HomeMy WebLinkAboutBLD2013-00299 ILDING PERMIT APPLICA1'i:'JN MLA09-00124
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD13-00299 Received Date: 9/24/2013
SITE ADDRESS: 304 SUNSET BLVD
PORT TOWNSEND, 98368
OWNER: ROBERT R PENNEL PHONE: 503-632-7289
LEILANI PENNEL
PO BOX 129
BEAVERCREEK OR 970040129 CAPE GEORGE COLONY DIV 2
SUBDIVISION: Block: 3 Lot: 12
PARCEL NUMBER: 938100311 Section: 13 Township: 30 N Range: 02 W
CONTRACTOR: SHIELDS/SMITH PHONE: 360-385-7156
260 KALA POINT DR
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION NEW SINGLE FAMILY RESIDENCE
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,363
VALUATION 269,576.00 ADD'L: HEAT TYPE: HTP
CODE EDITION: 2012 HEAT BASE: 932 HEAT TYPE:
OCCUPANCY: UNHEATED: 300 #OF STORIES:
OCCUPANCY:
OTHER:
CONST TYPE: SHORELINE:
GARAGE: 500
CONST TYPE: DECK: 80 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: OSS
WATER SYSTEM: 11050
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: 2 Prop: 2
Total: 2 Total: 2
Routing Date:
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $2,217.00 MEB 09/19/13 145371
Plan Check $1,441.05 MEB 09/19/13 145371 APPROVED
State Building Code $4.50 MEB 09/19/13 145371 �''1Lr ITV Y LJ�
Potable Water Application $66.00 MEB 09/19/13 145371 NOV 0 1 2013
Total: $3,728.55
Jefferson County DCD
MirlpmerL\rinf.\ft,rmc\G R1 Il ant, PIA rn+ O/9A/9MZ
s°N "N DEPARTMENT OF COMMUNITY DEVELOPMENT
. 7 621 Sheridan Street,Port Townsend,WA 98368
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" Tel Tel:360.379.4450 I Fax 360.379.4451
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Web:www.co.jeff erson.wa.us/communitydevelopment
-rsff l N G O E-mail:dcdaco.jefferson.wa.us
CERTIFICATE OF OCCUPANCY
PERMIT#: BLD13-00299
APPLICANT: ROBERT R PENNEL PHONE: 503-632-7289
LEILANI PENNEL
PO BOX 129
BEAVERCREEK OR 970040129
SITE ADDRESS: 304 SUNSET BLVD Issue Date: 11/7/2013
PORT TOWNSEND, 98368 Final Date: 9/9/2014
SUBDIVISION: 9381 Block: 3 Lot: 12
PARCEL NUMBER: 938100311 Section: 13 Township: 30 N Range: 2W
PROJECT DESCRIPTION: NEW SINGLE FAMILY RESIDENCE - BUILDING AND SHORELINE
EXEMPTION PERMM'S
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2012
EDITION.
OCCUPANCY GROUP:
TYPE OF CONSTRUCTION:
SPRINKLER SYSTEM yes e
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 9/9/2014
\\tidemark\data\forms\F_BLD_Occupancy.rpt 9/9/2014
Sally Ellis
From: Sally Ellis
Sent: Monday, September 08, 2014 4:32 PM
To: 'Mary Hathaway'
Cc: Frank Benskin
Subject: RE: BLD13-00299
Dear Mary,
I can't issue a C/O as this permit did not pass final today- If you have questions as to why it did not pass-you will have to
talk to Frank Benskin as he was the inspector for this final.
Sincerely
Sally L Ellis
Jefferson County Community Development
Permit Technician
621 Sheridan St.
Port Townsend,WA 98368
360-379-4452
sellis@co.jefferson.wa.us
From: Mary Hathaway [mailto:mhathaway@olympus.net]
Sent: Monday, September 08, 2014 1:37 PM
To: Sally Ellis
Subject: RE: BLD13-00299
Hi Sally, When you get a minute would you please fax me a CO for the above referenced building permit.
Thank you!
Mary Hathaway, Office Manager
Kelley Shields Inc.
(360)385-7156
www.kelleyshieldsinc.com
From: Sally Ellis [mailto:SEllis@co.jefferson.wa.us]
Sent: Wednesday, August 20, 2014 5:13 PM
To: dshields@olymus.net
Cc: info@kelleyshields.com
Subject: FW: BLD14-00222 42 Quinault loop Permit has been issued and is ready for pick up!!
1
From: Sally Ellis
Sent: Wednesday, August 20, 2014 5:09 PM
To: 'dshields @olymus.net'
Subject: BLD14-00222 42 Quinault loop
Hello,
Please note that the new building permit for a Single Family Residence at 42 Quinault Loop for Steven Beiswenger, has
been approved and issued and is ready for pick up.
Our office is open Monday-Thursday 9-4:30 closed for lunch from Noon to 1.
If you have any questions or need more information please feel free to contact me.
Sincerely
Sally L Ellis
Jefferson County Community Development
Permit Technician
621 Sheridan St.
Port Townsend,WA 98368
360-379-4452
sellis@co.jefferson.wa.us
No virus found in this message.
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Duct Leakage Affidavit . (C t v l
Permit#: ' (X 9
In SEP - 2 2014
House address or lot number: 304 Sunset Blvd.
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City: Port Townsend Zip: 98368 JEFFERSON COUNTY
DEPT.OF COMMUNITY DEUDOPMENT
Cond. Floor Area(ft2): 2/32S-
Source(circle one): 4 Q 0 Estimated Measured
❑ Duct tightness testing is not required for this residence per exceptions listed at the end of this document
Air Handler in conditioned space?0 yes no Air Handler present during test , 'yes❑no
Circle Test Method: Leakag to Outside I Leakage
Maximum duct leakage:
Post Construction,total duct leakage: (floor area x.08)= CFM @25 Pa
Post Construction,leakage to outdoors: (floor area x.06)= CFM @25 Pa
Rough-In,total duct leakage with air handler installed: (floor area x.06)= FM @25 Pa
Rough-In,total duct leakage with air handler not installed: (floor area x .04)= CFM @25 Pa
Test Result: i 3 CFM @25Pa
Ring (circle one if applicable): Open 1 2
Duct Tester Location: 11- H Pressure Tap Location: Rec.. eca=411
I certify that these duct leakage rates are accurate and determined using standard duct testing protocol
Company Name: poy" a 1446 Technician: Km"rcd
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Technician Signature: Date: /ll
—1)4 Phone Number:6 83- 3f 0l
Washington State Energy Code reference:
503.10.3 Sealing.All ducts,air handlers,filter boxes,and building cavities used as ducts shall be sealed.Joints and seams shall comply
with Section M1601.3 of the International Residential Code or 603.9 of the International Mechanical Code. Duct tightness testing shall be
conducted to verify that the ducts are sealed.A signed affidavit documenting the test results shall be provided to the jurisdiction having
authority by the testing agent.When required by the building official,the test shall be conducted in the presence of department staff.
Exceptions: 1.Duct tightness test is not required if the air handler and all ducts are located within conditioned space.
2.Duct testing is not required if the furnace is a nondirect vent type combustion appliance installed in an unconditioned space.
A maximum of six feet of connected ductwork in the unconditioned space is allowed.All additional supply and return ducts
shall be within the conditioned space.Ducts outside the conditioned space shall be sealed with a mastic type duct sealant and
insulated on the exterior with R-8 insulation for above grade ducts and R-5 water resistant insulation when within a slab or
earth.
PPIlirs Duct testing Cc icu atbr (New Construction)
House address or lot #: 304 sunset Blvd. I _
Conditioned Floor Area: wi �� �\
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Duct tester location: C‘ H /144,, alai
Pressure tap locatiion: Sl P - ?t�l
Ring (if applicable): Open 1 2 3 U
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KSI Kelley Shields Inc.
Kala Point Professional Building
260 Kala Point Drive
Port Townsend, Washington 98368
360.385.7156 phone
360.385.3115 fax
To: J7Y- 142'57
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Donna Frostholm
From: Donna Frostholm
Sent: Thursday, November 07, 2013 4:01 PM
To: 'Mraz, Richard A. (ECY)'; 'Kaminski-Richardson, Bridget(DNR)'; 'daniel.dafoe @dfw.wa.gov'
Subject: FW: sdp ex permit
Attachments: pennel permit.pdf
Rick, Bridget, and Dan:
Attached is a shoreline exemption for a single-family residence.
Let me know if you have any questions.
Regards,
Donna Frostholm
Associate Planner/Wetland Specialist
Jefferson County Department of Community Development
621 Sheridan Street
Port Townsend, Washington. 98368
dfrostholm(aco.-Jefferson.wa.us
360.379.4466
Department of Community Development is open from 9:00 to 4:30 Monday through Thursday; DCD is
closed on Friday.
All e-mails sent to and from this address will automatically be archived by Jefferson County
and emails may be subject to Public Disclosure under Chapter 42.56 RCW.
