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BLD2010-00134
UILDING PERMIT APPLICON MLA ew001pe62 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD10-00134 Received Date: 4/29/2010 SITE ADDRESS: 483 ROSE POINT DR QUILCENE, 98376 OWNER: ALVORD INVESTMENTS LLC PHONE: 206-420-4066 IRA GERLICH 2146 E SHELBY ST SEATTLE WA 98112-2028 FISHERMANS POINT SUBDIVISION: Block: Lot: 6+ PARCEL NUMBER: 951700006 Section: 31 Township: 27 N Range: 01 W CONTRACTOR: JENNINGS HEINS &ASSOC PHONE: (360) 509-2100 PO BOX 2198 POULSBO WA 98370 Contractor's License JENNIHA02209 Expires 9/28/2011 REPRESENTATIVE: AKJ ARCITECTS LLC PHONE: 206-427-0980 ARLENE JERMANN 641057 AVE S PROJECT DESCRIPTIOP REMODEL EXISTING SFR &ADD DORMER & DECK TYPE OF WORK - RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: VALUATION 200,000.00 ADD'L: 77 HEAT TYPE: EEE CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: SETBACK: DECK: 316 BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PUD BEDROOMS: BATHROOMS: Exist: 3 Exist: 2 Prop: 0 Prop: 0 Total: 3 % : 2 Routing Date: -- °21"^CLLCD Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,553.75 LYK 04/29/10 117617 Plan Check $1,009.94 LYK 04/29/10 117617 APPROVED State Building Code $4.50 LYK 04/29/10 117617 Potable Water Application $98.00 LYK 04/29/10 117617 SEP F 2010 Total: $2,666.19 Jefferson County Planning nm 9 &Building Department 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 #: BLD10-00134 SITE ADDRESS: 483 ROSE POINT DR Issue Date: 09/9/2010 QUILCENE, 98376 Final Date: 5/7/2014 APPLICANT: ALVORD INVESTMENTS LLC PHONE: 206-420-4066 IRA GERLICH 2146 E SHELBY ST SEATTLE WA 98112-2028 SUBDIVISION: FISHERMANS POINT Block: Lot: 6+ PARCEL NUMBER: 951700006 Section: 31 Township: 27 N Range: 01 W PROJECT DESCRIPTION: REMODEL EXISTING SFR &ADD DORMER & DECK in conjunction with a shoreline exemption permit(SDP10-00054) THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2006 EDITION. OCCUPANCY GROUP: R-3 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM yes THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 5/7/2014 \\tidemark\data\forms\F_BLD_Occupa ncy.rpt 5/7/2014 Stormwat-r �yT� s ® APPROVED Required I�lam` �.® STORMWATER PLAN 44 64, JEFFERSON COUNTY 4.\'k a= 1.0 DEPARTMENT OF COMMUNITY DEVELOPMENT _ SEP 8 2010 621 Sheridan Street• Port Townsend •Washington 9836E If, IEFFERS• •EV UN 360/379-4450 • 360/379-4451 Fax DEPT.OF 'etEV Lc - T `S iINO http://www.co.jefferson.wa.us/commdevelopment/ SIGNATUR.: /UrILOW_ STORMWATER SITE PLAN SUBMITTAL TEMPLA • MLA# 10-1102-- PROJECT/APPLICANT NAME: )0. 0 G 4612. •A M O 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. dormer £I4 ' rts�,'4 �a' .' 1o1d4 . c�I load ra,� £pG4f . S�f'+`kGGFu r� I o 2rc rr a ri ' rev el ,/_ 3 craw,/ dri've.c'o- . J Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. 9 E,u 01;4 es. ts ,'rlpj S'k Jurt o (3 a larkoe.,IL) k ‘14c. I . V i s. 1, I A_ r LL -4. . 3. Describe the existing vegetation. Indicate native veget tion areas on the site map. �9 is a tw;loped 10e. 1 �Qjcce1. S4ruau.� . Cs, coward r a¢ e a hoi +ier, Dbrt fir, Mad✓ c rk fndr ctr �^q , i 4. Describe the exlstin soils. Indicate soil t e on the site map. P P PS( Loaw‘ 40 11,6 " , Barr Loam o Le WAG 1 c►'�1 A'IIU.� Ir> b re) S-114 5. Describe the existing site hydrology(i.e., drainage; behavior of water on the site—above, below, and on the ground). Indicate existing stormwater drainage to and from the site on the site map. Depict separate drainage basins on the site map, if applicable,and indicate acreage of each. 6x 44-. C s c po are_ 4-ai Gl -G'n.zo f 6. Describe any excess levels of noise generated by the proposed use or activity: NOrvtAa.) OGurr 1 diArt t^ nfieuut evi stormwater site plan template—rev.10/21/2008 5 ' • • �. ,) 7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, steep slopes,etc.)on the site. Indicate Iota••n on the site ma.. 1. I %,ui_ .... CAP "T ` , .i AU. '' 1 -DLO ;4 4 g, 4,. • c 1 f/rll Si n • ; t � . a,. 