Loading...
HomeMy WebLinkAboutBLD2013-00157 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#: BLD13-00157 SITE ADDRESS: 51 E CEDAR ST Issue Date: 06/13/2013 PORT LUDLOW, 98365 Final Date: APPLICANT: LESLIE A HOYT PHONE: 253-840-1849 51 E CEDAR ST PORT LUDLOW WA 983659740 SUBDIVISION: PARADISE BAY ESTATES Block: Lot: PARCEL NUMBER: 983400421 Section: 22 Township: 28 N Range: 01 E PROJECT DESCRIPTION: New SFR with attached garage 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 \\tidemark\data\forms\F_BLD_Occupancy.rpt 2/27/2014 • BUILDING PERMIT I Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD13-00157 Received Date: 5/21/2013 SITE ADDRESS: 51 E CEDAR ST Issue Date 6/13/2013 PORT LUDLOW, 98365 Expiration Date 6/13/2014 OWNER: LESLIE A HOYT PHONE: 253-840-1849 51 E CEDAR ST PORT LUDLOW WA 983659740 PARADISE BAY ESTATES SUBDIVISION: Block: Lot: PARCEL NUMBER: 983400421 Section: 22 Township: 28 N Range: 01 E CONTRACTOR: HI-LINE HOMES PHONE: 253-840-1849 11306 62ND AVE E PUYALLUP WA 98373 Contractor's License HILINH*983BD Expires 11/8/2013 PROJECT DESCRIPTION: New SFR with attached garage TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,248 VALUATION 112,605.00 ADD'L: HEAT TYPE EEE CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: R 3 UNHEATED: #OF STORIES: OCCUPANCY: CONST TYPE: 5N OTHER: SHORELINE: CONST TYPE: GARAGE 484 SETBACK: DECK: 96 BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: 36705 Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $1,066.55 CJZ 05/21/13 142113 Exist: Exist: Plan Check $693.26 CJZ 05/21/13 142113 Prop: 2 Prop: 2 State Building Code $4.50 CJZ 05/21/13 142113 Total: 2 Total: 2 Potable Water Application $66.00 CJZ 05/21/13 142113 Total: $1,830.31 Directions to Site: HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. Request must be received by 3pm the day before the inspection is needed. Office Hours 9:00 am -4:30 pm MONDAY - THURSDAY HOT LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS APPLY-SEE ATTATCHED • Jefferson County Building Division Permit Nuer: BLD13-00157 Applicant: HOYT BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2009 International Building Codes To schedule inspections, call (360)379-4455 no later than 3:00PM the day before the inspection is needed. Requests received after 3:00 PM will not be scheduled for the next 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 8/30g it O la, ©.zaitt- Erosion Control 8/.30/13 Foundation Footing Qr� P/.30/13 U��Y Footing Drains Foundation Stem Wall �7 s_/3 Underground Plumbing Under Floor Framing t,.'„3_, Straps(hold downs) JJJ j�z! 5 A #r,t-D DowF-)S 61L I bpi/13 Ext. Shear Wall Nailing 1• 71////3 1119/ Rough in Plumbing /f/-1//3 � Framing �,/ !4 Q/_ Blocking 1,/�/2/ /3 �l/� Airseal // ///3 „^J! Insulation:Walls �Y Insulation: Floors al/0 t Insulation: Ceiling chili 4 �j� Int. Shear Wall Nailing J„/30//3 3 C. Wallboard Nailing Gas Line: Interior NA Q Gas Line: Exterior Propane Tank Heat/Chimney Clearance Mechanical Systems �a Blower Airtight Test 0l/9 14 Smoke&CO2 Drywell/Alt Drainage t") DRYiegL- 9/243 Address Posted 0// //4 FINAL INSPECTION a//¢ FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD13-00157 1.) 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. 