HomeMy WebLinkAboutBLD2013-00208 ItI
UILDING PERMIT APPLICA N BLDI3-00208
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD13-00208 Received Date: 7/2/2013
SITE ADDRESS: BROOKSIDE ST
PORT HADLOCK, 98339
OWNER: HABITAT FOR HUMANITY OF EAST PHONE: 360-643-3807
JEFFERSON COUNTY
PO BOX 658
PORT TOWNSEND WA 98368-0658 BROOKSIDE ESTATES
SUBDIVISION: Block: Lot: 4+
PARCEL NUMBER: 936500004 Section: 11 Township: 29 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
Contractor's License HABITFH912D5 Expires 3/15/2015
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP NSFR
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,092
VALUATION 100,000.00 ADD'L: HEAT TYPE:
CODE EDITION: 2012 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: OSS
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: 3 Prop: 1
Total: 3 Total: 1
Routing Date:
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $993.75 MEB 07/02/13 142237 APPROVED
Plan Check $645.94 MEB 07/02/13 142237
State Building Code $4.50 MEB 07/02/13 142237 o
Potable Water Application $66.00 MEB 07/02/13 142237 2013
Total: $1,710.19 Jeffe;gar} County DCD
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•
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#: BLD13-00208
APPLICANT: HABITAT FOR HUMANITY OF EAST PHONE: 360-643-3807
JEFFERSON COUNTY
PO BOX 658
PORT TOWNSEND WA 98368-0658
SITE ADDRESS: 110 BROOKSIDE ST Issue Date: 08/1/2013
PORT HADLOCK, 98339 Final Date: 9/2/2014
SUBDIVISION: 9365 Block: Lot: 4+
PARCEL NUMBER: 936500004 Section: 11 Township: 29 N Range: 1W
PROJECT DESCRIPTION: NSFR-no revision. Proceed as originally permitted. Hold lifted. 7/17/2013
-meb
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2012
EDITION.
OCCUPANCY GROUP:
TYPE OF CONSTRUCTION:
SPRINKLER SYSTEM yes •
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 9/2/2014
\\tidemark\data\forms\F_BLD_Occupancy.rpt 9/2/2014
INCLUDE WITH PERMIT fig 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 (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.
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
•
• I
Design Criteria for Splashblocks
A typical downspout splashblock is shown in Figure 3.1.7. In general, if
the ground is sloped away from the foundation and there is adequate
vegetation and area for effective dispersion, splashblocks will adequately
disperse stout'runoff. If the ground is fairly level, if the structure includes
a basement, or if foundation drains are proposed, splashblocks with
downspout extensions may be a better choice because the discharge point
is moved away from the foundation. Downspout extensions can include
piping to a splashblock/discharge point a considerable distance from the
downspout, as long as the runoff can travel through a well-vegetated area
as described below.
The following apply to the use of splashblocks:
1. Maintain a vegetated flowpath of at least 50 feet between the discharge
point and any property Y line structure, slope steeper than 15%,, stream
,
wetland, lake, or other impervious surface. Sensitive area buffers may
count toward flowpath lengths.
2. A maximum of 700 square feet of roof area may drain to each
splashblock.
3. For purposes of maintaining adequate separation of flows discharged
from adjacent dispersion devices,the vegetated flowpath segment for
the splashblock must not overlap with other flowpath segments, except
those associated with sheet flow from a non-native pervious surface.
4. Place a splashblock or a pad of crushed rock(2 feet wide by 3 feet
long by 6 inches deep) at each downspout discharge point.
5. No erosion or flooding of downstream properties may result.
6. Have a geotechnical engineer or a licensed geologist,hydrogeologist,
or engineering geologist evaluate runoff discharged towards landslide
hazard areas. Do not place Splashblocks on or above slopes greater
than 15%or above erosion hazard areas without evaluation by a
professional engineer with geotechnical expertise or a licensed
geologist,hydrogeologist,or engineering geologist, and approval by
the Local Plan Approval Authority.
7. For sites with septic systems, the discharge point must be downslope
of the primary and reserve drainfield areas. This requirement may be
waived if site topography clearly prohibits flows from intersecting the
drainfield or where site conditions(soil permeability, distance between
systems;etc) indicate that this is unnecessary.
Volume III—Hydrologic Analysis and Flow Control BMPs—August 2012
3-15
• a
house
I I I
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Roof II
downspout 1;::::%
serves up to film
700 sf. Of roof
I
LiHii::::: .--f--- 1
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Vegetated I ............
flow path
1•:::;:l •—......•••
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VSplash
block
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...
NTS
ISplash
block
Figure 3.1.7-Typical Downspout Splashblock Dispersion
Vc :it/7e III—Hydrologic Analysis and Flow Control BMPs—August 2012
3-16
.
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• •
Mary Blain
From: Mary Blain
Sent: Wednesday, July 17, 2013 11:38 AM
To: Randy Marx; Susan Porto
Subject: REGARDING BLD13-208
Howdy!
Last week I put a hold on a building app for Habitat for Humanity(BLD13-208, SEP12-85) (they had originally wanted to
cancel). I had already routed the application your way. Yesterday they called to re-activate the permit so I wanted to
let you know. If you need more info or have any questions, please feel free to contact me.
Thanks!
Mary Blain
Permit Technician
Dept of Community Development
621 Sheridan St
Port Townsend,WA 98368
ph: 360-379-4452
fax: 360-379-4451
mblain @co.lefferson.wa.us
All email to or from this email address may be subject to the Public Records Act contained in RCW 42.56.
Additionally, all email to and from the county is captured and archived by Information Services.
1
! '6 ,
Op Front Parcel Review 0
Parcel 936500004
Printed: July 5, 2013
HABITAT FOR HUMANITY OF EAST Site Address:
JEFFERSON COUNTY BROOKSIDE ST
PO BOX 658
PORT TOWNSEND, WA 983E PORT HADLOCK WA, 98339
Parcel Number: 936500004 S-T-R: 11-29N-01W Total Acreage I
Legal Description BROOKSIDE ESTATES LOT 4(UNDIV 1/6 INT IN TRACT Land Use: 9100
A) SUBJ/OPEN SPACE TRACT
Flood District: Fire District: 1 Planning Area: 4
Flood Map(FIRM)Panel No: School District 49 Zoning: 3
COMP PLAN t
DESIGNATION: f 1
COMMUNITY PLAN: UGA: UGA Trans
[ 1 Plot plan states "property line"
[V] Assessor's Map (Property lines on submitted plot plan must match the property lines as identified on the Assessor's 1/4 map)
[ 4 Legal Actress to Property YES NO
[ Parcel Tags or Scanned Documents YES NO
[ ESA's: Special Reports Nearby YES moo)
[ Designated Ag YES `NO� f✓'
[ ] horeline Designation: YES NO
[ Shoreline Slope ability: YES Ng —
Stream Typ .YES 0 \- - 6 ,, *. I OS_%:ham ' !1a ' • %Pr.
