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HomeMy WebLinkAboutBLD2012-00030 UILDING PERMIT APPLICAT I R 12-0 p018 ew Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD12-00030" Received Date: 1/31/2012 SITE ADDRESS: 11811 CENTER RD QUILCENE, 98376 OWNER: VERNON E MAHRT PHONE: 206-547-0776 3919 LATONA AVE NE#C1A SEATTLE WA 98105-6864 SUBDIVISION: Block: Lot: T 17+ PARCEL NUMBER: 701061010 Section: 6 Township: 27 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: MEGAN RUKKILA PHONE: 360-531-3494 11811 CENTER RD QUILCENE WA 98376 PROJECT DESCRIPTION`(-4000ALLON WATER STORAGE TANKS FOR RAINWATER "CATCIHMENT TO BE USED FOR POTABLE WATER TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 6,000.00 ADD'L: HEAT TYPE: CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: 1 CATCHMNT BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $125.25 LYK 01/31/12 131412 APPROVED. Plan Check $81.41 LYK 01/31/12 131412 State Building Code $4.50 LYK 01/31/12 131412 Total: $211.16 APR Kis 24 Jefferson County Planninc & Building Department Map Output Page 1 of 1 •_ ArcIM �"i 9{�N c 1N "°'°s` t4 ,- R f}ER TI 1 ,,�'E _COMMUNITY E1 ELOPMENT o ^, 4� r.; � . FI i 41 i - i ■ 70105X102 - 701osttiv3 i 5 62 eridan Streit p°l 701,::�S � 701Q61004 _Port To nsend WA ba3f - G - : _ N ' 1 � - - 4 ca director - • -> 704061002 701052011 ,. =, 107 62011\ 701061016 • O ; f — • ��'`b�� 7tlt064 a , 701061011 - 'E' pi eta ( Legend 4 ` 4 4 �� t'_, • � 6� Selected Features 70.06.0417 �- � 701062001 : — ds roodsH % Contours 1 t <§t, to Foot Content �, k 1.: `I f !G Foot Contour 33 i. i 1 ) t J -- ' / 1 I 47 704 052 ' to 701061006 i I j ( 1 ` 1 �4 1 i ' I ' ( ■ _ ■ 704064003 704064006 � , t 704064001 701 41530412 w ° t = a, Moos o•w,deab,•,:Otie•unca,y Cent*se-.- cts _ Q 45611 1,`' ',, FOR INFORMATIONAL PURPOSES ONLY- Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity.Data contained in this map is limited by the method and accuracy of its collection.Tue Mar 06 09:52:28 2012 Building Permits/ Inspections Development Review Division Long Range Planning (360) 379-4450 FAX: (360) 379-4451•http: : - .. • - -•= ••- -- - --- - -- ■ - •—a.! . -•— 112 4�.�•soN cob JEFFERSOI.OUNTY W ' A DEPARTMENT OF COMMUNITY DEVELOPMENT 1-) ` `4 621 Sheridan Street• Port Townsend • Washington 98368 360/379-4450 •• 360/379-4451 Fax .,qs p'N www.co.jefferson.wa.us/commdevelopment �IIN Master Permit Application MLA: iD— I g Pro ect Description(include separate sheets as ne �ss�ary)�: -4f� a4 aot blr si Q s Cy { Y 0 Rol-. Tax Parcel I mber: —÷8ld10 6 (3C�QS (acres/square feet � C7 Property Size: I ( q feet) Site Address and/or Directions to Property: I Property Owner(sl of Rocord: • a i sk V . v-- Telephone: Z8b a: +-O.} -t Q _Fax: email: rU 0. \ _ A t \ OW\ Mailing Address: 3�Vi_ \_1'w - Q V\\$C . C, Q ,W 9.8 t Oc ■ Applicant/Agent(if different from owner): M-e cq o v\ V∎\bC,\\ON Telephone: `�be- \- '--,4-°[dok— Fax: email: _ o.h\--AkSe yMb0.Y clIttl Mailing Address: t i e I ( CQv 4 v' v-a\\.@ te.t� • n11.\ \Ca r10 c W G�j - C' What kind of Permit?(Check each box that applies ❑Lot or Road Segregation Gilding ❑Critical Areas Stewardshi• Plan ❑ Demolition Permit ❑Variance(Minor, Majo • *e -c • • 1. •ra- — ❑Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a), I • j k..� f ' V E ❑ Manufactured Home .❑ Modular - .• - ❑Discretionary"D"or U i : -1 Ise__ .y. .. ❑ Commercial* ❑Special Use(Essentia °•,ip Facilities)** ❑ Change of Use ❑Boundary Line Adjust :n I ❑ Address 0 Road Approach_ ❑Short Plat** j JAN 3 2012 ❑ Home Business ❑ Cottage Industry ❑ Binding Site Plan** ❑Propane ❑Long Plat** ❑Sign - ❑Planned Rural Reside ntial el pp �YAmendmen • ** ❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alterati• MMUN TY DEVELOPMENT ❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions'* ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development** ❑Temporary Use ❑Shoreline Management Variance ❑Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District Map Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment *May require a Pre—Application Conference ❑Tree Vegetation Request **Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I hereby designate �� � �/ to act as my agent in matters relating to this ap lication for permit(s). OWNER SIGNATURE i`" `% J�i���Z. /C Date: / 3/ By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or its knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later inspections. Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application that he o he nts p for notice. Signature: / •,-. Date: / /_ 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-transferabl res onsi "ty for nn o d co plying with the ESA. The Applicant has read this disclai err an signs and dates it below. Signature: V Date: /--,An__..,:.r'........\4 44Cr1D11.(C44/444\T\Dr\B/lp?.(C\r`..