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BLD2014-00111
illUILDING PERMIT APPLICA1N BLD14-00111 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00111 Received Date: 3/24/2014 SITE ADDRESS: 5615 SR 20 PORT TOWNSEND, 98368 OWNER: JOHN D STALEY PHONE: 916-832-1431 4062 CLEAR CT PLACERVILLE CA 95667-7019 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901051026 Section: 5 Township: 29 N Range: 01 W CONTRACTOR: PHONE: PHONE: REPRESENTATIVE: KIMBERLY BARNETT PHONE: 360-681-0777 BUY-RITE HOMES PROJECT DESCRIPTION INSTALL NEW MANUFACTURED HOME TYPE OF WORK MOB SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,560 VALUATION 91,548.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: 05783 BEDROOMS: BATHROOMS: Exist: Exist: Prop: 3 Prop: 2 Total: 3 Total: 2 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $532.00 MEB 03/24/14 148501 APPROVED State Building Code $4.50 MEB 03/24/14 148501 Potable Water Application $67.00 MEB 03/24/14 148501 Total: $603.50 \\•11-4omor4\rinfo\forme\G P1 11 Ann PIA rn+ /MAMMA 0 • "N. eof DEPARTMENT OF COMMUNITY DEVELOPMENT 4. 621 Sheridan Street,Port Townsend,WA 98368 Tel:360.379.4450 I Fax:360.379.4451 Web:www.co.jefferson.wa.us/communitydevelopment E-mail:dcd(a,co.efferson.wa.us �`. INO, C� 1 CERTIFICATE OF OCCUPANCY PERMIT#: BLD14-00111 APPLICANT: JOHN D STALEY PHONE: 916-832-1431 4062 CLEAR CT PLACERVILLE CA 95667-7019 SITE ADDRESS: 5615 SR 20 Issue Date: 04/25/2014 PORT TOWNSEND, 98368 Final Date: 9/23/2014 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901051026 Section: 5 Township: 29 N Range: 1W PROJECT DESCRIPTION: INSTALL NEW MANUFACTURED HOME THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2012 EDITION. OCCUPANCY GROUP: TYPE OF CONSTRUCTION: SPRINKLER SYSTEM yes no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 9/23/2014 \\tidemark\data\forms\F_BLD_Occupancy.rpt 10/17/2014 . iw¢SOrr COa EF RSON COUNTY (`,.i_ 1( w DEPARTMENT OF COMMUNITY DEVELOPMENT 9sk 621 Sheridan Street I Port Townsend,WA 98368 I Web:www.co.iefferson.wa.us/communitvdevelooment Tel:360.379.4450 I Fax:360.379.4451 I Email:dcd onco jefferson.wa.us Building Permits&Inspections I Development Consistency Review I Long Range Planning I Watershed Stewardship Resource Center Master Permit Application MLA: Project Description(include separate sheets as necessary): PERMANANT PLACEMENT: NEW MANUFACTURE HOME Tax Parcel Number. 901051026 Property Size: 3.71 (acres/square feet) Site Address and/or Directions to Property: dt5" Si 4/ „Z© # Hwy 20 towards Discovery Bay past 4 corners. #5 IIiwy 20 on right. 1st driveway on left. Property Owner(s)of Record: JOHN&KATHLEEN STALEY Telephone. 9/l2 "-• >3a9— 3 J F- : , email: KIMSEQUIM @YAHOO.COM • Mailing Address:. 1 ,4 1 , ■c-Civ.1. Ste , Applicant/Agent(if different from owner): .i '�/t "LI ii '_ Telephone:360-681-0777 Fax: email: KIMSEQUIMCYAHOO.COM Mailing Address: 259403 HWY 101 SEQUIM,WA 98382 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) ❑Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d),or Cl** VI Manufactured Home ❑ Modular ❑Discretionary"D"or - - •.,.