Fish & Wild 1 e:YES NO
Wetlands:. NO C k too' 'Bie.r Va`drJl tM tea
Rare Plants:YES
Seismic: YES
Landslide:y.00, j9 ,`CA 4
+
Flood: NO F5
Erosion: YES
Aquifer Recharge Area:YES NO
SIPZ: none At Risk High Risk Coastal
CMZ: none High Risk Moderate Risk Disconnected CMZ
vrStormwater site plan s .tted: YesNo
Forest Lands: YES N
Adjoining Forest Lands: ' Commercial/ Rural/ Inholding
/Mineral Lands: YES 419
[/] gricultural Lands:
[ aeology: YES NO
[ Stormwater: New Impervious Surface oat Land Disturbin:Activity 5l \ ESA's 3
vtormwater Req's:Min Req#2 Min Req#1 thru#5 Min Req#1 thru , i
[ ] Notice Provisions/Disclosure:Airport YES _ NO MRL YES ckeb Forest Lands YES NO
[ i Landscaping Required: Yes
�d Parking Spaces Required NO 2 Other
V Building Height: 35' UBC Standard
ONLIMCk- i*o 26Y\C
`r lour -gcc 5i ch. Eoi —Vabted cpr
[ impervious Surface coverag een�age:
3 .3�
, Resource Lands&Public: 10% ti • Rural Industrliker UDC Sec 6.7
Rural Commercial: 60% ui ding Coverage:60%in Rural Industrial Lands only
[ ] Total Building(s) Size:
/ RVC:20,000 SF CC:5,000 SF NC:7,500 SF GC: 10,000 SF All others:subject to septic&water constraints/None specified
V] Setbacks: Front: V Left Side: aj Right Side: .� Rear:
Shoreline Setback:
LSHA Setback:
] Road Classification: q mat.% # 3
oad Approach: EXISTIN t NOT RE•
SEPA Required: YES XEMP
[ ] Flood Certificate: Pt
,[/ ] Existing Case(s)&Condition(s):
Violations: Yes .
[ ] Recorded Date of Subdivision: AFN Over 5yrs=UDC
Plat Conditions: <5yrs=Plat Conditions on plat or Old Ordinance
[ ] Lots/Require Declaration of Restrictive Covenant YEKD submitted: YES CND
[ ] UGA No Protest Agreement YES '• submitted: YES NO
[ ] Site Visit conducted YES O
[ ] Require Final Zoning Approva E NO
[ ] ADMIN: Setbacks entered in Permit Plan case N/A YES
New Parcel Tags entered in Permit Plan 4 YES
Special Reports Scanne N/A YES
Title Notes Updated
Parcel tags found for parcel 936500004
1.) EROSION/SEDIMEN 11/21/1996
Parcel tags found for parcel 936500004
2.) Storm Water Pla 11/21/1996
Cases Associated with APN 936500004
Cases Name Review Type Status Planner
ADR13-00038 HABITAT FOR HUMANITY OF El P
Application Received: 7/3/2013 Permit Issued/Case closed: Case Finaled:
HAB FOR HUM, NSFR
BLD13-00208 HABITAT FOR HUMANITY OF El P
Application Received: 7/2/2013 Permit Issued/Case closed: Case Finaled:
NSFR
SEP05-00074 MC CARRON C
Application Received: 3/15/2005 Permit Issued/Case closed: 12/1/2005 Case Finaled:
This SEP &SEP99-38 tiled w/SEP12-85
SEP12-00085 HABITAT FOR HUMANITY A
Application Received: 7/24/2012 Permit Issued/Case closed: 10/19/2012 Case Finaled:
sep05-74 expired &filed here
CAR99-00066 BISHOP F S THEISS
Application Received: 2/19/1999 Permit Issued/Case closed: 8/4/1999 Case Finaled: 8/4/1999
New alternative septic system.
SEP99-00038 MC CARRON C
Application Received: 2/19/1999 Permit Issued/Case closed: 8/27/1999 Case Finaled:
info filed to SEP05-74
\\tidemark\data\forms\R_Parcel_CRMLA.rpt 7/5/2013 Page 2 of 2
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AYR.WUOnNa RAN HOLD IXF4VMTION • WANE O.nIA PAN Ma flat ONFONA "A
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•
BrooIksid Esta tV s SECTION 11,TONSHIP 29 NORTH, RANGE 1 WEST,W.M•
JEFFERSON COUNTY,WASHINGTON
LEGAL DESCRIPTION NOTICE TO POTENTIAL PURCHASERS
A. PRIOR TO THE COMMENCEMENT OF ANY LAND DISTURBING ACTIVITIES ON THE SITE,AN
ALL THAT PORTION OF THE NORTHWEST 1/4 OF THE SOUTHEAST 1/4 AND THE NORTHEAST EROSOU ANO SEDIMENT CONTROL PLAN SMALL BE DEVELOPED TO THE STANDARDS O
I/4 OF THE SOUTHWEST 1/4 OF SECTION II,TOYISIHI.29 NORTH.RANGE 1 NEST,W.M.. THE WASHINGTON STATE DEPARTMENT OF ECOLOGY STORM WATER MANAGEMENT
DESCRIBED AS FOLLOWS: MANUAL(CURRENT EDITION)AND BE SUBMITTED TO THE DEPARTMENT OF PUBLIC
WORKS FOR APPROVAL. BEST MANAGEMENT PRACTICES SHALL BE IMPLEMENTED AND
COMMENCING AT THE SOUTH QUARTER CORNER OF SAID SECTOR TI,THENCE SOUTH USED AT AU.BYES DURING LAND DISTURBING ACTIVITIES.
89'25'04'EAST,ALONG THE SOUTH UNE OF THE SAID SOUTHEAST 1/4 OF SECTION 11,
859.13 FEET: B. PRIOR TO THE COMMENCEMENT OF ANY LAND DISTURBING ACTIVITIES ANO
THENCE NORTH IT36.00T NEST 1552.69 FEET TO THE TRUE POINT OF BEGINNING OF PRIOR TO ISSUANCE OF A BUILDING PERMIT,A STORM WATER STE PLAN
THIS DESCRIBED TRACT: SHALL BE DEVELOPED TO THE STANDARDS OF THE WASHINGTON STATE
THENCE CONTINUING NORTH 1•36'00 NEST 42.68 FEET,THENCE NORTH 0034'00" DEPARTMENT OF ECOLOGY STORM WATER MANAGEMENT MANUAL(CURRENT
NEST 708.26 FEET THENCE NORTH 8996•58*NEST,PARALLEL TO THE EAST-NEST EDITION)AND BE SUBMITTED TO THE DEPARTMENT OF PUBLIC WORKS FOR
CENTERLINE OF SAID SECTION It 465 FEET.MORE CO LESS TO THE CENTERLINE OF APPROVAL.
