Loading...
HomeMy WebLinkAboutBLD2012-00219ommilm litILDING PERMIT APPLICAT PN Re Review 0 pe:I v Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD12-00219 Received Date: 7/17/2012 SITE ADDRESS: 30 WHATNEY LN PORT LUDLOW, 98365 OWNER: STEVE DITTMAR PHONE: 206-619-6822 KATHERINE DITTMAR 22202 OLD POPLAR WAY BRIER WA 98036-8137 SUBDIVISION: Block: Lot: TX 1 PARCEL NUMBER: 821334005 Section: 33 Township: 28 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION 2 ADDITIONS TO EXISTING SFR & CONVERT UNHTD BASEMENT TO HTD SPACE &ADD 4 BATHROOMS TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ADD MAIN: 480 VALUATION 74,199.00 ADD'L: HEAT TYPE: HTP CODE EDITION: 2009 HEAT BASE: 234 HEAT TYPE: EEE OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: 05783 BEDROOMS: BATHROOMS: Exist: 2 Exist: 0 Prop: 0 • • 4 Total: 2 Total: 4 '� „. Routing I: -: `7 I7 12 Type Amount Paid :v: Date: Receipt: Approved/Date Permit $818.75 LYK 07/17/12 134994 APPFVED Plan Check $532.19 LYK 07/17/12 134994 State Building Code $4.50 LYK 07/17/12 134994 AUG 1 2012 Total: $1,355.44 Jefferson County Planning & Building Department Wirlcmor4\rh+e\fnrmc\C PI 11 Ann PIA r.,+ 7i17P,M1 DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan street,Port Townsend,WA 98368 Tel:360.379.4450 I Fax:360.379.4451 Web:w-ww.co.jefferson.wa.us/communitvdevelopment SSff t sco,0 E-mail:dcd(a`co.iefferson.wa.us CERTIFICATE OF OCCUPANCY PERMIT#: BLD12-00219 APPLICANT: STEVE DITTMAR PHONE: 206-619-6822 KATHERINE DITTMAR 30 WATNEY LANE PORT LUDLOW WA 98365 SITE ADDRESS: 30 WHATNEY LN Issue Date: 08/2/2012 PORT LUDLOW, 98365 Final Date: 12/4/2014 SUBDIVISION: Block: Lot: TX 1 PARCEL NUMBER: 821334005 Section: 33 Township: 28 N Range: 1E PROJECT DESCRIPTION:2 ADDITIONS TO EXISTING SFR & CONVERT UNHTD BASEMENT TO HTD SPACE &ADD 4 BATHROOMS in conjunction with a shoreline exemptio permit application (SDP12-00041). 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 41, THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 12/4/2014 THIS C/O PERTAINS ONLY TO WORK APPROVED THROUGH THE PERMITTING PROCESS. ANY ADDITIONAL WORK OUTSIDE THE SPECTRUM OF RESPECTIVE PERMIT IS NOT INCLUDED WITH THIS C/O. \\tidemark\data\forms\F_BLD_Occupancy.rpt 12/8/2014 • • C oNCdr j [ C `/ IE kL,..,_ '-'..4,%, JEFFERSON COUNTY ll . DEPARTMENT OF COMMUNITY DEVELO .III, T JUL172012 621 Sheridan Street • Port Townsend • Washingi�or :368 4. O 360/379-4450 • 360/379-4451 Fax ff LA iN0 http://www.co.jefferson.wa.us/commdevelopmen'J JEFFERSON COUNTY _ DEPT.OF COMMUNITY DEVELOPMENT STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# tr3 (50 PROJECT/APPLICANT NAME: 4 erA,A.V\ r (Air t Y of s Please answer all of the following questions to the best of your ability. Where the question calls for depiction on a site map, the applicant may choose to either incorporate the elements into the general plot plan for the Master Land Use Application or to submit a separate stormwater site plan map. Project Overview 1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the site map. f (( CO i A.tt& `l, 10(x 24f add t4-t`eas �e e)Cj s 361 2 s7-ori ( O �Q (moo u.te, R e_f) a. ;r e x I S .Z,.C� s`-ry c r re– +o ref k c,e MA_kiSr~l w;�d 6WI ) pt u i Jj w t re +✓►S co[CA.-1 e 1 ac . n s t- fi v.4 et tor. Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. i 4 pro)c 1 +© /krer S1 o fe.s eo-e4i i' -Prowl NOr4. 4-0 So do Ct.