Loading...
HomeMy WebLinkAboutBLD2010-00179 41Ib UILDING PERMIT APPLICAN MLA10-00208Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD10-00179 Received Date: 5/27/2010 SITE ADDRESS: 831 GRIFFITH POINT RD NORDLAND, 98358 OWNER: LAWRENCE M GRAVES PHONE: 360-316-1091 812 HARRISON ST PORT TOWNSEND WA 983686522 SUBDIVISION: Block: Lot: T 105 PARCEL NUMBER: 021324025 Section: 32 Township: 30 N Range: 01 E CONTRACTOR: LD RICHERT CONSTRUCTION PHONE: (360)379-5222 PO BOX 127 PORT TOWNSEND WA 98368 Contractor's License LDRICC*066L0 Expires 8/21/2009 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NSFR W/ATT GARAGE & A/G 250 GAL PROP TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,387 VALUATION 225,282.00 ADD'L.: 667 HEAT TYPE: EEE CODE EDITION: 2006 HEAT BASE: HEAT TYPE: PRO OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: CONST TYPE: 5N OTHER: SHORELINE: CONST TYPE: GARAGE: 490 SETBACK: DECK: 356 BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PUD BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 2 Prop: 2 Total: 2 Total: 2 Routing Date: Type - — 'FCm'ount Paid By: Date: Receipt: Approved/Date Permit $1,699.35 LYK 05/27/10 117766 APPROVED Plan Check $1,104.58 LYK 05/27/10 117766 Ik State Building Code $4.50 LYK 05/27/10 117766 AUG i(� 201U Potable Water Application $98.00 LYK 05/27/10 117766 I`� Total: $2,906.43 Jefferson County Planning & Building Department • • CONDITIONS for Building Permit# :BLD10-00179 1.) 2005 DOE STORMWATER MANUAL DRYWELL DESIGN CRITERIA ALL INFILTRATION SYSTEMS SHOULD BE AT LEAST 10 FEET FROM ANY STRUCTURE, PROPERTY LINE, OR SENSITIVE AREA. FOR SITE WITH SEPTIC SYSTEMS, INFILTRATION SYSTEMS MUST BE DOWNGRADIENT OF THE DRAINFIELD UNLESS THE SITE TOPOGRAPHY CLEARLY PROHIBITS SUBSURFACE FLOWS FROM INTERSECTING THE DRAINFIELD. DRYWELL BOTTOMS MUST BE A MINIMUM OF 1 FOOT ABOVE SEASONAL HIGH GROUNDWATER LEVEL OR IMPERMEABLE SOIL LAYERS. 2.) The road approach permit(RAP08-000063) must be inspected and finaled by the Jefferson County Department of Public Works prior to the final inspection/certificate of occupancy of this residence. Contact Terry Duff, Department of Public Works at 360-385-9159 for the final road approach inspection. 3.) To help prevent seawater from intruding landward into underground aquifers, all new 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. 4.) 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. 5.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 6.) 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. 7.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 8.) Not more than 2 unlicensed vehic�shall be stored on any lot unless totally s ned from view of neighboring dwellings and rights-of-way. Such screening shall mee 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 automobile 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 requirements 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. 9.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 10.) Building Setback from Griffith Point Road right-of-way is no less than 20 ft.; Shoreline Setback is 30 ft. from the top of the bank; side and rear setbacks are no less than 5 ft. If an environmentally sensitive area (ESA) is present, then the more restrictive setback shall apply. 11.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 12.) The building height is not to exceed 35 feet. 13.) 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. 