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HomeMy WebLinkAboutBLD2013-00128 BUILDING PERMIT APPLIcION BLD13-00128 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00128 Received Date: 4/18/2013 SITE ADDRESS: 213 GREEN MOUNTAIN LN BRINNON, 98320 OWNER: DESMOND MC CANN PHONE: 360-301-3880 PO BOX 191 BRINNON WA 98320-0191 LEMBERG SHORT PLAT SUBDIVISION: Block: Lot: 1 PARCEL NUMBER: 602341050 Section: 34 Township: 26 N Range: 02 W CONTRACTOR: BUY RITE HOMES PHONE: (360) 681-0777 259403 HWY 101 SEQUIM WA 98382 Contractor's License BUYRIH*08406 Expires 5/20/2014 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr NEW MANUFACTURED HOME - REPLACING AN EXISTING HOME TYPE OF WORK MOB SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,456 VALUATION ADD'L: HEAT TYPE: EEE CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: 24 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: 1PWELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: 2 Prop: 2 Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $0.00 JLA 04/18/13 State Building Code $4.50 JLA 04/18/13 142007 APPROVED Potable Water Application $66.00 JLA 04/18/13 142007 Total: $70.50 JUN 1 1 2013 Jefferson County DCD \\lirlomorLAAn+n\fnrmc\F RI Il Ann PIA rnf A/1R/9l12 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#: BLD13-00128 APPLICANT: DESMOND MC CANN PHONE: 360-301-3880 PO BOX 191 BRINNON WA 98320-0191 SITE ADDRESS: 213 GREEN MOUNTAIN LN Issue Date: 06/11/2013 BRINNON, 98320 Final Date: 5/21/2014 SUBDIVISION: LEMBERG SHORT PLAT Block: Lot: 1 PARCEL NUMBER: 602341050 Section: 34 Township: 26 N Range: 02 W PROJECT DESCRIPTION: NEW M/H - REPLACING AN EXISTING HOME -SERIAL#34159 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 5/21/2014 \\tidemark\data\forms\F_BLD_Occupa ncy.rpt 5/21/2014 • 0 . 1 ., ..... . .. 0_ C2.1F L7-1 .— '1 '. 1..'1)1111.1,4 i.t".'.111 'I .... a it.i'o :f'-,,..`134V M ral; • C:lif7C)1", puP S ..411 PC., - CO C...) _ j: ,-- — -'1.■-- ' 1111 1 1 . li 11H . i ' 1 . , CV _ # 0 . t I_ u_ ----2- 1 1 I I 1 ' i :- I 0 0 . I... ItllA c_ j 1 ' j i' ll ' l j • j 4 1 1 0 0 CO ol , 1 . i , , 1 , , ;I , 1 , 1 , , 1 >-. ! , , . , 1 , . 7-z--- , 1 1 . CI\ 1 ' 1 ■ i i--- . I < m • ; 1 . , . . . . , 1 . 1 1 111116•111MINIM10111011=111a : ' 1 , ; • 1 ;' I r , o.... ::. -1,.. t i I 1 ; II ill , ' ' 1 ' ; Z ■ ; ; ' ' 4: _>.. —" ° 0 1 , , 1 1 1 , ,„ ,,, , ' r■ '' 4-1-1 c , . ....., , ; 1 , , , 11 , ., ....i.... v) . I ' 1 , oi 0 . . ' - o i cc ' 0 ' 1 • :k1 f _!,,...■ 1 , . . . , H , ' .. 1 ' - ! : ' 1 ' .,7. , , , , i= i , 1 H 1- . 0 0 (1) x inx . cc 1 •.: Z , 8 co , , Lk, co I.1 1 cr) c:1 . 1 w . • (/) ■ 1 a . ' , < . : Li., , . • . x • 1, ; , , 1 „.., 1.-- , I • • . . ' • 1 I 1 1 , , ..:t --- ,• :: •--....--.:._._-:-:-/ ; , 1 1 . ; 1 . • • 0 ter,3 %cc JEFFERSON COUNTY D VEP EPARTMENT OF COMMUNITY DEVELOPMENT '! , L , ,7 621 Sheridan Street • Port Townsend •Washington 98368 u� �' 360/379-4450 . 