+.,_d VC/10 1i 14 441 -pro KA e-G.S1- -fo caec + 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. es t- o4 Lo# iS -Cc el di 9 ra.SS w ;+in apprax /s covered wi L1ock LLer el Wr - evJ type- `frees rew,ari 604- are qut4e old u,k.d vA kepi- 4. Describe the existin9 soils. Indicate soil type on the site map. So i ) #S d-01 k cw.d L•o R pt.,. at y +o a_to o Q'- 1 g t/ 5. Describe the existing site hydrology(i.e., drainage; behavior of water on the site—above, below, and on the ground). Indicate existing stormwater drainage to and from the site on the site map. Depict separate drainage basins on the site map, if applicable,and indicate acreage of each. Lo 4 s .e...t-e..tA.L y S I o J a,A- c r ys o() q u r�c.kI y oo pte r- ra I i.A D r i o-i C° d� 4. l Q K.c, (A) a. to/ 1-4..,,, e r v .�S al o, +&e w es Lot-Jet- 0 AP ROVED 6. Describe any excess levels of noise generated by the proposed use or act'vity: STORMWATER L� V�'1 ; vtar CO n.S4ruc,4ibv% hp i Se - row. Covs- `� veldhr 0.c7'dvbr*$ Nr EILLors are o.4- teas# 2S`v / c-t,v-a-y AUG - 2 2012 . Storm% r i P :11111 —1 Required 11'16_27 - i , r1.� i-;11 �� .. *' ' j t stormwater site plan template-rev.10/21/2008 5 III • , , 7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, C steep slopes,etc.)on the site. Indicate loc tion on the site map. `� / 11 S o p iv- L 0 f 'PV O etom N o.rr TcJ n sc7 04-1A,!a o c v '7'd IS l ,".t,, f'oo.Cla I l•cij to . 4. S 0.re o..-f -I-�Q o 7'G.er siJe !01 .0 1.,1`.•a., /✓bad . No W C. - h ck c._dl s o r Se- S[ 't i'ctie 0.!2 ct5 •e X r S4" i o ' J '141)AA S L.'vi e if c a_a W e f e -i'e."o_ Lo w.i Q i S 1 •c_a 4-e cI 8. Describe the general vicinity of the site, including adjacent land uses and structures, utilities,roads, and sensitive/critical areas (streams,wetlands,lakes,steep slo()oes,,etc.). A r /, `f�,..e. n 040r 1"t Z Q 4- `AT., i s a .. . i s i v. (a v�d -1-`x'0 .h `f-�,u CO v Yco Qc S�.%c'ne Road c .v,d i �...occ.{-e.d a roc I.2StM - (e NI of- C t s 1-4-aod (cu...., grr19.cj e. p r/ p I60 ks doe Sno Q,i r fe•Q 5t„ :,.c 1-Z04eAaci_ds Permanent Stormwater Control Plan This portion of the Stormwater Site Plan consists of the selection and installation of the appropriate stormwater control BMPs and facilities to remain in place after construction of the project is completed. "Medium" size projects are required to have the totals calculated of all impervious surfaces, pollution-generating impervious surfaces, and pollution-generating pervious surfaces to verify that the thresholds for treatment facilities and flow control facilities are not exceeded. g. Describe the developed site hydrology, as proposed. Indicate whether stormwater will be fully dispersed (i.e., per BMP T5.30 in the Manual)or,if not,what types of stormwater flow control will be utilized for the site or specific threshold discharge areas withi the site. Locate these facilities on the site plan and differentiate proposed facilities from exi ting facilities. ( e®4 d-- (.F0%)4.&-0.4176 n &ca r ns w 1 a 6e_ ca w.H e c---+el +a e i e.- if c2 W�tS or iO,c s & a r _hN ov1 U]LiZh w toec-1- sur't- Re (cx,+ c cm.pe �1°�" s ± t Y4-�.�,re Pctr elL _. Our pre eravi Ce. iS �n f -b O S w a y ( e iv►p-f-f t ��0 .e�/dt ;Ka e �o-F c�, o v EA) /a K m eX rfr„� r9 Y 10. If the project requires the use of stormwater treatment facilities, describe the types of stormwater treatment facilities proposed for use on the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. [This is normally for"large"projects or projects that involve the potential for dispersion of contaminants.] 