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Home My WebLink AboutBLD2014-00128 OBUISING PERMIT APPLIC ONO BLD14-00128 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD14-00128 Received Date: 4/14/2014 SITE ADDRESS: 54 SHIP VIEW CT PORT LUDLOW, 98365 OWNER: MARTIN C PETTIS PHONE: DIANE E PETTIS 73 TWIN FIRS ESTATES DR PORT ANGELES WA 983629278 WHITE ROCK COVE TRACTS DIV II SUBDIVISION: Block: Lot: PARCEL NUMBER: 821265019 Section: 26 Township: 28 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: III PROJECT DESCRIPTIOr DECK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP DEK MAIN: VALUATION 12,000.00 ADD'L: HEAT TYPE: CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: #OF STORIES: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: SETBACK: DECK: 552 BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Plan Check $144.95 JLA 04/10/14 148539 State Building Code $4.50 JLA 04/10/14 148539 Permit $223.00 JLA 04/10/14 148539 MAY 0 5 2014 Total: $372.45 Jefferson County DCD \14 irVomo r4\'1,34,3\forme\F RI fl 4 n Rid rnf A/1R/1111A r10IV cod,, JEFFE COITY • • \ W g DEPART M OF C MMUNITY DEVELOPMENT \a 04 621 Sheridan Street • Port Townsend • Washington 98368 (V7 360/379-4450 • 360/379-4451 Fax ,� cj www.co.jefferson.wa.us/commdevelopment NO Master Permit Application MLA: Project Description(include separate sheets as necessary): Tax Parcel Number: k 6 50 r Property Size: 3. / a crp 5 (acres/square feet) Site Address and/or Directions to Property: LsI1 J 5h 1 o i/> I�.,l u �- r-1- l (t q 8'36 Property Owner(s)of Record: YI Pc A-i-/ S Telephone: aIN 5?) -- D.5 -056 g Fax: email: f cxr vm r' k-i ci5 N'_ 964100. Mailing Address: t--514 �„Sh,p V i euJ e}. Pori &kJ( ice) W a , W..3 5 co-kJ"- Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑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),f.S _- ❑ Manufactured Home CI Modular ❑ Discretionary"D"or Unname. I "~ •: . ❑ Commercial* ❑ Special Use(Essential Publi•F:• "t s "* ell ❑ Change of Use ❑ Boundary Line Adjustment ❑ Address ❑ Road Approach ❑ Short Plat** /v ❑ Home Business CI Cottage Industry CI Binding Site Plan** // El Propane ❑ Long Plat** r' AP l 1 O 9 ❑ Sign ❑ Planned Rural Residential DeVIeIQEment(PRRD)/AtilCnd ❑Allowed"Yes"Use Consistency Analysis ❑ Plat Vacation/Alteration** ❑Stormwater Management ❑ Shoreline Master Program E ' ��F ns ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantia . ❑Temporary Use ❑ Shoreline Management Variance /o,i/y. ❑Wireless Telecommunication* ❑ Comprehensive Plan/UDC/Land Use District Map Am- t ❑ 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 �,� J "� Date: i Lj(,`1 l p 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 access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application that he Q.Lshe wants prior notice. Signature: 0 OL.iA,�,,.., �-�-� °� Date: I 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 responsi for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: 1 k (� i \� � � Date: G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc • • 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 assuming the responsibility of the General Contractor for the proposed project. Signature:L-f L,p ;) ,, Date: 'l/i t ""I — C:?/`'I GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New f'Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System V Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition n, Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well Two Party Type of Heat: Proposed: ❑ Public Total: 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 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 i Woodstove i Fireplace Insert i Hot Water Tank i Pellet Stove 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 For Office Use Only Amount Revision Main Floor Heated EH Bld App Review: 2nd Floor Heated Consistency Review: Other Heated Base fee: Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL: $ Receipt Number: Cash/Check Number: ESTIMATED COST(REQUIRED) Date: .Fair market value of all labor and materials oundation to finish ` i'J 000 Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc _S U I C -EOdC `" �� _APR 1 0; 2014 --0 o 1 JEFFERSON COUNTY ;' g DFPr:{3F COMMUNITY DEVELOPMENT l APPROVED ' , SITE PLAN APR 242014 �. JEFFERSON So t. ' D EPT.OF c R N r _» SIGNATURE: o �, N 4 % (a fv1t1 p0Yva Ecir.i 2/cry 5 ' - ` . - o { T )t,_ _ c c CN C:2) G • • Standard Conditions for Residential Development in Jefferson County 1. LIGHTING: 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. 