360/379-4451 Fax g JEFFERSON COU y JEFFERSON COiJMY hftp://www.co.jefferson.wa.us/commdevelopment/ COMMUNiTYDFVELO MFNT Stormwater. Calculation Worksheet MLA# PROJECT/APPLICANT NAME: e&/ `b6c61210,6 pG 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 o./7r go D 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 / sq/ft native vegetation to lawn or landscaped areas? Drainfield,septic tank, etc. sq/ft Circle: Yes No Well,utilities,etc. sq/ft Does the project convert 2%acres or more of native vegetation to pasture? Driveway,parking,roads,etc. sq/ft Circle: Yes No Lawn, landscaping, etc. sq/ft Other compacted surface,etc. sq/ft _ Indicate Total Volumes of Proposed: Total Land Disturbance ,-}t/to sq/ft Cut Fill (cu/yd) -72/24.4) % . /4 •/? [over) 6e44 t+.o , ham?6wd -9 4'0 Lpaito ae,Ynanre®C-280 4/6 • • 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)- 14454 sq/ft Structures(all roof area) 2/66 sq/ft Sidewalks sq/ft Sidewalks sq/ft Patios sq/ft Patios 028/) 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 v Ob(") sq/ft Other sq/ft Other sq/ft Total New 111452, sq/ft Total Existing D sq/ft TOTAL NEW+TOTAL EXISTING* .5/3/, sq/ft This amount will be used 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: St 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 two and correct to the best of my knowledge. also certify that this application is being made with the full knowledge and consent of all owners •f the affe =• •roperty. • - ';OWNER 0- ORIZED REPRE ATIVE SIGNATURE) (DATE) y i.....�.;iti101,1 '. .,.... 1'�}i i�n� .. ..,.:�._ �Y�dn`E. �-_ "v..w..�.`_.�$ i_LL�� �� }�� �h Pd_14eP� � �°'YIt 7 j�"ak 4 d-, ....� „�....Q>..—.. .._.= I3 LO I '5-14 k c;" JEFFER4 COUNTY DEPARTMERT OF COMMUNITY DEVELOPMENT .1 `-c 621 Sheridan Street• Port Townsend • Washington 98368 360/379-4450 . 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment `-- _TAT— Master Permit Application MLA: Project Description(include separate sheets as n eces ary):�t��/b q 171,9A)oc- ici�.Le d / ac Tax Parcel , Number: OZ, 3y/ 050 Size: - , (acres/square feet) Site Address and/or Directions to Property: ,3 4 , ri�4' '----''7 6-fir0- 7"__ 6 1 / -.Z //&I.j � m-n o�eww ,o�d ,L. tc . 1�..taf�ch-,,cam(, 6---A hte ,e-t- .PropergOwner(s)of Record: A• 6 A)d if e Ay ! 1... L.r,lc, 1 , / Telephoneo( -6OI - 880 Fax: email: Mailing Address: {?©. I©X /9I 4eiivA)onJ Ge? 9 2 Applicant/Agent(if different from owner): 6-,..y- e. /,fi s Telephone: ,Stp6-/0f31-O7'77 X 3LO 4 70..501 Tax: '�0-6,81--0777 email:h6-dip rbaucjkr Cjf}hcv.co m Mailing Address: 2.594/0,S SUu t /o / S eept i LOA 9838 a What kind of Permit?(Check each box that applies OBuilding ❑Variance(Minor,Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a),C(d),or C]** ❑ Single Family ❑ Garage Attached/Detached ❑ Discretionary"0"or Unnamed Use Classification X Manufactured Home ❑ Modular ❑ Special Use(Essential Public Facilities)** ❑ Commercial* ❑ Boundary Line Adjustment ❑ Change of Use ❑ Short Plat** ❑ Address ❑ Road Approach ❑ Binding Site Plan** ❑ Home Business ❑Cottagelndustry ❑ Long Plat** ❑ Propane ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑Sign ❑ Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions*" ❑ Stormwater Management ❑ Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance ❑Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium ❑Tree Vegetaion Request *May require a Pre—Application Conference **Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal, if known: / n / DESIGNATION OF AGENT I hereby design !