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BLD2014-00022
UILDING PERMIT APPLICA N BLD14-00022 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00022 Received Date: 1/16/2014 SITE ADDRESS: TOG RD OWNER: DAVID H TOMAR PHONE: 360-265-8379 SALLY J TOMAR 910 DESERT SAGE HOBBS NM 88242-9780 BRINNONWOLD SUBDIVISION: Block: Lot: PARCEL NUMBER: 936000206 Section: 23 Township: 26 N Range: 02 W CONTRACTOR: SUNRISE CUSTOM CABINETS PHONE: 360-427-2448 CHUCK RUTHERFORD 70 E HEATHERWOOD CT SHELTON WA 98584 Contractor's License SUNRICCO61J5 Expires 4/21/2013 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOII NSR - 2 STORY WITH ATTACHED GARAGE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 739 VALUATION 200,000.00 ADD'L: 1,000 HEAT TYPE: EEE CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: SHORELINE: GARAGE: 261 CONST TYPE: SETBACK: DECK: 272 BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: 0 Prop: 2 Prop: 2 Total: 2 Total: 2 Routing Date: Type Amount Paid Bv: Date: Receipt: Approved/Date Plan Check $1,122.55 JLA 01/13/14 145709 Permit $1,727.00 JLA 01/13/14 145709 APPROVED Potable Water Application $66.00 JLA 01/13/14 145709 State Building Code $4.50 JLA 01/13/14 145709 Total: $2,920.05 Jefferson County DCD \\firicmor4\rlo4o\fnrm\F RI Il Ann Rlrl rn+ 1/1R/9r11A �0-` " ('b, DEPARTMENT OF COMMUNITY DEVELOPMENT �, „� 621 Sheridan Street,Port Townsend,WA 98368 ..r Tel:360.379.4450 I Fax:360.379.4451 Web:www.co.jefferson.wa.us/communitydevelopment .g °�� E-mail:dcd @co.jefferson.wa.us CERTIFICATE OF OCCUPANCY PERMIT#: BLD14-00022 APPLICANT: DAVID H TOMAR PHONE: 360-265-8379 SALLY J TOMAR 910 DESERT SAGE HOBBS NM 88242-9780 SITE ADDRESS: 431 LEE WAY Issue Date: 02/25/2014 Final Date: 11/21/2014 SUBDIVISION: 9360 Block: Lot: PARCEL NUMBER: 936000206 Section: 23 Township: 26 N Range: 2W PROJECT DESCRIPTION: NSR- 2 STORY WITH ATTACHED GARAGE THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2012 EDITION. OCCUPANCY GROUP: R-3 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM yes co6__.> THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 11/21/2014 \\tidemark\data\forms\F_BLD_Occupancy.rpt 11/21/2014 r WSEC COMPLIANCE FORM -CTE ZONE 1 di rlProject: Tomar Residence MO. Telephone: I Warcel 0:1 I Date:(6/14/2012 'Type of Project: Single Family Res. Analyst:Kari Trevorrow For Foster&Williams Architects Total of Heated Area: 1,739 S.F. 15`Floor: 739 2"O Floor. 1000 Bsmt./Other: Heating tem ype: 12 Electdc Wall Heaters •Other(Specify): hhh •Boiler-Specify fuel Type: 0 Gas Furnace 0 Air Source Heat Pump ❑Ductless Heat Pun„ ❑Other(war): Glazing -ctg.` Compliance Method: •Prescriptive Opt.I •Prescriptive Opt II CI Presaiptive Opt to ❑System Analysis,Chapter 4 14.55% Check One: .. ❑Component Performance,Chapter 5-Calculation Worksheet Required Ventilation El Exhaust Fan & Fresh Air Vents (M1508.4) Energy Credit Option Type %'GI.Allowed V.Glazing 0.H.Glazing Doors System: ❑L tbatedied with Forced Air system(M1508.5) Option(s)From` ;Opt.1 0.13 0.34 0.50 0.2 ❑Heat Recovery Ventilation System (M1508.7) WSEC Table 9-1 Opt.2 0.25 0.32 0.50 0.2 0 ocher Opt.3 Unlimited 0.30 0.50 0.2 can Tate [: T We t *V Windows&Skyyhts) Actual Weighted U iakie,(W B ) iCo tfcu anc Fresc?M ►od 1 ((8.34 x 25340+(0,50x 8)x.0+8.0)= 0.34 ((029x253.0),+(0.0 x"O.#)))/053=0+OA_ 0.29 Glazing%Too Large Brie.ti tod2: ((032x253.0)+(05)x0))1(253:1 +(motopa 032 ((1329x2¢3 +(fX0 x0.0))l( .0+OA)= 049 Conforms pexie,method"S: ((O30x 253 +(OS x 0#(253:0+0,0144 0.30 1(0-29x253.0)+(0.0 x 0.0))I ,o 1 a 0)* .0� Conforms Shapes:R=Round,H=Hatt Rot.uA Q=Quarter Round, T=Triangle E=Exempt, Blank=Rectangular Window->444- Windows Window Room - U- Quan- Size y Area UA Brand Type Name Value tity W(D)I H Shape (S.F.) Value ,Milgard Tuscany or Montecito Horiz.Slider-3DM/SS/AR/LES/EGM Guest Bedroom 0.30 2 4° 4° 32.0 9.60 Milgard Tuscany or Montecito Horiz.Slider-3DM/SS/AR/LES/EGM Play Room 0.30 1 4° 4° 16.0 4.80 Milgard Tuscany or Montecito Horiz.Slider 3DM/SS/AR/LES/EGM Kitchen 0.30 1 3° 3° 9.0 2.70 Milgard Tuscany or Montecito Horiz.Slider-3DMISS/AR/LES/EGM Dining 0.30 2 3° 4° 24.0 7.20 Milgard Tuscany or Montecito Pict.-3DM/SS/AR/LES/EGM Dining 0.28 1 3° 5° 15.0 4.20 Milgard Tuscany or Montecito SI.GI.Dr.-3DM/DS/AR/LES/EGM Dining 0.28 1 6° 6 70 41.0 11.48 Milgard Tuscany or Montecito Pict.-3DMISS/AR/LES/EGM Living 0.28 2 3° 5° 0 30.0 8.40 Milgard Tuscany or Montecito Pict.-3DM/SS/AR/LES/EGM Master Bedroom 0.28 1 3° 5° 15.0 4.20 Milgard Tuscany or Montecito SI.GI.Dr.-3DM/DS/AR/LES/EGM Master Bedroom 0.28 1 6° 6 10 41.0 11.48 Milgard Tuscany or Montecito Horiz.Slider-3DM/SS/AR/LES/EGM Master Bedroom 0.30 2 3° 4° 24.0 7.20 Milgard Tuscany or Montecito Sing.Hung-3DM/SS/ARILES/EGM Master Bath 0.30 1 2° 3° 6.0 1.80 Target Weighted U-Value for Windows= 0.30 T g/Window Area/Total UA: 2d3.0».' 0.06 , Weighted U-Value=Su UA)I Total Window Area (not including exempt windows) Door Door Model Room U- Quan- Size Area UA Brand Number or Type Name Value tity W I H Shape (S.F.) Value Insul.Steel&Wd.Frame No Glazing Entry 0.37 1 3.1) 6 g. , 20.0 7.40 Insul.Steel&Wd.Frame No Glazing Garage to House 0.37 1 3° 6 8 20.0 7.40 Target Weighted U-Value,for Doors= 0.20 Total Door Area Total 40.0 14.80 Weighted U-Value=Sum(UA)lTotal Window Area>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>»: 0.37 Garden window up to 1%of floor area and 1 door up to 24 square feet may be exempted.Garden window area is tripled. AR=Argon gas, LE'Low E coating, LES=Low E Suncoat,,LESM'=Low E Suncoat Max, EG=Edge Guard, EGM=Edge Guard Max, 3D=3D Eneregy Package,3DM=3D Max Energy Package,SS=Single Strength 3018"Glass,DS=Double strength 1/4"Glass,HPLE=High Performance Low E, Temp.