14.) A stormwater 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. • Jefferson County Building Division Permit Num BLD10-00179 Applicant: GRAVES 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 44/ Erosion Control Foundation Footing 2I S/1 I 6 wA.M t-//N.5r lfnn d4K1 /C Footing Drains Foundation Stem Wall �.. Underground Plumbing Under Floor Framing co ` 1 Straps(hold downs) ? z4/13 I� Ext. Shear Wall Nailing : 30, ( / Rough-in Plumbing 7/i4//3 Framing 7/2 f/j3 f Blocking ?/z 4/3 Airseal �( sue/ 17�L f�Lr AAA.1DCivS D / /3 zO'" Insulation:Walls / J Insulation: Floors Insulation: Ceiling ') 1i), / Int. Shear Wall Nailing OS$ 5"i i,d4ccs 6k /1l3G Wallboard Nailing Gas Line: Interior r8Gas Line:Exterior 1Ps' Propane Tank Heat/Chimney Clearance 57i t/l1 fri/�"/ Drywell/Alt Drainage c See condition#1 - Drywell criteria Address Posted /AV / FINAL INSPECTION FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR ( 1 V - r1lL.A � -I-Li III •• �y "SON c4 JEFFERSO v OUNTY W ' '� DEPARTMENT OF COMMUNITY DEVELOPMENT 'I 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax �qp'� www.co.jefferson.wa.us/commdevelopment 81N Master Permit Application MLA: ID 9D ' Project Description(include separate sheets as necessar r): 4 7c New '3 I �PLC 1—A WV�`I IL�i1 ac1•)cz t`'/krTt}4.6) �r�iLrt, ,,-_ t i l - Lip Tax Parcel Number: d 2-1Zj�4- 1 p2� Property Size: I -I 1k[_( I/100 ( cre�)s quare feet) Site Address and/or Directions to Property: Q-l (OR 1 P►t,--1 ?i. 2J KIo- ►J o \jU 9 g3 5? Property Owner(s)of Record: Ult-t,vFe CE AA.. 6,17-kt�t-� Telephone: %'O 3 I (0 1 t C I Fax: — email: -h-I 6► 0" ► Gietki xr5 E.facet • Mailing Address: �?\2 I-P-b�t c.�t S �,14 T IP T- 4 . co,. Applicant/Agent(if different from owner): Lb 2-1 c t+t�e-I C't3. ( �--,,v`f-11CZ'Z7,72.. Telephone: '31 cl. 19222 Fax: S'ma...`., email: il Gl t ch E4e-i_e &a-titli---,(61-11 Mailing Address: - rz--9-- 1 L What kind of Permit?(Check each box that applies ❑ Lot or Road Segregation ❑Building ❑Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use) , ingle Family ❑Garage Attached/Detached 0 Conditional Use[C(a), C(d),or C]** ❑ Manufactured Home . 0 Modular - - ❑ Discretionary"D"or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use 0 Boundary Line Adjustment ❑ Address ❑ Road Approach ❑Short Plat** ❑ Home Business ❑ Cottage Industry 0 Binding Site Plan** Propane CILong Plat** ' )iyn 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration*" Cl 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 0 Jefferson County Shoreline Master Program Amendment *May require a Pre—Application Conference 0 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 J 1 '` to act as my agent in matters relating to this application for permit(s). ip OWNER SIGNATURE '' Date: S/Z //Cl 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 a• -ss and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any r-quired la/ ins..- I . ' affs access and ri•h • entry will be assumed unless the applicant inf rms the ounty in writing at the time of the appli,- ; a or =nts pn•r notice � � (0 Signature: I I Date: The action or actions Appli" t 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 tederal 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 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 ar i corn lian ' the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable r ility(or adhe ng t mplying with the ESA. The Applicant has read this disc er and s/gns and dates it below. Signature: Date: Z(. I/b L. LL G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc 1 • s bi • r t • APPROVED t STORMWATER PLAN (-_----,,soN--?..