� !' i1 �'. ., to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE `'""/%42-ti-.n'� 'u" �,2 -ti, Date: 1144-7-1 a.7e 7 6 13 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 a • right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any re•J =• later in •-«ions. Staffs a •-ss and right of entry will be assumed unless the applicant informs the County in writing at the time of- appli„iron th=the w= is prior noti•-=. Signatar UK/ . 19.._ -��4L _ 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 lake"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 iss ed will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)e en if y are in comp with the Je - -on County development code.The Applicant acknowledges that he,she or it holds individual and non- sfe -i•le tesponsib• or=•hering to a d complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature:'v , i ' _ , i_ A--u- Date: II BUILDER STATEMENT • r The signer of this - ement does h by certify thayt they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they i 'kassu ng the sponsi '` •f the Ge ral Contractor for the proposed project. Sign ture �� '.L' - / Date: GEN RAL CO TOJR MANUFACTURE;HOME INSTALLER: • PHONE: FAX: ily- - f) 06b) 6S1 `6777 (5w b61 - 67 O MAILING ADDRESS: 2_55Gj /a zj/.0 j_)6/ , a-C )yl EMAIL. t,;y,41 r Qr(JQ.Gt.h i.(l f kb P• Ctlf 6ri CONTRACTOR'S LICENSE GJ WAINS l NUMBER: )5114,e_7:// * 684LO b NUMBER ARCHITECT/ENGINEER: a_436-16 -4‘6 AP s PHONE (g46 g,2_6 -a,c Ax:( ) MAILING ADDRESS: 2 l/i/c 54), a , 254.6,Q/A,41 , /MAIL Project Type: Frame Type: ' Bathrooms: 3 Shoreline: Type of Sewage Disposal: y New )2< Wood Existing: o Sewer ❑ Addition ❑ Steel Proposed: 2 Bank 0 Community System ❑ Alteration/Remodel 0 Concrete Total: Z Height: 1 Individual System ❑ Repair 0 Masonry SEP Permit# ❑ Demolition 0 Other: Bedrooms: Water Supply: Existing: Setback: A Private well ❑ Two Party Typ f eat: Proposed: . ❑ Public _PLIEla Total: o Name of System: If this is a Commercial Project you must answer the followina: 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:. ❑Underground Tank. 0 Above ground Tank Size of Propane Tank: ❑Heat Stove ❑Cook Stove ❑ Woodstove ❑ Fireplace Insert ❑Hot Water Tank ❑Pellet Stove ❑Other Is this appliance beina 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 Office Use Only Amount Revision Main Floor Heated / EH Bid App Review: .�y b r 2"O Floor Heated Consistency Review: Other Heated Base fee: 2-g-. c Mezzanine Additional Section: Heated Basement Plan Check fee: _.- Unheated Basement State Surcharge fee: if' S a Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL: $9 j(O. 50 Receipt Number: /i` -7 Cash/Check Number: 3/�q� ESTIMATED COST(REQUIRED) Date: g:-/ per/J 2 .Fair market value of all labor and materials foundation to finish 0 Initials: <J4- ' Contractors or Tradespeopliiinter Friendly Page Page 1 of 1 • General/Specialty Contractor A business registered as a construction contractor with L£xl to perform construction work within the scope of its specialty.A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. Business and Licensing Information Name BUY RITE HOMES UBI No. 601013329 Phone 3604790795 Status Active Address 259403 Hwy 101 License No. BUYRIH*0840B Suite/Apt. License Type Construction Contractor City Sequim Effective Date 9/2/1992 State WA Expiration Date 5/20/2014 Zip 98382 Suspend Date County Clallam Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company QUANTUM ENT a HOMES INC Other Associated Licenses Specialty