HomeMy WebLinkAboutBLD2012-00029 CERTIFICATE OF OCCUPANCY
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
Carl Smith, Director/Building Official
PERMIT#: BLD12-00029
SITE ADDRESS: 11811 CENTER RD Issue Date: 04/10/2012
QUILCENE, 98376 Final Date: 10/22/2013
APPLICANT: VERNON E MAHRT PHONE: 206-547-0776
3919 LATONAAVE NE#C1A
SEATTLE WA 98105-6864
SUBDIVISION: Block: Lot: T 17+
PARCEL NUMBER: 701061010 Section: 6 Township: 27 N Range: 01 W
PROJECT DESCRIPTION: NSFR TO REPLACE EXISTING SFR
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009
EDITION.
OCCUPANCY GROUP: R-3
TYPE OF CONSTRUCTION: 5N
SPRINKLER SYSTEM yes no
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 10/22/2013
\\tidemark\data\forms\F_BLD_Occupancy.rpt 10/28/2013
Jr Iferson County Building C ion Permit Nu,: BLD12-00029
Applicant: MAHRT
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 cR. S
Setbacks � —/G�_/y rj' mimum setback from Center� Road right-of-way shall be 5 feet.
1` Minimum side and rear yard setbacks shall be 5 feet. Minimum setback
from the adjacent rural forest land parcel shall be 100 feet. If critical
areas are present,then the more restrictive setbacks shall apply.
Erosion Control SEE CONDITION 5
Foundation Footing 5 _(t',
Footing Drains I y I 1 Z Q�
Foundation Stem Wall 5 `j�-�lt,Q `/—
Underground Plumbing
Under Floor Framing Jr /Z, 17�
Straps(hold downs) G"[,`/
Ext. Shear Wall Nailing %04_/ %('Y
Rough-in Plumbing
Framing
Airseal '� .—�!' Lri)7
Insulation:Walls 91)49) 13 91/
Insulation: Floors
Insulation: Ceiling
Int. Shear Wall Nailing
Wallboard Nailing t
Gas Line: Interior 311
Gas Line: Exterior i/� ri‘b
Propane Tank "( -1,12
Heat/Chimney Clearance 10_13
Duct Test Cert ( f 7 o-ci
Blower Airtight Test (b, 2 �1.> r
Smoke&CO2 I b )-z ff)
Drywell/Alt Drainage SEE CONDITION 4&6r
Address Posted 1 1
` J
Cinia 1+2 rtor 4a cu l✓
FINAL INSPECTION :0(
N ✓a�-�"
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
I ILDING PERMIT APPLICAT J M ReviewT0018
Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD12-00029 Received Date: 1/31/2012
SITE ADDRESS: 11811 CENTER RD
QUILCENE, 98376
OWNER: VERNON E MAHRT PHONE: 206-547-0776
3919 LATONA AVE NE#C1A
SEATTLE WA 98105-6864
SUBDIVISION: Block: Lot: T 17+
PARCEL NUMBER: 701061010 Section: 6 Township: 27 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: MEGAN RUKKILA PHONE: 360-531-3494
11811 CENTER RD
QUILCENE WA 98376
PROJECT DESCRIPTIOt NSFR TO REPLACE EXISTING SFR
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,662
VALUATION 285,037.00 ADD'L: 578 HEAT TYPE: HTP
CODE EDITION: 2009 HEAT BASE: 135 HEAT TYPE: WOD
OCCUPANCY: R-3 UNHEATED: 838 # OF STORIES:
OCCUPANCY:
OTHER:
CONST TYPE: 5N GARAGE: SHORELINE:
CONST TYPE: SETBACK:
DECK: 996
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: 1 CATCHMNT
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 3 Prop: 3
Total: 3 Total: 3
Routing Date
Type Amount Paid Bv: Date: Receipt: Approved/Date
Permit $2,035.35 LYK 01/31/12 131413 APPROVE'
Plan Check $1,322.98 LYK 01/31/12 131413
State Building Code $4.50 LYK 01/31/12 131413 APR 10 wit
Potable Water Application $64.00 LYK 01/31/12 131413
Jefferson County Planning
Total: $3,426.83 & Building Department
! •
CONDITIONS for Building Permit# :BLD12-00029
1.) Prior to Final Occupancy the water catchment system must be inspected by a certified
American Rainfall Catchment Association (ARCSA) accredited professional and
documentation sent to the Jefferson County Health Department that the system was
installed as designed and will function as proposed.
2.) Prior to final occupancy a satisfactory bacterialogical water sample result must be
submitted to the Jefferson County Health Department taken from a faucet within the
household, that confirms the water catchment system and treatment is providing potable
water.
