HomeMy WebLinkAboutBLD2014-00012 BUILDING PERMIT APPLICATION BLD14-00
Review Type:
e:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD14-00012 Received Date: 1/10/2014
SITE ADDRESS: 1760 KALA POINT DR
PORT TOWNSEND, 98368
OWNER: KALA POINT OWNERS ASSOC PHONE: 360-385-0814
1760 KALA POINT DR
PORT TOWNSEND WA 98368-2505
SUBDIVISION: Block: Lot: TX 18
PARCEL NUMBER: 001281004 Section: 28 Township: 30 N Range: 01 W
CONTRACTOR: TBD PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP Replacement of 6 panel antennas and addition of equipment on
existing tower
TYPE OF WORK COM SQUARE FOOTAGE: COMMERCIAL:
TYPE OF IMP ADD MAIN: INDUSTRIAL:
VALUATION 18,000.00 ADD'L: HEAT TYPE:
CODE EDITION: 2012 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: NUMBER OF EMPLOYEES:
WATER SYSTEM:
BATHROOMS:
Exist:
Prop:
Total:
Routing Date:
Type Amount Paid By: Date: Receipt: Approved/Date
Plan Check $159.25 MEB 01/02/14 145678 APPROVED
State Building Code $4.50 MEB 01/02/14 145678
Permit $245.00 MEB 01/02/14 145678 DEC 3 2014.
Total: $408.75
Jefferson County DCD
\\4irlcmor4\rinfn\forme\G RI Il Ann PIA rn# 1/1!1/')(11A
i
isiov.-- - . an
„1.4
. „.
- , _ & ASSOCIATES , / NO .
GEOTECHNICAL ENGINEERING • ENVIRONMENTAL ENGINEERING
CONSTRUCTION TESTING & INSPECTION I
February 19,2015 Project No.: 106-15016
Jefferson County
Mr. Carl Smith
621 Sheridan Street
Port Townsend,WA 98368 Permit No.:BLD 14-00012
RE: Final Letter Regarding Special Testing&Inspection
WA1 Port Townsend Cell Tower
Dear Mr. Smith:
In accordance with our client's request and authorization, we have performed special testing and inspection
services for the above referenced project.The special inspections for this project were:
Special Inspection Required Performed
Structural Steel:
Bolting ® ■�
To the best of our knowledge, all work and noted deficiencies have been tested and/or inspected and have been
found to be in accordance with the approved plans and specifications.
If you have any questions or if we can be of further assistance, please do not hesitate to contact our office at
(360)598-2126.
Respectfully submitted,
KRAZAN&ASSOCIATES,INC.
el
Jeff Bowers
Construction Services Manager
Poulsbo Division
JMB/aw
cc
With Offices Serving The Western United States
1230 Finn[-ill Road NW Suite A•Poulsbo,Washington 98370•(360)598-2126•Fax:(360)598-2127
Sally Ellis
From: Sally Ellis
Sent: Friday, January 23, 2015 9:41 AM
To: 'annemariem @steringtc.com' 1
Cc: 'rcardoza@ldccorp.com'
Subject: BLD14-00012 1760 Kale Point Dr. Port Townsend WA
Good morning
I left Rick a voicemail today- It seems someone called in for a final inspection for BLD14-00012
Replacement of 6 panel antennas and addition of equipment to existing tower-
We are still needing the 2' party verification letter email or mailed to our office for this permit-before you can call in
for a final inspection.
Once that letter has been received we can final this permit.
I am unsure of where this letter comes from if it is something Rick provides to us or is it is something the Contractor
provides to us.
I just thought I would send you both an email in hopes that one of you know exactly what letter I am talking about and
can email that to me.
If you have any questions please feel free to contact me, if you have any questions and or need more information.
Thank you
Es C,,,
Sally L Ellis
Jefferson County Community Development
Permit Technician
621 Sheridan St.,Port Townsend,WA 98368
Mon-Thurs 9am-4:30pm,closed from 12-1
Ph: 360-379-4452 Fax: 360-379-4451
sellisna co.jefferson.wa.us
http://wvvw.co.jefferson.wa.us
1
Sally Ellis
From: Annemarie Montera<annemariem @sterlingtc.com>
Sent: Friday, January 23, 2015 10:01 AM
To: Erin Conley
Cc: rcardoza@ldccorp.com; Gavin Swayne; Frank Matranga; Sally Ellis
Subject: RE: BLD14-00012 1760 Kala Point Dr. Port Townsend WA
Erin:
When I picked up the Permit for this site I told you there is an inspection needed before the Final could be done. Please
look at the permit and see what you need to do and then get the letter to Sally so she can take care of the final
inspection for the site.
AnnemnarLe'Alonterc'
Treasurer/Chief Financial Officer
8
14
802- 134th St SW,Suite 110
Everett,WA 98204
Office: (425)361-7576
Fax: (425) 582-7978
Mobile: (425)754-2424
Email:annemariem( sterlingtc.com
Web Site:www.sterlingtc.com
From: Sally Ellis [mailto:SEllis @co.jefferson.wa.us]
Sent: Friday, January 23, 2015 9:41 AM
To: Annemarie Montera
Subject: FW: BLD14-00012 1760 Kala Point Dr. Port Townsend WA
From:Sally Ellis
Sent: Friday,January 23, 2015 9:41 AM
To: 'annemariem @steringtc.com'
Cc:'rcardoza@ldccorp.com'
Subject: BLD14-00012 1760 Kala Point Dr. Port Townsend WA
Good morning
I left Rick a voicemail today- It seems someone called in for a final inspection for BLD14-00012
Replacement of 6 panel antennas and addition of equipment to existing tower-
We are still needing the 2"d party verification letter email or mailed to our office for this permit-before you can call in
for a final inspection.
Once that letter has been received we can final this permit.
I am unsure of where this letter comes from if it is something Rick provides to us or is it is something the Contractor
provides to us.
1
I just thought I would send you both an email in hopes that one of you know exactly what letter I am talking about and
can email that to me.
If you have any questions please feel free to contact me, if you have any questions and or need more information.
Thank you
I
r ,
„„ 5,
. .„..,,, ,,..
55,, ,,
Sally L Ellis
Jefferson County Community Development
Permit Technician
621 Sheridan St., Port Townsend,WA 98368
Mon-Thurs 9am-4:30pm,closed from 12-1
Ph: 360-379-4452 Fax: 360-379-4451
sellis@co.jefferson.wa.us
http://www.co.jefferson.wa.us
No virus found in this message.