-, , �� JEFFERSON COUNTYAUG 9 2010 `.. DEPARTMENT OF COMMUNITY DEVELOPMENT JEFFERSON ti A DEPT.OF C __,.��� 621 Sheridan Street •• Port Townsend ••Washington 9836&, SIGNATURE: ��GAO 360/379-4450 • 360/379-4451 Fax �•..r SIN http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# 1 V- ( A PROJECT/APPLICANT NAME: e5.3t (fir(l(• ro t 44- 14uJ c 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. I6 deve o co! i -H— 5 i 4-c• w i V i Ad(vote act-c t,l av d rni vr. M ('rile- FaM1 (y Iree5tvcte,tc_ei 3-coo.- 4, e/e XDU, 5ephse skistewt ottr,i.. p ht.ine se rv'c a r tri-f. V n toucL.t.ed Parts a e ftAp s i i-c. w, (i r•c fa4'.: r.a f 1 Yc. Existing Conditions Summary 1 2. Describe the existing topography. Indicate contours on the site map. P►rcarG✓$-i i s re(a--i-i•v4_fy !<(re/ , will, 'a 0vi a ja 4, ' S(dpc -� G-�c_ YoY». -t tvr' o it 6a►a.k_. u r +0 " � roast . 'L bgMk i 5 1a k.s tscat.(y V er4-1 c.ea. w1.{-ti cxv4 Uncle its t, f t A S"a4.11. t ict, ,mac l c' 2-0`hA A. 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. Tht t.uhcic site tS e_evr_^ed t i'l6 notfl've v-e iv toct,sm Cy. cept W m. dr1veway h/Lt, 6ee41 aea.ee d . M "v r-c. Fe r, /If/K lock. ceda.y, Rtitot At et.Jrron cr /0"-34 Pali osnei if k) IG. ®tom+. V/tclerc11",/V Or Sa!al, W Id ros-r, PO(la! ( lactwF..err. /f ef'.er hAliv< , 4. Describe the existing soils. Indicate soil type on the site map. '' Li tie e/br,.4 4, Soul Iolc i'Adi'cafc a. YoA fetyer or 4.or '.sf d u-4 dve r _ a6o u ye-. 24i `, si i-ria'y /oci rrr ever 5..e /'re-r d ch c r h 0 t- Sail of iel lif>iactes 1 v'('fh rvt o t(7) 4,r,-di e{r- -~.-lost-c i`-�d so i/s ,bc.-/o i..1 -f-- -a ", 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. Vila-te rr 5 ee0-1,5 -1-6 .s i 4 k eot 51. t y i"L, j "-t-ke -fa,p I r r"S• of 5 o' onvit t-cfa In 4E ce. -(1) 5o Ole _eY"frPrt, i of O W rade i iotIPr > /o W S -f o -I-Lc s h b re. Thg-r e i s . c t&s tr. 4 sec nice .;-►-AwL -1 *it, 4, ' Air bon 4, 6. Describe any excess levels of noise generated by the proposed use or activity: lVD vie 1 D"Hi er 7Lita . et I_Y•pVCR / rev /r. `e4"4/ +. r (ds0- 'le stormwater site plan template—rev.10/21/2005 • • • 13. Describe the water quality system. N IA 14. Describe the conveyance system analysis and design. " /4 15. Describe the source of fill material, physical characteristics of fill material,and deposition of excess material. Fill $4 1-cs ea LA/f/�s (.."14.7 t St' Dr 'Alyea d 0/04 na. a ear 3 0 few a ved Prow _)cCu(r4..fr'0.-i Ate tire c.tei ...i/ _47. 4c c . 77'1 i'5 &l e d erect,' kv I r4,rri.Ct. « a rat . -f* e 1'1c Prtryles USI Clear-or" fwe StoPAY c gy_yr 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. IV rA 17. Describe the proposed surfacing material. 9r-Q fie l (a :)v-1 wa ya 18. Describe methods for restoration of the site.-US-e' 4:44..d ° f,l ACitk t-r gt f7'4°" - S'o 7' l CI4k.-it( p(4.,a'' , '�'.��s �.�F 4e'd etre&C. '7 ic._au0- .e c St cirri 61 .1cr-/ /"errate,/''.. 4.1 4'4. I 9 (41z'c R 'P4n( 'r^ /I/a 11 M41YtiAts* 6.rtS i i V4 S'!'V ' ‘',,'c !S. 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. 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. `: Coin -c R" fa 7 ( l`'f e l•:� ton f)4 t: / 4 ie r/ , 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. • r U/L- )/e /(i t'`�C; 4I(r • s ���Ef • CO2.