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HomeMy WebLinkAboutBLD2013-00093 BUILDING PERMIT APPLIcION BLD13-00093 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: : 3-00093 Received Date: 3/28/2013 SITE ADDRESS: REEN MOUNTAIN LN :RINN• �, • ": OWNER: DESMOND MC CANN "—° PHONE: 3603013880 PO BOX 191 Car rec„74-1 p BRINNON WA 98320-0191 REEN MTN SHORT PLAT SUBDIVISION: Block: Lot: PARCEL NUMBER: 602352029 Section: 35 Township: 26 N Range: 02 W CONTRACTOR: BUY RITE HOMES PHONE: (360) 681-0777 259403 HWY 101 SEQUIM WA 98382 Contractor's License BUYRIH*0840B Expires 5/20/2014 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NEW MANUFACTURED HOME TYPE OF WORK MOB SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION MAIN: CODE EDITION: 2009 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routinq Date: Type Amount Paid Bv: Date: Receipt: Approved/Date Manufactured Homes $228.00 MKF2 03/28/13 140162 _E C Imo' Lt V State Building Code $4.50 MKF2 03/28/13 140162 ---� Potable Water Application $106.00 MKF2 03/28/13 140162 4i Total: $338.50 MAY 7 2013 . JEFFERSON COUNTY t_ I`EPT OF COMMUNITY DEVELOPMENT I \\+ir+cmo r4\rloM\fnrmc\G RI Il Ann PIA m+ A/0/9(114 CERTIFICATE OF OCCUPANCY Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 Carl Smith, Director/Building Official PERMIT #: BLD13-00093 SITE ADDRESS: 70 GREEN MOUNTAIN LN Issue Date: 05/7/2013 BRINNON, 98320 Final Date: 7/29/2013 APPLICANT: DESMOND MC CANN PHONE: 3603013880 PO BOX 191 BRINNON WA 98320-0191 SUBDIVISION: GREEN MTN SHORT PLAT Block: Lot: PARCEL NUMBER: 602352029 Section: 35 Township: 26 N Range: 02 W PROJECT DESCRIPTION: NEW MANUFACTURED HOME THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009 EDITION. OCCUPANCY GROUP: TYPE OF CONSTRUCTION: SPRINKLER SYSTEM yes no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 7/29/2013 \\tidemark\data\forms\F_BLD_Occupan cy.rpt 9/12/2013 –r „Zit t ax Date 7/Z2 time received 30(? %� am � Mon. es. )Wed. Thur. —Fri. BLD: 1 3 — 9 3 Date: -Jz3 OWNER: Contact Name: _c� ADDRESS: 7u C-,,- if4'1 T Contact Number:360 t�,'3 f 0777 Notes: 206 . < .4 Foundation Plumbing - Framing Propane Tank Mechanical ' Setbacks _ Under-ground Framing Under ground — Furnace _ Footing Rough in Air seal Above ground _ Gas Stemwalt _ Hydronic Exterior shear Exterior lines Oil Straps Interior shear — Interior lines • Ducts Post Hole Ventilation — Appliance _ Underfloor ____ stove Man-Homes Setbacks ' Insulation. Foundation � Final Inspection : t mock&rte floor wall ceiling t `J g Address Postbd 1 -- - .- . .. - . ■- - ,A.....,.-1.1.--. • 4111 zi.o.vw4‘e. . • 2:--%*.,,,,o? . . -,. • ----.:A.ets,.-m-......„ - I' - . CiiiV.':,..: tIe''. L.,.1./•;# ' --------- - - . - . . . . . . Date_21e___I-k .'time received g • ...) pm Mon. 119 Thur. -Fri. BLD: , 3,-00 . ,....._ : • Date: 45-- -2 .: OWNER: l,- -.64, . - Contact Name7. • ADDRESS: 6&12(2.11/ .. VilVt.- le-,A,\ Contact Number.360 c. 60°tt--(7,- crc(q 1 r ,....;,,. bv2,3s)_ 021 g Notes:_ vi -- - S 1 CC 206 Y. - -,e- . - . ' Foundation Plumbing - Framing • . Propane Tank Mechanical Setbacks \// Under-ground Framing Underground Furnace - Footing V Rough in — Air seal Above ground Gas Stemwall -- Hydronic Exterior shear Exterior lines Oil Straps ---, Interior shear Interior lines . Ducts --- Post Hole Ventilation Appliance Underfloor _ Gas/wood stove Man-Homes . , • Setbacks • Insulation. . Final Inspection >-..1. Foundation- • - . 