HomeMy WebLinkAboutBLD2009-00192 IlkUILDING PERMIT APPLICA•N MLLA09 00p212
Review TyI
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD09-00192 Received Date: 6/30/2009
SITE ADDRESS: 820 OLD HADLOCK RD
CHIMACUM, 98325
OWNER: JOHN G BELLOW PHONE: (425) 218-7756
ROXANNE HUDSON
PO BOX 1015
CHIMACUM WA 98325-1015
SUBDIVISION: Block: Lot: T 76+
PARCEL NUMBER: 901112040 Section: 11 Township: 29 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: AL LATHAM PHONE: (360) 385-4105
205 W PATISON ST
PORT HADLOCK WA 98339
PROJECT DESCRIPTIOP LIVESTOCK BRIDGE TO MEET AG BMP'S
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 3,000.00 ADD'L: HEAT TYPE:
CODE EDITION: 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: 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 $54.11 KAS 06/30/09 108678 qPPR®VED
Permit $83.25 KAS 06/30/09 108678 H
State Building Code $4.50 KAS 06/30/09 108678
Total: $141.86 AUG 3 2009
Jefferson County Planning
&Building Department
411 S
r--0 f I 0 r--1-N,-,e,,,.\\t)4,, JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
kir
621 Sheridan Street• PortTownsend •Washington 98368 11~�N 3 U 2(JIJ
9
)01.
360/379 4450 3601379-4451 Fax
www.co.jefferson.wa.us/commdevelopment"b'1Nr el
;t l, ,•Ptt1 rni1 ` 11
Master Permit Application MfLA: ! 60\,- -`a
Project Description(include separate sheets as necessary): '.n
L-�.11Q -n dtd 46Y I w L vt���k Pk �W v?S
Tax Parcel .J Property
Number: 10 11 )2O 410 Size: 2 . b 3 4E (acres/square feet)
Site Address and/or Directions to Property:
$2 0 011 14acltc 1r - , jZC1 l
Property Owner(s)of Record: TO tt 8.1 ! V.!:rang. NuC)Ao✓)
Telephone: 42-5-1-2_1V-7 7 SI- Fax: email: & 'Intp ®C I k c "�t't._
Mailing Address: F 0. Bo( /015
Applicant/Agent(if different from owner): Al /...-attje vim. It ib
Telephone: ti np`O Sits q II Os Fax: email:CA ®,]Lt+t.-aISONY p,is V
Mailing Address: .C�s .L,.). ?Air 1.56 n St
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
❑ 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)lAmendments**
❑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)* El 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:
DESIGNATION OF AGENT
I hereby designate ;, r7la J, Yom- to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE Ii i .k Date: CI.- 30 ...ZOO _
By signing this applicat .n( . - o er/a; 7;'s,tha`th information provided herein,and in any attachments,is true and correct to the best of
his,her or it's knowl-..e. •ny material false ood or any omission of a material fact made by the owner/agent with respect to this application packet
may result in this permit b ing 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 ay accrue against Je'erson C.,n as a result of or in consequence of the'granting of this permit.
I further agree to provi•- a and ht of en 'fir ',n County-id its employees,representatives or agents for the sole purpose of application
review and any req ' '-d la -, specti.ns. s a' •-,- a d right of er«ry will be assumed unless the applicant informs the County in writing at the
time of the appli . on tha r she , : is prix jj/ •• •
Signature: •i `�4 (� Date: 4tgo!zoo■.The action or actions A..licant will undertake as a result of the issuance of this permit may negatively impact upon one orre threatened or
- endangered species an. •ul•,ead to a potential"take"'f an endangered species as those terms are defined in the federal law known as the
"Endangered Species Act"' •^."Jeffe on Count k no as ra s to the applicant that the actions that will be undertaken because this
permit has been issued I ; olate th ESA. An '.ivi al, p or ency can file a lawsuit on behalf of an endangered species regarding your
action(s)even if you - • in .•y�,liance th the Je on C n d velop nt code.The Applicant acknowledges that he,she or it holds individual
and non-transferab • respo • ity for•.hering to - h the A. The Applicant has read this disclaimer andsignsand date§§it below.
Signature:
PF"-
l Date: 4 - 3(..) -
�� — 2-6°
C:\Documents and Settings\•, ,\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc
• •
BUILDER STATEMENT
The signer oft ' 1. - ent d es here., •• � they. e the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be a: i . e res onsibili :f thz c: - :I Con actor for the proposed project. ,r�
Signature: 11 i Date: (.p '3o - zoo
r r
GENERAL CONT;ACTOR OR MANU •CTURED 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:
X New L Wood Existing: Ti Sewer
❑ Addition li Steel Proposed: Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System
❑ Repair C Masonry SEP Permit#
❑ Demolition C Other Bedrooms: Water Supply:
PP Y:
STeel t: q Existing: Setback: ❑ Private well C Two Party
Type of Heat: u n.1 t„ • j 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:
0 Underground Tank °Above ground Tank Size of Propane Tank:
❑Heat Stove 0 Cook Stove 0 Woodstove 0 Fireplace Insert 0 Hot Water Tank 0 Pellet Stove 0 Other
Is this appliance being installed in a Manufactured I 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.