Checked by AVG- www.avg.com
Version: 2015.0.5645 /Virus Database: 4260/8980 - Release Date: 01/23/15
2
5ON
,tF N JEFFERSON COUNTY S
r
DEPARTMENT OF COMMUNITY DEVELOPMENT �
1SH; G,O
Date: t' Time Time Received: I/` it am/pm Mon. Tue. Wed. Thur. (g
Date: l ‘-,2
BLD: ' C/ Contact Name:
Owner: 3 a k✓Sc, %.. Contact Number: 360 4 5,3 3r) i
Address: —l�� D (/ 4 )1 iU 206 C� l" L
U
Notes:
Foundation Plumbing Framing Propane Tank Mechanical
Setbacks Under-ground Framing Under ground Furance
Footing Rough In Air Seal Above ground Gas
Stemwall Hydronic Exterior shear Exterior lines Oil
Straps Hot Water Htr Interior shear Interior lines Ducts
Post Hole Ventilation Appliance
Underfloor Gas/Wood stove
Man-Homes Insulation
Final Inspection Ks
Setbacks Floor
Foundation Wall Address Posted
Block&Tile Ceiling
t N°, JEFFERSON COUNTY
0 DEPARTMENT OF COMMUNITY DEVELOPMENT
9'sflt NO-C-
Date: Wc% I5 time Received: q- 20 am/pm Mon. Tue. Wed. Thur. Fria
Date:
BLD: 1.4 s ( 2_ Contact Name: r tJj ,�1 `'„yy� e
Owner: gr a, Cardo2ct /Ve.v/,7G� Contact Number: 360 ��
Address: ✓ 206
Notes: 2,5 - L3L-'rl 7---f-4-1
Foundation Plumbing Framing Propane Tank Mechanical
Setbacks Under-ground Framing Under ground Furance
Footing Rough In Air Seal Above ground Gas
Stemwall Hydronic Exterior shear Exterior lines Oil
Straps Hot Water Htr Interior shear Interior lines Ducts
Post Hole Ventilation Appliance
Underfloor Gas/Wood stove
Man-Homes Insulation
Final Inspection
Setbacks Floor ��yy
Foundation Wall Address Posted
Block&Tile Ceiling
Drawing P.\201.3\_ToleconA13-625 Vonzon- WAI Port Townsend AWS\Drowtnqs\Construction\13625CD-Al-0 dwg Ptottd. Dec 28, 2013- 10 15prn
NJ
I, CO -4 C)-0 X Co
■
x'
r, .1 —1M0s.
0)- m .-0 5.,,-,)A,
M I-0•-0
0 m c X
>
>
Tv
'
%.1
m •r.
.- ).. s› z ::
„
,..z0 0,
s„.. z 0.----1 co cn 0
-<m
O O Q c:
-- 2<;u-I
,
..... X>0(2, • ,,
- gz c
K ..,,,
x' no 7,
>
. ,
7-1 7_1—1,,,m
•,,..„
•
cn zmm1
,.F4
-„
1....(I,12 c 3 2,or"
„
—4 nix'(/'m
m m m ---,
0 K>Z
>
0 ,
Z A.01)5°
,
--i(t)1.-.7.4
X Z 0
--;
.....,.
.0>....0
m 0)31
,--irr g
0,›,
°
. , 1
(E)PROPERTY LINE
I ...22.22.
---- .... ...
221,
I 1
I
... .,..,.............,... ,..... .
■
■
I .k . .
.,... ....
. . o
* 1 I
1 .. ..
, M
•
I .• •.
•
I ........,./../.....'../
::::
:
: .
CI>CD--1M 1-'4(
!
),
IC ..\.*J.°
I
I oT 0
X g
, •
I . :
I.
l .
.:
•.
266±
I
TOWER SETBACK :1 4, . i
5R'.1 g 7m 0
•
. Z:
>.:,
m 0 mul omr-0Z—1
,
•
i
,
•
-r1 z
I
I ' .
. .
: . Cf)71 • , P CO D
. : X N
C-1
1 p 0
,
• :
.
,
_,z
,
m 0 z 0
, : ..:
gm 2
m-ma j
. .I
I • • cn
I "
. .
i :
. .
. •
• •
• •
. .
• • . • •
•..• 77, :....:I
cnrn z..,,: 2-1 I>rsj..0r T9°7 1
7..... c 0
n x om zm
0
• o 0
•
•
z z
..
. . • .
, . . .. .
11 1 • ,•. •.
..• ., , I
.
I ...•
1 I
1 ,
..,
1 "
\
\
.•..,,,............1 1,1 i
.,. „
[ "" (E)PROPERTY LINE "....".
. _
J (
.
I i ;7,
1 , _
i (4
f ....1
1
,
1 i Z-
1. . 1 0
, .
' I.: it I M-1(1)
,
H >
■.,—
! i I m
I (ncn
,
H
' 1
' t i
1 '
ir
1 '
I 1
SHORECREST CT , 1
I o o
.. .,.,..... ,.
i
! t
. t
I '
1 ' ,
t t .
■
■ t t t
t
t■
* t t 1
CA
i t t 1
, t
. .
...
1 I 2
2 2
'• ... '
i
coo TRUE NORTH
: 4.•• „, , , • ,...
F
C.. 0..4
•
I.
,
>4. ,--s
[
1
M PZ1
..0
,./.
t
-r
.---.- —,
4=••
t t i
te.11
smah
■K,
IN-1
. 1 !
2
464 Ilicj
_ .......... -
•
. , >
0
.;
.14
r
,•=0,,'''''
,.., .
A 2 4,1 i Itie)
-.- ......••••••••••00000000,0,
I cn 0 0 79 Ill'' ' 1 i Cl Pg ar,C 75 [1:1 1
> rlim cn 2
d / p2rn nu' 8' 1 ril
C 6-c'3 - r li 1•
ma. C z 0 2 °' A. 4 g g (r, g; ■ xi
n wireless
SO 70
...141.11
co
co
co
co
i
C) c.
• •
Sally Ellis
From: Annemarie Montera<annemariem @sterlingtc.com>
Sent: Monday, December 29, 2014 1:47 PM
To: Sally Ellis
Cc: Erin Conley; Frank Matranga
Subject: Permit#14-00012
Attachments: STERLING Contractor's License-exp. 02.28.16.pdf
Sally,
STERLING Telecommunications&Construction will be the contractor on this work.
Our License#is STERLTC884C9 and our UBI#is 603-178-073 (see attached)
Our company address:
&TERI. 6
802- 134th St SW,Suite 110
Everett,WA 98204
I will be by tomorrow afternoon to pick up the permit. Please let me know if you need anything else.
