HomeMy WebLinkAboutBLD2012-00179 16ILDING PERMIT APPLICATS M Review eviewT0133
Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD12-00179 Received Date: 6/13/2012
SITE ADDRESS: 850 TALA SHORE DR
PORT LUDLOW, 98365
OWNER: GARY F GREENE PHONE: 206-547-8237 x 270
BETTY R GREENE
226 12TH AVE E
SEATTLE WA 981025806
SUBDIVISION: Block: Lot: TX 6+
PARCEL NUMBER: 821151005 Section: 15 Township: 28 N Range: 01 E
CONTRACTOR: BROCKMAN BUILDERS INC PHONE: (360)638-1125
33165 HOFFMAN RD NE
KINGSTON WA 98346
Contractor's License BROCKB1961ON Expires 9/15/2012
REPRESENTATIVE: BROCKMAN BUILDERS INC PHONE: 360-638-1125
PETER BROCKMAN
33165 HOFFMAN RD NE
PROJECT DESCRIPTIOr STAIRS TO THE BEACH
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 17,000.00 ADD'L: HEAT TYPE:
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY:
OCCUPANCY: UNHEATED: #OF STORIES:
OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total: __�
Routing Date:
(0— 13-IZ�
Type Amount Paid By: Date: Receipt: Er
Permit $293.25 LYK 06/13/12 131800Aii/Dat\,iE
Plan Check $190.61 LYK 06/13/12 131800 JUL, C, 201Z
State Building Code $4.50 LYK 06/13/12 131800
& Building
Total: $488.36 Jefferson County Planning
Department
•
'ef,'erson County Building Division Permit Num. BLD12-00179
Applicant: GREENE
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 SignatureNotes
/Setbacks `Cf, IU— ` "
Post Holes )c/ I C!- /
Framing
FINAL INSPECTION I2-I
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• •
CONDITIONS for Building Permit# :BLD12-00179
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.) The property owner shall comply with Water Conservation Measures (per list maintained
by the UDC Administrator).
3.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP)
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.
4.) Stormwater Management Standards, stormwater, erosion and sediment control shall be
required for the project as part of the building permit approval. The required plan will be a
small parcel erosion control plan, which does not require a stamp from a licensed
engineer.
5.) The design of the stairway shall be consistent with the plans submitted as Log items 11
&12 of the shoreline substantial development permit(SDP11-00057).
6.) The stairway shall be, or be painted or stained so as to blend into the natural color
scheme of the shoreline bluff.
7.) This approval does not authorize the removal of any large conifer trees.
8.) Erosion control measures shall be in place prior to any clearing, grading, or construction.
These control measures must be effective to prevent soil from being carried into surface
water by stormwater runoff. Sand, silt, clay particles, and soil will damage aquatic habitat
and are considered pollutants when discharged to waters of the state.
9.) Proper disposal of construction debris shall be on land in such a manner that debris
cannot enter the water body or cause water quality degradation of state waters. No fill or
other material shall be placed in the waters or intertidal areas of Jefferson County.
10.) Any discharge of sediment-laden runoff or other pollutants to waters of the state is in
violation of Chapter 90.48, Water Pollution Control, and WAC 173-201A, Water Quality
Standards for Surface Waters of the State of Washington, and is subject to enforcement
action.
11.) During construction, all releases of oils, hydraulic fluids, fuels, other petroleum products,
paints, solvents, and other deleterious materials shall be contained and removed in a
manner that will prevent their discharge to waters and soils of the state. The cleanup of
spills shall take precedence over all other work on the site.
12.) A permanent vegetative cover shall be established on denuded areas at final grade if they
are not otherwise permanently stabilized.
13.) Fresh uncured concrete in direct contact with the water is toxic to aquatic life. All concrete
shall be poured in the dry and allowed to cure a minimum of seven (7) days before contact
with the water.
14.) All lumber and other materials treated with preservative shall be sufficiently cured to
minimize leaching into the water or shore bed, in accordance with the Best Management
Practices approved by the Washington Department of Fish and Wildlife.
15.) Construction shall be in substanti mpliance with the site plan (Log item 12
SDP11-57)) submitted to Jefferson ounty during the permit process as they exis now or
are hereafter amended by Jefferson County and/or the Washington State Department of
Ecology.
16.) Work within the jurisdiction of the Shoreline Program other than as described above shall
receive separate review from this office.
17.) Substantial progress towards completion of the project shall be performed within two
years of the issuance of the permit.
18.) Prior to the issuance of a building permit for the proposal, the applicant shall apply for a
Hydraulic Project Approval (HPA) from the Washington Department of Fish and Wildlife.
Contact Margie Schirato, WDFW at(360) 427-2179 for the requirements.
19.) Pursuant to the email from the State Department of Natural Resources dated March 27,
2012 (Log item 17 of SDP11-57), the applicant shall contact said agency prior to
commencing construction.
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�� ON JEFFERSON COUNTY
k /V DEPARTMENT OF COMMUNITY DEVELOPMENT
'' 621 Sheridan Street• Port Townsend•Washington 98368
A 360/379-4450. 360/379-4451 Fax
�a . www.co.jefferson.wa.us/commdeveiopment
Master Permit Application MLA: 1'� — ( 3
Project Description(include separate sheets as necessary):
' 1`Gir-5 'k-r; -11ne i".actLi--) ii{
Tax Parcel Number: g-. ..11 Cj 1005 Property Size: I• a eik`v-?. . (acres/square feet)
Site Address and/or Directions to Property:
'',5�1 la S1-tor--e— ;:)r-iie R),---4 L► 4iaw ) 'k r.