=Tempered Glass,SD is Sun Defense Dual Low E Coating (Grids have no effect on U-Values unless noted otherwise) soN • „rio. JEFFERSO•OUNTY IA DEPARTMENT OF COMMUNITY DEVELOPMENT al • '4 621 Sheridan Street• Port Townsend •Washington 98368 -4` t• 360/379-4450 • 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment 14inve Master Permit Application MLA: Project Description(include separate sheets as necessary): New ersastruchi 0 vt Ztorky Nom e. Iv/.1---Gt 4&fa / Glx r e Tax Parcel Number: q•3 4_600-14 ¢- 7.34-oo a-,Zo 7 Property Size: 0,W...t." (.3 y,Act, tj(acres/square feet) Site Address and/or Directions to Property: ao 7 LE E WAY ettbtlac, (1-0\- Ctg3.20 Property Owner(s)of Record: Dm/0 4. So"Ity roiNNAIN, Telephone: 360-26 5- '1?3 7 Fax: email: PIM Mailing Address: Ci(6 W. cEGt4Vr 110 HQ5 N1V1 88240 Applicant/Agent(if different from owner): e.tkpxki.e.„0 L. Hin-I-WriForio Osit SomillA SE ek257-0•01.644/mE2f Telephone: -3‘0-11g7-029 S" Fax: 3k0 - / email: ivAit Mailing Address: -70 A_■0C,_ar_7 /4"17-0 4.-/4 9 r5-8- What kind of Permit?(Check each box that applies El Lot or Road Segregation Suilding 0 Critical Areas Stewardship Plan O Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) g Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or ** — El Manufactured Home .0 Modular .• - 0 Discretionary"D"or Unnamed U. O Commercial* 0 Special Use(Essential Public F- - O Change of Use 0 Boundary Line Adjustment ( Address a 07 'Road Approach rO. 11.14Y 0 Short Plat*" 0 Home Business 0 Cottage industry El Binding Site Plan** JAN 1 3 2014 0 Propane 0 Long Plat** , El Sign 0 Planned Rurai Residential Deve pr4fit(PRRD)/AmennmpntQ*4 0 Allowed"Yes"Use Consistency Analysis CI Plat Vacation/Alteration** JEFFERSON COUNTY b(Stormwater Management 0 Shoreline Master Program ExerriptionfMtrnil'ArbibiftEMOPMENT [2(Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** 0 Temporary Use 0 Shoreline Management Variance 0 Wireless Telecommunication* CI Comprehensive Plan/UDC/Land Use District Map Amendment 0 Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment *May require a Pre-Application Conference 0 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 el1441E5 litimeilfax ," to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE 4111 Date:4- II /11/1 3 -w or By signing this application form,the owner/agent a -sts 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 appli tion that he or she w prior Signature: g Date: A0707 3 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-transfer late r sponsibility for adhering to an complying with the ESA. The Applicant has read this disclai er an signs and dates it below. Signature: 1L 0.j1 iv,, I,Astocif/d Date: G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc all 0 • . BUILDER STATEMENT The signer of this statement does hereby cert. that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming the responsibility of th' eneral Contractor for the proposed project. l Signatur-• � . Dater U Ott//3 ar GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: Gr''_/7 1 D 3Af, SoNRtsE CvsrnM CAdtavrts ( ) ( ) MAILING ADDRESS: 70,E NE4 T-74. Wopo C.Tr, i 5 L tk 4 Eva- 9"(5 9 CONTRACTOR'S LICENSE / WAINS NUMBER: Sv 1�R tc c© 6 1.73- NUMBER 9/-,7/0 .3 S 76- ARCHITECT/ENGINEER: F,057ThAt tuati o A0 007„ /,p PHONE (3i3O) 426-06II FAx:( ) /A MAILING ADDRESS: SVFLit (04 9y j gyt EMAIL /1/141 teNV.,tt\1C)w5. e.iyw Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: t New IX Wood Existing: -0' 0 Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel J. Concrete Total: Height: XIndividual System ❑ Repair ❑ Masonry /We SEP Permit# O Bedrooms: Water Supply: Demolition ❑ Other: pP Y: Existing: -" Setback: 0 Private well ❑ Two Party Type of Heat: ere,OcgEra Proposed: A XPublic Total: A544 I FOo,4*rTb w Name of System:UhnvuoaoLe C a-Amk 4kor Pk' Ft . i'kenvw NOM IA wVsr ui4tr4 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: I Underground Tank 1 Above ground Tank Size of Propane Tank: I Heat Stove i Cook Stove I Woodstove i Fireplace Insert I Hot Water Tank i 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 Uwe.* - Amount .'-Revision Main Floor Heated 7.3 ,t p G., EH Bld App Review: 1-q 2"0 Floor Heated Consistency Review: fr o©© 11 aZl°- Z7V Other Heated Base fee: i-2 - — Mezzanine Additional Section Heated Basement Plan Check fee: f la S--"S- Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: U Ga, rzle/Carport c ,, M1 SUBTOTAL / r Decks (a ( 1-S `t 911/Rd Approach fee: 2?<cw At Other CQUt is Q C C-K /'■ 3 1 s`f 0 TOTAL: $ t,Us 4 Receipt Number: `c.�.C�de Cash/Check Number: „221 .z 2 q.P. a. 1vt2-fl ESTIMATED COST(REQUIRED) I Date: •Fair market value of all labor and materials foundation to finish ' ` �, 0 076o_i 000, 00 Initials: cPr G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc SUNRISE CUSTOM CABINETS Page 1 of 2 • • 0 Washington State Department of Labor & Industries ISUNRISE CUSTOM CABINETS Owner or tradesperson 70 E HEATHERWOOD CT RUTHERFORD,CHARLES L SHELTON, WA 98584 360-427-2448 Principals MASON,County RUTHERFORD, CHARLES L Doing business as SUNRISE CUSTOM CABINETS WA UBI No. Business type 601 541 282 Individual Governing persons CHARLES LEONARD RUTHERFORD ILicense Verify the contractor's active registration/license/certification (depending on trade) and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. SUNRICC061 J5 Effective—expiration 04/25/1994—04/21/2015 Bond RLI INSURANCE CO $12,000.00 Bond account no. RSB387320 Received by L&I Effective date 04/09/2002 04/21/2002 Insurance Hartford Cas Ins Co $300,000.00 Policy no. 52SBAUL9759 Received by L&I Effective date 02/26/2013 04/21/2011 Expiration date 04/21/2014 Savings No savings accounts during the previous 6 year period. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601541282&LIC=SUNRICC061 J5&SAW= 1/16/2014 Screen : 01 REAL PROPERTY MASTER Mode : INQUIRY Auto Roll : OFF Parcel # 000936000206 Geo Cd 260223411441 BRINNONWOLD Nbhd Cd 1345 BLK 2 LOT 6 Loc ID * Taxpayer Cd TOMA 4100 TOMAR , DAVID H T/P Chg Dt 4/27/2007 * Title Owner T/P Chg Usr JA Tax Code 0441 Status TX TAXABLE Land Use 9100 VACANT LAND Affidavit 109054 Vol/Page / C/U Code COMPLETE ADDRESS WINDOW Taxpayer TOMA4100 DAVID H TOMAR SALLY J TOMAR 910 DESERT SAGE HOBBS NM 88242-9780 Search Ke CMD 6 : End Window CMD 7 : End of Job zz 2- (t'L �« o Uperont Parcel Review o — 2 `(tip Parcel 936000206 Printed: January 28, 2014 Site A_ ddress: DAVID H TOMAR TOG RD SALLY J TOMAR 910 DESERT SAGE WA HOBBS, NM 882429780 al Acreage 0 Parcel Number: 936000206 S-T-R: 23-26N-02W Tot Use: 9100 Legal Description BRINNONWOLD BLK 2 LOT 6 Land Us Are.: 11 Fire District: 4 Flood District: School District 46 Zoning: Flood Map(FIRM)Panel No: COMP PLAN DESIGNATION: UGA: UGA Trans COMMUNITY PLAN: [!/r Plot plan states "property line" i ,/ Assessor's Map (Property lines on submitted plot plan must match the property lines as identified on the Assessor's 1/4 map) [ `� YES N• [ V]' Legal Access to Property NO o ` [ V Parcel Tags or Scanned Document-4M [ Vr ESA's: Special Reports Nearby YES NO [ v( Designated Ag YES NO [ v Shoreline Designation: YES [ t,Y Shoreline Slope Stability.. NO _ _ --WW1 ` Stream Type:YES NO FWHCA: YES NO Wetlands: YES NO Rare Plants:YES NO Seismic: YES NO Landslide NO . Flood: YES NO Erosion: YES NO /_ Aquifer Recharge Area:YES NO High Risk oastal SIPZ: none At Risk g CMZ: none High Risk Moderate RiskDiscs ected CMZ Stormwater site plan sus itted: YesNo [( l Forest Lands: YES NO Rural/ Inholding Adjoining Forest Lands: Commercial/ [ Mineral Lands: YES dP [ I/1 Agricultural Lands: YES '• [ VI Archaeology: YES [ / No Shooting Zone: YES • (Q ESA's �L Land Disturbing Activity [ l4 Stormwater: New Impervious Surface Min Req#I thru#10 Engineering Stormwater Req's:Min Req#2 eq#I thm#5 [ll/f Notice Provisions/Disclosure:Airport YES No MRL YES No Forest Lands vES No [V]' Landscaping Required: Yes No _ [ wr Parking Spaces Required NO Q Other 1 vY Building Height: UBC Standard ImpResoervious urce Surface Lands&Public:covera10%ge peretaResidenti. . Rural Industrial: P C Sec 6.7 L- yr Rural Commercial: 60% Area of Building Coverage:60%in Rural Industrial Lan s only t." Total Building(s) Size: RVC:20,000 SF CC: 5,000 SF NC:7,500 SF GC: 10,000 SFRAll others:subject to septic water constraints/None specified t/r Setbacks: Front: Left Side: ___— g Shoreline Setback: LSHA Setback: II L( Road Classification: Road Approach: EXISTING NOT REQ D RAP • [ L SEPA Required: YES EXEMPT ,t_.]- Flood Certificate: [ Existing Case(s)&Condition(s): Violations: Yes No AFN Over Syrs=UDC 1,1/". Recorded Date of Subdivision: <5yrs=Plat Conditions on plat or Old Ordinance Plat Conditions: +, 3J p, submitted: YES NO [�]' Lots/Require Declaration of Restrictive Coubmitted: YES NO [ t UGA No Protest Agreement YES [ (Ai Site Visit conducted YES 14) [ t.,r- Require Final Zoning Approval 'ES 40 ADMIN: Setbacks entered in Permit Plan case • YES [ New Parcel Tags entered in Permit Plan iYES Special Reports Scanned tg, YES Updated Title Notes Parcel tags found for parcel 936000206 08/28/2013 1.) WSRC Coaching - 2012-05-31, CZ CAO Cases Associated with APN 936000206 Revi` ew_Type Status Planner Cases Name ADR14-00002 P TOMAR Case Finaled: Application Received: 1/16/2014 Permit Issued/Case closed: NEW RESIDENTIAL=RES'S- BLD14-00022 P TOMAR Case Finaled: Application Received: 1/16/2014 Permit ARAGEuedlCase closed: NSR -2 STORY WITD F SEP93-00108 OLDENBURG Application Received: 2/18 Permit Issued/Case closed: 4/2/1993 Case Finaled: 8/14/199 pp - F SOM93t00108 TOMAR Case Finaled: Application Received: 8/14----/1995— Permit Issued/Case closed: Page 2 of 2 \\tidemark\data\forms\R_Parcel_CRMLA.rpt 1/28/2014 • • BUILDING PERMIT APPLICA, ON BLD14-00022 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00022 Received Date: 1/16/2014 SITE ADDRESS: TOG RD OWNER: DAVID H TOMAR PHONE: 360-265-8379 SALLY J TOMAR 910 DESERT SAGE HOBBS NM 88242-9780 BRINNONWOLD SUBDIVISION: Block: Lot: PARCEL NUMBER: 936000206 Section: 23 Township: 26 N Range: 02 W CONTRACTOR: SUNRISE CUSTOM CABINETS PHONE: 360-427-2448 CHUCK RUTHERFORD 70 E HEATHERWOOD CT SHELTON WA 98584 Contractor's License SUNRICCO61J5 Expires 4/21/2013 .(2-0. REPRESENTATIVE: PHONE: 7c;, 0 3 31 5-aux-ul e c i cw b tavja, q)66. ire PROJECT DESCRIPTION NSR - 2 STORY WITH ATTACHED GARAGE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 739 VALUATION 200,000.00 ADD'L: 1,000 HEAT TYPE: EEE CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: 261 SHORELINE: CONST TYPE: DECK: 272 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: 0 Prop: 2 Prop: 2 Total: 2 Total: 2 Routing Date: Type Amount Paid Bv: Date: Receipt: Approved/Date Plan Check $1,122.55 JLA 01/13/14 145709 Permit $1,727.00 JLA 01/13/14 145709 Potable Water Application $66.00 JLA 01/13/14 145709 State Building Code $4.50 JLA 01/13/14 145709 Total: $2,920.05 gON C • • 4, • or,. JEFFERSON COUNTY w�. ' IA' DEPARTMENT OF COMMUNITY DEVELOPMENT '"' ` `4 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax gyp$ www.co.jefferson.wa.us/commdevelopment HIND Master Permit Application MLA: Project Description(include separate sheets as necessary): 'New Cnrtskt Licht ov - T 4,v S t o r y M'ne- wt'Z-it at-a , / 60,vry e Tax Parcel Number: q"3 ts_600 261 9L 934-o'a- zo 7 Property Size: ©,7g.5'" (3 t Aer) a)(acres/square feet) Site Address and/or Directions to Property: 2.0 7 L1 E WA Y Pt• t,u, VA. Ct ad Property Owner(s)of Record: Zokx.A 4 It■ 1'o Ar\• Telephone: 3 6 a•-a6 5-- 03 7? Fax: N/4 email: . 