74rule/maYiAlonterar
Treasurer/Chief Financial Officer
STE $ a.
802 - 134th St SW, Suite 110
Everett,WA 98204
Office: (425)361-7576
Fax: (425) 582-7978
Mobile: (425)754-2424
Email:annemariemOsterlingtc.com
Web Site:www.sterlingtc.com
1
Sally Ellis
From: Annemarie Montera<annemariem @sterlingtc.com>
Sent: Monday, December 29, 2014 1:47 PM
To: Sally Ellis
Cc: Erin Conley; Frank Matranga
Subject: Permit#14-00012
Attachments: STERLING Contractor's License-exp. 02.28.16.pdf
Sally,
STERLING Telecommunications&Construction will be the contractor on this work.
Our License#is STERLTC884C9 and our UBI#is 603-178-073 (see attached)
Our company address:
STERIAG
802- 134th St SW,Suite 110
Everett,WA 98204
I will be by tomorrow afternoon to pick up the permit. Please let me know if you need anything else.
reirtri ilnarbe/Alonten,
Treasurer/Chief Financial Officer
SW,it L
1
802-134th St SW,Suite 110
Everett,WA 98204
Office: (425) 361-7576
Fax: (425)582-7978
Mobile: (425)754-2424
Email:annemariem@sterlingtc.com
Web Site:www.sterlingtc.com
3—b 000C2_
• •
Department of Labor and Industries STERLING TELECOM&CONST INC
PO Box 44450
Olympia,WA 98504-4450 Reg: CC STERLTC884C9
UBI: 603-178-073
Registered as provided by Law as
Construction Contractor
(CC01) - GENERAL
STERLING TELECOM & CONST INC Effective Date: 2/29/2012
802 134TH ST SW STE 110 Expiration Date: 2/28/2016
EVERETT WA 98204
• .
Sally Ellis
From: Mary Blain
Sent: Monday, December 15, 2014 3:28 PM
To: David W. Johnson
Cc: Sally Ellis
Subject: RE: Question about BP# 14-00012
Ian,
A Third party verification letter can be written up by the engineer stating that the installation was performed per the
plans. We will need it to be wet stamped from the engineer and it can either be emailed to me or the permit tech (cced)
or mailed to our office.
Please let me know if you have further questions.
Mary Blain
Plans Examiner I
Dept of Community Development
621 Sheridan St
Port Townsend,WA 98368
ph: 360-379-4461
fax: 360-379-4451
mblain @co.j efferson.wa.us
All e-mail sent to this address has been received by the Jefferson County e-mail system and is therefore subject to the
Public Records Act,a state law found at RCW 42.56.Under the Public Records law the County must release this e-mail
and its contents to any person who asks to obtain a copy(or for inspection)of this e-mail unless it is also exempt from
production to the requester according to state law,including RCW 42.56 and other state laws.
From: David W.Johnson
Sent: Friday, December 12, 2014 10:59 AM
To: Ian Downs
Cc: Frank Benskin; Mary Blain
Subject: RE: Question about BP#14-00012
You need to ask Frank Benskin or Mary Blain that(copied here)
From: Ian Downs [mailto:idowns @Idccorp.com]
Sent: Friday, December 12, 2014 10:54 AM
To: David W.Johnson
Cc:Sally Ellis
Subject: RE:Question about BP# 14-00012
Hello David,
Thank you for the information. Are there any forms that I would fill out for the "Second Party Verification"or should I
contact Frank Benskin about this step we need to take?
1
• •
Thank you so much for your time,
Ion Downs
Telecom Coordinator
LDC, Inc
The Civil Engineering Group
Ph.425.806.1869 Fx.425.482.2893
14201 NE 200th St, Ste 100
Woodinville, WA 98072
www.LDCcorp.com
"Engineering ABOVE the Standard"
From: David W.Johnson [mailto:djohnson @co.iefferson.wa.us]
Sent: Friday, December 12, 2014 10:24 AM
To: Ian Downs
Cc:Sally Ellis
Subject: FW: Question about BP# 14-00012
Waiting on a "Second Party Verification" per the Building Division (Frank Benskin)and assignment of a Contractor.
From:Sally Ellis
Sent: Friday, December 12, 2014 8:46 AM
To: David W.Johnson
Subject: RE: Question about BP# 14-00012
I just found that file in the active/issued permit file cabinet- I have placed it back into the pending draw you can now find it there.
thanks
From: David W.Johnson
Sent:Thursday, December 11,2014 9:42 AM
To:Sally Ellis
Subject: FW: Question about BP# 14-00012
Sally,
I couldn't find this file in the pending draw. Do you have it?
From: Ian Downs [mailto:idowns @Idccorp.com]
Sent:Thursday, December 11, 2014 8:09 AM
To: David W.Johnson
Cc: Elizabeth Goodnow
Subject:Question about BP#14-00012
Hello David,
I wrote a letter to Sally Ellis regarding Building Permit#14-00012 as we are going to begin work on this project in the
near future. She had mentioned that you were in need of some additional information before the Permit is going to be
issued. Other than the naming of the GC and the GC providing their license information,was there any other items that
you need before this Permit will be issued? Please let me know what I else we should provide.
2
• •
Thank you very much,
Ian Downs
Telecom Coordinator
LDC, Inc
The Civil Engineering Group
Ph.425.806.1869 Fx.425.482.2893
14201 NE 200th St, Ste 100
Woodinville, WA 98072
www.LDCcorp.com
"Engineering ABOVE the Standard"
3
%�SO`1
Co(.�� FFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
*.9SHr NO, 621 Sheridan Street Port Townsend,WA 98368 Web:www.co.Jefferson.wa.us/communitydevelooment
Tel:360.379.4450 I Fax:360.379.44511 Email:dcd(a)co.jefferson.wa.us
Building Permits&Inspections/Development Consistency Review/Long Range Planning/Watershed Stewardship Resource Center
Master Permit Application MLA:
Project Description(include separate sheets as necessary): Please see attached.
Tax Parcel Number:001281004
Property Size: 3.03 acres (acres/square feet)
Site Address and/or Directions to Property: 1760 Kala Point Dr., Port Townsend 98368
Property Owner(s)of Record: Kala Point Homeowner's Assoc.