2.) The site plan as submitted with the Building Permit application on May 21, 2013 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 May 21, 2013 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 3.) This parcel is within a no shooting area per JCC 8.50. \\firfamark\rlata\fnrmc\F RI Il Parmit Rlrfn rnt R/14/9lfl BUILDING PERMIT APPLIC,AS Review TION 00157 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00157 Received Date: 5/21/2013 SITE ADDRESS: 51 E CEDAR ST PORT LUDLOW, 98365 OWNER: LESLIE A HOYT PHONE: 253-840-1849 51 E CEDAR ST PORT LUDLOW WA 983659740 PARADISE BAY ESTATES SUBDIVISION: Block: Lot: PARCEL NUMBER: 983400421 Section: 22 Township: 28 N Range: 01 E CONTRACTOR: HI-LINE HOMES PHONE: 253-840-1849 11306 62ND AVE E PUYALLUP WA 98373 Contractor's License HILINH*983BD Expires 11/8/2013 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI' New SFR with attached garage TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,248 VALUATION 112,605.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: 484 SHORELINE: CONST TYPE: DECK: 96 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: 2 Prop: 2 Total: 2 Total: 2 Routing Date: ("")-(f Type Amount Paid By: Date: Receipt: Approved/Date APPROVED Total: JUN 132013 Jefferson County DOD --)(ic"6, JEFFERS.COUNTY L (�DEPARTMENT OF COMMUNITY DEVELOPMENT 11 621 Sheridan Street • Port Townsend •Washington 98368 - . 360/379-4450 • 360/379-4451 Fax 44 ,gyp www.co.jefferson.wa.us/commdevelopment ,; ivi N i i 21�13 i i i J `s_ ILI l � i Master Permit Application MLA. JEFFERSON COUNTY i___'NTT OF NIMMIIMPf nEVH OPMENT Project Description(include separate sheets as necessary): 5F J2 Tax Parcel Number: (117_3&/CC qL I' Property Size: (acres/square feet) Site Address and/or Directions to Property: I E.. Nh�lc�r i R-0 Lo ul LU wq q56)5 Property Owner(s)of Record: ! ,!--:S L I L Ff 0 YY 9iLi Telephone: )(S1), L J�", I ) Fax: I\) email: r — Mailing Address: r,I OL"f1R 5T1 Po'Rr Lt) L)Lll) WA f4Sj (p�) Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑Building ❑Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Use) Cil Single Family El Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home 0 Modular 0 Discretionary"D"or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use ❑Boundary Line Adjustment ❑ Address ❑ Road Approach ❑Short Plat** ❑ Home Business 0 Cottage Industry 0 Binding Site Plan** ❑Propane ❑ Long Plat** ❑ Sign ❑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 ❑Shoreline Management Variance ❑Wireless Telecommunication* ❑ 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: 4IL., DESK3NATION OF AGENT I hereby designate I LI Na, ( en ' LA' LLL/, to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE 1 Date: t) • l j �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 attomey'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 application that he or she wants prior notice. l I I Signature: 'f Date: b''xl 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-transferable responsibility f r adhering to and complying with the ESA. The Applicant has read this disclai er a[ Is))dgns and dates it below. Signature: `}{' Date: -I) Al G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc • BUILDER STATEMENT 0777, 16 U v L The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors! t they will be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: d GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX // ii ,;SON COUNTY f/i`rile ikii r iii 'o(c: 6.,AI!?,,4,,f. c f o)ut1,0. iAm iS";i If, ( )s'NO- I1,0 FPT nF Ui#7 1I0(11.- 1-4--- MAILING ADDRESS: EMAIL: h h i.,s r'Y)�E(i ii 1 cbnf'S L e'fVi CONTRACTOR'S LICENSE WAINS NUMBER: Il/Li '`jt-1`1S34 tab NUMBER ARCHITECT/ENGINEER: vi<c/16 6 4 6;i,,� PHONE (LSD)56.40 I S'`I`i FAX:(25 ) 7 7 0. 