8. Describe the general vicinity of the site including adjacent land uses and structures,utilities,roads, and sensitive/critical areas (streams,wetlands, lakes,steep slopes,etc.). n `IL 46G IS OCL o 't`�lt�tG ►�t-So N o►'�t 1''Gtl�`�tX ja►? ICI.o k, [N aC . pie 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 fac•ities on the site plan and Fliffergate pr posed facilities from existing fa 'lities. 0 .enrilef rrrisLiz -ni Rept cgt. 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 projects that involve the potential ' n c}f centamin�nts.] n .�tcluite Ala en �s , 11. Describe the performance goals and standards applicable to the proje , II-_� _ee • I AS rr�rr►�r i S S av u-kd . 12. Describe the flow control system. 2 1J,,D 94 pl Oalt. Ova r -Pi °�S - At-Si . cprr1 Ot0( '�/ Uk o S� 40614 r . stormwater site plan template—rev.10/21/2008 6 • • 13. Describe the water quality system. Vot 14. Describe the conveyance§ystemianalysis and design. lropork fo dritilei 1 —4s4` aowrt JoH-/S e rs . 15. Describe the ource f fill material,physical characteristics of fill material, and deposition of excess material. No f/I hilarcAr8 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. N/Ac 17. Describe the proposed surfacing material. PA 18. Describe methods for restoration of the site. IVA 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 flow or treat runoff.] If included, list the Manuals here. / N A 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. NA 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. , , ' S e1"_Z f4t14 1 lr tv . stormwater site plan template—rev.10/21/2008 • • 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 Pian 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 ll Section 3.2.3 of the Manual (beginning on page 3-7). 12 Required Elements—Construction SWPPP 1. Mark Clearin Limits, , No Ae..Arroi tY) o trr. 131-190(4 dad op Is W/bh -lv►s1 • k Y • t r"'prskis . 2. Establish Construction Access. L(K ACM-. pi/d o�rl�lGKla� . 3. Con,trplo w Rates. NAk 4. Install Sediment Controls. N/A 5. Stabilize Soils. P/6( 6. Protect Slopes. • l il s I ■ 7. Protect Drain Inlets. No eintilei 140 stormwater site plan template—rev.10/21/2008 8 • • 12 Required Elements-Construction SWPPP(continued) 8. Stabilize Channels and Outlets. KVA- 9. Control Pollutants. IVA 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). NM 11. Maintain Bestklana ement Pr ctit:es(BM s . (iehcr c�o✓- .w((I bb 04.0%-4- 64- ail -(-;~ oeurt (4 4V'. tk fc..- e reel/Kibtt . 12. Manage the Project. 4evter4 Ovvi r- ,� be- are�c�, - ,A- 4( Ji►iA.o �cr; OW*. it e ►re .eu ora.nuf4- 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). N Ac b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). (VA 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are ze,r adjacent to the ite. - ep Std 6b PI al- g , e 1 g'okil e, - stormwater site plan template—rev.10/21/2008 9 • • b. Description of special requirements for working in or near environmentally sensitive areas. WA 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. Construct' n sequence , , l wi r S b. Construction phasing(if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Provide a proposed con ruction schedule. :�,... " ill - . b VD II II. Wet Season Construction Activities. a. Proposed wet season construction activities. WA- b. Proposed et season construction activities for environmentally sensitive areas. 7. Financial/Ownership Responsibilities. a. Identify the pro erty owner responsib t itiati9n of bonds and/or other financial securities. Air)r t frivol of b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. p ,/ reCrOotret Li tvib 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following, if applicable. a. Sediment Ponds/Traps. N//5‹ b. Diversions. c. Waterways. d. Runoff/Stormwater Detention Calculations stormwater site plan template—rev.10/21/2008 10 • • SECTION 11—EROSION AND SEDIMENT CONTROL PLAN Sediment and erosion control measures may be depicted on the master land use application plot plan,a stormwater site plan,and/or a separate Construction SWPPP site plan. This is a checklist to ensure that the following are depicted on a site plan: 1. General. a. Vicinity Map