HomeMy WebLinkAboutBLD2012-00252 4/UILDING PERMIT APPLICAN MLA12-00178
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD12-00252 Received Date: 8/16/2012
SITE ADDRESS: 3383 WEST VALLEY RD
CHIMACUM, 98325
OWNER: BRUCE GLEEMAN PHONE: 360-732-0696
AMY R DUBIN
3383 W VALLEY RD
CHIMACUM WA 983259751
SUBDIVISION: Block: Lot: TX 13
PARCEL NUMBER: 901342027 Section: 34 Township: 29 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOt NSFR W/ U/G 500 GAL PROP TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW IN 1,153
VALUATION 113,239.00 ADD'L: 240 HEAT TYPE: RAD
CODE EDITION: 2009 HEAT BASE: HEAT TYPE: WOD
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: SHORELINE:
CONST TYPE: SETBACK:
DECK: 280
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: 1PWELL
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 2 Prop: 3
Total: 2 e 3
Routing Date: /
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $1,072.15 LYK 08/16/12 135110
Plan Check $696.90 LYK 08/16/12 135110 APPROVE'
State Building Code $4.50 LYK 08/16/12 135110 Oc-f 23 2:412
Potable Water Application $64.00 LYK 08/16/12 135110
Total: $1,837.55 Jefferson County Pianninm;.
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DEPT. JEFFERSON COUNTY
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�� , JEFFERSON COUNTY
,-1 DEPARTMENT OF COMMUNITY DEVELOPMENT
1-) ` '.4( 621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
4Ar gyp.www.co.jefferson.wa.us/commdevelopment
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Master Permit Application MLA: 13—I gg
Project Description(include separate sheets as ne ary):
1.)5F12. (>0.7 1 . -oO i 0c.
Tax Parcel Number: C3 134202.7 Property Size: (acres/square feet)
Site Address and/or Directions Property:
33`rs 3 (), ...,Sr �(A �-( ,'�c i-�4 �n , (A.A. Gig 325
Property Owner(s)of Record: rC , - r • - a,..,. `.ss:`
Telephone: Go G ? 3 a 0(0 4 Fax: email:
Mailing Address: 3S'3 G,.). )....MI ilci 0 .rnnac.�-. U.) pr. 4r8 325r
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies ❑Lot or Road Segregation
Phuilding ❑Critical Areas Stewardship Plan
❑ Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use)
Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d),or C]**
❑ Manufactured Home .❑ Modular - ❑Discretionary"D"or Unnamed Use Classification
❑ Commercial* 0 Special Use(Essential Public Facilities)**
❑ Change of Use ❑❑BoundaShort Plat ry Li* ;111,1t l ii R�V/n E
O Address ❑Road Approach
O Home Business ❑Cottage Industry ❑Binding Sit , a
'Propane ❑Long Plat*
O Sign - ❑Planned R 1 idene�rel9pct(P-,'• riendments**
❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacati 'f J Cation
❑Stormwater Management 0 Shoreline a$t 'rogram Exemption/Perm �;;�isions*'`
O Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline anage - NI+.y! ;f ti i ti -•
ent**
❑Temporary Use ❑Shoreline ana• A - li
!memo k ' 4, .1
O Wireless Telecommunication* ❑Comprehens - .. -: -.. ' -r
‘4-. amendment
O 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 application for permit(s).
OWNER SIGNATURE Date:
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 a equired later i•-•- tions. Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the
time oft OM xtion that h or sh:w nts prior notice. ++
)4 Signature: k r�C Vic-(%� Date: 1 \ 0 — 4
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 •' ou are in liance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and no -[a erable respo sibili or adhering to and complying with the ESA. The Applicant has read this aime and siigQ�s and dates it below.
Signature: `.. 9,i� '.-� Date: 0 /v`
• II
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��n�respo gstbiiity f the General Contractor for the proposed project.
i nature:: +tN►.1" 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:
$t New ❑ Wood Existing: _ ❑ Sewer
❑ Addition ❑ Steel Proposed: _ Bank ❑ Community System
_
❑ Alteration/Remodel ❑ Concrete Total: _ _ Height: ),Individual Syst^m
❑ Repair Masonry SEP Permit# PI
o Demolition ❑ Other: Bedrooms: Water Supply:
- Existing: 0 Setback: Private well ❑ Two Party
Type of Heat: Proposed: 22.