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. 2. BUILDING HEIGHT: The building height is not to exceed 35 feet. 3. OUTDOOR STORAGE: Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 4. UNLICENSED VEHICLES: Not more than 2 unlicensed vehicles shall be stored on any lot unless totally screened from view of neighboring dwellings and rights-of-way. Such screening shall meet all applicable performance and development standards specific to the district in which the storage is kept, and shall be in keeping with the character of the area. Screening shall meet the requirements of Chapter 18.30 JCC. Outdoor storage of 3 or more junk motor vehicles is prohibited except in those districts where specified as an automobile wrecking yard or junk (or salvage) yard and allowed as a permitted use in Table 3-1 or Chapter 18.18 JCC, and such storage shall meet the requirements of JCC 18.20.100, Automobile wrecking yards and junk (or salvage) yards. In no case, shall any such junk motor vehicles be stored in a critical area. 5. PARKING: A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 6. This permit has been reviewed consistent with JCC 18.40.130 & 140. Notice: this permit does not excuse the applicant from complying with other local, state and federal ordinances, regulations or statues, applicable to the proposed development, but consistent with RCW 90.58. Future development beyond that specified in this permit shall require further review. 7. BMPs: 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. 8. NOTICE: This permit does not excuse the proponent from complying with other local, state, and federal ordinances, regulations, or statutes applicable to the proposed development, but consistent with RCW 90.58. Development pursuant to this permit shall be undertaken subject to the applicable policies and performance standards of the Jefferson County Shoreline Management Master Program and the Jefferson County Unified Development Code. If during excavation or development of the site an area of potential archaeological significance is uncovered, all activity in the immediate area shall be halted, and the Administrator shall be notified at once. The Federal Endangered Species Act rules to protect threatened Chinook and Summer-run Chum salmon became effective on January 8, 2001. Bull trout have been listed as threatened since early 2000. Under the ESA, any person may bring lawsuit against any individual or agency that "takes" listed species (defined as causing harm, harassing, or damaging habitat for the listed species). In addition, the National Marine 2013-03-07 SFR StdConditions 3/7/2013 1 • Fisheries Service can levy penalties. Portions of Jefferson County, including marine waters, are included as "critical habitat" for a listed species. Development of property along any marine shoreline, freshwater shoreline, or floodplains could harm habitat if protective measures are not taken. To minimize the potential to damage habitat, all property owners developing adjacent to marine shoreline, freshwater shoreline, or floodplains are advised to do the following: All development activities should avoid unstable slopes, wetlands, and forested areas near surface waters Remove minimal vegetation for site development, especially large trees Allow trees that have fallen into surface waters to remain there Infiltrate