Telephone: Fax:
Mailing Address: 1760 Kala Point Dr.,Port Townsend 98368 email:
Applicant/Agent(if different from owner): Verizon Wireless do Rick Cardoza
Telephone: 253-218-9017 Fax: 425-482-2893
Mailing Address: 14201 NE 200th ST#100.Woodinville,WA 98072 email: rcardozaCc�ldccorp.com
What kind of Permit?(Check each box that applies ❑ Lot or Road Segregation
❑Building ❑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 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
❑Temporary Use ( ) 0 Shoreline Management Substantial Development**
O Wireless Telecommunication* ❑Shoreline Management Variance
❑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 Confe
Please identify any other local,state or federal permits required for this proposal,if k ownrence
I hereby designate R i G Crardo DESIGNATION OF AGENT
�l 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 t•provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application
review and any 1•ui -• -ter inspections. S ..I access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the applica `,; - : s prior notice.
Signature: I /' / I
Date: ` G� 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 y7V1Pliz,in com•'.nce with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transferable res a• er;;osol:Tir co • '•• ' •
E . The Applicant has read this disclaime and si dates it below.
Signature: , /
Date:
07/24/2013
�gON C • V I IA I
`` °
4. ` °2a JEFFERSON COUNTY
-` DEPARTMENT OF COMMUNITY DEVELOPMENT
4.sso+ 621 Sheridan Street I Port Townsend,WA 983681 Web:www.ro' rson.wa.us/communi deve
Tel:360.379.44501 Fax:360.379.4451 Email:dcd �f
I @co.jefferson.wa.us
Building Permits&Inspections l Development Consistency Review/Long Range Planning/Watershed Stewardship Resource Center
Master Permit Application
MLA:
Project Description(include separate sheets as necessary):Please see attached.
1.
Tax Parcel Number:001281004
Property Size:3.03 acres (acres/square feet)
Site Address and/or Directions to Property:1760 jCala Point Dr., Port Townsend 98368
Property Owner(s)of Record: Kala Point Homeowner's Assoc.
Telephone: Fax
Mailing Address: 1760 Kale Point Dr..Port Townsend 98368 email:
Applicant/Agent(if different from owner): Vernon Wireless c/o Rick Cardoza
Telephone: 253-218-9017 Fax 425-482-28g3
Mailing Address: 14201 NE 200th ST#100.Woodinville.WA 98072 email: rcardoza @Idcxorp.com
What kind of Permit?(Check each box that apples
❑Building ❑Lot or Road Segregation
❑ Demolition Permit 0 Critical Areas Stewardship Plan
0 Variance C a Economic Use)Single Family ❑Garage Attached/Detached ❑Conditional Use ( ),C d)�Reasonable
C **❑ Manufactured Home 0 Modular
❑ Commercial*0 "D"or Unnamed Use Classification
❑ Change of Use ❑Special Use(Essential Public Facilities) "'
❑Boundary Line Adjustment
❑ Address 0 Road Approach
❑Home Business ❑Co ❑Short Plat Site
❑Propane Cottage Industry ❑Binding Site Plan**
❑Sign ❑Long Plat**
❑Planned Rural Residential Development(PRRD)/Amendments**
❑Allowed"Yes"Use Consistency Analysis
0 Vacation/Alteration**
❑Stormwater Management
❑Site Plan ❑Shoreline Master Program Exemption/permit Revisions**
❑Temporary Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development
❑Shoreline Management Variance **
o 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
Please Identify any other local,state or federal permits required for this proposal,If k own:ence
hereby designate R i�,k • DESIGNATION OF AGENT
rdo ' to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE 1 'va'.l��i�
Date: I/2. / 2. ()/ti
hiisBy signing this application tom,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of
, ere or its this knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet
Y permit being null and void.
I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and
expenses which may In any way accrue against Jefferson County as a result of or in consequence of the granting of this permit.
I further agree to provide access and right of entry to Jefferson County and Its employees,representatives or agents for the sole purpose of application
review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the application that he or she wants prior notice.
Signature:
The action or Date:
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 ends
"Endangered Species Act"or"ESA."Jefferson County makes no assurances to as those terms are actions in the federal law known because the
permit has been issued will not violate the ESA Any individual,group applicant thus the behalf that an will be a undertaken species because this
actton(s)even if you are in compliance with the Jefferson County or agency can file a lawsuit t on behalf d e endangered he,she s individual
al
and non-transferable responsibility ty 1opnent code.The Applicant acknowledges that he,she or It holds individual
ponsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature:
Date:
07/24/2013
Drawing:P:\2013\_Telecom\13-625 Verizon-WA1 Port Townsend AWS\Drawings\Construction\13625CD-Al-D.dwg Plotted: Dec 28, 2013- 10 15p
N 0 2I Z co
OOC A -I moj
I rn M mC�Om
D m�D--t �
m CDDZO
J DcDZf,y
t" Z {mmD
° O O CO Z
n A O�j
E 73c �
D p
>C
Dx
sp
1
m zmmx
n 0 m o< , 3
T
m .Amy
1
Imam
ii p E D Z
o zm. i
-I In r �' 4„
— Cnn 0°m 1.,,
Co�a.O
mDNA .,,,
71>- ~'`�.
(E)PROPERTY UNE ,__ `"^.,,....I
x
I I
Q
m l 1••
\ A r.
i 0• m N_
I cc.
, (� ! m rF ID
TO
•
i w h x
4 t•
I t ' i 1t
266'3 t ... '
TOWER SETBACK t o,,,� , i
. m x 8 iy '
N
c 2 %� a °A�n
•
1 z omi
r—
E 0 a z
•
�< rm-cn>
•\ I I (np � C TDZ
\ti I I mo L 1 c—zio•
\ riz + ( vzA
�� * °Ma°
A• O\ :71 O O m
gg z<
I Oom 0�•
z
s w z
y 1 I r 1
, 1 x 1
F i E PROPERIY UNf .-.-._.__ _..._ ._...... ..,,.__
77 I � 3!(({
O
E € u
E 1I
I, i' m .
k n
n
m
1
1
E
1 , i k
_...
I •
SHORECRESTCT
} 4
6
I
I [. I I !
3
i
Z
d I . — Vf , 7.1,
1
i k t-_ _- __.
____ 1 t 1 1 , 4,ii 9 ....,•P'g
w zip....1
v 00O $ate _� '�
O g ° m D 3m ? "2
:-I ' r ,�, n I?1 m v I Tt ::
—
m cn x , m ' A { €
D m qm a� R
Rr l ,
3 1 0P — m 1.4t 1 g = 0 a,C I m g 5 3!°NI mD Z ver° g AN° = 2 i wireless
;U .Z7 I v N n n ...
cn
co
-� co O w l0I;i 4@a@
i
•
7
,444•4494,
BUILDER STATEMENT II
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 assuming the responsibility of the General Contractor for the proposed project.