•- "- _errs (� ❑ Commercial* ❑Special Use(Essenti: ,h , - I V t. ❑ Change of Use ❑Boundary Line Adjus ❑ Address ❑Road Approach ❑Short Plat** ❑Home Business ❑Cottage Industry ❑Binding Site Plan** ❑Propane ❑Long Plat** MAR 2 4 2014 ❑Sign ❑Planned Rural Resid= =I >velopment(PRRD)/Amend taa- ❑Allowed"Yes"Use Consistenc Analysis ❑Plat Vacation/A ti• ❑Stormwater Management PPrd vet, 0 Shoreline Master ram p a''•._,y it ions** ❑Site Plan Approval Advance termination(SPAAD)* ❑Shoreline Manag t Su'ray f o; ,i s ; rpMENIT ❑Temporary Use ❑Shoreline Manag e, - ❑Wireless Telecommunication* ❑Comprehensive Plari/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: •ESIGNATION OF AGENT I hereby designate ay 1 11711/' i / '.o to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE;a, ���1/�! Date: tLr(k i L x.12 M 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. Staff's access and right of entry wit be assumed unless the applicant informs the County in writing at the time of the application I -.)re or she wants .. or noti Signatu = —/ uv •. . '. , «.r/l.l 4( Dat e:—43/-07' a The action or actions Applicant will unde -,e as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential lake"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been 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 responsibility for adherin. .and •• plying with the E '. The Applicant has read this disclaimer and igrys and dates it below. Sigce' ::. 41!:.. .y.... ar r . *! . /. i Date: 4/�ii ir OF 07/24/2013 8 a BUILDER STATEMENT The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be -u •the = ••,,bility of the General Contractor for the proposed project. Signature: ,a; 1�1,∎�.,14 . Date: /��G-�"c k 12I 2U I Li GENERAL CO7- CTOR OR MANUFACTURED HOME INSTALLER: PHONE: g/(9 77 I FAX: By leirr t1O►uer (, )a/.©7e6) MAILING ADDRESS: j1 Y /Of <6910l 144 EMAIL: CONTRACTOR'S LICENSE WAINS CG'nil- 1p v cx 92365 NUMBER: n(fl/2 $ //L4( .. NUM !1 R/BER Q . 796'_ 7g ARCHITECT/ENGINEER: PHONE!3tho, p /()777 FAx:( ) MAILING ADDRESS: ,259‘60 3 . t�l Qi lg EMAIL K i 4 4.S-610/M e c •C ern Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: I< New ❑ Wood Existing: ‘-- -:------‘-- -:---- ❑ Sewer ❑ Addition ) Steel Proposed: cY Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: cZ Height XIndividual Sys ❑ Repair ❑ Masonry SEP Permit# / 00/'92_. ❑ Demolition ❑ Other. Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Heatk• Proposed: $-, Public YO cce t-tig. Total: Name of System: f Ub If this is a Commercial Protect you must answer the followinu: Number of Parking Spaces: Currant: Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed .. IBC Occupancy: IBC Type of construction: Will you have Food Service? Y : ell IfJhis is a Propane Tank and/or Appliance Installation Permit mark all items below that apply': /v/#4- Underground Tank Above ground tank Size of Propane Tank: Heat Stove Cook Stove Woodstove Fireplace.nsert rehtO I evotS telleP I knaT retaWtoH I 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 size,distances from the propane tank to all properly lines,buildings and septic system components, including the reserve area. Square Footage Current Proposed For Office Use Only Amount Revision Main Floor Heated /5700 EH BId App Review: 2"0 Floor Heated Consistency Review 2 Other Heated Base fee: c - 2 Mezzanine Additional Section: l l Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: / ,1 cam' Garage/Carport SUBTOTAL ( v Decks 911/Rd Approach fee: ■ 1 othe- TOTAL: q(o�"� Receipt Number: i kG O k Cash/Check Number: 2 3 t b ESTIMATED COST(REQUIRED) Date: (�/ •Fair market value of all labor and materials foundation to finish / Initials: 07/24/2013 • SS f m N CD 30'-0" 15'-0" I 15'-0" 46x39H Opt.14x39V r 4%41 i ( 80.VS .l is i _ = = -- COMBO J ■ ink ......I■r■ 1w D '■■ ■ ■■■■■■ o c..---w OEM so e7 • mr-immt ID „.1, F3.-) 441 I _, b W NNE s Ern i`jam' co a ii■■■■, cl ... 