COUNTY ROAD NO.18:
THENCE SOUTHWESTERLY,ALONG THE SAID CENTERLINE 778 FEET,MORE OR LESS,TO A C. THE LOTS.PARCELS OR TRACTS CONTAINED WITHIN THIS SUBOINSON WERE
PONT WINCH IS NORTH 8916'56•NEST FROM THE TRUE POINT OF BECNNING: APPROVED BASED ON DESIGN STANDARDS AND REGULATORY REQUIREMENTS
THENCE SOUTH 8996•S6'EAST.PARALLEL TO THE SAID EAST-NEST CENTERLINE OF IN EFFECT AT THE TIME OF FINAL APPROVAL. SEWAGE DISPOSAL SYSTEMS
SECTION 11,711 FEET,MORE OR LESS,TO THE TRUE POINT OF BEGINNING HAVE NOT BEEN APPROVED FOR THE LOTS,PARCELS OR TRACTS CONTAINED
EXCEPT RIGHT OF WAY APPROPRIATED BY DRAINAGE DISTRICT N0.1 N JEFFERSON WITHIN THE SUBDIVISION. ON-SITE SEWAGE DISPOSAL SYSTEMS SHALL
COUNTY SUPERIOR COURT CAUSE NO 3193; MEET DESIGN STANDARDS AND REGULATORY REQUIREMENTS IN EFFECT AT
SITUATED IN JEFFERSON COUNTY.WASHINGTON. THE TRAE OF APPLICATION FOR SEWAGE DISPOSAL PERMIT. PURCHASER
SHOULD CONTACT THE JEFFERSON COUNTY HEALTH DEPARTMENT FOR
TOGETHER NTH AND SUBJECT TO AN EASEMENT FOR INGRESS,EGRESS,AND UTUTY PROCEDURES CONCERNING PERMIT APPLICATIONS. ANY REMOVAL OF OR
PURPOSES.60.00 FEET IN 195TH.60.00 FEET NESTERLY AND SOUTHERLY OF THE MAJOR DISTURBANCES OF SOIL WHIN RAE PROPOSED DRAINT1ELD AREAS
FOLLOWING DESCRIBED LIE; MAY CREATE STE CONDITIONS NAT ARE UNACCEPTABLE FOR THE
COMMENCING Al THE SOUTH QUARTER OF SAID SECTION 11;THENCE SOUTH 89•25'04' INSTALLATION OF SEWAGE DISPOSAL SYSTEMS.
EAST,ALONG THE SOUTH UNE OF THE SAID SOUTHEAST 1/4 OF SECTION I1,859.13 FEET:
0. APPROVAL OF THIS SUBDIVISION DOES NOT CONSTITUTE APPROVAL OF
THENCE NORTH 17'36'00'WEST 588.96 FEET TO THE TRUE POINT OF REQUIRING OF BUILDING OR SEWAGE DISPOSAL PERMITS ON EACH LOT. PERMIT
THIS DESCRIBED LINE; APPROVALS HALL BE SUBJECT TO BUILDING LOT PLANS,TYPE OF USE,
THENCE CONTINUING NORTH 17'36'00'NEST 1.006.41 FEET; CONTOURS.AND SOILS ON NONDUAL LOTS. PERMITS HALL BE RENEWED
THENCE NORTH 0034'00'NEST 708.28 FEET: IN ACCORDANCE WTH STE CONDITIONS AND REGULATIONS EXISTING ON THE
THENCE NORTH 8916'S6T NEST PARALLEL TO THE EAST-WEST CENTERLINE OF SAID DATE THE PERMIT IS APPLIED FOR.
SECTION 11,434 FEET,MORE OR LESS,TO THE EASTERLY RIGHT-OF-WAY OF COUNTY E. toga,' Ha( MCL 41rc1m ant recorded ender
ROAD NO.18 AND THE TERMINUS OF THIS DESCRIBED LINE. dFA)s9y GOb.
ALL SITUATE IN THE COUNTY OF JEFFERSON.STATE OF WASHINGTON.
LAND SURVEYOR'S CERTIFICATE OPEN SPACE/OPEN •sPACe MaindemaAIM
I.MATHEW C.MACLEARNGBIRRY,REGISTERED AS A LAND SURVEYOR WY THE STATE OF AN EQUAL AND UNDIVIDED ONE-SIXTH INTEREST IN TIE OPEN SPACE SHOWN
WASHINGTON,CERTIFY THAT THIS PLAT OF W000RIDGE VILLAGE IS BASED ON AN ACTUAL ON THE FACE OF THIS PLAT SHALL BE VESTED IN THE OWNER OF EACH
SURVEY OF THE LAND DESCRIBED HEREIN,CONDUCTED BY ME CR UNDER MY DIRECTION LOT.The opera—New,and Ina1n4PFAL.BE♦'116 open orIGL.
DURING THE PERIOD OF MARCH.1996 THROUGH AUGUST,1998; THAT THE DISTANCES. .S(Wll be•Nile reape»■6J114y 04 4160 101 wanes'W14i11n
COURSES ANO ANGLES ARE 010089 HEREON CORRECTLY:AND THAT MONUMENTS HAVE tills 4 4)Yl9ien.
BEEN SET AND LOT BOUNDARIES STAKED ON THE GROUND WTH 3/4•IRON PIPES WITH
SURVEYOR'S I.D.CAP No.8425.
� 0 40 . APPROVALS -
ATHEW C MAO.EARNSBERRY 'Z.4,4;°P . s l. �.CER11F1CATE NUMBER 8425 i \TOR, FFERS 1_ ~ W�// //++DI CTOR EFFER501 COUNTY HEALIW DEPAR MERIT
p,
/AYdf t o%v DIRECTOR.JEFFE•... . TY PUBLIC ••KS DEPARTMENT
IMF
EXPIRES: 7.1098 ? th,
DATE: *441. JEFFE' • COUNTY OE I REVIEW DIVISION igi;
DEDICATION
•
KNOW ALL PERSONS BY THESE PRESENTS THAT ME,ME UNDERSIGNED OWNERS O
INTEREST IN THE LAND HEREBY SUBDIVIDED,OF OUR OWN FREE HILL AND CONSENT,HEREBY
DECLARE THIS PLAT TO BE THE THE GRAPHIC REPRESENTATION OF THE SUBDIVISION MADE •
HEREBY,AND DO HEREBY DEDICATE TO JEFFERSON COUNTY FOR THE USE OF THE PUBLIC APPROVED BY THE JEFFERSON COUNTY BOARD O••/. MINERS THIS
FOREVER IN FEE SIMPLE ALL STREETS SHOWN AS PUBLIC HEREON AND DEDICATE THE USE �JJ��l4 I _
THEREOF FOR ALL PUBLIC PURPOSES NOT INCONSISTENT NM THE USE THEREOF DA O I--- I 19
FOR PUBLIC HIGHWAY PURPOSES AND ALSO THE RIGHT TO MAKE AU.NECESSARY ( ` ��
SLOPES FOR CUTS AND FILLS UPON THE LOTS SHOWN THEREON IN THE ORIGINAL /V _'
REASONABLE GRADING OF SAID LOTS AND AVENUES. FURTHER,THE UNDERSIGNED
INNERS WAVE FOR THEMSELVES.THEN SUCCESSORS AND ASSGNS,ANY AND ALL CHAIRMAN ARO OF COM
CLAIMS FOR DAMAGES AGAINST JEFFERSON COUNTY WHICH MAY BE OCCASSIONED ATTEST:CLERK OF THE BOARD OF COMMISSIONERS
BY THE ESTABUS MERIT,CONSTRUCTION.OR MAINTENANCE OF PUBLIC ROADS
WITHIN THAT PORTION OF THIS SUBDIVISION DEDICATED TO JEFFERSON COUNTY. •
C '`,V A' I���e�'F��A..�{�
IN WTNESS WHEREOF HE HAVE SET OUR HANDS AND SEALS. •'Q `��/ )/
BY: •— .�_ BY: .l�.c�a� '�'P� -_ TREASURER'S CERTIFICATE O
f J ES MCC NOREEN M.MCCARRON •
A - • I HEREBY CERTIFY THAT ALL STATE AHD COUNTY TAXES HERETOFORE LEVIED
BY: BY: ___ AGAINST ME PROPERTY DESCRIBED HEREIN,ACCORDING TO THE BOOKS AND
JAYS $MOP CE DISHCP RE S O MY OFFICE.HAVE BEEN FULLY PAID AND DISCHARGED INCLUDING
/T9 TAXES. \
CHA C.SELL t Innil S \./f.Wlc .5),•n '
