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HomeMy WebLinkAboutBLD2013-00132 • •BUILDING PERMIT APPLICON BLD13-00132 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00132 Received Date: 4/23/2013 SITE ADDRESS: 363 POCKET LN PORT TOWNSEND, 98368 OWNER: APRIL SURGENT PHONE: 206-948-8075 ZACHARY HINDERYCKY 4214 SOUTH FINDLAY ST SEATTLE WA 98118-2409 SUBDIVISION: Block: A Lot: 16 PARCEL NUMBER: 002242018 Section: 24 Township: 30 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION SFR WITH ATT CARPORT TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,800 VALUATION 70,000.00 ADD'L: 272 HEAT TYPE: EEE CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: 598 SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: 05783 BEDROOMS: BATHROOMS: Exist: Exist: Prop: 1 Prop: 1 Total: 1 Total: 1 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,727.35 JLA 04/22/13 142011 Plan Check $1,122.78 JLA 04/22/13 142011 State Building Code $4.50 JLA 04/22/13 142011 Potable Water Application $66.00 JLA 04/22/13 142011 Total: $2,920.63 11+Irlcmerle\An+alfnrme\ RI n Ann Rid rn+ A/74Y)l112 • • f r, DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street,Port Townsend,WA 98368 Tel:360.379.4450 I Fax:360.379.4451 Web:www.co.jefferson.wa.us/communitydevelopment 5>ft `} 0 E-mail:dcd @co.jefferson.wa.us CERTIFICATE OF OCCUPANCY PERMIT#: BLD13-00132 APPLICANT: APRIL SURGENT PHONE: 206-948-8075 ZACHARY HINDERYCKY 4214 SOUTH FINDLAY ST SEATTLE WA 98118-2409 SITE ADDRESS: 363 POCKET LN Issue Date: 05/7/2013 • PORT TOWNSEND, 98368 Final Date: 9/10/2014 SUBDIVISION: Block: A Lot: 16 PARCEL NUMBER: 002242018 Section: 24 Township: 30 N Range: 2W PROJECT DESCRIPTION: SFR WITH ATT CARPORT THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009 EDITION. OCCUPANCY GROUP: TYPE OF CONSTRUCTION: SPRINKLER SYSTEM yes no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 9/10/2014 \\tidemark\data\forms\F_BLD_Occupancy.rpt 9/19/2014 studio tb 12515 NE 132ND CT.#A203 I.P. `CLARK' KIRKLAND,WA 98034 (BENT) 5.4' NORTH 329.99' S 88°43'54"E (206)852-8029 P TRA r ic�,ryd LP. 'CLARK' -- __"'� R S 88°43'54_E 32999' 4.S' NORM POCKET LANE /111/811111111111111/M/11111ra- - -- __ I -- __ � K---. I/�/ LP. IN TREE N -_ AV 1.,,,,A, ,,,...,.. ififf i�' • I ILiih I c' #11--I. 1% *lop 111111, c:, ∎O =,-7:.;,,'‘s,`''.: pitiP---'. - - ._:,. ti en I �I c. I Niiictra C y i r� Q I *lor 1 1 `-- ,I W I jig \ 3 I ' I ,,i I I 228 I-- • I p 28C i o eL 34C I II I w Ic4 �, 1 ' SOl1iFl EDGE GRAVEL Z i I '` 1 I I I 1— 1 I W I I °° ' 1 p V Nr I 0 Pi I il T n''''' kt- a_ § I1 M � N' 1 01 0 < I I vJ I I W `I 121- U 3I1 N I o O I IO Q INI II, z°N II I I I W �p N. I N N , I 1 I I I I I 0 ' I 1I � 1 1 I ' I I I I � I 1I N I II 1 , PROPERTY TAX ID: #002242018 1 II I LOT SIZE: 5.12 ACRES di:,' BUILDING FOOTPRINT: 1800 S.F. w I1 GRAVEL DRIVE: 1677 S.F. I 1 1 CONCRETE PADS: 633 S.F. ' I I ROOF AREA: 2984 S.F. 1 I J I 1 CONDITIONED FLOOR AREA: I 1 MAIN FLOOR 1800 S.F. I LOFT 194 S.F. 1 1 I TOTAL 1994 S.F. 1 I ' ii11 I ir -\ A , L �- Q r °0 \ 4.15.13- - - -__ - - - - - - __ y 330.00' N 88°57'33"W SITE PLAN N t �' " 1 FULL SITE PLAN . .,. I. SCALE: 1" = 50' AOa �. _� � studio tb ., 12515 NE 132ND CT.#A203 ,,.:... W Et o KIRKLAND,WA 98034 z o i Q (206)852-8029 M�! Da $ � a ---' w. 0,04 (-NJ , _iigh C� C_ J u a :• _ J Z cc o w r a wH� WO `) Q M CO U W m z-, m-�O 0- Lc) ON WN NO yrj aN} Iaa 3aa°, 3 > Q VI CO 0oa 0�a Z I\ 0 / \ -{ .�. 9 _ _ min uwru :0 40'-0" S� 13£� W Cr i \ 3NI1 . CD O z� 2131dM ��'` � NNW"' Nei L.LJ LLI I I:lt :::: liv W \ V N Ee V \ 0 0 C7 w� / M . 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O 0 goco CN w a pO� cew O _ I"I- Q w O � VwZ ^ wa� Z m in p OZ Hi# c3 UO O w O m 0x O o [I .^ CO o � 0 in La O 0 m 0 J ce >-- ' . o. co in O Oo w a o u ~ CL O ° z vi Vw a � O U ° w m Uv~i > o _ Li 1 , a-0\_ Q ..._ o ��0 X ea N 3 _. o•-1-- c.., x I- plvq- - -a i . ,, O �� c „tr.,. . , IMO 0 0 v X NO en w w / — O • a 47.