Specialty Effective Expiration License Name Type Status 1 2 Date Date OLYMPLD952C4 DEVELOPMENT OLYMPIC LAND Construction General Unused 2/24/2005 2/24/2009 Expired DEVEL INC Contractor Business Owner Information Name Role Effective Date Expiration Date CAVANAUGH,JON RICHARD President 09/02/1992 Bond Information Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 2 OLD REPUBLIC YLI222426 05/10/2002 Until Cancelled $12,000.0003/15/2002 SURETY CO Assignment of Savings Information No records found for the previous 6 year period Insurance Information Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date O 18 CONOVERINS ZHS905743800 05/10/2011 05/10/2013 $500,000.00 05/09/2012 17 NORTHLAND NY102755 05/10/2010 05/10/2011 $1,000,000.00 05/10/2010 INSURANCE CO 16 NORTHLAND NY102755 05/10/2009 05/10/2010 $1,000,000.00 05/08/2009 INSURANCE CO 15 NORTH PACIFIC C06160235 05/10/2009 05/10/2010 $1,000,000.00 04/22/2009 INS CO NORTHLAND 14 INSURANCE NY102755 05/10/2008 05/10/2009 $1,000,000.00 05/06/2008 COMPANY 13 NORTH PACIFIC C04160235 05/10/2007 05/10/2008 $1,000,000.0004/23/1937 INS CO 12 NORTH PACIFIC C03160235 05/10/2006 05/10/2007 $1,000,000.0004/17/2006 Summons/Complaint Information No unsatisfied complaints on file within prior 6 year period Warrant Information No unsatisfied warrants on file within prior 6 year period Infractions/Citations Information No records found for the previous 6 year period https://fortress.wa.gov/lni/bbip/Print.aspx 4/18/2013 1 • \ f i -7--- 7\ / \ \ 1 ' i1 om I ° �o i m rD� /z / N, 8._____\_\ , -0 ao % i______- ) to �, �Zjj I 2 g \ Dy oOA11 � �h..Q OCR / IAO NA1� 2= • . 2 �� \ \ D°8 conC7 b�i M pb o b pii / \ \ . A 7 �/' \ ~ 4 \( \ ti I D o —___._�� y . , ,\y/ ,.., (.1...., . 6., ,,, /I '� C°i 0 2. 'y` ' 50 0 .. cs _'ms's xi m o ,, / �y Op - �� rt )c-ct. U \ -i a i M� / \\ \ yO Q°� k- I I P O 4,../rn r1 07 i i \ \\ \ \ Rl O N ~ \ N O y CA rl CO i _ -\\ ____.----- ..__.-----Z1 P / _____\ _____ ' i . \, _ GREEN — OUNTAIN LAN — ------ _ v+ n cf ei f 0O `0 y 0 n\ v $r k J ( .J l Ns VP: � i 0n C Co 0 CD co 4 It =) iffil o 0 r,, 0 III I r.,............. ,; :".... .s, Et.. ..._, r , , ITA tv.4.,...,, . ign 1 slw" ."mmal 71:„...:L.).1.; •c ... .,...)„. - 1",J Op Front Parcel Review 0 Parcel 602341050 Printed: April 22, 2013 DESMOND MC CANN Site Address: PO BOX 191 213 GREEN MOUNTAIN Lt BRINNON WA 983200191 BRINNON, WA 983200191 BRINNON WA, 98320 Parcel Number: 602341050 S-T-R: 34-26N-02W Total Acreage 5 Legal Description LEMBERG SHORT PLAT LOT l(S/C XMPT Land Use: 1100 PTN)SUBJ/EASE Flood District: Fire District: 4 Planning Area: 11 Flood Map(FIRM)Panel No: School District 46 Zoning: e-C- COMP PLAN DESIGNATION: CppIMUNITY PLAN: UGA: UGA Trans [ ] Plot plan states "property line" [ 14 Assessor's Map(Property lines on submitted plot plan must match the property lines as identified on the Assessor's 1/4 map) [ VI Legal Access to Property YES NO [✓f Parcel Tags or Scanned Documents YES NO [ ✓J ESA's: Special Reports Nearby YES NO [V] Designated Ag YES 0 [ 1/f Shoreline Designation: YES NO [C.