HomeMy WebLinkAboutBLD2012-00068 ILDING PERMIT APPLICA N BLDI2-00068
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD12-00068 Received Date: 3/5/2012
SITE ADDRESS: 266 ROBINSON RD
BRINNON, 98320
OWNER: BRENDAN C BARTLETT PHONE: 831-383-9101
HELEN V BARTLETT
565 CHINQUIPIN DR
BOSSIER CITY LA 71111-5176 GAUL SHORT PLAT
SUBDIVISION: Block: Lot: 1
PARCEL NUMBER: 502153031 Section: 15 Township: 25 N Range: 02 W
CONTRACTOR: REALITY HOMES INC PHONE: (253)926-6330
1308 ALEXANDER AVE E STE B
FIFE WA 98424
Contractor's License REALIH1984CN Expires 2/15/2012
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION NSFR W/A/G 50 GAL PROP TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,028
VALUATION 111,000.00 ADD'L: HEAT TYPE: RAD
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: SHORELINE:
CONST TYPE: DECK: 340 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: 1 PWELL
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 2 Prop: 1
Total: 2
Routing Date:
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $1,055.35 LYK 03/05/12 131515 APPROVED
Building Code $4.50 LYK 03/05/12 131515 APPROV
E D
Potable Water Application $64.00 LYK 03/05/12 131515
Plan Check $685.98 LYK 03/05/12 131515
Total: $1,809.83 ,Jefferson County DCD
" `. Cb DEPARTMENT OF COMMUNITY DEVELOPMENT
I 621 Sheridan Street,Port Townsend,WA 98368
' Tel:360.379.4450 I Fax:360.379.4451
s - Web:www.co.jefferson.wa.us/communitydevelopment
}frCa E-mail:dcdaco.jefferson.wa.us
CERTIFICATE OF OCCUPANCY
PERMIT#: BLD12-00068
APPLICANT: BRENDAN C BARTLETT PHONE: 831-383-9101
HELEN V BARTLETT
565 CHINQUIPIN DR
BOSSIER CITY LA 71111-5176
SITE ADDRESS: 266 ROBINSON RD Issue Date: 01/29/2014
BRINNON, 98320 Final Date: 10/13/2014
SUBDIVISION: Block: Lot: 1
PARCEL NUMBER: 502153031 Section: 15 Township: 25 N Range: 2W
PROJECT DESCRIPTION: NSFR W/A/G 50 GAL PROP TANK
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009
EDITION.
OCCUPANCY GROUP: R-3
TYPE OF CONSTRUCTION: 5N
SPRINKLER SYSTEM yes no
THE PROJECT PASSED ITS FIN INSPECTION AND RECEIVED FINAL SIGN OFF ON 10/13/2014
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folleir7N. : JEFFERSON COUNTY
,40, • DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street•Port Townsend•Washington 98368
360/379-4450. 360/379-4451 Fax
` 4 wow.00.j erson.wa.us/cornmdevetopment
Master Permit Application MLA: 0 _Li 2-
Project Desaiplion(include separate sheets as necessary):
lot- Stwo E FAMO tteSID 6 NCE Kt 246 C .Mo(2.N.1T VIEW U2, flgINNO t4 1 WA 9332-o
Tax Parcel Number: Sat I S 30 3 I Property Size: I-1Lj. ACRES (acreslsgeara-feet)
Site Address and/or Directions to Property: 26 6 Co .M a R-rt t4 T vi B w' DR.