1
• w t I
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT#: BLD13-00299 Received Date: 9/24/2013
SITE ADDRESS: 304 SUNSET BLVD Issue Date 11/7/2013
PORT TOWNSEND, 98368 Expiration Date 11/7/2014
OWNER: ROBERT R PENNEL PHONE: 503-632-7289
LEILANI PENNEL
PO BOX 129
BEAVERCREEK OR 970040129 CAPE GEORGE COLONY DIV 2
SUBDIVISION: Block: 3 Lot: 12
PARCEL NUMBER: 938100311 Section: 13 Township: 30 N Range: 02 W
CONTRACTOR: SHIELDS/SMITH PHONE: 360-385-7156
260 KALA POINT DR
PROJECT DESCRIPTION: NEW SINGLE FAMILY RESIDENCE - BUILDING AND SHORELINE
EXEMPTION PERMITS
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,363
VALUATION 269,576.00 ADD'L: HEAT TYPE: HTP
CODE EDITION: 2012 HEAT BASE: 932 HEAT TYPE:
OCCUPANCY: UNHEATED: 300 #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: 500 SHORELINE:
CONST TYPE: DECK: 80 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: OSS
WATER SYSTEM: 11050 Type Amount Paid By: Date: Receipt:
BEDROOMS: BATHROOMS: Permit $2,217.00 MEB 09/19/13 145371
Exist: Exist: Plan Check $1,441.05 MEB 09/19/13 145371
Prop: 2 Prop: 2 State Building Code $4.50 MEB 09/19/13 145371
Total: 2 Total: 2 Potable Water Application $66.00 MEB 09/19/13 145371
Total: $3,728.55
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
•
' CONDITIONS for Building Permit# :BLD13-00299
1.) The jroect shall adhere to the Best Management Practices(BMPs)to control stormwater,
P 9
erosion and sediment during construction. BMPs shall address permanent measures to
stabilize soil exposed during construction, and in the design and operation of stormwater
and drainage control systems.
2.) The site plan, as submitted with the building application on September 19, 2013, has been
reviewed for consistency under the UDC, and has been approved by Jefferson County
Department of Community Development. Any modifications, changes, and/or additions to
the stamped, approved site plan dated September 27, 2013 shall be resubmitted for
review and approval by Jefferson County Department of Community Development.
3.) This project was reviewed and approved as a Shoreline Exemption under under JCC
18.25.090(5).
4.) dlf
\\tirlamark\data\fnrmc\F RI 11 Permit Rlrin rnt 11/7/9M3
1
Standard Conditions for Resid•al 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. 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.
7. 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.
8. 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
2013-03-07_SFR_StdConditions 3/7/2013 1
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Parcel Number: 938100311
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Owner Mailing Address: t �'�''��
ROBERT PENNEL
LEILANI PENNEL
PO BOX 129
BEAVERCREEK OR97O040129
Site Address:
304 SUNSET BLVD
PORT TOWNSEND 98368
Property Description:
CAPE GEORGE COLONY DIV 2 I BLK 3 LOT 12 I I
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5un5et Blvd, 1'i = 20'
Flee, + 105' 96,21' Elev, +103'
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Owner Mailing Address: 0` � �'��
ROBERT PENNEL
LEILANI PENNEL
PO BOX 129 TOEVVED BEAVERCREEK OR970040129
Site Address: SEP 1 9 2013
304 SUNSET BLVD
PORT TOWNSEND 98368
JEFFERSON COUNTY
Property Description: DEPT OF COMMUNITY DEVELOPMENT
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N L'Orj JEFFERSONCOUNTY
. `► 01-16
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street•Port Townsend•Washington 98368
•Pit! 360/379-4450. 360/379-4451 Fax
ISWINOtt° www.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA:
Project Description(include separate sheets as necessary):
V.)el.) SIIJ LC pew lot ac-S) e
Tax Parcel
Number. q�O l 00 **AI Size: `1,cal (a square feet)
Site Address and/or Directions to Property:
'so4 SU p PSL > * 1 bw ri..p I IA/A. ni g 3
•Property Owner(s)of Record: L
Telephone: -.► ;>� �� 'or. €t
Mailing Address: ���: r !!'7,4111111111111111111111121110_ .,r. �) /: "7I
Applicant/Agent(if different from owner): / 5 /AUC • -t
Telephone: " l 5 Fax - email:d SAl tai j Q 91 t,s.
Mailing Address: "Zo( 0 . t*j� / 1265C" `
What kind of Permit?(Check each box that applies
Building ❑Variance(Minor,Major or Rna nnah,In FconorpicUse)
❑ Demolition Permit ❑Conditional Use[C(a),C(d)y' C �J E
❑Single Family ❑Garage Attached/Detached ❑Discretionary"D°or Un V l�
❑ Manufactured Home ❑ Modular ❑Special Use(Essential P • •:pities)**
❑ Commercial* 0 Boundary Line Adjustment S E P 1 9 2013
❑ Change of Use ❑Short Plat**
❑ Address ❑Road Approach ❑Binding Site Plan** I i
❑Home Business ❑Cottagelndustry ❑Long Plat** LI`
propane ❑Planned Rural Residential Dev-,•,.. ,P.- **
�i,•�(i-r,•,
❑Sign ❑Plat Vacation/Alteration** • 'WENT
❑Allowed'Yes°Use Consistency Analysis ❑Shoreline Master Progra - - _._-
❑Stormwater Management ❑Shoreline Management Substantial Development'"
❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance
❑Temporary Use ❑Comprehensive Plan/UDC/Lan!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:
SIGNATION OF AGENT
I hereby designate ! rV,A•ty S ( , to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE_►X)I. c iM�r►r Date: (I1,"I 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 ortssion of a material fact made by the owner/agent with respect to this application packet
may result in this permit being nun and void.
I further agree to save,indemnify and hold harmless Jefferson County against aff liabilities,judgments,court costs,reasonable attorney's fees and
expenses which may in any way accrue against Jefferson County as a rest.*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. Staff's access and `.tit of entry will be assumed unless the applicant' the County in writing at the
time of the appli . that - or shpznts prior.• ce.
Signature: Vf Date: `'t
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 al 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 wd not violate the ESA. Any individual,group or agency can fie 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 iron-trans on
respsibinhr and •' • ' ,! with the ESA 'The Applicant has read this signs and dates it below.
Signature: 1.401...../ Date: Ct
C:\Documents and Settings\caral\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc
1
BUILDER STATEMENT
The signer of this statement does :-.i3.-, •-rtify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be assuming the .'•: tty of the General Contractor for the proposed project.
Signature: Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
tbalt0C11 S,+,E14DS /tNG. ('346)3&Si%S�. (360 ;�S'-'3IIS
MAILING ADDRESS: 11 h I J • pit , ear. EMAIL:d shy)Q'�s Q oIi km p,S. N et„
CONTRACTOR'S LICENSE J WAINS•NUMBER: 1Kr GLy ISO 1° NUMBER
ARCHITECT/ENGINEER: c i4l eteJ `y 're PHONE (160) 7,c.7 s T AX:( )
MAILING ADDRESS:�Q ST• /` • EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
A New R Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: 2.. Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: — Height X Individual System
❑ Repair ❑ Masonry SEP Permit# /3•001 DI
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: .1 S� Li Private well ❑ Two Party
Type of Heat: Proposed: ' lit Public
im c,lr ed Total: me Sys e • ciair
If this is a Commercial Project you must answer the following:
Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces:
Number of occupants(indudes owners,tenants,employees,etc) Current Proposed
IBC Occupancy: IBC Type of construction: WU you have Food Service? Yes / No
If this is a Propane Tank anchor Appliance Installation permit,mark all items below that apply:
0 Underground Tarn CI Above ground Tank Size of Propane Tank
0 Heat Stove 0 Cook Stove 0 Woodstove 0 Fireplace Insert 0 Hot Water Tank 0 Pellet Stove 0 Other
Is this appliance being installed in a Manufactured/Mobile Home? Yes / No
When applying fora permit to install a propane tank you must also submit a site plan showing all of the buildings,all property
lines,tank location and sae,distances from the propane tank to all property lines,buildings and septic system components,
including the reserve area.
Square Footage Current Proposed For Office Use Only Amount Revision
Main Floor Heated EH Bid App Review. al
11(03 wn-hsg.sr ..�'cc
2na Floor Heated Consistency Review 2_2 ?
2 y
�
Other Heated Base fee:
221
Mezzanine Additional Section:
Heated Basement C1,y„L 1 DO 4,1 s. Plan Check fee: ,I ' f I I .O S-, 0 ..1A4„,...4,,„.
Unheated Basement 36 O S7 2y State Surcharge fee: `1"f1` c `% .Ub
Other Unheated Pot Water Review fee: /0 6 • w t S-/2 •
Garage/Carport SUBTOTAL g
Soo 14 tizt;.�'' 1101-QS-Ss.