( Shoreline Slope Stability: YES cD Stream Type:YES NO Fish & Wildlife:YES NO Wetlands: YES NO Rare Plants:YES NO Seismic: YO Landslide. NO 5 u Lk-` Flood: YES NO Erosion: YES NO Aquifer Recharge Are. `► NO S-C SIPZ: none At Risk High Risk Coastal CMZ: none High Risk Moderate RiskDisconnected CMZ Stormwater site plan sus is itted: YesNo [ Forest Lands: YES M Adjoining Forest Lands: Commercial/ Rural/ Inholding [j- Mineral Lands: YES gra [ n-- Agricultural Lands: YES lb_ [ (j- Archaeology: YES _ �^ [ f/( Stormwater: New Im,-r 'I Surface `/L Land Disturbing Activity 2 (f p ESA's Stormwater R : :Min Req#2 Min("LE #1 thru#5 Min Req#1 thru#10 Engineering [ i'r Notice Provisions I • ure:Ai ort YES NO MRL YES NO Forest Lands YES NO [ Landscaping Required: Yes ,' o [ Parking Spaces Required NO Other [ Building Height: allP UBC Standard [ r Impervious Surface covers ercentage: Resource Lands&Public: 10W Rural Residential.) Rural Indus.Per UDC Sec 6.7 Rural Commercial: 60% Area of Building Coverage:60%in Rural Industrial Lands only [ Total Building (s) Size: [�VC:20,000 SF CC: 5,000 SF NC:7,500 SF GC: 10,000 SF All others:subject to septic&water constraints/None specified etbacks: Front: Left Side: Right Side: Rear: Shoreline Setback: LSHA Setback: [ frf Road Classification: Road Approach: 44118P NOT REQ'D RAP [ V SEPA Required: YES 4 EMPT [ t Flood Certificate: (4 [ LA Existing Case(s) &Condition(s): Violations: Yes No ^^-- [ t C'Recorded Date of Subdivision: (7� AFN Over 5yrs=UDC Plat Conditions: <5yrs=Plat Conditions on plat or Old Ordinance [ Lots/Require Declaration of Restrictive Covenant YES O, bmitted: YES NO [L UGA No Protest Agreement YES .!S submitted: Y NO [�r�J Site Visit conducted YES '� [ vJ Require Final Zoning Approval YES [ ] ADMIN: Setbacks entered in Permit Plan case 4184 YES New Parcel Tags entered in Permit Plan 4 /: YES Special Reports Scanned&YEs No parcel tags found for parcel Cases Associated with APN 602341050 Cases Name Review Type Status Planner BLD13-00128 MC CANN P Application Received: 4/18/2013 Permit Issued/Case closed: Case Finaled: NEW MANUFACTURED HOME - REPLACING AN EXISTING HOME BLD85-00028 LEMBERG F Application Received: 4/23/1985 Permit Issued/Case closed: 7/13/1995 Case Finaled: 7/17/1995 Reactivated for inspection &T.b. SEP13-00045 MC CANN P Application Received: 4/19/2013 Permit Issued/Case closed: Case Finaled: SEP78-00229 MC CANN N Application Received: 8/24/1978 Permit Issued/Case closed: 8/31/1978 Case Finaled: SOM78-00229 MC CANN N Application Received: Permit Issued/Case closed: Case Finaled: \\tidemark\data\forms\R_Parcel_CRMIA.rpt 4/22/2013 Page 2 of 2 JACK WESTERMAWI Jciie re ty i;oartho� ASSESSOR p0 w x 20, Pori Tsnnred,WA 90308 (384038341M MOBILE HOME INFORMATION FORM OWNER'S NAME/MAILING ADDRESS: NAME: .tJ�+ o,Ji ADDRESS: .D . C.�X /9/ s(ge/,{JAJO•c) PHONE NO. 3 4QQ 1-388() 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 eS7 • (B)MODEL /046/C (C)YEAR 2D/2 (D)LENGTH ,62- (E)WIDTH at`f3 (F)SERIAL# 1/15-q (G)YOUR PURCHASE PRICE(Do not include sales taa),I,OC)G . ° " PURCHASE DATE 091/3 2)PREVIOUS OWNER/LOCATION OF MOBILE ROME: (IF NEW MOVE TO QUESTION 3) (A)FROM WHOM DID YOU PURCHASE MOBILE ADDRESS (B)WAS MOBILE ROME ASSESSED IN JEFFERSON COUNTY LAST YEAR?Yes No If Yes, Previous address of mobile. It No, What County was Mobile assessed in last year. 3)WHERE MOBILE HOME IS TO BE LOCATED: (A)WILL THE MOBILE HOME BE IN MOBILE ROME PARK Yes 0) (B)IF LOCATED IN MOBILE kOMB PARK: NAME do ADDRESS OF PARK Lot/Space# (C) IF NOT LOCATED IN MOBILE HOME PARK: NAME OF LAND OWNER: LOCATION ADDRESS .43 g ■L/ 1'//o1L/7 T / ) L.L sde/.U.c..b.J QB d REAL PROPERTY PARCEL#/DESCRIPTION 6 D Z 3 AIl ()SO. A ature of pplleant/ THANK YOU FOR YOUR HELP! t 4JO CASSELL.Property Technician • • Jefferson County DCD Building Division Correction Notice PERMIT NUMBER / 7—12.8 OWNER JOB LOCATION i I ((.49/ 1147 Inspection of this structure has found the following violations: ox. f ?