0 •-.,i- Block&Tie floor _wall ceiling. Address Posted s - - . \./ w4:Sy'T.-. ` jai'( -time received ��//S(;�e / pm V:ii Tues. Wed: Thur. Sri. • Date . ,r 0 ,� BM Date: OWNER: Vi1C • - Contact Name: ADDRESS: • - 7 0 0/I f I4 1 V i Contact Number. �360 (—O77 .. ( 206 -— '` c • Notes: - • Foundation Piumbinq Framing' Propane Tank Mechanical Setbacks Under-ground Framing Underground • Furnace • Footing Rough in Alrseal Above ground - Gas _ Sternwall __ Hydronic Exterior shear Exterior lines Oil • Straps Interior shear _ Interior lines • Ducts #•^ - • Post Hole Ventilation . . . Appliance Underfloor _ Gas/woodstove Man Hon - Setbacks Insulation. Final Inspection •;•a z i • Foundation �y'-• Block&Tie floor wall ceiling. . Address Posted • • . r• • - II Bu) .ite Homes McCann,Desmond d I Green Mountain Ln 259403 Hwy 101 Sequim WA 98382 Brinnon WA 98320 360-681-0777 NORTH Parcel#602352029 c/o Birdi 360-670-5014 scale r=40' as of 3/26/13 CI \ 300.00' -----% 100'renlicnu from well alo well hOit- 4- W it k W W 1 \ If deck 4x6 Transformer 33 , ' Dtailliield I 168.8g —PI"'■ 1_11— 60,00' --110.-J Proposed Manufactured 1 ■ Home 28x56 16 I1 deck.4x6 \ . . clank / la 300.00' \ APPROVED SITE PLAN 300.00' splash block 50'runoff splash block 30 run off N. APR 7 1 2013 ver• . ,-1±‘,4471437, I f. ,ilizarAtati.,,Le v :, ow, v a i ii.,...........____ c..... Listing Ariveway total 300' ' 160.00' ...-- --- I _ -totill_ Y 300.00' _____ IIIPY 4 � Off\ JEFFEROUNTY -` DEPARTMENT OF COMMUNITY DEVELOPMENT ' 621 Sheridan Street • Port Townsend • Washington 98368 - ., 360/379-4450 • 360/379-4451 Fax ' www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: Project Description(include separate sheets as necessa ): 6!i / 'c y7 „,c,i e Lf c -ci - Tax Parcel Property Number: 696 Z .271 %� Cs Size: j d eA40 (acres/square feet) Site Address and/or Directions to Property: ,Lis koa /D l 414.71 r /Jo-e�( 4(4 -C, C.4r12 ,et , .P.„L Property Owner(s)of Record: 2 „a g/ 'LJ�, Telephone:3 Cr.t- 3C'I - Fax: email: ilailingAddress: /3 t YT �J ie'/ ze-k 96052,6 � Applicant/Agent(if different from owner): Id -�t., �h Telephone:.3G.C?-kAl-o'777 02- /366- 76-S-m Fax: email: Pled,i 60 bauc)ji 0 cif uo.e I,1 Mailing Address: 2 %i O Yijdoci /0/ :SF fal ryt L1 p) Y'cA':se Z What kind of Permit?(Check each box that applies Building ❑Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a), C(d), or C]** ❑.Single Family ❑ Garage Attached/Detached ❑ Discretionary"D"or Unnamed Use Classification g Manufactured Home ❑ Modular ❑ Special Use(Essential Public Facilities)** ❑ Commercial* ❑ Boundary Line Adjustment ❑ Change of Use ❑ Short Plat** ❑ Address ❑ Road Approach ❑ Binding Site Plan** ❑ Home Business ❑ Cottagelndustry ❑ Long Plat** ❑ Propane ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑ Sign ❑ Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management ❑ Shoreline Management Substantial Development ❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance ❑Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium ❑Tree Vegetaion Request *May require a Pre—Application Conference **Requires a Pre-Application Conference Please identify any other local, state or federal permits required for this proposal, if known: C ; DESIGNATION OF AGENT I hereby designa e •04 :' -/ ' 2?c-c.cr to act as my agent in matters relating to this application for permit(s). _ OWNER SIGNATURE l fi +�i � kt;OV^,-s. Date: 1,471.x'. o , IA A I, 1 l j 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 it's 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 a\nd any req 'fired later insp:ctio s. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of a applio.. ion th=t he or; e ants prior no ce. — Signature:t-- . -�--�--' Date: Pei / The action or actions Applican will undertake`as a result of the issuance of this permit may negatively impact u•en one or more threatened or endangered species and could lead to a potential lake"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(A even if y.0 are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and nonsi abler ponsib.ity for adhering . and complying with the ESA. The Applicant has read this disclaimer and igns and dates it below. Signature. Date: / i ' Z 7 , )/�i • __so__ BUILDER STATEMENT le The signer of this tatement d•-s hereby certify/that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will;be as• ing the res•,.n ibility of the eeneral Contractor for the proposed project. Signature.\ 4 . ° L Date: GEN 'RAL CONT CTOR 0- MANUFACTURED HOME INSTALLER: PHONE: FAX: -e - ,_l,e— 1)x/7'-1r/J r (,(r0)(n 'l _,..)-7 7 J/ ( ) MAILING ADDRESS. 5G� YO� �GLu/, /L! LC�Jy) EMAIL: v)i r 1 ,Lao k-k Lc) L-if1ll.0© . 6,6 4vi CONTRACTOR'S LICENSE V WAINS NUMBER: 6Gt V RI N 08 Ve1 1 NUMBER ARCHITECT/ENGINEER: Q,,,,:p,.- &---/-)-(go PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL • .project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: i N New X Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: i_ Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: A Height: individual System ❑ Repair ❑ Masonry SEP Permit#(3-QQC>l, - oz`Fy ❑ Demolition ❑ Other: Bedrooms: ‘ Supply: Existing: Setback: Private well i Two Party Type of Heat: - Proposed: ❑ Public rke,TLiC- Total: Name of System: If this is a Commercial Pro'ec ou must answer the followin Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants, employees, etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No If this is a Pro•ane Tank and/or A..fiance Installation .ermit mark all items below that apply: ❑Underground Tank 0 Above ground Tank Size of Propane Tank: ❑Heat Stove 0 Cook Stove 0 Woodstove ❑ Fireplace Insert ❑Hot Water Tank ❑ Pellet Stove ❑Other Is this a..Iiance bein. 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: 2' Floor Heated _ Consistency Review: 2 Z C 03 Other Heated Base fee: -a3'g. ` Mezzanine A i n:' d�tnt�i { .���` Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: '1/ iv Other Unheated 7 Pot Water Review fee: �j DO Garage/Carport ci SUBTOTAL S1 Decks / 911/Rd Approach fee: — �- gx6- lie/X�� _ _ - — Other TOTAL: $ 7, Receipt Number: P/C":"/ (p 2 Cash/Check Number: 3 0 3 � ESTIMATED COST(REQUIRED) Date: . 