-.6 O Ou ,-0-,tl .--; ,1-37 L it 0 w o r'ma � a 0_ V N O =� O N Z� N wN0Z N J.,rV r...-u_Zp= N Q-- oZm3 a �Oaz -- �k-8Ow w • "ga a !Ai r � m Zgw W �U' I�l� r- m O>_00 O OZ>1-00 c, u � C--?, r l > o c ,, N 1 e- r z1 i LI C4 0 • L,) ,3—► ; z.. i ''pN 0 JD EE COUNTY ••LE-,— W `� DEPARTMENT OF COMMUNITY DEVELOPMENT C__9 [F_'-',.7.._, r� I" `- 621 Sheridan Street• Port Townsend • 983. < Washington 9 6 ' 360/379-4450 • 360/379-4451 Fax Lww.co.jefferson.wa.us/commdevelopmen U 1 AIN p !J Master Permit Application MLA:JEIFFRSON COUNTY r l umuwansnonnkusda Project Description(include separate sheets as necessary): ATT 041<eiroe�T Tax Parcel hfumber: 007-2 4 2 0 I $ Property Size: �0 1�„ - 2*/ eios',N;res/square feet) t Site Address and/or Directions to Property: 34, 3 f 0c-K i LA-►)t✓ i Po 2T rou.l,J S COP Property Owner(s)of Record: 2-&44srt2"( l-Ft DefzY Gk ■ •t- ,t e-t.. EST Telephone: lob,g 48.SO 5 Fax: email: 7.414,14443 ewe ld e-r 'E ,pct, Mailing Address: 42-I4 S, F loop.,4' SL 5rGitTT1-$ Its/Pt Ct ri,g' Applicant/Agent(if different from owner): tt n. SSuir—forer.lT Telephone:Scmo. 3•4-1• qQ9 I Fax: >' email: Jasa,r9 cve} a►ups h•C Mailing Address: I ADC EreIFF rrti Poe w rr ta-D • N_oQU 4/kNr) WA, citg 3s 7 What kind of Permit?(Check each box that applies ❑Lot or Road Segregation ' Building ❑Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use) X Single Family la Garag- —glre etached ❑Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home .❑ Modul„ - - ❑Discretionary"D"or Unnamed Use Classification ❑ Commercial* ❑Special Use(Essential Public Facilities)** ❑ Change of Use ❑Boundary Line Adjustment ❑ Address ❑Road Approach ❑Short Plat** ❑ Home Business ❑Cottage Industry ❑Binding Site Plan** ❑Propane ❑Long Plat** ❑Sign - ❑Planned Rural Residential Development (PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration** ❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions** ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development** ❑Temporary Use ❑Shoreline Management Variance ❑Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District Map Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment *May require a Pre Application Conference ❑Tree Vegetation Request "Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I hereby designate 1-11.4 S V R17 , to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE ///� . ■ , ,, �_,Lisua Date: 2, .1. . 13 ( By signing this application form,the owner/agent-attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or its knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or-in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application th- •e or she w•nts p'. -- ice. ) gnature: �/' �� r Date: f-, "1-i 13 ✓✓'11The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual ' and non-transferable res.o sibility for a. erin ' • complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. ignature: �/� __ - ,� -' Date: 2-r , 13 G:\PexmitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc • .. ____, III BUILDER STATEMENT 1 , \jr) - _ L= \ . r- The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors an h 1 I ,they will be assuming responsibility of eneral Contractor for the proposed project. i E , I 1 1 t, ;I signature: _/ir/� —■, ■� ` Date: 2 r Z., (3 �' I l / GENERAL CONTRACTOR OR MANUFA RED HOME INSTALLER: PHONE: J ,1 FAX: JEFFERSON r' NTY 0 wNEEe-S (�) `i�kt,68S_5 DERT.O�COMF l 1 /ELO°RMENT MAILING ADDRESS: 4 24 4 5, GI INN Qyt4-N SA. 5eP1'ritE In/A EMAIL: ZOtIf-19.e-W4aleir Aka; I. LdWI CONTRACTOR'S LICENSE a ri tir WAINS NUMBER: N`A NUMBER ARCHITECT/ENGINEER: NIA PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: New ' Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: I Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: I _ Height: Cil Individual System ❑ Repair ❑ Masonry SEP Permit# 5ep t2--00000► ' O Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: I )o;,Public E 6-C�tr t G Total: I Name of System: P U 0 If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No . If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: 1 Underground Tank 1 Above ground Tank Size of Propane Tank: j Heat Stove j Cook Stove j Woodstove I Fireplace Insert I Hot Water Tank j Pellet Stove I Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines,tank location and size,distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. _ Square Footage Current Proposed For Office U ,= y -_ Atli-►u lt; evisio Main Floor Heated 1 EH Bld App Review: i46c0CQ t 73 2"°Floor Heated ( l„d;F r) Z}2 set 4 `, Consistency Review: �ap Other Heated `P Base fee: O , Mezzanine Additional Section: Heated Basement Plan Check fee: f Unheated Basement State Surcharge fee: SD Other Unheated Pot Water Review fee: 0(9 Garage/ •rpo P SUBTOTAL 3 0�)(e 103 (mss afll;!p©g-l a 3 t 911/Rd Approach fee: Other TOTAL: $',a(Q(p-(¢3 AI th . 'e• -eceipt Number: (41 o f ill ...4141111 Cash/Check Number: STIMATED COST(REQUIRED Date: "4(aa-13 •Fair market value of all labor•n• u- -vials foundation to finish ~- Initials: col opt) . o� °-.6.------- G:\PemtitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc • 1 • IIP J t. , I ' .„0 ,,, 4, JEFFiM l'C3Utd-Y [)TT Or C r f r ;, �Jn!1o.erN 0 l;��r�� � r..,,G �tiT 36" HIG MUST P OF4"S r—36" HIGH GUARD RAIL, ��DC'� vt't 0 / MUST PREVENT PASSAGE OF 4"SPHERE LOFT IPORTION OF LOFT > 5'-0"CLG. 159 S.F. ,41At s PORTION OF LOFT > 7'-0"CLG. 35 S.F. MN III IN LOFT PLAN N-E--f) SCALE: 1/4" = 1' - 0" 1 . * i J r,� :CU 1} Lam- '7 L L I '\'� n , , I Jrr�il: i'�TY �� ` 36" HIG MUST P OF 4"S '�y� 36" HIGH GUARD RAIL, a" D�`�C� MUST PREVENT PASSAGE OF 4"SPHERE LOFT / PORTION OF LOFT > 5'-0"CLG. 159 S.F. liWt 1IF PORTION OF LOFT > 7'-0"CLG. 35 S.F. N-EDLOFT PLAN SCALE: 1 /4" = 1' — 0" • STRATUM GROUP P.O.Box 2546,Bellingham,WA 98227 Phone(360)714-9409 1 r i L `\\/� September 13,2012 L ? _— E I Jim Surgent 1265 Griffith Point Rd /L ;� L„ Nordland, WA 98358 JEFF CO, ,Ty er Re: Geology Hazard Assessment Parcel#002242018 Pocket Lane,Jefferson County,WA Dear Mr. Surgent I visited the property in July to assess the geology hazard of subject property. It is my understanding that a home is proposed to be built on the north portion of the property between Pocket Lane and a low area that angles across the central portion of the site. It is my opinion that the proposed home site not at risk from landslides or erosion and that the entirety of the northern portion of the property is not at risk from landslides. SITE GEOLOGY The Geologic Map of Northeastern Jefferson County, Washington(Gayer, 1976) indicates the site is underlain by Vashon Age glacial till. The Geologic Map of the Port Townsend South and Part of the Port Townsend North 7.5-minute Quadrangles, Jefferson County Washington (Schasse and Slaughter,2005)mapped just to the east area and indicates glacial till in the same locations as Gayer(1976). The till was deposited directly by glacial ice during the last glacial period approximately 20,000 to 14,000 years ago. The till consists of poorly sorted mix of clay to cobble sediments. Observations on the subject property including test pits are consistent with the mapping described above.The site is underlain by very compact silty sand and gravel that is very poorly sorted. Topography on the site and vicinity indicates valleys that were likely eroded by glacial melt water during the late stages of the last glacial period. While some water may very periodically flow or collect in these alleys including on the subject property,the valleys are remnant features from a time when the glacial ice margin was located very near the subject property to the east. SPECIFIC SITE OBSERVATIONS The property consists