3.) The building permit has been approved for potable water based recorded document
AFN#566105. The restrictive covenent is required to ensure that potable water can only
be supplied by a properly managed treatment unit and conservation of water use as
specified in the water system design.
4.) Foundation drains are proposed to be tightlined into drywells.
2005 DOE STORMWATER MANUAL DRYWELL DESIGN CRITERIA
ALL INFILTRATION SYSTEMS SHOULD BE AT LEAST 10 FEET FROM ANY
STRUCTURE, PROPERTY LINE, OR SENSITIVE AREA.
FOR SITE WITH SEPTIC SYSTEMS, INFILTRATION SYSTEMS MUST BE
DOWNGRADIENT OF THE DRAINFIELD UNLESS THE SITE TOPOGRAPHY CLEARLY
PROHIBITS SUBSURFACE FLOWS FROM INTERSECTING THE DRAINFIELD.
DRYWELL BOTTOMS MUST BE A MINIMUM OF 1 FOOT ABOVE SEASONAL HIGH
GROUNDWATER LEVEL OR IMPERMEABLE SOIL LAYERS.
EACH DRYWELL MAY SERVE UP TO 1000 SQUARE FEET OF IMPERVIOUS
SURFACE FOR EITHER MEDIUM SANDS OR COURSE SANDS.
TYPICALLY DRYWELLS ARE 48 INCHES IN DIAMETER (MINIMUM)AND HAVE A
DEPTH OF 5 FEET (4 FEET OF GRAVEL AND 1 FOOT OF SUITABLE COVER
MATERIAL).
FILTER FABRIC (GEOTEXTILE) MUST BE PLACED ON TOP OF THE DRAIN ROCK
AND ON TRENCH OR DRYWELL SIDES PRIOR TO BACKFILLING.
SPACING BETWEEN DRYWELLS MUST BE A MINIMUM OF 4 FEET.
5.) CONSTRUCTION ENTRANCES SHALL BE STABILIZED WHEREVER TRAFFIC WILL
BE LEAVING A CONSTRUCTION SITE AND TRAVELING ON PAVED ROADS OR
OTHER PAVED AREAS WITHIN 1,000 FEET OF THE SITE.
THE ENTRANCE SHALL BE CONSTRUCTED ON A FIRM COMPACTED SUBGRADE.
QUARRY SPALLS (OR HOG FUEL) SHALL BE ADDED IF THE PAD IS NO LONGER IN
ACCORDANCE WITH THE SPECIFICATIONS. (13MP C105, 2005 DOE STORMWATER
MANUAL).
ANY SEDIMENT THAT IS TRACKED ONTO PAVEMENT SHALL BE REMOVED BY
SHOVELING OR STREET SWEEPING. THE SEDIMENT COLLECTED BY SWEEPING
SHALL BE REMOVED OR STABILIZED ON STIE.
ANY QUARRY SPALLS THAT ARE LOOSENED FROM THE PAD, WHICH END UP ON
THE ROADWAY SHALL BE REMOVED IMMEDIATELY.
UPON PROJECT COMPLETION AND SITE STABILIZATION, ALL CONSTRUCTION
ACCESSES INTENDED AS PERMANENT ACCESS FOR MAINTENANCE SHALL BE
PERMANENTLY STABILIZED.
•
6.) DESIGN CRITERIA FOR SPLASH BLOCKS:
A VEGETATED FLOWPATH OF AT LEAST 50 FEET SHOULD BE MAINTAINED
BETWEEN THE DISCHARGE POINT AND ANY PROPERTY LINE, STRUCTURE,
STEEP SLOPE, STREAM, WETLAND, LAKE, OR OTHER IMPERVIOUS SURFACE.
SENSITIVE AREA BUFFERS MAY COUNT TOWARD FLOWPATH LENGTHS.
A MAXIMUM OF 700 SQUARE FEET OF ROOF AREA MAY DRAIN TO EACH
SPLASHBLOCK.
A SPLASHBLOCK OR A PAD OF CRUSHED ROCK(2 FEET WIDE BY 3 FEET LONG
BY 6 INCHES DEEP) SHOULD BE PLACED AT EACH DOWNSPOUT DISCHARGE
POINT.
NO EROSION OR FLOODING OF DOWNSTREAM PROPERTIES MAY RESULT.
FOR SITES WITH SEPTIC SYSTEMS, THE DISCHARGE POINT MUST BE
DOWNSLOPE OF THE PRIMARY AND RESERVE DRAINFILED AREAS.