21 —1_3 .Fair market value of all labor and materials foundation to finish —. —_ Initials: _ ,� —_ Contractors or Tradespeopleer Friendly Page Page 1 of 1 General/Specialty Contractor A business registered as a construction contractor with L&I to perform construction work within the scope of its specialty.A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. Business and Licensing Information Name BUY RITE HOMES UBI No. 601013329 Phone 3604790795 Status Active Address 259403 Hwy 101 License No. BUYRIH*0840B Suite/Apt. License Type Construction Contractor City Sequim Effective Date 9/2/1992 State WA Expiration Date 5/20/2014 Zip 98382 Suspend Date County Clallam Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company QUANTUM ENT&HOMES INC Other Associated Licenses Specialty Specialty Effective Expiration License Name Type Status 1 2 Date Date • OLYMPLD952C40LYMPIC LAND Construction General Unused 2/24/2005 2/24/2009 Expired DEVELOPMENT INC Contractor Business Owner Information Name Role Effective Date Expiration Date CAVANAUGH, JON RICHARD President 09/02/1992 Bond Information Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 2 OLD REPUBLIC YLI222426 05/10/2002 Until Cancelled $12,000.0003/15/2002 SURETY CO Assignment of Savings Information No records found for the previous 6 year period Insurance Information Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date 18 CONOVERINS ZHS905743800 05/10/2011 05/10/2013 $500,000.00 05/09/2012 17 NORTHLAND NY102755 05/10/2010 05/10/2011 $1,000,000.00 05/10/2010 INSURANCE CO 16 NORTHLAND NY102755 05/10/2009 05/10/2010 $1,000,000.00 05/08/2009 INSURANCE CO 15 NORTH PACIFIC C06160235 05/10/2009 05/10/2010 $1,000,000.00 04/22/2009 INS CO NORTHLAND 14 INSURANCE NY102755 05/10/2008 05/10/2009 $1,000,000.00 05/06/2008 COMPANY 13 NORTH PACIFIC C04160235 05/10/2007 05/10/2008 $1,000,000.0004/23/1937 INS CO 12 NORTH PACIFIC C03160235 05/10/2006 05/10/2007 $1,000,000.00 04/17/2006 Summons/Complaint Information No unsatisfied complaints on file within prior 6 year period Warrant Information No unsatisfied warrants on file within prior 6 year period Infractions/Citations Information No records found for the previous 6 year period https://fortress.wa.gov/lni/bbip/Print.aspx 3/28/2013 0 M • z N i gg, -AF ... zo vm,,. D A v ^4_ _ :f:a ° m T;:,oc y 08 - m \ n z v " a) o — Z s K" m L fD p c - o S88 s. <<F • (NE1/4 34- 26N - 2W) a Y ' N T \\ ( ( \ 673.06 672.90' 672.90' A v ° pMNN \\ \\ tPNr2 U Oi I-r N C I., - JOO \�� A✓ NX NG N . Wzcn x 4 ` \\ \ \ N N taa \ N z \ \ WI /..94 232.86' N m Z 336.92' 336.92' \ -A 0 ePE 1//. II .1.4 U U)Z m N\'O P ti rn 0DO \\ \ U'NG p m Z N 2. 337.04' l \ mu\ >N A x W -y p // mN °N N 236.]1' - ` / \ n O O \ "A f 337.1617 \ 3Z m \ f ig N oSmm \ \ o o( \ s u> \\ 34457' '4),,,m g \ N \� -- — o cn myp 337.39' 337.39' -- 674.78' is N X$ \ i.N I N 1349.56' 0 VC.N O 675.16' Z X 2 < \ / N f 7 z 0 // \\O ----- omo < / / y�5, \ N / r A/ti / 0 \� O=r N / - / -<O ON / �� \ T x N 9T3 ?N \" I PN m A. N N G 532' 2 \ `J 94 �sOr m O NC TA%354 D10 Ii9x / \ °8�o —( Z 2`625a.TAX 31)(TOTAL) \ 2`7i7 . y� \ \ \ \ - D rrl _o" e (y � N c N CO � N m o k 8 8 C a /:.' I o /,\ ti. Io o°o o Jl j O C a 1. , o y_ v (NE1/4 35- 26N - 2W) Z o C) mN --I Cn Z ui , N v a v = m ° N Z F m-?...3 II n " N O N s o o a 1 o N 1 N JACK %VESTLIII AN ,rerre. 4y 4 th v ASSESSOR PO has a Oq Peet Te�-ro6ead, $'�'.% va'i3 (388)3854105 MOBILE HOME INFORMATION FORM OWNER'S NAME/ /MAILING ADDRESS: NAME: , eSniDnl d 14e ivAit4J ADDRESS:- /D. 6Qs 9_ I 2Zi.j.