1312tNNON , Wit g1T32o
Property Owner(e)of Record: 6R-e-N OArI o�4 HS N (2)Pr2�rl.. C l E V l
Telephone: 83I 3$3 °Ftol Fax mai:hdcjobeSbgr�. f iehrdxnl.c nit/
Mailing Address: 66S G1t•k U%PIN DR. , &os51E2 CiTy , LA ° i
<i itA R r 2012
Applicant/Agent(if different from owner):
Telephone: Fax L email:
Mailing Address: IFFFFRCl1N Cl1UNTY
of Permit?(Check each box that apples DEPT.OF COMMUNITY DEVELOPMENT
0 Critical Areas Stewardship Plan
0, -not Permit ❑Variance(Minor,Major or Reasonable Economic Use) •
VSingle Family ❑Garage Attached/Detached 0 Concilional Use[C(a),C(d),or C]**
❑ Manufactured Home 0 Modular 0 Discretionary 13"or Unnamed Use Classification
❑ Commercial* 0 Special Use(Essential Public Facilities)*•
�o�Change
ddresses Use 0 Road Approach O Short S Line ,
O)lome Business 0 Cottage Industry 0 Binding Site Plan**Long Plat**
WPropane 0 Sign ❑Planned Rural Residential Development(PRRDyAmendments**
O Allowed'Yes'Use Consistency Analysis 0 Plat Vacation/Alteration**
O Stormwater Management ❑Shoreline Master Program ExemptionlPetml Revisions**
•
O Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substanlial Development**
OWireless Temporary Use * ❑Shoreline Management Variance
0 Comprehensive Plan/UDCA..and Use District Map M enchnert
O Forest Practices Act/Release of Sinn-Yen Moratorium ❑Jefferson County Shoreline Master Prog am-Amendnrent •
* e Pre—Application Conference ❑Tree Vegetation Request
**Requires a Conference
Please identify any other local,state or federal permits required for this proposal,if known:
.DESIGNATION OF AGENT
I hereby designate to act as my agent in matters relating to this application for permit(s).
OwnSR SIGNAT nE Date:
By signing this appacadon form,the owneragent 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 awnerlagent with respect to this application packet
may result in this perm*being null and void.
I further agree to save,indemnify and hold harmless Jefferson County against all Utilities,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 grinding 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 imams the County In writing at the
hethne of the application that Signature: mile I if a notice. ,, C ( DA i- "- Die: 25 kb 200--
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 ale'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
perm*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 that he,she or it holds� -
htng with ESa Applicant has read this and signs and dates It below.
Signature:and M J t r mp C. t �fi
t)•.•. c+.r (-aC.`rd Date: 23 � ?.of 2
GAPeunitCenteAlt##FORMS###WRD FORMSWaster Permit Application 5-29-0s doc
• •
BUILDER STATEMENT
The signer of this statement does hereby aertfy that they are the Owners of the panrel referenced herein,that they are not Roensed contractors and that
they will be'p,�, �/ the of the General Contractor for the prq�ect Feb Signature:'�C c�Ur.... C C. ECtr Date: Feb ?A-,0—
GENERAL CoKreacroe OR MANUFACTURED NOME txsrAuEn PtroNE: Fax
Rt:aWTY f -OMES IWC (36o)582 I6-02. (360) 587. icob
MAILING ADDRESS: t3o• ALEX AIVi�EJL.Prot stir b, Pifer, WA EMAL: rick.fitAfAo,s@(eati iiorvtes(KG.cow WAINS
NusreER:
CONTRACTOR'S LICENSE I.EP%LIfIiet SL1-GN �� NUMBER
ARCFSTECT/ENGIN E:tt: PHONE ( ) FAx:( )
MAILING ADDRESS: tom.