- 3._.)-
Decks 911/Rd Approach fee:
2 214.c4.4
Other U, TOTAL: $
ricis�•S �lo2N.S�
""Rece' Number:
II 5- 1 PC° 1 Ad
4 ' Cash 94umber: 0 it $ SL..i)13— 1 o�-
ESTIMATED COST(REQUIRED) 2580 Date: ��/c,//3 L.
.Fair market value of all labor and materials foundation to finish
Initials:
C:\Documents and Settings\canal\Loral Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc
Contractors or Tradespeople Pr iv Friendly Page • Page 1 of 1
General/Specialty Contractor
A business registered as a construction contractor with Lftl 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 KELLEY SHIELDS INC UBI No. 600579660
Phone 3603857156 Status Active
Address 260 Kala Point Dr License No. KELLESI150LF
Suite/Apt. License Type Construction Contractor
City Port Townsend Effective Date 6/6/1985
State WA Expiration Date 6/6/2015
Zip 98368 Suspend Date
County Jefferson Specialty 1 General
Business Type Corporation Specialty 2 Unused
Parent Company
Other Associated Licenses
Specialty Specialty Effective Expiration
License Name Type 1 2 Date Date Status
KALABBL936PA KALA BLUFFS Construction LLC General Unused 10/1/2007 10/1/2011 Expired
Contractor
ii
Business Owner Information
Name Role Effective Date Expiration Date
KELLEY, DENNIS M President 06/06/1985
SHIELDS, DENNIS A Vice President 06/06/1985
Bond Information
Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date
8 CBIC SC8396 05/28/2002 Until Cancelled $12,000.0005/06/2002
Assignment of Savings Information No records found for the previous 6 year period
Insurance Information
IlnsurancelCompany Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date
29 Wesco WPP1026482 06/02/2013 06/02/2014 $1,000,000.00 05/22/2013
Insurance Co
28 GENERAL BAG0007583 06/02/2010 Until Cancelled $1,000,000.00 06/01/2010
FIDELITY INS CO
General
27 Insurance Co. BAG000687200 06/02/2009 06/02/2010 $1,000,000.0005/26/2009
of Ameri
26 GENERAL INS BAG0005694 06/02/2008 06/02/2009 $1,000,000.00 05/28/2008
CO OF AMERICA 00
25 QUANTA BAG000384000 06/02/2007 06/02/2008 $1,000,000.0005/31/2007
INDEMNITY CO
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 9/24/2013
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03
M - • Up Front Parcel Reviev. LD l3'
Parcel 938100311
Printed: September 27, 2013 � SP ,D �,,0 �� y
-/�
ROBERT R PENNEL Site Address:
LEILANI PENNEL 304 SUNSET BLVD V,J (oc1—
BOX 129
BE -16E1)1-3
BEAVERCREEK, OR 970040 PORT TOWNSEND WA, 98368 _
Parcel Number: 938100311 S-T-R: 13-30N-02W Total Acreage 0
Legal Description CAPE GEORGE COLONY DIV 2 BLK 3 LOT 12 Land Use: 9100
Flood District: Fire District: 1 Planning Area: 2
Flood Map(FIRM)Panel No: ' School District 50 Zoning: jc? t
COMP PLAN
DESIGNATION:
COMMUNITY PLAN: UGA: UGA Trans
[ ] Plot plan states "property line"
[ ] Assessor's Map (Property lines on submitted plot plan must match the pnperty lines as identified on theAssessor's 1/4 map)
[ ] Legal Access to Property ›S,°. NO
[ ] Parcel Tags or Scanned Documents YES N_9-'
[ ] ESA's: Special Reports Nearby YES 1\1„C '
_-
[ ] Designated Ag YES NV
5 �I
[ ] Shoreline Designation: ES NO (g)ii ��'u 3
(�- �� �110��-
[ ] Shoreline Slope Stability:C NO 61 Cf , C'—/
Stream Type:YES Q1� ' '
Fish& Wildlife:YES NO/
Wetlands: YES NO
Rare Plants:YES N
Seismic: YES
Landslide: YES NC/
Flood: YES
Erosion: YES N_Of
Aquifer Recharge Area: NO XCX..,t, l t t 1_..eL--k-6).
SIPZ: none At Ris High Risk � /}-�4 if
CM none High Risk Moderate Risk Disconnected CMZ (J
Stormwater site plan submitted: ' o
[ ] Forest Lands: YES N
Adjoining Forest Lands: Commercial/ Rural/ Inholding
[ ] Mineral Lands: YES N9/
[ ] Agricultural Lands: YES NO
[ ] Archaeology: YES N9"
[ ] No Shooting Zone: YES NV
[ ] Stormwater: New Impervious Surface C)S;' Land Disturbing Activity L-'(`j 0 C s- ESA's
Stormwater Req's:Min Req#2 Min Req#1 #5 Min Req#1 thru#10 Engineering
[ ] Notice Provisions/Disclosure:Airport YES NO_— MRL YES NO,,— Forest Lands YES NO,.-
[ ] Landscaping Required: Yes N9
[ ] Parking Spaces Required NO a Other
f 1 Building Height: j�5' UBC Standard
[ ] Impervious Surface cove a percentage:
Resource Lands&Public: Rural Residential: O. Rural Inilial: Per UDC Sec 6.7
Rural Commercial: 60% Area of Building Coverage:60%in Rural Industrial Lands only
[ ] Total Building (s) Size:
RVC:20,000 SF CC: 5,000 F NC:7,500 SF GC: 10,000 SF All others:subject to septic&water constraints/None specified
[ ] Setbacks: Front: '1 0 'Left Side: s Right Side: c Rear:
Shoreline Setback:
LSHA Setback: /(
[ ] Road Classification: ((tf L-CE,
Road Approach: EXISTING NOT REQ'D RAP
[ ] SEPA Required: YES EXE1vIP
[ ] Flood Certificate:
� l
[ ] Existing Case(s)&Condition(s): ‘,j) ../J
Violations: Yes 1)l"^ {
[ ] Recorded Date of Subdivision: <3 f ,: � t `AFN f ' Over 5yrs=UDC
Plat Conditions: __ <5yrs=Plat Conditions on plat or Old Ordinance
[ ] Lots/Require Declaration of Restrictive Covenant YES , submitted: YES NO
[ ] UGA No Protest Agreement YES N rsubmitted: YES NO
[ ] Site Visit conducted YES N-
[ ] Require Final Zoning Approval YES NO
[ ] ADMIN: Setbacks entered in Permit Plan case N/A YES
New Parcel Tags entered in Permit Plan N/A YES
Special Reports Scanned N/A YES
Title Notes Updated
Parcel tags found for parcel 938100311
1.) WSRC Coaching - blackberry removal 05/13/2013
CAO
Parcel tags found for parcel 938100311
2.) WSRC Coaching - contractor referral --->JCHBA 07/16/2013
Other
Cases Associated with APN 938100311
Cases Name Review Type Status Planner
ADR09-00030 PENNEL F
Application Received: 4/16/2009 Permit Issued/Case closed: Case Finaled:
911 -SUNSET BLVD
RCVD & RTD REVISED SITE PLAN TO TLD 06/03/09 KAS
M LA09-00124
BLD13-00299 MLA09-00124 PENNEL P
Application Received: 9/24/2013 Permit Issued/Case closed: Case Finaled:
NEW SINGLE FAMILY RESIDENCE
PRJ09-00077 MLA09-00124 PENNEL P
Application Received: 4/16/2009 Permit Issued/Case closed: Case Finaled:
SPAAD
ZON09-00041 MLA09-00124 PENNEL 1 A
Application Received: 4/16/2009 Permit Issued/Case closed: 6/18/2009 Case Finaled:
SPAAD-Site Plan Advanced Approval Determination for residenfial development
SEP13-00107 PENNEL P
Application Received: 9/10/2013 Permit Issued/Case closed: Case Finaled:
Shoreline exemption for construction of septic system (and house).
\\tidemark\data\forms\R_Parcel_CRMLA.rpt 9/27/2013 Page 2 of 2
• DEVFJPMENT REVIEW TIME MEET
Date Time Comments '
q -7— 13 )94,0 . ( , e, 4?� .