b. Jefferson County Approval Block c. Erosion and Sediment Control Notes 2. Site Plan. a. Legal description of subject property. b. North arrow. c. Indicate boundaries of existing vegetation (e.g.,tree lines,pasture areas,etc.). d. Identify and label areas of potential erosion problems. e. Identify FEMA base flood boundaries and Shoreline Management boundaries(if applicable). f. Show existing and proposed contours. g. Indicate drainage basins and direction of flow for individual drainage areas. h. Label final grade contours and identify developed condition drainage basins. i. Delineate areas that are to be cleared and graded. j. Show all cut and fill slopes indicating top and bottom of slope catch lines. 3. Conveyance Systems. a. Designate locations for swales, interceptor trenches,or ditches. b. Show all temporary and permanent drainage pipes,ditches,or cut-off trenches required for erosion&sediment control. c. Provide minimum slope and cover for all temporary pipes or call out pipe inverts_ d. Shows grades,dimensions,and direction of flow in all ditches, swales,culverts and pipes. e. Provide details for bypassing off-site runoff around disturbed areas. f. Indicate locations and outlets of any dewatering systems. 4. Location of Detention Best Management Practices(BMPs). Identify location of detention BMPs. 5. Erosion and Sediment Control Facilities. a. Show the locations of sediment trap(s), pond(s),pipes and structures. b. Dimension pond berm widths and inside and outside pond slopes. c. Indicate the trap/pond storage required and the depth,length,and width dimensions. d. Provide typical section views through pond and outlet structure. e. Provide typical details of gravel cone and standpipe,and/or other filtering devices. f. Detail stabilization techniques for outlet/inlet. g. Detail control/restrictor device location and details. h. Specify mulch and/or recommended cover of berms and slopes. i. Provide rock specifications and detail for rock check dam(s),if applicable. j. Specify spacing for rock check dams as required. k. Provide front and side sections of typical rock check dams. I. Indicate the locations and provide details and specifications for silt fabric. m. Locate the construction entrance and provide a detail. 6. Detailed Drawings. Any structural practices used that are not referenced in the Ecology Manual should be explained and illustrated with detailed drawings. 7. Other Pollutant BMPs. Indicate on the site plan the locations of BMPs to be used for the control of pollutants other than sediment(e.g.,concrete wash water). 8. Monitoring Locations. Indicate on the site plan the water quality sampling locations to be used for monitoring water quality on the construction site. Sampling stations should be located upstream and downstream of the project site. stormwater site plan template—rev.10/21/2008 11 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. 2-112.0 0 4/ (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 ix.ca ,:-. ,,',!-7,71Frii! - __---Th › Lc.; _. /\\ I P , )-c2 3...to,6.,,,,......____ \ ,cGa_____- - ■ . \ / _--- ,-- <' (1) a, \ / / , . 13er __---- N'34‘ O• CD 9, 03 M Lb,44.SON_ / ___ 0 .,-- \ ii: S LL __..::———— . i———7— \ •',p1" IA' /' co co I s ca, 520 ,..." \ C'Z'I(Y 1-A* rti) \ ,,, 4 / -, Az., „,,, ,,,, T.. I I C",■.-‘53 - ^ • ,.. -i ' ‘szt, ,,, `,"/ \ s., \ / .NIV-i-‘‘ _/ - -,- - i0 - - % 101.-'' \ 1 1 l '. 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V.4 :7-6,-so g 0 C..•■•4 D II gg@i-. ;,.... ...... r , ,..,..... r, .....■,k te • ?.\ - )r,, --) JEFFERSON COUNTY FT w ‘ DEPARTMENT OF COMMUNITY DEVELOPMENT " 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450. 