11. Describe the performance goals and standards applicable to the project. ,/ vv.peo it Very w..1ti w..wI 0.s 'tL c-rs`-otle o e-cts ire IeSs4I.c-,,1 3.3 -1 /e c 3 C i t..e t a 4.- o.r e t a A.(Hi tS-i-vt 4 ed &rea s will b e re)./.,4-.4/ W''(t. v'. ve uel 1 -a�da.A. o(' La...Aswpe pick t4.-6 apgreprra-te -n L ctrect 12. i •- n '. Co 57:......j a Tc � . (�rs 1 `P i.e....--._ a44. ( eo sq-�+ 4ro -X vda,'-4-0Acte.a. idx2.q`) sU,• M .Tiw a ..,. • •r- a - r _- d -'or+ a • :►1f+ - • of g at of ro0 C Sill" • C e 3"v"3,41.o.ia,',iu yi• t1iumm()`10 a � .wpi„r S stomwater tQ la4 e � , ,,,, „ .- 6 • • 13. Describe the water quality system. flfl rr 11 S/ -t i s a tre�r Q ( ( C a..d0 P air sr� (e> 0 S 7`�'e-G:+�S 'e its 7' gwr- cL�'es o r d�rm.w tt'II L p used fa CA-44, sexc o.r ji So i(L..rt C,t7 r.S r-u C7f-d`8 A i 1 r ff:11E�[CflE v rl 14. Describe the conveyance system analysis and design. Y Y n (� C(0 5 ec0 J p +�" %.uI 2 . 0-4-4) �=UJv•OXL at. •:T1[ , . ;c chi w e(,1 P r Ia r°0 sway f 11 JEFFERSON COUNTY DEPT.OF COMMUNUY utvaOPMENT 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. ai=r(( w '(..rrrc. cv ells p c 1 (e w rb - -vu∎ So 5 e S-cQ rrcje-4, u-c-t CO v-S÷1 -orav , w14t, 9 rh v-0.1 tet v,rp peY' co it.C(-c�� � t►s 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. w ;(( 6e usecQ al.(a per ice a 17. Describe the proposed surfacing material. �/ O Uew Sv r`E�cd�.e( en..®, �er J'a,l m5 p I0,„,0 �� ott 1,3 Srr�C 18. Describe methods fo restoration of the site. / p jf� All it a c e«s w f l( to a Lt J J w r` vta. d,re. n'f I lei!Dv\ c9 r I a vak c mp r� a f f roof.rick+ cxrect 19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for "large"projects only and only those for which facilities are required to control flow or treat runoff.] If included, list the Manuals here. (Pe) 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. 014 e 21. List other necessary permits and approvals as required by other regulatory agencies. If those permits or approvals include conditions that affect the drainage plan or contain more restrictive drainage-related requirements,describe those conditions or restrictions here. S e p4 s'r s-f e S E P 12. — 6 2 stormwater site plan template—rev.10/21/2008 7 • • CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN (SWPPP) The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the template that follows must be installed on the ground during all construction phases of the project. The proponent is responsible for preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential development. SECTION I—CONSTRUCTION SWPPP NARRATIVE 1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or will be addressed. Identify the type and location of BMPs used to satisfy the required element. If an element is not applicable to the proposal,justify in writing. Descriptions of the 12 Elements are found at Volume II Section 3.2.3 of the Manual(beginning on page 3-7). • • 12 Required Elements—Construction SWPPP 1. Mark Clearing Limits. d v l c(ecz e 1 w t o tee_ C2) /o (wo.v e c.d r 61,+n C 3 +o 5 a pp t e f,e e$ r _ sip 4-� sy clt-e 2. Establish Construction Access. t o s -- w t l f b U dd e) s41dti. g v-et cO(n)4 W ur 3. Control Flow Rates. �"e)n 5e. r1 :S & !otted W e vse.cg -to Co ,t -frDI �t=(co w t 4 e 4. Install Sediment Controls. wwr( ( doe 95 e� 5. Stabilize Soils. D:s isle" 4' 5. (Is tog ral edi ac r.