Property Owner(s)of Record: Oar y ei,4 4 %c:.:-= -•1I 6,nee-ne-- L,7 0 L II V
Telephone:2.6(e"54.1 7-fsa37 zx t. Z70 Fax eman:
Mailing Address: 221a tZ ' et Kurz- Rer5� W j Sect , 4•
Applicant/Agent(if different from owner): 1,fr ,1 o�two/ g�e-o colour i L S1- 2012
Telephone: 3 'th.?g`"I!?e—' Fax: L .,email:,�bPeeg note: ..�
Mailing Address: ;'0. go' 10(0, V1,�t gis-tzs.�, t.r-'h : ' 3 Y j eap-M Ii._k.
Whjt kind of Permit?(Check each box that applies p p JD-I-LIMN CNN iV
h
uilding ❑Critical Areas ewatdsf IanMMUNITY DEVELOPMENT
❑ emolition Permit 0 Variance(Minor,Major or Reasonable Economic Use)
/MiSingle Family 0 Garage Attached i Detached 0 Conditional Use[C(a),C(d),or Cj**
❑ Manufactured Home 0 Modular 0 Discretionary"D"or Unnamed Use Classification
❑ Commercial* 0 Special Use(Essential Public Facilities)**
❑ Change of Use 0 Boundary Line Adjustment
❑ Address 0 Road Approach 0 Short Plat**
❑Home Business 0 Cottage Industry 0 Binding Site Plan"
❑Propane 0 Long Plat"
❑Sign 0 Planned Rural Residential Development(PRRD)/Amendrnents*`
❑Allowed"Yes Use Consistency Analysis 0 Plat Vacation/Alteration**
Storrnwater Management 11 Shoreline Master Program Exemption/Permit Revisions*`
Site Plan Approval Advance Determination(SPAAD)* OShoreline Management Substantial Development
0 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 0 Jefferson County Shoreline Master Program Amendment
*May require a Pre—Application Conference 0 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 1 t 12 rAlcnv✓1 t S.-y° -*13t.6 kkr5 to act as my agent in matters relating to this application for permit(s).
�T- i c.
— OwNER SIGNrii-ue ^t l 7/1u/ _ Date:---1 �, +
1 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 owneriagent 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 1 further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application
i 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 application that he or she wants prior / ) '�
.......1.1 Signature:/1 7 \ VA , �y Xi � -. 1(�it611
Date:
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-tra s sibility for adhering to and complying with the ESA. The Applicant has read this d to er an signs and dates it below.
--, Signature. Date:l0 6 Jo I/
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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:
t C,LiGvvl-G:-1 Bla ickrs,, -4(._ . aC) (c-1125'+ ( )
MAILING ADDRESS: ?C• -°O)( l‹I) .✓(a.c '.1i I.i.,l • EMAIL: p1,�sr;7Ck.drili/IZC�C't 1i/ir9k• r/e-�"
CONTRACTOR'S LICENSE fit// qe.-if 6 WAINS
NUMBER: B P-C:4-tom q 1-1—Gt�i' NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: • EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
., r1 ew , 2-' ood Existing: 0 Sewer
O Addition 0 Steel Proposed: Bank ❑Community System
❑ Alteration/Remodel 0 Concrete Total: kit aLm--
❑ Repair 0 Masonry 0 Ie
❑ Demolition 0 Other. brooms:
Existing: ❑ Private well 0 two Party
Type of Heat: Proposed: --), I 0 Public
Total: IName of to
J u
If this is a Commercial Protect you must answer the following: n/lj FF RS r C NTY
Number of Parking Spaces: Current: Proposed: Numb 1,i a
�.
Number of occupants(includes owners,tenants,employees,etc) Current - i
IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes I No
If this is a Propane Tank and/or Appliance Installationpermit.mark all items bej9w that apply: i/C
I Underground Tank I Above ground Tank Size of Propane Tank:
I Heat Stove I Cook Stove I Woodstove I Fireplace Insert I Hot Water Tank I Pellet Stove 1 Other/�4l
Is this appliance being installed in a Manufactured obile Home? Yes / No jl at_
When applying for a penult to install a propane tank you must also submit a site n showing all of the buildings,all property
lines,tank location and size,distances from the propane tank to all property lines,buildings and septic system components,
including the reserve area.
Square Footage Current Proposed For fl, "`t O'ntly Amount .: S4Ylsion
• Bid Review.
Main Floor Heated • EH App i .,.�
2m Floor Heated " .;. i. Consistency Review: 722
4 r;
Other Heated T ` Base fee. ( 13
=t
Mezzanine >`.Yy:,;„," ' Additional Section: _-
Heated Basement Plan Check fee: l 4;(C I
Unheated Basement , State Surcharge fee: 50
Other Unheated Pot Water Review fee: --- _
Garage/Carport SUBTOTAL
•
Decks/ /i1c3 /'! 911/Rd Approach fee: '
Other 7 TOTAL: $° )Q , p
.� `•,�_.,,, Receipt Number: 13
"`: Cash/Check Number. r/ J'.i'
ESTIMATED COST(REQUIRED) Date:
.Farr market value of all labor and materials foundation to finish ---(19— I ----H-6r'%'----).
4 ./7 Odo Initials:
•
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