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HomeMy WebLinkAboutBLD2011-00106 S CERTIFICATE OF OCCUPANCY Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 (800) 831-2678 Al Scalf, Building Official PERMIT #: BLD11-00106 SITE ADDRESS: 61 RANDOLPH ST Issue Date: 06/28/2011 PORT HADLOCK, 98339 Final Date: 10/6/2011 APPLICANT: TODD B SHOLD PHONE: 360-301-0803 JOHN T SHOLD LIFE ESTATE PO BOX 28 PORT HADLOCK WA 983390028 SUBDIVISION: SHOLD'S ADDITION Block: 3 Lot: 3 PARCEL NUMBER: 994800303 Section: 2 Township: 29 N Range: 01 W PROJECT DESCRIPTION: NEW M/H THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009 EDITION. OCCUPANCY GROUP: TYPE OF CONSTRUCTION: SPRINKLER SYSTEM yes _no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 10/6/2011 I:\F_BLD_Occupancy.rpt 10/29/19 1 MANUFACIRRED/MOBILE HOME INSTA!ATION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD11-00106 Received Date: 4/28/2011 Date:ADDRESS: 61 RANDOLPH ST Issue 6/28/2011 PORT HADLOCK, 98339 APPLICANT: TODD B SHOLD JOHN T SHOLD LIFE ESTATE PO BOX 28 PORT HADLOCK WA 983390028 SUBDIVISION: SHOLD'S ADDITION Block: 3 Lot: 3 PARCEL#: 994800303 Section: 2 Township: 29 N Range: 01 W CONTRACTOR/ SHOLD EXCAVATING PHONE: (36)385-0480 DEALER PO BOX 179 PORT HADLOCK WA 98339 (360) 379-6892 Contractor's License SHOLDI*224LT Expires 7/9/2012 PROJECT DESCRIPTION: NEW M/H _ ZA0,1 MAKE: LIBERTY YEAR: 2006 SIZE: 56X16 Directions To Site: 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 Erosion Control [" • MH Foundation (11Wt ��r�,�,� ��Q t Blocking&Tie Down �� I ✓'-` '/� "'+ I Skirting&Ventilation Gas Line: Exterior Propane Tank Pressure Test Drywell/Alt Drainage T(_ I( Address Posted FINAL INSPECTION 01 FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR SPECIAL CONDITIONS APPLY-SEE REVERSE SUILDING PERMIT APPLICA•N MRevew000 97 Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD11-00106 Received Date: 4/28/2011 SITE ADDRESS: 61 RANDOLPH ST PORT HADLOCK, 98339 OWNER: TODD B SHOLD PHONE: 360-301-0803 JOHN T SHOLD LIFE ESTATE PO BOX 28 PORT HADLOCK WA 983390028 SHOLD'S ADDITION SUBDIVISION: Block: 3 Lot: 3 PARCEL NUMBER: 994800303 Section: 2 Township: 29 N Range: 01 W CONTRACTOR: SHOLD EXCAVATING PHONE: (36)385-0480 PO BOX 179 PORT HADLOCK WA 98339 Contractor's License SHOLDI*224LT Expires 7/9/2012 REPRESENTATIVE: ROBERT MILLER PHONE: 360-385-2373 PO BOX 395 PORT HADLOCK WA 98339 PROJECT DESCRIPTIOI' NEW M/H - TYPE OF WORK MOB SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 869 VALUATION ADD'L: HEAT TYPE: EEE CODE EDITION: 2009 OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: 05783 BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 2 Prop: 1 Total: 2 Total: 1 Routing Date: -c-9-II Type Amount Paid Bv: Date: Receipt: Approved/Date Manufactured Homes $213.00 LYK 04/28/11 123458 APpR® Potable Water Application $62.00 LYK 04/28/11 123458 VE Total: $275.00 JUN 28 2011 Jefferson County Plannin, & Building Department • • SPECIAL CONDITIONS CASE # BLD11-00106 1.) The application was reviewed by the Jefferson County Department of Community Development staff on March 24, 2009 for the potential presence of Environmentally Sensitive Areas (ESAs) under the provisions of the Unified Development Code (UDC). After an initial Geographic Information Systems mapping review and an investigative site inspection, the following ESAs were confirmed to be present on the subject property: urban shoreline designation; fish &wildlife; seismic; landslide hazard area 1; SUSC aquifer recharge area; coastal SIPZ. 2.) See SPAAD ZON09-00009 for findings that apply to this property. 3.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological formations that allow percolation of the surface water into the soils and the underlying zone of saturation. Aquifers are geologic formations that contain sufficient saturated permeable material to yield significant quantities of water to wells and springs. Aquifers serve as the source of drinking water within most of the rural portions of Jefferson County. 4.