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' 0 C CO. 97',C• :/b,_1' CZ itip ..--, oirrr-qtrz - 0 ':1 -NA% ../.- 48, . < z M < ()PCITLc--30(4,49' .1;.: ? .- jib . .rn,mv, ..-.;,,,,...,,-,,;,.\ -...... . 0 f.... ......x , ,-;?...,. .4947-00. r 1:$ $40 C):5 b''S,-\ • .41■11° • ' /z Q) .--. ...••• cn Orn m ....4" -)=-- ‘,..) 1 I 0 j:}Z )".40.1.• C-: ''''i $ 1•411117 '.. .. "4"0 4'4°. SIIW' IC , 11 , ..., . I • houll 1[1; [1:.............. Roof downspout serves up to oiiiiiiii 700 sf. Of roof 50' min. .... ..:.- Vegetated flow path I ; I— Splash 'I block I Downspout extension NTS ,2- Splash / block Figure 3.t7-Typical Downspout Splashblock Dispersion • Vc :tine III–Hydrologic Analysis and Flow Control BMPs–August 2012 3-16 • S Design Criteria for Splashblocks A typical downspout splashblock is shown in Figure 3.L7. In general, if the ground is sloped away from the foundation and there is adequate vegetation and area for effective dispersion, splashblocks will adequately disperse storm runoff.If the ground is fairly level, if the structure includes a basement, or if foundation drains are proposed, splashblocks with downspout extensions may be a better choice because the discharge point is moved away from the foundation. Downspout extensions can include piping to a splashblock/discharge point a considerable distance from the downspout, as long as the runoff can travel through a well-vegetated area as described below. The following apply to the use of splashblocks: 1. Maintain a vegetated flowpath of at least 50 feet between the discharge point and any property line, structure, slope steeper than 15%, stream, wetland, lake, or other impervious surface. Sensitive area buffers may count toward flowpath lengths. 2. A maximum of 700 square feet of roof area may drain to each splashblock. 3. For purposes of maintaining adequate separation of flows discharged from adjacent dispersion devices,the vegetated flowpath segment for the splashblock must not overlap with other flowpath segments, except those associated with sheet flow from a non-native pervious surface. 4. Place a splashblock or a pad of crushed rock(2 feet wide by 3 feet long by 6 inches deep) at each downspout discharge point. 5. No erosion or flooding of downstream properties may result. 6. Have a geotechnical engineer or a licensed geologist,hydrogeologist, or engineering geologist evaluate runoff discharged towards landslide hazard areas. Do not place Splashblocks on or above slopes greater than 15% or above erosion hazard areas without evaluation by a professional engineer with geotechnical expertise or a licensed geologist, hydrogeologist, or engineering geologist, and approval by the Local Plan Approval Authority. 7. For sites with septic systems,the discharge point must be downslope of the primary and reserve drainfield areas. This requirement may be waived if site topography clearly prohibits flows from intersecting the drainfield or where site conditions (soil permeability, distance between systems,etc) indicate that this is unnecessary. Volume III—Hydrologic Analysis and Flow Control BMPs—August 2012 3-15 Standard Conditions for Residenttevelopment 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 Fisheries Service can levy p•ties. Portions of Jefferson County, incling marine waters, are included as "critical habitat"for a listed species. Development of property along any marine shoreline, freshwater shoreline, or floodplains could harm habitat if protective measures are not taken. To