AV 4 / 6 v/Cf1A— qt-p
\\tidemark\data\forms\R_MLT_Case_CRMLA.rpt September 18,2012
road . . Page 1 of 1
ADDRESS INFORMATION FOR 304 SUNSET BLVD
ROAD NUMBER:P165
ROAD NAME:SUNSET BLVD
ADDRESS:304
APT:
REAL MILE POST:.25 R
APPLICANT:PENNELL,ROBERT&LEILANI
ADDRESS CREATION DATE:04/21/09
PARCEL:938100311
LEGAL:CAPE GEORGE COLONY DIV 2 BLK 3 LOT 12
GRID:AA-3-D
FIRE DIST:1
ZIP:98368
POSTAL DISTRICT:PORT TOWNSEND
PLANNING AREA:2
VOTING DIST:
CEMETERY DIST:
HOSPITAL DIST:
SCHOOL DIST:50
WATER DIST:
SITE LONGITUDE:122.87915
SITE LATITUDE:48.09943
SITE COORDINATE TYPE:ENTRANCE
ACCESS LONGITUDE:0
ACCESS LATITUDE:0
MODIFY DELETE ADDRESS NAME SEARCH REPORTS
http://isserver/Address/RoadAddressDetail.asp?ROAD NUMBER=P165&ADDRESS=304 9/27/2013
BUILDING PERMIT APPLICIPION MLA09-00124
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD13-00299 Received Date: 9/24/2013
SITE ADDRESS: 304 SUNSET BLVD
PORT TOWNSEND, 98368
OWNER: ROBERT R PENNEL PHONE: 503-632-7289
LEILANI PENNEL
PO BOX 129
BEAVERCREEK OR 970040129 CAPE GEORGE COLONY DIV 2
SUBDIVISION: BIB 3 Lot: 12
PARCEL NUMBER: 938100311 Section: 13 Township: °' Range: 02 W
CONTRACTOR: SHIELDS/SMITH " 360-385-7156
260 KALA POINT DR
REPRESENTATIVE: t f yJ /p ��v _.
PROJECT DESCRIPTION NEW SINGLE FAMILY RESIDENCE
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,363
VALUATION 269,576.00 ADD'L: HEAT TYPE: HTP
CODE EDITION: 2012 HEAT BASE: 932 HEAT TYPE:
OCCUPANCY: UNHEATED: 300 #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: SHORELINE:
CONST TYPE: GARAGE: 500 SETBACK:
DECK: 80 BANK HEIGHT:
SEWAGE DISPOSAL: OSS
WATER SYSTEM: 11050
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: 2 Prop: 2
Total: 2 Total: 2
Routing Date:
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $2,217.00 MEB 09/19/13 145371
Plan Check $1,441.05 MEB 09/19/13 145371
State Building Code $4.50 MEB 09/19/13 145371
Potable Water Application $66.00 MEB 09/19/13 145371
Total: $3,728.55
Mirlcmerlr\rlefn\fnrn,c\C RI fl Ann Rlrl rn+ 0/2A/2(112
• Ilf,Ab I -5 - Vt 1
A4,5oN co JEFFERSON COUNTY
W ' \., 1" DEPARTMENT OF COMMUNITY DEVELOPMENT
"'' " ,` 621 Sheridan Street• Port Townsend •Washington 98368
-..� 360/379-4450. 360/379-4451 Fax
� p� www.co.jefferson.wa.us/commdevelopment
�SBING�S
Master Permit Application MLA:
Project Description(include separate sheets as necessary):
Tax Parcel Number. crt,8 'pp IN,t Pros e 11,MO (acref,quare feet) 0
Site Address and/or Directions to Property:
-so4 SU PoSer 12)1.4b. e7 . 9-rolvir..t,1 In/)4- �i'g 3 `
Property Owner(s)of Record: .�A� - L
Telephone: - "5 . J' .P, 111Iii a , Ito
Mailing Address: 1l; r T _ iiiiIt, .a. -1 .I. ,
Applicant/Agent(if different from owns): /tE4 5 /NC. • w, /
Telephone:+ '3 .:' t Fax: - email:dSI1/e/dS Cl 4wIt,S. e'f,
Mailing Address: 2 0 v0 . 10" ' '6650), Aes
What kind of Permit?(Check each box that applies
'wilding ❑Variance(Minor,Major or :-. ••-• - -• -
❑ Demolition Permit ❑Conditional Use[C(a),CO)�I. C l 11 \ /7 i
❑Single Family ❑Garage Attached/Detached ❑Discretionary"D"or Unna r{1 lJ
❑ Manufactured Home ❑ Modular ❑Special Use(Essential P Fa I 'lities)**
❑ Commercial* ❑Boundary Line Adjustmen
❑ Change of Use ❑Short Plat** , S c ' ; 9 t' 3
❑ Address ❑Road Approach ❑Binding Site Plan** i j
❑Home Business ❑Cottagelndustry ❑Long Plat** y U
lit:Propane 0 Planned Rural Residentia Devel•• - I.•E --mi I'll(� **
i• -•
❑Sign ❑Plat Vacation/Alteration ,� �;,, „y �_• *WENT
❑Allowed"Yes"Use Consistency Analysis ❑Shoreline Master Progra - -- vi . -
[3 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 Ad/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:
ESIGNATION OF AGENT
I hereby designate l"q,J� C ( to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE , .,.. _Al. _ ..j Date: °Atli`t L'
By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of
his,her or 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 info the County in writing at the
time of the appli .. '•n that e or she nts prior • 'ce.
Signature: .rte ' . �. Date: a, t1. 1
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-transfe e responsibility f adheri and comp g with the ESA. The Applicant has read this disclaimer nd signs and dates it below.
Signature: ` ' - NP-4-/a e, Date: �th I l• y
C:\Documents and Settings\carat\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc
BUILDER STATEMENT
The signer of this statement does her certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be assuming the res lity of the General Contractor for the proposed project.
Signature: Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
1�'Lt 1 St+it'1OS Irvc.. (36o)32S-115. (%o 515-'1113
MAILING ADDRESS: 024,p 1 LAO/. pr. D.. • Y, EMAIL:A shl aid S @ Ai V S• ..,
CONTRACTOR'S LICENSE WAINS
NUMBER: VeLL T 15 0 F NUMBER
ARCHITECT/ENGINEER: �' ' PHONE (3,,) / _• ., I 1 AX:( )
MAILING ADDRESS:760 Stijl /7 . %iit. • EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
Z. New , Wood Existing: p ❑ Sewer
❑ Addition ❑ Steel Proposed: YZ Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: . .. Height jiit Individual System
❑ Repair ❑ Masonry -�N�•r_ SEP Permit# 13'00101
❑ Demolition ❑ Other: Bedrooms: Water Supply:
y 1
Existing: Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: 2 Lit Public -. '
t k „IP Total: 2 (m4�et��
If this is a Commercial Prolect you must answer the following: G„p
Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces:
Number of occupants(includes owners,tenants,employees,etc) Current Proposed
IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No
If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply:
Underground Tank [1 Above ground Tank Size of Propane Tank:
❑Heat Stove ❑Cook Stove ❑Woodstove Q Fireplace Insert 0 Hot Water Tank ❑Pellet Stove ❑Other
Is this appliance being installed in a Manufactured/Mobile Home? Yes / No
When applying for a pennit to install a propane tank you must also submit a site plan showing all of the buildings,all property
lines,tank location and size,distances from the propane tank to all property lines,buildings and septic system components,
including the reserve area.
Square Footage Current Proposed For Office Use Only Amount Revision
Main Floor Heated EH Bld App Review. o'(�,
1 "31163 NI-hi.sz. -4
2"0 Floor Heated Consistency Review. 2--n 8
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C:\Documents and Settings\carat\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc
•
s JEFFERSON COUNTY I WE
rk DEPARTMENT OF COMMUNITY DEVELOPMENT �.
EP 192013
621 Sheridan Street•Port Townsend•Washington 98368
360/379-4450.360/379-4451 Fax JEFFERSON COUNTY
http://twAv.cojefferson.wa.us/cohundevelopment/ DEPT.OF COMMUNITY DEVELOPMENT
Stormwater Calculation Worksheet
MLA# PROJECT/APPUCANT NAME: 90,-5,0,7-
DETERMINING STORMWATER MANAGEMENT REQUIREMENTS:This stormwater calculation worksheet should be completed first
to classify the proposal as'small;"medium,'or loge.' The size determines whether a Stormwater Site Plan is required in conjunction
with a stand-alone stormwater management permit application,budding permit application,or other land use approval application that
involves stormwater review. The basic information will also be helpful for completing a Stormwater Site Plan,if required.
�/ •PARCEL SIZE(I.E..SITEI
I
Size of parcel Z` acres An acre contains 43,560 square feet. Fes/the acreage by this figure.
Size of panel at square feet l/000 scut
Land-disturbing activity is any activity that results in movement of earth,or a change in the existing sod cover(both vegetative and
non-veg )and/or the existing soil topogrra shy.. Land disturbing activities include,but are not Ranted to clearing, grading, Bing,
excavation,and compaction associated with stabilization of structures and road construction.
Native vegetation is vegetation comprised on plant species,other than noxious weeds,that are indigenous to the coastal region of the
Pacific Northwest and which reasonably could have been expected to naturally occur on the site. Examples include species such as
Douglas fir,western hemlock,western red cedar,alder,big-leaf maple,and vine maple;shrubs such as willow,elderberry,saimonberry,
and salal;herbaceous plants such as sword fern,foam flower,and fireweed.