7.) A vegetative buffer of 30-feet shall be permanently maintained from the top or edge of the
Landslide Hazard Area. All buffers shall be measured perpendicularly from the top of the
Landslide Hazard Area.
8.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated.
Should buffer disturbance occur during construction, the Unified Development Code
(UDC)Administrator shall require replanting with native vegetation. No alterations shall be
made to the Landslide Hazard Area or its associated buffer without prior authorization by
the UDC Administrator.
9.) Prior to and during approved construction activities, the perimeter of the landslide hazard
area buffer shall be marked with a temporary sign. The sign shall be placed in such a
manner that it can be directly observed from the construction area. The sign shall contain
the following statement: "Landslide Hazard Area and Buffer- Do not Remove or Alter
Existing Vegetation."
10.) All construction activities shall not encroach upon the landslide hazard area buffer. This
includes the storage or preparation of materials.
11.) The applicant shall permanently separate the boundary of the Landslide Hazard Area
Buffer from the remainder of the subject property through installing logs, trees, a hedge
row, or any other prominent physical marking approved by the UDC Administrator.
12.) Critical Aquifer Recharge Areas may require special protection measures to mitigate water
quality degradation. The submitted proposal does not require additional aquifer
protection measures. However, during construction the project shall follow the Best
Management Practices (BMPs) and facility design standards as identified and defined in
the Stormwater Management Manual for the Puget Sound Basin.
13.) The identified Fish and Wildlife Habitat Area (Type F Stream), shall maintain a vegetative
buffer setback of 150 feet. The setback shall be measured horizontally from the Ordinary
High Water Mark (OHWM) to the proposed single family residence.
14.) An additional setback of five (5) feet is required from the edge of the buffer area to the
proposed single family residence.
15.) A permanent physical separation along the boundary of the stream buffer area shall be
installed and permanently maintained. Such separation can include installing logs, trees,
a hedgerow, or any other prominent physical marking approved by the UDC Administrator.
16.) A Stormwater Site Plan has beer)mitted and approved by the Departments
Community Development. Once the subject permit has been issued the applicant shall
fully implement the provisions of the submitted plan and contact the Jefferson County
Department of Community Development to arrange a schedule to inspect the property for
plan compliance. A Certificate of Occupancy will not be issued until the Department
verifies plan compliance. No clearing for roadways or utilities shall occur on the project
site until clearing necessary for the installation of temporary sedimentation and erosion
control measures have been completed.
17.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
18.) 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.
19.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
20.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
21.) The building height is not to exceed 35 feet.
22.) Exterior lighting for residential uses shall not exceed twenty feet(20') in height from the
finished grade, excepting when such lighting is an integral part of a building or structure.
Ground level lighting is encouraged.
23.) Lighting fixtures shall be designed and hooded to prevent the light source from being
directly visible from outside the boundaries of the property. The intensity or brightness of
all lighting, during construction and after project completion shall not adversely affect the
use of surrounding properties or adjoining rights-of-way.
24.) Minimum setback from Center Road right-of-way shall be 5 feet. Minimum side and rear
yard setbacks shall be 5 feet. Minimum setback from the adjacent rural forest land parcel
shall be 100 feet. If critical areas are present, then the more restrictive setbacks shall
apply.
���; ONC, RUNTY
JEFFERSON •
DEPARTMENT OF COMMUNITY DEVELOPMENT
'I ` 1.4 621 Sheridan Street • Port Townsend • Washington 98368
360/379-4450 • 360/379-4451 Fax
O� www.co.jefferson.wa.us/commdevelopment
BINe
Master Permit Application MLA: 'a - \,
Project Description(include separate sheets as necessary):
Tax Parcel Number: ' ®tQ\0 \O J Property Size: 3 i, cc ,-e, (acres/square feet)
Site Address and/or Directions to Property:
//6i/ Cei,T�.- (&I. u ; Ic.eiicyi 04, y1374
Property Owner(s)of Record: firer" 0 n M..-/, t7
Telephone: oz 6 b -5 ' I -e`7 ?6 Fax: Se,,-n e email: re,3,1,1 4.rt 1 /c crvr, Cii;H
Mailing Address: 3 '/ 9 ,L•=toa.et, rI LIN., ti'� Ar 1/05' S.C.eyfile, u,i?, i.',r✓/ o s
Applicant/Agent(if different from owner): Nj c;14 4,•,t H A :/a-
Telephone: ,3E>0 — 765- cO / >'/ Fs+x:ceI% 36o- 53i•- 34'(i`' email: hie e1-2.rtfl"� a)em44V ,y.
