HomeMy WebLinkAboutBLD2000-00199 THIS BUILDING IS
NOT FINALED .
THIS IS AN INCOMPLETE
BUILDING APPLICATION . THE
PERMIT WAS NEVER ISSUED .
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BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00199 Received Date: 3/29/2000
SITE ADDRESS: 11 BEAR RD
QUILCENE, 98376
APPLICANT: JOSEP OVAERT PHON : 37 -7° ! C
10533 24T -SE Z.-3
EVERETT WA 98208 ///111
SUBDIVISION: TAX 191 Block: Lot:
PARCEL NUMBER: 601334186 Section: 33 Township: 26 N Range: 01 W
CONTRACTOR: OWNER PHONE:
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: CARPORT
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 3,840.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 1997 HEAT BASE: HEAT TYPE:
OCCUPANCY: U-1 UNHEATED: #OF STORIES:
OCCUPANCY:
CONST TYPE: 5N OTHER: SHORELINE:
GARAGE: 384
CONST TYPE: SETBACK:
DECK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM: STORMWATER: YES NO AREA
BEDROOMS: BATHROOMS: Wetland Erosion
Exist: Exist: Seismic Streams
Prop: Prop: Flooding Landslide
Total: Total: F&W Plat Conditions
Routing Date: Shoreline Aquifer
Forest: Commercial Rural
Proximity
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $97.25 MAM 03/29/00 25496
Plan Check $29.18 MAM 03/29/00 25496
State Building Code $4.50 MAM 03/29/00 25496
Code Violation $97.25 MAM 03/29/00 25496
Total: $228.18
1:1F_BLD_App_Bld.rpt 10/29/99
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Jefferson County Department of Community Development
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$DN �cer 621 Sheridan Street,Port Townsend WA 88368[360]318-4450 0 0
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Project Description:
Building Type: Project Type: Frame Type:
Single Family X New Wood
▪ Garage Attached/Detached C Addition ❑ Steel
▪ Modular E Alteration/Remodel ❑ Concrete
= Commercial C Repair ❑ Masonry
I Multi-family/#of Units I Demolition ❑ Other:
Industrial
Other: C__ 2.(tr2- '
Bedrooms: Bathrooms: Type of Sewage Disposal: 1V Type of Heat:
Choose one: �y p
Existing: Existing: C Sewer Community Syst l ❑ Electricity ❑ Oil
Proposed: 0 Proposed: ❑ Individual System 1 ❑ Woodstove ❑ Propane
Total: Total: If not sewer,fill out the following: 1' ❑ Heat Pump
❑ Conventional 7 Alternative ❑ Other
Permit# SEP
Water Supply:
❑ Private well = Tw Party Well❑ Public:Name of water system:
Square Footage: For Office Use Only
Main Floor UBC OCCUPANCY GROUP LS
2ND Floor Base fee Ci LS
3'el Floor Plan Check fee 2
l'Se
Htd Basement State Surcharge fee
Unhtd Basement Subtotal 2-2-`i<2-2-`i<- 1
Garag: Carport 3 814 Sc D. ' r. 3V�1 y O Pot Water Review fee 1
Decks 911/Rd Approach fee y�
Commercial TOTAL Z Z ,
Industrial Receipt # Z *1,'
Other Cash/Check# (0-2- 1
Total Valuation: Initials 'AC-.i\
Or ���� Date '�, c.-'��!
Estimated Cost:
If within 200' o . -,
Distance to Bank or Ordinary High Water Mark ft.Bank Height ft.
By signing the application orm,the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any
omission of a material fact made by the applicant/owner 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 attomey'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 it's employees,representatives or agents for the purpose of application review and any required later inspections.
Access and right of entry to the applicant's property or structure shall be requested and shall occur during regular business hours.
Signature:\\k, Cst Date: 031 2-51 ZODC.7
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,, BUILDING PERMIT APPLICATION
' Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00199 Received Date: 3/29/2000
SITE ADDRESS: 11 BEAR RD
QUILCENE, 98376
APPLICANT: JOSEPH GOVAERT PHONE:
10533 24TH DR SE
EVERETT WA 98208
SUBDIVISION: TAX 191 Block: Lot:
PARCEL NUMBER: 601334186 Section: 33 Township: 26 N Range: 01 W
CONTRACTOR: OWNER PHONE:
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: CARPORT
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 3,840.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 1997 HEAT BASE: HEAT TYPE:
OCCUPANCY: U-1 UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N SHORELINE:
GARAGE: 384
CONST TYPE: DECK SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: P,r2"5
WATER SYSTEM: STORMWATER: YES NO /AREA
BEDROOMS: BATHROOMS: Wetland Erosion n0
Exist: Exist: Seismic j Streams NO
Prop: Prop: Flooding IL • Landslide
Total: Total: F&W Plat Conditi s 1
Date: Shoreline ve i Aquifer ?'U_
Routing Forest: Commercial IN' Rural—4(u a ,,,,Z)"f7;
Proximity , �~" (��.o —
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $97.25 MAM 03/29/00 25496 } a
Plan Check $29.18 MAM 03/29/00 25496 �# _
State Building Code $4.50 MAM 03/29/00 25496 ���� •
i
Code Violation $97.25 MAM 03/29/00 25496
Total: $228.18
'
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I:1F BLD App,Bid.rpt 10/29/99
•
• •
• STORMWATER CALCULATIONS
Owner/Applicant: 3OG6iA alto
��LL (� ❑ PROPOSED LAND DISTURBING ACTIVITY
Site Address: lA 11 CAr9-- \LqJ Drainfield area cleared sq.ft.