��©��� PRONE NO. 3880 The ptr A: «e of this ell tionnaire is to obtain information regarding either the current ;tottian of a mobile home or the previous ownership and location of a mobile home. This will help our office determine whether the mobile home is already on the tax :Nrklls in Jefferson C:<P qty or if it has been moved to this county from another area. )M ['BILE HOME DATA: (A) MAKE e)46/" ./1) (B)MODEL K-/L),Z. (C)YEAR Z4/6 (D).LENGTH 5/0 (E)WIDTH Z8 OF)SERIAL#i3 (G)YOUR PURCHASE PRICE(Do not iadnde sales tax) 75, 400 PUBC DATE 8/I'1 113 2)PREVIOUS OWNER/LOCATION OF MOBILE HOME: (IF NEW MOVE TO QUEST! N 3) (A)FROM WHOM DID YOU PURCHASE MOBILE L J -leTE �© ADDRESS 2 5.q1/613 /i i e ri Ze)ti 969382 )W S MOBILE HOME ASSESSED Uf JEFFERSON COUN'T'Y LAST YEAR?Yes i If Yes, Previous s address of nubile. If No, at County was Mobile assessed in last year_ 3)WHERE MOBILE HOME IS TO BE LOCATED: (A)WILL.THE MOBILE HOME B:. MOBILE HOME PARK? 'lies No ( ' IT LOCATED IN MOBILE HOME PARK NAME ;ti=.: Audi {SS OF PARK Lot/Space (C) N ' ' LOCATE t IN " °OBILE HOME PARK: t AME OF LAND OWNERS be-S 1710 , /7'1 (�A)JAJ LOCATION ADDRESS g&TA) P Du,)-ril i.J LA) ;,[J,e/,J,3O/0 91'32., REAL PROPERTY PARCEL#/DESCRIPTION 66 oz'/ /'__ /ir►�1���► J 1A� Bt stare of a,-plieani T OU FOR YOUR HELP! (MA-. COSSELL, Property Technician iii1p Front Parcel Review 4. -L-.1) (_ —cl .* Parcel De j Luo, u.,73 ,_ ,.._ ' Site Address:! - 5-E e 0 G attti WA, Parcel Number: S-T-R: -- Total Acreage Legal Description Land Use: Flood District: Fire District: Planning Area: Flood Map (FIRM)Panel No: School District Zoning: COMP PLAN DESIGNATION: COMMUNITY PLAN: UGA: UGA Trans [ Plot plan states "property line" [ vi" Assessor's Map (Property lines on submitted plot plan must match the property lines as identified on the Assessor's 1/4 map) [ 1,/]' Legal Access to Property YES NO [ IParcel Tags or Scanned Documents YES NO [ ky ESA's: Special Reports by YES 6 [ cDesignated Ag YES [ ✓r Shoreline Designation: YES ( ' [ v( Shoreline Slope Stability: YES NO Stream Type:YES NO Fish & Wildlife:YES NO Wetlands: YES NO Rare Plants:YES NO Seismic: YES NO Al---- Landslid YES NO k Flood: YES NO Erosion: YES NO Aquifer Recharge Ar a:YE NO 5(3...6 c___SIPZ: none At s High Risk Coastal CMZ: none High Risk Moderate RiskDisconnected CMZ Stormwater site plan sub itted: YesNo [ tr Forest Lands: YES NO Adjoining Forest Lan s: Commercial/ Rural/ Inholding [ fl,r Mineral Lands: YES DSO [ 1/t" gricultural Lands: YES • [ ( Archaeology: YES [ Stormwater: New Imper -•-. _ rface Land Disturbing Activity 2 T g ty � ESA's Stormwater Req' _ ■in Req#2 ' Min R q#1 thru#5 Min Req#1 thru#1 d Engineering [ Notice Provision 1,•.. osure:Airport YES NO MRL YES NO Forest Lands YES NO [ t ' Landscaping Required: Yes No [ 1-1—___Parking Spaces Required NO Other l `T Building Height:igt1P UBC Standard - _ 4 5 (1,,, J--- '\ ,✓Y c_ 9 --c [/f Impervious urtace coverage percentage: Resource Lands&Public: 10% Rural Residential 25°• Rural Industrr UDC Sec 6.7 Rural Commercial: 60% Area of Building Coverage:60%in Rural Induslierands only [ Total Building (s) Size: RVC:20,000 SF CC: 5,000 SF NC: 7,500 SF GC: 10,00 All others:subject to septic&water constraints/None specified A [ '.J Setbacks: Front: 1 Left Side: Right Side: 5 Rear:constraints, gone Setback: LSHA Setback: [ II—Road Classification: Road Approach: EXISTING Q' RAP j [ SEPA Required: YES EXEMP [ OrFlood Certificate: [ L.,- Existing Case(s) & Condition(s): Violations: Yes No ['✓j Recorded Date of Subdivision: AFN Over 5yrs=UDC Plat Conditions: <5yrs=Plat Conditions on plat or Old Ordinance [L,(-:Lots/Require Declaration of Restricti ovenant YE O submitted: YES NO [l. UGA No Protest Agreeme ES submitted: YES NO [ (� ite Visit conducted 411110 NO [!