2?fAt Mailing Address: Q(0 W. O Era kf'lT aA<E 13 0 �j Ho6IS S /VM $572.640 Applicant/Agent(if different from owner): CtitAtkl.�.9 L HurNE1%Forio O84 5t)rn.MA SE C 2,n-D' M' Telephone: 3d0-4 7-o?9 5c 8' Fax: ,4,0- Si 3,,Z -0/171 email: A•%3' Mailing Address: 70 E 4TN e 'tvevd .s• r 5/71. 1 rat/ 4.14 9 8.S8' What kind of Permit?(Check each box that applies ❑Lot or Road Segregation giuilding ❑Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use) Igt Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d),or,Gj** ❑ Manufactured Home. .❑ Modular • - - ❑Discretionary"D"or Unnamed J : , 14 a+ice, II V E ❑ Commercial* ❑Special Use(Essential Public Fl, ❑ Change of Use ❑Boundary Line Adjustment I f 0 Address 7 I Road Approach U � Y ❑Short Plat** r go Home Business ❑Cottage Industry ❑Binding Site Plan** 1 ' JAN 3 2014 ❑Propane ❑Long Plat** I l I J( ❑Sign ❑Planned kurai Residential Devploptr ee t(PRRD)/AmennmPnts*'j ❑Allowed"Yes" Use Consistency Analysis ❑Plat Vacation/Alteration** JEFFERSON COUNTY XStormwater Management ❑Shoreline Master Program Exernptioni7e0fatCR&ItioffiEffLOPMENT 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 i944/V ES '. livr/ re/f 4 to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE r ' ' .� -' aer- , Date: - 11 iii/I i By signing this application form,the owner/agent a -sts 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 appli tion that he or she w n prior noti Signature: �/ 2�L OZ Date: ///7770/3 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-transfer ble r sponsibility for adhering to aliscomplying with the ESA. The Applicant has read this disclai er an signs and dates it below. Signature: 41 1_ \A Date: !i�7a0/3 _O___ • BUILDER STATEMENT The signer of this statement does hereby certi that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming the responsibility of th, eneral Contractor for the proposed project. Signatures d,Ce' is-/,,,,-- Date: II ////43 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAx: GYM e/42 1).elAO St1nl41 SE Ct.srv, cewovers ( ) ( ) MAILING ADDRESS: 70 e b' T LV00 CT, / CONTRACTOR'S LICENSE �� v�( 112`t- 9C -5.�� NUMBER: WAINS Su t iC c C 4 T,r NUMBER 9/-07/ 'J 3 8 7.S" ARCHITECT/ENGINEER: ;F05 tutUlArvo pO QCJ?l. /O PHONE (.340) 42 b-06// FAX:( )4i/A MAILING ADDRESS: SA[=L1-00 ,4 9B'6 13", EMAIL Aeta / ,FC)SteAU.st I‘lcivils, 634/ Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ( New X Wood Existing: ..0-- C Sewer C Addition ❑ Steel Proposed: a Bank G Community System C Alteration/Remodel )3, Concrete Total: A _ Height: (Individual System u Repair C Masonry �'� SEP Permit# C Demolition ❑ Other: Bedrooms: Water Supply: Existing: -.0- Setback: 0 Private well ❑ Two Party Type of Heat: G►p&c4E Proposed: XPublic Ete-thrte ( 5906v404-rip w Total: AMI Name of System:Oi;t rnroie ep.t.* 4t1i• PlvS Fly iRcrilil Netk,M \J s r .u4-r 4 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 Pro•ane Tank and/or A••liance Installation •ermit mark all items below that a••I : i Underground Tank i Above ground Tank Size of Propane Tank: i Heat Stove i Cook Stove l Woodstove 1 Fireplace Insert f Hot Water Tank i Pellet Stove 1 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 Use Only - Amount Revision Main Floor Heated Igy EH Bid App Review: q 7.3q t ct, 2m Floor Heated Consistency Review: 4, WO J f OZ'7U- Z-2-5? • Other Heated Base fee: Mezzanine Additional Section Heated Basement Plan Check fee: p (Z 2. S Unheated Basement State Surcharge fee: t /� Other Unheated --�` 'P " t —C Pot Water Review fee: / U6 , Gar�ae/Carport SUBTOTAL / ° - - _Z '.ors Decks ti 911/Rd Approach fee: cw b ° 1.- 22 4 Other 4 C Ct� / 2)441,440. TOTAL: O. 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I I i .. /41111 • • • • gsoN oo6, JEFFERSON COUNTY ; -N., DEPARTMENT OF COMMUNITY DEVELOPMENT ,;1` r=; via i . -�~ 621 Sheridan Street • Port Townsend • Washington 98368 � 360/379-4450 • 360/379-4451 Fax 01 2014 IIN http://www.co.jefferson.wa.us/commdevelopment/ JEFFERSON COUNTY ''r OF CO^;^P,1IUNITY DEVELOPMENT Stormwater Calculation Worksheet MLA# PROJECT/APPLICANT NAME: OAINALZ,5 L, (Z UTbtefWFoRJ 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 0, 78'5 acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet 31112 ao 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) acid/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 a 1 3 4 sq/ft native vegetation to lawn or landscaped areas? Drainfield, septic tank, etcT „�,9' O &. sq/ft Circle: Yes Io Well, utilities,etc. tovh nvvtitr tA.,e.11 sq/ft Does the project convert 2'/z acres or more of native vegetation to pasture? Driveway, parking,roads,etc. R sq/ft Circle: Yes N Lawn, landscaping, etc. 1/,SU49 sq/ft Other compacted surface,etc. sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance .3 I/ 7� sq/ft Cut $4 Cu`ftl Fill [8 GoYh(cu/yd) [over] stormwater talc worksheet Rev 9-9-2010—REV 9/9/2010 1 ' ill• 0 • i 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) 4 39,. sq/ft Structures(all roof area) .0' sq/ft Sidewalks ,e sq/ft Sidewalks ,■ • sq/ft Patios sq/ft Patios 1 sq/ft Solid Decks .6 ' sq/ft Solid Decks 4ge. sq/ft (without infiltration below) (without infiltration below) Driveway, parking, roads,etc 2, 6/67 e7 sq/ft Driveway, parking, roads, etc 71 6/G 0 sq/ft Other sq/ft Other R k tua/ 75-0 sq/ft Total New 3� SS. sq/ft Total Existing 3/Z/a sq/ft TOTAL NEW+TOTAL EXISTING* _ 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: 9..3 tr % Does the site have 35%or more of existing impervious surface? Circle: Yes 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. Zi (LANDOWNER A O IZED REP SEN SIGNATURE) (DATE)/1/ 7/767/-3 b r� ,,,,,,,,,,,,,,o,, ,,—,,,,�`F`ORrOFFIC,I FUSE ON �°`�� td g f 1 e ti sF A J 1. : b y a A"+Va r s gin r `off rt. v x� 9;. d v' S 3 a S< g` T 4 ' ✓"p- ;, �+T. ' l `, - 'x a -f:c.s oz s 4 y4 'S X, t,�ix� �� �Q^ -Y, „e k �„e�'k�,�3 e^'s� i�,:�' x �x3 '�7y. ,.