TREASURER OF JEFFERSON COUNTY T
ACKNOWLEDGMENT astillt
STATE OF WASHINGTON 55- *(,HISA a�"' } FILING RECORD �`'� 3�
COUNTY OF&FFER9RN
Kin& 8• FLED F CORD AT ME REQUES
ON THIS DAY PERSONALLY APPEARED BEFORE ME.JAMES MCCARRON*AND NOREEN I THIS DAY OF 19 A.O.AT •
M.MCCARRON7HUSBAND AND RIFE,JAMES BISIOP.ANO JARCE SSHOP'HUSBANO MINUTES PAST O'CLOCK M.AND aECBRNI IN LIME .LONG V•'I P•SS-
AND WIFE.AWE CRONES; SFR AS HIS SEPARATE ESTATE,TO ME KN01111 TO PLATS PAGE ... �aaR�1EECEEEORDS OF—JEFFERSON COUNTY,WASHINGTON. '310 •
•
BE OREWNC INSTRUMENT, CKNOWLE00EDEMAT THEY S(NEO THE SAME OF 'GNOJ UNOI�-WIU NRHD A10 � M EL0I L� 1/^
•
THEIR OWN FREE AND VOLUNTARY ACT AND DEED,FOR THE USES AND PURPOSES Ca I,,W,,,•EAU-79165 1(/e.- -.--•� F J_R-
THEREIN MENTIONED. tom d xp,T{IsB (41, JEFFERSON COUNTY AUDITOR' DEPUTY
• OVEN UNDER MY H • • • 'CAL SEAL THIS_131 DAY OF •N i
- .�. _ .'may, N(JT'h TwI L.oe.IN ALTO �' i �. J
J•�pMl X00, !W FOR THE � W S91Iu+nu auy Ili ti
C ...... NOTARY PUBLIC IN AND FOR THE t _
1.:341%,..„, STATE OF WASHINGTON.RESIDING kr Fbar}/p{]LDCL' y
1 `l I Y }J
AT �+�
MAhhA
TARNSBERRY, Inc. SURVEYORS°ENGINEERS°PLANNERS
159 WYATT WAY NE I BAINBRIDGE ISLAND,WASHINGTON (206)U2.5514 PAGE 2 OF 2
•
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I4rooksid Estates suB95_0007
ii SECTION 11,TOWNSHIP 29 NORTH, RANGE 1 WEST,W.M.
JEFFERSON COUNTY,WASHINGTON
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C v°d�`,''090�`;o o?o r o 6."0?-;',0 o,4<,e�o°,O°O%-, c OO/O?)O0r; 06-'09Hb°r'O°r
' N 8916'56•W 433.54'
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mita),
6 JEFFERSON NT JUL 1 2013
621 Sheridan Street-Port Townsend-Washington 98368 JEFFERSON COUNTY
1 360/379-4450.360/379-4451 Fax DEPT.OF COMMUNITY DEVELOPMENT
http_//www.cojefeon.wausfconwndevetopment/
Stormwater Calculation Worksheet
MLA# PROJECT/APPLICANT NAME: 14 c.1.7:1:�4 4.- i✓�n.,c..�,,. .g13 C.-
DETERMINING STORMWATER MANAGEMENT REQUIREMENTS This storn ater calculation worksheet shouldv,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 stonnwater review. The basic information will also be helpful for completing a Stormwater Site Plan,if required.
PARCEL SIZE(LE_.SITE)
Size of parcel 1 ,j(2 acres An acre contains 43,560 square feet. Multiply the acreage by this figure.
Size of parcel in square feet ';`71'5 q S 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 I
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 saal;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 clewed for:
Does the project convert%acres or more of
Construction site for structures I t A sq/ft native vegetation to lawn or landscaped areas?
_
57
Drainfreld,septic tank,etc. il 2C"' ` soft Circle: Yes 6
Well,utllities,etc. sgtft Does the project convert 2 6 acres or more of
native vegetation to pasture?
Driveway,parking,roads,etc. i-loo selft ,.-�
Circle: Yes (Nta
Lawn,landscaping,etc. sq/ft
Other compacted surface,etc. "D cu C' sq/ft Indicate Total Volumes of Proposed:
Total Land Disturbance C.31i sg/t Cut a O Fill O jcu/yd)
[over)
stom estertalcwafcteet—REV.2I2(Y2006 1
�_ ._ ..,.,, . .,.� ..., ....,... • •
�5i
• •
impervious atrffa€e is a #surface that either prevents or retards the entry of water t sod `^-
prior to development. A hard surface area which causes water to run off the surface u greater qua tliik, ' r
.r;I-+.s
from the flow present under natural conditions faric tar meat Co �€v surfs,, e t€ rr
tops,walkways, patrol.drry ays,panting lots or storage areas,concrete or asphalt paves, g •-r packed earthen meat
and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater. , jut_
2 20
STORMWATER CALULATIONS—IMPERVIOUS SURFACE i L
JEFFERSON CO n
NEW EXISTING DEPT.OF COMMUNITY D EL !IT
Structures(all roof area) 1 S 1 cl sgff Structures(all roof area) sq t
Sidewalks 6-3-- sgtlt Sidewalks sc/it
Patios < &l/ft Patios sgfft
Solid Decks. soft Solid Decks sr ft
(without infiltration below) � (without infiltration below)
(`
Driveway,parking,roads,etc 00 sgtft Driveway,parking,roads,etc &V t.
Other sq/ft Other sglft
Total New 111 cl) teen Total Existing c) sglft
TOTAL NEW+TOTAL EXISTING* 11/4) scgitt This amount vet be used to amebic total tot coverage.
The following questions will help determine whether the pr project is considered development or redeveloPment
DEVELOPMENT v.REDEVELOPMENT
Divide the total e�impervious surface above by the size of the parcel and convert to a perms: ',3 5°fQ
Does the site have 35%or more of is i impervious surface? Circle: Yes t+hi
FURTHER INSTRUCTIONS: if the answer is yes, the proposal is considered redevelopment and the attached t=lgure 2 should be
used to determine the applicable Minimum Requirements. If th e answer is no,the proposal considered new development and the
attached Figure.1 should be used. At this juncturr, the apptcant should refer to the applicable Flow Chart to determine the Minimum
Requirements for stormwater management. DCD staff will help verify the classiftcation of the pct and the applicatkxe-requirements.