(Require Final Zoning Approval YES NO [ , ADMIN: Setbacks entered in Permit Plan case YES New Parcel Tags entered in P rmit Plan /A YES Special Reports Scanned N/) YES No parcel tags found for parcel Cases Associated with APN Cases Name Review Type Status Planner Application Received: Permit Issued/Case closed: Case Finaled: \\tidemark\data\forms\R_Parcel_CRMLA.rpt 3/11/2013 Page 2 of 2 ISup$ 3 —_ 93 McCann,Desmond 4-1y-Rite homes Green Mountain Ln 259403 �-jwy 101 brinnon WA 98320 5e9ui1T1 WA 98)82 f arcel#602352029 360-681-0777 NORTH c/o birch 360-670-5014 scale 1"=40' as of 3/26/13 Kevisecl 4/1 6/t 3 30000' — ►i D 1toL , [iM n APR 182013 ,.yy IOU radious from well _ 1 11 \TR JEFFERSON COUNTY DEPT.OF COMMUNITY DEVELOPMENT \w SO.00 W�••` deck�O 1 Tr. 600 ►► Proposed Manufactured er 1 0, iE ■ Home 282x56 35 we r"' 156.67' 16' \ .. Teak 300.00' 300.000 / \ eplaslx 50'r.011 ,p\ / 5fl oif / _ / 160.00' mow • • PRAINFEELD AREA SLOFE IS 1670 sEwAGE. Dispos4, 08s„ , 1RTH APPn for on .,,, ,,,.---i TEST HOLES = 0 „, ,,, ua te .., 1 gfl // CREEK---___ -,...., ....„.., .. ,.*.: GU,G' 'YSON ar - 'Itt(4 • ' )42-1.■ - .1. , _dr . EYPIREg77i. „ 1/ . , GREEN MOJNIAIN 4 NE 955.76' ,vyAt ,LINE *wog* ess - . 673 77' 14 ..0 btilding,„,‘nudilelertenee ct Wl e*e - ,„ouity"d •4 7. OUSE A 4i • , .... 4ettetl°11‘° i 4;7' . l''')/ 3 6. . MP TANK 5 F'TIC TAN . • p,-( \\4‘ ,•.k 0-• -N410.7, / RAP145 100' ,, / -.OM 681.81' ow- RFSEKVE AREA ) A1\Fla:AEA:I al • ..,,.. 4. /1 / ,.... .4.,. ... / ,... .."74... V-- '-' / • ---i / . '-..."--H... /• / . - A ,Se • /477.,1c/16-cl /3(d6,1,0,1, --------1 ,6&T;-&i MaucrTAJA) LAJ 8e 1 AJAJ C 1 i_)3 00, ., -To r24)... 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Wed Apr 10 12:52:56 2013 t A (c---C http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&Cl... 4/10/2013 Map Output 41 ID Page 1 of 1 ArcIMS HTML Viewer Map 7/1-'\--- - i ill ---' . -----___ L ))(7,--■ , („ f---- _4-1 --r s ) ) - ,/ ,. 2362,) ,,„ , c. ) - --) cl--71---- ---7--It. '''- Legend . 0 Selected Features / / ..-/ ,..---/ ____ 602352024 ' 11 . / _.••• %,...,, ,,,,./ JC_Roads isi Parcels-H Contours ) / E/ ._„ 4, / 7-) io Fool Contour , SD Faot Contour . ■ Landslide Hazard Sc --- - ' - St KieS il eV! Mat:Wale 6023-1'2,"(.:. .-- .../ 602352008 Sis3 hi 602352004 '' ---- ' ---- /---------- 602 341V 8 ---/-'..."----. -" -.0.0C•IN/--'-'602iS2OZT--' ------ I/ 602352--4,-.11._ 014 602352015I37- dsd ri,.....?°crscri Canty Central Services GSS --- —- .., 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. Wed Apr 03 08:12:35 2013 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&Cli... 4/3/2013 III s ON � 6 JEFFERSON COUNTY 47 erN fir DE PARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •VVashington 98368 0 360/379-4450 • 360/379-4451 Fax LNG http://www.co.jefferson.wa.us/commdevelopment/ Stormwater. Calculation Worksheet MLA# PROJECT/APPLICANT NAME: /��"-6d'X./C-7C._ J C(a.r-r t___ _ 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 I acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet 2I 7, Fc ( sq/ft L 