,D ty l.i=1 ,. -.hr !r C• ,.!:.•j OF 1 _ ti•L. 4. • L,i,.�.'__ •
Calculate the dal area to be cleared,graded,fined, . Answer the following two questions related to
excavated,and/or compacted for proposed development conversion of native vegetation:
project include in this calculation the area to be cleared for
e- Does the project convert 34 acres or more of
Construction site for structures '2 Z0 sglt native vegetation to lawn or landscaped areas?
Drainfeid,septic tank,etc. ZOO Nat Circle: Yes (
Weft,utaities,etc. sg/ft Does the project convert 2 Yz aaes or more of
Driveway,poking,roads,etc. 0D0 native vegetation to pasture?
Lawn,landscaping, Circle: Yes No
etc. D 0 scot
Other compacted surface,etc. sglft Indicate Total Volumes of Proposed:
Total Land Disturbance — sq/ft Cut Fill / (cu/yd)
[over)
aomiwater talc Mcnnhea—REV.22&2008
• •
Impervious surface is a hard surface that efther prevents or retards the entry of water into the soil mantle as under natural conditions
prior to development. A hard surface area which uses water to run off the surface in greater quantities or at an increased rate of flow
from the flow present under natural conditions prior to development Common impervious surfaces include, but are not limited to roof
tops,walkways, patios,driveways, parking lots or storage areas,concrete or asphalt paving,gravel roads, packed earthen materials,
and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater.
STORMWATER CALULATIONS—IMPERVIOUS SURFACE
NE ILN EXISTING
Structures(all roof area) c w sglft Structures(all roof area) sq/ft
Sidewalks sq/ft Sidewalks. sgtft
Patios ,orb sq/ft Patios sq ft
Solid Decks sq/ft Sold Decks sq/ft
(without infiltration below) .� (without infiltration below)
r
Driveway,parking,roads,etc p�Dv sgfft Driveway,parking,roads,etc sq/tt
Other 4 sq/ft Other stet
Total New v sq/ft Total Existing *gift
TOTAL NEW+TOTAL EXISTING* 2t t1� *gift *This amount wilt be used to check total lot coverage.
The following questions will help determine whether the proposed project is considered development or redevelopment
DEVELOPMENT v.REDEVELOPMENT
Divide the total existing impervious surface above by the size of the parcel and convert to a percentage: / %
Does the site have 35%or more of existing impervious surface? Circle: Yes No
FURTHER INSTRUCTIONS: If the answer is yes, the proposal is considered redevelopment and the attached Figure 2 should be
used to determine the a nplicable Minimum Requirements. If the answer is no,the proposal is considered new development and the
attached Figure 1 should be used. At this juncture,the applicant should refer to the appficable Flow Chart to determine the Minimum
Requirements for stomnirater management. DCD staff wN help verify the classification of the project and the application requirements.
For proponents of 'small" projects who must comply only with lAnknh m Requirement #2—Construction Stormwater Pollution
Prevention--an additional sulmittal is not required. The proponent is responsible for employing the 12 Elements to control erosion and
prevent sediment and other pollutants from leaving the site during the construction phase of the project. Pick up the Construction
Stormwater Pollution Prevention(SWPP)Best Management Practices(BMPs) Packet Proponents of'mecum'projects—those
that must meet only Minimum Requirements #1 through #5—and for large' projects—those that must meet all 10 Minimum
Requirements—are required to stdxml a Storm ter Site Plan. DCD has prepared a submittal,termiate of a Stormwater Site Plan,
principally for rural residential projects. Complete the termlate in the Stonnwater Site Plan instructions and Submittal Template or
prepare a Stormwater Site Plan using the step-by-step guidance in the Stormwater Management Manual.
APPUCANT SIGNATURE
By signing the Stormwater Calculation Worksheet, I as the applicant/owner attest that the information provided herein is true and
correct to the best of my knowledge. I also certify that this application is being made with the hilt knowledge and consent of all
owners of the affected property.
( -OR .- REPRESENTATIVE TURF) (DATE)
stormy/star cat waicsheet-.REV.=WOOS 2
•
.0oN c.
X49 °�,� JEFFERSON COUNTY
. M DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street- Port Townsend•Washington 98368
360/379-4450.360/379-4451 Fax
`rl`IING http://www.co.jefferson.wa.us/commdevelopment/
Stormwater Site Plan Instructions and Submittal Template
"Medium" and "Large" Projects
[Includes Construction Stormwater Pollution Prevention Plan(SWPPP)and Permanent Stormwater Control Plan]
The submittal template for a Stormwater Site Plan has been developed from information presented in the Department of
Ecology 2001 Stormwater Management Manual for Western Washington (Manual), which is the set of stormwater
management standards for new developmeht and redevelopment in Jefferson County.
The Stormwater Site Plan, Minimum Requirement #1 in the Manual, is the comprehensive report containing all of the
technical information and analysis necessary to evaluate a proposed new development or redevelopment for compliance
with stormwater requirements. A Stormwater Site Plan is required for all°medium°and large"projects. (For background
information, refer to the Stormwater Management Information Sheet.)
The Stormwater Site Plan includes a Construction Stormwater Pollution Prevention Plan (SWPPP — Minimum
Requirement#2)that addresses sediment and erosion control during construction and a Permanent Stormwater Control
Plan that addresses stormwater on the project site in its developed condition through dispersion, infiltration, or, if
necessary,flow control and/or treatment facilities.
The steps for preparing and the content of a Stormwater Site Plan are summarized below and more fully described in
Chapter 3 of Volume I of the Manual. The attached submittal template is intended to be a format applicable to typical rural
residential construction. For these cases, completion and submittal of the template results in a complete land use
application.
THE TWO MAIN COMPONENTS OF A STORMWATER SITE PLAN
I. Construction Stormwater Pollution Prevention Plan
A Construction Stormwater Pollution Prevention Plan (SWPPP) is a document that describes the potential for pollution
problems on a construction project and which explains and illustrates the measures to be taken to control these problems.
The basis for requiring a SWPPP,the twelve elements required to be in a SWPPP,the suggested step-by step procedure
to follow, and the suggested Best Management Practices(BMPs)to follow, are all described in Volume II of the Manual.
A SWPPP consists of two sections, a narrative and the drawings. A description of the contents of the narrative and the
drawings sections, and checklists for each of these sections, are in Section 3.3 of Volume IL For typical rural residential
projects, DCD provides a Construction Stormwater Pollution Prevention(SWPP)Best Management Practices(BMPs)Packet
to assist with the preparation of the Construction SWPPP.
H. Permanent Stormwater Control Plan
A Permanent Stormwater Control Plan is a document that describes the basis for, and the means of implementing,
permanent Best Management Practices(BMPs)for flow control and treatment facilities after the project is completed. The
content of a Permanent Stormwater Control Plan is described in Section 3.1.5 of Volume I of the Manual. The permanent
BMPs and facilities for flow control and treatment are described in Volumes Ill, IV, and V of the Manual. The submittal
template is intended for rural residential projects that can fully disperse or infiltrate stormwater. The template may not be
appropriate or sufficient for applications involving larger or more complex projects.
stormwater site plan template.doc—rev.10/12/2003
1
•
INSTRUCTIONS
To prepare a Stormwater Site Plan,follow the steps outlined below,complete the Stormwater Site Plan template,sign and
submit together with the Master Land Use Application (MLA). This information may also be provided on other diagrams,
plans, studies, or attachments submitted with the project application. If so, please indicate such on this supplemental
permit application. As the template is designed mostly for rural residential development, it may not be as useful for a
larger project as an independently prepared Stormwater Site Plan. For any particular project, the Administrator may
waive specific submittal requirements determined to be unnecessary for review of the application.
Note: Prior to filling out the submittal template, read through these steps for preparing a Stormwater Site
Plan. Preliminary or draft versions of the individual components may be helpful in the case that
redesigning an original layout would result in a proposal that has less environmental impacts and is
significantly simpler in terms of meeting stormwater requirements. For example, if the proposal can
utilize the 'full dispersion'BMP(T5.30 in the Manual), there is no need to provide for flow control or
flow treatment on the site. For more information on the easiest way to meet stormwater
requirements, refer to the "Low Impact Development"Information Sheet BMPs used during the
construction phase and that are included in the Construction SWPPP may also be useful as elements
of the Permanent Stormwater Control Plan.
STEP 1: COLLECT AND ANALYZE INFORMATION ON EXISTING CONDITIONS
Collect and review information on existing site conditions, including topography, drainage patterns, soils, ground cover, critical areas,
adjacent areas, existing develdiment, existing stormwater facilities. The Jefferson County website provides an Internet Map Server
(IMS)function(http://www.co.jetferson.wa.us). If available,a Development Review Division(DRD)planner may be able to assist you in
collecting this information.
Analyze the information to determine site limitations,including:
• Areas with high potential for erosion and sediment deposition(based on soil properties,slope,etc.);
• Locations of sensitive and critical areas(e.g.,vegetative buffers,wetlands, steep slopes, floodplains, geologically hazardous
areas,streams,susceptible aquifer recharge areas,etc.);and
• The natural receiving waters to which the stormwater runoff either directly or eventually discharges.