2 2 Z C MAILING ADDRESS: 1130( t:-.ZA=° Aoe E P„+yai(/a (fiG. EMAIL l;;cibrC..' C k,1'rnr L ell t'S•c ;✓ti' Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: it New R Wood Existing: [1 Sewer ❑ Addition i i Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel Li Concrete Total: Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit#SE?l�j-occ 30 ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: 11 Private well ❑ Two Party Type of Heat: Proposed: Nj<Public r lec-t-r:c _ Total: Name of System: pk-0 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 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 For Ana Akre Only Amount ,",,Revision Main Floor Heated �- ` EH BId App Review: n 2"O Floor Heated • < Consistency Review: . a Other Heated Base fee: Mezzanine Additional Section: Heated Basement Plan Check fee: p J 92 (P Unheated Basement State Surcharge fee: ( ° Other Unheated Pot Water Review fee: I 04,, Garage/Carport ,yqa SUBTOTAL L)503,6 a, ,14 31 Decks 911/Rd Approach fee: Other LOvt'feA Pt'•,h `l(! Arlo 40 TOTAL: $ .��Receipt Number: /I . II ( 3 'cfoPash/Check Number: ESTIMATED COST(REQUIRED) __Date: • _\'Z .Fair market value of all lakor and materials foundation to finish J 9 1,0 O 0 CI'''} Initials: ' C7e G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc • Op Front Parcel Review Parcel 983400421 Printed: May 21, 2013 LESLIE A HOYT Site Address: 51 E CEDAR ST 51 E CEDAR ST PORT LUDLOW WA 983659740 PORT LUDLOW, WA 983659 PORT LUDLOW WA, 98365 Parcel Number: 983400421 S-T-R: 22-28N-01 E Total Acreage 0 Legal Description PARADISE BAY ESTATES BLK 4 LOTS 26 &27 Land Use: 1101 Flood District: Fire District: 3 Planning Area: 8 _ Flood Map(FIRM) Panel No: School District 49 Zoning: Rb COMP PLAN DESIGNATION: COMMUNITY PLAN: UGA: UGA Trans [ Plot plan states "property line" [vr Assessor's Map (Property lines on submitted plot plan must match the property lines as identified on the Assessor's 1/4 map) [ v' Legal Access to Property NO [ t J"Parcel Tags or Scanned Documents YES 0 [ c.,K ESA's: Special Reports Nearby YES [ tDesignated Ag YES CO �.f" oreline Designation: YES [ Shoreline Slope Stability: YES Stream Type:YES NO Fish& Wildlife:YEs NO Wetlands: YES NO Rare Plants:YES NO Seismic: YES NO Landslide: YES NO Flood: YES NO Erosion: YES NO/ Aquifer Recharge Arei:YES NO 5(iL C - SIPZ: none At Ris High Risk Coasta CMZ: none High Risk Mo derate oderate R1skDlsSnnected CMZ Stormwater site plan submitted: YesNo [ Forest Lands: YES (IQC-5) ' Adjoining Forest Lan s: Commercial/ Rural/ lnholding [V/( Mineral Lands: YES 4.0 [ >4 gricultural Lands: YES • [ Archaeology: YES 0 64& 'Pr‘it Vie'LLA [vr Stormwater: New Im.-- ', urface2 I'" Land Disturbing Activity ---2--1 6 Lit!. ESA's Stormwater Re.' :Min Req#2 Min R-q#1 thru#5 Min Req#1 thru#10 1 Engineering [ v( Notice Provision ri sc osure:Airport YES NO MRL YES NO Forest Lands YES NO [yr. Landscaping Required: Yes [ Parking Spaces Required NO AP Other f Of-- Building Height c UBC Standard [ ] . Impervious Surface coveragiarcentage: 2-.7- e 0 Resource Lands& Public: 10% Rural Residenti .._25% ) Rural Indust,Per UDC Sec 6.7 Rural Commercial: 60% Area of Building rage:60%in Rural Industrial Lands only [ ] Total Building (s) Size: RVC: 20,000 SF CC: 5,000 SF NC: 7,500 SF GC: 10 0 0 SF All others:subject to tic&water constraints/ a specified [ V Setbacks: Front: tO Left Side: Right Side: _ — Rear: Shoreline Setback: LSHA Setback: [ yr Road Classification: Road Approach: xISTIN N T REQ'D RAP [ 1X SEPA Required: YES ExE PT [V Flood Certificate: [ li( Existing Case(s) & Condition(s): Violations: Yes No [ 1,]' Recorded Date of Subdivision: AFN Over 5yrs=UDC Plat Conditions: <5yrs=Plat C itions on plat or Old Ordinance [ L Lots/Require Declaration of Restrictive Covenant Y S O, submitted: Y NO kfri cR 3 a [ t,}- UGA No Protest Agreement YES NO, submitted: YES [cA Site Visit conducted YES CSIO [ 'l.]' Require Final Zoning Approval [ ADMIN: Setbacks entered in Permit Plan case / YES New Parcel Tags entered in Permit Plan YES Special Reports Scanned /A YES No parcel tags found for parcel Cases Associated with APN 983400421 Cases Name Review Type Status Planner BLD13-00157 HOYT I P Application Received: 5/21/2013 Permit Issued/Case closed: Case Finaled: New SFR with attached garage OTH10-00019 HOYT CLS Application Received: 8/19/2010 Permit Issued/Case closed: Case Finaled: 9/1/2010 OTH13-00003 HOYT CLS Application Received: 2/19/2013 Permit Issued/Case closed: Case Finaled: 2/22/2013 1 HOUR TECHNICAL ASSIS 1ANGE SEP03-00053 JOHNSON C Application Received: 3/4/2003 Permit Issued/Case closed: Case Finaled: info from this case filed to SEP05-36. THIS EES ONLY RECORD! THIS IS NOTA PERMIT!! SEP05-00036 LEWIN V Application Received: 2/4/2005 Permit Issued/Case closed: Case Finaled: EES ONLY RECORD!! NOW FILED SEP13-30 THIS IS NOTA PERMIT!!! info from cancelled EES case#SEP03-53 filed here SOM05-00036 HOYT V Application Received: 2/4/2005 Permit Issued/Case closed: Case Finaled: SEP13-00030 HOYT A Application Received: 3/6/2013 Permit Issued/Case closed: 5/1/2013 Case Finaled: SEP05-36 (O&M only) now filed here \\tidemark\data\forms\R_Parcel_CRMLA.rpt 5/21/2013 Page 2 of 2 0 S 0'5 ON co& JEFFERSON COUNTY P I , 0LE 0 V --) ►; DEPARTMENT OF COMMUNITY DEVELOPMENT `�` •- 621 Sheridan Street • Port Townsend • Washington 98368 f�?< �� 11 �q�, (.O 360/379-4450 • 360/379-4451 FaxII LINO http://www.co.jefferson.wa.us/commdevelopment/ �I 1 IJi JEFFERSON COUNTY _ DEPT.OF COMMUNITY DEVELOPMENT Stormwater Calculation Worksheet MLA# PROJECT/APPLICANT NAME: DETERMINING STORMWATER MANAGEMENT REQUIREMENTS: This stormwater calculation worksheet should be completed first to classify the proposal as "small,""medium," or"large." The size determines whether a Stormwater Site Plan is required in conjunction with a stand-alone stormwater management permit application, building permit application, or other land use approval application that involves stormwater review. The basic information will also be helpful for completing a Stormwater Site Plan, if required. PARCEL SIZE(I.E., SITE) Size of parcel acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet I , 1 sq/ft Land-disturbing activity is any activity that results in movement of earth, or a change in the existing soil cover (both vegetative and non-vegetative) and/or the existing soil topography. Land disturbing activities include, but are not limited to clearing, grading, filling, excavation, and compaction associated with stabilization of structures and road construction. Native vegetation is vegetation comprised on plant species, other than noxious weeds, that are indigenous to the coastal region of the Pacific Northwest and which reasonably could have been expected to naturally occur on the site. Examples include species such as Douglas fir, western hemlock,western red cedar, alder, big-leaf maple, and vine maple; shrubs such as willow, elderberry, salmonberry, and salal; herbaceous plants such as sword fern, foam flower, and fireweed. LAND DISTURBING ACTIVITY, CONVERSION OF NATIVE VEGETATION, AND VOLUME OF CUT/FILL Calculate the total area to