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. VINIUMISIMMISOIIRIMR• .. LAND DISTURBING ACTIVITY,CONVERSION OF NATIVE VEGETATION AND VOL ME 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'/.acres or more of Construction site for structures /55Z i sq/ft native vegetation to lawn or landscaped areas? , Drainfield, septic tank, etc. sq/ft Circle: Yes No Well, utilities, etc. sq/ft Does the project convert 2%acres or more of native vegetation to pasture? Driveway, parking, roads, etc. sq/ft Circle: Yes No Lawn, landscaping, etc. sq/ft Other compacted surface,etc.r)(,C C. [f sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance I') 71 sq/ft Cut Fill_ (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. ma= AIIIIMMIRMISCMWOIMIGE600.1 STORMWATER CALULATIONS–IMPERVIOUS SURFACE NEW EXISTING Structures (ail roof area) /5 18 sq/ft 1 Structures (all roof area) 4)11/L c. ,' sq/ft Sidewalks sq/ft Sidewalks sq/ft Patios sq/ft Patios sq/ft — Solid Decks sq/ft Solid Decks sq/ft (without infiltration below) (without infiltration below) ?' Driveway, parking, roads, etc sq/ft Driveway, parking, roads, etc (,'(C'( sq/ft Other sq/ft Other sq/ft Total New /5 sgift Total Existing (R /(• sq/ft TOTAL NEW+TOTAL EXISTING* 4/584 sq/ft *This amount will be used to check total lot coverage. The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT v. REi EVELOPMENT I Divide the total existing impervious surface above by the size of the parcel and convert to a percentage: /. V % p Does the site have 35%or more of existing impervious surface? Circle: Yes No, FURTHER INSTRUCTIONS: If the answer is yes, the proposal is considered redevelopment and the attached Figure 2 should be used to determine the applicable Minimum Requirements. If the answer is no, the proposal is considered new development and the attached Figure 1 should be used. At this juncture, the applicant should refer to the applicable Flow Chart to determine the Minimum Requirements for stormwater management. DCD staff will help verify the classification of the project and the application requirements. For proponents of "small" projects who must comply only with Minimum Requirement #2—Construction Stormwater Pollution Prevention—an additional submittal is not required. The proponent is responsible for employing the 12.Elements to control erosion and prevent sediment and other pollutants from leaving the site during the construction phase of the project. Pick up the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet. Proponents of"medium" projects—those that must meet only Minimum Requirements #1 through #5—and for large" projects—those that must meet all 10 Minimum Requirements—are required to submit a Stormwater Site Plan. DCD has prepared a submittal template of a Stormwater Site Plan, principally for rural residential projects. Complete the template in the Stormwater Site Plan Instructions and Submittal Template or prepare a Stormwater Site Plan using the step-by-step guidance in the Stormwater Management Manual. APPLICANT SIGNATURE By signing the Stormwater Calculation Worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the best of my knowledge. 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Fweitar,„ w 2:511Eumommfb ..dickaj.... • 1,..k.• uc, ns V - •-s il c,” , ' . unimmune.••!