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HomeMy WebLinkAboutBLD2013-00149 1 N rF) DEPARTMENT OF COMMUNITY DEVELOPMENT -. 621 Sheridan Street,Port Townsend,WA 98368 Tel:360.379.4450 I Fax:360.379.4451 /,i. Web:www.co.jefferson.wa.us/communitydevelopment ,�y,J{t 0,t�'i'' E-mail:dcd@co.jefferson.wa.us CERTIFICATE OF OCCUPANCY PERMIT #: BLD13-00149 APPLICANT: JAY D MAC VANE PHONE: 206-849-0010 12811 SUNRISE DR NE BAINBRIDGE IS WA 98110-1118 SITE ADDRESS: 261 COUNTRY RIDGE DR Issue Date: 07/11/2013 CHIMACUM, 98325 Final Date: SUBDIVISION: Block: Lot: PARCEL NUMBER: 801045011 Section: 4 Township: 28 N Range: 1W PROJECT DESCRIPTION: NEW SINGLE-FAMILY RESIDENCE THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009 EDITION. OCCUPANCY GROUP: R-3 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM No THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON Acting Building Official, Patty Charnas \\tidemark\data\forms\F_BLD_Occupancy.rpt 6/12/2017 BUILDING PERMIT • Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD13-00149 Received Date: 5/15/2013 SITE ADDRESS: 261 COUNTRY RIDGE DR Issue Date 7/11/2013 Expiration Date 7/11/2014 OWNER: JAY D MAC VANE PHONE: 206-849-0010 12811 SUNRISE DR NE BAINBRIDGE IS WA 98110-1118 COUNTRY RIDGE SUBDIVISION: -- Block: Lot: 11+ PARCEL NUMBER: 801045011 Section: 4 Township: 28 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: Contractor's License HABITFH912D5 Expires 3/15/2015 PROJECT DESCRIPTION: NEW SINGLE-FAMILY RESIDENCE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 544 VALUATION 90,000.00 ADD'L: 448 HEAT TYPE: OIL CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: 42 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: 1 PWELL Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $923.75 ZAL 05/15/13 142089 Exist: Exist: Plan Check $600.44 ZAL 05/15/13 142089 Prop: 1 Prop: 1 State Building Code $4.50 ZAL 05/15/13 142089 Total: 1 Total: 1 Potable Water Application $66.00 ZAL 05/15/13 142089 Total: $1,594.69 Directions to Site: HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. Request must be received by 3pm the day before the inspection is needed. Office Hours 9:00 am -4:30 pm MONDAY- THURSDAY HOT LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS APPLY-SEE ATTATCHED Jefferson County Building LTiision Permit Nu ; , r: BLD13-00149 Applicant: MAC VANE BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2009 International Building Codes To schedule inspections, call (360)379-4455 no later than 3:00PM the day before the inspection is needed. Requests received after 3:00 PM will not be scheduled for the next day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Setbacks 9/1 Erosion Control Foundation Footing 1 ii 3 Footing Drains ��rCA I Foundation Stem Wall Jizj'3 Underground Plumbing Under Floor Framing7=/-1-) . Straps(hold downs) iya/13 Ext.Shear Wall Nailing /7P1/.`tt C / �. Rough-in Plumbing 1,� 11 Framing Blocking 1;26-1 CPIS Airseal C /1 Insulation:Walls /5- );.— Insulation: Floors Insulation:Ceiling (VII/ /2 // 1 ' Int.Shear Wall Nailing 47115_( / 1 Wallboard Nailing 1.i 51 IF • U-*/ Gas Line:-tnfe`rior Gas ine: erior Pry"Tank— Heat/Chimney Clearance /(#7 Mechanical Systems (e)//z /,yiEr Duct Test Cert �� Blower Airtight Test t'D/ // j Smoke&CO2 o iPvr) Drywe /Alt-Brairrage Address Posted 0/0-111 `yy . Water Meter Inspection f (---)/--) iiy1 J�vth•./L,,,,�� • • 09,Nco\'\}/\. )-$?