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HomeMy WebLinkAboutBLD2007-00356 •UILDING PERMIT APPLICAT IN MReiwoos7 Type:I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00356 Received Date: 6/30/2007 SITE ADDRESS: 151 WAMPUM POINT RD QUILCENE, 98376 OWNER: WILLIAM H WRIGHT PHONE: (425) 837-9318 LINDSAY L WRIGHT 25008 SE MIRRORMONT WAY ISSAQUAH WA 98027-7312 SUBDIVISION: Block: Lot: TX46a PARCEL NUMBER: 701194028 Section: 19 Township: 27 N Range: 01 W CONTRACTOR: NIEMAN CONSTRUCTION CO PHONE: (360)765-4787 P. 0. BOX 846 QUILCENE WA 98376-0846 Contractor's License NIEMACC018MZ Expires 8/15/2008 REPRESENTATIVE: PHONE: II PROJECT DESCRIPTIOP NEW SFR W/ATTACHED GARAGE ALSO A/G 500 GAL PROPANE TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 2,600 VALUATION 350,000.00 ADD'L: 470 HEAT TYPE: PRO CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N SHORELINE: CONST TYPE: GARAGE: 878 SETBACK: 30 DECK: 470 BANK HEIGHT: 6 SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: 2 Prop: 4 Total: 2 Total: 4 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $2,393.75 KAS 06/30/07 91340 Plan Check $1,555.94 KAS 06/30/07 91340 APPROVED State Building Code $4.50 KAS 06/30/07 91340 Potable Water Application $58.00 KAS 06/30/07 91340 AUG '' 2007 Total: $4,012.19 Jefferson County Planning & Building Department ��sON co,„, DEPARTMENT OF COMMUNITY DEVELOPMENT 4. a 621 Sheridan Street,Port Townsend,WA 98368 ` Tel:360.379.4450 I Fax:360.379.4451 Web:www.co.jefferson.wa.us/communitydevelopment yysF�f .f E-mail:dcda.co.jefferson.wa.us N CERTIFICATE OF OCCUPANCY PERMIT#: BLD07-00356 APPLICANT: WILLIAM H WRIGHT PHONE: (425) 837-9318 LINDSAY L WRIGHT 25008 SE MIRRORMONT WAY ISSAQUAH WA 98027-7312 SITE ADDRESS: 151 WAMPUM POINT RD Issue Date: 08/8/2007 QUILCENE, 98376 Final Date: 8/25/2015 SUBDIVISION: Block: Lot: PARCEL NUMBER: 701194028 Section: 19 Township: 27 N Range: 1W PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE & A/G 500 GAL PROPANE TANK & SHUFELINEFXEMPTIuN (SDP07-0054) THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2003 EDITION. OCCUPANCY GROUP: R-3 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM yes no; THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 8/25/2015 \\tidemark\data\forms\F_BLD_Occupancy.rpt 9/3/2015 Jefferson County Building D•ion Permit Null: BLD07-00356 Applicant: WRIGHT BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: 2003 International Building Codes To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection. Requests received after 7:00 AM will not be scheduled for that day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Setbacks ti"1(� Erosion Control Foundation Footing Z_ _ Footing Drains 4//3/oe /11 Foundation Stem Wall y _12-�� l 2 t" J 1 � � Underground Plumbing Under Floor Framing ce 1 o, Straps(hold downs) ni©oip Neza Drw,r; 11114io ':n#ldAtc 000A Yti- Ext. Shear Wall Nailing I('I _0ii, Fl_£_ Po.sfiaK /o4..5 Rough-in Plumbing - Ct✓sed4 p A.a of- �`Z Lugs Forz 64RAr.A at L/I3/e2, I Framing 0A/ig aiR 4'.lf.<,eAle/A-'dit . 121fr VIS gt/i c,L 4 Lle✓c-Q pis lit Blocking 9// //3 Airseal //3 cy Insulation:Walls // ,/t3 Insulation: Floors Insulation: Ceiling V/16/I c# Int. Shear Wall Nailing 9/1' Wallboard Nailing 4 /_/S I (( 7/4 Gas Line: Interior q I �C l- ^ Gas Line: Exterior 0/1c Propane Tank c6 W/( /l Heat/Chimney Clearance ywe ainage //' - &-4frinf OIL 4/t3/6$ Address Posted C� 617 # `,� V IliVOLAR IostaAua) 6f f3 f' c AQACE Q,uvx FINAL INSPECTION g �- FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • CONDITIONS for Building Permit# :BLD07-00356 1.) PRIOR TO OCCUPANCY& BUILDING FINAL INSPECTION FINAL APPROVAL OF SEPTIC SEP07-57 IS REQUIRED. 2.) ANY PORTION OF TRANSPORT LINE UNDER A DRIVEN WAY IS TO BE SLEEVED/CASED OR EQUIVALENT. 3.) The application was reviewed by the Jefferson County Department of Community Development staff on August 8, 2007 for the potential presence of Environmentally Sensitive Areas (ESAs) under the provisions of the Unified Development Code (UDC). After an initial Geographic Information Systems mapping review and an investigative site inspection, the following ESAs were confirmed to be present on the subject property: urban shoreline designation; unstable shoreline slope stability; waterfowl; landslide hazard area 2; flood; SUSC aquifer recharge area; coastal SIPZ. 4.