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HomeMy WebLinkAboutBLD2013-00283 - CANCEL 411t3 UILDING PERMIT APPLICATION B 0283 Ree view view Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00283 Received Date: 9/13/2013 SITE ADDRESS: CLEVELAND ST PORT HADLOCK, 98339 OWNER: MAGNE STEINSVIK PHONE: LAURA J CURCIO PO BOX 17317 SEATTLE WA 981271017 I RON DALE AC TRACTS SUBDIVISION: Block: Lot: PARCEL NUMBER: 962700084 Section: 7 Township: 29 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: I PROJECT DESCRIPTIOr STORAGE SHED, PREFAB, NO HEAT, NO PLUMB TYPE OF WORK GAR SQUARE FOOTAGE: 1 TYPE OF IMP NEW VALUATION 7,000.00 MAIN: CODE EDITION: 2012 ADD'L: HEAT TYPE: UH OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: 336 SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $157.00 MEB 09/12/13 142497 Plan Check $102.05 MEB 09/12/13 142497 APPROVED State Building Code $4.50 MEB 09/12/13 142497 Total: $263.55 SEP 12 2013 Jefferson County DOE NWiom,r4\rin#.\fnrmc\G RI Il Ann PIA rn4 011 1 111'2 ' D NO F * c,, 0 rn U ii gi _.- Nil 14 i N '7 G av E t. 57". 5 5E— ,... ) lr 1 --t • 4 77 ,., h • ■ 0 d 4: L 1.1 -k il • -e i 1 w �' iz 1 LI, II U ' -t?_ til .t x6` 1° Om I A. ak ..z.k- 0 e- r z 4 z x a a N al .r w .r �� ,�t;�-� ,� 0 00... , .. p w �'� p o 8 LowERoAk ► ,Ry 0 . A 7 P AZ( '0 ' g 6 F VU G o� rn nrrt %, - RI 2 N n C N G a W U V r .�FFERSON J BOX 571 _UWNSEND, WA 98368 (360) 385 -9150 Received From: **ORIGINAL** Receipt Number 4646 COMMUNITY DEVELOPMENT Receipt Date 11/08/2013 Clerk TCASH REFUND CK - STEINSVIK nRcpt Fund/Dept Description Revenue Paid 3685 143-000-010 BUILDING BASE & INSPECTIONS 322 10 0 0 81.00- 143-000-010 ZONING APPROVAL APPLICATIONS 345 81 40 0 228 .00- 143-000-010 PLAN CHECK FEES 345 83 0 0 102 .05- 143-000-010 SEPA/ENVIRONMENTAL REVIEW 345 89 0 0 78.00 650-511-000 STATE BUILDING CODE FEES 386 0 0 0 4 .50- Total 493 .55- Tender: Refund 493 .55- a 4RtT1 5 96088211'1330 TREASURER OF JEFFERSON COUNTY PORT TOWN ND,WA 98368 1 1/8/2093 PAYTO THE> MAGNE STEINSVIK I 4j 1'493.55 ORDER OF Four Hundred Ninety-Three and 55/100****** DOLLAF 1. •i MEMO ®, Refund DCD 1110 2 2888u' 1: L 2 3 3088 2 5I:_ 110 500000 ? ? 3 301 (t3( I 3 vy\IE) Pe- S • Mary Blain From: Mag Steinsvik[steinsvik @cablespeed.com] Sent: Friday, November 01, 2013 3:29 PM To: Mary Blain Subject: RE: additional information requested Hi Mary, Sorry for delay in getting to this home email as well as your voice mail. Yes, please do cancel the permit process for my shed. I will look for a full refund of$569.55 less the$76.00 processing fee. Thank you. Mag Steinsvik 206-619-0666 162 . 6 From: Mary Blain [mailto:mblain@co.jefferson.wa.us] Sent: Wednesday, October 23, 2013 11:16 AM To: steinsvik steinsvik Subject: RE: additional information requested Q`5 • Mag, 1 I received your phone call. If you can confirm via email that you would like to cancel y p y y your permit application, I can send the request to the treasurer's office for a refund, minus the hourly intake processing fee of$76. Once I've received this email, I can close your file and request the refund. Sincerely, Mary Blain Permit Technician Dept of Community Development 621 Sheridan St Port Townsend, WA 98368 ph: 360-379-4452 fax: 360-379-4451 mblain @co.iefferson.wa.us All email to or from this email address may be subject to the Public Records Act contained in RCW 42.56. Additionally, all email to and from the county is captured and archived by Information Services. 