\7.3 1Pv\tv FINAL INSPECTION 1// // " /11 FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • CONDITIONS for Building Permit# :BLD13-00149 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 May 15, 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 May 15, 2013 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 3.) The project is located within WRIA 17 and thus is subject to compliance with the WA State Department of Ecology In Stream Flow Rule for that region. The parcel is located within the Chimacum sub-basin; as such, state regulations require the following: 1. Water use shall be limited to domestic use only, and such use shall not include outdoor irrigation. "Domestic use" means use of water associated with human health and welfare requirements, including water used for drinking, bathing, sanitary requirements, cooking, laundering and other incidental household uses, including potable domestic water requirements associated with commercial and industrial purposes. (WAC 173-517-150(8)) 2. INSTALLATION OFA WATER METER, MEETING DEPARTMENT OF ECOLOGY SPECIFICATIONS, IS REQUIRED FOR ALL NEW USES THROUGHOUT THE WATERSHED. (WAC 173-517-180) BROCHURES WITH SPECIFICATIONS ARE ENCLOSED WITH THE PERMIT. 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LI-1 wS � --I tZ� z C� CO O Nt 1) CD n a. aCD ori;O p p -t O cp Z - Wp oa O 0 L (� Cn Pa CD O yP N M 5 0 '-3 w 0- a as o 0 , '.o CDO O co b ¢- N O O oo CA - O BLD13-00149 BUILDING PERMIT APPLIC fION Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD13-00149 Received Date: 5/15/2013 SITE ADDRESS: COUNTRY RIDGE DR CHIMACUM, 98325 OWNER: JAY D MAC VANE PHONE: 206-849-0010 12811 SUNRISE DR NE BAINBRIDGE IS WA 981101118 COUNTRY RIDGE SUBDIVISION: Block: Lot: 11+ PARCEL NUMBER: 801045011 Section: 4 Township: 28 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr NEW SINGLE-FAMILY RESIDENCE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 544 VALUATION 90,000.00 ADD'L: 448 HEAT TYPE: OIL CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: SETBACK: DECK: 42 BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: 1PWELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: 1 Prop: 1 Total: 1 Total: 1 1 Routing Date: 5,e___ Lc/�d ( Type Amount Paid Bv: Date: Receipt: Approved/Date Permit $923.75 ZAL 05/15/13 142089 APPROVED Plan Check $600.44 ZAL 05/15/13 142089 State Building Code $4.50 ZAL 05/15/13 142089 JUL 1 a 21,1 Potable Water Application $66.00 ZAL 05/15/13 142089 Total: $1,594.69 Jefferson County DCC \\firlcmorL\Anfo\forme\C RI n Ann RIA rn+ c/1 G/9l114 III0__--------\� ��, ,SO.N co& JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT MM } 5 2 �3 ` 621 Sheridan Street • Port Townsend •Washington 98368 � 360/379-4450 • 360/379-4451 Fax kgs N� O$ www.co.jefferson.wa.us/commdevelopment JEFFERSON CUM DEPT.OF COMMUNITY DEVELOPMENT Master Permit Application MLA: Project Description (include separate sheets as necessary): 55iNkGLc FQMiL- g" - Tax Parcel Number: 0 f 0415 Oil iProperty Size: It.( G t 2.02.,' eci (acres/square feet) Site Address and/or Directions to Property: C u j i"c i R i t) 72 i lscz Property Owner(s)of Record: , tf Y 0 M A e—VINIG Telephone:( oC.) SA©I — 001 © Fax: email: UsRTi't u CON sT'R0c.,"pcti 6.: 4 HA?L Mailing Address: e It .5,uNRte;: ]Df., NS— 1AiN5e3b 6r-- 15(ANL) iVJA ig))0 Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑ Lot or Road Segregation %Building ❑ Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) TA Single Family ❑ Garage Attached/Detached 0 Conditional Use[C(a), C(d),or C]** 0 