-`.+'.�' x: ':�` i �,�:"�a � ygf'y� =�a y r -" .a.x 14na`�K'0. a , 5'. ;i. iii-. gift r''� 1. e ! z -, a ;`x x* ,viii stormwater catc worksheet Rev 9-9-2010—REV.9/9/2010 2 M 582106 POP 3 COV 02/18/2014 11:42 AM $74.00 DAVID TOMAR Jefferson County WA Auditor's Office - Donna Eldridge: Auditor VIII 10:4'?.1fiIt'IitY,1L Y.IILYIE MN.1 1441ini ki 11111 Jefferson County Department of Community Development Development Review Division 621 Sheridan Avenue Port Townsend,WA 98368 DECLARATION OF RESTRICTIVE COVENANT • Grantors: David & Sally Tomar Grantee: Jefferson County Department of Community Development Jefferson County Health& Human Services k THIS DECLARATION is made and entered this t l day of Ve.b00Qc•t` , 2014, by ow :Icon/Nor-Gne■ SqU i TTv 01ar , hereinafter referred to as "Owner(s)," the legal and equitable owner(s) of the real property described herein. A. RECITALS 1. Legal Description: This Restrictive Covenant shall affect and restrict the real property("the property") legally described as follows: Parcel Numbers: 936 000 206 Section: 23 Township: 26N Range: 02W ramp Subdivision: Brinnonwold Block: 2 Lot(s): Lots 6 & 7 sta j/erisc / 2. Building Permit Application. The Owner(s)have applied or will apply for a building permit through the Jefferson County Department of Community Development ("the County") and/or an on-site sewage permit through the Jefferson County Health & Human Services ("Health Department")to make certain improvements upon the above-described property. 3. Purpose. For purposes of complying with the County's building and land use codes and ordinances, as well as the Health District's minimum land area for issuance of an on-site sewage permit per WAC 246-272, the Owner(s) desire to treat all of the above-described property as one building tract, and in particular, desires to do so for the purpose of zero lot line setbacks for Construction of a Single Family Residence. 4. Assurance to County. The Owner(s) desire to assure the County that the property described P:\DavidWJ\Planner Info2\DRC Tomar BLD14-00022.doc Page 1 of 3 N M above shall be and remain as one building tract for purposes of improvements to be constructed upon the property; NOW, THEREFORE, in consideration of the benefits derived by this Restrictive Covenant, the Owner(s) declare, covenant and agree as follows: B. COVENANT 1. Specific Restriction and Covenant. The property described above, shall constitute a single building site, and no lot or lots or any part thereof shall be transferred or conveyed in any manner unless and until the building(s), structure(s) or on-site sewage disposal provisions are made to conform to the then-existing zoning provisions on a reduced site. This restrictive covenant shall not be removed unless such an action is approved by the County and the Health Department. 2. Covenant Running with the Land. This restrictive covenant affects and restricts the described property and shall be construed as a covenant running with and touching and concerning the land and inuring to the benefit of the Owner(s), the public generally, and the County. 3. Binding upon Successors and Assigns. This restrictive covenant shall bind and restrict the land, the Owner(s), their heirs, grantees, successors and assigns. 4. Recording. Upon its execution, this Declaration shall be recorded with the Jefferson County Auditor. All contracts and deeds or other instruments of conveyance relating to the property or any part thereof shall contain reference to this covenant. 5. Enforcement. In addition to any other party having a legal right to enforce this covenant, the County shall have the right to enforce and compel compliance with this covenant, including all remedies available at law and equity. The County shall have the right in any such proceeding to recover its attorney fees and costs. 6. Compliance with Code Requirements. This Declaration does not amend or modify, nor is it intended to amend or modify any requirements of the County's ordinances or any other law or regulation dealing with or affecting the use of land or construction of improvements upon lands. 7. Estoppel. The Owners by this Declaration specifically estop themselves and all of their successors and assigns and all persons presently or hereafter having any interest in the property from asserting or contending in any manner that this restrictive covenant is not a full and adequate covenant running with the land and binding upon the property. 8. Severance. Invalidation of this covenant by judgment or court order shall not affect any of the other covenants which shall remain in full force and effect. P:\DavidW7\Planner Info2\DRC Tomar BLD14-00022.doc Page 2 of 3 9. Warranty of Authority. The Owner(s) signing below warrant that they are the sole Owners in fee of the real property described above and are authorized to make this Declaration and so bind the property. 10. Governing Law. This RESTRICTIVE COVENANT shall be governed by the laws of the State of Washington. 