For proponents of "aurae#" who rirtust snly with Minimum Re�qu cement eons Stone ater Pollution
Prevention—an additional submittal is not required. The proponent ist responsible for employing the 12 Elements to control erosion and
prevent sediment and other pollutants
frorre the sit during tier r rstruction phase of tE tom. Pick the Construction
S rnewater"Pollution Prevention(SWPP)"Best Management Practices(SIIdPS)€acket Proponents of grreedi r"
that must meet only Minimum Requirements #1 through #5—and for "tango" projects submittal ter€rplate of a St€rrr€wate€� Site Plan,
prm afly for rural residential Projects-
' Complete the'terrr the �torrnwater Std l t� t ica it S nrit#al T s
prepare a Stormewater Site P using the step-by-step guidance in the Stormwater Management Manual.
APPLICANT SIGNATURE
By signing the Stormwater Calculation Worksheet, t as the applicantlowner attest that the information provided herein is tare and
correct to the best of my kns ieerge_ I also certify that ttris appit ti€ is being made v the futt kn a and consent of ate
owners of the a ced prope r;'
`.
l%s
' %/ 2.w7-13 I
(GATE)
(I.ANDC VNER c4AGrTHOR REPRESENTATIVE SIGNATUR€)
2
stormwater caic worksheet-REV.2!202008-
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 (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.
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
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Contractors or Tradespeople Peer Friendly Page • Page 1 of 1
General/Specialty Contractor
A business registered as a construction contractor with LEI 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 HABITAT FOR HUM/E JEFF COUNTY UBI No. 601850143
Phone 3603792827 Status Active
Address Po Box 658 License No. HABITFH912D5
Suite/Apt. License Type Construction Contractor
City Port Townsend Effective Date 3/25/2009
State WA Expiration Date 3/25/2015
Zip 98368 Suspend Date
County Jefferson Specialty 1 General
Business Type Corporation Specialty 2 Unused
Parent Company
Business Owner Information
Name Role Effective Date Expiration Date
KIMBALL, FRED BRYANT President 03/25/2009
GARTON,MARGO DIANE Secretary 03/25/2009
STANDISH,ALLEN JOSEPH Treasurer 03/25/2011
EEKHOFF, DAVID PAUL Vice President 03/25/2009
CAMFIELD, PHYLLIS JEAN Treasurer 03/25/2009 03/25/2011
Bond Information
lBondjBond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date'
1 TRAVELERS CASE 105222439 03/06/2009 Until Cancelled $12,000.0003/17/2009
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
Ace American
6 Insurance GL1065870-13 04/01/2013 04/01/2014 $2,000,000.00 03/05/2013
Company
5 Federal Ins Co GL1065870-12 04/01/2012 04/01/2013 $2,000,000.00 03/05/2012
4 Federal Ins Co GL106587011 04/01/2011 04/01/2012 $1,000,000.0003/14/2011
3 FEDERAL INS CO GL106587010 04/01/2010 04/01/2011 $1,000,000.00 03/12/2010
2 FEDERAL INS CO_GL106587009 04/01/2009 04/01/2010 $1,000,000.00 03/25/2009
1 FEDERAL INS CO GL1065870 04/01/2008 04/01/2009 $1,000,000.0003/25/2009
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 7/3/2013
c
.
?" DEPARTMENT OF COMMUNITY DEVELOPMENT L�0 L� V
41 b4 i 621 Sheridan Street•Port Townsend-Washington 98368 7
$ 360/379-4450. 360/379-4451 Fax 2 2013
q ,gyp www.co jetferson.wa.us/commdevelopment J U L
b
Master Permit Application LA: EFFERSON COUNTY
Project Description(include separate sheets as necessary):
DiP I.Ur LOMMUNIW,-
fax Parcel Property
Number Z)t 500 f i d 1/ Size: 5-13 3 )-5j S 4? (acresisquare feet)
Site Address and/or Directions to Property:
q,/ ) / j 1
ci rte► C :✓v��G...Y"► �C C� h✓n aS f �ar� ��Li�c t.vh t t L.+u�J l�'•y"6i J c.� !a:�t�, r z
Property Owner(s)of Record: F./e.6:4-_4 (1.r l-4 r~►e,�-r. y ��SG !/ "
Telephone: 36O t N 3 - 3 kV? Fax: 7 _.3-7-x]�2 r a email:L-..�i i r....44:c Oate;t,i.i
Mailing Address: po 3,L.v. 6'5f Pc,-I. T.,,J.,6'e.L ' e0 4 CIT.36F cje,. G
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies
DBuilding 0 Variance(Minor,Major or Reasonable Economic Use)
D Demolition Permit 0 Conditional Use[C(a),C(d),or C]**
6'Single Family D Garage Attached'/Detached 0 Discretionary"D"or Unnamed Use Classification
D Manufactured Home D Modular 0 Special Use(Essential Public Facilities)**
D Commercial* D Boundary Line Adjustment
D Change of Use 0 Short Plat**
D Address El Road Approach 0 Binding Site Plan**
D Home Business 0 Cottagelndustry [I Long Plat**
El Propane 0 Planned Rural Residential Development(PRRD)/Amendments**
- E7 Sign 0 Plat Vacation/Alteration**'
D Mowed`Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions
D Stormwater Management 0 Shoreline Management Substantial Development**
0 Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance
D Temporary Use D Comprehensive Plan/UDC/Land Use District Map Amendment
D Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment
D Forest Practices Act/Release of Six-Year Moratorium 0 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:
A 'Q, DESIGNATION OF AGENT
i hereby designate N r, to act as my agent in matters relating to this application for perrrdt(s)-
OWNER SIGNATURE Date:
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- My 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 ins.-_`.ns. Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the applicatio e ' at he. - wants pr• no .-.
Signature: _ , ../- i ._ / . - Date: 0- - 3
6
The action or actions Applicant will undertake as a '-suit 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 tae 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 po --•+� for ad - =to and" •,,.4' t vrititttle E r The Applicant has read this disclaimer and
' signs and dates it below:
Signature: l Z. I l A — !�. Date: '2-,977-r
1
c:\Documents and Settings\carat`,Local Saints\Temporal},lattanet Fifes\OL .S \Master PennitApplzeatson 12-11-2006-cloc
&ep 12 "$s .
• BUILDER STATEMENT 410
The signer of this statement does hereby certify that they are the Owners of the parted 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: 91,1,4‘ek / , , , • A. Date: Z-ZI
■ HOME GENERAL CONTRACTOR OR MMUFA - il rtOME INSTALLER: PII4ObE: FAX:.