_r. um.r..,111111 111111: m 3 (4434,1 IiIMINIMM1111111111 ' ; illWIIIIMIIIIIIIIIIIr •oms 11M111111111111111l 1 r , , :211.11111111 reaammill ' C) 9 CD IC ) ri )Qn II CND) , . 1 WU A , , ii CD 7.- X '\ ' ''',"ti'• @ e 1 cn 1 > 1 --1 MANUFACTURED/MOBILE HOME INS 1ALLATION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD13-00093 Received Date: 3/28/2013 SITE ADDRESS: 70 GREEN MOUNTAIN LN Issue Date: 5/7/2013 BRINNON, 98320 APPLICANT: DESMOND MC CANN PO BOX 191 BRINNON WA 98320-0191 SUBDIVISION: GREEN MTN SHORT PLAT Block: Lot: PARCEL#: 602352029 Section: 35 Township: 26 N Range: 02 W CONTRACTOR/ BUY RITE HOMES PHONE: (360) 681-0777 DEALER 259403 HWY 101 SEQUIM WA 98382 (360) 381-0780 Contractor's License BUYRIH*0840B Expires 5/20/2014 PROJECT DESCRIPTION: NEW MANUFACTURED HOME MAKE: YEAR: SIZE: Directions To Site: To schedule inspections, call (360)379-4455 no later than 3:00 PM the day before the inspection is needed. Requests received after 3:00 PM will not be scheduled for the next day's inspections. Office Hours 9:00 -4:30 MONDAY-THURSDAY 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 Erosion Control MH Foundation (ia/i3 r" Blocking&Tie Down • Skirting&Ventilation 7/0 /f (1 Gas Line: Exterior j~ Propane Tank Pressure Test Drywell/Alt Drainage Address Posted 7/Z3//3 FINAL INSPECTION ( y". FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR SPECIAL CONDITIONS APPLY -SEE REVERSE i • SPECIAL CONDITIONS CASE # BLD13-00093 1.) 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. 2.) The site plan as submitted with the Building Permit application on March 28, 2013 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 April 11, 2013 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 3.) This approval is for a New Manufactured Home 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. 4.) DWJ \\tidemark\data\forms\F_BLD_Permit_Mobile.rpt 5/7/2013 . . 4.0 LIMITS OF SURVEY Asbestos surveys are non-comprehensive by nature and subject to many limitations as described below. Our assessment has considered risks pertaining to asbestos; however, this survey is limited to only those locations sampled. This survey was not designated to identify all potential concerns or eliminate all risk associated with potential asbestos containing materials (PACMs). Evaluation of other risks, such as toxic and hazardous substances in (or in contact with) soil and ground water, structural, electrical, mechanical, radon gas, slope stability, building settlement, moisture, or site-drainage/flooding, have not been included. No warranty, expressed or implied, is made. The site visit consisted of a through visual walk-through of the subject area for the purpose of viewing and sampling PACMs. Accelerated Analytical is not responsible for materials, which require destructive means to access, or materials that are hidden from sight, those materials hidden behind walls or materials, which cannot be found with reasonable diligence. Accelerated Analytical LLC performed this survey in accordance with the generally accepted standards of care in the sampling profession in Washington State at the time of this study. This asbestos survey was performed in preparation for a demolition of the subject structure. Todd L. Venable AHERA Accelerated Analytical LLC AHERA No: 12-1807 P.O Box 309 5 Phone:360-239-0354 Littlerock,Washington 98556 Email: acceleratedanalytical @comcast.net