1 # • From: steinsvik steinsvik [mailto:steinsvikOcablesaeed.com] Sent: Monday, September 30, 2013 5:38 PM To: Mary Blain Subject: Re: additional information requested Hi Mary, Just back in town and sorry for delay. The drawing was to scale (.25 inch=25 feet) so one should be able to see distance from property line and the septic field. I also wrote in the septic field distance of 55 feet when suggested by your office colleague. I presume this is the "septic reserve area" you Are referring to? If not,please tell me what it is. A gentleman in your office, by the name of Frank, had spoken to my wife who gave him the name of the builder. Builder and Frank spoke. When my wife spoke with Frank, he said he had all his questions answered and as long as we used piers to fit the 4x4 skid on bottom of shed, all would be fine. So,to summarize all this: Shed is constructed of wood, floor joists and walls on 16 inch centers w/3/4 plywood. Shed will sit on pier blocks or cinder blocks over a gravel foundation. Will get more information for you if needed. Thank you. Mag Steinsvik On Thursday, September 19, 2013, Mary Blain wrote: Dear Mr. Steinsvik, I was in the process of routing your permit application and realized your site plan was missing the septic reserve area and the setback from the proposed storage shed site and the south property line. Also, our plans examiner would like to know what kind of shed it is, a brand name so we can look up how you plan to anchor it, and what type of foundation the shed is being placed on. Attached is the site plan we received. You are welcome to add the additional information and email back. 2 • • Thank you, Mary Blain Permit Technician Dept of Community Development 621 Sheridan St Port Townsend, WA 98368 ph: 360-379-4452 fax: 360-379-4451 mblain@cojefferson.wa.us All email to or from this email address may be subject to the Public Records Act contained in RCW 42.56. Additionally, all email to and from the county is captured and archived by Information Services. 3 • Mary Blain From: Mary Blain Sent: Friday, October 04, 2013 9:43 AM To: 'steinsvik steinsvik' Subject: RE: additional information requested Dear Mr.Steinsvik, A standard septic system has a the septic tank,the drain field and a reserve area. All three need to be shown on your site plan so Environmental Health has an accurate portrayal of the system to compare to the one they have on their file. With your permission I can label the necessary setbacks from the property line. Also, part of the building permit process is Plan Check. The Plans Examiner still needs two copies of the plans for how the shed was built so he can make necessary comments and approval marks. I apologize for the inconvenience. You are welcome to mail the plans to us to avoid a trip. I can also print them from a pdf up to 11x17. I'm happy to route this through as soon as I have the revised Site Plan and the plans. r f pis Sincerely, e- Mary Blain e■(ti.�' Permit Technician Dept of Community Development yF _ r 621 Sheridan St cam• f7if / 7 krh Port Townsend, WA 98368 Sr F P ph: 360-379-4452 fax: 360-379-4451 mblain@co.jefferson.wa.us All email to or from this email address may be subject to the Public Records Act contained in RCW 42.56. Additionally, all email to and from the county is captured and archived by Information Services. From: steinsvik steinsvik [mailto:steinsvik @cablespeed.com] Sent:Mary Monday, September 30, 2013 5:38 PM � r._ �� �� f(� To: Ma Blain t (/ Subject: Re: additional information requested Hi Mary, eV-0 Just back in town and sorry for delay. The drawing was to scale (.25 inch=25 feet) so one should be able to see distance from property line and the septic field. I also wrote in the septic field distance of 55 feet when suggested by your office colleague. I presume this is the "septic reserve area" you Are referring to?If not,please tell me what it is. 1 • Mary Blain From: steinsvik steinsvik[steinsvik @cablespeed.com] Sent: Monday, September 30, 2013 5:38 PM To: Mary Blain Subject: Re: additional information requested Hi Mary, Just back in town and sorry for delay. The drawing was to scale (.25 inch=25 feet) so one should be able to see distance from property