. IYf ' p �. { tr,,,, rl lily
Square Footage Current Proposed ForOrficefise Only ' 1# of 'rg fwevis�; T I' ;.i,
I 'd`m 6'r,
Main Floor Heated A - [� EH Bld App Review: rJIA P
2ntl Floor Heated ,t Consistency Review: n 13, O0
Other Heated , Base fee:
Mezzanine Additional Section:
Heated Basement -''‘` - , Plan Check fee: �y'1
N ;; : .
11
Unheated Basement . I State Surcharge fee: ,i ��
Other Unheated Pot Water Review fee: ,
Garage/Carport LIA SUBTOTAL 354• D o
Decks fie:
Other _PA3� u;< ,5hr><o�ln9 4g1.rx)
440 W TOTAL: $ a[o
Receipt Number: CO 8!_'7g
rt ?
''t ID
!( , i,, , 4, \\t j ph/Check Number: ,, 10
,t V
ESTIMATED COST(REQUIRED) Date: r I '��
Fair marks d materials founciet p�t�fnish� _ (d3-�
( e0 J.J'tl e) u' h,... Initials:
:—:'177;1(' rnIfrT . '' 'r
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• •
JEFFERSON COUNTY CONSERVATION DISTRICT
205 W. Patison St., Port Hadlock, WA 98339 - Phone (360) 385-4105 FAX (360) 385-4823
al(a7jeffersoncd.orq
Spring Rain Farm Livestock/Farm Equipment Bridge
Project Description
John Bellow purchased the Spring Rain Farm property (820 Old Hadlock Rd., Chimacum WA
98325) in December 2008. Prior to his ownership the farm had been used for raising
livestock, most recently horses. In order to access the pastures on each side of Chimacum
Creek livestock and farm equipment crossed the creek using a ford (wet crossing). John
wants to protect the creek from the impacts of using the ford by constructing a bridge for
livestock and farm equipment. The bridge is one component of his efforts to protect and
improve stream habitat.
Since acquiring the farm John has protected the farm for agriculture through a conservation
easement with the Jefferson Land Trust. He has also worked with the Conservation District
on a stream habitat improvement project, and enrolled 3.6 acres of riparian zone in the
Conservation Reserve Enhancement Program (CREP). The stream habitat improvements
include removing an old spoils berm along the creek to reconnect flood plain and add wood
structures in the stream channel. This project has received necessary permits and will be
constructed summer 2009. The CREP buffer will be planted in winter 2009/2010. In addition
to protecting the creek from livestock/farm equipment crossings the bridge will provide shade
and cover for fish utilizing this reach of Chimacum Cr..
JUIN 3 0 20119
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Port Hadlock, WA 98339
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Jefferson County Building Di ion Permit Num. BLD09-00192
Applicant: BELLOW
BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2006 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
Foundation Footing
Straps(hold downs)
FINAL INSPECTION 7_ (( _ 1J IG
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
CONDITIONS for Building Permit# :BLD09-00192
1.) A FLOOD ELEVATION CERTIFICATE PREPARED BY A QUALIFIED PROFESSIONAL
MUST BE SUBMITTED TO JEFFERSON COUNTY PRIOR TO RECEIVING A BUILDING
FINAL. THE FLOOD ELEVATION CERTIFICATE MUST DEMONSTRATE THAT THE
LIVESTOCK BRIDGE IS AT LEAST ONE (1) FOOT ABOVE THE 100-YEAR FLOOD
ELEVATION AND THAT THE BRIDGE HAS BEEN PROPERLY ANCHORED.
2.) 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.
3.) In addition to Jefferson County permit conditions, the project proponent shall comply with
all conditions set forth by the Washington Department of Fish and Wildlife through
Hydraulic Project Approval.
4.) Prior to commencing development activity, the proponent is responsible for informing the
US Army Corps of Engineers (COE) in order for COE to determine whether a Department
of the Army permit or review is required. Generally, review is required for construction
and dredging in or around navigable waters of the US and for work or fill in hydrologically
connected wetlands. Contact the US Army Corps of Engineers, Seattle District
Regulatory Branch, PO Box 3755, Seattle WA 98124, (206) 764-3495, for more
information.
5.) Work within the jurisdiction of the Shoreline Master Program other than as described
above shall receive separate review from this Department.
6.) All new construction and substantial improvements shall be constructed with materials
and utility equipment resistant to flood damage.
7.) 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.
8.) The building height is not to exceed 35 feet.