Mailing Address: i i f i i CC',*IC.- Rd: Lip;;.: /(e raa., r.�)/1 9 f 376 VW'ctS� v. C -�� �`- -
W at kind of Permit?(Check each box that applies 0 Lot or Road Segregation
dr;ilding 0 Critical Areas Stewardship Plan
Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use)
OSingle Family 3arage Attached/Detached ❑Conditional Use[C(a),C(d),or C]**
0 Manufactured Home . .t Modular - ❑Discretionary"D"or Unnamed Use Classification
❑ Commercial* 0 Special Use(Essential Public Facilities)**
❑ Change of Use ❑Boundary Line Adjustment
❑ Address ❑ 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/Perrnit Revisions**
-Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management-Substantial D ldopment**
'❑Temporary Use ❑Shoreline Management ' A' (� �/�
❑Wireless Telecommunication* ❑Comprehensive Plan/UD /t r erl9istr ^t�►h'a i nt
❑ Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Sl�orrie Master Program Amen i nt
*May require a Pre—Application Conference 0 Tree Vegetation Request
**Requires a Pre-,4ppb'patioiInfe4-edce7112
Please identify any other local, state or federal permits required for this prpyoal, if known:
DESIGNATION OF AGENT Irr' fy
"'"r.O. CP•
I.i'll:,TY nrva p r-
I hereby designate A i e y 4 ' uu A Kc /4. to act as my agent in matters Telatrng`tattiis-appitbati t su s)•
OWNER SIGNATURE �i/'� l' Date: L/ 3] "
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 applica6��oq of he or she wants rior notice.
Signature: .� Date: 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 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-transferablelidherinq to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: Date: t
111
• 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 assum' a responsibility of th en ral a "r f the proposed project.
+ / Date: V .-�:�� '1_�1\
Signature: v
_
GENERAL CONTRACTOR OR MANUFACT RED HOME INSTALLER: PHONE: FAx:(
( ) )
MAILING ADDRESS: EMAIL:
CONTRACTORS LICENSE WAINS
NUMBER
NUMBER: r\ •
; PHONE (3I./)j i _ aid?'FAX:( ;) ', , per/
ARCHITECT/ENGINEER: ,, �. ,;('4 ,,b I
MAILING ADDRESS: ) \ ,\'� ii-, 2 EMAIL \\,,; S�( V�Ic,c 4 ) °\IY\G1]1,( ,)(�
1 ) \.��`� `.(\; ) � ��e�.�'1�.�t,�. � ((
Frame Type: Bathrooms: Shoreline: Type of Sewage(Disposal:
- New Type: J� Wood Existing: a �f'/� 6 Sewer
0 Steel Proposed: 3 Bank 0 Community System
❑ AdditionaiTotal: 3 Height: Individual System •I
O Repairtion/Remodel 0 Concrete 'SEP Permit# l,-3`-1
❑ 0 Masonry
0 Other: Bedrooms: nl Water Supply:
DemolitionExisting: iU' Setback: ❑ Private well 0 Two Party
�« Proposed: ❑ Public
T o r^ r� ,� Total: Name of System: �a n w.<rc r
�1 ��A/Uln� C"6crGhmcv*1--
If this is a Commercial Project you must answer the following: \c\\
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 SerMice? Yes / No
a If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply:
,Underground Tank 1 Above ground Tank Size of Propane Tank: J
i Heat Stove i Cook Stove i Woodstove I Fireplace Insert i Hot Water Tank I Pellet Stove I Other
Is this appliance being installed in a Manufactured/Mobile Home? Yes I rNoi
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. i , ,,ip,1,f r, > '�° " �£, -4 �t1 :#,. 1''t,,�� NS ze li
3 � i �.0 � t t,�, ���ifl�fts?N,�.�.;t �f�f�v.��":.�„��.�
Square Footage Current Proppsed f , tce §e,,a s P�� 5 , . A .
Main Floor Heated • �Jt EH Bid App Review: r7/^
IM to A, ;.t CO
2"d Floor Heated V i q�' Consistency Review: oag
CI Base fee:
....
Other Heated (9.035-
Additional Section:
Mezzanine ---r
Heated Basement3 ' Z�$‹.`. Plan Check fee: 13aa.Ci C'
Unheated Basement ;s �` State Surcharge fee: 4- O
4 ,k Pot Water Review fee:
• Other Unheated I 3'
Garage/Carport Ii- :'" SUBTOTAL 3
3-1 .