Manufactured Home .0 Modular - 0 Discretionary"D"or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use 0 Boundary Line Adjustment ' Address 0 Road Approach_ 0 Short Plat** O Home Business 0 Cottage Industry ❑ Binding Site Plan** ❑ Propane ❑ Long Plat** agn 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes" Use Consistency Analysis 0 Plat Vacation/Alteration** ❑ Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions** ❑ Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Substantial Development** ❑ Temporary Use 0 Shoreline Management Variance ❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment *May require a Pre–Application Conference ❑Tree Vegetation Request **Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). i OWNER SIGNATURE' ;1/4'.,..........„.. 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 its knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application review and any required later ifispections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application that he'or she wants prior notice. 1 ; Signature: ,f'( ( Date: �, 'yy / , ,. The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you a in compliance with the Jefferson County development code.The Applicant acknowledges hat he,she or it holds individual and non-transferabl responsibility for adhering to and complying with the ESA. The Applicant has read this disci imeriand signs and dates it below. Signature: ( f. L— ' Date: 5/q / 1 / r G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc ' r , • • BUILDER STATEMENT The signer of this stat ment does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuminjie responsibility of the General Contractor for the proposed prof t. Signature: !" r (i (' Date. _.4-2 j/13 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) — FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: New Wood Existing: N;-h,, El Sewer E Addition E Steel Proposed: i Bank E Community System ❑ Alteration/Remodel E Concrete Total: i _ Height: 'i4 Individual System • Repair E Masonry — SEP Permit# Demolition E Other: Bedrooms: Water Supply: Existing: Rin Setback: % Private well ❑ Two Party Type of Heat: Proposed: D_ E Public CJi I` 14Livi..� Total: j 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: 1 Underground Tank 1 Above ground Tank Size of Propane Tank: 1 Heat Stove 1 Cook Stove 1 Woodstove 1 Fireplace Insert 1 Hot Water Tank 1 Pellet Stove 1 Other OIL 17 ' . Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines, tank location and size, distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. Square Footage Current Proposed For Office Use Only Amount Revision Main Floor Heated 54/--1 y�oa9-yy EH Bld App Review: �y 1)97 2n°Floor Heated 44c, 3, &b2 4/Consistency Review: i DO • Other Heated Base fee: i 9a 3 , 7S Mezzanine , Additional Section: Heated Basement Plan Check fee: /D yj, 1�/� ( z 7 Unheated BasementState Surcharge fee: '/ ° Other Unheated Pot Water Review fee: / 0 6 , aJ Garage/Carport SUBTOTAL / 91/0• bg Decks 2: Z 911/Rd Approach fee: A778- � O7 1171 Other /i 13 Z TOTAL: $$1 ipb, i%9 Receipt Number: /ya O Cash/Check Number: //oSS ESTIMATED.COS-T(REQUIRED) Date: L57/5/3 Initials: •Fai. arket value of all labor a••materials foundation to finish Initials: $ 90; coo /•�, _ I .-.,r, —:.re-.«e.