stormwater from buildings and driveways onsite through drywells rather than discharging directly into surface waters or roadside ditches The Federal Bald and Golden Eagle Protection Act requires landowners within 660 feet (1/8th of a mile) of an eagle nest to consult with the US Fish and Wildlife Service. This Eagle Act prohibits anyone from "taking" bald eagles. This federal law defines the term "take" and describes the possible legal consequences when a "take" occurs. Among other actions, "take" includes a disturbance of bald eagles or their habitat. Under federal law a permit may still be required for activities that impact bald eagles or their habitat. Contact the US Fish and Wildlife Service (http://www.fws.gov/pacific/eagle/) to learn more about how this law affects your project. Any individual, group, or agency can bring suit for a listed species "taking", even if you are in compliance with Jefferson County development codes. The risk of a lawsuit against you can be reduced by consulting with a professional fisheries habitat biologist, and following the recommendations for site development provided by the biologist. For more information, contact the National Marine Fisheries Service in Seattle, or the U.S. Fish and Wildlife Service. 2013-09-06 SFR—StdConditions 9/6/2013 — 2 0 •• XI 1 I I f I 0 . "11 .c F. APR 1 -0 2014 I [ ' o Lei i €FFERSON COUNTY °� c OFRT.OF COMMUNITY DEVF.I-OPMENT c in -c CI .�. . 7 Pt es2 7 r4. 0 io "0 2/ . - I- ) 1 cip I - -0' - - . i ...,„ ._ ... ... „,._„_.. ___. :�f` ' r qc • • • 1/4) 0\ ‘'P tc 0 fra g2, "s:Z) LI p p CN. U 14J: (rg OP, cClcb \ (T, APR 1 0 201=+ jrFFERSON COUNTY DIP[OF COWLINITY DEVELOPMENT Hello! • • • • Please note the following items on the Checklist (attached): /faster Permit Application: (attached) two Sets of Plans Floor Plan (please label all the rooms and show where the deck will be. This is necessary for the review in Environmental health. This can be a basic drawing) mite Plan (checklist for this on second page of the "checklist" attachment, no bigger than 11x17 please. Please show where the proposed deck is going on the site plan) Stormwater Calc Worksheet (attached) If you can send me the sq footage of the proposed deck and the approximate valuation of the project, including labor and let me know if there is a septic on the property I can send you the fees. Also, a deck built to code has the following: 1. Handrails required on one side with four or more risers. (stairs) 2. Handrail height measured vertically from tread nosing not less than 34"/not more than 38" 3. Maximum rise step of 7 3/4 inch (for stairs) 4. Minimum treat depth 10" (stairs) Please let me know if you need help filling anything out. ' C� V!E Thanks! APR - 2 2014 Mary Blain JEFFERSON COUNTY Permit Technician - DEP.OFCOMMUNITYDEVELOPMENT Dept of Community Development 621 Sheridan St Port Townsend, WA 98368 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. 's'° -- \ , 1 ) _ - 0 • * 0 1 CO M > a 11 • 't 0 I I )0 , Ai 4,• 1 ' ' -t' ' ' ,.. '''', .1 'Ii, in m G) 0 ._ _-- --. > i \ I i I 0^ t 0 c 1 1 tn - 73 Z S......N-ta 06 1 1 i'' -9- ,,:. .•4 pt. 0 _1 i,N: O 1.) i';■ 1 ll . , 1 fl %.0' -i'"I)( ' m M C ' I 0 * Clri S F X-rTh.-...-- i..Z:„ , ••■ .. F--=T--:'"r, -'"-- r—---.• 1 ' 0 .; ; 1k IN k VP 1 h — i --•„._ N ,....... Q:, ii, • -t- M1 I , 1=4. 1 ■1 , . 0 ' 0 tre T3 323 M 1 — --— I ,___,„-------------7 sr, -4, S -1- 'A ...I 4 s■.- i 4 I. I 1 - 1 I , ,-, ,, s ■ CI 3 -1 I i 1 \4 \s Fr '1). " 71 , :1 0 ,-,-; l' ..r■ •N - , . _ — 91) or:. —, J 'Z1 k id ._._ . , ..,,, ,......__,.... , . 