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological formations that allow percolation of the surface water into the soils and the underlying zone of saturation. Aquifers are geologic formations that contain sufficient saturated permeable material to yield significant quantities of water to wells and springs. Aquifers serve as the source of drinking water within most of the rural portions of Jefferson County. 5.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 6.) Geologically Hazardous Areas in Jefferson County are characterized by slope, soil type, geologic material, and groundwater that may combine to create problems with slope stability, erosion, and water quality during and after construction or during natural events such as earthquakes or severe rainstorms. 7.) Marine shorelines and islands are susceptible to a condition that is known as seawater intrusion. Seawater intrusion is a condition in which the saltwater/freshwater interface in an aquifer moves inland so that wells drilled on upland areas cannot obtain freshwater suitable for public consumption without significant additional treatment and cost. Maintaining a stable balance in the saltwater/freshwater interface is primarily a function of the rate of aquifer recharge (primarily through rainfall) and the rate of groundwater withdrawals (primarily through wells). The Washington Department of Ecology is the agency with statutory authority to regulate groundwater withdrawal for individual wells in Jefferson County. New development, redevelopment, and land use activities on islands and in close proximity to marine shorelines in particular should be developed in such a manner to maximize aquifer recharge and maintain the saltwater/freshwater balance to the maximum extent possible by infiltrating stormwater runoff so that it recharges the aquifer. 8.) The parcel is located within a coastal SIPZ (seawater intrusion protection zone) according to the County GIS map. There are voluntary and mandatory measures identified in the Jefferson County Seawater Intrusion Policy (Resolution 44-22, effective September 23, 2002) that apply to well drilling proposals and building permit applications on existing lots of record. A Coastal SIPZ is defined as: all islands and area within one-quarter mile of marine shoreline, but no history of chloride concentration above 100 mg/L in groundwater sources within 1000 feet. 9.) A vegetative buffer of 30-feet shall be permanently maintained from the top or edge of the Landslide Hazard Area. All buffers shall be measured perpendicularly from the top of the Landslide Hazard Area. 10.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated. Should buffer disturbance occur during construction, the Unified Development Code (UDC)Administrator shall require replanting with native vegetation. No alterations shall be made to the Landslide Hazard Area or its associated buffer without prior authorization by the UDC Administrator. 11.) All construction activities shall not encroach upon the landslide hazard area buffer. This includes the storage or preparation of materials. 12.) Critical Aquifer Recharge Areas may require special protection measures to mitigate water quality degradation. The submitted proposal does not require additional aquifer protection measures. However, during construction the project shall follow the Best Management Practices (BMPs) and facility design standards as identified and defined in the Stormwater Management Manual for the Puget Sound Basin. 13.) To help prevent seawater from illding landward into underground aquifers,Oew development activity on Marrowstone Island, Indian Island and within 1/4 mile of any marine shoreline shall be required to infiltrate all stormwater runoff onsite. 14.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: Water conservation measures: 1. Roof and other intercepted precipitation shall be routed to on-site detention ponds and/or other approved means and allowed to be released to the soil slowly. 2. Water collected from Storm water and roof catchments may be used for watering lawns and gardens. Unless catchment water has been treated to meet drinking water standards, there shall be no cross connections allowed between the potable supply and impounded water. 3. Water withdrawn from wells on each property shall not be used for watering of lawns and/or gardens. 4. Ground water withdrawn from each property shall be restricted to a rate of three (3) gallons per minute. 5. Installation of water conserving fixtures such as low flow toilets, faucets and shower restrictors and other water saving plumbing fixtures. 