360/379-4451 Fax (9 www.Co.jefferson.wa.us/commdevelopment c Master Permit Application APR 2 J LV V MLA: lb (c2 Project Description(include separate sheets as necessary): Renovation of an existing home, construction of a dormer addition to home&renovation of an exist detached shop. Tax Parcel 951700006 Property Number: Size: 6.90 Acres(300,704.88 SF) (acres/square feet) Site Address and/or Directions to Property: 483 Rose Point Road,Quilcene,WA 98376(South on East Quilcene Rd,Past McDonald Rd onto Rose Point Road,Past Fishermans Drive to project address on left) Property Owner(s)of Record: Alvord Investments LLC(do Ira Gerlich) Telephone:(206)419-8149 Fax: (206)695 2870 email: iragerlich @alvord.com Mailing Address: 2146 East Shelby Street,Seattle,WA 98112-2028 Applicant/Agent(if different from owner): Arlene Jermann,AKJ Architects LLC Telephone: 206-427-0980 Fax: 206-723-5306 email: a^eneeakjarchitectsc«^ Mailing Address: AKJ Architects LLC,6410 57th Avenue South,Seattle,WA 98118 What kind of Permit?(Check each box that applies JBuilding ❑Variance(Minor,Major or Reasonable Economic Use) ❑ Demolition Permit ❑Conditional Use[C(a),C(d),or Cj** p Single Family ❑Garage Attached/Detached ❑ Discretionary"D"or Unnamed Use Classification ❑ 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*" l 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: DESIGNATION OF AGENT I hereby designate Arlene Jarman,AKJ Architects LLC to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE .? Date: 544 2(- /v 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 it's 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 application that h� he wants oti� . s Signature: , 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-transferable r sibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: Date: 4,,2( —('a C:\Documents and Settings\caral\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc • • 4_ 21 " 22O1r"r 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: 1- '7 (— J e GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: Jennings Heins Associates,General Contractor ( 360 )779-7716 (360 )697-4800 MAILING ADDRESS: jim@jenningsheins.com EMAIL: jimMenningsheins.com CONTRACTOR'S LICENSE WAINS NUMBER: JENNIHA02209 NUMBER Not Applicable ARCHITECT/ENGINEER: Quantum Consulting Engineers-Structural Engineers PHONE (206 )957-3900 FAX: 206 ( ) 957-3901 MAILING ADDRESS: 1511 Third Avenue,Suite 323,Seattle,WA 98101 EMAIL dtenton@quantumce.com Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New N Wood Existing: 2 ❑ Sewer if Addition ❑ Steel Proposed: 0 Bank L. Community System of Alteration/Remodel C Concrete Total: Height: il Individual System ❑ Repair ri Masonry See Map SEP Permit# ❑ Demolition L Other: Bedrooms: Water Supply: Existing: 3 Setback: o Private well ❑ Two Party Type of Heat: Proposed: 0 41 Public ELECTRIC BASE BOARD Total: 3 See Map Name of System:FISHERMANS POINT WATER SYSTEM If this is a Commercial Proiect 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: 0 Underground Tank 0 Above ground Tank Size of Propane Tank: 500 GALLON ❑Heat Stove ❑Cook Stove ❑Woodstove ❑ Fireplace Insert ❑Hot Water Tank ❑Pellet Stove ❑Other Is this appliance being installed in a Manufactured I 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. S•uareFoote•e Current Pro••sed :Tve For 6 ;=°4 , ,_ _', •,± „ .- . ,aA rt. Main Floor Heated EH Bld App Review: 1,107 2 ' Floor Heated 613 " Consistency Review: E Other Heated Base fee: IIMM Mezzanine tenrnsM- Heated Basement Plan Check fee: li' Unheated Basement State Surcharge fee: /�7 • Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL 3 45.1• )q Decks y, = 911/Rd Approach fee: CC 1,234 _ EXIJO Other TOTAL: Jti t Al Exist Heated Shop 400 Receipt Number: Cash/Check Number: ESTIMATED COST(REQUIRED) Date: .Fair 4.arket - • - -•- -•• r aterials foundation to finish .: CO 00 Initials: C:\Documents and Settings\caral\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc 0 J CADocramseft rd SeulnerIALTAAlly raa■ire.6.tu niFfie QUI Aw000 bra yanrsnor.•:18PM a a a PI 7 6 0- / • L ! _/ ! I DN n T N 0 414t /1■ _= c) / w o -,4,3, 11 RI A -e -1 / oy rao y I�J z� : ___ g 1; —II ; ) --; • O I o. 