(o S e 'Fst v r t 7 Nut.14 tit d,Q 0. . f • 6. Protect Slopes. // / r 5 !o peg a P 9 ew fe /r tnJ I l( pri-n�cl y S//21-14, / o iA L a.Q't a 0. I'i°Ct;S D tl' �Q4d J e C/ /?Lf r cQ4 ct,h S Lye -r-ra-.�v, OikAir4�e/ CQ tect / 7. Protect Drain Inlets. !! Me) cQMt.`A i (. YS oA S!/.e stormwater site plan template-rev.10/21/2008 8 12 Required Elements—Construction SWPPP(continued) 8. Sta ilize Channels and Outlets. (v A- 9. Control Pollutants. 4 J'wc.J 0.4., 1l. .0 e d S e.cpp rt ■ : ( J 44.1/•• . 0.(o TA. w trr4 1..ct_ _p Q r.ect. . ' . • d, - . ( '- , SI L, L I V 1 -- 10. Control De-Watering the act of pumping groundwater or stormwater wf�r rom an active constructio i 4114 --e r- >L _ . - . - Fi�.•-1I . _i y f •, •' i,;Ill 111 A - 1� IMO tat - . e of i� o to Mit.A - 1 r„' 00, dl' 11. Maintain Best Management Pract�ices(BMPs). / / DEP I'/!•c` �� �e_c.L s�+ 11 co t^.-Ir�cfor c...4. Q„L,ar al 1Ctbor wit[ be t tos`�r-jc4e& ©Vt 5 i 4c- in..-4 wa.-c�a t......e w-i- D c�a-+.-e S at-4 Or.J K er a a! i 1 I 4 ea o w t;Y-e V1n 6 S^- c 4 +r wL tP r 12. Manage the Project. (f p ( (( r ©L we,r u. I I,e ( r -c-c w„.ci,v>t....1 4.r' a.c,.( c,) I1( L& Cr v"c(4-•, t�t4.A c f ts'r' rc mac..• 2. Adjacent Areas. . a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). ((�� �I(r�, �pp�� //�� // � I at,+A.CD Slopes Soo`L •r- We. � 4z,u- o..r: 4 ri -L c * .O r-c.L o o`t•' S v l a r - s, • • • _ / , .// .1 l _ of - • tt. ♦ r A. .4 A .. I to ._- III.0. o p ail-4 c.vt.'�-e� rib e� e . r- car ece.S b. p of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 �tyards). i n (1 / r �t 1 1/4C. T®c'�bSrc0 e, a:4— l., caK wo.4rtiay lac&e. aeas AS ` road a 4 e .1 r ..u 0- , 1 . - et if _ . . ►1� t .f /► - t ,k. S ■ >r o o CI-CC S —! �) [rec. 7 4.n 'YtnQ_ TT-c}�//Lin.II s 3. Environmentally Sensitive Areas. a. Description of environment Ily ssensitive areas that are on or adjacent to the site. N f) e u.c.t vts,.wt.49..t,L fir s Op S;-L rv_ o..d-e_�s are m vt 5-r k•56c,4, t fo4e.er STS et� Q4- 5't�.•� e 1Q4a.44 oie +Fd '7 Os OA W®o Si- Carte., e stormwater site plan template-rev.10/21/2008 9 • a „. , , b `D c iption of special requirements for working in or near environmentally sensitive areas. 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils(e.g.,erodibility, settleability,permeability,depth,texture, soil structure). • e1^-'e- p F -e e-vt o 0-0 c 4- Co t-c+u-J c.,4-ce 7n a.r•e t , ca^ 'e.d EN1.c I e_ FL0 ( 0 0 ( -Pr^a w. in itti I ' 1'cP'e- 14A-Cti k 5. Construction Phasing. a. Co Co struction sequence 1rt1 a� (� R 1/L` fre---c9,5 J d c- pr-e? ) pew KS)._(.4 Y l7 r/1) Fro--(Nl e 1 1 6 C7.�11 t)A-4- r�02it-A-,4A L..-1.�._s r Q., zrv. LVt_0SY /io C P r d-5un i / b. Construction phasifig(if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Provide a proposed co stru ion schedule. , p l S i 4-e prep 5-d-0-� c.�1-I1. �1�0,4, t o fpfy vac.f 61-c), 9,e l2 • II. Wet Season Construction Activities. r to l a. Pro•osed wet season construe io -_... ..r a �� . ' t�� ` y . ri _ air 20 _pm.at* —�b��ropose• we season • tvi ies or env onmen a y ,- ,- - - . . /\IOutte._ 7. Financial/Ownership Responsibilities. a. Identify the property. ,owwner respo sible for the initiation of bonds and/or other financial securities. b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. r re rs©+1 e.