\ +f+tfPnun.Tetttttt\DODIORMS\C,,{rentDRDForms\MasterPermitAonlication5-29-08.doc • . y 1 ") `j& JEFFERSON COUNTY j - E C� LIME -,-\ , DEPARTMENT OF COMMUNITY DEVELOPMENT D/ - `.ti 621 Sheridan Street • Port Townsend • Washington 98368 I��' MAY 5' 2013 O 360/379-4450 • 360/379-4451 Fax �� INO� http://www.co.jefferson.wa.us/commdevelopment/ I JEFFERSONCOUNTV ___DEPT,p�DMMUNIpj DEVELOPMENT Stormwater Calculation Worksheet MLA# PROJECT/APPLICANT NAME: _ ? _ . ) i `�; 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 4,. G G acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet _L 2,`ibi sq/ft Land-disturbing activity is any activity that results in movement of earth, or a change in the existing soil cover (both vegetative and non-vegetative) and/or the existing soil topography. Land disturbing activities include, but are not limited to clearing, grading, filling, excavation, and compaction associated with stabilization of structures and road construction. Native vegetation is vegetation comprised on plant species, other than noxious weeds,that are indigenous to the coastal region of the Pacific Northwest and which reasonably could have been expected to naturally occur on the site. Examples include species such as Douglas fir,western hemlock,western red cedar, alder, big-leaf maple, and vine maple; shrubs such as willow, elderberry, salmonberry, and salal; herbaceous plants such as sword fern, foam flower, and fireweed. LAND DISTURBING ACTIVITY, CONVERSION OF NATIVE VEGETATION,AND VOLUME OF CUT/FILL Calculate the total area to be cleared, graded, filled, Answer the following two questions related to excavated, and/or compacted for proposed development conversion of native vegetation: project. Include in this calculation the area to be cleared for: Does the project convert%acres or more of Construction site for structures -7th sq/ft native vegetation to lawn or landscaped areas? Drainfield, septic tank, etc. -5, � 2 sq/ft Circle: Yes No- Well, utilities, etc. 360 sq/ft Does the project convert 2'/2 acres or more of G, 1 native vegetation to pasture? Driveway, parking,roads, etc. c,�� sq/ftp Circle: Yes No Lawn, landscaping, etc. sq/ft Other compacted surface, etc. ., 127 sq/ft Indicate Total Volumes of Proposed: C / i+- Total Land Disturbance 5 4� sq/ft Cut t/? Fill i'O (.' (cu/yd) [over] stormwater calc worksheet Rev 9-9-2010—REV.9/9/2010 1 • I 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. STORMWATER CALULATIONS–IMPERVIOUS SURFACE NEW EXISTING Structures (all roof area) 7 e L', sq/ft Structures (all roof area) sq/ft Sidewalks 12- 7 sq/ft Sidewalks sq/ft Patios G sq/ft Patios sq/ft Solid Decks 0 sq/ft Solid Decks sq/ft (without infiltration below) (without infiltration below) Driveway, parking, roads, etc B d sq/ft Driveway, parking, roads, etc sq/ft Other sq/ft Other sq/ft Total New I I-795 –1795 sq/ft Total Existing sq/ft TOTAL NEW+TOTAL EXISTING* I , )`j1) sq/ft *This amount will be used BY STAFF to check total lot coverage. The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT v. REDEVELOPMENT Divide the total existing impervious surface above by the size of the parcel and convert to a percentage: 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. I also certify that this application is being made with the full knowledge and consent of all owners of the affected property. rt 5 '101; 0- (LANDbW ER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) FOR OFFICE USE ONLY SMALL MEDIUM LARGE REDEVELOPMENT Stormwater Site Plan: Yes No stormwater calc worksheet Rev 9-9-2010—REV 9/9/2010 2 a •Up Front Parcel Review• Parcel 801045011 Printed: May 15, 2013 JAY D MAC VANE Site Address: 12811 SUNRISE DR NE COUNTRY