11. Disclaimer. Since no survey was submitted as part of your Restrictive Covenant, the County accepts no liability for what facts a survey might have revealed. A survey might have revealed that a structure or improvement believed to be on the grantor's property is, in fact, located wholly or partially upon someone else's property or upon property that is not the subject of this application. But, in the absence of a survey, the GRANTOR bears sole responsibility if such a problem arises. ted this day of c vckf` , 2014. � Owner er YnAnd t CC STATE OF IHNGTON ) LAD. ) ss COUNTY OF 3IERSE N ) On this day personally appeared before me, DqUiet euvA S0.I L� T - rfo me known to be the individual described in and who executed the within and foregoing instrument, and acknowledged that he signed the same as his free and voluntary act and deed, for the uses and purposes therein mentioned. Given under my hand and official seal this t1* r_"day of ` , 2014. C2Ake t.4) I■PLL1/4/ NOTARY PUBLIC in and f r th tate of•Waskingtea ov. 4.40 tCe residing at L.-e.Gt.. Co u.vk _ My commission expires: C.I.Z kt Approved: /rim inistrator Date OP.(til . )fin,tit4A.` SAGE'. ' c--(.t•, P:\DavidWJ\Planner Info2\DRC Tomar BLD14-00022.doc Page 3 of 3 INNIIIIIIII 8'-O" ,25'-P" 11'-4" . 4pr0n 3'-8" 31.;3H 1I'-0" 31,_11' . o J �z w v: . o c IJ I ,1/,l I JJ • I • 30 40 30 40 . 11 7., Ft,�r 1 "7'�-'°�•17.7- ,7.71-..1 ;�`; 1 YES -.:t- r v r s-„ 7, :CKING • \ Master Bedroom \A / e > • 122"xv' I o: • 1ACCE •� µ. 50 5� / 1 i4Li IIII IIHIIIHHIUtI 2k `x s i'WARDROBE IN / - 1 1., '_ " ®� . . \ I; . (:J ��Ui.e I. Living Room D. �� 11111111 ' 13� I • �al I . r w 1 • UPPER• \ • ---- L -- `., 9 l d Ic; DininRoom Kitchen. I , . _• y 1-100 " I HI r I -..1,-.,:' \ / _ . 6PAN3 � ,• I .: , •in! I D W. - i �) e' el, -t--1 1 II f 30 40 3040 30 30 I 14 N N S. • L 12'-0" / • • pr Area Table FRONT Floor Area EG- s8 • 40 40 40 40 40 40 N- . r N- „: . v . t . N ' IA / � o 'I _ \ - /' i Guest Bedroom N Play Room it 4 / !(y Imo)/ t \ I \ _ ` 4 % \• 44 1 1 IA \ ��xhN�.,,.� „ • / \ Bath • ! 1 '1 m Pan I _ 1 I; / . ;:' ;' \ \ •t g_ 7ixct k kid.,` 1,., 1 .'; P ^1. ,aetitle:t .:U' 4 / \ F 1 r • 1 / 30 STORAGE I . I SOLID C RE / _ \ DOOR. it I / \ IJ 0 / ( STEPS r/ 8'-10" 4'—E" t„ 1 26 up / 1{Fj •\ / . 4'-I" / •/•'^ '• 5" L'. • / ;: 2x6\STUDS / / W/R- INSUL. • .'' . .... .,, , `� /• nB mqn cgrt e . .+< ra �>_ 1 Garage / �— �' / a I /....( ,, 1 I pis" GYP. BD.O ALLS L 1 Utility i "'�' i 4 55,8' TYPE "X' GYP. BD. is � \ ON CE IL. OF GARAGE •\ ,® I ,: . `�� I • •-- Pan 2 ,u; 1 OUTLET IN ' rl' • CEILING FOR iz, p '\ DOOR OPENER I � i h ,, ,„ Furnace \ ; L� ,r t 3� \Room r. 1. a , )2E 11, �' / ' 90 �0 GARAGE DUOR UP / 1' A �' • ' I I /'/' I , I • I \ FRoNT L I 1 2 3 6'-6" 61-'3" 21.3" 11-T" 4 /r .,.. 3'-6" 4'-6" i I3'-3" '; 4'-4" -(t,mu PIP ' • • • • A.oi.°iv CO6, JEFFERSON COUNTY kt, �y DEPARTMENT OF COMMUNITY DEVELOPMENT fT ;11 f-; 1", Q V E . 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax � 04 21c9IN (CO http://www.co.jefferson.wa.us/commdevelopment/ j f JEFFE RSON COUNTY t "rT,OF COVMUNl7V DEVELOPMENT Stormwater Calculation Worksheet MLA# PROJECT/APPLICANT NAME: 0.l�Ai\1 g,.5 L, R tillAVif=ORJ 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 D, 7845 acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet 31),2 'e 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 l,1 3 4 sq/ft native vegetation to lawn or landscaped areas? Drainfield, septic tank, etc L'')(t6TUuv) 1/02.. sq/ft Circle: Yes 6 Well, utilities,etc. Cavrtwtvwit/ We l/ sq/ft Does the project convert 2 1/z acres or more of native vegetation to pasture? Driveway, parking,roads,etc. 2 4 a sq/ft � Circle: Yes IN Lawn, landscaping, etc. /5OO sq/ft Other compacted surface,etc. sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance S I/ 7 sq/ft Cut 84 w`lm Fill j b Co`ih(cu/yd) [over] stormwater calc 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) I� sq/ft Structures(all roof area) sq/ft Sidewalks .SK' sq/ft Sidewalks sq/ft Patios sq/ft Patios sq/ft Solid Decks sq/ft Solid Decks 4Ft ' sq/ft (without infiltration below) (without infiltration below) Driveway, parking, roads, etc 2,, </(o sq/ft Driveway, parking, roads, etc 7, 4/G Q sq/ft Other sq/ft Other Re d Wad 75-0 sq/ft Total New 3 SS sq/ft Total Existing 312./ sq/ft TOTAL NEW+TOTAL EXISTING* 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: 93 8' % Does the site have 35%or more of existing impervious surface? Circle: Yes 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. &zd2 nu �-/ /1/ 7/7e,73 (LANDOWNER OR AUTHO IZED REP SENTATIVE SIGNATURE) (DATE) F0 ':QF I CE SE O LV' ''S.. '" -..g.' ,x `� '.' +"1'", t .� ,s� 3� r S'� „, +x �`"C.E ; s •t* 4 :.:. ,y,.1r` '¢ksgg A� .�ng�` F a ��-���� xx � �� '�' y sMf u,,,. ���ix.a��d�x3 r F �,. �t?'� 3,s=y 'x��'xf� � 1�� �`.t ,. z. 3k3 xzi{ ag _.a a .x 'Ax,��? .e s+ 0 3� 4� y..�'Y7 f �'x a. '��aA �?�t Slid LL x �r IH U tt, E_r __ A DEV O m Ye stormwater talc worksheet Rev 9-9-2010—REV 9/9/2010 2 M 582106 POP3 COV 02118!2014 11:42 AM $74.00 DAVID TOMAR Jefferson County WA Auditor's Office - Donna Eldridge: Auditor 1111 rd1/2140114'Ii'i+di U .OMN.1 I11rai RTi llid 11111 Jefferson County Department of Community Development Development Review Division 621 Sheridan Avenue Port Townsend,WA 98368 DECLARATION OF RESTRICTIVE COVENANT Grantors: David & Sally Tomar Grantee: Jefferson County Department of Community Development Jefferson County Health& Human Services k DECLARATION is made and entered this `l Ada of �@.