- FI N,a-L °A t'Z, ,S'-ett t,- biAd AAA. /3)/ /- r9-E-7"h It \\1/4 0?\ ‘'C 4 You are hereby notified that no more work shall be done upon these premises until the above violations are corrected, unless noted otherwise. When corrections have been made, II fo inspection. Date /3� Inspect•!. BUILDING DIVISION(360)379-4450 'INSPECTION HOTLINE(360)379-4455 THIS NOTICE MUST BE KEPT WITH APPROVED PLANS ON SITE I MANUFAJRED/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#: BLD13-00128 Received Date: 4/18/2013 SITE ADDRESS: 213 GREEN MOUNTAIN LN Issue Date: 6/11/2013 BRINNON, 98320 APPLICANT: DESMOND MC CANN PO BOX 191 BRINNON WA 98320-0191 SUBDIVISION: LEMBERG SHORT PLAT Block: Lot: 1 PARCEL*: 602341050 Section: 34 Township: 26 N Range: 02 W CONTRACTOR/ BUY RITE HOMES PHONE: (360)681-0777 DEALER 259403 HWY 101 SEQUIM WA 98382 (360) 381-0780 Contractor's License BUYRIH*08408 Expires 5/20/2014 PROJECT DESCRIPTION: NEW MANUFACTURED HOME-REPLACING AN EXISTING HOME MAKE: KARSTEN YEAR: 2012 SIZE: 52X28 Directions To Site: To schedule inspections, call (360)379-4455 no later than 3:00 PM the day before the inspection is needed. Requests received after 3:00 PM will not be scheduled for the next day's inspections. Office Hours 9:00-4:30 MONDAY-THURSDAY 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 L1N6/ qjc ,-7. I qi n ' 3w ...., , 7/23f 13 FINAL INSPECTION /✓ (3-�'(�j � ��, �' el< FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR SPECIAL CONDITIONS APPLY-SEE REVERSE • • SPECIAL CONDITIONS CASE # BLD13-00128 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 April 18, 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 April 22, 2013 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 3.) This approval is for a Replacement 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. \\tidemark\data\forms\F_BLD_Permit_Mobile.rpt 6/11/2013 INCLUDE WITH PERMIT -.APPLICANT • Standard Conditions for Residential Development in Jefferson County 1. LIGHTING: 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. 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. 2. BUILDING HEIGHT: The building height is not to exceed 35 feet. 3. OUTDOOR STORAGE: Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 4. UNLICENSED VEHICLES: 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. 5. PARKING: A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 6. NATIVE VEGETATION: Among the native conifer species which may be used in buffers or for re- vegetation include, but are not limited to: Grand Fir (Aibes grandis), Sitka Spruce (Picea sitchensis), Shore Pine (Pinus contorta), Douglas Fir(Pseudotsuga menziesii), Western Red Cedar(Thuja plicata), and Western Hemlock (Tsuga heterophylla). Among native tree species which may be used includes: Vine Maple (Acer circinatum), Big-Leaf Maple (Acer macrophyllum), Red Alder (Alnus rubra), Pacific Madrone (Arbutus menziesii), Quaking Aspen (Populus tremula), Black