of an overall very gently sloping land from Pocket Lane on the north side of the property to a slope that slopes down to a topographic valley that angles across the mid section of the property. This gentle slope area is somewhat undulating and is covered by a thick forest of mature trees. Soils underlying the site consist of topsoil underlain by very hard compact • • September 13,2012 Pocket Lane Property,Discovery Bay,WA Geology Hazard Assessment silty sand gravel consistent with glacial till. The slope down to the bottom of the valley is approximately 15 feet high and slopes at an overall angle of 30 degrees or less. Other than very minor soil creep and root throw from past tree toppling there is no significant slope movement. The valley bottom has some wet areas but no well defined stream flow channel and no erosion taking place. CONCLUSIONS AND RECOMMENDATIONS Based on my visual inspection of the subject property and vicinity,review of available eolo is g g literature and maps,and review of LiDAR imagery y I conclude tha t there is no landslide risk on the subject property. Slopes are gentle enough that other than minor soil creep on the steeper slope,no slope movement should be expected. The home should be founded on native undisturbed soils below the upper organic layer.Depth compact glacial till should be on the order of 2 feet or less. Some deeper areas may be present due to past toppled tree roots filling in deeper depressions so foundation excavations should extended down to native bearing soils throughout the foundation foot print. The home can be placed up to and even on the slope down to the valley as long as the foundation is placed on the native glacial till and the base of the foundation is located 5 feet horizontally from the slope. This is not a geology hazard setback,but is to avoid differential settlement of the foundation. Stormwater can readily be infiltrated into the ground surface through infiltration/dispersion methods such as dispersion trenches or splash blocks. If conditions appear different than those described in this report,or other concerns arise,we request that we be notified so we can review those areas and modify our recommendations as required. We appreciate the opportunity to be of service to you. Should you have any questions please contact our office at(360)714-9409. Sincerely yours, to, 4►. . S m Group 0 McShane,M.Sc.,L.E.G. ,r r Licensed Engineering Geologist ; 1 g g gi �,.c � Daniel McShane Stratum Group 2 File:7,5.10 • • #5°N coy, JEFFERSON COUNTY 8 C ( DEPARTMENT OF COMMUNITY DEVELOPMENT ,/ ; ' _ 621 Sheridan Street • Port Townsend •Washington 98368 1 ===:/ XmdeveIopmenU u u !ent/ IEFr"E TY VDT Stormwat er Calculation Worksheet , g-t MLA# PROJECT/APPLICANT NAME: Aci.t.AtiQ'-f pit,.ex('c�x 4 6uRt E1 T DETERMINING STORMWATER MANAGEMENT REQUIREMENTS: This stormwater calculation worksheet should be completed first to classify the proposal as "small,""medium,"or"large." The size determines whether a Stormwater Site Plan is required in conjunction with a stand-alone stormwater management permit application, building permit application, or other land use approval application that involves stormwater review. The basic information will also be helpful for completing a Stormwater Site Plan,if required. PARCEL SIZE(I.E.,SITE) Size of parcel (2. acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet Z2.7 al O5 _sq/ft Land-disturbing activity is any activity that results in movement of earth, or a change in the existing soil cover(both vegetative and non-vegetative) and/or the existing soil topography. Land disturbing activities include, but are not limited to clearing, grading, filling, excavation,and compaction associated with stabilization of structures and road construction. Native vegetation is vegetation comprised on plant species, other than noxious weeds,that