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Date: 4// f7 BLD: )4 " ,0151z- Contact Name: Owner: Contact Number: 360 s! 7 ' Address: c$1' i, Vir t. 206 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.Y____ Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling *Front Parcel Review Ze Parcel 821265019 Printed: April 22, 2014 MARTIN C PETTIS Site Address(es): DIANE E PETTIS 54 SHIP VIEW CT PORT LUDLOW, WA 98365 73 TWIN FIRS ESTATES DR PORT ANGELES, WA 983629278 Parcel Number: 821265019 S-T-R: 26-28N-01E Total Acreage 3 Legal Description WHITE ROCK COVE TRACTS DIV II TRACT 7 W/PTN Land Use: 1100 OS V10/P105 Flood District: Fire District: 3 Planning Area: 8 Flood Map(FIRM) Panel No: School District 49 Zoning: 'jZ( _ COMP PLAN 1 DESIGNATION: COMMUNITY PLAN: UGA: UGA Trans [ ] 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) [ ] Legal Access to Property YES NO [ ] Parcel Tags or Scanned Documents YES NO [ ] ESA's: Special Reports arby YES NO [ ] Designated Ag YES [ ] Shoreline Designation: S [ ] Shoreline Slope Stability: 400 NO <54414t4/ Stream Type:YES Oil FWHCA: YES Or Wetlands: YES ire Rare Plants:YES ft Seismic: YES IPO Landslide: YES i* Flood: YES Erosion: YES `16' Aquifer Re • e Area:YES SIPZ: AAt Risk High Risk Coastal CMZ: on- High Risk Moderate RiskDisconnected CMZ Stormwat- - plan su• itted: YesNo [ ] Forest Lands: YES NO Adjoining Forest Lanes: Commercial/ Rural/ Inholding [ ] Mineral Lands: YES elf [ ] Agricultural Lands: S • [ ] Archaeology: YES l0 [ ] No Shooting Zone: YES [ ] Stormwater: New Impervious Surface Land Disturbing Activity ESA's Stormwater Req's:Min Req#2 Min Req#1 t #5 Min Req#1 thru#10 Engineering [ ] Notice Provisions/Disclosure: a ' -∎ort YES MRL YES a O Forest Lands YES rro [ ] Landscaping Required: Yes �t. [ ] Parking Spaces Required 2 Other I- 1 Building Height: 35' UBC Standard [ ] Impervious Surface coverage p n • Resource Lands&Public: 10% ural Residentia• /o Rural Industrial:•UDC Sec 6.7 Rural Commercial: 60% Area of Building Coverage:60%in Rural Industrial 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: Ze, Left Side: S Right Side: S Rear: S Shoreline Setback: LSHA Setback: [ ] Road Classification: Road Approach: EXISTING a. t EQ'D RAP [ ] SEPA Required: YES EXEMPT [ ] Flood Certificate: [ ] Existing Case(s) & Condition(s): Violations: Yes No [ ] Recorded Date of Subdivision: AFN 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, submitted: YES NO [ ] Site Visit conducted YES NO [ ] Require Final Zoning Approval YES NO [ ] ADMIN: Setbacks entered in Permit Plan case N/A YES New Parcel Tags entered in Permit Plan N/A YES Special Reports Scanned N/A YES No parcel tags found for parcel Cases Associated with APN 821265019 Cases Name Review Type Status Planner BLD14-00128 PETTIS I P Application Received: 4/14/2014 Permit Issued/Case closed: Case Finaled: DECK CAM14-00075 PETTIS NA M Application Received: 2/5/2014 Permit Issued/Case closed: 2/5/2014 Case Finaled: Building permit requirements for a deck. BLD95-00359 SILVA F Application Received: 6/28/1995 Permit Issued/Case closed: 7/10/1995 Case Finaled: 2/26/1996 single family res OTH95-00153 SILVA A Application Received: 6/28/1995 Permit Issued/Case closed: 6/30/1995 Case Finaled: SEP89-00089 SILVA F Application Received: 5/3/1989 Permit Issued/Case closed: 7/18/1989 Case Finaled: 8/21/1992 SOM89-00089 SILVA RCR Application Received: 8/21/1992 Permit Issued/Case closed: 3/1/2012 Case Finaled: \\tidemark\data\forms\R_Parcel_CRMLA.rpt 4/22/2014 Page 2 of 2 �iSSON cpG JEFFERSONUNTY • ' ��\' li)4° DEPARTMENT OF COMMUNITY DEVELOPMENT \ ■�� '� '\` `4( 621 Sheridan Street• Port Townsend • Washington 98368 r� ‘(),) 360/379-4450 • 360/379-4451 Fax ,,IANG p� www.co.jefferson.wa.us/commdevelopment lr Master Permit Application MLA: Project Description(include separate sheets as necessary): Tax Parcel Number: g a a 50 ( 9 Property Size: 3, / a CJ'p 5 (acres/square feet) Site Address and/or Directions to Property: 5 q 6111p VI 0,<J b•-• ? nr-i- Lud I Oicd i WI , q 836 5- Property Owner(s)of Record: lT) 0, vie. I- ill at-(-1 ri nf'_f`f-%,5 Telephone: c)\57) — „2 a 5 —056 g Fax: I email: f Gt.r'nel r �t`Ci5 e_ ��G p, Mailing Address: h14 L Sj- p U i e� of- Pork J 'a-IA) to a . % ?. ' (-, 5- Cc