—.._.TAD TI V_ -\T! Tl__...A__,___•_- r nn nn_I_ BUILDER STATEMENT • The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that ,they will be ass i the r nsibility of the General Contractor for the proposed project. r ' Signature: • Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: New ❑ Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: _ Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition her: Bedrooms: Water Supply: 1 u4-S•RC Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: ❑ Public Total: Name of System: If this is a Commercial Protect 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 I Woodstove 1 Fireplace Insert 1 Hot Water Tank 1 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 FC-urrent Proposed FOQftice V A QnIy Ainoi nt Revision Main Floor Heated EH Bld App Review: rr(f) 2m Floor Heated Consistency Review: •_]C r Other Heated Base fee: .l—35 Mezzanine Additional Section: Heated Basement Plan Check fee: .81 . 141 Unheated Basement State Surcharge fee: Other Unheated" Pot Water Review fee: Garage/Carport SUBTOTAL 78(7 Decks 911/Rd Approach fee: _ Other TOTAL $ C gr 1(p Receipt Number: 6Bp `'1 t 2 Cash/Check Number �� ;-ESTIMATED COST(REQUIRED), Date: •Fair market value of all labor and materials foundation to finish e:0; a9Q. Initials: —�� ,...i.ci..-r.n..rc•uuu\ran r.,clln 7,re%r•_.__.._.11D n c.._. ..\!S De« :.e....1:,..,.:... .. O_1R.1...- Jefferson County Building Dion Permit Numt3€r: BLD12-00030 Applicant: MAHRT 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 day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Setbacks Minimum setback from Center Road right-of-way shall be 5 feet. Minimum side and rear yard setbacks shall be 5 feet. Minimum setback _from the adjacent rural forest land parcel shall be 100 feet. If critical areas are present,then the more restrictive setbacks shall apply. Rough-in Plumbing Miscellaneous tank placement Q � 7 6e.E. d \�7 j 5 p r I or TO Q FINAL INSPECTION 2 FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • CONDITIONS for Building Permit# :BLD12-00030 1.) A vegetative buffer of 30-feet shall be permanently maintained from the top or edge of the Landslide Hazard Area. All buffers shall be measured perpendicularly from the top of the Landslide Hazard Area. 2.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated. Should buffer disturbance occur during construction, the Unified Development Code (UDC)Administrator shall require replanting with native vegetation. No alterations shall be made to the Landslide Hazard Area or its associated buffer without prior authorization by the UDC Administrator. 3.) Prior to and during approved construction activities, the perimeter of the landslide hazard area buffer shall be marked with a temporary sign. The sign shall be placed in such a manner that it can be directly observed from the construction area. The sign shall contain the following statement: "Landslide Hazard Area and Buffer- Do not Remove or Alter Existing Vegetation." 4.) All construction activities shall not encroach upon the landslide hazard area buffer. This includes the storage or preparation of materials. 5.) The applicant shall permanently separate the boundary of the Landslide Hazard Area Buffer from the remainder of the subject property through installing logs, trees, a hedge row, or any other prominent physical marking approved by the UDC Administrator. 6.) 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. 7.) The identified Fish and Wildlife Habitat Area (Type F Stream), shall maintain a vegetative buffer setback of 150 feet. The setback shall be measured horizontally from the Ordinary High Water Mark(OHWM) to the proposed single family residence. 8.) An additional setback of five (5)feet is required from the edge of the buffer area to the proposed single family residence. 9.) A permanent physical separation along the boundary of the stream buffer area shall be installed and permanently maintained. Such separation can include installing logs, trees, a hedgerow, or any other prominent physical marking approved by the UDC Administrator. 10.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 11.) 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. 12.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 13.) The building height is not to exceed 35 feet. 14.) Exterior lighting for residential uses sh• all not exceed twenty feet(20') in height from the finished grade, excepting when such lighting is an integral part of a building or structure. Ground level lighting is encouraged. 15.) 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. 16.) Minimum setback from Center Road right-of-way shall be 5 feet. Minimum side and rear yard setbacks shall be 5 feet. Minimum setback from the adjacent rural forest land parcel shall be 100 feet. If critical areas are present, then the more restrictive setbacks shall apply. West Property Line \OA, f. <P N/e J .. �\ CO 7 \ -> / N \ m \ . m � ° D)< n ' (n I+ 00 -I CJ Da 1-O _. p O -o ° m x ! 0P o c g a ;U CD �• v i: ; m m o a N ic: i o is L7 Co„--,✓-. Cn' ..._.,_.,,_- ; • is , -.41‘ :::.;'"7 -- ,, . , S-.. 4 ''''''''''''''\.''*' : . 01.i., . 40 !, / ~ : �:: `� �10 MOg 04 > d' �" ` ` � , E .). -0 . - C r- . 4106 :• • r. per .. . 3 CI a) n o 5 V N N a ih1 ! 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