Signature: Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER:TBD 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 1 Wood Existing: Sewer
Addition 1 Steel Proposed: Bank 1 Community System
X Alteration/Remodel Ii Concrete Total: Height: 1 Individual System
Repair 7 Mason ry SEP Permit#
Demolition Other: Bedrooms: Water Supply:
Existing: Setback:
Type of Heat: Proposed: Private well Two Party
Total: 1 Public
Name of System:
if this is a Commercial Proiect you must answer the following; N/A
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
)f this is a Prooane Tank and/or Aooliance Installation Hermit mark all items below that aoDly: N/A
Underground Tank Above ground tank Size of Propane Tank:
Heat Stove Cook Stove Woodstove Fireplace.nsert rehtO 1 evotS telleP 1 knaT retaW toH
Js this aooliance being installed in a Manufactured/Mobile Home? Yes I 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:
2`"Floor Heated Consistency Review: , 2
Other Heated Base fee:
Mezzanine Additional Section: G
/
Plan Heated Basement an Check fee: l Sl , 2,c
Unheated Basement State Surcharge fee: 1{i
Other Unheated Pot Water Review fee:
Garage/Carport SUBTOTAL &
Decks 911/Rd Approach fee:
Other
0 TOTAL: $
Receipt Number: 'I tisl.-1---g
Cash/Check Number: I
ESTIMATED COST(REQUIRED) Date: Z "TV
market value of all labor and materials foundation to finish ( /7, i e f
$18,000 Initials:
hr1✓tA .
07/24/2013
• •
From front page of Master Permit Application
PROJECT DESCRIPTION:
Verizon Wireless proposes to modify an existing unmanned telecommunications facility with the
replacement of six(6)panel antennas with six(6)new panel antennas and the addition of 3 RRU's units,
1 RAYCAP distribution OVP box,three(3)TMA's and(1)hybrid cable mounted on existing self support
tower.
AA
RA
i3
4
• •
4 °N cob JEFFERSON COUNTY
r=i DEPARTMENT OF COMMUNITY DEVELOPMENT
,rc` _*`ti 621 Sheridan Street • Port Townsend • Washington 98368
O 360/379-4450 • 360/379-4451 Fax
/c,, ...00 http://www.co.jefferson.wa.us/commdevelopment/
Stormwater Calculation Worksheet
MLA# PROJECT/APPLICANT NAME: (J"`
Ca.v- cL U-Gt.
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 1..S2Sacres An acre contains 43,560 square feet. Multiply the acreage by this figure.
Size of parcel in square feet\'*. 1otv:, v. sq/ft
Land-disturbing activity is any activity that results in movement of earth, or a change in the existing soil cover(both vegetative and
non-vegetative) and/or the existing soil topography. Land disturbing activities include, but are not limited to clearing, grading, filling,
excavation, and compaction associated with stabilization of structures and road construction.
Native vegetation is vegetation comprised on plant species, other than noxious weeds,that are indigenous to the coastal region of the
Pacific Northwest and which reasonably could have been expected to naturally occur on the site. Examples include species such as
Douglas fir,western hemlock,western red cedar,alder, big-leaf maple, and vine maple; shrubs such as willow,elderberry, salmonberry,
and salal; herbaceous plants such as sword fern,foam flower, and fireweed.
LAND DISTURBING ACTIVITY, CONVERSION OF NATIVE VEGETATION,AND VOLUME OF CUT/FILL
Calculate the total area to be cleared, graded,filled, Answer the following two questions related to
excavated, and/or compacted for proposed development conversion of native vegetation:
project. Include in this calculation the area to be cleared for:
Does the project convert a/,acres or more of
Construction site for structures �,7� sq/ft native vegetation to lawn or landscaped areas?
Drainfield, septic tank,etc. (�/ sq/ft Circle: Yes Cho )
Well, utilities,etc. sq/ft Does the project convert 2'/2 acres or more of
native vegetation to pasture?
Driveway, parking,roads,etc. sq/ft
Circle: Yes
Lawn, landscaping, etc. sq/ft
Other compacted surface,etc. sq/ft Indicate Total Volumes of Proposed:
Total Land Disturbance sq/ft Cut Fill i (cu/yd)
[over]
stormwater calc worksheet Rev 9-9-2010—REV 9/9/2010 1
• I
Impervious surface is a hard surface that either prevents or retards the entry of water into the soil mantle as under natural conditions
prior to development. A hard surface area which causes water to run off the surface in greater quantities or at an increased rate of flow
from the flow present under natural conditions prior to development. Common impervious surfaces include, but are not limited to roof
tops, walkways, patios, driveways, parking lots or storage areas, concrete or asphalt paving, gravel roads, packed earthen materials,
and oiled, macadam or other surfaces which similarly impede the natural infiltration of stormwater.
STORMWATER CALULATIONS—IMPERVIOUS SURFACE
NEW EXISTING
Structures(all roof area) sq/ft Structures(all roof area) (20V • sq/ft
Sidewalks sq/ft Sidewalks sq/ft
Patios 6 sq/ft Patios Li U sq/ft
Solid Decks sq/ft Solid Decks sq/ft
(without infiltration below) (without infiltration below)
Driveway, parking, roads, etc 0 sq/ft Driveway, parking, roads,etc fige O sq/ft
Other I. sq/ft Other
' sq/ft
—
Total New 2 sq/ft Total Existing �j 0 S sq/ft
TOTAL NEW+TOTAL EXISTING* sq/ft
*This amount will be used BY STAFF to check total lot coverage.
The following questions will help determine whether the proposed project is considered development or redevelopment.
DEVELOPMENT v. REDEVELOPMENT
Divide the total existing impervious surface above by the size of the parcel and convert to a percentage: \ %
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 StormwaterManagement Manual.
APPLICANT SIGNATURE
By signing the Stormwater Calculation Worksheet, I as the applicant/owner attest that the information provided herein is true and
correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all
owners of the affected property.