This information will be useful in site design and in the compbation of the Permanent Stormwater Control Plan and Construction
SWPPP.
STEP 2: PREPARE PRELIMINARY DEVELOPMENT LAYOUT
Based upon the analysis of existing site conditions,locate the buildings,driveways,roads,parking lots,and landscaping features for the
proposed development Consider the following points when laying out the site:
• Fit development to the terrain to minimize land disturbance; confine construction activities to the least area necessary and
away from critical areas;
• Preserve areas with natural vegetation(especially forested areas)as much as possible;
• On sites with a mix of soil types, locate impervious areas over less permeable soil (e.g., till) and by to restrict development
over more porous soils(e.g.,outwash);
• Cluster buildings together,
• Minimize impervkxis areas;and
• Maintain and utilize the natural drainage patterns.
The preliminary development layout will assist in determining threshold discharge areas for calculating whether size thresholds under
Minimum Requirements#6,#7, and#8(for large' projects)are exceeded and as a basis for the drawings and maps required for the
Stormwater Site Plan.
stormwater site plan template.doc—rev.1W12/2003 2
•
•
STEP 3: PERFORM AN OFF-SITE ANALYSIS
This step is for"large" projects (i.e., adding 5,000 square feet or more of new impervious surface, converting a/. acres of pervious
surfaces to lawn or landscaped areas,or converting 2%acres of forested area to pasture)at the discretion of the UDC Administrator.
See Section 2.6.2 of the Manual for more information.
STEP 4: REVIEW THE APPLICABLE MINIMUM REQUIREMENTS
The Stormwater Calculation Worksheet is a required submittal for all development and redevelopment land use applications.
Completing the Worksheet helps determine the broad category of the proposal—"small," "medium," or "large" project—and the
applicable Minimum Requirements. "Small" projects need to meet Minimum Requirement#2 only. "Medium° projects need to meet
Minimum Requirements#1 through#5. °Large"projects need to meet all the Minimum Requirements,#1 through#10. The Minimum
Requirements are as follows:
1. Preparation of Stormwater Site Plans(Chapter 3 of Manual) 6. Runoff Treatment
2. Construction Stormwater Pollution Prevention 7. Flow Control
3. Source Control of Pollution 8. Wetlands Protection
4. Preservation of Natural Drainage Systems and Outfalls 9. Basin/Watershed Planning
5. On-site Stormwater Management 10. Operation and Maintenance
The Manual provides descriptions and instructions in Volume I,Chapter 2. Information sheets,application materials,and DRD planners
can help describe the Minimum Reqtarements to applicants.
Note: "Large" projects, as part of meeting Minimum Requirements #6 – Runoff Treatment – and #7 – Flow Control, are
compared to Table 2.1 and Table 2.2 in the Manual to determine whether on-site stormwater management BMPs are
sufficient or treatment facilities or flow control facilities are required. The flow control determination may necessitate use
of the Western Washington Hydrology Model managed by the Department of Ecology. Consult Sections 2.5.6 and 2.5.7
of Volume 1, Chapter 2 of the Manual for more information.
Again, the easiest way to meet stormwater requirements is to design the project so that natural drainage is preserved, impervious
surface is limited,and full dispersion(BMP T5.30)is implemented By using'low impact development"techniques in the site design,
the need for treatment and flow control facilities is eliminated, simplifying preparation of the Stormwater Site Plan and often the site
construction process itself. For more information on these techniques,consult the"Low Impact Development"Information Sheet.
STEP 5: PREPARE A PERMANENT STORMWATER CONTROL PLAN
Select stormwater control BMPs and facilities that will serve the project site in its developed condition. The selection process is
presented in Volume I, Chapter 4. After consideration is given to how selected BMPs and facilities fit within and serve the entire
preliminary development layout, the designer may want to reconsider the site layout to reduce the need for construction of facilities or
the size of the facilities by reducing the amount of impervious surfaces created and increasing the areas to be left undisturbed. The
Permanent Stormwater Control Plan should contain the following sections(Section 3.1.5 of Volume I,Chapter 3):
• Existing Site Hydrology(i.e.,the behavior of water on the site—above,below,and on the ground)
• Developed Site Hydrology (special requirements for projects and threshold discharge areas within projects that requirement
treatment and flow facilities)
• Performance Standards and Goals
• Flow Control System
• Water Quality System
• Conveyance System Analysis and Design
Essentially, in terms of site hydrology,the developed condition of the site should match the pre-developed condition,with is forested
land cover (unless reasonable, historic information is provided that indicates the site was prairie prior to settlement). For "large"
projects, totals of impervious sin-faces, pollution-+generating impervious surfaces, and pollution generating pervious surfaces must be
tabulated for each threshold discharge area for which on-site BMPs are the sole stormwater management approach.
stormwater site plan tenrplate.doc—rev.10/12/2003 3
• _ r •
STEP 6: PREPARE A CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN (SWPPP)
The Construction SWPPP for projects adding or replacing 2,000 square feet of impervious surface or more or clearing 7,000 square
feet or more(Le., "medium' or"large projects), must contain sufficient information to demonstrate to the UDC Administrator that the
potential pollution problems have been adequately addressed for the proposed project. An adequate Construction SWPPP includes a
narrative and drawings. The narrative is a written statement to explain and justify the pollution prevention decisions made for a
particular project. The narrative contains concise information concerning existing site conditions, construction schedules, and other
pertinent items that are not contained on the drawings. The drawings and notes describe where and when the various BMPs should be
installed, the performance the BMPs are expected to achieve, and actions to be taken if the performance goals are not achieved.
There are 12 Elements that must be considered in the development of a Construction SWPPP, unless site conditions render that
element unnecessary and the exemption from that element is clearly justified in the narrative. The 12 Elements cover the general water
quality protection strategies for limiting site impacts during c onstrnx tion and are described in detail in Section 2.5.2, Volume I of the
Manual.
The 12 Elements of Minimum Requirement#2,Construction Stormwater Pollution Prevention,are:
1. Mark Clearing Limits 5. Stabilize Soils 9. Control Pollutants
2. Establish Construction Access 6. Protect Slopes 10. Control De-watering
3. Control Flow Rates 7. Protect Drain Inlets 11. Maintain BMPs
4. Install Sediment Controls 8. Stabilize Channels and Outlets 12. Manage the Project
For ease of use, the Stornwater Site Plan submittal template below includes a section that lists the 12 Elements and provides the
opportunity to include sufficient information for rural residential and other relatively simple Construction SWPPPs. For more complex
projects,a separate narrative and set of plans may be preferred or required.
Volume II of the Manual is dedicated to Construction Stormwater Pollution Prevention. A step-by-step BMP selection process and a
complete description of the BMPs applicable to each element is provided in Chapters 3 and 4. Additionally, DCD provides a
Construction Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet that summarizes the 12
Elements and excerpts from the Manual sample sediment and erosion control measures for typical rural residential development. The
Packet should prove useful for completing the Construction SWPPP component of the submittal template.
On construction sites that infiltrate all stormwater runoff,the primary consideration in the preparation of the Construction SWPPP is the
protection of the infiltration facilities from fine sediments during the construction phase and protection of ground water from other
pollutants. On construction sites that discharge to surface water, the primary consideration in the preparation of the Construction
SWPPP is compliance with the State Water Quality Standards. The step-by-step procedure outlined in Volume II, Section 3.2 is
recommended for the development of these Construction SWPPPs.
STEP 7: COMPLETE THE STORMWATER SITE PLAN
The Stormwater Site Plan encompasses the entire submittal to Jefferson County in conjunction with a land use or building permit
application. The following documents or sections should be included:
• Project Overview
• Existing Conditions Summary
• Off-site Analysis Report(if required;usually for large projects)
• Permanent Stormwater Control Plan
• Special Reports and Studies(such as soil testing,wetland delineation,etc.,if applicable)
• Other Permits(approvals required by other regulatory agencies that include stormwater management conditions)
• Operation and Maintenance Manual(for each flow control and treatment facility,if applicable)
• Bond Quantities Worksheet (for performance bond or other financial guarantee for proper construction and operation of
construction site BMPs and permanent drainage facilities,if required)
The submittal template below is designed for rural residential and other relatively small or simple projects. For larger and more
complex projects--partic[.larly those that involve stormwater treatment and/or flow control—more information may be required and an
independent Stormwater Site Plan may be the preferable submittal format.
STEP 8: CHECK COMPLIANCE WITH ALL APPLICABLE MINIMUM REQUIREMENTS
A Stormwater Site Plan as designed and implemented should specifically fulfill all Minimum Requirements applicable to the project.
