HomeMy WebLinkAboutBLD2011-00224 MLA11-00179
ILDING PERMIT APPLICATigl Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD11-00224 Received Date: 8/10/2011
SITE ADDRESS: 120 ADMIRALTY LN 351
PORT LUDLOW, 98365
OWNER: GORDON W FOOTE PHONE:
DEBORAH FOOTE
24317 87TH PL W
EDMONDS WA 98026-9005 THE ADMIRALTY#2
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 990300217 Section: 9 Township: 28 N Range: 01 E
CONTRACTOR: TOLLEFSON BUILDERS INC PHONE: (360) 732-4080
TODD HULBERT
PO BOX 100
CHIMACUM WA 98325
Contractor's License TOLLEBI977N9 Expires 3/16/2013
REPRESENTATIVE: TOLLEFSON BUILDERS INC PHONE: (360) 732-4080
TODD HULBERT
PO BOX 100
PROJECT DESCRIPTIOP REPAIR & REPLACE EXISTING DECK & REPLACE POSTS
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP DEK MAIN:
VALUATION 15,000.00 ADD'L: HEAT TYPE:
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY:
OCCUPANCY: UNHEATED: #OF STORIES:
OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: 500 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
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 $151.25 LYK 08/10/11 12807 APPRJVE1
Permit $100.00 LYK 08/10/11 128008
Plan Check $163.31 LYK 08/10/11 12807 AUG6A 1UU
State Building Code $4.50 LYK 08/10/11 12807 Jefferson County Planning
Total: $419.06 &Building Department
Jefferson County Building Division
Permit Number: BLD11-00224
Applicant: ADMIRALTY II HOMEOWNERS A;
3UILDING 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
Foundation Footing ftyg-_ I(
f,rl
Framing 10 _ (3 t
FINAL INSPECTION i _ 3 I 1/ 41)
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• •
CONDITIONS for Building Permit# :BLD11-00224
1.) To help prevent seawater from intruding landward into underground aquifers, all new
development activity on Marrowstone Island, Indian Island and within 1/4 mile of any
marine shoreline shall be required to infiltrate all stormwater runoff onsite.
2.) 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.
3.) MANDATORY MEASURES FOR COASTAL SIPZ:
1. For proof of potable water on a building permit application, applicant must utilize
DOH-approved public water system if available.
2. If public water is unavailable, a qualifying alternative system may be used as proof of
potable water or an individual well may be used as proof of potable water subject to the
following requirement:
a. Chloride concentration of a laboratory-certified well water sample submitted with
building permit application.
3. If public water is unavailable, a qualifying alternative system may be used as proof of
potable water.
4.) 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.
5.) This parcel is within a no shooting area per JCC 8.50.
6.) Residential developers and individual builders shall be required to preserve shoreline
vegetation and reduce the associated risk of erosion during construction and any future
activity which may impact the stability of the shoreline.
7.) The building height is not to exceed 35 feet.
8.) The development shall be essentially the same as the original in location, size,
configuration, and external appearance.
9.) A Coastal Geologic Site Assess*prepared by Jim Johannessen dated Jul", 2011
was submitted with this application. This report addresses the 500 ft(approx) of water
frontage along the property and provides specific recommendations regarding drainage,
erosion vegetation management for the development but does not specifically address the
deck replacement.
This is a relatively small project(deck replacement within the existing footprint) and no
plans to implement the geotechnical report recommendations were submitted with this
permit application. Should the property owners or Condominium Association decide to
implement the recommendations in the geotechnical report, additional plans and permits
are required. Contact the Department of Community Development at 360-379-4450 to
determine application submittal requirements and review criteria.
10.) A Coastal Geologic Site Assessment prepared by Jim Johannessen dated June 21, 2011
was submitted with this application. This report addresses the 500 ft (approx) of water
frontage along the property and provides specific recommendations regarding drainage,
erosion vegetation management for the development but does not specifically address the
deck replacement.