Pip1 Type: F Type: Bathrooms: Shoreline: Type of Sewage Disposal:
C�' Nevi or Wood E dstkig:. C ❑Sewer
❑ Addition ❑ Steel Proposed: I Bank ❑Community System
❑ Akeration/Reeodei ❑ Corxxete Total: I Height 4/Individual System
❑ .Repair ❑ Masonry
SEP Per #sE?4y-006 •
13 Demofi6'on ❑ Other
Bedrooms: Water Supply:
0 r t.-,« • :wee ❑ Two Party
aa_�. 5. . ,
T mil- S`js-r rM Total: Fr- c, 1, o� lie: - w system
if this is a commaeradal f+eolsc:t von must the fdfowino- ( _ ����
Number of Parl Spaces: Cunene Proposed: h9 Ritrrtber5of hhE�ipC P . > _ • -
Number of occupar (includes owners,tenants,ernployeee,etc) & w iu r
IBC Occupancy: IBC Type of construction: (ktaRil( - . ? / No
It Is is ir. amdf' ,r . � a ill L ;_..'.:, � :.:"- - '-�;t OPMENT
1 Underground Tank Above ! , ; e T: Size of Propane" . %a o r• de-
1 Heat Stove Cook Stove I Woodstove I Fireplace Insert 1tiiot Water Tanlc I Pellet Stove • , _r De e... •
in this au lance beirtsr installed a Manufactured/fiAo6tis flame? Yes / No
When applying fora permit to ank a propene t you must als ssubmit a site plan showing all of the bu ,all properly
Ilnesy tank location and size,distances from die propane tank to all property lines,buildings and sep6ic system component,
Including the resolve area.1"M
Main Floor Heated !0 Z g EH Bid App Review l O
2"0 Floor Heated
0 Consistency Review: ����
Other Heated
ease fee: I 0_55
Mezzanine o _ section
Heated Basement 0 -, Plan Check fee: (0 85 0
Unheated Basement ` State Surcharge fee: 5p
0 Other Unheated 0 , Pot Water Review fee:
ib
0 -� SUBTOTAL ct�
Decks 0 - z 911/Rd
Approach fee: .x,/sa
3� , `
Other # -: TOTAL• 3
0 Receipt Number:
{ ( 3 I
m Cash/Check Number: 77 I
ESTIMATED Mw ALT�Es.w
DCOSfT p(R�E�QUIRED) Date:
11 t . 000_.00 ►I
•
G:\PerinitCcnoa\ FORMS###\DRD FORMS1Master Pent App&&tion S-29-084oc
1
Jefferson County Building IJt6ision Permit NOW. BLD12-00068
Applicant: BARTLETT
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 4411
Erosion Control ItYpiist
Foundation Footing 4')i 2'I y
Footing Drains
Foundation Stem Wall 1.
Under Floor Framing �
Straps(hold downs)
51C/4`i (�
Ext.Shear Wall Nailing '(fQ//K
Rough-in Plumbing 2 1 T
Framing t(di #11))) H—Airseal
Insulation:Walls
Insulation: Floors /D/ /i4 911
Insulation:Ceiling (A3 K
Int.Shear Wall Nailing
rfr
Wallboard Nailing (e\ii ,)°'
Gas Line: Interior
Gas Line:Exterior
Propane Tank h
,Cq iLI giV
Heat/Chimney Clearance ! / 00(4 4rivt__ /1
Blower Airtight Test
/1 03
Smoke&CO2 16/0 1 .,
Drywell/Alt Drainage _(iV/314 111 /
Address Posted ii/i (i4 dT
►t ater Meter Inspection mpg/iv to comply with conditions of permit because of the seawater intrusion
issues.
FINAL INSPECTION � S1/
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
•
S
CONDITIONS for Building Permit# :BLD12-00068
1.) The potable water supply serving this parcel has had extensive chloride testing and
hydrogeologic review since chloride sample results completed in 2009 by the Department
of Ecology indicated the well was at high risk for seawater intrusion. The property has
been vacant for at least 2 years and the outcome of the most recent revised hydrogeologic
assessement attributed the high chloride results to over pumping by the previous tenant of
the property.
This building permit is being approved provided that a NTT be recorded in order to ensure
the well use is limited and monitoring data is submitted in accordance with the notice.
Notice to title was recorded under AFN_581222
The NTT stiputlates that the property owner agrees to the following as a condition of
permitting the single familty residence proposed with this permit:
• The well will not be used for irrigation, lawn or garden watering. Indoor domestic use
only.