RIDGE DR BAINBRIDGE IS WA 981101118 BAINBRIDGE IS, WA 981101' CHIMACUM WA, 98325 Parcel Number: 801045011 S-T-R: 4-28N-01W Total Acreage 5 Legal Description COUNTRY RIDGE LOT 11 SURVEY V10/P176 Land Use: 9100 Flood District: Fire District: 1 Planning Area: 6 Flood Map(FIRM)Panel No: School District 49 Zoning: �---T(t) COMP PLAN DESIGNATION: COMMUNITY PLAN: UGA: UGA Trans [ vf Plot plan states "property line" [ Assessor's Map (Property lines u miffed plot plan must match the property lines as identified on the Assessor's 1/4 map) [ Legal Access to Property ES NO [ Parcel Tags or Scanned Documents YES � [ i� 6)ESA's: Special Reportsarby YES [ yr Designated Ag YES �fd0 [ L Shoreline Designation: SES 1 [UV Shoreline Slope Stability: YES0 Stream Type:YES NO Fish & Wildlife:YES NO Wetlands: YES NO Rare Plants:YES NO Seismic: Y NO Landslide NO � U- L CU— 1--" Flood: YES NO C Erosion: YES NO Aquifer Recharge Area:YES NO SIPZ: none At Risk High Risk Coastal CMZ: none High Risk Moderate RiskDisconnected CMZ Stormwater site plan sub II'tted: YesNo [ Forest Lands: YES .O Adjoining Forest Lands: !, Commercial/ Rural/ Inholding [ Mineral Lands: YES [ vr Agricultural Lands: YES [1,4— Archaeology: YES 0 �� [V( Stormwater: New Im urface ' G Land Disturbing Activity 7 D ESA's Stormwater Re :Min Req#2 Min keg#1 thru#5 Min Req#1 thru#101 Engineering [ t.-r Notice Provisions isc osure:Airsort YES NO MRL YES NO Forest Lands YES NO [L,..-}-- Landscaping Required: Yes d • [0 Parking Spaces Re uired NO g Other I IA Building Height: 35' UBC Standard [ ]' Impervious Surface coverae percentage: Resource Lands&Public: I Rural Residential: 25% Rural Indu I: Per UDC Sec 6.7 Rural Commercial: 60% Area of Building Coverage:60%in Rural Industrial Lands only [ 1/1-• Total Building (s) Size: RVC:20,000 SF CC: 5,000 SF NC: 7,500 SF GC: 10 000 SF All others:subject t tic&water constraints/None s ecified [ Setbacks: Front: `2, Left Side: '- Right Side: 1-, Rear: 4, Shoreline Setback: LSHA Setback: [ frr Road Classification: Road Approach: EXISTING NOT RE ' P [ i/] - SEPA Required: YES EMPT [ k]— Flood Certificate: ` [ E.,, Existing Case(s) & Condition(s): Violations: Yes No [V- Recorded Date of Subdivision: AFN Over 5yrs=UDC Plat Conditions: <5yrs=Plat Conditions on plat or Old Ordinance VI. Lots/Require Declaration of Restrictive Covenant YES 4�s.6bmitted: YES NO [ f/ UGA No Protest Agreement YE submitted: YES NO [ kr Site Visit conducted YES [ fr( Require Final Zoning Approval . ES NO [ C'ADMIN: Setbacks entered in Permit Plan case N/ YES New Parcel Tags entered in Permit Plan �_ j YES Special Reports Scanne N YES No parcel tags found for parcel Cases Associated with APN 801045011 Cases Name Review Type Status Planner ADR13-00029 MAC VANE P Application Received: 5/15/2013 Permit Issued/Case closed: Case Finaled: 911 - COUNTRY RIDGE DR BLD13-00149 MAC VANE P Application Received: 5/15/2013 Permit Issued/Case closed: Case Finaled: NEW SINGLE-FAMILY RESIDENCE PRJ13-00206 MAC VANE P Application Received: 5/15/2013 Permit Issued/Case closed: Case Finaled: SEP06-00028 MAC VANE C Application Received: 1/27/2006 Permit Issued/Case closed: 4/6/2006 Case Finaled: now filed w/ SEP13-5 SEP13-00005 MAC VANE A Application Received: 1/17/2013 Permit Issued/Case closed: 2/28/2013 Case Finaled: SEP06-28 (expired) filed here USR03-00104 MAC VANE A Application Received: 11/18/2003 Permit Issued/Case closed: Case Finaled: \\tidemark\data\forms\R_Parcei_CRMLA.rpt 5/15/2013 Page 2 of 2