minimize the potential to damage habitat, all property owners developing adjacent to marine shoreline, freshwater shoreline, or floodplains are advised to do the following: All development activities should avoid unstable slopes, wetlands, and forested areas near surface waters Remove minimal vegetation for site development, especially large trees Allow trees that have fallen into surface waters to remain there Infiltrate stormwater from buildings and driveways onsite through drywells rather than discharging directly into surface waters or roadside ditches The Federal Bald and Golden Eagle Protection Act requires landowners within 660 feet (1/8th of a mile) of an eagle nest to consult with the US Fish and Wildlife Service. This Eagle Act prohibits anyone from "taking" bald eagles. This federal law defines the term "take" and describes the possible legal consequences when a "take" occurs. Among other actions, "take" includes a disturbance of bald eagles or their habitat. Under federal law a permit may still be required for activities that impact bald eagles or their habitat. Contact the US Fish and Wildlife Service (http://www.fws.gov/pacific/eagle/) to learn more about how this law affects your project. Any individual, group, or agency can bring suit for a listed species "taking", even if you are in compliance with Jefferson County development codes. The risk of a lawsuit against you can be reduced by consulting with a professional fisheries habitat biologist, and following the recommendations for site development provided by the biologist. For more information, contact the National Marine Fisheries Service in Seattle, or the U.S. Fish and Wildlife Service. 2013-09-06 SFR StdConditions 9/6/2013 2 JACK WESTERMAN II, Jefferson 1 Doty(:ssrtbs■se ASSESSOR PO Max 1220, Port Tewomead,WA 98368 13600 385-9105 MOBILE ROME INFORMATION FORM OWNER'S NAME/MAILING ADDRESS: NAME: ..._\D tiM is A-Tti 1.-eel srA Leg , ADDRESS: /? PHONE NO. 9/4' - 'yy' �- The purpose of this questionnaire is to obtain information regarding either the current location of a mobile home or the previous ownerahi ..1.L., f a mobile home. This will help our office determine whethe rj l p 'l d on the tax rolls in Jefferson County or if it has been mov. i' g ro rT y \ ���ili#-�siit� fx�om tither area. \\ \ 'MOBILE ROME DATA: � - \ 4.;\∎\ 2 4 2 j4 \\ 1,,k , ----I (A) MAKE afS {� (B)MODE 4► ` /Or., 0;1I MIOEVE1.O'��.NT ` t 1� s �J (D)LENGTH 52 / (E)WIDTH .3'0 / (F)SERIAL# .55 Le 1 (G)YOUR PURCHASE PRICE(Do not melade sales tax) FO rOD PURCHASE DATE 3/0, 2)PREVIOUS OWNER/LOCATION OF MOBILE HOME: (IF NEW MOVE TO QUESTION 3) (A)FROM WHOM DID YOU PURCHASE MOBILE ADDRESS (B)WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR?Yes No If Yes, Previous address of mobile. If No, What County was Mobile assessed in last year. 3)WHERE MOBILE HOME IS TO BE LOCATED: (A)WILL THE MOBILE HOME BE IN MOBILE HOME PARK? Yes (B)IF LOCATED IN MOBILE HOME PARK: NAME die ADDRESS OF PARK Let/Space# (C) IF NOT LOCATED IN MOBILE HOME PARK: NAME OF LAND OWNER: —G"r(-\-Le LOCATION ADDRESS „O/J c f'W q ao t •PD Di `1C' t; 1 n REAL PROPERTY PARCEL #/DESCRIPTION 9 0 l0 5 /02 4' ill,44‘ Signature ap Ream* • THANK YOU FOR YOUR HELP! 4OMs,V QQ JO COSSELL, Property Teehnieian Op Front Parcel Review • Parcel 901051026 Printed:April 3, 2014 JOHN D STALEY Site Address: 4062 CLEAR CT 5615 SR 20 PLACERVILLE CA 956677019 PLACERVILLE, CA 95667701 PORT TOWNSEND WA, 98368 Parcel Number: 901051026 S-T-R: 5-29N-01W Total Acreage 4 Legal Description S5 T29N R1W TAX 42&TL TAX E-2 Land Use: 9100 Flood District: Fire District: 1 Planning Area: 5 Flood Map(FIRM)Panel No: School District 50 Zoning: P—:\ \ '.7) 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 poperty lines as identified on theAssessor's 1/4 map) [ ] Legal Access to Property YES NO [ ] Parcel Tags or Scanned Documents YES NO [/f SA's: Special Reports Nearby NO S " ,c0J) ,,,, ,1�r-o,,�, [ Designated Ag YES 1• ■ _ ] Shoreline Designation: ES 0 _, E _��_411 _.