Decks („ 911/Rd Approach fee:
mot_ i _ at'� '; �nsil �
A TOTAL: $3- l�J
Other h x
kst I �
t Receipt Number: \ )`4 3
73 a Cash/Check Number:
TIMATED COST(REQUIRED) - Date:
.Fair market value of all labor and materials foundation to finish Initials:
-•- \"ucl,nu rc+t+ttt\nun PTIRMS\Current DRD Forms\Master Permit Application 5-29-08.doc
• III P ED
AP ROV
STORMWATER PLAN
env,
ON Cr JEFFERSON COUNTYMAR 2 2 2Q12
Kq DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street • Port Townsend •Washington 98368 ,
���
p 360/379-4450 • 360/379-4451 Fax rept or .i. l,'. 1: r ,. •.i„I:,
IsznNO� http://www.co.jefferson.wa.us/commdevelopment/ SIONA FAI���h 1/t MEW
)
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
f MLA# 1 9,J l5( PROJECT/APPLICANT NAME: ''v.R,4,V A3 rA ,AV\'C \ k,t Ori. l.,:vo( .'\V\
}
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.
C 5-CCv uk. c. b r , -1-. ', c;-c \ \u r e. ot., k. c
` Rag. . lease• , • „_ 0 C��rece A, - \, c��3a� OLy1 M.
--el 4 , 7 . \cc c . \ v:;�`\ of, e nn t,-,Q,\c 5,\_Q_ k-vw w\k\
Existing Conditions Summary
..Mov��'� .
2. Describe the existing topography. Indicate contours on the site map.
`b 3\• �\o p e c 1 c , ( 5 E ( YA ,
ik1,)" to vo ' , ay.v . co r.Ne c-cbm �\/,q. . otstn�+r -t -k w. Cc a
' to ' to ? C)'.
3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
EnA"t 0� <<t ,. ' • . • U., .' X;Q_UA rQ \a 1 , 1-,�v- A Pc'v- x 1J \t
.� -E- � �as
S Wi) c, - Qaw,t, Ce ii 4� ca, . 1 cllr `-Yw
4. Describe the existing soils. Indicate soil type on the site map. •
a`c1 i,„_cad 4 c \IQ Lt 1 C-M0,4 ` ate t S (ion 60-eck sf. I=4 jW\ I OAi.
5. Describe the existing site hydrology (i.e., drainage; behavior of water on the site`al:1b,e, below, and on the grou-c1).,l dicate
existing stormwater drainage to and from the site on the site map. Depict separate drainage basins on the site , ap, if
applicable, and indicate acreage of each. . JEFFERSON ' �NTY I
} 1 ��� 4 O 00 JuSQ �,kZ5 ai��, w\ c fvc lli 9KoPut.
-1\ cow. �\(\11.. his . `,)V�_ \t- 1611,1,V1 i--- c tiPeS �Skvrn \ni 1( \.i(tV\ Cl
t. s C3,cV t c\ 3 c,'? 6 .
•
6. Describe any excess levels of noise generated by the proposed use or activity:
raj( ' b k, 1 1
c-e T\tor C OV) rL...c..04\ 1 `-)_,D.W(I ' 0 C c+ 0.0 ,-)yw
Stormwat °S
Requi e
stormwater site plan template—rev.10/21/2008 5
t ; '- ' twM SOT$
7. Describe significant geograpiic featu es and critical areas (i.e., environmentally sensitive areas such as wetlands, streams,
st'ep slopes,etc.)on the site.. Indicat location on the site map.
Lr) StOQQ.- c-0‘0A q nkYc *--o A- to -V0.Stl n e reQK
04444.t _ 6: ,: cam Vlnu e
8. Describe the general vicinity of the site, incluaing adjacent land uses and structures, utilities, roads, and sensitive/critical areas
streams,wetlands, lakes,steep slopes,etc.).
a ace ink ��1 ef- O . t .Q�k i5 c 5 '� 1� reSsi.PV1(L on ?A ,(t��Pc,
C1 _ _ C .�\ e� i 9 . Qc Kit), -1 k\A t c�. 1S a r c-0, 1,
cQM.
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 plan and differentiate proposed facilities from existing facilities.
?\() (DV (IV a . CO\\eck e.6f ca c c ov� 1A6-er C nA clack*
-b She - \ot6v\ ( c \\ . �c�r ,cie d t-�- V� —
L ,, ,q ty) u kAyc{- c oe e. S- rrv_\fir.
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 facilities from existing facilities. [This is
normally for"large"projects or projects that involve the potential for dispersion of contaminants.]
CCU wa - 1 \7vJ ' )C 5oLAN1-k\ . Six Wes.