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 5.) Geologically Hazardous Areas in Jefferson County are characterized by slope, soil type, geologic material, and groundwater that may combine to create problems with slope stability, erosion, and water quality during and after construction or during natural events such as earthquakes or severe rainstorms. 6.) The parcel is located within a coastal SIPZ (seawater intrusion protection zone) according to the County GIS map. There are voluntary and mandatory measures identified in the Jefferson County Seawater Intrusion Policy (Resolution 44-22, effective September 23, 2002) that apply to well drilling proposals and building permit applications on existing lots of record. A Coastal SIPZ is defined as: all islands and area within one-quarter mile of marine shoreline, but no history of chloride concentration above 100 mg/L in groundwater sources within 1000 feet. 7.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: Water conservation measures: 1. Roof and other intercepted precipitation shall be routed to on-site detention ponds and/or other approved means and allowed to be released to the soil slowly. 2. Water collected from Storm water and roof catchments may be used for watering lawns and gardens. Unless catchment water has been treated to meet drinking water standards, there shall be no cross connections allowed between the potable supply and impounded water. 3. Water withdrawn from wells on each property shall not be used for watering of lawns and/or gardens. 4. Ground water withdrawn from each property shall be restricted to a rate of three (3) gallons per minute. 5. Installation of water conserving fixtures such as low flow toilets, faucets and shower restrictors and other water saving plumbing fixtures. 6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation). Please NOTE that the above listed measures are not intended to be exhaustive, but rather is intended to be illustrative of the types of water conservation measures. 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.) The applicant is proposing to create or add 1,009 square feet of impervious surface and 1,215 square feet of land disturbing activities. JCC 18.30.060 and 18.30.070 require your proposal comply with Minimum Requirement#2 (Construction Stormwater Pollution Prevention) of the Department of Ecology 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. 10.) The project shall comply with liktruction Stormwater Pollution Preventions/PP) 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. 11.) Jefferson County determined that this proposal is categorically exempt from review under the State Environmental Policy Act(SEPA) pursuant to WAC 197-11-800(1)(b)(i). 12.) The site plan as submitted with the Building Permit application on April 28, 2011 has been reviewed for consistency under the UDC, and has been approved by Jefferson County Department of Community Development. Any modifications, changes, and/or additions to the stamped, approved site plan dated June 24, 2011 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 13.) This approval is for a Placement of a New Manufactured Home only. Any future permits on this site are subject to review for consistency with applicable codes and ordinances and does not preclude review and conditions which may be placed on future permits. 14.) A Restrictive Covenant for Irondale/Hadlock Sanitary Sewer System No Protest Agreement was recorded on May 1, 2009 under AFN 547767 with the Jefferson County Auditor. 15.) NOTICE: This permit does not excuse the proponent from complying with other local, state, and federal ordinances, regulations, or statutes applicable to the proposed development, but consistent with RCW 90.58. Development pursuant to this permit shall be undertaken subject to the applicable policies and performance standards of the Jefferson County Shoreline Management Master Program and the Jefferson County Unified Development Code. If during excavation or development of the site an area of potential archaeological significance is uncovered, all activity in the immediate area shall be halted, and the Administrator shall be notified at once. The Federal