line and the septic field. I also wrote in the septic field distance of 55 feet when suggested by your office colleague. I presume this is the "septic reserve area" you Are referring to? If not, please tell me what it is. A gentleman in your office, by the name of Frank, had spoken to my wife who gave him the name of the builder. Builder and Frank spoke. When my wife spoke with Frank, he said he had all his questions answered and as long as we used piers to fit the 4x4 skid on bottom of shed, all would be fine. So,to summarize all this: Shed is constructed of wood, floor joists and walls on 16 inch centers w/ 3/4 plywood. Shed will sit on pier blocks or cinder blocks over a gravel foundation. Will get more information for you if needed. Thank you. Mag Steinsvik On Thursday, September 19, 2013, Mary Blain wrote: Dear Mr. Steinsvik, I was in the process of routing your permit application and realized your site plan was missing the septic reserve area and the setback from the proposed storage shed site and the south property line. Also, our plans examiner would like to know what kind of shed it is, a brand name so we can look up how you plan to anchor it, and what type of foundation the shed is being placed on. 1 .rSON 0O JEFFERSO( UNTY " -�" "` r . 0 M t� ri\ W DEPARTMENT OF COMMUNITY DEVELOPMENT D '� 621 Sheridan Street• Port Townsend •Washington 98368 4► . * 360/379-4450 . 360/379-4451 Fax SEp 1 2 2013 1 �sN www.co.jefferson.wa.us/commdevelopment 2° L 'I JEFFERSON COUNTY Master Permit Application OF con. /UNITY DEVELOPMENT Description(include separate sheets as necessary): D EYIV E2 o F 14 A-1-140)..e. S7zoM64.SI.1E,13 �t� ( , pkoh■� Tax Parcel Number: Q[ap1ex0$N Property Size: #2.6.'" „M.quare feet) Site Address and/or Directions to Property: LIDO t,iEV&aAN.o Sr, Poor giokock USA q 8339 Property Owner(s)of Record: !Y1 A6,N $re,Als Ii AND 1-h uAA Caa,c l O Telephone: al• e-61el-O(-D Fax: email:$TEJA SV/K®cA8).ESPEEk.(O4 Mailing Address: 4 O- aoK Is 7 5 , Po 12-1- 4 R DI.oe Jr-- W A 9833 9' Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each.box that applies ❑ Lot or Road Segregation Ci4Building 6-reks.41-1 Sttai ) ❑ 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* ❑ Special Use(Essential Public Facilities)** ❑ Change of Use ❑ Boundary Line Adjustment ❑ Address ❑ Road Approach_ ❑ Short Plat** O Home Business ❑Cottage Industry ❑ Binding Site Plan** ❑ Propane ❑ Long Plat** . • ❑Sign ❑ Plarinea 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 ❑ Shoreline Management Variance 0 Wireless Telecommunication* ❑ Comprehensive Plan/UDC/Land Use District Map 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 any required later inspections. Staffs --•- and right of entry will be assumed unless the applicant informs the County in writing at the time of the application that he o • e wants prior n• - p Signature: _ Date: q- l-1/ 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-transferable responsibility f dhering to and ompl ing with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: +V "* ` , Date: �1-(3-13 G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc i -- • BUILDER STATEMENT The signer of this statement does hereby certi •t they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming the -s,onsibility of th; .ral Contractor for the proposed project. Signature: 14\01, Date: et-q", GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE_ FAX: MAG1 IvE S NSV/K gnu 649 0(044,, ( ) MAILING ADDRESS: p© BOX. 15?5 EMAIL: 5TEt>.jSV1 k CONTRACTOR'S LICENSE ®c48ii'EsPE&�'�� NUMBER: WAINS NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: t. New 0*Ebliuo SEem4)14. Wood Existing: 0 0 Sewer 0 Addition 0 Steel Proposed: O Bank 0 Community System 0 Alteration/Remodel 0 Concrete Total: 0 Hei?ht: 0 Individual System 0 Repair 0 Masonry SEP Permit# 0 Demolition o Other: Bedrooms: Water Supply: Existing: 0 Setback: 0 Private well 0 Two Party Type of Heat: Proposed: O AMA) E Total: / 0 Public 2$O , Name of System. • 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 i Woodstove I Fireplace Insert I 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 EH BId App Review: .