____n) .....c r...2___ 112.7 1,1—
(LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
rPOPrPICEV$E0,44,YWF''',':';,:''''r, ,, SRI
$044, 1 00,101 '''-', -ARE Rfwt )VgLGko MS„9,0**1 r :#50 l0k N
stormwater calc worksheet Rev 9-9-2010--REV.9/9/2010 2
1143UILDING PERMIT APPLICAON BLD14-00012
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD14-00012 Received Date: 1/10/2014
SITE ADDRESS: 1760 KALA POINT DR
PORT TOWNSEND, 98368
OWNER: KALA POINT OWNERS ASSOC PHONE: 360-385-0814
1760 KALA POINT DR
PORT TOWNSEND WA 98368-2505
SUBDIVISION: Block: Lot: TX 18
PARCEL NUMBER: 001281004 Section: 28 Township: 30 N Range: 01 W
CONTRACTOR: TBD PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOr Replacement of 6 panel antennas and addition of equipment on
existing tower
TYPE OF WORK COM SQUARE FOOTAGE: COMMERCIAL:
TYPE OF IMP ADD INDUSTRIAL:
VALUATION 18,000.00 MAIN:
CODE EDITION: 2012 ADD'L: HEAT TYPE:
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL: NUMBER OF EMPLOYEES:
WATER SYSTEM:
BATHROOMS:
Exist:
Prop:
Total:
Routing Date:
Type Amount Paid By: Date: Receipt: Approved/Date
Plan Check $159.25 MEB 01/02/14 145678
State Building Code $4.50 MEB 01/02/14 145678
Permit $245.00 MEB 01/02/14 145678
Total: $408.75
\\4irlemor4\rlo4o\fnrr RI fl Ann PIA rni 1/1(lr)f11A
,, � 11A �r
00N c
,ems 4G�-c JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
4. 621 Sheridan Street 1 Port Townsend,WA 983681 Web:www.coisfler.on.waus/communitvdevebamen(
191,9 NO Tel:360.379.44501 Fax:360.379.44511 Email:dcd@co.iefferson.wa.us
Building Permits&Inspections/Development Consistency Review)Long Range Planning/Watershed Stewardship Resource Center
Master Permit Application MLA:
Project Description(include separate sheets as necessary):Please see attached.
Tax Parcel Number.001281004 Property Size:3.03 acres (acres/square feet)
Site Address and/or Directions to Property:17_ nj(ala Point Dr.,Port Townsend 98368
Property Owner(s)of Record: Kale Point Homeowner's Assoc.
Telephone: Fax email:
Mailing Address: 1760 Kale Point Dr..Port Townsend 98368
AppiicanUAgent(If different from owner): Verizon Wireless c/o Rick Cardona
Telephone: 253-218-9017 Fax 425-482-2893 email: rcardoza61l.* •na.com
Mailing Address: 14201 NE 200th ST#100.Woodinville.WA 98072
What kind of Permit?(Check each box that applies ❑Lot or Road Segregation
❑Building ❑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 Rural Residential Development(PRRD)/Amendments**
❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration**
❑Stor nwater Management ❑Shoreline Master Program Exemption/Permit Revisions**
❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development**
❑Temporary Use
Wireless Telecommunication*
❑Shoreline Management Variance
® ❑Comprehensive Plan/UDC/Land Use District Map Amendment
❑Forest Practices Act/Release of Six Year Moratorium ❑Jefferson County Shoreline Master Program Amendment
*May require opus—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
hereby designate R. Gk- tAoz o. to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE Date: //Z, / 2 C)i 11
By signing this application form,the owner/agent attests that the information provided herein,and inn 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. Stars access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the application that he or she wants prior 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-transferable responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: Date:
07/24/2013
III/�gON �,
�e� °02 J ERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
4gsy1 N o÷ 621 Sheridan Street I Port Townsend,WA 983681 Web:www.co.jefferson.wa.us/communitvdevelooment
Tel:360.379.44501 Fax:360.379.4451 I Email:dcd(c co.jefferson.wa.us
Building Permits&Inspections J Development Consistency Review J Long Range Planning I Watershed Stewardship Resource Center
Master Permit Application MLA:
Project Description(include separate sheets as necessary): Please see attached.
Tax Parcel Number:001281004 Property Size:3.03 acres (acres/square feet)
Site Address and/or Directions to Property: 1760 Kala Point Dr., Port Townsend 98368
Property Owner(s)of Record: Kala Point Homeowner's Assoc.
Telephone: Fax: email:
Mailing Address: 1760 Kala Point Dr.. Port Townsend 98368
Applicant/Agent(if different from owner): Verizon Wireless do Rick Cardoza
Telephone: 253-218-9017 Fax: 425-482-2893 email: rcardozata.�.ldccoro.com
Mailing Address: 14201 NE 200th ST#100.Woodinville,WA 98072
What kind of Permit?(Check each box that applies ❑ Lot or Road Segregation
❑Building ❑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 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
O 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 R. Gk... Carcloza 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 t•provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application
review and any 1•ui -. -ter inspections. S .I access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the applica ?t,,,Ly„ = s prior notice. _`��fJ/ I
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 :111- in corn.'.nce with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transferable res a. er co e SA. The Applicant has read this disclaime and ms nd dates it below.
Signature: j Date: / 3'
07/24/2013
. + • .
From front page of Master Permit Application
PROJECT DESCRIPTION:
Verizon Wireless proposes to modify an existing unmanned telecommunications facility with the
replacement of six(6)panel antennas with six(6)new panel antennas and the addition of 3 RRU's units,
1 RAYCAP distribution OVP box,three(3)TMA's and(1)hybrid cable mounted on existing self support
tower.
}gQ
3
lgggy�
}
}
F
MBUILDER 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 assuming the responsibility of the General Contractor for the proposed project.