are indigenous to the coastal region of the Pacific Northwest and which reasonably could have been expected to naturally occur on the site. Examples include species such as Douglas fir,western hemlock,western red cedar, alder, big-leaf maple,and vine maple; shrubs such as willow,elderberry, salmonberry, and salal; herbaceous plants such as sword fern,foam flower, and fireweed. LAND DISTURBING ACTIVITY,CONVERSION OF NATIVE VEGETATION,AND VOLUME OF CUT/FILL Calculate the total area to be cleared, graded,filled, Answer the following two questions related to excavated, and/or compacted for proposed development conversion of native vegetation: project. Include in this calculation the area to be cleared for: Does the project convert g acres or more of —Construction site for structures 2.14/3 sq/ft native vegetation to lawn or landscaped areas? Drainfield, septic tank,etc. sq/ft Circle: Yes Well, utilities,etc. sq/ft Does the project convert 21/2 acres or more of native vegetation to pasture? Driveway, parking,roads,etc. j 6 77 sq/ft Circle: Yes No Lawn, landscaping, etc. I 0 0 sq/ft Other compacted surface, etc. sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance 5j j I 0 sq/ft Cut 100 Fill 5V (cu/yd) [over] stormwater caic worksheet Rev 9-9-2010—REV.9/9/2010 1 • • Impervious surface is a hard surface that either prevents or retards the entry of water into the soil mantle as under natural conditions prior to development. A hard surface area which causes water to run off the surface in greater quantities or at an increased rate of flow from the flow present under natural conditions prior to development. Common impervious surfaces include, but are not limited to roof tops, walkways, patios, driveways, parking lots or storage areas, concrete or asphalt paving, gravel roads, packed earthen materials, and oiled, macadam or other surfaces which similarly impede the natural infiltration of stormwater. STORMWATER CALULATIONS–IMPERVIOUS SURFACE NEW EXISTING'• Structures(all roof area) 291.1. sq/ft Structures(all roof area) 631 sq/ft Sidewalks sq/ft Sidewalks 0 sq/ft Patios sq/ft Patios sq/ft Solid Decks sq/ft Solid Decks sq/ft (without infiltration below) 1/ (without infiltration below) Driveway, parking, roads, etc Yt7� sq/ft Driveway, parking, roads,etc 0 sq/ft Other sq/ft Other V,.., sq/ft Total New L i l6 1 sq/ft Total Existing sq/ft TOTAL NEW+TOTAL EXISTING* y) 66 1 sq/ft *This amount will be used BY STAFF to check total lot coverage. The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT v. REDEVELOPMENT Divide the total existing impervious surface above by the size of the parcel and convert to a percentage: % Does the site have 35%or more of existing impervious surface? Circle: Yes No FURTHER INSTRUCTIONS: If the answer is yes, the proposal is considered redevelopment and the attached Figure 2 should be used to determine the applicable Minimum Requirements. If the answer is no, the proposal is considered new development and the attached Figure 1 should be used. At this juncture, the applicant should refer to the applicable Flow Chart to determine the Minimum Requirements for stormwater management. DCD staff will help verify the classification of the project and the application requirements. For proponents of "small" projects who must comply only with Minimum Requirement #2—Construction Stormwater Pollution Prevention—an additional submittal is not required. The proponent is responsible for employing the 12 Elements to control erosion and prevent sediment and other pollutants from leaving the site during the construction phase of the project. Pick up the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet. Proponents of"medium" projects—those that must meet only Minimum Requirements #1 through #5—and for "large" projects—those that must meet all 10 Minimum Requirements—are required to submit a Stormwater Site Plan. DCD has prepared a submittal template of a Stormwater Site Plan, principally for rural residential projects. Complete the template in the Stormwater Site Plan Instructions and Submittal Template or prepare a Stormwater Site Plan using the step-by-step guidance in the Stormwater Management Manual. APPLICANT SIGNATURE By signing the Stormwater Calculation Worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected property. � r .2- c 2' c3 (LAND• ',ER•R AUTHORIZED R ••ESE •TI SIGNATURE) (DATE) 2e nr v°.'" 