_13 X . e_G.Sk- S1/4.a e ck Y\Lv.> �`k-I-vkC'k-k..Ck_, . (:&11_ ,►rk.. -n\
11. Describe the performance goals and standards applicable to the project.
"T ANNZ,_c_. Wl\i\DAR, IA\\KVOA4 O 'vvy bkal 5. Sv\-'Z W.Qs3, .
\/.Q r-o c-D e -'X 02 Cc cis ktr� n,6 . 1, v\-
12. Describe the flow control sys,tem. ,, (,4 s �v\( c� t�S-� er n t \ifeA1-1 S . �at- _
s. 0- c
v� _
stormwater site plan template—rev.10/21/2008
6
• • •
13. Describe the water quality system.
Vie \ Q \� o��f P�t o�� (�tr�4 C`�(\. P
14. Describe the conveyance system ana ysis and design. ` ,
e\ \_,-„--) (-- \c-o,\ Yc\G _,.( r.r t. -i \:n 5\T Inv � Q • -T W \n Q,
15. Describe the source of fill material, physical characteristics of fill material,and deposition of excess material.
-,\:\ ,;„1r `��� \ \C\ \��v ,,' ,� ` _i \r__j\l ti \ •s,s. "ti\,
t) r\ „• --wp_C\ _ `J .
16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code. `
c c.v . c t n \ii. ,. L_:Li - � �)S CKN1� C Ou,v- C\\:
w \ .� � V C� ,(tee& aV Q�cl . c k c ,)y(- Ku �n� ,,,,l k,,v„�
\�sv\5 ,)
17. Describe the proposed surfacing material. _
�� , r. " a 01 c ��( CPC . -�_L.
\N -- `�\\C ;,,\. c Q X\ 1. , •
18. Describe methods for restorati n of the site.
( ( Q_L S \1\,VC .C )\J QY <. QW COOS{Q Own,yr (((1 b
WAwit.wit. 6, CrcyS .
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 flowrrt tra + u•- pit e-Manuals
here. I�i)ice L� V I ff, D\
I
20. List here and include any special reports or studies conducted to prepare the Sto�i I��t�r Site Plan. I v,
h \ = JEFFERSON COUNTY
--�I)1}'I.OF COMIVIUNIlY DFA'F!(901'-NT
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.
�` 5�5� � CIA Cc*C'') %04,t V\— 5�S� ��"l \ a v� i'
e . Ct r tiV*;. C\PQ, 9 7,n\,wti .
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. ,
V O rv�L- Co�SE<� i6(N v j:1� b-e c� aG�� �cc E c, v)a rY &,
� c C.: rx �F �� ouh Ott. OUc \t P COYl fir;(r —e
yy", Q\da ((ck Cur1,6 rq_J (emu
2. Establish Constructioh Aceess.
r
3. Control Flow Rates.
4. Install Sediment Controls.
5. Stabilize Soils.
6. Protect Slopes.
(T
7. Protect Drain Inlets.
stormwater site plan template—rev.10/21/2008 8
• •
12 Required Elements—Construction SWPPP(continued)
A. Stabilize Channels and Outlets.
9. Control Pollutants.
t I-
10. Control De-Watering (the act of pumping groundwater or stormwater away from an active construction site).
11. Maintain Best Management Practices(BMPs).
K
Manage the Project.
104.
IJ � i --
i) JAN j ' !
L
IJ
2. Adjacent Areas. ; JEFFERSON COUNTY
a. Description of the adjacent areas that may be affected by site disturbance (e. tt ka ' '^!ha F VagiF -,--residential
areas, roads).
IL (t y if I( l,c_ LA/( (I i'))1 b-u ' S' ( ,/-e/ '(n c = co/e•
// IMiZai i P. ' ififINI
b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
/.-yards). .
r tact) r, (t`Q K CSe�L n 3 I_ 7 ear �1Drb, .e (-4Z 14v74
g.
• 1/ e--, I AIL. . :�- H.
3. Environmentally Sensitive Areas.
a. Description of enviro mentally se sitive areas that are on or adjacent to the site.
.D0 )40, C vR �C_PagJana i� to C-- -SSE _K e� F.
•
stormwater site plan template—rev.10/21/2008 9
• •
b. Description of special requirements for working in or near environmentally sensitive areas.
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).