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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 Jennings Heins a Assoc Inc UBI No. 601903837 Phone 3607797716 Status Active Address Po Box 2198 License No. JENNIHA02209 Suite/Apt. License Type Construction Contractor City Poulsbo Effective Date 9/29/1998 State Wa Expiration Date 9/28/2011 Zip 98370 Suspend Date County Kitsap Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company Other Associated Licenses Specialty Specialty Effective Expiration License Name Type Status 1 2 Date Date JIMHEC*072QA Jim Heins Construction General Unused 11/1/1993 2/17/2000 Archived Construction Contractor NORTHW60920T North Wood Construction General Unused 9/30/1991 12/24/2001 Archived Builders Contractor DOUGJC*173LL Doug Jennings Construction General Unused 6/13/1983 5/25/2000 Archived Construction Contractor JIMHEC*186QA Jim Heins Construction General Unused 11/1/1982 11/1/1993 Archived Contractor Contractor NORTHWB204JH North Wood Construction General Unused 4/8/1980 4/8/1991 Archived Builders Contractor NORTHWB994BA North Wood Construction General Unused 1/1/2001 1/17/2009 Expired Builders Inc Contractor Business Owner Information Name Role Effective Date Expiration Date Jennings, Douglas E &Nbsp; 01/01/1980• Heins,James F &Nbsp; 01/01/1980 Bond Information Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 5 CBIC SF6455 09/28/2004 Until Cancelled $12,000.00 09/17/2004 4 CUMBERLAND CAS MB008007214 09/28/2002 Until Cancelled 09/28/2004 $12,000.0008/07/2002 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 AMERICAN 11 SAFETY 156AU16012400 12/06/2009 12/06/2010 $1,000,000.00 12/09/2009 INDEMNITY CO 10 CBIC C115F6455 12/06/2005 Until Cancelled 12/12/2009 $1,000,000.00 12/05/2005 WESTERN 9 HERITAGE INS SCP0543059 12/06/2004 12/06/2005 $1,000,000.00 12/06/2004 CO WESTERN 8 HERITAGE INS SCP0553377 12/06/2004 12/06/2005 $1,000,000.0012/06/2004 CO https://fortress.wa.gov/lni/bbip/Print.aspx 4/29/2010 Contractors or Tradespeople Oter Friendly Page • Page 2 of 2 7 UNDERWRITER'S KM03RG025 12/06/2003 12/06/2004 $1,000,000.0001/07/2004 OF LLOYD'S NORTH 6 AMERICAN SPEC BXC000284302 10/14/2003 10/14/2004 $1,000,000.0010/13/2003 INS CO 4 MA CAS SCP33908576 09/28/2001 Until Cancelled 09/26/2001 Summons/Complaint Information No unsatisfied complaints on file within prior 6 year period • https://fortress.wa.gov/lni/bbip/Print.aspx 4/29/2010 Jefferson County Building pillion Permit Num BLD10-00134 Applicant: ALVORD INVESTMENTS LLC BUILDING PERMIT INSPECTION APPROVALS kpplicable Code: 2006 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 Setbacks Minimum setback from Rose Point Drive right-of-way shall be 20 feet. Minimum side yard setbacks shall be 5 feet. All development shall be located landward of the"Building Setback Line"as identified on the recorded plat. Erosion Control SEE CONDITIONS 2&3 Foundation Footing Footing Drains Foundation Stem Wall Underground Plumbing Under Floor Framing Straps(hold downs) Ext.Shear Wall Nailing Rough-in Plumbing Framing Blocking Airseal Insulation:Walls Insulation:Floors Insulation:Ceiling Int. Shear Wall Nailing Wallboard Nailing Gas Line: Interior Gas Line:Exterior Propane Tank Heat/Chimney Clearance Drywell/Alt Drainage SEE CONDITION 1 Address Posted FINAL INSPECTION d (DI ) { FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • BUILDING PERMIT • Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD10-00134 Received Date: 4/29/2010 SITE ADDRESS: 483 ROSE POINT DR Issue Date 9/9/2010 QUILCENE, 98376 Expiration Date 9/9/2011 OWNER: ALVORD INVESTMENTS LLC PHONE:206-420-4066 IRA GERLICH 2146 E SHELBY ST SEATTLE WA 98112-2028 FISHERMANS POINT SUBDIVISION: Block: Lot: 6+ PARCEL NUMBER: 951700006 Section: 31 Township: 27 N Range: 01 W CONTRACTOR: JENNINGS HEINS &ASSOC PHONE: (360) 509-2100 PO BOX 2198 POULSBO WA 98370 Contractor's License JENNIHA02209 Expires 9/28/2011 PROJECT DESCRIPTION: REMODEL EXISTING SFR&ADD DORMER & DECK in conjunction with a shoreline exemption permit(SDP10-00054) TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: VALUATION 200,000.00 ADD'L: 77 HEAT TYPE: EEE CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: 316 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PUBLIC Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $1,553.75 LYK 04/29/10 117617 Exist: 3 Exist: 2 Plan Check $1,009.94 LYK 04/29/10 117617 Prop: 0 Prop: 0 State Building Code $4.50 LYK 04/29/10 117617 Total: 3 Total: 2 Potable Water Application $98.00 LYK 04/29/10 117617 Total: $2,666.19 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 7 am the day 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 • • CONDITIONS for Building Permit# :BLD10-00134 1.) Applicant is proposing to utilize the existing drainage system consisting of gutters and downspouts which are tightlined. 