Signature: Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER:TBD 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
X Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System
❑ Repair ❑ Masonry SEP Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: ❑ Public
Total: Name of System:
Jf this is a Commercial Proiect you must answer the following; N/A
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 Pronane Tank and/or Appliance Installation Hermit.mark all items below that annly: N/A
Underground Tank Above ground tank Size of Propane Tank:
Heat Stove Cook Stove Woodstove Fireplace .nsert rehtO i evotS telleP i knaT retaW toH 1
Js this annliance beina 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:
2na Floor Heated Consistency Review: 2�
Other Heated Base fee: n
Mezzanine Additional Section: /
Heated Basement Plan Check fee: f cs7 , 2c
Unheated Basement State Surcharge fee:
C(/
Other Unheated Pot Water Review fee: /,' '
Garage/Carport SUBTOTAL -
Decks 911/Rd Approach fee: (�S(p
Other TOTAL: $
Receipt Number: 7 11S-611
Cash/Check Number: - 3-14 ESTIMATED COST(REQUIRED) Date: 1 I t `2 ��
•Fair market value of all labor and materials foundation to finish /
$18,000 Initials: ,,�/�
07/24/2013
PUT ( Sl C2-
Front Parcel Review
(o: 100 .-- t p : cD Parcel 001281004
Printed: January 14, 2014
KALA POINT OWNERS ASSOC Site Address:
1760 KALA POINT DR 1760 KALA POINT DR
PORT TOWNSEND WA 983682505
PORT TOWNSEND, WA 983E PORT TOWNSEND WA, 98368
Parcel Number: 001281004 S-T-R: 28-30N-01W Total Acreage 3
Legal Description S28 T3ON R1W TAX 18 Land Use: 9800
Flood District: Fire District: 1 Planning Area: 4
Flood Map(FIRM)Panel No: School District 50 Zoning:
COMP PLAN
DESIGNATION:
COMMUNITY PLAN: UGA: UGA Trans
[ vf Plot plan states "property line"
[ Assessor's Map (Property lines on submitted plot plan must match the property lines as identified on the Assessor's 1/4 map)
[ .4 Legal Access to Property NO
[ v] Parcel Tags or Scanned Documents YES NO
[ yr ESA's: Special Reports arby YES NO
[ - Designated Ag YES
[ v]' Shoreline Designation: YES
[ Shoreline Slope Stability: YES NO
Stream Type:YES NO
FWHCA: YES NO J�
Wetlands: YES NO
Rare Plants:YES NO
YES NO
Landslide: YES NO
Flood: YES NO
Erosion: YES NO
Aquifer Recharge Area:YES NO
SIPZ: none At Risk High Ris Coastal
CMZ: none High Risk Moderate Ri kDisconnected CMZ
Stormwater site plan submitted: YesNo
[ ] Forest Lands: YES NO
Adjoining Forest Lands: Commercial/ Rural/ Inholding
[ ] Mineral Lands: YES NO
[ ] Agricultural Lands: YES NO
[ ] Archaeology: YES NO
[ ] No Shooting Zone: YES NO
[ ] Stormwater: New Impervious Surface Land Disturbing Activity ESA's
Stormwater Req's:Min Req#2 Min Req 1 thru#5 Min Req#1 thru#10 Engineering
[ ] Notice Provisions/Disclosure:Airport Y NO MRL YES NO Forest Lands YES NO
[ ] Landscaping Required: Yes No
[ ] Parking Spaces Required NO 2 t
f 1 Building Height: 35' UBC Standard
[ ] Impervious Surface coverage centage:
Resource Lands&Public: 10% gip Rural Residential: 25% Rural Industrii r UDC Sec 6.7
Rural Commercial: 60% Area of Building Coverage:60%in Rural Industria Lands only
[ ] Total Building (s) Size:
RVC:20,000 SF CC:5,000 SF NC:7,500 SF GC: 10,000 SF All others:subject to septic&water constraints/None specified
[ ] Setbacks: Front: Left Side: Right Side: Rear:
Shoreline Setback:
LSHA Setback:
[ ] Road Classification:
Road Approach: EXISTING NOT REQ'D RAP
[ ] SEPA Required: YES EXEMPT
[ ] Flood Certificate:
[ ] Existing Case(s) &Condition(s):
Violations: Yes No
[ ] Recorded Date of Subdivision: FN Over 5yrs=UDC
Plat Conditions: <5yrs=Plat Conditions on plat or Old Ordinance
[ ] Lots/Require Declaration of Restrictive Covenant YES NO, submitted: YES NO
[ ] UGA No Protest Agreement YES NO, submitt d: YES NO
[ ] Site Visit conducted YES NO
[ ] Require Final Zoning Approval YES NO
[ ] ADMIN: Setbacks entered in Permit Plan elk /A YES
New Parcel Tags entered in Permit Plan ��1A YES
Special Reports Scanned N/A YES
Title Notes Updated
Parcel tags found for parcel 001281004
1.) WSRC Coaching - 2011-12-13 07/11/2013
Other
Parcel tags found for parcel 001281004
2.) WSRC Coaching - 2010-06-15, CZ 09/04/2013
Other
Cases Associated with APN 001281004
Cases Name Review Type Status Planner
BLD90-00290 KALA POINT OWNERS ASSOC. F
Application Received: 5/4/1990 Permit Issued/Case closed: 5/16/1990 Case Finaled:
ADDITION TO EXISTING EXISTINGNAMTENANCE BLDG (1900 SQ. F IT
BLD92-00776 KALA POINT OWNERS ASSOC. F
Application Received: 12/17/1992 Permit Issued/Case closed: 12/29/1992 Case Finaled:
150' steel lattice tower, cellular phone site
BLD99-00793 SPRINT PCS F
Application Received: 12/3/1999 Permit Issued/Case closed: 6/2/2000 Case Finaled: 8/10/2000
construct wireless equipment on grounds and antennas on existing o� w
PRE99-00024 KALA POINT OWNERS ASSOC. F J SMITH
Application Received: 6/23/1999 Permit Issued/Case closed: 8/13/1999 Case Finaled:
The applicant proposes to attach to an existing 150' lattice tower. In addition, the applicant proposes to mount twelve
(12) antennas at the ninety six foot(96') level on the existing lattice tower.
SEP89-00254 KALA POINT OWNERS ASSOC. F
Application Received: 3/6/1989 Permit Issued/Case closed: 3/13/1989 Case Finaled: 9/13/1990
OFFICE/SHOP
ZON99-00039 SPRINT PCS F J SMITH
Application Received: 9/15/1999 Permit Issued/Case closed: 1/4/2000 Case Finaled: 8/10/2000
The applicant proposes to attach a new array of antennas onto an existing 1 bO' lattice tower. Sprint PCS proposes to
lease approximately 1020 square feet on the property for development of a generator and propone tank, as well as
equipment cabinets, which house radio equipment and batteries. In addition, the applicant proposes to mount twelve
(12) antennas (three(3) arrays of four(4) antennas)at the 127 foot level on the existing lattice tower.
•
\\tidemark\data\forms\R_Parcel_CRMLA.rpt 1/14/2014 Page 2 of 3
ZON99-00044 SPRINT PCS F J SMITH
Application Received: 10/29/1999 Perm ssued/Case closed: 2/29/2000 Cas coaled: 8/11/2000
Application to attach a new array of antennas onto an existing 1b0 toot lattice tower.Sprint proposes to lease
approximately 1200 square feet on the property. The lease area will be developed with a generator and propane tank,
as well as equipment cabinets, which house radio equipment and batteries. In addition, the applicant proposes to
mount three (3)arrays of four(4) antennas-for a total of twelve(12)antennas at a height of 127 feet on the existing
tower. Parcel#821-222-001 within Section 22, Township 28 North, Range 1 East WM near Port Ludlow.