-fr/c A-t t 4 stormwater site plan template—rev.10/21/2008 7 • i 12 Required Elements- Construction SWPPP(continued) 8. Stabilize Channels andt Outlets. 1- L �:/ r'f/A • ,lV tt 4'�) ` !'l7�' �/lf!/�II°?-ef 47)' tit r-C orp 9. Control Pollutants. ,1,(- PO/1 f�tk f5 /iV iG/ ke ere-A'Y!J//€ ` £ L 7-Az SOvrez, /(/o ✓dii</ 4- A't erl a fi r e w r Il lie duo crt s 1'1 e. (a-i cp- ?'e Drc' d. c/ra aeA_` will be 1 rac 1.1 b./ ttwai zlr-ot c�rr'v��,,sa- oc,vicf sitars s e''F�, per /? M P C /57 10. Control De-Watering (the act of pumping groundwater or stormwater away from an active construction site). EXcc rtit'o- i -IVAf€ /A 1( ()fed em/ r'II d es'pergc mi&.1 cr o�'► r � And- Q6/ewret , F'Izr`c -/-11 u j t.-e 5o1! , 11. Maintain Best Management Practices(BMPs). r '!c `r€'c76'o-v Mvf 711'4/lee," 5?rsa.er x_.6 ter l a s 'c r-�t ee fr ty. l ' 414C coy/,SI-iv di' + `,'.�-►e'7f -i c i.► w/f l J- ',p e rff , (at /vt n,'47' ./i c ac..,. neon Ilk k 6&S`r,;', %tr...ot //ro w r/l .. rem Orr d no / ?'ec 71`-0 342 c'ct fc,t-Y►R I et r'a,.t, o r /pro je ct`* 12. Manage 4he Prpject. cl 1e_ctu l e. 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas,roads). A f -/-l\c 10 w n d rcla e r l i✓ l's a Vcr 1-1 caJ ctilicS-fr".41 : b c!,-ro S c i 0 iG ' do(.4 ;1, - s, he ck(7, h-ectCA. Al( rem ofr (f j9t f i.l t--crec ye !4- re ac.Ptof -14-f pera.r•il by 1,1 (ir- Ot'l Y-- 6 e ra't1'crvt -h, _ ke. ¢ c Ft.e{, k‘et",a sir r:a ckt c' , b. Description of the downstream drainage path leading from`fhe site to the receiving body of water(minimum distance of 400 yards). Cira d`el-Cf ta ,, ro()AO( �` , iv le tit.1 � s he e.N% (y Vele ea! a± `f`"-c. F TdF*. /x itz. -. 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. �11.5# The cae4 (-see It 4thAve stormwater site plan template—rev.10/21/2008 9 • • • SECTION II—EROSION AND SEDIMENT CONTROL PLAN Sediment and erosion control measures may be depicted on the master land use application plot plan, a stormwater site plan, and/or a separate Construction SWPPP site plan. This is a checklist to ensure that the following are depicted on a site plan: 1. General. a. Vicinity Map b. Jefferson County Approval Block c. Erosion and Sediment Control Notes 2. Site Plan. a. Legal description of subject property. b. North arrow. c. Indicate boundaries of existing vegetation (e.g.,tree lines, pasture areas, etc.). d. Identify and label areas of potential erosion problems. e. Identify FEMA base flood boundaries and Shoreline Management boundaries(if applicable). f. Show existing and proposed contours. g. Indicate drainage basins and direction of flow for individual drainage areas. h. Label final grade contours and identify developed condition drainage basins. i. Delineate areas that are to be cleared and graded. j. Show all cut and fill slopes indicating top and bottom of slope catch lines. 3. Conveyance Systems. a. Designate locations for swales, interceptor trenches, or ditches. b. Show all temporary and permanent drainage pipes,ditches, or cut-off trenches required for erosion &sediment control. c. Provide minimum slope and cover for all temporary pipes or call out pipe inverts. d. Shows grades, dimensions, and direction of flow in all ditches, swales,culverts and pipes. e. Provide details for bypassing off-site runoff around disturbed areas. f. Indicate locations and outlets of any dewatering systems. 