4.,.L. 1,--1- -a.- i-14.,,.....:4 c:-.3,-_ (34,) 6td 3- '3 re'es? (36 ) .5`-11- 7r,?`"4-
-\
MAILING ADDRESS: 17 of.. C...41c R. 4. ..,--. ..,,,, ,, LIA EMAIL: ,..,N 4,,,.......„..k.... , 0 k --..,..1._
CONTRACTOR'S LICENSE Cina WAINS
NUMBER: kkA Bn- FiAll b5 NUMBER
ARCHITECT/ENGINEER' ..r.c,etc,e.,,,,, i„hi.,, /...„,....1„,,f,.._ PHONE(3LC)-3/-41 -TO cIO FAX'(
MAILING ADDRESS: nn -1-.1,v, tor ,-,•4 R,4 To....„.. ..z.,4EMAIL rt*/..AA.A.rol 0
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
X. New X Wood Existing: Li Sewer
U Addition Li Steel Proposed %Able' Balk U Community System
Li Alteration/Remodel U Concrete Total: toil:Ili Height X Individual System
Li!. Repair Li Masonry SEP Permit it 17-c>00T-6—
u Demolition U Other Bedroonts: Wader Supply:
Existing: Setback: U Private well u Two Party
Type of Heat: Proposed: 3 X Public
14.....,.4 Total_ _.,>_____
. Name of System:
If this is a Commercial Project you must answer the following:
Number of Parking Spaces: Currant Proposed Number of ADA Parking Spaces_
Number of occupants(includes owners,tenants,employees,etc) Current Proposed
IBC Occupancy- IBC Type of construction- MI you have Food Service? Yes I No
if this is a Fromm Tank anthem'Anolimice Installation Pernik.mark all/Was below that arrOv:
0 Underground Tank ID Above ground Tank Size of Propane Tank
EDHeat Stove 0 Cook Stove In Woodstove 0 Fireplace Insert 0 Hot Water Tank 0 Pellet Stove 1:1 Other
Is this being installed in a llizmutictured t Raub Home? Yes ! No
When applying Sara permit to'erste"a propane tank you must also submit a site plan showing all of the fulkffngs,all property
lines,Mir location and size,distances from the propane tank to all properly fines,buildings and septic system comparrens,
including the reserve area
Square Footage Current Proposed ,.. For Office Use Only , Amount Revision ..
Main Floor Heated i-l31a EH Bid App Review: ......7 Go.. CO
709t i 0
2m Floor Heated Consistency Review: ,(DD
Other Heated
- Base fee:
993. 75 '
Mezzanine Additional Section: ■■■. .,■■■■■■•■•
Heated Basement Plan Check fee:
(0-ti S • 9 V
Unheated Basement State Surcharge fee: zi s D
/ *
Other Unheated Pot Water Review fee: //1 L. OD
V 10IP r
Garage/Cs-port SUBTOTAL z 0-5(0, 149
Decks , 911/RdrAppfeadt-taa= cR_D 9- 00
c....-v.
Other TOTAL: $ .98ltt /9
Receipt Number. ILI 7__2_g 4
CashiCheck Number:
D 4 2-S
ESTIMA I it•---r i-i =RED} Dale:
.Fa" arkf u- -of all labor an. = 'Is foundation to finish
WOWS:
CADoeugnents and Settings\(-Aral\Lo,..11 Settrngs\Temporary internet Hes\OLK&A.Master Peanut Applicancal 12-19-20664nc
Habitat for Humanity of East Jefferson County 08423
Jefferson County Dept of Community Dev't 6/19/2013
Date Type Reference Original Amt. Balance Due Discount Payment
6/7/2013 Bill 2,284.19 2,284.19 2,284.19
Check Amount 2,284.19
1110 General Operati • • 2,284.19
/ °SOrr �O
w °�, JEFFERSON COUNTY
DEPARTMENT (COMMUNITY DEVELOPME
Date: J1 ?/)4rime Received: f (s� ) 6*-3mm Mon. Tue. Wed Thur. Fri.
Date:
BED: 3 a* : Contact Name: b A, A L.>
Owner: j l /4yv A . Contact Number: 36! —
Address: I 4 i i/CS i , 5 ,:i.
Notes: ) old h.i27 1.-f bt 1r h ,5 Wer'� C 4 lir%�' aft.
Foundation Plumbing Framing Propane Tank Mechanical
Setbacks Under-ground Framing Under ground Furance
Footing Rough In Air Seal Above ground Gas
Stemwall Hydronic Exterior shear Exterior lines Oil
Straps Hot Water Htr Interior shear Interior lines Ducts
Post Hole Ventilation Appliance
Underfloor Gas/Wood stove
Man-Homes Insulation
Final Inspection
Setbacks Floor
Foundation Wall Address Posted
Block&Tile Ceiling
• Inspections are required to be d in by 3:00 pm to receive an inspection ext day. Do to
staffing issues,at this time,we c nnot guarantee that you will receive an ins ion the next day.
day. Unless you receive a call from us,assume we will arrive on your requested inspection day.
You may leave an inspection request 24 hours a day, and Inspections are available from
Monday through Friday.
We cannot determine the time we will arrive in advance. However, if you call our office the
morning of your inspection,around 9:00 a.m.,we can give an estimate of when the inspector will
arrive. Our general office phone number is 360 379-4450.
• An approved set of plans are to be on site with building permit for all inspections. If permit and
plans are not on site at time of inspection,a re-inspection fee must be paid prior to re-scheduling
another inspection.
If no access, no inspections will be performed, and a re-inspection fee must be paid prior to
re-scheduling another inspection.
• Inspectors will not access a home that has personal affects inside when the owner is not present.
• Commercial projects require 24 hour notice for inspection.
• --
Date 1 ( i 7 time received �, 1 pm Mon. Tues. Thur. - Fri.
BLD: 1 3 - t10,9 (� /
Date: j (0
OWNER: - Contact Name: 2
ADDRESS: 1 l b 15 r 00KS iA/ Contact Number.360 Co'l3 35cP
Notes: - 206 - •"t
•
Foundation Plumbing • Framing Propane Tank - Mechanical '
Setbacks _ Under-ground Framing Under ground Furnace _
Footing Rough In ( Alr seal Above ground •— Gas
Stemwall _ Hydronic Exterior shear Exterior lines Oil —'
Straps Interior shear Interior lines •Post Hole Ventilation Ducts _
Underfloor Appliance
Man-Homes
Gas/wood stove
Setbacks - Insulation Final Insp ect ion
t
!)Foundation
Block&Tie �',
— floor wall ceiling
- g Address Posted •
•
•
4110 .V.I•id•ws.,..
.-q,s:4`,.vqzi •
. . • YEZ,1W4f".e. .-. . .
—...--...41,... ....,..„—„,,-
-:- - - .
1,4144 17:01"
/
. .
• . -... ......-...:..'....f.t.,.....Lt.:IA..' =v.-11.e.
. . .
. .
• n
Date IL+ time received a'5 z- am c) Mon. Tues. 011) Thur. --Fri.
• BLD: /3 - 00 . Date: /'ZS.
. , • .
OWNER: /491WT re/IL- fl i`rl" - • • Contact Name:.
•ADDRESS: _ I/O 5 eC)04K.iii)E 61' Contact Number.360 be -5067 -
• ... .
. . 206 • ,•
• 5..
Notes: • •
.
. - .
. .
- -
• -
. . , .
.Foundation .Plumbing -Framing' • • Propane Tank • Mechanical •
._..
•
Setbacks . Under-ground Framing Underground • Furnace .
Footing Rough in Air seal . Above ground - Gas
Stemwall _ Hydronic Exterior shear )( Exterior lines Oil
Straps _ Interior shear Interior lines . Ducts V• .
• Post Hole - - Ventilation • • Appliance
-
•
• Underfloor Gas/wood stove
Man-Homes - •
• ' .