- .-g- 2- Floor Heated Consistency Review: z �j Other Heated Base fee: 2/5--/- ii‘t‘ii"-L 1S.1 Mezzanine Additional Section: ----I Heated Basement /----- - Plan Check fee: / 32 /05- rev L Unheated Basement State Surcharge fee: q ‘` , —Other Unheated Pot r — Water Review fee: // Garage/Carport SUBTOTAL - Decks 911/Rd Approach fee: . � Other Sw (o TOTAL: $ l‘SL (..,l"1 ?,55 - ) , 7. Receipt Number: 'N 2 1401 Cash/Check Number: 5T O_ ESTIMATED COST(REQUIRED) Date: •Fair market value of all labor and materials foundation to finish �f -r, 6 4 7tco,DO Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc i nj l ��SON COQ JEFFERS COUNTY jvv — 1- .' i Th '� ' r�' DEPARTMENT OF COMMUNITY DEVELOPMENT ir, , 621 Sheridan Street • Port Townsend •Washington 98368 L' i \ r-� i ` `' ! i '360/379-4450 • 360/379-4451 Fax 1 'i ; VI l � w . 1 1 , 0 www.co.jefferson.wa.us/commdevelopment qS, N � U �u 1 Master Permit Application IErFERSO cOu n Project Description(include separate sheets as necessary): D Ez-NM. a - Pa A.r,AB�.e. 5.779nAC -shiei) , i'�, (te-e.. - pLrn Tax Parcel Number: Q 4p 19VO$H Property Size: .2.5 410 quare feet) Site Address and/or Directions to Property: g LIDO C4.IEvet.AND S r, PoQ-r Ao Loa< 119A q 8339 Property Owner(s)of Record: /Y]A G,N i $Te,NSV//c Awl:. Dig AA Ca(2Gt D Telephone: /2Ct9-tot -o(do(0 Fax: email:`✓TE-410V/!C®cA8).ESPEf) .ro/h Mailing Address: 1?-0'- 2'o c i75. , PO R1- 14 AA{.06 bx. 1,A)4 9833 9' Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address What kind of Permit?(Check eac\box that applies ❑ Lot or Road Segregation IlfBuilding I o-ntj' i:L1 S ttaD) ❑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* ❑ Special Use(Essential Public Facilities)** • Change of Use ❑ Boundary Line Adjustment ❑ Address ❑Road Approach_ ❑Short Plat** ❑ Home Business ❑Cottage Industry ❑Binding Site Plan** ❑ Propane ❑Long Plat** ❑ Sign ❑ Planned kurai 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 ❑Shoreline Management Variance ❑Wireless Telecommunication* ❑ Comprehensive Plan/UDC/Land Use District Map Amendment [3 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 any required later inspections. Staff's - - and right of entry will be assumed unless the applicant informs the County in writing at the time of the application that he o -'e wants prior n s p Signature: J ;....111 Date: q- `-i3 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-transferable responsibility-f dhering to and ompl ing with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: 4K . ._� Date: q-13-j3 -411) • BUILDER STATEMENT The signer of this statement does hereby certi, -t they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming the s onsibility of,th a ral Contractor for the proposed projectct. Signature: �o� Date: �' t' 3 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: MAGINis 5- Ai. V/K 1206?) t0/9 04 (o ( ) MAILING ADDRESS: Pe Box 1557 EMAIL: 5 T FaM vik CONTRACTOR'S LICENSE ®GA81.ESPEIPiO•Cl�rY) WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: $. New OttED,,uo Schwass.. Wood Existing: O ❑ Sewer IC Addition C Steel Proposed: D Bank ❑ Community System 0 Alteration/Remodel 0 Concrete Total: 0 Height: 0 Individual System 0 Repair 0 Masonry a SEP Permit# C Demolition 0 Other: Bedrooms: Water Supply: Existing: 0 Setback: 0 Private well 0 Two Party Type of Heat: Proposed: O / C Public Pala a Total: 0 Name of Systern 13'0 8 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 i Above ground Tank Size of Propane Tank: i Heat Stove I Cook Stove 1 Woodstove 1 