The applicant should review to check that these requirements are satisfied and that all information provided is true and correct prior to
signing and submitting the Stormwater Site Plan. (The signature box appears at the end of the submittal template.)
stormwater site plan tertplate.doc—rev.10112/2003 4
• • • S
N
°� JEFFERSON COUNTY
*C
DEPARTMENT OF COMMUNITY DEVELOPMENT
SOS 621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450.360/379-4451 Fax
-aNO'1 http://www.co.jefferson.wa.us/commdevelopment/
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# PROJECT/APPLICANT NAME: { (6".1 pa et.
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.
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Existing Conditions Summary
2. Describe the existing topography. Indicate contours on the site map.
/0/A) I
3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
4. Describe the existing soils. Indicate soil type on the site map.
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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.
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6. Describe any excess levels of noise generated by the proposed use or activity:
stormwater site plan teeplate.doc—rev.10/12/2003 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 location on the site map.
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.).
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 a lion 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 facilities on the site plan and differentiate proposed facilities from existing facilities.
FO Oct LPr t N ?T P',weu..s •
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 or projects that involve the potential for dispersion of contaminants.]
11. Describe the performance goals and standards applicable to the project.
12. Describe the flow control system.
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stormwater site plan template.doc—rev.10/12/2003 6
13. Describe the water quality system.
14. Describe the conveyance system analysis and design.
15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material.
16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code.
17. Describe the proposed surfacing material.
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18. Describe methods for restoration of the site.
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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 induded,list the Manuals
here.
20. List here and indude any special reports or studies conducted to prepare the Stormwater Site Plan.
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.
stoimwater site plan template.doc—rev.10112/2003
. .
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 Plan 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 section 2.5.2 of the Manual(beginning on page
2-15).
12 Required Elements—Construction SWPPP
1. Mark Clearing Limits.
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2. Establish Construction Access.
3. Control Flow Rates.
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4. Install Sediment Controls.
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5. Stabilize Soils.
6. Protect Slopes.
7. Protect Drain Inlets.
stormwater site Wan template.doc—rev.10/12/2003 8
• •
12 Required Elements—Construction SWPPP(continued)
8. Stabilize Channels and Outlets.
9. Control Pollutants.
10. Control De-Watering(the act of pumping groundwater or stomwater away from an active construction site).
11. Maintain Best Management Practices(BMPs).
12. Manage the Project.
�
2. Adjacent Areas.
a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, ands, residential
areas,roads).
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b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards).
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3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
stormwater site plan template.doc—rev.10/12/2003 9
• • • •
b. Description of special requirements for working in or near environmentally sensitive areas.
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. Construction sequence
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 construction schedule.
Sr ece- ' pod - l 5 -a, /14.01.4 IS
IL Wet Season Construction Activities.
a. Proposed wet season construction activities.
b. Proposed wet season construction activities for environmentally sensitive areas.
7. FinanciaUOwnership Responsibilities.
a. Identify the property over responsible s a initiation of bonds and/or other financial securities.
IOW totirt-b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impacts.
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8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable.
a Sediment Ponds/Traps.
b. Diversions.
c. Waterways.
d. Runoff/Stamwater Detention Calculations
stormwater site plan template.doc—rev.10/12/2003 10
M • •
SECTION II—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.doc—rev.10//22003 11
• S
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. .
(LANDOWNE OR AUTHORIZED REPRE ATIVE SIGNATURE) ATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
stormwater site plan template.doc—rev.1W12/2003 12
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Parcel Number: 938100311
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Owner Mailing Address: ?\. �"�'"'+�
ROBERT PENNEL
LEILANI PENNEL
PO BOX 129
BEAVERCREEK 0R970040129
Site Address:
304 SUNSET BLVD
PORT TOWNSEND 98368
Property Description:
CAPE GEORGE COLONY DIV 2 l BLK 3 LOT 12 I l I
North
Sunset 131 vd, 1" 20'
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Parcel Number: 938100311
Owner Mailing Address: ` ��
ROBERT PENNEL
LEILANI PENNEL
PO BOX 129
BEAVERCREEK 0R970040129
Site Address:
304 SUNSET BLVD
PORT TOWNSEND 98368
Property Description:
CAPE GEORGE COLONY DIV 2 I BLK 3 LOT 12 1 1 1
North
5u met et 131vd. I" = 20'
lev: + 105' 96.21' Hey: Io3'
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•
Jefferson County DCD Building Division
Correction Notice
PERMIT NUMBER 13 - 667-99
OWNER 4:11wJ L
JOB LOCATION 3.0 Lit �u/li 1 i Bt V p
Inspection of this structure has found the following violations:
1, ELOLJ£stz AIR -rtGpr YrST Cfre,tzT1 le ATE
D t- r T r ,
1 c7,47: '�j�F A 36.fcam'
�C�G L 444 t'a-•J�' I O ou fZ. O p lC.,e'
POD 11- 0-i A.l St= uJ 4t- n -C+t�N
4101°
You are hereby notified that no more work shall be done upon these premises until
the above violations are corrected, unless noted otherwise. When corrections have
been made, call for inspection.
Date q/5// ,�,�� _40
BUILDING DIVISION(360)379-4450 INSPECTION HOTLINE(360)379-4455
I THIS NOTICE MUST BE KEPT WITH APPROVED PLANS ON SITE
0 •
Jefferson County DCD Building Division
Correction Notice
PERMIT NUMBER 13 -29l
OWNER
JOB LOCATION `'O y ,ScINyA.fi
Inspection of this structure has found the following violations:
0 57Vi F 70P oP F✓xoizv c% .us /N ,S45 e rptc—w i7tt <iur✓x+s-ti•r
FMK. Xi/ 7aA°
® "bb //VSr)C4-7-ro,J <rt g1na t-ar97 6 /nJ$.4.41.0'4=0`17-.
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l
(") ii(
its(1p
You are hereby notified that no more work shall be done upon these premises until
the above violations are corrected, unless noted otherwise. When corrections have
been made, all for inspection.
Date S/3 /` Inspector
BUILDING DIVISION(360)379-4450 I PECTION HOTLINE(360)379-4455
THIS NOTICE MUST BE KEPT WITH APPROVED PLANS ON SITE
Jefferson County DCD Building Division
Correction Notice
PERMIT NUMBER 13- PO 29 9
OWNER 6A01101_
JOB LOCATION O 4 Su N 5 e.t, lj1...V.b
Inspection of this structure has found the following violations:
/..16-r 1444 n
You are hereby notified that no more work shall be done upon these premises until
the above violations are corrected, unless noted otherwise. When corrections have
been made, call for inspection.
Date za/4//3 Inspector
BUILDING DIVISION(360)379-4450 INSPECTION HOTLINE(360)379-4455
THIS NOTICE MUST BE KEPT WITH APPROVED PLANS ON SITE
����SO\ caG _.
ti JEFFERSON COUNTY
`' DEPARTMENT OF COMMUNITY DEVELOPMENT
Date: ! V' Time Received: /5— am/CO Mon. Tue. Wed. Thur. ri.7)
Date: 7-5-
BLD: i/e-02 9 9 Contact Name: 5� -
y�-�raryrs
Owner: Contact Number: 360 eD/
Address: gQ If c_5-JOVC-4. /3 C- 206
Notes: R,, ,,,)t;,/ S'/ ccpc/- rG
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
I
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Date. 2 i 'time received /PZ(:> (--1191 pm
Mon. Tue . y‘tecit- Thur. -
fp BED:
- • - •
OWNER: - . • Contact Name
-7/572-
-
ADDRESS: 36)'9 -(.5-0A ..4t7- e. Contact Number:360
- ..
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Notes: . .
• ., . 206 • , . ..
4-;-:
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.Foundatidn .Plumbibq - Framing Mechanical l
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Linder ground Furnace •
Footing Rough in --SZ Alr seal -..X1/4 Above ground . • Gas
Stemwall _ I'lydronic Exterior shear Exterior tines Oil
Straps __ Interior shear Interior lines • Ducts
-r•__-
Post Hole • - Ventilation . Appliance '•
' Underfloor
.. Gas/wood stove
Man-Hon-les ..
'
•
• Setbacks • Insulation. . •
. • - Final inspection -,-,!: •
Foundation.- . . • i7.:',;= - i:s)
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Block&Tie floor wall ceiling . Address Posted •
•
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, _
4w4sON _�°q. JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
9y+xINQ1°
Date: OP Time Received: ,Q:3f am/pm Mon. Wed. Thur. Fri.
Date: 1///
IP): 13 - 0014? Contact Name:
Owner: PnJet.r. Contact Number: 360
Address: 304 Sri,uE-r 81_140 206
Notes:
Foundation Plumbing Framing Propane Tank Mechanical
Setbacks Under-ground Framing Under ground Furance
Footing Rough In x 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
'4e i, coG JEFFERSON COUNTY f
fl
DEPARTMENT OF COMMUNITY DEVELOPMENT
Date: 3° Time Received: "-1,`5 �.. C /pm Mon. Tue. a,4We �) Thur. Fri.
Date: 3.