‘3PQ r 2014 b THIS DECL , Y by cow a 1-1 rrt G S 1 v a hereinafter referred to as "Owner(s)," 1 owl wl 7`T , the legal and equitable owner(s) of the real property described herein. A. RECITALS 1. Legal Description: This Restrictive Covenant shall affect and restrict the real property("the property") legally described as follows: Parcel Numbers: 936 000 206 Section: 23 Township: 26N Range: 02W Subdivision: Brinnonwold WIr. Block: 2 Lot(s): Lots 6 & 7 stirerific / 2. Building Permit Application. The Owner(s) have applied or will apply for a building permit through the Jefferson County Department of Community Development ("the County") and/or an on-site sewage permit through the Jefferson County Health&Human Services ("Health Department")to make certain improvements upon the above-described property. 3. Purpose. For purposes of complying with the County's building and land use codes and ordinances, as well as the Health District's minimum land area for issuance of an on-site sewage permit per WAC 246-272, the Owner(s) desire to treat all of the above-described property as one building tract, and in particular, desires to do so for the purpose of zero lot line setbacks for Construction of a Single Family Residence. 4. Assurance to County. The Owner(s) desire to assure the County that the property described P:\DavidWJ\Planner Info2\DRC Tomar BLD14-00022.doc Page 1 of 3 N M above shall be and remain as one building tract for purposes of improvements to be constructed upon the property; NOW, THEREFORE, in consideration of the benefits derived by this Restrictive Covenant,the Owner(s) declare, covenant and agree as follows: B. COVENANT 1. Specific Restriction and Covenant. The property described above, shall constitute a single building site, and no lot or lots or any part thereof shall be transferred or conveyed in any manner unless and until the building(s), structure(s) or on-site sewage disposal provisions are made to conform to the then-existing zoning provisions on a reduced site. This restrictive covenant shall not be removed unless such an action is approved by the County and the Health Department. 2. Covenant Running with the Land. This restrictive covenant affects and restricts the described property and shall be construed as a covenant running with and touching and concerning the land and inuring to the benefit of the Owner(s), the public generally, and the County. 3. Binding upon Successors and Assigns. This restrictive covenant shall bind and restrict the land, the Owner(s), their heirs, grantees, successors and assigns. 4. Recording. Upon its execution, this Declaration shall be recorded with the Jefferson County Auditor. All contracts and deeds or other instruments of conveyance relating to the property or any part thereof shall contain reference to this covenant. 5. Enforcement. In addition to any other party having a legal right to enforce this covenant, the County shall have the right to enforce and compel compliance with this covenant, including all remedies available at law and equity. The County shall have the right in any such proceeding to recover its attorney fees and costs. 6. Compliance with Code Requirements. This Declaration does not amend or modify, nor is it intended to amend or modify any requirements of the County's ordinances or any other law or regulation dealing with or affecting the use of land or construction of improvements upon lands. 7. Estoppel. The Owners by this Declaration specifically estop themselves and all of their successors and assigns and all persons presently or hereafter having any interest in the property from asserting or contending in any manner that this restrictive covenant is not a full and adequate covenant running with the land and binding upon the property. 8. Severance. Invalidation of this covenant by judgment or court order shall not affect any of the other covenants which shall remain in full force and effect. P:\DavidWJ\Planner Info2\DRC Tomar BLD14-00022.doc Page 2 of 3 0 0 9. Warranty of Authority. The Owner(s) signing below warrant that they are the sole Owners in fee of the real property described above and are authorized to make this Declaration and so bind the property. 10. Governing Law. This RESTRICTIVE COVENANT shall be governed by the laws of the State of Washington. 11. Disclaimer. Since no survey was submitted as part of your Restrictive Covenant, the County accepts no liability for what facts a survey might have revealed. A survey might have revealed that a structure or improvement believed to be on the grantor's property is, in fact, located wholly or partially upon someone else's property or upon property that is not the subject of this application. But, in the absence of a survey, the GRANTOR bears sole responsibility if such a problem arises. ted this day of c JO il V° , 2014. Owner er / N.ewri1R tcry STATE OF';dSH ON ) L,tc,.. ) ss COUNTY OF:IFFR-SAN ) F On this day personally appeared before me, (Jt n J0.I I I J vv,Arro me known to be the individual described in and who executed the within and foregoing instrument, and acknowledged that he signed the same as his free and voluntary act and deed, for the uses and purposes therein mentioned. Given under my hand and official seal this Ct4day of P1-10 9 ,2014. Gee t/ _ Nis NOTARY PUBLIC in and f r th tate ofd en residing at LULL Co GM_ My commission expires: Z'(A.1•1 (l ) X.0 IS Approved: '-re Dili /jy lirreall!IT inistrator Date o . Q (n.wt o e S ht--C G e, L4. --i.t., P:\DavidWJ\Planner Info2\DRC Tomar BLD14-00022.doc Page 3 of 3 4'-0" _ A'-0" S'-011 ./ / 2L�'-011 - TO TOP OF • L✓ BANK (MIND 12'-10" / 12'-2" '+ AD.% w 48' OIG.1N16 'E- 1 16"x8" CONT. FIG. W/ (3) *4 BARS • �� — — - — — - - -- e- I--"-I L. _ _ -L — — — — ' ' / b 01 16"x8" SCREENED In I 1 it FNQ. VENT PROVIDE -II. -- MIN.OF 5 PER CODE I I :1131.14x.lePl...111Ox.P.SSIT:x ON a 3221 REGISTEIPED _ CONG. , A CHITF,T - - - \- : ii 1 -sue 1 8 — 4x10 BEAM tYP. �Q S RANT L.. FOST(R TATS OF WASHIN ►O� - —4 - I - - ' i i 30"x18" CRAWL SPA 1 r.