6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation). Please NOTE that the above listed measures are not intended to be exhaustive, but rather is intended to be illustrative of the types of water conservation measures. 15.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: 1. Installation of a flow meter. 2. On-going well monitoring for chloride concentration. 3. Submittal of monitoring data to County. 16.) MANDATORY MEASURES FOR COASTAL SIPZ: 1. For proof of potable water on a building permit application, applicant must utilize DOH-approved public water system if available. 2. If public water is unavailable, a qualifying alternative system may be used as proof of potable water or an individual well may be used as proof of potable water subject to the following requirement: a. Chloride concentration of a laboratory-certified well water sample submitted with building permit application. 3. If public water is unavailable, a qualifying alternative system may be used as proof of potable water. 17.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 18.) The applicant is proposing to create or add 5287 square feet of impervious surface and 5980 square feet of land disturbing activities. JCC 18.30.060 and 18.30.070 require the project applicant submit a stormwater plan meeting Minimum Requirements#1 through#5 of the Department of Ecology Stormwater Management Manual for Western Washington. The stormwater plan shall address measures to control stormwater, erosion and sediment during construction and shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 19.) A Stormwater Site Plan has been submitted and approved by the Department of Community Development. Once the subject permit has been issued the applicant shall fully implement the provisions of the submitted plan and contact the Jefferson County Department of Community Development to arrange a schedule to inspect the property for plan compliance. A Certificate of Occupancy will not be issued until the Department verifies plan compliance. No clearing for roadways or utilities shall occur on the project site until clearing necessary for the installation of temporary sedimentation and erosion control measures have been completed. 20.) Jefferson County determined that this proposal is categorically exempt from review under the State Environmental Policy Act (SEPA) pursuant to WAC 197-11-800(1)(b)(i). 21.) The site plan as submitted with the building permit application on June 29, 2007 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 August 8, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 22.) This approval is for a single famaksidence with attached garage and 500 go above-ground propane tank 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. 23.) The parcel has been designated as RR 1:5 under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. 24.) A Declaration of Restrictive Covenant has been recorded on July 18, 2007 under AFN 525499 for the purpose of identifying a limited size septic capacity of three bedrooms maximum. 25.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 26.) 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 autormobile 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 requriements 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. 27.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 28.) The building height is not to exceed 35 feet. 29.) Residential developers and individual builders shall be required to preserve shoreline vegetation and reduce the associated risk of erosion during construction and any future activity which may impact the stability of the shoreline. 30.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 31.) 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. 32.) 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. 33.) Minimum setback from Wampum Point Road right-of-way shall be 20 feet. Minimum setback from shoreline shall be 30 feet measured from the Ordinary High Water Mark. Minimum side yard setbacks shall be 5 feet. 34.) An address of 151 Wampum Point Road, Quilcene has been assigned to the parcel. Wampum Point Road is private (P538). 35.) The parcel is served by an individual on-site well. 36.) A septic permit(SEP99-0061) is incomplete and now filed with SEP07-0057 that was approved on July 3, 2007. A well review (USR98-0096)was approved on December 15, 1998. A SPAAD (ZON05-0040)was approved on August 30, 2005. A shoreline exemption permit (SDP07-0054)will be issued with the building permit for the residence. 