iv,- Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑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 s ❑ Manufactured Home ❑ Modular ❑ Discretionary"D"or Unnamed .u- -;',1 '_• ❑ Commercial* ❑ Special Use(Essential Pu 1 i,cF oil∎t s ** ❑ Change of Use ❑ Boundary Line Adjustmen " 11 V ❑ Address ❑Road Approach ❑ Short Plat** -1, ❑ Home Business ❑Cottage Industry ❑ Binding Site Plan** /U 1/ p . ❑ Propane 0 Long Plat A , Q 2 1r ❑Sign ❑ Planned Rural Residerial Development(PRRD)/Amend ❑Allowed"Yes"Use Consistency Analysis ❑ Plat Vacation/Alteratiofi** r� ❑Stormwater Management ❑Shoreline Master Program Ex-fripf• - . •ns ❑ Site Plan Approval Advance Determination (SPAAD)* ❑ Shoreline Management Substantia ::,}='•,, **me! ❑Temporary Use ❑Shoreline Management Variance _ ``OPME-Nr ❑Wireless Telecommunication* ❑ Comprehensive Plan/UDC/Land Use District Map Am- = t ❑ 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 Pm-Application Conference Please identify any other local, state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I hereby designate R to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Q / a .- IJ'Q• Date: 'f- /— 2.01 14 By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or its knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later inspections. Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application that he Q she wants prior notice. L1 Signature: t , .. V.X-"�k-k- , Date: 1-I -,,, c)/ -I 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 responsiIifi for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. 1 Signature: A ,(1AUL_- \ OctAA Date: J / —7.0/c] G:\PemutCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc • • 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 assuming the responsibility of the General Contractor for the proposed project. Signature: ,(? o J Date: 2-0/`{ GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: New Wood Existing: 1 Sewer • Addition = Steel Proposed: Bank = Community System V Alteration/Remodel = Concrete Total: Height: Individual System • Repair = Masonry SEP Permit# • Demolition 2 Other: Bedrooms: Water Supply: Existing: Setback: 1 Private well 1 Two Party Type of Heat: Proposed: = Public Total: 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 Propane Tank and/or Appliance Installation permit, mark all items below that apply: I Underground Tank 1 Above ground Tank Size of Propane Tank: 1 H• eat Stove 1 Cook Stove 1 Woodstove i Fireplace Insert i Hot Water Tank 1 Pellet Stove 1 Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines, tank location and size, distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. Square Footage Current Proposed For Office Use Only Amount Revision Main Floor Heated EH Bld App Review: 2n°Floor Heated Consistency Review: Other Heated Base fee: Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 65J- 911/Rd Approach fee: Other TOTAL: $ Receipt Number: Cash/Check Number: ESTIMATED COST(REQUIRED) Date: .Fair market value of all labor and materials oundation to finish 1 000 Initials: G:\PermitCenter\###FORM###\DRD FORMS\Master Permit Application 5-29-08.doc • • C oN J EJ EFFERSON COUNTY `i 6� DEPARTMENT OF COMMUNITY DEVELOPMENT al V4,7NG1" 621 Sheridan Street Port Townsend Washington 98368 360/379-4450 360/379-4451 Fax http://www.co.jefferson.wa.us/commdevelopment/ rilStormwater Calculation Worksheet ! , c 0 v 7 �--- MLA# PROJECT/APPLICANT NAME: � APF�, 1 G �:1 -�, M +;A t -fie , I Di cwt.. JEFFERSON COUNTY DEPT.OF COMMUNITY DEVELOPMENT 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(LE.,SITE) Size of parcel 3: i acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet j 3 `jj,= 16`6 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 A,ITY,CONVERSION OF NATIVE VEGETATION,.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 sq/ft native vegetation to lawn or landscaped areas? Drainfield, septic tank,etc. 0 sq/ft Circle: Yes No t^e Well, utilities, etc. lJ sq/ft Does the project convert 2 1/2 acres or more of native vegetation to pasture? Driveway, parking, roads, etc. l.