Endangered Species Act rules to protect threatened Chinook and Summer-run Chum salmon became effective on January 8, 2001. Bull trout have been listed as threatened since early 2000. Under the ESA, any person may bring lawsuit against any individual or agency that"takes" listed species (defined as causing harm, harassing, or damaging habitat for the listed species). In addition, the National Marine Fisheries Service can levy penalties. All areas in Jefferson County are included as "critical habitat"for a listed species. Development of property along any marine shoreline, freshwater shoreline, or floodplains could harm habitat if protective measures are not taken. To minimize the potential to damage habitat, all property owners developing adjacent to marine shoreline, freshwater shoreline, or floodplains are advised to do the following: -All development activities should avoid unstable slopes, wetlands, and forested areas near surface waters - Remove minimal vegetation for site development, especially large trees -Allow trees that have fallen into surface waters to remain there - Infiltrate stormwater from buildings and driveways onsite through drywells rather than discharging directly into surface waters or roadside ditches The Federal Bald and Golden Eagle Protection Act requires landowners within 660 feet (1/8th of a mile) of an eagle nest to consult with the US Fish and Wildlife Service. This Eagle Act prohibits anyone from "taking" bald eagles. This federal law defines the term "take" and describes the possible legal consequences when a"take" occurs. Among other actions, "take" includes a disturbance of bald eagles or their habitat. Under federal law a permit may still be required for activities that impact bald eagles or their habitat. Contact the US Fish and Wildlife Service (http://www.fws.gov/pacific/eagle/) to learn more about how this law affects your project. Any individual, group, or agency can bring suit for a listed species"taking", even if you are in compliance with Jefferson County development codes. The risk of a lawsuit against you can be reduced by consulting with a professional fisheries habitat biologist, and following the recommendations for site development provided by the biologist. For more information, contact the National Marine Fisheries Service in Seattle, or the U.S. Fish and Wildlife Service. 16.) Outdoor residential storage shoe maintained in an orderly manner and slreate no fire, safety, health or sanitary hazard. 17.) Not more than 2 unlicensed vehicles shall be stored on any lot unless totally screened from view of neighboring dwellings and rights-of-way. Such screening shall meet 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. 18.) The building height is not to exceed 35 feet. 19.) Building setback from Randolph St is no less than 20 feet. Side setbacks are no less than 5 feet. Shoreline setback is no less than 30 feet. 20.) See SPAAD ZON09-00009 for conditions that apply to this property. 21.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. JACK WESTERMAN III Jefferson Count,' rihoase ASSESSOR PO Box 1220. Port Townsend, WA 98368 (360) 385-9105 MOBILE HOME INFORMATION FORM OWNERS NAME/MAILIING ADDRESS: /_ ,'S NAME:! i t M4'fk ' _ _A Cr)dd Dv-1✓�-er- ADDRESS:_ //Pro•. r 315-J thafc-c;F (A.4 cy339 PHONE NO.SC3 0) 3ss �3 r�3 The purpose of this questionnaire is to obtain information regarding either the current location of a mobile home or the previous ownership and location of a mobile home. This will help our office determine whether the mobile home is already on the tax rolls in Jefferson County or if it has been moved to this county from another area. 1)MOBILE HOME DATA: (A) MAKE Ll be/4y (B) MODEL W I to b 0• 5- (C) YEAR o2006 ' (D) LENGTH 51, (E) WIDTH IS (F) SERIAL # (G) YOUR PURCHASE PRICE (Do not include sales taa ( ,°0°,-e° PURCHASE DATE 2) PREVIOUS OWNER/LOCATION OF MOBILE HOME: (IF NEW MOVE TO QUESTION 3) (A) FROM WHOM DID YOU PURCHASE MOBILE Larry Ma4-rv1..1 ADDRESS cct 10 A b & NIA) led-z —6'1 (B) WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR? Yes /No If Yes, Previous address of