( R 44)04.4-5-1 I / (cl-Li 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following, if applica• . ,� q , a. Sediment Ponds/Traps. J�f I b. Diversions. c. Waterways. d. Runoff/Stormwater Detention Calculations stormwater site plan template—rev.10/21/2008 10 • Stormwater Site Plan Changes If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan, the proposed revisions shall be submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised drawings showing any structural changes, and any other supporting information that explains and supports the reason for the change. Final Corrected Plan Submittal If the project included construction of conveyance systems, treatment facilities,flow control facilities, or structural source control BMPs (not standard on-site stormwater management BMPs), the applicant shall submit a final corrected plan ("as-builts")when the project is completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as constructed. APPLICANT SIGNATURE By signing the Construction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all owners 0 the affected property. 7 //s--/2_0 tz (' DOWNER OR AUTHORIZED REPRESENTATIV IGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: stormwater site plan template—rev.10/21/2008 12 oN cO JEFFERSONNOUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT • 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax 4'� p'� www.co.jefferson.wa.us/commdevelopment FxIN� Master Permit Application MLA: ( 9H 5D Project Description(include separate sheets as necessary): Pilo?0S e acicitt71)1,tn or (2) t0rX ztf (a6c:kovi5 fo elc(14-619 19A0 ioust a repay"r- e c '.d ,9 Lovre Tax Parcel Number: 3 2 33 4 - 0 0 S Property Size: ( o 5 acre,5 (acres/square feet) Site Address and/or Directions to Property: i-1 ri41 1f f Per Lud ' . = uJ� ' 036 rowflf ' brr 0 ► e o tt SI�iK� �� iLeodolh � Property Owner(s)of R-cord: S-Ft.Ie W i 0-4"d .,a 9191,191HEIMP In ,. Telephone: a 0 6— 6 I 1-6 8 Z Fax: it 2-r'774-712 r email: S w r r s s _ 'if Coj4,t Mailing Address: i-2 2O-2 ©IJ Poplar t.J at/ 14 r re() W f} I Vo 3 6 Applicant/Agent(if different from owner): —$a v.t a — Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑Lot or Road Segregation 2 WEB Building ❑Critical Areas Stewardship I. ❑ Demolition Permit ❑Variance(Minor,Major or - ,:, =ble Economic Use) K Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d) r ❑ Manufactured Home .❑ Modular ❑Discretionary"D"or Unnam ; Claattnn7 2012 ❑ Commercial* ❑Special Use(Essential Publ p i ities)** ❑ Change of Use ❑Boundary Line Adjustment ❑ Address ❑Road Approach_ ❑Short Plat** JEFFERSON COUNTY Home Business ❑Cottage Industry ❑Binding Site Plan** DEPT.OF COMMUNITY DEVELOPMENT _ Propane ❑Long Plat** ❑Sign - ❑Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration** ❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions'" ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development** ❑Temporary Use 0 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: �� cN( /j_ DESIGNATION OF AGENT I hereby designate r , r- to act as my agent in matters relating tot is appli tion for permit(s). OWNER SIGNATURE •---- Date: 1 1 S— ').0 (2. 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 re ired later ins ctions. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the appli ion thgt he"or wants prior notice. /(�r Signature: Date: l / 0 I 2 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 J are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfe *"le rn ".,:j gt,for adhering to and complying with the ESA. The Applicant has read this disclairrjer and/signs and dates it below. ,1 Signature: t ,1,j Date: 7/ 1S zo(Z The signer of thi tatement does hereby BUILDER STATEMENT they will be ass� Y certify that they EMENT ng th responsi re of the General ey are the fowte Owners of the Signature: parcel referenced herein,that they are not licensed ��- proposed project.'7 GENERAL CON RACTOR O contractors and that R MANUFACTURED HOME Date: �� 2_o N � ME INSTALLER: MAILING ADDRESS: PHONE: ( ) FAx: CONTRACTOR'S LICENSE ( ) NUMBER: EMAIL: ARCHITECT/ENGINEER: WAINS MAILING ADDRESS: N--- UMBER Project T PHONE ( ) Type: Frame Type: EMAIL FAx:( ) G New Ype- Bathrooms: IsL New X Wood Existing: Shoreline; 0 Alteration/Remodel L Steel Proposed: Type of Sewage Disposal: Masonry Total: Bank Community System 0 Demolition Height: 0 Other:_ Bedrooms: Individual System Ty• of t: Existing: SEP Permit# SF 12 tiZ T Proposed: --- Setback: Water Supply; ��a'. 0 0 Private well 0 Two Party ini Total: --� �. t cs./ �public Ifthis is a Commercial Project ---L ou must answer the followin : Name of System: U� _ Number of Parking Spaces: Current: Number of occupants(includes owners tenants employees, —._�S Numbe IBC Occupancy: Proposed: IBC r etc) Current Daa= �—,� If this i Occupancy: a Pro•ane Tank and/or q••Type of construction: ! �At;,e " ,...._m: o , . Underground Tank 1 fiance Installation •ermit mark all items Will you hav ,, Above ground Tank Belo Service? Yew N° Heat Stove )(Cook Stove I W tha� - u„�. Is this a °Odstove I Size of Propane Tank: S v ••++ 1 7u2(0.12 ) fiance bean installed in a Manufactulredi/�Insert 01'J . Q ( . When applying °t Water Tank i Pell: R.t i for a permit to install a propane Mobile Home? Other When tank for and size,distances p°mane tank submit i v. /ncludin• the propane you must also subm/t a site plan s owl . JEFFERSON COUNTY the reserve area, P pane tank to all props ings•uare Foots•e property lines,bull•In s and septic system com Main Floor Heated Current Pr°.reed ponents, pp 1-1 o For Office Use OnI laor Heated dQ O © Q �i .1-19g21 EH Bid App Review: Amount Revision • Other Heated o Z 0 Consistency Review: Heated Basement Additional Section: • O . 1� Unheated Basement ”' Illeszg317Z$ Plan Check fee: Other Unheated•--" _-� O State Surcharge fee: 53z ' ..____.Garage/Carport Pot Water Review fee: Decks d MINNIM SUBTOTAL '� `' Other 911/Rd A (`" N„,,t p °use_ '2 5 0 italligMll Approach fee: I,:1 nl TOTAL: $f 65 ' Receipt Number: ESTIMATED COST RE Cash/Check Number: 3 Q9� •Fairmarket v lue QUiRED) j a f a//laborand mater/a/s foundation to finish �• • ►44dGY�bK - SY Date: � Re•air� E?'y 7�i] Initials: �-•�e 4mniminaimin T ' if �7'-0" i i 7 • 48'-0" •1 4 na o .1 10'-0" ►• 28'-0" ..41 10'-0" GT 5"—� t 14 8'-10" �� T-9" -'-101/2„ 1. 1 Imo.' A to oo Irmo= w . 0 0 I • '* `°- a 8'-10" I,, IN � g _ - E. NfIts W6" Mill o a V - 02 til 1 n z ?•,_6" _, a' 9 a_ 6ill -2 N Er .------., ,,,,,i(ci *, , „ 4t liffillifi !I 1 -v IMO I & ev °_ /4'-0"�4'_6" , om I' ifl, °_ C) ft ks,-0 ! N N • - o OM I!■ i ii Al , , i N , , $ 0'-Oa as a ' - - a. pzi i r —5'8" 8'-10" IIII w 10.-0" ooal �— O - o - N r T N O ,-h 0 Q 6 i N I... - ' r+ 1-+ ' O ..i_i__ i ii ni.m ao 12'-11/2" i5'-2" 14'- 0" ` - ?� � ri N.' _Fir n .. "1:3 0 -' < o0 a- 7 (m�D 0 CL 28'-O" I I col m ?! H 0 C 0 N 7. N = m v 9 - 0 e.013 w ar o 0 = F — o > > —-- o) mom 7 •c =! 7 ao y RI c- OR1 ao m O 0 n * S a. (D x O0 C= W -4' 0 "' H 7 7 x• m 3 * .4 N co 7' ^' -% _. O cam C Q- m m 0 O O C -, r+ m m ' > — r (WD X t n n W N�. C can _. u u U N N ' (D N m c 3 �. = o -, " z zz III1111�000 m 3 cm * m H !D '3 K 3 < 7 00 OC I V �/\/J F 0 % cm 7- O �- 7 N m z V �I e� C n a m moo c 7 ro N �I Omc7XC f -„ it c n d, ° � Ii a- et 0 11111111111• 7 01 Q 3 a eV Ai. DJ o 7'-1" o II r•1 6'-7" 0 o 3.9.. ., ..... ::, .N► t,_,, w G_. O h QO O. Ni ori st . 