37.) A"Construction Drawing" Flood Elevation Certificate was prepared by a licensed surveyor M\i4010 d submitted with the application. The Certificate identified the base flood elevation of feet. The lowest floor of the structure is required to be elevated at least one (1) foot -sove base flood elevation or 11 feet. PRIOR TO FINAL BUILDING INSPECTION, P r PROPONENT SHALL PROVIDE THE DEPARTMENT WITH AN ORIGINAL"FINISHED" L, o.• CONSTRUCTION" FLOOD ELEVATION CERTIFICATE THAT HAS BEEN VERIFIED BY l \sti A LAND SURVEYOR AUTHORIZED BY LAW TO CERTIFY ELEVATION INFORMATION 111 n „"", IN THE STATE OF WASHINGTON. 38.) Flood hazard reduction measures are to be used as required by the Jefferson County Flood Damage Prevention Ordinance 07-0515-06 (Jefferson County Code Chapter 15.15). 39.) Construction Materials and Meth.of Construction to Reduce Flood Hazards (i)All new construction and substantial improvements shall be constructed with materials and utility equipment resistant to flood damage. (ii) All new construction and substantial improvements shall be constructed using methods and practices that minimize flood damage. (iii) Electrical, heating, ventilation, plumbing, and air-conditioning equipment and other service facilities shall be designed and/or otherwise elevated or located so as to prevent water from entering or accumulating within the components during conditions of flooding. Locating such equipment below the base flood elevation may cause annual flood insurance premiums to be increased. 40.) New construction and substantial improvement of any residential structure shall have the lowest floor, including basement, elevated one foot or more above the base flood elevation (BFE). 41.) Fully enclosed areas below the lowest floor that are subject to flooding are prohibited unless designed to automatically equalize hydrostatic flood forces on exterior walls by allowing for the entry and exit of floodwater. Designs for meeting this requirement must either be certified by a registered professional engineer or architect or must meet or exceed the following criteria: a. A minimum of two openings having a total net area of not less than one square inch for every square foot of enclosed area subject to flooding shall be provided. b. The bottom of all openings shall be no higher than one foot above grade. c. Openings may be equipt with screens, louvers, or other coverings or devices provided that they permit the automatic entry and exit of floodwater. 42.) During the SPAAD review, the proposal was sent to the Washington State Department of Fish &Wildlife (WDFW) for potential water fowl and harbor seal habitats. WDFW found that the proposal would not conflict with the habitats as long as the buffer is remaining intact. 43.) The proposed residence is located approximately 90 west of the mapped identified landslide hazard area. Therefore, a geotechnical report was not required for this review. 67 rUILDING PERMIT APPLICAT vN MRAOWTOpe3: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00356 Received Date: 6/30/2007 SITE ADDRESS: 151 WAMPUM POINT RD QUILCENE, 98376 OWNER: WILLIAM H WRIGHT PHONE: (425) 837-9318 LINDSAY L WRIGHT 25008 SE MIRRORMONT WAY ISSAQUAH WA 98027-7312 SUBDIVISION: Block: Lot: TX46 PARCEL NUMBER: 701194028 Section: 19 Township: 27 N Range: 01 W CONTRACTOR: NIEMAN CONSTRUCTION CO PHONE: (360)765-4787 P. O. BOX 846 QUILCENE WA 98376-0846 Contractor's License NIEMACC018MZ Expires 8/15/2008 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NEW SFR W/ATTACHED GARAGE ALSO A/G 500 GAL PROPANE TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 2,600 VALUATION 350,000.00 ADD'L: 470 HEAT TYPE: PRO CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: # OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: 878 SHORELINE: CONST TYPE: DECK: 470 SETBACK: 30 BANK HEIGHT: 6 SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: 2 Prop: 4 Total: 2 Total: 4 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $2,393.75 KAS 06/30/07 91340 Plan Check $1,555.94 KAS 06/30/07 91340 APPROVED State Building Code $4.50 KAS 06/30/07 91340 Potable Water Application $58.00 KAS 06/30/07 91340 AUG 2007 Total: $4,012.19 Jefferson County Planning & Building Department _., ,----„is 0 iR Fil ii-4 \\\\Y., 11-41 i. 4g' C. JEFFERSL�COUNTY } DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend • Washington 98368 3620/379-4450 • 360/379-4451 Fax ',4s �p . www.co.jefferson.wa.us/commdevelopment I �I�,� �I� 't KING Master Permit Application MLA: 01 - ' 1 Project Description(include separate sheets as necessary): Wright Single Family Residence fii 1 t#4 Aff7'!t"i1ti) 6;f'/it 1. Tax Parcel Property Number: 701194028 Size: 1.9837 acres (acres/square feet) Site Address and/or Directions to Property: r5/ WAMPUM /'T R1 �L(J&C e �: !