sq/ft 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, 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: Does the project convert'A acres or more of Construction site for structures sq/ft native vegetation to lawn or landscaped areas? Drainfield,septic tank, etc. sq/ft Circle: Yes Well, utilities, etc. sq/ft Does the project convert 2%acres or more of native vegetation to pasture? Driveway, parking, roads, etc. sq/ft Circle: Yes No Lawn, landscaping, etc. sq/ft Other compacted surface, etc. sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance sq/ft Cut Fill (cu/yd) [over] stormwater calc worksheet—REV.11/3/2008 1 • • 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) sq/ft Structures(all roof area) Z'�'� sq/ft Sidewalks sq/ft Sidewalks sq/ft Patios sq/ft Patios sq/ft Solid Decks sq/ft Solid Decks sq/ft (without infiltration below) (without infiltration below) Driveway, parking, roads,etc sq/ft Driveway, parking, roads, etc sq/ft Other sq/ft Other sq/ft Total New sq/ft Total Existing ZZ�a 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: % Does the site have 35%or more of existing impervious surface? Circle: Yes No 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 Stonnwater 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 o rs of the affected property. 9 1'A-7 LANDOWNER THORIZEp REPRESENTATIVE SIGNATURE) (DA ) FOR OFFICE USE ONLY f: ` ; SMALL MEDIUM LARGE REDEVELOPMENT Stormwater Site Plan: Yes No stormwater calc worksheet—REV.11/3/2008 ►'v? 20 4, 22 PM • Nc. 085 _ • � 1a �� J m1e ' r� ,- M t -tip I 401 's z-- tt 111111 I iot 71 pw ; i : \, , p , 1 a tit • _ri A i.4 frit 1 /.2-ti 1 1 ti 1 f 5. . ,, I ,„c° , i 1 q..4 VI 414',1%*Zc3. 1 .1Zi 4 IV rn co it.) 4 1 k: ',t i. 4 L,.., ., , 4 itt tilei i At 0 0 19 1,) !zji 3cli 1 , Z .--, I 'Tit: ilji' 4 t't g' -I c- i x 1 1 a i 2 i \'..:\ 4' l' --.. ti ' lfe'm g xi .14 ° D 51 - t',I irliii — ' -63.'? i 2 l'•gt 4.1 le, 6 jzi i 5 -,- , 1,Q a3 i ti bv 4 i:,'..-0.. 4' l' i. i ILI iti a."' ,,t; ! ‘3- 0 -ri hz. la t. i°t4ati iv 31 ; -, a" aT s ik ,,, . 5 R W ot 1 : ' iY l,r $ y4 �T �i { 's,� Gj rt4 i a -gig•ilE (` ; b c. !„4,s : t:, ,,—.. tkic) • �- J7 4 II p i!! 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