5'-3" l — JI 15 r I I . O Vf ■ co I :',. . , 0 a :, it S A 12'-7" I J '_:,111111MIIIMU c===21111/111/1111811111, a r:, 0 , I \ F-' U = co tn I v o ~ Na. w p _J., _i_ \ 1 w N /A --- 4, 5'-2" . 8'-10 13/16" < �� fD A .+ ------ u 0 r-- 0 14'-0.. I� r' .... �_ nil n o T I- III! U.S tn v C a m C C®) fmOD will. CU 0 6� �� —' - 0 3 z z -, r G'-4" C _ W • -< o v X r• N = ■ ■ r N 0,;i A z O l l • m G7 Cd N (D (D 6 0go � a p o-ti o ; rF 0- .- < n s 0 �+ 14'-0" 3) r . _ Q D 113't CZ r— — — — — — — II A 7 NIol `I '{ H H:/ F H: � H O 1 r _ 0 Q I 0. (D 0) _, m• rn N ( 1- N 0� � = a°o z oa (J) -P m --I Z I — - my Iv EX1S f 0'W WELIL EA�_EN 1 , fit o ° I ;�a `'� o v •ukio a till r,Ox 10'4 ti Ida'+ . . MI g Fri 2 O c0 o V� �"-i emu ." • �a zo m-0 z �- i_'n, ZM I -i ■∎. o-N 50 ....,4......, ..... _ cn r-D �I r r30�' M3N II 84' 0 0� • 03 1-”:, =-1- ! of Icy — Kr_—_� oc� � "� _8 _ .. ::.--C) =i It r� I r Z n :. / iir..0i :11 x I I� °z cI S II I m o ... ./ / 8- g y I. '` A I II L I wN II z� II rn _ _ ti S''qe7 C rt.* I* CI CA .. 4, 1-o m x o --1 . - SHINE WROAD -ccn. n°c \ N �O ■ d i �C r9�S7\��� ` zz� zR4 P kt.11 rS ...TFR� �z 10--I = rn mIL4 �1 ti4.•••• •// ZC3 mq C z ® 3 r , ' •01 A a w N tm° ..0 .00.140 z o i/// x A, i3 °s n HaT> n, a a � W ( I.nl 5 q 4 °' -- B SOILS APPLICATION LLC. c g ni to N i u TAX PARCEL #821-334-005 cR to n N F _ w� 863 CARLSBORG ROAD, SUITE A, °' , - SEQUIM, WA 98382 I �" n DITTMAR PH (360) 683-6300 FAX (360) 683- 4,,!ry T 0 o r" s M Z c•> ''J = Q O V rn O N m z O 0 N . A full(� A 1 ,:.' °2. SPECI ONDITIONS APPLY-SEE ATTATCHED ,F 4 Jefferson County Building Division Permit Number: BLD12-00219 Applicant: DITTMAR BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2009 International Building Codes To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection. Requests received after 7:00 AM will not be scheduled for that days 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 Note cZ f ,� „ ..�/ Setbacks � /,(4,�y5 min um setback from /c(Jatn�ey Lane and Shine Road rights-of-ways / shall be 20 feet. Minimum north and east setbacks shall be 5 feet. Erosion Control 6/Z9/1/ r_ SEE CONDITION 3 Foundation Footing g-, 7. Footing Drains 9, 7. /.2._ (^ Foundation Stem Wall `3cy`( Underground Plumbing b N Under Floor Framing q/ B Straps(hold downs) R` 14/ 1� K Ext.Shear Wall Nailing IG .(1. (t 2 Rough-in Plumbing /l5/11 ieteo OM 4.-1/-13 l fit►;, Framing te3611 OIK �sd,t,bm�j60 tithe yer_APpR�� L Blocking ` A) Airseal 1/Atil li iInsulation:Walls Insulation: Floors S 4 t V -M C Insulation:Ceiling 3,41/,1 *. "SP C Int.Shear Wall Nailing / 1 1S Wallboard Nailing Shah/ Gas Line: Interior / ,/3 Gas Line: Exterior 6 tg rjl ,1 0 Propane Tank Jc r �^ 6/'0/6 I'a uonEe�e0N1; 101 ( ('f"7-6-s- d ` pu,crz. i 51: .g, Z4!--11) ' L‘44,,k117,--r,k 1/15/i 1- I Drywell/Alt Drainage SEE CONDITIONS 1 &2 Address Posted kr`Pl-e.— . r'12 0101- 40- gel;4 eP !