► -A' (L ... a h V Shoreline Slope Stability:4/5.' 0 Stream Type:YES FWHCA: YES c c Q- k J (A, 5hAv6 — cf.-4;0 6—) Wetlands: ES NO c,/A 1_ LA.1 . 40 . , '...._ Rare Plants:YES Seismic: YES 43 Landslide 0) 1Fi � ': 4�_ — ' ,_s_ , (1l . _,._ , . ,1' ' 1 .1t 4�d Flood: DES 4 • lv • '+ _‘I L:c94A_T CM Erosion: YES ig) Aquifer Recharge A rea:YES SIPZ: none At Risk igh Risk _ oastal _ CMZ: High Risk Moderate RiskDisconnected CMZ Stormwater site plan submitted: YesNo V] Forest Lands: YES IO Adjoining Forest Lan sue: /iAli, Commercial/ Rural/ Inholding [/] Mineral Lands: YES ITN Agricultural Lands: CD[ ] Archaeology: YES NO [� No Shooting Zone: ES No [ ] Stormwater: New Impervious Surface Land Disturbing Activity ESA's Stormwater Req's:Min Req#2 Min Req#1 thru#5 Min Req#1 thru#10 Engineering [ ] Notice Provisions/Disclosure:Airport YES NO MRL YES NO Forest Lands YES NO [ ] Landscaping Required: Yes No [ ] Parking Spaces Required NO 2 Other f 1 Building Height: 35' UBC Standard [ ] Impervious Surface covera ercentage: I f I / Resource Lands&Public: 10° /° Rural Indus Per UDC Sec 6.7 Rural Commercial: 60% Area of Building Coverage:60%in Rural Industrial Lands only ] Total Building(s) Size: I g(o 0 RVC:20,000 SF CC:5,000 SF NC:7,500 SF GC: 10,000 SF All others:subject to septic&water constraints/None specified y[ ] Setbacks: Front: �?7 Left Side: t - Right Side: ,S Rear:5 Shoreline Setback: LSHA Setback: -1741.-- Road Classification: S ,A1 Road Approach: EXISTING NOT REV R • ' •JCC.Qj lUtU 1 ' c�Q f,—j SEPA Required: YES E PT) � Flood Certificate: Existing Case(s) &Condition(s): 71., L 1izu Qz5 ,o r/ Violations: Yes No J Recorded Date of Subdivision: AFN Over 5yrs=UDC Plat Conditions: <5yrs=Plat Conditions on plat or Old Ordinance Lots/Require Declaration of Restri • Covenant submitted: YES NO [� GA No Protest Agreement YE' submitted: YES NO [ S. 'sit conducted Y Require Final Zoning Approval Y . 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 901051026 1.) WSRC Coaching - 2011-10-12, CZ 08/26/2013 Other Parcel tags found for parcel 901051026 2.) WSRC Coaching - 2011-10-12, CZ 08/26/2013 CAO Cases Associated with APN 901051026 Cases Name Review Type Status Planner ADR14-00005 STALEY F Application Received: 2/20/2014 Permit Issued/Case closed: Case Finaled: 3/24/2014 New address BLD14-00111 STALEY P Application Received: 3/24/2014 Permit Issued/Case closed: Case Finaled: INSTALL NEW MANUI-AC I UF(EU HOME M LA12-00239 BLD12-00358 MLA12-00239 STALEY I A Application Received: 11/5/2012 Permit Issued/Case closed: 11/15/2012 Case Finaled: STAND ALONE STORMWATER SEP13-00112 STALEY A Application Received: 9/27/2013 Permit Issued/Case closed: 11/18/2013 Case Finaled: \\tidemark\data\forms\R_Parcel_CRMLA.rpt 4/3/2014 Page 2 of 2 Map Output • • Page 1 of 1 ArcIMS HTML Viewer Map ~..„ / ' ' ~'^^` � `a/se. ���vs/ . . , a���'�'� eza/c ' i//o;1. s~a/,::» Legend Selected Features / xn_Roau, Parcels-H ~-� ' ~' Contours , � � / ' / lo Foot Contour | ^/ m�=^o"m�, I , / � � 2 | �' �j , ��.::::.::'H , i � ) / �� / � � . \ � ' � �' .