be cleared, graded,filled, Answer the following two questions related to excavated, and/or compacted for proposed development conversion of native vegetation: project. Include in this calculation the area to be cleared for: Does the project convert%acres or more of Construction site for structures I a-As sq/ft native vegetation to lawn or landscaped areas? Drainfield, septic tank, etc. sq/ft Circle: Yes 0 Well, utilities, etc. sq/ft Does the project convert 2 1/2 acres or more of native vegetation to pasture? Driveway, parking,roads, etc. OO sq/ft Circle: Yes C (:____ Lawn, landscaping, etc. sq/ft Other compacted surface, etc. sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance R n z3t.- sq/ft Cut Fill (cu/yd) [over] stormwater calc worksheet Rev 9-9-2010—REV 9/9/2010 1 • Impervious surface is a hard surface that either prevents or retards the entry of water into the soil mantle as under natural conditions prior to development. A hard surface area which causes water to run off the surface in greater quantities or at an increased rate of flow from the flow present under natural conditions prior to development. Common impervious surfaces include, but are not limited to roof tops, walkways, patios, driveways, parking lots or storage areas, concrete or asphalt paving, gravel roads, packed earthen materials, and oiled, macadam or other surfaces which similarly impede the natural infiltration of stormwater. STORMWATER CALULATIONS—IMPERVIOUS SURFACE NEW EXISTING Structures(all roof area) sq/ft Structures (all roof area) sq/ft Sidewalks sq/ft Sidewalks sq/ft Patios sq/ft Patios sq/ft Solid Decks sq/ft Solid Decks sq/ft (without infiltration below) (without infiltration below) Driveway, parking, roads, etc sq/ft Driveway, parking, roads, etc sq/ft Other sq/ft Other sq/ft Total New sq/ft Total Existing sq/ft TOTAL NEW+TOTAL EXISTING* sq/ft *This amount will be used BY STAFF to check total lot coverage. The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT v. REDEVELOPMENT Divide the total existing impervious surface above by the size of the parcel and convert to a percentage: % Does the site have 35%or more of existing impervious surface? Circle: Yes No FURTHER INSTRUCTIONS: If the answer is yes, the proposal is considered redevelopment and the attached Figure 2 should be used to determine the applicable Minimum Requirements. If the answer is no, the proposal is considered new development and the attached Figure 1 should be used. At this juncture, the applicant should refer to the applicable Flow Chart to determine the Minimum Requirements for stormwater management. DCD staff will help verify the classification of the project and the application requirements. For proponents of "small" projects who must comply only with Minimum Requirement #2—Construction Stormwater Pollution Prevention—an additional submittal is not required. The proponent is responsible for employing the 12 Elements to control erosion and prevent sediment and other pollutants from leaving the site during the construction phase of the project. Pick up the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet. Proponents of"medium" projects—those that must meet only Minimum Requirements #1 through #5—and for "large" projects—those that must meet all 10 Minimum Requirements—are required to submit a Stormwater Site Plan. DCD has prepared a submittal template of a Stormwater Site Plan, principally for rural residential projects. Complete the template in the Stormwater Site Plan Instructions and Submittal Template or