Fireplace Insert I Hot Water Tank I Pellet Stove 1 Other Is this appliance being installed in a Manufactured t 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-012y, _ Amount Revision Main Floor Heated EH Bld App Review: 7/1 2na Floor Heated Consistency Review: 2•7 • Other Heated Base fee: Mezzanine — /5— - Additional Section: / ` Heated Basement — — Plan Check fee: / o 2 ;05- Unheated Basement State Surcharge fee: /�,� c Other Unheated -- (, -�- Pot Water Review fee: /-------- ''_ SUBTOTAL Decks _ 911/Rd Approach fee: Other 504 ��<21 �"j �j _ .0,7( TOTAL: $ �� J/, `l)561 7. Receipt Number: 142 _lcu Cash/Check Number: ST°- ESTIMATED COST(REQUIRED) Date: 4f �i •Fair market value of all labor and materials foundation to finish �3 47Dor).D0 Initials: 5 G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Masrer Prrm;t ar r t: coo(IQ a i011lV E {-,011401 ,,ON c JEFFERSON COUNTY�i, A, DEPARTMENT OF COMMUNITY DEVELOPMENT SEP 1 2 2013 <, o pc 621 Sheridan Street• Port Townsend •Washington 98368 JEFFERSON COUNTY N O� 360/379-4450 • 360/379-4451 Fax DEPT.OF COMMUNITY DEVELOPMENT �`Y-Z IN0� http://www.co.jefferson.wa.us/commdevelopment/ Stormwater Calculation Worksheet MIA# PROJECT/APPLICANT NAME: TO 1116l NF 5TrE1/115 11 1 K 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 2.5�• acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet fO$,3E'O sq/ft '' urbin activity is any activity that results in movement of earth, or a change in the existing soil cover(both vegetative and Land-disturbing tY Y non-vegetative) and/or the existing soil topography. Land disturbing activities include, but are not limited to clearing, grading, filling, excavation,and compaction associated with stabilization of structures and road construction. Native vegetation is vegetation comprised on plant species, other than noxious weeds,that are indigenous to the coastal region of the Pacific Northwest and which reasonably could have been expected to naturally occur on the site. Examples include species such as Douglas fir,western hemlock,western red cedar,alder, big-leaf maple,and vine maple; shrubs such as willow,elderberry, salmonberry, and salal; herbaceous plants such as sword fern,foam flower,and fireweed. LAND DISTURBING ACTIVITY,CONVERSION OF NATIVE VEGETATION,AND VOLUME OF CUT/FILL Calculate the total area to be cleared,graded,filled, Answer the following two questions related to excavated, and/or compacted for proposed development conversion of native vegetation: project. Include in this calculation the area to be cleared for: Does the project convert 3/4 acres or more of Construction site for structures 334,.2��o sq/ft native vegetation to lawn or landscaped areas? Drainfield, septic tank,etc. 0 sq/ft Circle: Yes No Well,utilities,etc. 0 sq/ft Does the project convert 2'/2 acres or more of native vegetation to pasture? Driveway, parking, roads,etc. O sq/ft Circle: Yes No Lawn, landscaping, etc. 0 sq/ft Other compacted surface,etc. 0 sq/ft Indicate,Total Volumes of Proposed: Total Land Disturbance 33(/ q so/ft Cut • l Fill (cu/yd) / [over] • • lmpervipu$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) 3,360 sq/ft Structures(all roof area) 3(o0D sq/ft Sidewalks sq/ft Sidewalks 3 4 s sq/ft Patios 0 sq/ft Patios / /0 sq/ft Solid Decks 0 sq/ft Solid Decks sq/ft (without infiltration below) (without infiltration below) Driveway,parking, roads, etc O sq/ft Driveway, parking, roads,etc S7 E)0 sq/ft Other © sq/ft Other o sq/ft Total New 33 sq/ft Total Existing - sq/ft TOTAL NEW+TOTAL EXISTING* sq/ft This amount will be used to check total lot coverage.CtS 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: ' 7- Does the site have 35%or more of existing impervious surface? Circle: Yes No 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. 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