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HomeMy WebLinkAboutBLD2015-00221 - 01 PERMIT APPLICATION BUILDING PERMIT APPLICATION BLD15-00221 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD15-00221 Received Date: 6/30/2015 SITE ADDRESS: ANCHOR LN. OWNER: PORT LUDLOW ASSOCIATES LLC PHONE: 360-301-3179 70 BREAKER LN PORT LUDLOW WA 98365-9766 9689- LUDLOW COVE DIVISION 2 SUBDIVISION: Block: Lot: PARCEL NUMBER: 968900020 Section: 17 Township: 28 N Range: 1 E CONTRACTOR: PORT LUDLOW ASSOCIATES LLC PHONE: 360-437-2101 70 BREAKER LN PORT LUDLOW WA 98365 Contractor's License PORTLAL994L8 Expires 5/2/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NSFR WITH ATTACHED GARAGE- TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,495 VALUATION 246,675.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: SHORELINE: RA CONST TYPE: GAGE:CK: 190 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: SEW WATER SYSTEM: 68700 BEDROOMS: BATHROOMS: Exist: 0 Exist: Prop: 2 Prop: 2 Total: 2 Total: 2 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $0.00 SRE 06/30/15 APPROVEDPlan Check $0.00 SRE 06/30/15 State Building Code $0.00 SRE 06/30/15 AUG 14 2015 Potable Water Application $0.00 SRE 06/30/15 Total: $0.00 Jefferson County DCD \\firlcm,r4lrlofnIfnrrmc\F RI n Ann P1,i rnf Rnn/91115 "GILDD BUBLD15-00221 ING PERMIT APPLICAN Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD15-00221 Received Date: 6/30/2015 SITE ADDRESS: ANCHOR LN. OWNER: PORT LUDLOW ASSOCIATES LLC PHONE: 360-301-3179 70 BREAKER LN PORT LUDLOW WA 98365-9766 9689- LUDLOW COVE DIVISION 2 SUBDIVISION: Block: Lot: PARCEL NUMBER: 968900020 Section: 17 Township: 28 N Range: 1E CONTRACTOR: PORT LUDLOW ASSOCIATES LLC PHONE: 360-437-2101 70 BREAKER LN PORT LUDLOW WA 98365 Contractor's License PORTLAL994L8 Expires 5/2/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NSFR WITH ATTACHED GARAGE- TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,495 VALUATION 246,675.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: SHORELINE: CONST TYPE: �ECRKAGE' 190 SE0 TBACK: BANK HEIGHT: SEWAGE DISPOSAL: SEW WATER SYSTEM: 68700 BEDROOMS: BATHROOMS: Exist: 0 Exist: Prop: 2 Prop: 2 Total: 2 Total: 2 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $0.00 SRE 06/30/15 Plan Check $0.00 SRE 06/30/15 State Building Code $0.00 SRE 06/30/15 Potable Water Application $0.00 SRE 06/30/15 Total: $0.00 ltfirinn-rorleltinfn fnrrnc\F RI fl Ann Rlrf rnt annf9nf' • • was°N �o DEPARTMENT OF COMMUNITY DEVELOPMENT 4 U 621 Sheridan Street,Port Townsend,WA 98368 --1 Tel:360.379.4450 1 Fax:360.379.4451 I� C a Web:www.co.'efferson.wa.us communi -v- ..�,• E-mail:dcd�a)co.jefferson.wa.us N°� �l��i JUN 3 0 2015 PERMIT APPLICATION' LiEFFERsoN couNTY I FPTTOF COMMUNITY DEVELOPMENT Steps in the Permit Process: -Review application checklist to ensure all information is completed prior to submitting application. -Make sure septic has been applied for and water availability has been proven. -Make an appointment to meet with the Permit Technician by calling 360-379-4450. -This is not a standalone application;it must be accompanied by a project specific supplemental application. -Fees will be collected at intake. Additional fees may apply after review and payment is required before permit is issued. For Department Use Only Building Permit# Related Application#s: MLA# Site Information Assessor Tax Parcel Number: 968900020 Site Address and/or Directions to Property: Property is located in the Ludlow Cove Subdivision on Lot 20 Access (name of street(s)) from which access will be gained: Paradise Bay Road,Anchor Lane Present use of property: 9100-Vacant Land Description of Work (include proposed uses): Construction of a single family home with detached garage Wastewater-Sewage Disposal This property is served by Port Townsend or Port Ludlow sewer system? YES ✓ NO — — If not served by sewer identified above, identify type of septic system below: Type of Sewage System Serving Property: Septic Septic Permit#: Community Septic Name of System: Case#: Are other residences connected to the septic system? Additions or repairs to sewage system: Is it a complete or partial system installation: Complete Partial _ Has a reserve drainfield been designated? Yes No — — Date of Last Operations& Maintenance check: Attach last report to application Describe or attach any drainfield easements, covenants or notices on title,which may impact the property: I I The authorized agent/representative is the primary contact for all project-related questions and correspondence. The County will mail /e-mail requests and information about the application to the authorized agent/representative and will copy(cc)the owner noted below. The authorized agent/representative is responsible for communicating the information to all parties involved with the application. It is the responsibility of the authorized agent/representative and owner to ensure their mailbox accepts County email(i.e., County email is not blocked or sent to"junk mail"). Applicant/Property Owner Information Property Owner: Name: Port Ludlow Associates Address: 70 Breaker Lane,Port Ludlow,WA 98365 Phone#: (360)437-2101 E-mail Address: J Please contact Authorized Agent/Representative with project info. (select only one). Property Owner Signature: Date: Note: For projects with multiple owners,attach a sep ate sheet with each owner(s)information and signatures. Applicant: Authorized Agent/Representative Of other than owner) Name: Cliff OBrien Address: 70 Breaker Lane, Port Ludlow,WA 98365 Phone#: (360) 301-3179 E-mail Address: cobrien@westharborhomes.com Professional: Is this an Authorized Agent/Representative for this project? NO YES Engineer Architect Surveyor Contractor 1 Consultant Name: Port Ludlow Associates License# PORTLAL994L8 Address: 70 Breaker Lane, Port Ludlow,WA 98365 Phone#: (360) 301-3179 E-mail Address: cobrien@westharborhomes.com Professional: Is this an Authorized Agent/Representative for this project? NO YES 1 Engineer ✓ Architect Surveyor Contractor Consultant Name: Michael Anderson License# Address: 330 Cleveland Street,Port Townsend,WA 98368 Phone#: (360)531-1011 E-mail Address: santiago2@cablespeed.com Professional: Is this an Authorized Agent/Representative for this project? NO YES 7 Engineer Architect 1 Surveyor Contractor Consultant Name: Union Studio License# Address: 140 Union Street, Providence, RI 02903 Phone#: (401)272-4724 E-mail Address: 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 or her 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 making any issued permit null and void. I further agree to that all activities I intend to undertake or complete associated with this permit will be performed in compliance with all applicable federal,state and county laws and regulations and I 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 inspections. Applicant may request noticeof the County's intent_ to enter upon the property for visits related to this application and subsequent permit issuance. Signature: �� '"7 v Print Name: Larry Smith Date: 06/30/2015 fermi[:1pp 6ca tion Parc 2 of 2 SON c-, DEPARTMENT OF COMMUNITY DEVELOP l kf T621l:Sheridan360.379.4450 Street,Port Townsend,WA 98368 S C L V T-14 eFax:360.379.4451 --- ^C Web:www.co.iefferson.wa.us/communitvdevelopment E-mail:dcd@co.jefferson.wa.us I JUN 3 0 2015 43wi NCt�� SUPPLEMENTAL APPLICATION LJJEFFERSON COUNTY RESIDENTIAL OR COMMERCIAL BLDG_PERIMI MUNITYDEVELOPMENT For Department Use Only Receipt#: Date: Related Application#s: Payment#: Site Information Owner Name: Port Ludlow Associates Assessor Tax Parcel#: 968900020 Type of Building New x Replacement Relocated Addition Repair Demolition *A separate permit is required Select One: Single Family Residence x Modular Other list Proposed Building/Project Number of floors 1 # new bedrooms 2 existing 0 total bed 2 # new bathrooms 2 existing 0 total bath 2 Heat Source Select all that apply: Electric x Heating Oil Wood Propane Enter the square footage(sq/ft)that applies in each field: Structure Existing Sq/Ft Proposed Sq/Ft ICC Valuation (Office Use) Residential/Commercial Main Floor 0 1495 Residential/Commercial Second Floor 0 0 Additional Floors- heated/unheated 0 0 Basement- unfinished 0 0 Basement-finished space or habitable 0 0 Detached Garage- heated/unheated 0 260 Attached Garage- heated/ unheated 0 0 