✓ sq/ft Circle: Yes CIO Lawn, landscaping,etc. U sq/ft Other compacted surface, etc. �,�,�° sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance /_;. sq/ft Cut (_. Fill t, (cu/yd) [over) 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. • D EcEovErT, APP 1 0 2014 JEFFERSON COUNTY DEPT OF COMMUNITY DEVELOPMENT The following questions will help determine whether the proposed project is considered development or redevelopment. 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 Stormtivater Pollution Prevention (SWPPI Best Manaaement Practices (BMPs1 Packet. Proponents of"medium" projects—those that m STORMWATER CALULATIONS—IMPERVIOUS SURFACE nimum Require Plan, princip late or prepare NFW FYICTINf. II • By sig Structures(all roof area) ✓' sq/ft Structures(all roof area) sq/ft ae and correc miners of the Sidewalks 0 sq/ft Sidewalks sq/ft (LANDOV'Patios 0 sq/ft Patios sq/ft FOR Solid Decks 55 a sq/ft Solid Decks sq/ft (w tl,o,.t nflt,olio..Lamle.,,) (,,%tl,o.t;.,filt,At!.below) SMALL MEDIUM LARGE REDEVELOPMENT Stormwater Site Plan: Yes No stormwater calc worksheet.doc—REV.1/14/2013 1 Driveway, parking, roads, etc sq/ft Driveway, parking, roads, etc sq/ft ic:,, ......„.....„ Q -,.. .... , • 1....-..t ,1'.1.. , ,...r.:. .4....g-•--i* ..._ -- - t) U :* k ,A-,.; C.• ....., 1 . , \'■ ri, Ii'"1 '''''. rb (f cio, ... („..„, .'t P f. co (II g (..... . 6\ CV ....6. 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I .x•:cc.G... r- + FOR INFORMATIONAL PURPOSES ONLY- Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity. Data contained in this map is limited by the method and accuracy of its collection. Thu Air 24 15:40:46 2014 http://gisserver/servlet/com.e sri.esrimap.Esrimap?ServiceName=ovmap&ClientV ersion=4.0&Form=True... 4/24/2014 • • Jefferson County Building Division Permit Number: BLD14-00128 Applicant: PETTIS 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 Setbacks _ I C FO�rtiny-drains 1 FAQ Strap s-(#9el6i-do ,as) Framing 4-a-7-1 r j;`�Q l ' Septic System Finaled A final inspection will not be scheduled until all of 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 • • CONDITIONS for Building Permit# :BLD14-00128 1.) The site plan as submitted on 04/10/2014 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 04/24/2014 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 2.) This approval is for a deck only. Any future permits on this site are subject to review for consistency with applicable codes and ordinances and does not preclude review and conditions which may be placed on future permits. 3.) 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. 4.) zal \\tidemark\data\forms\F_BLD_Permit_BIdg.rpt 5/5/2014 BUILDING PERMIT • Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD14-00128 Received Date: 4/14/2014 SITE ADDRESS: 54 SHIP VIEW CT Issue Date 5/5/2014 PORT LUDLOW, 98365 Expiration Date 5/5/2015 OWNER: MARTIN C PETTIS PHONE: DIANE E PETTIS 73 TWIN FIRS ESTATES DR PORT ANGELES WA 983629278 WHITE ROCK COVE TRACTS DIV II SUBDIVISION: Block: Lot: PARCEL NUMBER: 821265019 Section: 26 Township: 28 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: DECK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP DEK MAIN: VALUATION 12,000.00 ADD'L: HEAT TYPE CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: SETBACK: DECK: 552 BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Plan Check $144.95 JLA 04/10/14 148539 Exist: Exist: State Building Code $4.50 JLA 04/10/14 148539 Prop: Prop: Permit $223.00 JLA 04/10/14 148539 Total: Total: Total: $372.45 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 JEFFERSON COUNTY NO. 143539 DATE ((`,((LI' RECEIVED FROM rn r �'`v�f �I Q S DESCRIPTION BARS# AMOUNT I CURRENCY l 2 2 3 COIN L,n.. ✓ ( LI �t. 4) NECKS ��, 2 z ( 3u`K • ' !-y8B,.,, 7 q, `'' 2 D .24 LL2 (9 SO\v1, CA-P /R- 0 i '1° —) A'(.._ Ile YOL m XI 0 TOTAL� BY h c(Y s