� 1 AREAWAY WMEtAL- m eI 14x4PNI y. 0 , , WAIII.III. .T. 05T0N — - - - - \- 1 1 - — 14"x14" •• G. PIER I I ''' 0 a3LK — - - - - -' - - \ 0 - - - JI N = �- II II II Lim i'l i 1 1 it - 0 Ix � ! 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Bath . 1 . / 1 1,9•1 oi> g A4 ,ll ‘ . • • . , ‘ ,._.......„..,,,...._ :Lir--•—•\.. ./ ii:7.; 1 . 122"x30' I It ATTI I I . . ir ., 50 11, . ; 5s2 6 ! 1; . I Ili', • , ,' .E I W S a. ze. WARDROBE 2� ■ /. '� I -.111111111111 •1111111111 h ; idle II I 111 li Living Room • I 30 I 11§,fi . ___. _ . .\ r———— fa tY . 4 -011 2 3T w MICRO _ o L---- I _W." UPPED• I CJ : DininRoom Kitchen• 1 e. - \ : _ - HOOD."L IZ"sH1 1 <' III \ \ /. ---• _ • .AND PAN 3 1 I DAL % 0 1 • ID� ■� 3 30 40 30 40 �+ . I 1•,1 H 3fH 30 . N 12'-0" • / • • 1r Area Table IFRONT) Floor Area • a � N � r • _ FYtiri�^L S - Y .y: ti t., „ y V � i `✓ �` '�` � 3' '-`:' yr riar • • - •'+r• F iir r `i ,s, 4 04140 AC,1,46.4 ' 'W ite,# ,- - - ' , -.44, Aro; 4.; ..- ii,,-ir.„*....,04_#,9(41,1 , W.titf‘' ''f-ift.'ll''''Ts - ' . '''''''' ' iI i,„ JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 9SHIN6 Date: 11/5 Time Received: /f IM (93,m Mon. Tue. Wed. hur Fri. Date: /#// BLD: /4 - Za Contact Name: Owner: --12s7/14..)— Contact Number: 360 q76- 0339 Address: I7L3/ J z°c L41)- 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 ... .5__ Foundation Wall Address Posted Block&Tile Ceiling ,SO@N co �� G. JE JE JEFFERSON COUNTY 44 DEPARTMENT OF COMMUNITY DEVELOPMENT 9SRfNO.c Date: 11/3 Time Received: /2.:1-7 a pm Mon. 4011, Wed. Thur. Fri. Date: iiN BLD: 14 . 2Z Contact Name: Owner: //"fr1 Contact Number: 360 '170 O3 Address: 1/3/ Ler WAY 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 i cc.--s° co, JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Date: "7 / Time Received: iii/- am/0 on Tue. Wed. Thur. Fri. Date: g-9 BLD: / Li' oZ2-- Contact Name: Owner: � // '' Contact Number: 360 970 6539 Address: Z/3 3/ "(2,,' WA/ 206 Notes: 6 Foundation Plumbing Framing Propane Tank p Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Straps Oil p Hot Water Htr Interior shear Interior lines Post Hole Ducts Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Setbacks Final Inspection Floor Foundation Wall Block&Tile Address Posted — Ceiling "if c�°� JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 9SHr NG,e /////� c P Date: r Time Received: 5-5' am/pm Mon. Tue.. 0. Thur. Fri. Date: 7/0 BLD: /. ---„VN Contact Name: Owner: Contact Number: 360 Q 2 n a. 9 Address: 43/ t /� 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 'ioc red @ /11,y lot 3°3,43 R ��'G� co JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT -'si1!V GAG e Date: '9` Time Received: v° "71 ' �""` � rri pm Mon. Tue. (Wed) Thur. Fri. A' Date: '`- ` BLD: ` ..g,, „ : Contact Name: Owner: Contact Number: 360 97 (7.-e„,,,;(- Address: '.-1.--i / t,,e . 206 Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing , Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling '`` % JEFFERSON COUNTY 4" DEPARTMENT OF COMMUNITY DEVELOPMENT 9,sk(NGI° Date: & S Time Received: _xi am/pm Mon. Tue. Wed. Thur. ID Date: 0 -P BLD: /174—;•2• Contact Name: Owner: Contact Number: 360 ?70 0 Address: '3/ L.e- fy 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 4`�;SON coG2 JEFFERSON COUNTY al A DEPARTMENT OF COMMUNITY DEVELOPMENT 95 ]] Date: <j/zrg Time Received: 921 a Jpm Mon. Tue. Wed. an Fri. Date: -2c( BLD: PI'62,7– Contact Name: Owner: Contact Number: 360 17t) . , Address: G13/ Li., L,J,4-(' 206 Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In )( Air Seal lk 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 IMMIMMIMMMIIIIIIIIIIIIIIIIII �e 50\ c,‹, JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT SHlNG'C�� Date: 4//,' Time Received:g/g/ a- /pm Mon. Tue. CI. Thur. Fri. Date: 4-11P BLD: /9 -,2.2, Contact Name: Owner: /9 Contact Number: 360 `j70 0 73z Address: 05/ `rte MC (Le 206 Notes: 1+7) 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 ice, _ m4�4s a ON c0°2. JEFFERSON COUNTY �9s DEPARTMENT OF COMMUNITY DEVELOPMENT Date: (,.-(O Time Received: ( a alp Mon. Tue. Thur. Fri. Date: BLD: it-1'-- ' , Contact Name: Owner: Contact Number: 360 4?0 O3 Address: (_f3( LQ9- W A7 206 Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing iN 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 ■ .,esoN coc JEFFERSON COUNTY ss DEPARTMENT OF COMMUNITY DEVELOPMENT Date: AI/3 Time Received: ji 162_ EP pm Mon. Tue. Wed. Thur. Date: 1`/9 BLD: 14- - ODZ?'2-2.-.. Contact Name: Owner: -1epA A R- Contact Number: 360 976) 63;9 Address: 431 Lae U?,i-s- 206 Notes: rI iCS f' r L'OcAL.. 1,151 1f5LAeIC■/or Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Underground 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 w O ,14 °oG JEFFERSON COUNTY #50 OF COMMUNITY DEVELOPMENT DEPARTMENT Date: 3_( (Time Received: 1(2)- Ypm o Tue. L.Wed. Thur. Fri. Date: -t,4 l BLD: 14--zz Contact Name: Owner: Contact Number: 360 Q ,n3ct q Address: 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 0f@3a3.t3 ' --roc Rd 6.1331,_ ter Cb JEFFERSON COUNTY “+t, c,, ,_ DEPARTMENT OF COMMUNITY DEVELOPMENT 06091-1- 9yR7Ndgo Date: '3.1D Time Received: ifS ! 4.m Mon. Tue. Wed Thur. Fri. , Date: 3.�1 Z 1 BID: J - 02 Contact Name: Owner: Contact Number: 360 97& 0.137 Address: 4/3) (...a...2— 'j,,,n_7 206 Notes: -/Irt---(__ C _ C Foundation Plumbing Framing Propane Tank Mechanical Setbacks X Under-ground Framing Under ground Furance Footing jx 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