Driveway Length ft.
X Width ft.
9 Digit Parcel Identification No.: 1.01 " I $t0 = Total Driveway sq.ft.
Permit Number: Clearing and Grading for Site Development
PLOT PLAN (Well/Structures/Utilities/etc.) sq.ft.
sq.ft.
INDICATE the following information. Total Land Disturbance sq.ft.
Draw entire parcel to scale. Indicate scale of plot plan:
One inch equals ❑ IMPERVIOUS SURFACE
Proposed Structures (all roof area) sq.ft.
C 1. North arrow Existing Structures (all roof area) sq.ft.
❑ 2. All property boundaries and dimensions Sidewalks sq.ft.
❑ 3. Names of adjacent streets Concrete Patios sq.ft.
❑ 4. Driveway/s & parking spaces Proposed:
❑ 5. Major features such as ravines, Driveway Length ft.
seasonal creeks, bodies of water, etc. X Width ft.
❑ 6. Septic tank, drainfield and reserve area location, = Total Driveway sq.ft.
existing or proposed, and distance to Total Impervious Surface sq.ft.
closest structure
❑ 7. Sewer lines The Stormwater Manual sets forth the following Small Parcel
Minimum Requirements:
❑ 8. Wells and/or water lines • Construction Access Route Stabilization:
❑ 9. Neighboring wells within 150 feet Construction vehicle access shall be, whenever feasible,
limited to one route. Access points shall be stabilized with
❑ 10. Paved surfaces (patios) quarry spalls or crushed rock to minimize the tracking of
❑ 11. Structures, existing and/or proposed sediment onto public roads. If sediment is inadvertently
transported onto public roads, roads shall be cleaned
❑ 12. Setbacks (distances to property thoroughly at the end of the day by shoveling or sweeping.
Street washina should only be done after the bulk of the
boundaries, structures, banks, sediment has been removed by sweeping.
and shorelines) • Stabilization of Exposed Soil:
All exposed and unworried soil shall be stabilized by sodding,
❑ 13. Easements for access or utilities seeding, mulching, plastic covering, application of gravel base
14. Arrows showing direction of slope on roads and driveways, or other appropriate means within
seven days during the period from May 1 to September 30
assume an elevation of 100 feet at one and within two days during the period from October 1 to April
lot corner and indicate the other lot 30. Mulch shall be applied to a minimum depth of two inches.
• Protection of Adjacent Properties:
corner elevations in relation to it Adjacent properties shall be protected from sediment
deposition by appropriate use of vegetative buffer strips,
sediment barriers or filters, dikes, mulching, or by a
FOR APPLICATIONS ADJOINING SHORELINES, combination of these measures and other appropriate Best
Management Practices (BMPs).
INDICATE: • Maintenance:
❑ 15. Ordinary high water mark All erosion and sediment control BMPs shall be regularly
inspected and maintained to ensure continued performance of
❑ 16. Top of bank, if over 10 feet high their intended function.
❑ 17. Slope of bank in degrees • Other Appropriate BMPs as required by Jefferson
County to mitigate the effects of increased runoff shall be
applied.
H:IH O ME\PL N CNTR\FORMS\PLOTPLN.FRM9/97
Jefferso*ounty Department of Community D•opment
621 Sheridan Street, Port Townsend, WA 98368
•
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CRITICAL AREAS QUESTIONNAIRE
Applicant Name S05e 41� C-4000 '
X Building Application _ Land Use Application _ Shoreline Application
On-site Sewage Application _ Subdivision Application Other:
1 . Is there any standing or running water on the surface of the Yes _ No
property or on any nearby property at any time during the year?
If YES, please describe:
IA-AA tJ'UL n
2. Has any portion of the property or any nearby property ever been Yes _X No
identified as a wetland or swamp?
If YES, please describe:
3. Are any willows, skunk cabbage, alders, or cottonwoods present Yes _ No
on your property or adjacent properties?
If YES, please describe:
4. Are there any indications on any portion of the property or on any YES No
nearby property of rockslides, earthflows, mudflows, or landslides?
If YES, please describe:
5. Please indicate which line best represents the steepest slope found
on your property. (Check appropriate box)
E O cl Ci ❑ E C
r i i r i r i
r r / / / / /
I / i / / /
rr / / / / / rr
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Or• _- •
(Questionnaire Continues on Back)
Page 1 of 2
6. Does the site have steep slopes with little to no vegetation?• YES No_dX
If YES, please describe:
7. Does the site contain high percentages of silt and/or very fine _ YES X NO
sand?
If YES, please describe:
8. Does the site contain ground water seepage or springs near the YES NO
surface of the ground?
If YES, please describe:
By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their
knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner 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 it's employees, representatives or agents for the purpose of
application review and any required later inspections. Access and right of entry to the applicant's property or structure shall be requested and
shall occur during regular business hours.
Signature Q� C l re) Date C 3t25 j2
FOR OFFICE USE ONLY
❑ Wetlands ❑ Seismic
CRITICAL AREAS ON OR ❑ Aquifer Recharge Area (zone ) ❑ Fish & Wildlife Area 1
IMMEDIATELY ADJACENT TO SITE: ❑ Frequently Flooded Area ❑ Fish & Wildlife Area 2
❑ Erosion ❑ Landslide
❑Seismic ❑ Commercial Forest
Section Township North Range
Parcel Number: Parcel Size:
Comprehensive Plan Land Use Designation: Reviewed by:
Community Plan: Date:
Page 2 of 2
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