`6`L/ &r ie i-fa,v i-t_r u t ie.S EC 17C1 N 41/+% CM.:7-E k!) TL) f/157 Q'Li/f craif ( 1 Z'',. /f?/t t-C 1?) / /41/)5f1-YIkL(D // 1 t" Property Owner(s)of Record: William&Lindsay Wright Telephone: 425-837-9318 Fax: email:william.wright5@comcast.net Mailing Address: 25008 SE Mirrormont Way, Issaquah,WA,98027 Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: 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]** CiCI Single Family 50 Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification O Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment ❑ Change of Use 0 Short Plat** O Address 0 Road Approach 0 Binding Site Plan** ❑ Home Business 0 Cottagelndustry 0 Long Plat** ® Propane 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Sign S,�4 Plat-_ Vacation/Alteration** ill I( 0 Allowed"Yes"Use Consistency Analysis `�( Sfibr line Nler Program I_xemptiuniPetmit Revisions" RI Stormwater Management 0 Shoreline Management Substantial Development** 0 Site Plan Approval Advance Determination(SPAAD)* 0 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 0 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: DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or 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 and any required later inspecti ns. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the pl' tion th or.sbe nts prior notice. Date: 6/25/2007 Signature: 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 yo are in compliance .h the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-trap f a @ repon ib'ity/for h ring to and c plying with e ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: /V C v ' Date: 6/25/2007 C:\Documents and Settings\carat\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc 41111 BUILDER STATEMENT • R 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: I! I f r� GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: d, 7R*a 11110 Nieman Construction Co. Inc. (360)765-4787 (360)765-3529 MAILING ADDRESS: PO Box 846 Quilcene,WA,98376 EMAIL: • nlemanConStwct10r11r1C@msn.COm CONTRACTOR'S LICENSE WAINS NUMBER: NIEMACC018MZ NUMBER ARCHITECT/ENGINEER: Anderson Peyton PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL See •ttached report Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: XI New X Wood Existing: a Sewer u Addition 11 Steel Proposed: 4 Bank 11 Community System u Alteration/Remodel II Concrete Total: 4 Height: X Individual System Li Repair II Masonry 6' SEP Permit# SEP07-00057 Li Demolition I_1 Other: Bedrooms: Water Supply: Existing: Setback: X Private well I I Two Party Type of Heat: Proposed: 2 30' a Public t {; 1 i; Total: 2Name 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: ❑Underground Tank ril Above ground Tank Size of Propane Tank: 500 GAL 0 Heat Stove ®Cook Stove 0 Woodstove ® Fireplace Insert ®Hot Water Tank 0 Pellet Stove 0 Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / o 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: 2600 tR ` .(: I g , . 2na Floor Heated Consistency Review: 470 LIB iat fO 1 ,.)5 (')� Other Heated Base fee: Mezzanine Additional Section: -s. Heated Basement Plan Check fee: 1 c fA. C,Ii I t Unheated Basement State Surcharge fee: 4 .5r Other Unheated Pot Water Review fee: 00 Garage/Carport 878 [ICitI `1 i, SUBTOTAL 4 a L ' 5�`l .,X,911/Rd Approach fee: l Decks 250 4,1 t kiwi . Other�r Ei'er,4 liar. hi :).LC, `. 13 5 A_c) TO AL: $ 4-a.,.J• ,9 Receipt Number: 9 1l D Cash/Check Number: l ESTIMATED COST(REQUIRED) Date: I /� .Fair market value or an foundation to finish r.? 0 i 1 00 " ��' � � ���* Initials: %vii C:\Documents and Settings\carat\Local Settings\"Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc • R BC EIVEI ) 4, ',N c°% JEFFERSON COUNTY JUN Z. 3 2:. I-) . . 1 DEPARTMENT OF COMMUNITY DEVELOPMENT •� 621 Sheridan Street• Port Townsend • Washington 98368 FFFFHSU�i11UNIVOCP u u I r �1ING' http://www.co.Jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# d1 -3 VI PROJECT/APPLICANT NAME: William &Lindsay Wright Please answer all of the following questions to the best of your ability. Where the question calls for depiction on a site map, the applicant may choose to either incorporate the elements into the general plot plan for the Master Land Use Application or to submit a separate stormwater site plan map. Project Overview 1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the site map. Single family residence with typical suburban landscaping. Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. Building site is nearly flat with a slight slope towards the existing drainage swales 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. Majority of the building site Is covered with various grasses and weeds,many noxious.There is no native vegetation in the building area. 4. Describe the existing soils. Indicate soil type on the site map. The building site is gravelly-sandy fill over log yard debris.There is almost no top soil. 5. Describe the existing site hydrology(i.e., drainage; behavior of water on the site—above, below, and on the ground). Indicate existing stormwater drainage to and from the site on the site map. Depict separate drainage basins on the site map, if applicable,and indicate acreage of each. See map 6. Describe any excess levels of noise generated by the proposed use or activity: APPROVED None STORMWATER PLAN t 60 Pa L rt v>J AUG - 8 2007 La St tormwa .A P s` stormw plan template.doc-rev.10/1 3 Requires 1,'�+It ���'� 1EFFERS IVC 5 ` DEPT.OF C , ,EO ENT SIGNATURE: .1, • • 7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, steep slopes, etc.)on the site. Indicate location on the site map. See site map 8. Describe the general vicinity of the site,including adjacent land uses and structures, util )ClailrAl Anti��F'N�c, )areas (streams,wetlands, lakes, steep slopes,etc.). See site map Rail\Irl)nn'}I1rli Permanent Stormwater Control Plan This portion of the Stormwater Site Plan consists of the selection and installation of the appropriate stormwater control BMPs and facilities to remain in place after construction of the project is completed. "Medium" size projects are required to have the totals calculated of all impervious surfaces, pollution-generating impervious surfaces, and pollution-generating pervious surfaces to verily that the thresholds for treatment facilities and flow control facilities are not exceeded. g. Describe the developed site hydrology, as proposed. Indicate whether stormwater will be fully dispersed (i.e., per BMP T5.30 in the Manual) or, if not, what types of stormwater flow control will be utilized for the site or specific threshold discharge areas within the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. Stormwater not fully dispersed. See site map. 10. If the project requires the use of stormwater treatment facilities, describe the types of stormwater treatment facilities proposed for use on the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. [This is normally for"large"projects or projects that involve the potential for dispersion of contaminants.] Not required. 11. Describe the performance goals and standards applicable to the project. Direct stormwater to existing drainage swales to slow flow of run off and for trash and sediment removal. 12. Describe the flow control system. Direct stormwater to existing drainage swales to slow flow of run off and for trash and sediment removal. stormwater site plan template.doc—rev.10/12/2003 6 • • 13. Describe the water quality system. None RE(111:3Ar c, T n7 14. Describe the conveyance system analysis and design. JUN t None required Jfj )3111P�I(,r' 15. Describe the source of fill material, physical characteristics of fill material, and deposition of excess material. None required 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. None required 17. Describe the proposed surfacing material. Nnne required 18. Describe methods for restoration of the site. None required 19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for "large"projects only and only those for which facilities are required to control flow or treat runoff.] If included, list the Manuals here. Not required 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. None 21. List other necessary permits and approvals as required by other regulatory agencies. If those permits or approvals include conditions that affect the drainage plan or contain more restrictive drainage-related requirements,describe those conditions or restrictions here. None known stormwater site plan template.doc—rev.10/12/2003 7 • • CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN(SWPPP) The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the template that follows must be installed on the ground during all construction phases of the project. The proponent is responsible for preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential development. SECTION I—CONSTRUCTION SWPPP NARRATIVE 1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or will be addressed. Identify the type and location of BMPs used to satisfy the required element. If an element is not applicable to the proposal,justify in writing. Descriptions of the 12 Elements are found at section 2.5.2 of the Manual(beginning on page 2-15). 