- ^zeo___~_`` FOR INFORMATIONAL PURPOSES ONLY- Jeferaun County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity. Data contained in this map is limited by the method and accuracy of its noUeodon. ThuApr O3 16:56:05 2014 � 1 , 1 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.0... 4/3/2014 Map Output • • Page 1 of 1 ArcIMS HTML Viewer Map 001324053,_,A. ,,;,v; C013240.38 I I ':X:,`±'.:13,.:•' • • . 90,051.005 ao1324wr 9ata519§5 -- i -u, , 991051008 r t 901053019 _ 901051009 l USttx;t I .i' _ ': 90104ry y431051012 • 901051016•1,:1051013.:x'011 D'r 901051020 ! Legend I 901051016 / c3 Selected Features ,901051024 901042006.1 j 0,./ JC_Roads 901051025 k/ re Parcels-H 901051026 i 941042001 Landslide Hazard I rr / In Skrdes / / n non 1 901051004 1 /901051010 M°aera7° / I —* Shghi 1 1!/ ' I 901042001 Ili 9010510'8 i 90105101$ ill I ;' `.1 w.r xcrrdetl a;.,Ar.m Carey Carty Sa sces 01MMMIMOMMINIMM29ft FOR INFORMATIONAL PURPOSES ONLY- Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity. Data contained in this map is limited by the method and accuracy of its collection. Thu Apr 03 16:59:58 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientV ersion=4.0... 4/3/2014 • • JEFFERSON COUNTY 7:-:..1 - DEPARTMENT OF COMMUNITY DEVELOPMEI \Jt ,i I MAR 2 �Jl 621 Sheridan Street • Port Townsend •Washington 983• ��' 360/379-4450 • 360/379-4451 Fax L-- r COMP( ' ` httpa/www.co.jefferson.wa.us/commdevelopment/ �```�` :0 C FVEIOP'1 � � of co��nl�.ln�in o. Stormwater. Calculation Worksheet 6 /2_4933s MLA# PROJECT/APPLICANT NAME: ',ST/ft s Y DETERMINING STORMWATER MANAGEMENT REQUIREMENTS:This stormwater calculation worksheet should be completed first to classify the proposal as"small,""medium,"or"large." The size determines whether a Stormwater Site Plan Is required in conjunction with a stand-alone stormwater management permit application, building permit application, or other land use approval application that involves stormwater review. The basic information will also be helpful for completing a Stormwater Site Plan,if required. PARCEL SIZE(I.E.,SITE) Size of parcel (' acres /�/ An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet /E!'(( /POI sq/ft Land-disturbing activity is any activity that results in movement of earth, or a change in the existing soil cover(both vegetative and non-vegetative) and/or the existing soil topography. Land disturbing activities include, but are not limited to clearing, grading, filling, excavation,and compaction associated with stabilization of structures and road construction. Native vegetation is vegetation comprised on plant species, other than noxious weeds,that are indigenous to the coastal region of the Pacific Northwest and which reasonably could have been expected to naturally occur on the site. Examples include species such as Douglas fir,western hemlock,western red cedar,alder,big-leaf maple,and vine maple;shrubs such as willow, elderberry, salmonberry, and salal;herbaceous plants such as sword fern,foam flower,and fireweed. LAND DISTURBING ACTIVITY,CONVERSION OF NATIVE VEGETATION,AND VOLUME OF CUT/FILL Calculate the total area to be cleared,graded,filled, Answer the following two questions related to excavated,and/or compacted for proposed development conversion of native vegetation: project. Include in this calculation the area to be cleared for: Does the project convert%acres or more of Construction site for structures /5790 sq/ft native vegetation to lawn or landscaped areas? Drainfield,septic tank,etc. sq/ft Circle: Yes C Well,utilities,etc. PUP sq/ft Does the project convert 2%acres or more of native vegetation to pasture? Driveway, parking,roads,etc. 3 Dt7 sq/ft Circle: Yes No Lawn, landscaping,etc. ,.0r sq/ft Other compacted surface,etc. �//''B) eft t Indicate Total Volumes of Proposed: /' Total Land Disturbance _ ! 