mobile. S 0 II V E If No, What County was Mobile assessed in last year. { �/ 1` ir 3)WHERE MOBILE HOME IS TO BE LOCATED: APR 2 8 1011 (A) WILL THE MOBILE HOME BE IN MOBILE HOME PARK? Yeagi No EFFERSON COUNTY (B)IF LOCATED IN MOBILE HOME PARK: , DEPT OF COMMUNITY DEVELOPMENT NAME & ADDRESS OF PARK Lot/Space # (C) IF NOT LOCATED IN MOBILE HOME P RK: NAME OF LAND OWNER: 7vdO ShII LOCATION ADDRESS 1, 4ic4 iladioce uJA- REAL PROPERTY PARCEL #/DESCRIPTION ! ( ePOO 3O3 J E Signature of applicant THANK YOU FOR YOUR HELP! Lanralee Kiesel, Property Technician (SPAA 6- axV-q JE PERSON COUNTY einik ' DEPARTMENT OF COMMUNITY DEVELOPMENT i 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax ' www.co.jefferson.wa.us/commdevelopment a Master Permit Application MLA: 1 ( -9 Project Description(include separate sheets as necessary): Tax Parcel Number. ct- 3 Property Size: (acres/square feet) Site Address and/or Directions to Property: (01 e.Oiot -- , u2)4 98.3.9 Property Owner(s)of Record: I n �4 n TSI/ i ESQ � ' 4 k i Pp � n ) fry � ? � (� C Telephone: `3 —.0 $ ) Fax: email: Mailing Address: _U• I Cam'¢ � ( I .t� 33 q �� RIApplicant/Agent('f different from owner):TelephoneL O 3 S ',93 3 Fax: email:14'14-xilIRr Dcc,'31-tyeed,Cc04 Mailing Address: .O. tin> 3 Pr. - l(c . try 4 q W39 What kind of Permit?(Check each box that applies ❑Lot or Road Segregati4 n�/ I uilding ❑Critical Areas Steward pi, v ❑ Demolition Permit ❑Variance(Minor, Major or easonable Economic Use) C),Single Family ❑Garage Attached./Detached 0 Conditional Use[C(a) MCd Or C]** 'j l Manufactured Home .0 Modular D Discretionary"D"or Ina ed ua salfiQ4ti2O11 ❑ Commercial* El Use(Essentia Q c Facilities)** ❑ Change of Use 0 Boundary Line Adjustrpebt ❑ Address 0 Road Approach 0 Short Plat** I JEFFERSON COUNTY ❑ Home Business ❑Cottage Industry 0 Binding Site Plan** L DEPT OF COMMUNITY DEVELOPMENT ❑ 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/Pemlit Revisions'`* ❑Site Plan Approval Advance Determination(SPAAD)* E 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: a DESIGNATION OF AGENT I hereby designate 'ML-' ? � Mi f 4C! to act as my agent in matters relating to this application for permit(s). WNER SIGNATURE E / '�G�/� Date: LI-As--( 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 ap ica n th t e or a wa p• r no Signature: 4�� J Date: CI' $- t I /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 riot 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-transfe ble es ons lity fo d�ri�ngg�t d complying with the ESA. The Applicant has read this disci, i er and sig s and dates it below. 'Signature: 'G �; ��fYGe Date: .91a-- I • • 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: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: —� = �, C' Q -/ �6� C, � ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) Fax:( ) MAILING ADDRESS: EMAIL Pjroject Type: Frame Type; Bathrooms: Shoreline: Type of Sewage Disposal: ew Yk Wood Existing: _ ❑ Sewer ❑ Addition 0 Steel Proposed: I Bank 0 Community System ❑ Alteration/Remodel 0 Concrete Total: I Height: k Individual S t ❑ Repair ❑ Masonry �. 'SEP Permit#(I , ❑ Demolition ❑ Other: Bedrooms: Water Suppy: 1 Existing: Setback: 0 Private well 0 Two Party Types of Heat: Proposed: • " Public C IQW. I G Total: - — — Name of Systemt If this is a Commercial Project you must answer the following: t Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants.(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy [t'? 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: 1 Underground Tank 1 Above ground Tank Size of Propane Tank: 1 Heat Stove 1 Cook Stove 1 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 i ,5. rX2' ,Ai � ivy ,k'); e : ,,,,' • 0114 , . Main Floor HeatedOf § � ; EH Bid App Review: .2, :-- 2m Floor Heated <?� � .-- Consistency Review: ,; 1w �� 1 r Other Heated , ' ? Base fee: Mezzanine r „ Additional.Section: Heated Basement 4 � '"'r' - t.K ,�y Plan-Check fee: _ Unheated Basement t . State Surcharge fee: __ . Other Unheated 'x : Pot Water Review fee: i60 Garage/Carport ``-. 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