12 Required Elements—Construction SWPPP 1. Mark Clearing Limits. 1E11 Site is already cleared VFt )) 0.,,,, r„, , ^„R 2. Establish Construction Access. Utilize existing access road and driveway JEFIllüu ISID rii 3. Control Flow Rates. Install sediment trap(BMP C240)at existing drainage swale flow and sediment control. 4. Install Sediment Controls. Install Straw Bale Barriers (BMPC230), Silt Fence(BMP C233)and Sediment Trap(BMP C240)at existing drainage swale flow and sediment control. 5. Stabilize Soils. Use Mulching (BMP C121), and Plastic Covering (BMP C12.3)to cover any erosion prone IIIdteridlb. 6. Protect Slopes. Not required. 7. Protect Drain Inlets. Not required. stormwater site plan template.doc—rev.10/12/2003 8 • • 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. Not required 9. Control Pollutants. No vehicle maintenance is required. Concrete handled per C151 Concrete Handling (C151) 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). De-watering will not be required. 11. Maintain Best Management Practices(BMPs). Construction stormwater controls to be inspected weekly and removed within 30 days of construction completion. 12. Manage the Project. 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). None. b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). Drainage from swales enters existing culvert which drains to Quilcene Bay 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. None. RiAbWh ') t. JEtkliSUI\q;1110 '1 I:' stormwater site plan template.doc—rev.10/12J2003 9 • • b. Description of special requirements for working in or near environmentally sensitive areas. Not required. 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils(e.g., erodibility, settleability, permeability,depth,texture, soil structure). None on site. 5. Construction Phasing. a. Construction sequence Normal single family residence sequence. b. Construction phasing(if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Provide a proposed construction schedule. Not known. II. Wet Season Construction Activities. a. Proposed wet season construction activities. Not known. b. Proposed wet season construction activities for environmentally sensitive areas. Not applicable. 7. Financial/Ownership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. William & Lindsay Wright b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. Not applicable. 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following, if applicable. Not applicable. a. Sediment Ponds/Traps. c. Waterwa s. Rl -ATEIVR c. Waterways. d. Runoff/Stormwater Detention Calculations stormwater site plan template.doc—rev.10/12/2003 (I:FF Hh IJ I!l 11 u U III I r I I I:i l 10 • • Stormwater Site Plan Changes If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan, the proposed revisions shall be submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised drawings showing any structural changes,and any other supporting information that explains and supports the reason for the change. Final Corrected Plan Submittal If the project included construction of conveyance systems, treatment facilities, flow control facilities, or structural source control BMPs (not standard on-site stormwater management BMPs),the applicant shall submit a final corrected plan ("as-builts")when the project is completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as constructed. APPLICANT SIGNATURE By signing the Construction SVVPPP worksheet, I as the applicanVowner 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. *' 6/25/2007 ND wNER OR A HORIZED R P SENTATI SI NATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: RECEW1Rl 0 JU, 6 .,i IERHSIIP111111NP 4i: stormwater site plan template.doc—rev.10/12/2003 12 Lindsay toad 3 East Quilcene Road _ — _ GI g6,b9oZ6N _ _ - c)o Zv'E 8 ve'L6�M_ ` X i ! rrn o oa w•_ _...n • ��r n�a•n�_ I N Z 00 t c m 2 c _ E J °sloe N►v(edB e'ys Pro�tddes G i N Ce w Cov°'i L' al -� _ • 3,N " _,�_ - 5D Treed nP)B c . cn < --u • `° N ce a I }m N� X elf D tdpuZOus � (�u I m N p w 2 �p1NN a N05n.� �r nE �K Te 4- =, J 0_0 J S.64N (� N 111 ! 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