/r 5/i - FINAL INSPECTION I9 I p FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR CONDITIONS for Building Permit# :BLD12-00219 1.) DESIGN CRITERIA FOR SPLASHBLOCKS: A VEGETATED FLOWPATH OF AT LEAST 50 FEET SHOULD BE MAINTAINED BETWEEN THE DISCHARGE POINT AND ANY PROPERTY LINE, STRUCTURE, STEEP SLOPE, STREAM, WETLAND, LAKE, OR OTHER IMPERVIOUS SURFACE. SENSITIVE AREA BUFFERS MAY COUNT TOWARD FLOWPATH LENGTHS. A MAXIMUM OF 700 SQUARE FEET OF ROOF AREA MAY DRAIN TO EACH SPLASHBLOCK. A SPLASHBLOCK OR A PAD OF CRUSHED ROCK(2 FEET WIDE BY 3 FEET LONG BY 6 INCHES DEEP) SHOULD BE PLACED AT EACH DOWNSPOUT DISCHARGE POINT. NO EROSION OR FLOODING OF DOWNSTREAM PROPERTIES MAY RESULT. FOR SITES WITH SEPTIC SYSTEMS, THE DISCHARGE POINT MUST BE DOWNSLOPE OF THE PRIMARY AND RESERVE DRAINFILED AREAS. 2.) 2005 DOE STORMWATER MANUAL DRYWELL DESIGN CRITERIA ALL INFILTRATION SYSTEMS SHOULD BEAT LEAST 10 FEET FROM ANY STRUCTURE, PROPERTY LINE, OR SENSITIVE AREA. FOR SITE WITH SEPTIC SYSTEMS, INFILTRATION SYSTEMS MUST BE DOWNGRADIENT OF THE DRAINFIELD UNLESS THE SITE TOPOGRAPHY CLEARLY PROHIBITS SUBSURFACE FLOWS FROM INTERSECTING THE DRAINFIELD. DRYWELL BOTTOMS MUST BE A MINIMUM OF 1 FOOT ABOVE SEASONAL HIGH GROUNDWATER LEVEL OR IMPERMEABLE SOIL LAYERS. EACH DRYWELL MAY SERVE UP TO 1000 SQUARE FEET OF IMPERVIOUS SURFACE FOR EITHER MEDIUM SANDS OR COURSE SANDS. TYPICALLY DRYWELLS ARE 48 INCHES IN DIAMETER (MINIMUM)AND HAVE A DEPTH OF 5 FEET(4 FEET OF GRAVEL AND 1 FOOT OF SUITABLE COVER MATERIAL). FILTER FABRIC (GEOTEXTILE) MUST BE PLACED ON TOP OF THE DRAIN ROCK AND ON TRENCH OR DRYWELL SIDES PRIOR TO BACKFILLING. SPACING BETWEEN DRYWELLS MUST BE A MINIMUM OF 4 FEET. 3.) CONSTRUCTION ENTRANCES LL BE STABILIZED WHEREVER TRAF WILL BE LEAVING A CONSTRUCTION ITE AND TRAVELING ON PAVED ROADS OR OTHER PAVED AREAS WITHIN 1,000 FEET OF THE SITE. THE ENTRANCE SHALL BE CONSTRUCTED ON A FIRM COMPACTED SUBGRADE. QUARRY SPALLS (OR HOG FUEL) SHALL BE ADDED IF THE PAD IS NO LONGER IN ACCORDANCE WITH THE SPECIFICATIONS. (BMP C105, 2005 DOE STORMWATER MANUAL). ANY SEDIMENT THAT IS TRACKED ONTO PAVEMENT SHALL BE REMOVED BY SHOVELING OR STREET SWEEPING. THE SEDIMENT COLLECTED BY SWEEPING SHALL BE REMOVED OR STABILIZED ON STIE. ANY QUARRY SPALLS THAT ARE LOOSENED FROM THE PAD, WHICH END UP ON THE ROADWAY SHALL BE REMOVED IMMEDIATELY. UPON PROJECT COMPLETION AND SITE STABILIZATION, ALL CONSTRUCTION ACCESSES INTENDED AS PERMANENT ACCESS FOR MAINTENANCE SHALL BE PERMANENTLY STABILIZED. 4.) Future building permits may require a"Bedroom Restrictive Covenant"to be recorded due to the number of extra rooms in this residence. 5.) 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. 6.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 7.) Critical Aquifer Recharge Areas may require special protection measures to mitigate water quality degradation. The submitted proposal does not require additional aquifer protection measures. However, during construction the project shall follow the Best Management Practices(BMPs)and facility design standards as identified and defined in the Stormwater Management Manual for the Puget Sound Basin. 8.) 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. 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.) 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. • 13.) 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. 14.) Minimum setback from Whatney Lane and Shine Road rights-of-ways shall be 20 feet. Minimum north and east setbacks shall be 5 feet. 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. 17.) Residential developers and individual builders shall be required to preserve shoreline vegetation and reduce the associated risk of erosion during construction and any future activity which may impact the stability of the shoreline. \\tidemark\riata\fnrmc\F RI fl Permit RIrkn rnt