Cottonwood (Populus trichocarpa), Bitter Cherry (Prunus emarginata), Oregon White Oak (Quercus garryana), Cascara (Rhamnus purshiana), Pacific Willow (Salix lasiandra), and Scouler's Willow (Salix scouleriana). Among the native shrub species which may be used are: Sevice-Berry (Amalanchier alnifolia), Red Osier Dogwood (Cornus stolonifera) Salal (Gaultheria shallon), Ocean Spray (Holodiscus discolor), Indian Plum (Oemlaria cerasiformis), Pacific Ninebark (Physocarpus capitus), Red Flowering Currant (Ribes sanguineum), Wild Rose (Rosa nutkana), Swamp Rose (Rosa pisocarpa), Willows (Salix ssp.), Red Elderberry (Sambucus racemosa), Snowberry (Symphoricarpos albus), Evergreen Huckleberry (Vaccinium ovatum), Red Huckleberry (Vaccinium parvifolium). 7. This permit has been reviewed consistent with JCC 18.40.130 & 140. Notice: this permit does not excuse the applicant from complying with other local, state and federal ordinances, regulations or statues, applicable to the proposed development, but consistent with RCW 90.58. Future development beyond that specified in this permit shall require further review. 2013-03-07 SFR StdConditions 3/7/2013 1 • 8. BMPs: The project shall adhere to the Best Management Practices (BM s) 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. 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. 2013-03-07 SFR StdConditions 3/7/2013 2 440,16114:TosiegA4 Date 7/7 time received / 2-7-7 am /e) Mon. Tue . Wed: al Fri. • BLD: 11-- /2 a - Date: .• OWNER: - - _ • _ Contact Namec /��,,/ 7 ADDRESS: 21•r - a•le r/1/!b vrv'{l a,+, Contact Number 360- (Cld f 0? 7_`'.; 206 Notes: . -• .Foundation Plumbing Framing' Propane Tank Mechan oai Setbacks Under-ground Framing Underground Furnace • Footing , Rough in Alrseal Above ground Gas _- Stemwall _ Hydronic Exterior shear Exterior lines • Oil • Straps ____shear Interior lines _ Ducts Post Hole • Ventilation Appliance Underfloor .Gas/wood stove Man-Hones Setbacks • Insulation. - Finallnspection '_ • Foundation ? ` Block&Tiie floor _wall ceiling. . Address Posfe'd • • •A. ;:. :t.:r • Date 2� Mime received Z27 am !� �` . Mon�:Wed: Thur. -Pri. • . Date: S d , f OWNER: _ '7 Contact Name: • ADDRESS: Art3 (r(2.54/) AA% Contact Number:360 E0(�j r 077 : t;1_ r Notes: - 206 �� r. a :Foundation Plumbing • Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furnace Footing Rough In Air seal — Stemwall _ Hydronic Above ground Gas _ Straps Exterior shear Exterior lines Oil _ St Straps Interior shear Interior lines • Ducts Ventilation _ — Underfloor Appliance ____ Man•Honies Gas/wood stove Setbacks - Insulation Foundation_ Final Inspection Blocki3<Tie floor _wall ceiling :`" Address Posted ;E�Y'd �r� Y f .t Date 7/2-2, time received (2.33 am /6 Mon. :Wed: Thur. -Pri. Date: t OWNER: Contact Name ADDRESS:— - j vtEx t-f-liu.A, 21 3 c.r Contact Number:360 6g! 0777 Notes —v: 206 rt Foundation Piu_mbina. - Framin --g Propane Tank• Mechanieat ' • Setbacks Under-ground Framing Footing Rough In Air seal Under ground Furnace Stemwall __ Hydronic Above ground _ Gas — StrapStraps Exterior shear ____ Exterior lines Oil — s le — Interiorshear Interior lines Ventilation Ducts —` Und'efioor Appliance, • Man•Homes Gas/wood stove Setbacks — insulation • Foundation- • Block&Tie floor Final inspection _wall ceiling . � t . 4 Address Posted