BLD12-00346 SPRINT S
Application Received: 10/25/2012 Permit Issued/Case closed: 11/7/2012 Case Finaled:
MODIFICATIONS TO EXISTING ANTENNAAND CABINETS
BLD13-00257 SPRINT-GENERAL DYNAMICS A
Application Received: 8/21/2013 Permit Issued/Case closed: 9/11/2013 Case Finaled:
ADD (1) MICROWAVE DISH (MICROCELL)TO EXISTING ANTENN7VMWER
BLD14-00012 KALA POINT OWNERS ASSOC P
Application Received: 1/10/2014 Permit Issued/Case closed: Case Finaled:
Replacement of 6 panel antennas and addition of equipment on existing tower
M LA07-00190
BLD07-00161 MLA07-00190 VIRELESS- REALCOM SARAH' I F
Application Received: 4/19/2007 Permit Issued/Case closed: 8/1/2007 Case Finaled: 3/18/2008
REMOVE (4)ANTENNAS &ADD (12)ANTENNAS TO EXISTING LAI I ICE POWERS
PRJ07-00054 MLA07-00190 KALA POINT OWNERS ASSOC P
Application Received: 4/20/2007 Permit Issued/Case closed: Case Finaled:
REMOVE (4)ANTENNAS &ADD (12)ANTENNAS TO EXISTING LATTICE TOWERS
ZON07-00034 MLA07-00190 VERIZON WIRELESS II A
Application Received: 4/19/2007 Permit Issued/Case closed: 8/1/2007 Case Finaled:
Verizon Wireless proposes to remove four(4) existing omni antennas and add twelve(12) new panel antennas onto a
modified antenna platform to the existing lattice telecommunications tower located at 1760 Kala Point Dr, Port
Townsend. The proposal does not include new ground equipment. The antennas will be painted to match the existing
site conditions. The original tower was permitted by Jefferson County in 1992 and the associated wireless equipment
on grounds and antennas on the tower were permitted by Jefferson County in 1999 (ZON99-00039).
This proposal requires a Type II Conditional Administrative Use permit with public notice. State and local agencies
have been asked to review and comment on the proposal. Review under the State Environmental Policy Act(SEPA) is
required per WAC 197-11-800(25).
M LA10-00163
BLD10-00136 MLA10-00163 VERIZON WIRELESS I F
Application Received: 4/29/2010 Permit Issued/Case closed: 7/27/2010 Case Finaled: 8/16/2010
SWAP OUT A 2 FT MIW-DTSFl WITH A 6 FT M/W DISH ON EXISTING LAI I ICE TOWER
M LA10-00390
BLD10-00372 MLA10-00390 KALA POINT OWNERS ASSOC I F
Application Received: 10/26/2010 Permit Issued/Case closed: 1/26/2011 Case Finaled: 4/30/2013
Adding 3 panel antennas and cabinet to the existing permitted lattice telecommunications tower.
M LA11-00043
BLD11-00048 MLA11-00043 KALA POINT OWNERS ASSOC I F
Application Received: 3/3/2011 Permit Issued/Case closed: 5/18/2011 Case Finaled: 2/13/2012
REPLACE & UPGRADE 12 EXIS LING ANTENNAS
SOM89-00254 KALA POINT OWNERS ASSOC F
Application Received: 9/13/1990 Permit Issued/Case closed: Case Finaled:
BLD00-00102 SPRINT PCS F
Application Received: 2/11/2000 Permit Issued/Case closed: 3/15/2000 Case Finaled: 3/31/2000
INSTALL AN ANTENNA TO BE LOCATED ON EXISTING TOWER (PCS)
\\tidemark\data\forms\R_Parcel_CRMLA.rpt 1/14/2014 Page 3 of 3
Jefferson County Building Division Permit Number: BLD14-00012
Applicant: KALA POINT OWNERS ASSOC
BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2012 International Building Codes
To schedule inspections, call (360)379-4455 no later than 3:00PM the day before the inspection is needed.
Requests received after 3:00 PM will not be scheduled for the next 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
Miscellaneous second party verification required
A final inspection will not be scheduled until the following are completed and signed off by the applicable Department:
• Building Permit Conditions are met • Septic Permit Final/Complete for any building containing plumbing
• Land Use Conditions met and signed off • Public Works Permit Final(where applicable)
FINAL INSPECTION
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
! 0
CONDITIONS for Building Permit# :BLD14-00012
1.) The proposal meets JCC18.42.020(2)(d)which exempts the following from the provisions
of the Chapter 18.42, JCC:
Emergency or routine repairs, reconstruction, or routine maintenance of previously
approved facilities, or replacement of transmitters, antennas, or other components of
previously approved facilities which do not create a change in visual impact;
2.) The site plan as submitted with the Building Permit application on January 10, 2014 has
been reviewed for consistency under the UDC, and has been approved by Jefferson
County Department of Community Development. Any modifications, changes, and/or
additions to the stamped, approved site plan dated January 14, 2014_shall be
resubmitted for review and approval by Jefferson County Department of Community
Development.
3.) DWJ
\\tidemark\data\forms\F_BLD_Permit_Bldg.rpt 12/30/2014
BUILDING PERMIT
•
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT#: BLD14-00012 Received Date: 1/10/2014
SITE ADDRESS: 1760 KALA POINT DR Issue Date 12/30/2014
PORT TOWNSEND, 98368 Expiration Date 12/30/2015
OWNER: KALA POINT OWNERS ASSOC PHONE: 360-385-0814
1760 KALA POINT DR
PORT TOWNSEND WA 98368-2505
SUBDIVISION: Block: Lot: TX 18
PARCEL NUMBER: 001281004 Section: 28 Township: 30 N Range: 1■1
CONTRACTOR: STERLING TELECOMMUNICATIONS &CONSTRUCTIONSPHONE: 425-361-7576
802-134TH ST SW SUITE110
EVERETT WA 98204
PROJECT DESCRIPTION: Replacement of 6 panel antennas and addition of equipment on existing
tower
TYPE OF WORK COM SQUARE FOOTAGE: COMMERCIAL:
TYPE OF IMP ADD MAIN: INDUSTRIAL:
VALUATION 18,000.00 ADD'L: HEAT TYPE:
CODE EDITION: 2012 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM: Type Amount Paid By: Date: Receipt:
BATHROOMS: Plan Check $159.25 MEB 01/02/14 145678
Exist: State Building Code $4.50 MEB 01/02/14 145678
Prop: Permit $245.00 MEB 01/02/14 145678
Total: Total: $408.75
NUMBER OF EMPLOYEES:
Directions to Site:
HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION
THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED
BUILDING INSPECTION HOT-LINE 379-4455.
Request must be received by 3pm the day before the inspection is needed.
Office Hours 9:00 am -4:30 pm MONDAY- THURSDAY
HOT LINE AVAILABLE 24 HOURS A DAY
SPECIAL CONDITIONS APPLY-SEE ATTATCHED