prepare a Stormwater Site Plan using the step-by-step guidance in the Stormwater Management Manual. APPLICANT SIGNATURE By signing the Stormwater Calculation 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 .5(3,A (LANDOWNER OR AUI RIZED REPRESENTATIVE SIGNATURE) (DATE) FOR OFFICE USE ONLY SMALL MEDIUM LARGE REDEVELOPMENT Stormwater Site Plan: Yes No stormwater calc worksheet Rev 9-9-2010—REV 9/9/2010 2 cn v Xi Vng:Z, i m Z TA O N 0 Z i O Cj 111 I) v a o m 2 N SN ri �r V V` J k 4e. r 0 yN - H 12, 2 2 c) ri rii o m C ?ya � o z y� C r �n O 2 A co yam Ilik. nri t�O op 1co 2 =y o 0 ,, 01 T-11114. -..---------,Of z�C r,QN 210 - • � • yinon 100.00 �I ti 2 T "71 x k .7�r.� 0 r ,s oc j r -`'�_ (� I i t �� I cz�czj o �I N �_ ii _i 0 t- :1---LS-Z I 1 1 I I. I I ' �`� !. a ar � i i�i z x w ' I 1 1I'1" I I'' I ("r^ I 1 I I 1 8 U Ck! ICO � I I I,•I�1 I O� x (711Q. u, Qc� a;- "r• �0t 11 1 I I czjc�i 1 I 1� $ o ^�G�j2 / x ' I 1 I I �'\ 'N a n r I I I I rl 0 y I I I it 0 ` J , 1 I I I I x Z� I I I // I !� ? ti Ab /1 c I 11 i ! I L) ) vip " I I I O �ptb � �O I I 1 I o mot, T o x — —�. ' p 0? Ito:- 10 1 i oO O V �V S+� w 1 t)� I' £L --"-I 0 ......, , u) o RJ1 11 x '� , oe > P I I�, I it I CM i z -r I b z it !. I� z�I e �� x gypp, R 4a. ram' _y mPotl o�� o m �{��� _ — — � - _ - / J am- Ir0 ,i, — —�' L — / °°•°° 7so' : I ,g 1• H pp Q0Oti N "0�zk ��kw -0I 222 CO I �2 �� dam �S�C o �' 0 0 ply �ano�r'* r�0z x C a i �" i z m z� ptv 01 o, O0co oN 2� 0 0 rr,nM i� ��'r�� 00� DO 0 OQ �2 � � 020 �O-I A �00 i _ i0 0 0 -4z 0 Z � 2)'' r�'0i =�2 ®k ~'0 m\ ya m om s`o� , I � ? z,,Sx c zu t/� ®� "' o czi 0 o 0 • a� a 22rczj 6- co,- o n O n p Wpmm a�� zz —I_ kr) g C) m , ti O �� 3 "' �_ � Pf. N. - QOX -----------: II C) Hamm • . 4....t._ I Zit COm m /� -n L �/ S p0 Z� ' m L/ O ^ s1 C 0 rn�' Z cm�n �f 1t t� rn11 r an 3 Z t� by j '0 2 y vn r m mzyr o� till u Zp • A W �.. "'� it 0 r> 0 O C 0 Z ' I,,,', '. -.:.,t-,.J.. • • ' ?....„''''',;,, .,-;','• '•:, ..::14.:.....4:W=Lttet',.; -.:',.,'' ,''.. ,,- y�*' , > .�,�r F , y 4r1 1 r-As, t yagl• � �tt' !v- • 1 - .. ,°„a,-,,,,,J.,1( -rvP r +u/A�w�; . ,,,1 -,4 '�f' to`4 yam,.,k z. p CO > I- mlm =MN I , _ 9' A W G) NhA i'fl eOcn --I DPH m „ ZD (nOz mmo 0oz z C mm> N 2 cwWnD -im ( 1mm 7-011 F -0 D � r= p � 70mm mNr9 i? 737J • 'JIM p_ O 0 00 * m -D-i = ODcr • DOr 00 > > -i r. 7373D mmo zZ zZ rD- 71i > WrD- JQ) Z -^ (ANO W � - W 0 = mcn - mw UnUn Un0) r- U' * "5mrZ1 m 0Un -I0 -0 -0 mm2 (n D cn 2 - -irm rcn . C r DD r m2 m2 m g1ZD00 o p vxon � xx > rD z -m-i0 -m-io O mD * rzc cD ncn 0° cn +� mm � � -i nr O Cn0 �np M Zr0 dm Zpam2 _< Ioi Un rD- rD- = Or- -1 fll—.. o � O -i m * M9-O Cn n oro7J • 11 - , v owi7 -zim m -fir mmm O2 r_ C 2 - orn mz j CD > O 0 0 O LT- OG Z y , Z D Z D Z - > - m 1 0 r"• z rz � mrD- i = �00 � � D rDm � r�V) � �Qm •Am Nm Tf'12 - CZ) z 'i � ° ,=@ zD � z2 m vm 0mzc � -i DDa KD� -i Un xc 00 -Ip > , - O GDz oo � 02 r > 0 co 2 � � � �71T1 co � Glr � CAC� a -mIrr- Z r2 � m � .< > "- "0 r0 ' z UnUn � Zm vcm D 000( * -I > - 4' mm 00 0 � c 0 C) mD � � CI) Z• XX Z cn rr- 0 m G CD a CR • z011 I O U) I 00 m 7 Cx G) D r 0 zt -0 rn m z ii w > o o ze co ____I m ..._ rth , — a m — v _ -rj-J 1 1 m El - ® m 0 zi J = Z C7 L z 1 r_ _�cae� Zm n I C D I, r j m D co C--' pp _ iv 14, - 4 'S•i O-, i,i Ilmnimi al i N O T 16 6 • 6 6 ., ., ,..:... 1, 411)..,. c„ ,:te sc\ . . _1 l c_ 0 ODD -o;_ (/� m z N=Zrn SHEAR WALL LESLIE •. IV N�o= HOYT 0 0D'O 51 EAST CEDAR ST. H'L E o ; _w z PLAN PORT LUDLOW, WA 98365 HOMES 0 w ,......16D m (360)437-7942 www.HiLineHomes.com ©copyright 2005 HiLine Homes