4 3 ;® b?gam, t, ' 't'q d .`4° 'u9 ,4. A%53 ` a �. .«.,.,,,.... ,,,, Vil fib'.Ph t 61?:-: Y _e " 4 ay` � stormwater calc worksheet Rev 9-9-2010—REV 9/9/2010 2 4 gOh co%O L, Sw� JEFFERSON COUNTY ` t. / DEPARTME•OF COMMUNITY DEVELOP NT L'ir v S Date: Time Time Received: 2,-Ilt ama Mon. Tue. Wed. hur Fri. Date: g^(L BUD: 'S^ k zj-Z--.--' Contact Name: Owner: 1 ,4cC,(2_� Contact Number: 360___% +J( ` Address: 3(.0 11(Jz)ce�� °r� fiVl.. 206 Notes: II 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 DEPARTMEIDJF COMMUNITY DEVELOP 1 9S„t NG.cG Date: R -21 Time Received: XZ 7 amaii Mon. Tue. Wed. Thur. Date: -2,1-- BLD: 13- i'2 Contact Name: Owner: Contact Number: 360 3'7q L„, ,.5 Address: 3 6 3 1)6 f-(4”--f- Li.) 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 X Setbacks Floor Foundation Wall Address Posted-%� Block&Tile Ceiling Front Parcel Review • Parcel 002242018 Printed: April 25, 2013 APRIL SURGENT Site Address: ZACHARY HINDERYCKY 363 POCKET LN 4214 SOUTH FINDLAY ST SEATTLE, WA 981182409 PORT TOWNSEND WA, 98368 Parcel Number: 002242018 S-T-R: 24-30N-02W Total Acrea:diP Legal Description S24 T30 R2W TAX 12 W/1/17TH NT IN COMM AREA Land Use: 9100 W/1/17TH INT IN OG#3 BLK A LOT 16 Flood District: Fire District: 1 Planning Area: 2 Flood Map(FIRM)Panel No: School District 50 Zoning: COMP PLAN DESIGNATION: COMMUNITY PLAN: UGA: UGA Trans [ Fir-- Plot plan states "property line" i JP ,erifrr 0 [V' Assessor's Map (Property lines on submi •lot plan must m. c t 'property lines as identi led on the Assessor's 1/4 map) [ vY Legal Access to Property 4, NO [ frr Parcel Tags or Scanned Documents r6) NO (3[ fr' ESA's: Special Reports Nearby YE N [ tfr--Designated Ag YES !, [ ler Shoreline Designation: YES NO [ ter Shoreline Slope Stability• YES NO 5-_Cj — cp 41)t S Stream Type:YES NO Fish& Wildli' NO f g e_ �( tC c (-20 Wetlands: YES 0 "L Rare Plants:YES NO Seismic: YES NO Landslide: YES NO Flood: YES NO Erosion: YES NO Aquifer Recharge Are—NO CL) (_ SIPZ: none At High Disk Coastal CMZ: none High Risk Moderate RiskDisconnected CMZ Stormwater site plan submitted: YesNo [ fry-- Forest Lands: YES O Adjoining Forest Lan . Commercial/ Rural/ Inholding [ Dr Mineral Lands: YES i [ f,,r Agricultural Lands: YES 40 [ (4" Archaeology: YES 0 ,r-- f� f [ Stormwater: New Impervious Surface- l 6 6 ( Land Disturbing Activity ( C CI ESA's Stormwater Req's:Min Req#2 n q#1 thru#5 Th4in Req#1 thru#10 Engineering [ V1 Notice Provisions/Disclosure:Ai meal YES NO MRL YES NO Forest Lands YES NO [ C/r Landscaping Required: Yes • [ C Parking Spaces Re• ' ed NO Other ( 0/Building Height: 40P UBC standard [,. ] Impervious Surface coverage�centage: o Resource Lands&Public: 10% Rural Residentia. 25% Rural Industri er UDC Sec 6.7 ; Rural Commercial: 60% Area of Building • erage:60%in Rural Industrial Lands only i [V Total Building(s) Size: RVC:20,000 SF CC:5,000 SF NC:7,500 SF GC: 10,000 SF All others:subject to se tic&water constrainlsINone specified [ t( Setbacks: Front: 2_u Left Side: Right Side: Rear: to Shoreline Setback: LSHA Setback: [ ]rr Road Classification: Road Approach: EXISTING N Q'D RAP [ SEPA Required: YES MPT [ VI Flood Certificate: P A" [ K-- Existing Case(s)&Condition(s): Violations: Yes No [ y]— Recorded Date of Subdivision: AFN Over 5yrs=UDC Plat Conditions: <5yrs=Plat Conditions on plat or Old Ordinance [ Lots/Require Declaration of Restrictive ovenant YES submitted: YES NO [ iy:, GA No Protest Agreement YES submitted: YES NO [ 14' Site Visit conducted YES ED [' Require Final Zoning Approval YES [ ADMIN: Setbacks entered in Permit Plan case 0 YES New Parcel Tags entered in Permit Plan YES Special Reports Scanned 1 YES No parcel tags found for parcel Cases Associated with APN 002242018 Cases Name Review Type Status Planner ADR13-00012 SURGENT F Application Received: 2/11/2013 Permit Issued/Case closed: Case Finaled: 4/16/2013 911 BLD13-00132 SURGENT P Application Received: 4/23/2013 Permit Issued/Case closed: Case Finaled: SFR WITH ATT CARPOK I SEP12-00093 SURGENT/ZAK HINDERYCKX A Application Received: 8/10/2012 Permit Issued/Case closed: 9/26/2012 Case Finaled: \\tidemark\data\forms\R_Parcel_CRMLA.rpt 4/25/2013 Page 2 of 2 Jefferson County Building Division Permit Number: BLD13-00132 Applicant: SURGENT BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2009 International Building Codes To schedule inspections, call (360)379-4455 no later than 3:00PM the day before the inspection is needed. Requests received after 3:00 PM will not be scheduled for the next day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Setbacks ,,,G t.. C.. Erosion Control b-1(-1.3 �G Foundation Footing b Footing Drains 1 %� 1� Foundation Stem Wall _t �� Underground Plumbing t'Q Under Floor Framing ,( Straps(hold downs) t(47. t2l .-7� Ext.Shear Wall Nailing 7_i3 AA» Rough-in Plumbing '/�c3-0- Framing itv�1 `i' r l� PIA Airseal Insulation:Walls ti/ D Insulation: Floors 6L4$ Insulation:Ceiling i//10/13 a D< Int.Shear Wall Nailing AVA Wallboard Nailing iiV03 Gas Line: Interior �f11 // Gas Line:Exterior ASA Propane Tank /Q Heat/Chimney Clearance 464 Mechanical Systems �f,jify� , r Duct Test Cert ,/�A Blower Airtight Test �1/ Smoke&CO2 Drywell/Alt Drainage g/' /� Address Posted 8/1104 • FINAL INSPECTION 12,14 O_ t( CPS G FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • CONDITIONS for Building Permit# :BLD13-00132 1.) The project shall adhere to the Best Management Practices(BMPs)to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 2.) The site plan as submitted with the Building Permit application on April 23, 2013 has been reviewed for consistency under the UDC, and has been approved by Jefferson County Department of Community Development. Any modifications, changes, and/or additions to the stamped, approved site plan dated April 25, 2013 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 3.) This building approval accounts for 240 GPD of septic system capacity, as designed and approved SEP12-00093 is sized for only one single family residence. It is not sized for an Accessory Dwelling Unit(ADU). The minimum daily design flow per residence is 240 GPD. \\tirlamark\data\fnrms\F RI 11 PPrmif Rlrin rnt 5/7/9(113 • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD13-00132 Received Date: 4/23/2013 SITE ADDRESS: 363 POCKET LN Issue Date 5/7/2013 PORT TOWNSEND, 98368 Expiration Date 5/7/2014 OWNER: APRIL SURGENT PHONE: 206-948-8075 ZACHARY HINDERYCI% 4214 SOUTH FINDLAY ST SEATTLE WA 98118-2409 SUBDIVISION: Block: A Lot: 16 PARCEL NUMBER: 002242018 Section: 24 Township: 30 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: SFR WITH ATT CARPORT TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,800 VALUATION 70,000.00 ADD'L: 272 HEAT TYPE: EEE CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: SHORELINE: GARAGE: 598 CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: 05783 Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $1,727.35 JLA 04/22/13 142011 Exist: Exist: Plan Check $1,122.78 JLA 04/22/13 142011 Prop: 1 Prop: 1 State Building Code $4.50 JLA 04/22/13 142011 Total: 1 Total: 1 Potable Water Application $66.00 JLA 04/22/13 142011 Total: $2,920.63 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