Setbacks • Insulation. . • Final inspection ::::•-•• •
• -,..
Foundation-- • • • - '-•'.'.. .
Block&Tie floor _wall ceiling . Address PoSled
1
............................-
• S
Dlpg--
• 0.
_ ■
0°
otAio- 4,1) O ,.........,-. ..
fo,
. ,,..-4.5:-.0w- • .
. .. 6,0,4, "
• .• .
1 q::14-.&m:/-71
"--""'""'°- . . . .
•
•
- • - -
Date Vii 'time received 3:10. arn /C) Mon. Tues. _Wed; Tt-C2.ir --Fd. •
• MD: 13 - De)2-1=10 .
Date: 1/4 2— ' •
•
IJ
OWNER: t///1917 for_ ilbimAn)rne . • . . Contact Name,:
ADDRESS: 114) -45P-60(4 SIDV" 5-i- Contact Number:360 M3 607
• ,
206 ,.
6 .t
Notes: ,1-1113 tAdS."L i VA PGZ.- 13A gel e a .
.Foundation Plumbing - Framing Propane Tank Mechanical ' '
— •
Setbacks Under-ground Framing Underground Furnace
— —
Footing Rough In Air seal Above ground Gas
—
Stemwall _ Hydronic Exterior shear Exterior lines Oil
Straps Intedor shear Interior lines • Ducts f---.____ . .
• Post Hole Ventilation Appliance
Underfloor — Gas/wood stove
MarpHornes
,
Setbacks • Insulation Final Inspection
Foundation .
-;-:
Block&Tie floor )4 wall ceiling. . Address Posted
i
. ,.
. ,..■5,iitii..
• :4:4422z0,14.
SCAVit-070 -
.... - . irill~kial• .
. - -
. . .
R-- /
Tue .. Wed: Thur
r.,_-......:
BUD: S -- 6) . - Date: - . •
- Contact Name:
OWNER: • -
,R2_,_tt2e2E5_
ADDRESS: - - I OK. Contact Number.360 ()// 27
_
, .
Notes: .
- •
' . - . . .
Foundation Pluri__1_,__9! .D.111 - Framing' Propane Tank Mechani'
cal
----- .
SetbaCks — Under-ground Framing Underground Furnace
Footing Rough in ____ Air seal Above ground Gas
_
Stemwall )E Hydronic Exterior shear Exterior lines Oil
Straps Interior shear Interior lines . Ducts 9
___
Post Hole Ventilation Appliance •
Underfloor .. Gas/wood stove
Man-Homes
.
Setbacks
— Insulation. Final Inspection
Foundation . . .;'')
•
Block&Tie floor wall ceiling. . Address Posted
i
• .
•
1
S -
- ,it.....1.-
. . 1.1,,*8.-. 4VA'•
. i":$4,:.• -61Y4,1,155°,,,,,--, 14-14:
.' .
set
Date -- time received • __am I 0 .. -
Mon. Tue . 1Z) Thur. -Fn. •
-
BLD: —42,041. . - Date: .
- .
OWNER: a.. Contact Name.
. -
ADDRESS: : __ . 2- -- ---4.
;La?
Contact Number 360___30_,,n i
.
Notes:
. . . .
. - -
Foundation PIPn------11---"n Framing . Pro al__._a_ L__Iarlic - h
Mecanical - -
_____--------
Setbacks 1 Under-ground_ Framing Un
er und Furnace
dgro
FOOting V _ Rough in Air seal . Above ground • - Gas
_
Sternwall _ Hydronic Exterior shear Exterior lines Oil
• -
Straps _ Interior shear interior lines . Ducts
Post Hole _ Ventilation Appliance _
Underfloor _ •Gastwood stove
Man-Homes -
- -
Setbacks _ • Insulation. Final Inspection_
Foundation. ._ __ . 'i= '0
Dock&Tie _ floor __Nvall ceiling . Address Posted _• 1
-.-
•
1 - - -
-
• .
s 2.4,..r.••1,.......
;,•.,-,mt..ri,--:00 g. .
'- • •..0.,::::::=.7.7.1:::...v ..•.......- -
::,:tilas.f•Tty•B", a R.,.....if,..,d- .
• . - 104?-, 4/.4._ q..`"-i,;''.... .o' •-!.,.7"rti.;F.
- -
. . •
. .
-- - -
Date_ __'time received 50 5 am /0 Mon. Tue . Wed: -Pn.
dr . •
• BLD: ,/3 -- g0 K _ -
Date: • -
OWNER: - - . Contact Name:.
.
.
ADDRESS: /1 0 -6/‹.0 OK 2 Nu... '7
Contact Number.360
206 ,
Notes: DrCk 7/. . -
. . -
Foundation Plumbing - Framing' - . Propane Tank • Mechanical . .
Setbacks Under-ground Framing Underground Furnace
Footing Rough in Air seal Above ground Gas
— __— _
Stemwall -- Hydronic Exterior shear Exterior lines Oil
Interior shear Interior lines . Ducts 9_____
_
Post Hole Ventilation Appliance •
• Underfloor _ Gas/wood stove
Man-Hornes •
Setbacks • Insulation Final Inspection ..,
Foundation •:
....i.
Block&Tie floor _wall ceiling. . Address Posted
s
_ -
• •
••.-...cvx7*.W.-. •
,::.-- .4..r....Tr-IM.....r.o,.,„,4.,1-.
. „:„4,,..4,zig *A-i-_;E. - •
. i IAA,'Ww..."'.2:t•-ilie ILF, . 0
- - -
• •IL=, - •4..,4 T -
- .
. .
_ •
Date ive d_A time time rece Ala_
- '. ial9/ pm - !ion. TueS. ,.Wed: Thur. --Fri.
BLD: , e -0.5 . Date: I 2. — ct. • .
OWNER:
- -
-- .
. Contact Nam
ADDRESS: ID cotact Num:e
r:360_ E__ 83:.0
Notes 206 ill
. .
Foundation Plumbing - Framing Propane Tank - Mechanical
____,--
Setbacks _ Under-ground Framing Under ground
Footing Rough in _ Air seal Furnace
— Above ground . Gas
Stemwall _ Hydronic _____
Exterior lines Oil
Exterior shear Interioi,lines . Ducts
Interior shear
Straps -- Ventilation
Post Hole __ Appliance
Underfloor G as/wood stove
Man-Homes .
Setbacks Insulation. . Filial Inspection
Foundation-
4,y
Block&-rie floor. wall ceiling . Address Postid
- i
...
N •
QQw4sO % JEFFERSON COUNTY
` DEPARTMENT OF COMMUNITY DEVELOPMENT
�,y'r FI NO Q1
•
Date: 1me Received: �� �� am/O Mon. Tue. ed. Thur.
qfjP
Date: 7 I l
-BLD: �_� Contact Name: �i
Owner: Contact Number: 360 53 f — 3(�G6
Address: (Cs ( �-2O6
Notes: 73'21 `� / Rot
Foundation Plumbing Mechanical
6 , ,Setbacks Under-ground - Furance, ,Footing Rough In } Gas
Stemwall Hydronic ` } t� ;� �, , .„1r,,,,,,4,. $� Oil
Straps Hot Water Htr =f - , . , ` ' Ducts
Post Holey Appliance
t. f � Gas/Wood stove
Man-Homes ° ,
w 0 - „
Final Inspection X.,
Setbacks
Foundation. Address Posted
Block&Tile
• •
- Inspections are required to be called in by 3:00 pm to receive an inspection the next day. Do to
staffing issues,at this time,we cannot guarantee that you will receive an inspection the next day.
day. Unless you receive a call from us, assume we will arrive on your requested inspection day.