4. Location of Detention Best Management Practices (BMPs). Identify location of detention BMPs. 5. Erosion and Sediment Control Facilities. a. Show the locations of sediment trap(s), pond(s), pipes and structures. b. Dimension pond berm widths and inside and outside pond slopes. c. Indicate the trap/pond storage required and the depth, length, and width dimensions. d. Provide typical section views through pond and outlet structure. e. Provide typical details of gravel cone and standpipe, and/or other filtering devices. f. Detail stabilization techniques for outlet/inlet. g. Detail control/restrictor device location and details. h. Specify mulch and/or recommended cover of berms and slopes. i. Provide rock specifications and detail for rock check dam(s), if applicable. j. Specify spacing for rock check dams as required. k. Provide front and side sections of typical rock check dams. I. Indicate the locations and provide details and specifications for silt fabric. m. Locate the construction entrance and provide a detail. 6. Detailed Drawings. Any structural practices used that are not referenced in the Ecology Manual should be explained and illustrated with detailed drawings. 7. Other Pollutant BMPs. Indicate on the site plan the locations of BMPs to be used for the control of pollutants other than sediment(e.g.,concrete wash water). 8. Monitoring Locations. Indicate on the site plan the water quality sampling locations to be used for monitoring water quality on the construction site. Sampling stations should be located upstream and downstream of the project site. stormwater site plan template—rev.10/21/2008 11 • • BUILDER STATEMENT 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: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: L I) 2t Cr4 i (CO& 3-7q . '- 272 ( ) sA.tz MAILING ADDRESS: 'PO F ,jZ-. 1 2:7 i I,viik , EMAIL: I d r 1 G her-1- Tw,Al L . CUB, CONTRACTORS LICENSE WAINS NUMBER: I d r-i GCS cp uo LJj NUMBER • ARCHITECT/ENGINEER: IM I C stet__ (_ 9CI.4.,Qyt4M QL- PHONE (36O) W I(y-FAX:( ) MAILING ADDRESS: CI 3¢ e,. ?At 1 Li i4pn2kl 910 EMAIL Pr, ject Type: Frame Type: Bathrooms: ,% Shoreline: Type of Sewage Disposal: New Wood Existing: .-�r ❑ Sewer Addition ❑ Steel Proposed: �/ Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: � Height t I�Individual Syst m ❑ Masonryi SEP Permit# I (' - I ❑ Repair ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: — Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: — i CIPublic Total: — 30 Name of System: •Lt I)• 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: i Underground Tank i Above ground Tank Size of Propane Tank: 2I:2 D (o06-Z—. i Heat Stove I Cook Stove i Woodstove i Fireplace Insert i Hot Water Tank i Pellet Stove i Other 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. S•uare Footage _ _ Current Proposed For Office Use Only Amount Revision Main Floor Heated I .12 �-EH Bld App Review: i� OJT . f13— 2` Floor Heated (060�. ^ICICI( Consistency Review: , I ' _ Other Heated Base fee: I OC1 � .&5 -Mezzanine i^ IX M�} - 4 01- Heated Basement Plan Check fee: . Unheated Basement State Surcharge fee: O Other Unheated Pot Water Review fee: / I2 Garage/Carport 4410 l' 0-150 SUBTOTAL ,�r q� Decks 3�(a c,: ..T3s,� 911/Rd Approach fee: 1 LOCI � Other TOTAL: $31(31,1:J _ n j-Tyi , Receipt Number: ( 1-1 7l�1 ,�( 1 Cash/Check Number: — ESTIMATED COST(REQUIRED) Date: F - --7— .Fair market value of all labor Ord materials foundation to finish )-{DI I �y = Initials: 10 1 :_ J G:\PerrnitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc • • • .• 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. �L `There l L . 