HomeMy WebLinkAboutBLD2010-00265 MLA10-00
IDIUILDING PERMIT APPLICJN Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD10-00265 Received Date: 7/27/2010
SITE ADDRESS: 13846 CENTER RD
QUILCENE, 98376
OWNER: RODNEY P WIDMAN PHONE: 360-765-3905
EILEEN V WIDMAN
PO BOX 432
QUILCENE WA 98376-0432
SUBDIVISION: Block: Lot: TX 1
PARCEL NUMBER: 702131007 Section: 13 Township: 27 N Range: 02 W
CONTRACTOR: M & C CONSTRUCTION INC PHONE: 360-683-4571
653 N 7TH AVE
SEQUIM
WA WA 98382
Contractor's License MCCONI*990LE Expires 10/5/2011
REPRESENTATIVE: M & C CONSTRUCTION INC PHONE: 360-683-4571
MEL HENDRICKSON
653 N 7TH AVE
PROJECT DESCRIPTION NEW GARAGE ATTACHED TO M/H
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 19,000.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY:
OTHER:
CONST TYPE: GARAGE: 484 SHORELINE:
CONST TYPE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 0 Prop: 0
Total: 0 __-- Total'. 0
Routing Date:
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $307.25 LYK 07/27/10 118037 APPROVEDPlan Check $199.71 LYK 07/27/10 118037 'cam
State Building Code $4.50 LYK 07/27/10 118037 SEP O 201U
Total: $511.46
Jefferson County Planning
& Building Department
Jefferson County Building Dion Permit Nu11!•: BLD10-00265
Applicant: WIDMAN
BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2009 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
Setbacks — ( F .s(
Erosion Control
Foundation Footing `_ _i c• z.
Footing Drains
Foundation Stem Wall
Straps(hold downs)
Ext. Shear Wall Nailing
Rough-in Plumbing
Framing 27,HI It
Drywell/Alt Drainage
Address Posted -I' i' 5
FINAL INSPECTION 3I rI I i r
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• •
CONDITIONS for Building Permit# :BLD10-00265
1.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
2.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
3.) The building height is not to exceed 35 feet.
4.) The sbmitted site plan reflects the following setbacks:
61' Setback from Southern Property Line
66' Setback from Western Prperty Line
287' Setback from Eastern Property Line
All site plan setbacks from property lines meet JCC requirements.
if-"ON--
�4, L. JEFFERSON COUNTY
W ' DEPARTMENT OF COMMUNITY DEVELOPMENT
'� • `4 I 621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
j
www.co.jefferson.wa.us/commdevelopment
BtN
Master Permit Application MLA: t —3g61
Pr ect Description(include separ to sheets as necessary):
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Tax Parcel Number: Property Size: (acres/square feet)
P Y ( 4
Site Address and/or ections to Prope Pu
13hU I tl( � j ' co
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Property Owner(s)of Record: Li r -4 I.P Q r l (0I .K(l')/t '-
Telephone: T1-'7 F email:
Mailing Address: .1 R C 1.t.LA(S n LoA (j 3--(40
Applicant/Agent(if different from owner): t _ l ryt eidC S()
Telephone: Fax: email:
Mailing Address: +h
t kind of Permit?(Check each box that applies U 0 Lot or Road Segregation
tuilding 0 Critical Areas Stewardship Plan
❑ Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use)
❑ Single Family larag Atta Detached 0 Conditional Use[C(a),C(d),or C]**
O Manufactured Home .0 Modula ". 0 Discretionary"D"or Unnamed Use Classification
O Commercial* 0 Special Use(Essential Public Facilities)*7 G•'I1
❑ Change of Use 0 Boundary Line Adjustment
O 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 ❑Shoreline Master Program Exemption/Permit Revisions**
❑ Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development**
❑Temporary Use ❑Shoreline Management Variance
❑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 ❑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 Ei-- f-I V N V R 1 C.v 5 014 to act as my agent in matters relating to this application for permit(s).
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-OWNER SIGNATURE , ,,2, ,, Date: 7- 27--1 L
-
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 p ii a tiro Jn that he w nts rip notice.
Signature: \�`rd� 1 I �pVX 14^ Date: 7 - 2-7-1 6
r
The action or actions App' ant 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 tederal 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-tr s rablR responsibi' adhering to,and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: Date: 7 -2 7 — 1.
• •
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:
GENNER C�ONT TOR OR MANUFACTURED HOME INSTALLER: PHONE: Fax:
Oil
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
7Pr ject Type: F me Type: Bathrooms: Shoreline: Type of Sewage Disposal:
New Wood Existing: ❑ Sewer
"❑NAddition ❑ teel Proposed: Ara Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: !/ Height: Ip<Lndividual System
O Repair 0 Masonry EP Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: 0 Private well 0 Two Party
TorMiat: 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 1 Above ground Tank Size of Propane Tank:
I Heat Stove 1 Cook Stove I Woodstove 1 Fireplace Insert i 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.