• Installation of a 1000 gallon minimum storage tank together with a submersible well
pump having a capacity of no more than 3 gallons per minute is required.
• A source flow meter must be placed on the well service line to the residence and
water usage shall be documented at least quarterly. Meter documentation must be
submitted to Jefferson County Community Development on an annual basis and to be
maintained with the potable water review case.
• A source sample tap must be installed prior to the storage tank to isolate water quality
tests from distribution.
• On-going annual well monitoring for chloride concentration is required. Samples must
be taken from the source sample tap. Submittal to Jefferson County Community
Development is required annually and to be maintained with the potable water review
case.
• The applicant acknowledges that connection to a DOH-approved public water system
is required if available and when available.
2.) In accordance with the NTT for potable water, the installation of a source sample tap is
required, prior to storage. This tap is to be used for on-going chloride testing as a
condition of the approval.
Contact JCPH for a site inspection to verify, fees will be charged for this inspection.
3.) To help prevent seawater from intruding landward into underground aquifers, all new
development activity on Marrowstone Island, Indian Island and within 1/4 mile of any
marine shoreline shall be required to infiltrate all stormwater runoff onsite.
4.) MANDATORY MEASURES OF HIGH RISK SIPZ:
Water conservation measures:
1. Roof and other intercepted precipitation shall be routed to on-site detention ponds
and/or other approved means and allowed to be released to the soil slowly.
2. Water collected from storm water and roof catchments may be used for watering lawns
and gardens. Unless catchment water has been treated to meet drinking water standards,
there shall be no cross connections allowed between the potable supply and impounded
water.
3. Water withdrawn from wells on each property shall not be used for watering of lawns
and/or gardens.
4. Ground water withdrawn from each property shall be restricted to a rate of three(3)
gallons per minute.
5. Installation of water conserving fixtures such as low flow toilets, faucets and shower
restrictors and other water saving plumbing fixtures.
6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation).
Please NOTE that the above listed measures are not intended to be exhaustive, but rather
is intended to be illustrative of the types of water conservation measures.
•
5.) MANDATORY MEASURES FOR HIGH RISK SIPZ:
1. For proof of potable water on a building permit application, applicant must utilize
DOH-approved public water system if available.
2. If public water is unavailable, a qualifying alternative system may be used as proof of
potable water or an individual well may be used as proof of potable water subject to the
following requirements:
a. Variance from Chapter 173 WAC standards granted by Ecology per WAC 173-160-
106 for a new groundwater well within 100 feet of a sea-salt water intrusion area per WAC
173-160-171 (i.e., within 100 feet of a groundwater source showing chloride
concentrations above 200mg/L or within 100 feet of the marine shoreline); or for an
existing or proposed groundwater well not subject to an Ecology variance, applicant must
provide evidence through a hydrogeologic assessment(relevant components of an
Aquifer Recharge Area Report per UDC 3.6.10.e) of a reasonable probability that the
subject aquifer will not be degraded by the proposed use of well.
b. Installation of a flow meter.
c. On-going well monitoring for chloride concentration.
d. Submittal of flow and chloride data to the County per monitoring program.
3. If public water is unavailable, a qualifying alternative system may be used as proof of
potable water.
6.) A flow meter shall be installed prior to final sign off of the building permit.
7.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP)
Elements#1 through#12 of the Department of Ecology's Stormwater Management
Manual for Western Washington 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.) The site plan, as submitted with the building application on March 5, 2012, 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 January 13, 2014 shall be resubmitted for review
and approval by Jefferson County Department of Community Development.
9.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
10.) 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.
11.) A minimum of two(2) on-site parking spaces shall be provided for the single family
residence.
12.) This parcel is within a no shooting area per JCC 8.50.
13.) 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.
14.) 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.
• •
15.) The building height is not to exceed 35 feet.
16.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
\\firlAmark\rlata\fnrms\F RI 11 Permit Rlrin nit 1/99/9014