5. Construction Phasing.
a. Construction sequepce
cip (21(to,q , f -0 S`t►nA h6Me , .c)( pry f�3r /iPCv4oiyti() 11;>(/)
b. Construction phasing(if proposed) �l �(2
6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
I. Provide a proposedi construction sch ule.
�41AA(f( j P +• n tlYVl.� f u �Se,,Z 20/7/ ii/� 4o4 L'2J�ci_t
nY a\ h ✓~ . cs, � ri/ !�I .Ze; / A �r' t. o'_/
II. ,Wet Seasoral Constructigh-Activities. / C� , 4rl. 4j `
_ a. Proposed wet season construction activities.
( W\ViA 0 k-a M\\ 0 ('Oil stritr Cool/9/1- 1
b. Proposed wet season construction activities for environmentally sensitive areas.
\,Of\(
7. Financial/Ownership Responsibilities.
a. dentify the prop rt owner responsible for the initiation of bonds and/or other financial securities.
\ �t��) uKrk
b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impacts.
•c, _u-,,,.Q()-nF,-7\.._ k, v i
8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following, if applicable.
a. Sediment Ponds/Traps. 41
b. Diversions.
c. Waterways.
d. Runoff/Stormwater Detention Calculations
stormwater site plan template—rev.10/21/2008
10
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.
(LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
•
stormwater site plan template—rev.10/21/2008
12
I
-L a N
1.
rnth
i
� \ d d Q. • ..e... ,..„‘
J � O O O
VVVNNIII VNl
, , 0 ,q r 46.0.,
rn ---' VIM
1 --1\ N t co pk- x---%—i q VA ,,
1 P 4 , N
fin, \)--;--, -,�: IPP
-- il.-
\...
ak. ! t x A°--'° ' TglIkk `
-67 r ,/T/T ) ( 1:--- r-_�1 "' � q- NI A— ��
/ , ) mf i
a
N
Z
r CID 0
0 36-0•
AUl l D-D• 15-0• 12'•4•
5!4• 4'-6' 2'-5' 2-10' 4,0' 2'-1O'
1 N
Z \ I i I
\ I
-■ . Ilan �■-1 6_�■ta���■1 . _. I
1 - -
Cr I
A I I
\ 0, L-.- J ___
II a raliptili-L
- _ — :-- Ii j
11111E111 1SG1NDill it b Ir
_
�
'kik'''. __ _
U
IL -
0 ■ N7RY G ! � i
�C �C=■ , t
I..:
AL16N
l ,I ilMb3
UM EIM
12-4• nIill !ERI N
Boni itinlim i!..
1 lin pm- Lim.= i 'zt, F
ill" ' liraltipaill boo i --_,:li -6., ilR, il -4.- -
i--' III It*. /I Plq a
I szli IP iii O w
0 1111111iiiiitjmil ,
thro' isn , ,,„ ..,, „
45111 did:
liii I• •- �:■■ ii:' ° 2O6D ce, ta1
I 2--s
-� °T EOM I3IF 5KF/ROD 64\
i 0 / nor IIllith • 4
b
1‘. -iirkiMLA 1121 4i .
a illi r ■%2„F O r■ � K2D
1.11111 I ! t---I3,
�y
�_:.__ 4020- --
i .,. ,./ , i
_ ___ _
hI 0 1 i / \ I
u u u , \ PU
z / 3 mob' t5
0
Ns 56-0'
m �� -__J- ®® ®®
A
"' oD TITLE: 1j OWNER: 6540 REp6IECT
c, A ARIriTECT P.O.Bov 760
D g m R/CK 4 MEGAN RUKKILA JW Simon OWon,W 96076
_ Vob:Mb6313107
MAIN FLDOR PLAN G ell CENTER ROAD _
O N �` t D'T4// w 113 PROJCENE, ASHI GTON 9A376 360-531-3494JEFF D E S I-V 1 w- EmeY.Iwdugn6610pp1W1ma1
a " 0 LJ" b PROJECT LOCATION: SIAMOFw, �R , F ERMIT SET
11311 CENTER ROAD a OUILCENE,WA9NINGTON Residential Architecture • Site Planning
.wrw n.7M�u.Vfn6Wt5 r•�irs tn.[aufino�sruEi 7��.wn+s vfer.�vae n.�s nen u TfxcO.
c, I N I
W
Mp 4 il RW
< & W S 0 / 6=6• ' c (1> 15=0' / /?'{• /2'0•/
lj
0 i t
lit
.P. t \ \) -i
1 _ocl_..,, , ,. , i ,
o
4„,,, A 1. ,,,,,i- i-- il
,-- ,,, ?i'" \----------' '
d b N
1. .-:10:,,lp
tO i -e.-- , q
`; 0 ''' 2(:----65,..'""---"-----.1
YY A lil 1.�
N tlF§A g /2!' /
A P :'I _-ni
V �. , �° '30%6 co
x.