2.) 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. (BMP 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. 3.) A SILT FENCE SHALL BE INSTALLED AS CLOSE AS PRACTICABLE TO THE PROPOSED NEW DECK IN ORDER TO INSURE THAT SILT DOES NOT TRAVEL TOWARDS THE TOP OF THE STEEP SHORELINE BANK PRIOR TO ANY LAND DISTURBING ACTIVITY. APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO MAKE SURE THAT SILT DOES NOT TRAVEL OVER THE BANK. THE MINIMUM HEIGHT OF THE TOP OF SILT FENCE SHALL BE 2 FEET AND THE MAXIMUM HEIGHT SHALL BE 2 1/2 FEET ABOVE THE ORIGINAL GROUND SURFACE. THE SILT FENCE SHALL BE BURIED IN A TRENCH TO A MINIMUM DEPTH OF 5 INCHES BELOW THE GROUND SURFACE. THE TRENCH SHALL BE BACKFILLED AND THE SOIL TAMPED IN PLACE OVER THE BURIED PORTION OF THE SILT FENCE, SUCH THAT NO FLOW CAN PASS BENEATH THE FENCE AND SCOURING CAN NOT OCCUR. ANY DAMAGE TO THE SILT FENCE SHALL BE REPAIRED IMMEDIATELY. SEDIMENT DEPOSITS SHALL EITHER BE REMOVED WHEN THE DEPOSIT REACHES APPROXIMATELY ONE-THIRD THE HEIGHT OF THE SILT FENCE, OR A SECOND SILT FENCE SHALL BE INSTALLED. 4.) 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. 5.) VOLUNTARY MEASURES OF C•TAL&AT RISK SIPZ: • Water conservation measures: 1. Roof and other intercepted precipitation shall be routed to on-site detention ponds and/or other approved means and allowed to be released to the soil slowly. 2. Water collected from Storm water and roof catchments may be used for watering lawns and gardens. Unless catchment water has been treated to meet drinking water standards, there shall be no cross connections allowed between the potable supply and impounded water. 3. Water withdrawn from wells on each property shall not be used for watering of lawns and/or gardens. 4. Ground water withdrawn from each property shall be restricted to a rate of three (3) gallons per minute. 5. Installation of water conserving fixtures such as low flow toilets, faucets and shower restrictors and other water saving plumbing fixtures. 6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation). Please NOTE that the above listed measures are not intended to be exhaustive, but rather is intended to be illustrative of the types of water conservation measures. 6.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: 1. Installation of a flow meter. 2. On-going well monitoring for chloride concentration. 3. Submittal of monitoring data to County. 7.) MANDATORY MEASURES FOR COASTAL SIPZ: 1. For proof of potable water on a building permit application, applicant must utilize DOH-approved public water system if available. 2. If public water is unavailable, a qualifying alternative system may be used as proof of potable water or an individual well may be used as proof of potable water subject to the following requirement: a. Chloride concentration of a laboratory-certified well water sample submitted with building permit application. 3. If public water is unavailable, a qualifying alternative system may be used as proof of potable water. 8.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 9.) 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. 10.) 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. 11.) 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." 12.) All construction activities shall not encroach upon the landslide hazard area buffers. This includes the storage or preparation of materials. 13.) 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. 14.) Landslide Hazard Buffers are areas that shall be maintained in their natural condition, however, minor pruning or alteration of vegetation may be permitted as long as the function and character of the buffer are not diminished.