0 Lei" sq/ft Cut Fill (cu/yd) [over] tt ,064 sei), ._ --_ • • 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 (STING Structures(all roof area) /5(e 0 sq/ft Stru res(all roof area) sq/ft Sidewalks sq/ft Sidewalks sq/ft Patios sq/ft Patios sq/ft Solid Decks sq/ft Solid Decks sq/ft (without infiltration below) (without infiltration bet .) Driveway, parking, roads, etc 300 sq/ft Driveway,parking,roads, = sq/ft Other sq/ft Other sq/ft Total New /21e0 sq/ft Total Existing sq/ft TOTAL NEW+TOTAL EXISTING* /840 sq/ft "This amount will be used to check total lot coverage. The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT v.REDEVELOPMENT II t Divide the total existing impervious surface above by the size of the parcel and convert to a percentage:Do t/;l V % 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 applicanUowner 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 pro.erty. 41.merria .14:6:///if " Volaf (LANDO ER OR THO'ZED REPRESENTATIVE SI NATURE) (DATE) w 1 r - - t 'pr ar i 9 �i�Jl ` `�� s�1¢ ��4��th ���a �-�a� ����._ A71 °'_ 0 • xi 7 tD 30'-0" ' 15'-0„ I 15'-0„ 0 46x39H O1t.14x39V r 1-11 gp^T� e lr -11I - � -- C COMBO J Ii i [ w 0 Pit a I= mil■oe=■ o "° c - .gym W o• or"ems , 0 s m ■m k.•■ ■1 i■mt co e_o 3 (c) -Lia 2. g 0 al,0'1 _. CL jc- U I'',eeeeaI o X111111 111.1, till la MP 1=------1 q i • lees r 5' 3 k$ 11 '-1,1cn N N .� o I I cx >g g' o - ko I ,-s rn N L r• o cry e ? rte .- T Y._ t rn H m rn o --1 0 0 a 0p I c o 0 • _ -N.: `o, g ao W Bs . Ci i co mm �� i c, c \, 1 ° o c� °vim ice , � 3 CD ® 1- T.+ I I •NJ 476x-58 `"' — J 4 w c.7 -I ;ro S,. 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F) 0 Co :. , 0 /7/0 a, -‹ , - . - , o • ..,;'"'--1 P E-1 tv CA 7_, m q ' CD •-• , k-Vo ›. 114 / 016 ' , '2•-, -6 i nil 111 ” / / 1 0 0 , , , .• 0 o-)— a ...„ •4%6, 1,,_---.- ' — q ' c: 4 /1,7,•,\,--,--0) ,/,/_, . C CCil..0-wtt ' • , ....1 rr, --o 4 f-c '•-• V) tVil53 0 Z - .91,',. - % / . .. • ! :a. b#C7..›.8•411'4 if451 ,•-'' • •'‘ i 14 (---:::'• \ ..::., . 0c:/:fg-ki..'1.,..i'g,..', • . - / rri . ..7...°,m:inn 't.'il,-.41,,■!.,...„., :-: .,..- . jlii V < l'.,, 0—.•M'D •••• . . '...'\,-. 00■)'.481,` ... ...,_.. -P-.. . - • 6 z;c.n.. •*.- ....■ - or ITC rri• .--.-•. 4... r-. •,- oxtz..• • -. , > t., _If( 4t:(iirr) Z g ..... . tor ....._ --- V' t-- . 11 i A`�S°� °� JEFFERSON COU • G�. DEPARTMENT OF COMMUNITY DEVELOPMENT y-1SH t c,',° Date: /„t Time Received: am/pm 7 /pm Mo . Tue. Wed. Thur. Fri. Date: 9' BLD: /q. /1/ Contact Name: XIpabst /y Owner: Contact Number: 360 73+FZ Address: ;5'(015' /-10-).7, ,2-0 206 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 I 4F�S°\ ��o JEFFERSON COI* 0 DEPARTMENT OF COMMUNITY DEVELOPMENT -1,,,,,,G,°� Date: of-(C7 Time Received: '3`{ a 4101 Mon. Tue. Wed. Thur. Fri. Date: 1- 1-L BLD: 1Y-- // / Contact Name: t Owner: Contact Number: 360 Vgi 077 7 Address: 6(,/$-- SW/` 20 206 Notes: V't 1, 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 SON CO goo, G 2{{ JEFFERSON COUN DEPARTMEI OF COMMUNITY DEVELOPIINT 9SHING,0� Date: '(/1 Time Received: 02 c am/a Mon. 40. ed Thur. Fri. Date: BLD: I . 