. ❑ Public
M
&Id 1 i Total: Name of System: •
w
If this is a Commercial Proiect 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.•fiance Installation •-rmit mark all items below that a••I :
jnderground Tank I Above ground Tank Size of Propane Tank: IDO TQ I-
I Heat Stove i Cook Stove $/lloodstove t Fireplace Insert i Hot Water Tank I Pellet ove 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 fmr Office Use;e my Amount Revision
Main Floor Heated EH Bid App Review: n/
_ ( 16 3 3g5$7 .Ato _
22 Floor Heated a 13)$ Consistency Review:
Other Heated Base fee: 1072 • 15
Mezzanine Additional Section: 1
Heated Basement Plan Check fee: LP9 .(10
Unheated Basement State Surcharge fee: 4.5°
Other Unheated• Pot Water Review fee: ,o3-
Garage/Carport SUBTOTAL
X
_ )74.55
Decks covered. En 4_11i 911/Rd Approach fee:
280 q(o(n3(DO ts-n
Other TOTAL $
Receipt Number: 1 351 10
tI 3q0� Cash/Check Number: 1 023
STIMATED COST(REQUIRED) Date:
•Fair ma materials foundation to finish ` Ill tiWe""
0 000 — Initials: _
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,, `' ( , DEPARTMENT OF COMMUNITY DEVELOPMENT
w 621 Sheridan Street,Port Townsend,WA 98368
Tel:360.379.4450 Fax:360.379.4451
Web:www.co.jefferson.wa.us/communitydevelopment
q7 E-mail:dcd @co.jefferson.wa.us
CERTIFICATE OF OCCUPANCY
PERMIT#: BLD12-00252
APPLICANT: BRUCE GLEEMAN PHONE: 360-732-0696
AMY R DUBIN
3383 W VALLEY RD
CHIMACUM WA 983259751
SITE ADDRESS: 3383 WEST VALLEY RD Issue Date: 10/23/2012
CHIMACUM, 98325 Final Date: 12/17/2014
SUBDIVISION: Block: Lot: TX 13
PARCEL NUMBER: 901342027 Section: 34 Township: 29 N Range: 1W
PROJECT DESCRIPTION: NSFR W/ U/G 500 GAL PROP TANK
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009
EDITION.
OCCUPANCY GROUP: R-3
TYPE OF CONSTRUCTION: 5N
SPRINKLER SYSTEM yes n
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 12/17/2014
\\tidemark\data\forms\F_BLD_Occupancy.rpt 12/17/2014
Jefferson County Building Division Permit Number: BLD12-00252
111
Applicant: GLEEMAN
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 10/16/2012 setbacks pass as presented 10-16-12 RTB
Erosion Control
Foundation Footing 10/16/2012 footing pass 10-16-12 RTB
Footing Drains �p-25--(
Foundation Stem Wall F4?)
i� -tom-ice
Underground Plumbing
/ I
Straps(hold downs)
2'�- I Z vb
Ext.Shear Wall Nailing
,2-s- c
Rough-in Plumbing 4'1 _
'
Shower Pan
10-V1 S
Framing y,
-Blacking-- tc.' i
Airseal 14 10 f 13
Insulation:Walls
7 frpli3
Insulation:Floors
#ireirS Wit
d/JpeR5L4B t2
Insulation:Ceiling JO-11-‘5
Int.Shear Wall Nailing 2 _ a
Wallboard Nailing V24/13
Gas Line: Interior
Gas Line:Exterior 9/243
Propane Tank #41/3 J
Heat/Chimney Clearance I A(413 /J�
Mechanical Systems ��yy
Blower Airtight Test
Smoke&CO2 tb`C1--l3
Drywell/Alt Drainage 1_t 1_ `3 SEE CONDITION 1 FOR SPLASHBLOCK CRITERIA
Address Posted c'L/ v)2
• •
FINAL INSPECTION
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• •
CONDITIONS for Building Permit# :BLD12-00252
1.) DESIGN CRITERIA FOR SPLASH BLOCKS:
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.) A setback of 40-feet, measured perpendicularly from the wetland edge, shall be
permanently maintained as a buffer. No filling, grading, clearing, or other alteration of the
wetland or its buffer is allowed.
3.) A permanent physical separation along the upland boundary of the wetland 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.
4.) 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.
5.) All construction activities shall not encroach upon the wetland buffer. This includes the
storage or preparation of materials.
6.) The project shall adhere to the Best Management Practices (BMPs)to control stormwater,
erosion and sediment during construction. BMPs shall address permanent measures to
stabilize soil exposed during construction, and in the design and operation of stormwater
and drainage control systems.
7.) A stormater plan has been submitted and approved by the Department of Community
Development. Once the subject permit has been issued the applicant shall fully
implement the provisions of the submitted plan and contact the Jefferson County
Department of Community Development to arrange a schedule to inspect the property for
plan compliance. A Certificate of Occupancy will not be issued until the Department
verifies plan compliance. No clearing for roadways or utilities shall occur on the project
site until clearing necessary for the installation of temporary sedimentation and erosion
control measures have been completed.
8.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
9.) Not more than 2 unlicensed vehiclehall be stored on any lot unless totally sailed
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.
10.) A minimum of two (2)on-site parking spaces shall be provided for the single family
residence.
11.) 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.
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.) The building height is not to exceed 35 feet.
14.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
15.) Minimum setback from West Valley Road right-of-way shall be 20 feet. Minimum side and
rear yard setbacks shall be 5 feet. If a critical area is present, then the more stricter
setback(s) shall apply.
16.) The existing well for this development lies within the WRIA 17. Per Washington State
Department of Ecology consultation on_Oct. 18th 2012 , documentation has been
provided to support a determination that the well is exempted and not subject to the
in-stream flow rule for domestic use, metering, and exempt well irrigation.
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