._, .
-emu q - ,
____.
0
1r • 1r st
b \ n �. n \ \
,
m 13yaN
N_ N / 3_/• f 3_/. /d d' 24'-4•
'f
w
•
H
I '
,/ / / m 41i 1Lf
d iJ
to 36-0
-r / -
_ \ C
\\ r,
\IN rn
m
A 0 L ,„--I---., ,..--—--.
w \\ li = I r 1 d. // \\ /
•
-: P \\ O _
a
\`\1% A _ -k /
-I.. 11 \ g V, i .
A \ TY 20 20 1O'
V
\ N ''V V GbT GG .
la1
\\ b —_ /i 1) O O / / • 4,0• /
rn I ; - _ �_ e_ ____�__,L______ -
i___-
LP r �j \ 0 5'FIB.TUB/ ' ¢�- I W m 0 a 1
0 r / 51/OWER / bb„ r ---- F R t
i I
4111) CD
_ , / R 4000 B,F
- 00 0 rl
'...___ _.., \ / I i , �• L.,
A i.i tiff x Lt ,7,7_:
J
1 : 4 ,'''') ! .la'
g N \ u
1,,, , r u \
\ IFin4
����, � T °
ff x /
4:: \ /
0 5040sE\\I \ \
r, r, / 3,q' , I 3,4' s L
fq
!II mLJ N
i P b \ 10,4' /2,0'/
/
9 /t/ `\
/ l
PILE' n OWNER: 6540 WAVERED
ARQ^IIIECT P.O.Box 711
N L D D / - Oulu.,WA 94]i1
D ' g m / y ,L / m RICK a MEGAN RUKK/L A o1_— .1 W Simon
`n N !` P�.4NS 7 DE 1/i II..S hell CENTER ROAD _ W.:3eo.s3I.Tim
GXJILGENE,IUASHINGTON 99376 360-531-3494 .EFF 9uoR DES 1—G—N ' fe"`°"'°�'
ti 0 PROJECT LOCATION: nAE�tSIMON PERMIT SET �"'""" "�'
-�. N Q 1011 CENTER ROAD
LNa CENE,WASHING.roN Residential Architecture • ^a—ils Planning
West Property Line \0
�f
_�
op
7 N \
1
'D C� C
x ••
\< to ' (n II+ CO V- X OOvO( 0N D
co1:7) C O v '0 n .
.. 0- u, m oC * a co 3 °o co m c 0- r
x Oa cD < ra,- -"^- 0- 3' j (ADD O (D
m o a
(/� 7 .� Cl) C (DCD x a N
v - Ulm -a �_ O Cr (0 v
t a
O C � f / .t " ,'�./ ..�. � ��S `�� `tip �...a+, ♦/
::,-.1
•
g Q p • MOB}I05 V� �, �'� • :• Al � ,,,_,g g- .). -o
1010,
u
%_ ZF-? N
O p
E f A
6i._ UHI
4roo � y� ] .-]. CD v y z ��, y r y y
jCJ7 A CO N `�� z z I-I r d co) o
I N Z7 m D D 177 6 V1 y (/1
ci
lb ry o rn ai 111i
to CO rn 0 oCD Ui p cp ^y Z I
xz d z � b
ocu 3 � -o 5- m v, c, -0 v n aa (D Ds �
� 3 0 0 � v . ���3 � 0Eimmmm � oI � Z y � z
nxy � n
m °: a s cu coo `� y `'lllyyy.'.'.'2yyy��J""•
'�^ �] Y o
3
o " (ncn3 m v, - o ►r-3 n CZy : x tile)
o
x
0 o s j 6 -o C� y tilCrJ b n
� � � z y � rojn OIL-] �' › � (z')
U
v C. I-. I-3 pz cn I" •0 Cm7 C n ^�
� � 04cp .Ti t 0z x
zrL (Th
� nod
ttl
o d �
1071
_ . _ - 0 .-i Cri '' tT1 c4 !
a o r
It "
CD
cn o _ —._ _ _ _ o ,r t7
CD 0
CD CDO, O t7
p 0 X
n o c
7
j (ODrii (p
n,
n_ p
i-- -; j IJ J Cr) ~pi: a
i o CD Q co
ell . 0
-,, II rry nn� .. . O D
v G U u j 5.J11 Y m
0 J t.,,„, ram.
a m ci (� "L� N b I I O
07cD --ICD N 111 �� . ! Ul
-, g , ► �- o h� O (-4Z
... ....,,,
N m - cu •C kJ.
-i
-o o a �. u •
j oc o
o 27.
o
A