1-441vl tel� Wetfr'r or /r1d�i C41/ ' c At kVcl laP.7d?IAA tS r any ' otJ frJ e1 r fout On t'" rote,75 ' h.ei e /r ca ve rfit Ca:( Iroe . u I /S'- 2o ' h i G, a f _ he c.L: 8. Describe the general vicinity of the site, including adjacent land uses and structures, utilities, roads, and sensitive/critical areas (streams,wetlands, lakes, steep slopes, etc.). `Thy t t s'rvest' b aot Are :1/-.Al-eve 416 ed p#tJrof Z-f ui ractet (G-r--tc4 IA-/ Road) I ?owe,- t phone. Putra, Awl d oueta( p ee y bar, - ro.4-01 tit, Ann-r14. a4.,Itd so d4 oc.e ex{s „� S„ !c mow+,iy hbnies, LBG•cjed a 'ap# 39' brae( Froevt ® r c .. 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 verify 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. Rao ' 1 vr,o{C t ill b e df to e l eel fo d rti cut/OS noun `f`i Pi we Ls ►,u ,(f 6e C gy►c?Eyed as"per Fi j vtc 3,41 'tke 'S r4^1v 4c.e Mat 41,1,00,e, bk-ity.e Aua % /`u/Jofc t4.v// -/'/n rrt fti a. stA,r /e w fr,/.4 irr-;tu 1,1 r et 4,'(/-€ v e j e-t 1.1-77; The 5' �a-e Mr/"6/l el, 77' rem , ' i- 'tiff he trf/V dt'S, ,ta,y"c7+ pry' /3fri P 7'S.3(:)- 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.] 11. Describe the performance goals and standards applicable to the project. —Fix pc, 4 r r�,�;:..��t' �' � o 1',,. (c 1't : I) en -, Hrcolc ,th r xt1 vv a 4 e'< 0.6 5.`r c=� - .- sa7`ert7'r! a•t~crVi ryCAae7 cr j6c' c/ 'o 17 cc /,'` l�vs,/rP LO'r1/ e it) ,prey-4-4,1 .r`ti/- kJ* r ln frt.)I�'cry i ep `?'iNe !rocdnr3! -) ?r,e " ih e bee.J f :F, "r•t r-e et e-4✓ t clj {°.Flr !)�r( ,• 12. Describe the flow control,system. system. , .o f c.m @� % �t It .leap eS cry t^fs. way I-c>e,_ecr,. 56,ne•f (r'a U -f 3 c�'r`s� �r-s*ern PocE.l stormwater site plan template-rev.10/21/2008 6 • • 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 Volume II Section 3.2.3 of the Manual (beginning on page 3-7). 12 Required Elements—Construction SWPPP 1. Mark Clearing Limits. Pr,'0if' -6) cwis fry c,A' /'n-r'' S o-(" ari tr a 4 cfear.,d w r'df tot de/7i,e4_7'rd wry 4t...c .47er7c'r:-cc; Ptr t'Gla5, SAorclril; et i.ro hxe n1 A/ led iv/f.' P'( .I c r:, , y-r, 1L prcSery tv /1 be -f/c •r�1 rxl b-er 12>M/° C/C�7 Establish Construction Access. Cttyr Strac.ci s2/r4,41 ee eXtVli'et q clr-rtn- kr/ (1 h‹. ed'iu‘lrS'>7ed ore. 13m P cioc 3. Control Flow Rates. Ai ! f c:.pe o rill S 5",7 ' l s S"A a(/o W e„i of/4,Ir -- t l.rc_ ctf i(/ kr 4. Install Sediment Controls. r r� r/E$v'.1 41,4 , e?t'/".�E't ! /F 1 14f l7 e.c +.+ c..) YLGL i /,mil"' (1 1ri' •ci lit-f / p de? r7 ?'1 to f �O. !t.'-� (;"f (. c' 49(, ...ri S<'cp /3�""eor /�'1 "tF�.� •sue .t e^r 1 1'JC 7{ZA/Chi rite, c. i s f 'w� 4.44.•,o� c7 # . i'ao t 5. Stabilize Soils. esci soP/. , i . Ill be ,hro o(41 wli-4 1)(4.,sf t rh-eri,i,a w:)(/ B MP -/2") , 6. Protect Slopes. IV/A A4 c/ot e—c,' 3 , / o r -.cIe r l O nt-?cd Cr11 //-c /U() c vi S rYUC. cr i Pta(/a.Cec-1,1 Ira ! r"f7 c > .SGL r7 d J" r t.. • 7. Protect Drain Inlets. /�} Ala i 74- err) stormwater site plan template—rev.10/21/2008 8 • • b. Description of special requirements for working in or near environmentally sensitive areas. A 1 i Cc-vis e c+C.+►VIA cut N 'i t f es - S f`avelA w .f r r vvt a 4' IA)%if �w > . beech , 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). lJ/A ,5*e O(J 4 fro tore eras'i'avi pia 5. Construction Phasing. a. Construction sequence �5 c F f . (2) o (3)(fFv*'ure) A� b. Construction phasing(if proposed) r. N o S P.ec4- 1 na e ir- AC -ice coot T u cA oN/k. , iAlA U, i A. 4414C 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). Provide a proposed construction schedule. Sept-cm.bt-r 20/ : aradi4AT f tot acting IJovewiac.r 2.4/c9 — LThrl.c ✓2.