1 I I Contact Name: Owner: Contact Number: 360 cop 0 77 7 Address: 5-05- t-f-wa/ 2,t7 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 Cr� � aCrrcrtavw wury T Vqsa DEPARTMEN F COMMUNITY DEVELOPIVIT +r Date: 5—z7 Time Received: " pm Mon. Tue. Thur. Fri. C./ Date: 2 BLD: l c —//l Contact Name: Owner: Contact Number: 360 C®g/a 777 Address: j70/5- S/L Z) 206 Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks �,j Under-ground Framing Under ground Furance Footing /lx` 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 SPECIAL CONDITIONS CASE# BLD14-00111 1.) 10' minimum separation required between the water line and any onsite sewage system components including sewage transport lines. 2.) SEPTIC SYSTEM COMPONENT SETBACKS TO STORMWATER MANAGEMENT FACILITIES- Any interceptor/curtain drain or foundation drain, or any other source of water that is downgradient or below MUST be setback a minimum of 30' from any septic system dispersal area (drainfield) and 5' from any septic tanks. Splash blocks must be directed away from ALL septic components. Subsurface stormwater infiltration, subsurface soil dispersal systems with NO discharge point must be located a minimum of 10 ft. downgradient of the drainfield. 3.) The project shall adhere to the Best Management Practices(BMPs)to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 4.) The site plan as submitted with the building application on 3-24-2014 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 4-4-2014 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 5.) This approval is for a manufactured home only. Any future permits on this site are subject to review for consistency with applicable codes and ordinances and does not preclude review and conditions which may be placed on future permits. 6.) CJZ \\tidemark\data\forms\F_BLD_Permit_Mobile.rpt 4/25/2014 • I MANUFACTURED/MOBILE HOME INSTALLATION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD14-00111 Received Date: 3/24/2014 SITE ADDRESS: 5615 SR 20 Issue Date: 4/25/2014 PORT TOWNSEND, 98368 APPLICANT: JOHN D STALEY 4062 CLEAR CT PLACERVILLE CA 95667-7019 SUBDIVISION: Block: Lot: PARCEL#: 901051026 Section: 5 Township: 29 N Range: 01 W CONTRACTOR/ DEALER PROJECT DESCRIPTION: INSTALL NEW MANUFACTURED HOME MAKE: KARSTEN YEAR: 2014 SIZE: 52X30 Directions To Site: To schedule inspections, call (360)379-4455 no later than 3:00 PM the day before the inspection is needed. Requests received after 3:00 PM will not be scheduled for the next day's inspections. Office Hours 9:00-4:30 MONDAY-THURSDAY ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes 5 )-110 eL 034 7 l��l W A final inspection will not be scheduled until all of the 27us / following are completed and signed off by the applicable Department: • Building Permit Conditions are met • Septic Permit Final/Complete for any building containing plumbing • Land Use Conditions met and signed off • Public Works Permit Final(where applicable) FINAL INSPECTION (;I\ )t.� FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR SPECIAL CONDITIONS APPLY-SEE REVERSE S • Jefferson County DCD Building Division Correction Notice PERMIT NUMBER /V-/// OWNER 5'j.t JOB LOCATION 5-6/5— �� Inspection of this structure has found the following violations: 0 / /I-LC. yob C$L/3oi,3 ®,) , 7 t..-mrit Pe,"- r 44- Avg — Ave,#47- ;mss. D\c/ 47,,, . - 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 ca for inspection. Date /// // Inspector BUILDING DIVISION(360)379-4450 IN ECTION HOTLINE(360)379-4455 THIS NOTICE MUST BE KEPT WITH APPROVED PLANS ON SITE