4 °- G t Contact Name: ,
�
Owner: Contact Number: 360
O
Address: - `(A c 0 206
Notes: °t° ,7, t
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
-Homes Insulation
Final Inspection
Setbacks Floor
Foundation Wall Address Posted
Block&Tile Ceiling
• Co
�4�w¢ IA JEFFERSON COUNTY
4. DEPARTMENT OF COMMUNITY DEVELOPMENT
9gyINGI-
Date: 1y�.if Time Received: �',2/ p
�� pm Mon Tue. Wed. Thur. Fri.
1l Date: ,?)Z
BLD: 13 - (WI vl Contact Name:
aner: Contact Number: 360 5-- -7
ctress: '. 0 SUS ` 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
¢g ON CO
wow° % JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
9s
Date: ? g Time Received: .'-7) am/ Mon. Tue. Wed. Tf►ur< Fri.
Date: . -
BLD: ," -255 Contact Name:
Owner: 1. ,, d, Contact Number: 360 ,, ,
dress t r 1 , ,, 206
Notes: ‘ . (.. gin'
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
- ' • "
• .
. . -
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. •
. -
. . - . ..r.- .
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. Date \27 e) 'time received 10 , Icam / pm Mon. Tue . YVed:
Date: I
OWNER: "el V\ 0.ess....A c.4 . . - Contact Name.:
.
ADDRESS: _______ K ..
Contact Number.360 SEC-7( Ch
, ,......., .
..
Notes: • .
. •
. • . - •
Foundation mbing. - Frnln V Propane Tank Mechanical ,•
. . .•
Setbacks Under-ground Framing Under ground Furnace
Footing _ 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 . Gas/wood stove
0 Man-Homes
Setbacks . Insulation V Final Inspection -..,
• Foundation
--.'
Block&Tie floor _wall ceiling. • Address Posta
- s
„oN co
,��w o. JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
�gstirN6c-
Date: (21 c Time Received: am/pm Mon. Tue. d. Thur.
Date: 19--( b
BLD: ! ” Contact Name: f r f
ner: Pe-Er 6-nr') S S Contact Number: 360 -)o l -- * c:', I q fo
Illikess: 3i'4 S-IA r)S-P 4 8( V l7 206
Notes: —1711- A-Thiyii-2eA -0 (6-e., 1-1 a 1 v,Q) " 1-7c14(5 ryli £ 0 41)x ,
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
-- ■■ . .. .. i.m.mimimimm.mmummimmmimminummi...................
. '
•
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-49.
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• ......,- .
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- -
. -4.1 s.1• -
. -
. . _. .
•
• Date f Z.^ tg time received q 44 —0 0, pm Mon. Tue . Wed: Thur. 0 -
BLD: 13- 2• 9 , • . Date: 17 —2-0 "
OWNER:
Contact Namec
- - •
ADDRESS: 30 4-1 6-0 to s....1- Contact Number:360
-,-_,-,
206
II
Notes: - _
.
i"-
' .
. .
Foundation Plumbing - Framing • . Propane Tank- - Mechanical
..
. .
Setbacks Under-ground Framing Under ground Furnace
Footing Rough in Air seal Above ground Gas
Sternwall -- Hydronic Exterior shear Exterior lines _ Oil
Straps Interior shear Interior lines . Ducts
Post Hole
7
-
Ventilation Appliance
Underfloor - Gas/wood stove
•
• Man-Homes
•
Setbacks • Insulation. . •
Final Inspection
.
- Foundation- - -
Address Posted
floor wall ceiling
Bloc &Tie
i
■
�4w4sON.°oz� JEFFERSON COUNTY
*moo
DEPARTMENT OF COMMUNITY DEVELOPMENT
'NI 146
Dili: ,26 Time Received: T'd`°` /i/,b ar pm Mon. Tue. Wed. Thur. ri.
Date:
BLD: / 3 c ? Contact Name:
Owner: Contact Number: 360 5-7456
Address: 30`/ .5-0/0w- &Ai 206
Notes:
Foundation Plumbing Framing Propane Tank Mechanical
Setbacks X 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
.`"w4`SON c0°2 JEFFERSON COUNTY
Q ..
DEPARTMENT OF COMMUNITY DEVELOPMENT
9gwr Nc,„°
Date: f—2/ Time Received: 2 3 L am410 Mon. Tue. ed. Thur. Fri.
Date: /--LZ
• ,?' Q9 Contact Name:
Owner: Contact Number: 360 „5"---- 7/
Address: 3a c/ G.Svt,,Sit7` .8'L(144 206
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
_ _
en-Homes Insulation
Final Inspection
Setbacks Floor
Foundation Wall Address Posted
Block&Tile Ceiling
ak. ON `e, JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
qsk ,
Date: 3) (0 Time Received: (0 (c ( r /pm Mon. Tu Wed. Thur. Fri.
Date: "(I I
• u3— AR4 Contact Name:
Owner: Contact Number: 360 ' 35 7/S(('
Address: '30-F -3.1/491.k._'C 206
Notes: &L.) B
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
On-Homes Insulation
Final Inspection
Setbacks Floor
Foundation Wall Address Posted
Block&Tile Ceiling
Jerson County Building Ulv•
ision Permit Ater er: BLD13-00299
Applicant: PENNEL
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 e2
Erosion Control 4/6111/
Foundation Footing L2--6—/S ��
Footing Drains
Foundation Stem Wall r' _(j,„( rUNtArico Fx—ro.74 torte i tiv7 I1. �C
Underground Plumbing 20,t �1
Under Floor Framing
Straps(hold downs)
Ext. Shear Wall Nailing I_ZZ-1 { Q..-
Rough-in Plumbing 2,1111 � (f
Framing Z4t, fit N aS
Blocking
Airseal ti /1
Insulation:Walls
6/ty (.16 1,66k
Insulation:Floors 9/511
31
Insulation:Ceiling
q/s/«r
Int.Shear Wall Nailing 3)5 1,4 �G-
Wallboard Nailing /ii lLJ F 13 Gas Line: Interior
).)/At
Gas Line:Exterior lVijik
Propane Tank l3
Heat/Chimney Clearance 14/4-
Mechanical Systems q/51/If
Duct Test Cert l
Blower Airtight Test
Smoke&CO2 9l.5JI4
Drywell/Alt Drainage Frripi2 O fA. .�
Nfrel 1 6i; *4M pek_pn ry/ot bo-
Address Posted 6t 1'1
• •
FINAL INSPECTION 9.11-11,i
FINAL INSPECTIO MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
CONDITIONS for Building Permit# :BLD13-00299
1.) The project shall adhere to the Best Management Practices(BMPs)to control stormwater,
erosion and sediment during construction. BMPs shall address permanent measures to
stabilize soil exposed during construction, and in the design and operation of stormwater
and drainage control systems.
2.) The site plan, as submitted with the building application on September 19, 2013, has been
reviewed for consistency under the UDC, and has been approved by Jefferson County
Department of Community Development. Any modifications, changes, and/or additions to
the stamped, approved site plan dated September 27, 2013 shall be resubmitted for
review and approval by Jefferson County Department of Community Development.
3.) This project was reviewed and approved as a Shoreline Exemption under under JCC
18.25.090(5).
4.) dlf
\\tidemark\rlataWnrms\F RI 1) PArmit Rlrin rnt 11/7/9n11
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT#: BLD13-00299 Received Date: 9/24/2013
SITE ADDRESS: 304 SUNSET BLVD Issue Date 11/7/2013
PORT TOWNSEND, 98368 Expiration Date 11/7/2014
OWNER: ROBERT R PENNEL PHONE: 503-632-7289
LEILANI PENNEL
PO BOX 129
BEAVERCREEK OR 970040129 CAPE GEORGE COLONY DIV 2
SUBDIVISION: Block: 3 Lot: 12
PARCEL NUMBER: 938100311 Section: 13 Township: 30 N Range: 02 W
CONTRACTOR: SHIELDS/SMITH PHONE: 360-385-7156
260 KALA POINT DR
PROJECT DESCRIPTION: NEW SINGLE FAMILY RESIDENCE - BUILDING AND SHORELINE
EXEMPTION PERMITS
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,363
VALUATION 269,576.00 ADD'L: HEAT TYPE: HTP
CODE EDITION: 2012 HEAT BASE: 932 HEAT TYPE:
OCCUPANCY: UNHEATED: 300 #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: 500 SHORELINE:
CONST TYPE: DECK: 80 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: OSS
WATER SYSTEM: 11050 Type Amount Paid By: Date: Receipt:
BEDROOMS: BATHROOMS: Permit $2,217.00 MEB 09/19/13 145371
Exist: Exist: Plan Check $1,441.05 MEB 09/19/13 145371
Prop: 2 Prop: 2 State Building Code $4.50 MEB 09/19/13 145371
Total: 2 Total: 2 Potable Water Application $66.00 MEB 09/19/13 145371
Total: $3,728.55
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