©// trowi r''tc 1 pn.c.��g�'n� -h tt/'s1re II. Wet Season Construction Activities. a. Proposed wet season construction activities. PAP-M en7 / Cn c/2)1 I47 ,1 V U c b. Proposed wet season construction activities for environmentally sensitive areas. 7. Financial/Ownership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. r retterc b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following, if applicable. a. Sediment Ponds/Traps. M//A b. Diversions. /t/ /4 c. Waterways. /U/, d. Runoff/Stormwater Detention Calculations stormwater site plan template—rev.10/21/2008 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 SWPPP 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 oft affected property. (LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: 4 stormwater site plan template—rev.10/21/2008 12 i m o n W D .;' I I5. m to .. ;�(„` z x \ _ I 0 N Qo N -r 1 (7 ( 03 'O C g C7 -i C- rn N Co N a> V1 0 0 ' ;_ tD (�D O fC C O 1 iir7 1____ (..,7c),.. o '�° Q ii) �1 p a co c°1i 5 0 V c m • v L. el. CD 3 I 0o: \ xca > >. cia \, t.. V) O Li vi ?-II - 4i: '1\--- t co o f. n N D :XI / (j.-"V '''' - ,...------ (. V "-'-.:7..k....r,.i k d N I siirDcri onN � r� C a o •m o 0.) co cJ a -I a0 o !-.s o • a o or0S l , c m CI) m " o r< � �M ..00.000S N ° .Z 3 a 3 o v0 S • o 4 N 0'cn o a N o N a z m o a O ei C( r o 0 o ss8 j ©lddd c, O 6a�aW�x c or � .0 u ddd a oaa o ve CD.. 'i + wx °ilCVI 0 ./ E`aCD ` IF HI aJ 614 —T-, ,, 3 N • ,, P z -. = -vim rtO rk e lib 9 -__ 4-7 PI oiv. ' t=4, - - * •' Iv -St.', 4.''..1.0 v0\.,'' ,tk, , vo 1 , p .4z. co LA) Sil I LC ' b w ,,f•r-,i.311,47 4 V.14:4",tititr. , . cur'{ {; '� N r" I ,6l 0 co A r. Reserve to.) A ' 0 o tv * z' = ' `� zuCO > a W7/ ,-p �. El •R 9 fD (.0o Reserve , , i. A 1 o p� 0 \ itk Cj. o O , ` i . • If ,44Ito ‘ * , / • it 44. it .4 / v v Ao -Dpi s Z .\T-6-\ D N D X N 7 -ph ' \-8 la , N �``��� CO ik m w7p4 - 7. O FEd i z z oQ O g `' A N I i D z "W1 coo < iiit `) 0 Im _ o Z w N D N -y w m -4 ylli ,` O r CO 2 O ni i O m w r CD • v Cn � Q vs _ N 0 �an�n0 6u�3six3 Z D \ CD O m CO, II peo� �u!od �1 4i1J0 D z '� C 4 xr 0 , . . . , . ------- . , (---- , ,,,,c, <p,br, ncroN. - 'O m.)'-4 DmOZ1 P D •ma11nDD DRn�ro ° -‹ nmr m Ir r ADbrOa m0rp " ,vm IV _m ..or ~ _ ' ----..IObpOm OAn A CP A 0 N III ,1 C ywNo - . UC-` mn 0 wIIII • rI 0 A - —a-• a 00Op0' Oz bbb0ti" O mm mW r •y6ZZ n „ ro . •• GOONwP A � AN J n n N A ro 1 Z I ♦._ 0 0 n b b m I"0 ._ Z m Z 1 Q -� I a °• Z ro P ` , m N..........�O NI en N W N w P Oro"V!NMO'MN+O. A a I <1 n..i m m i ro 1 a^.q O m b O A A m w m o,n • 0 ��° I \ m<imI;1^ -rD-mDn°•XXD • ` \ e" l l :Mx,—b 0 a m m 3 0 N 7 m Z I m Z p I P,n - . r N Pnrnm c11�An,yDbm Z 1,�0- wmmrnx,nDpDmmpZn<"'mmpQiOro N I A- ^ iN O1 a � A r r r mmlZDinmAnD pDi H J 1 III m 0 . < f 1 m m D A P \ r ♦ 1. k ♦ \ ` 1 ♦ ♦ ` 0 .r r I • O OD 7. b oA I r � � O I V V ____2. 1 r z .: . —J.; n p; ii___;:: p0 O D 1 O cE w 0 o•0 -' N r n ;° N _—in N O O d V 1 • 0 . r a A D o ro 1" • =1 l l • A O (J n L , . oA j — : N 7 O f 1 -.--OP / ro -A 1 IN 'or o v 1 I I // 02 0 [ 1 r IIA .J - �O ' A O ii• III — m • 1 .II'T 1 f T i 1 r ..:; 1 Cl. all a y t___________I J_ L \ i . D my ! L . P . RICH ERT A ! o 1,.. i 0 m GEN ERAL CONSTRUCTION AND DESIGN Z Z v' P .O . BOX 127 PORT TOW NSEN D WASH INGTON 98368 a 1 n 360 . 379. 5222 ......\ m i