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Square Footage Current Proposed ��ceU �=' ,= " t' -�` -ion
.E. EH BId App Review:
Main Floor Heated '::,. '.Z:.'...,: . . olayi-t
-a
2nd Floor Heated .i Consistency Review:
Other Heated :; s Base fee:
Mezzanine - Additional Section:
Heated Basement
Plan Check fee:
Unheated Basement State Surcharge fee: "4 3"
�--
Other Unheated Pot Water Review fee:
Garage/Carport 4�G/j nii . 4(.0
i i ' 4
911/Rd Approach fee: �c�
Decks vI1
Other TOTAL: $
3' 1. l(
— Receip
t Number: ( I Se 3-7
. Cash/Check Number:
ESTI RED) Date: 27 -I0
rr m� o t value of all labor an aterials foundation to finish
rWl�, Initials: / j
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bq, JEFFERSON COUNTY
g q. DEPARTMENT OF COMMUNITY DEVELOPMENT
621'Sheridan Street- Port Townsend • Washington 98368
360/379-4450 • 360/379-4451 Fax
�`�8INO http://www.co.jefferson.wa.us/commdevelopment/ . .
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# l V -ag l PROJECT/APPLICANT NAME: O P I- l 4 El � J I,,J 1 Dm
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.
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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. Indicdte soil type on the site map.
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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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6. Describe any excess levels of noise generated by the proposed use or activity:
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stormwater site plan template—rev.10/21/2008 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. Indicate location on the site map.
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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 olan and differentiate proposed facilities from existing facilities.
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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 facilitiep from existing facilities. [This is
normally for"large"projects or projects that involve the potential for dispersion of contaminants.]
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11. Describe the performance goals and standards applicable to the project.
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12. Describe the flow control system. .
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stormwater site plan template—rev.10/21/2008 6
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13. Describe the water quality system.
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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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ern16. 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 and only those for which facilities are required to control flow or treat runoff.] If included, list the Manuals
here.
20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan.
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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.
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stormwater site plan template-rev.10/21/2008
7
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 Control's.
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5. Stabilize Soils.
6. Protect Slopes.
7. Protect Drain Inlets.
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stormwater site plan template—rev.10/21/2008 8
• •
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).
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).
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. 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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II. 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.
a. Sediment Ponds/Traps.
b. Diversions.
c. Waterways.
d. Runoff/Stormwater Detention Calculations
stormwater site plan template—rev.10/21/2008 10
' . .
SECTION II—EROSION AND SEDIMENT CONTROL PLAN
Sediment and erosion control measures may be depicted on the master land use application plot plan,a stormwater site plan,and/or a
separate Construction SWPPP site plan. This is a checklist to ensure that the following are depicted on a site plan:
1. General.
a. Vicinity Map
b. Jefferson County Approval Block
c. Erosion and Sediment Control Notes
2. Site Plan.
a. Legal description of subject property.
b. North arrow.
c. Indicate boundaries of existing vegetation(e.g.,tree lines, pasture areas, etc.).
d. Identify and label areas of potential erosion problems.
e. Identify FEMA base flood boundaries and Shoreline Management boundaries (if applicable).
f. Show existing and proposed contours.
g. Indicate drainage basins and direction of flow for individual drainage areas.
h. Label final grade contours and identify developed condition drainage basins.
i. Delineate areas that are to be cleared and graded.
j. Show all cut and fill slopes indicating top and bottom of slope catch lines. • ,
3. Conveyance Systems. ', }t •'�''
a. Designate locations for swales, interceptor trenches, or ditches. •
b. Show all temporary and permanent drainage pipes, ditches, or cut-off trenches required for erosion &sediment control.
c. Provide minimum slope and cover for all temporary pipes or call out pipe inverts.
d. Shows grades,dimensions, and direction of flow in all ditches, swales,culverts and pipes.
e. Provide details for bypassing off-site runoff around disturbed areas.
f. Indicate locations and outlets of any dewatering systems.
4. Location of Detention Best Management Practices(BMPs). Identify location of detention BMPs.
5. Erosion and Sediment Control Facilities.
a. Show the locations of sediment trap(s), pond(s), pipes and structures.
b. Dimension pond berm widths and inside and outside pond slopes.
c. Indicate the trap/pond storage required and the depth, length, and width dimensions.
d. Provide typical section views through pond and outlet structure.
e. Provide typical details of gravel cone and standpipe, and/or other filtering devices.
f. Detail stabilization techniques for outlet/inlet.
g. Detail control/restrictor device location and details.
h. Specify mulch and/or recommended cover of berms and slopes.
i. Provide rock specifications and detail for rock check dam(s), if applicable.
j. Specify spacing for rock check dams as required.
k. Provide front and side sections of typical rock check dams.
I. Indicate the locations and provide details and specifications for silt fabric.
m. Locate the construction entrance and provide a detail.
6. Detailed Drawings. Any structural practices used that are not referenced in the Ecology Manual should be explained and
illustrated with detailed drawings.
7. Other Pollutant BMPs. Indicate on the site plan the locations of BMPs to be used for the control of pollutants other than
sediment(e.g., concrete wash water).
8. Monitoring Locations. Indicate on the site plan the water quality sampling locations to be used for monitoring water quality on
the construction site. Sampling stations should be located upstream and downstream of the project site.
stormwater site plan template—rev.10/21/2008 11
•• r '
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./ 'r
Q. WGrt 7- Z)- I6
(LANDOWNER AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
stormwater site plan template—rev.10/21/2008 12
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