This is a relatively small project(deck replacement within the existing footprint) and no
plans to implement the geotechnical report recommendations were submitted with this
permit application. Should the property owners or Condominium Association decide to
implement the recommendations in the geotechnical report, additional plans and permits
are required. Contact the Department of Community Development at 360-379-4450 to
determine application submittal requirements and review criteria.
ozv cod •
JEFFERSONUNTY
�� 4' DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street • Port Townsend • Washington 98368
360/379-4450 • 360/379-4451 Fax
www.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA: , — -19
Project Description (include separate sheets as necessary):
Tax Parcel Number: C1 crvc,Z t 3- — `i`I v 3vc: a I '?f. Property Size: (acres/square feet)
Site Address and/or Directions to Property:q�0 °U t ti �5 �Zv
•
Property Owner(s)of Record:
Telephone: Fax: _ email:
Mailing Address:
Applicant/Agent(if different from owner):
Telephone: .3() `•� t Z 3? ` ' Fax: ,66,c: 7 S) L/C email:
Mailing Address: PC) too is /vv C -'- � -"t i r.�4_ 32 7)04 (c= 4-)
What kind of Permit? (Check each box that applies 0 Lot or Road Segregation
uilding 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]**
O Manufactured Home .0 Modular 0 Discretionary"D"or Unnamed Use Classification
O Commercial* 0 Special Use(Essential Public Facilities)**
❑ Change of Use 0 Boundary Line Adjustment
O Address 0 Road Approach_ 0 Short Plat**
O 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 ❑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 Manage
❑Wireless Telecommunication* 0 Comprehensive P arr/ Ei
i ent
❑ Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County hb li
*May require a Pre—Application Conference 0 Tree Vegetation R cjLu �
**Re uires a re-Application Conference
Please identify any other local, state or federal permits required for this p o�p8sat, if known: J
11•
DESIGNATION OF AGENT JEFFERSON COUNTY
I hereby designate lc-lc-I /4 i f"✓' t to act as my agent in matt rs rql grtgotti jap 'WANK?t (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 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 t in/ e ants fo notice.
—
r
' t6�lba `7S J
Signature: �'�--��
f Date: /c, ) (
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-trirsferd ponsiity f adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature:✓� � Date: (4-% t
•
• 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 assumin t poasibility of the General Contractor for the proposed project.
Signature: . ,!Z // Date: (6 — lc
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
i�i 1 t.i-Sc,/. 6,-, l' rS .�= IA C_ (66°) •3)- 11&5 - (36d ) 1 3'. /o I
MAILING ADDRESS: EMAIL.:
CONTRACTORS LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: rame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
C New Wood Existing: ❑ Sewer
C Addition ❑ Steel Proposed: Bank 0 Community System
C Alteration/Remodel ❑ Concrete Total: _ Height: 0 Individual System
repair ❑ Masonry SEP Permit# _
Demolition C Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well ❑ wo 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:
1 Underground Tank i Above ground Tank Size of Propane Tank:
i Heat Stove i Cook Stove i Woodstove 1 Fireplace Insert 1 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 [urrent Proposed For Office Use Only • Amount Revision
Main Floor Heated EH Bld App Review: ____---__...
2°Floor Heated Consistency Review: ( 3
Other Heated Base fee:
Mezzanine A e1 fqn:,12 0.4cm
Heated Basement an Check fee: 1 31
Unheated Basement State Surcharge fee: •50
Other Unheated Pot Water Review fee:
Garage/Carport SUBTOTAL
Decks ,,. ,00 911/Rd Approach fee: _______—
Other �,(„) TOTAL: $ ' (aq o(.
•
Receipt Number: (a .e 7 i c cOSs
• Cash/Check Number:
EST ATE' • ' • - - : Date: /, 01
•Farr market value of all labor and materials foundation to finish !AO l(I
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