You may leave an inspection request 24 hours a day, and Inspections are available from
Monday through Friday.
- We can ndt determine-Mestime we:Wil)arrive in advance. However, if you call our office the
morning of your inspection,around :'6O a.m.,we can give an estimate of when the inspector will
arrive. Our general office phone number is 360 379-4450.
- An approved set of plans are to be on site with building permit for all inspections. If permit and
plans are not on site at time of inspection,a re-inspection fee must be paid prior to re-scheduling
another inspection.
• If no access, no inspections will be performed,and a re-inspection fee must be paid prior to
re-scheduling another inspection.
• Inspectors will not access a home that has personal affects inside when the owner is not present.
Commercial projects require 24 hour notice for inspection.
• e..,..-5-Vi?:...,
V.1.•,..... '
[17,7g17: 'I? -OT1
• _ -
Date 7---3 time received 100 90/ pm Mon. Tues Thur. - Fri.
BLD: /g 0261g Date:
OWNER:
Contact Name:
ADDRESS: /10 134 o o ic. -•/17 -
. Contact Number:360
206 ft
.
Notes:
• -
- '
Foundation Plumbing - Framing Propane Tank Mechanical
Setbacks Under-ground )c Urideiground Furnace _
Footing Rough In Air seal Above ground • Gas ____
Stemwall ______ Hydronic Exterior shear Exterior lines Oil
Straps --- Interior shear interior lines • Ducts
--
Post Hole L. . Ventilation Appliance
Underfloor Gas/wood stove
Man-,Homes
Setbacks • Insulation Final Inspection >7.A
IN
.
- Foundation •
-a'
Block&Tie floor wall ceiling Address Posted
fox c
4s7 �°t JEFFERSON COUNTY
DEPARTMENT *COMMUNITY DEVELOPME.
Date: Ve Time Received: 9:Z7 ar 'pm Mon. Tue. ed Thur. Fri.
Date: 1-0- 1'3
BLD: 13 Loa Contact Name:
Owner: Contact Number: 360 443 -38 7
Address: //6 $,2 D& %r 206
Notes: %Menioo 5N erz. V. Dqt.BoAtD tat'"Li,ut
Foundation Plumbing Framing Propane Tank Mechanical
Setbacks Under-ground Framing Under ground Furance
Footing Rough In Air Seal Above ground Gas
Stemwall Hydronic Exterior shear Exterior lines Oil
Straps Hot Water Htr Interior shear Interior lines Ducts
Post Hole Ventilation Appliance
Underfloor Gas/Wood stove
Man-Homes Insulation
Final Inspection
Setbacks Floor
Foundation Wall Address Posted
Block&Tile Ceiling
S !
II
"SON N. JEFFERSON COUNTY
9� DEPARTMENT OF COMMUNITY DEVELOPMENT
2s + o
Date: /2-1 Time Received: 2 7 arr p§ Mon. 40 Wed. Thur. Fri.
Date: j2
BLD: 13 a Q ' Contact Name:
Owner: Contact Number: 360 710 2,5-13—Q3y
Address: / jp i3,rd c,Di 206
Notes:
Foundation Plumbing Framing Propane Tank Mechanical
Setbacks Under-ground Framing Under ground Furance
Footing Rough In Air Seal Above ground Gas
Stemwall Hydronic Exterior shear Exterior lines Oil
Straps Hot Water Htr Interior shear Interior lines Ducts
Post Hole Ventilation Appliance
Underfloor Gas/Wood stove
Man-Homes Insulation
` Final Inspection
Setbacks Floor \"'.\
Foundation Wall Address Posted
Block&Tile Ceiling
Jefferson County Building Division Permit Null: BLD13-00208
Applicant: HABITAT FOR HUMANITY OF EAE
BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2012 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 1 4" )
Erosion Control
Foundation Footing )U")3 XZ g-/y-13
Footing Drains 714/3
Foundation Stem Wall -I et_
Underground Plumbing a/4 13 G
Under Floor Framing `
Straps(hold downs)
Ext.Shear Wall Nailing -1(�51(.-3
Rough-in Plumbing it 3 /
Framing I -6 — 13
r
Airseal 1 I _1—x3
Insulation:Walls
Insulation:Floors /
fia/> 2,, 04.46 /4.)11-44— 4 I/ Blee,&z of< 11117 13 f
Insulation:Ceiling 20(2^1,1
Int.Shear Wall Nailing
Wallboard Nailing 1 -e-/41
lurwriscr
-.leaterirrrtrsTCIg'arance
Mechanical Systems `b`� /'�. �
44.Beet T Bert
Blower Airtight Test .C � Y _
Smoke&CO2 s0,-(2.,11 r+�
Drywell/Alt Drainage Zs'C 2,, 2
Address Posted �- 2`c
•
III
FINAL INSPECTION QSI- V ( (�
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING B EING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• •
CONDITIONS for Building Permit# :BLD13-00208
1.) The site plan as submitted with the building application on 7-2-13 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 7-2-13 shall be resubmitted for review and approval by Jefferson
County Department of Community Development.
2.) The site plan as submitted with the building application on 7-2-13 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 7-2-13 shall be resubmitted for review and approval by Jefferson
County Department of Community Development.
3.) 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.
4.) This approval is for a Single Family Residence 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.
5.) Planner-Colleen Zmolek
6.) This parcel is within a no shooting area per JCC 8.50.
\\tirIAmark\rlafa\fnrmc\F RI 1) Parmit Rlrin rnt R/1/2011
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT#: BLD13-00208 Received Date: 7/2/2013
SITE ADDRESS: BROOKSIDE ST Issue Date 8/1/2013
PORT HADLOCK, 98339 Expiration Date 8/1/2014
OWNER: HABITAT FOR HUMANITY OF EAST PHONE: 360-643-3807
JEFFERSON COUNTY
PO BOX 658
PORT TOWNSEND WA 98368-0658 BROOKSIDE ESTATES
SUBDIVISION: Block: Lot: 4+
PARCEL NUMBER: 936500004 Section: 11 Township: 29 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: NSFR no revision. Proceed as originally permitted. Hold lifted. 7/17/2013
-meb
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,092
VALUATION 100,000.00
ADM.: HEAT TYPE
CODE EDITION: 2012 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: SHORELINE:
GARAGE:
CONST TYPE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL: OSS
WATER SYSTEM: 05783 Type Amount Paid By Date: Receipt:
BEDROOMS: BATHROOMS: Permit $993.75 MEB 07/02/13 142237
Exist: Exist: Plan Check $645.94 MEB 07/02/13 142237
Prop: 3 Prop: 1 State Building Code $4.50 MEB 07/02/13 142237
Total: 3 Total: 1 Potable Water Application $66.00 MEB 07/02/13 142237
Total: $1,710.19
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 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