Garage 2nd fl - unfinished storage 0 0 Garage 2nd fl -finished space or habitable 0 0 Carport-2 walls or less 0 0 Deck- uncovered 0 16 Covered porch 0 174 Other (shed, barn, pole bldg,etc.) 0 0 Estimated Cost of Project (Required): $246,675 $ • • List existing buildings on property (i.e. house,garage, accessory dwelling unit,shed, barn, mobile home,other): All Existing Buildings on Property Use Builders Statement The signer of this statement certifies 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: Print Name: 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 or her knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet ay result in making any issued permit null and void. Signature: �� �-✓ Print Name: Larry Smith Date: 06/30/15 For Department Use Only Building Permit Fees Building Base Plan Check Review Land Use Review $234.00 Septic Review $80.00 Potable Water $109.00 Technology/Scan $19.50 State Fee $4.50 Other Fees Shoreline Exemption Zoning Zoning Other New Address Road Approach Total Fees Receipt# Date: Cash/Check/CC: MICHAEL I.ANDERSON Civil Engineer a Land Surveyor 330 Cleveland Street Port Townsend,WA 98368 MEMO DATE: December 7,2015 TO: Jefferson County Community Development Department Attention: Building Department FROM: Michael J.Anderson PE&PLS J• wAsyq e 414 l e cL ! / �,! � `� /f q( . �: EXP. DATE: 05 / 05 / 16 SUBJECT: Ludlow Cove Phase II Project Architectural Plans by Union Studio This is to certify that the following changes to the footing detail apply to all the approved building permit plans for the subject development: 1. The formed key has been deleted from the plans and is not required. 2. The two(2)number 4 bars are sufficient for the footing typically shown as 1'8"wide by 10"deep and consistent with the 2012 IRC. Please attach this information into all the applicable aapplicable fines.. Thanks for your consideration. e: Port Ludlow Associates, Owner p lor 0 LUDLOW COVE 2 BUILDING PERMITS DECEMBER 7, 2015 LOT NUMBER APN PERMIT NUMBER 1 968 900 001 BLD14-00123 2 968 900 002 BLD14-00276 5 968 900 005 BLD15-00366 10 968 900 010 BLD15-00353 14 968 900 014 BLD15-00339 15 968 900 015 BLD14-00468 16 968 900 016 BLD15-00101 17 968 900 017 BLD15-00346 19 968 900 019 BLD15-00274 20 968 900 020 BLD15-00221 23 968 900 023 BLD15-00222 25 968 900 025 BLD15-00249 32 968 900 032 BLD15-00336 38 968 900 038 BLD14-00277 42 968 900 042 BLDI.5-00345 2012 Washington State Enereode: UA Alternative Worksheet, Type Occupancies Zero_Energy Plans Version Lot 20 Kingston (G6) Garage Left Waterfront D ! O ! Q v 1 Ludlow Cove Phase 2 Port Ludlow Associates LLC I I'�I,, . JUN 30 2015 {J 70 Breaker Lane u Ll! Port Ludlow, WA 98365 Ll JEFFERSON COUNTY 1 360-437-8242 I DEPT.OF COMMUNITY DEVELOPMENT Contact: Cliff Obrien Conditioned Floor Area 1,495 Conditioned Building Volume 13455 Weather Station Pon Townsend •i Component Performance, R-3 occupancies Code Target Values Area UA Area UA Doors U = 0.300 113 34 113 26 Overhead Glazing U = 0.500 0 0 0 0 Vertical Glazing U = 0.300 224 67 253 76 FlatNaulted Ceilings U = 0.026 1,495 39 1,495 40 Wall (above grade) U = 0.056 1.514 85 1,485 85 Floors U = 0.029 1,495 43 1,495 37 Slab on Grade F = 0.540 0 0 0 0 Below Grade Wall U = 0.042 0 0 0 0 Below Grade Slab F = 0.570 0 0 0 0 Target UA Total 268 Proposed UA Total 264 Target Credits from Table 406.2 0.5 Proposed Credits from 1.5 Table 406.2 Qualifies If the Proposed UA<_the Target UA, and the Proposed Credits From Table 406.2 are>_those required in Section R406.2 than the home meets the 2012 WSEC. Exterior Doors Plan Component Door Width Height ID Description Ref. U Qt. Feet inch Feet Inch Area UA Therma Tru Classic Craft • Custom 0.23 1 6 ° 6 8 40 9 Therma Tru Smooth Star • Custom 0.14 1 3 ° 6 8 20 3 PlyGem Pro Series 960 HPSC Patio Door • Custom 0.27 1 7 6 7 ° 53 14 • ' Custom 0.00 0 0 • Custom 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 Copyright 2013,WSUEEP10-009(Version 11)Copied by permission from Washington State University Extension Energy Program. (see copyright restrictions) 6/29/2015 1 of 6 2012 Washington State Ener ode: UA Alternative Worksheet, Type `Occupancies Sum of Area and UA 113 26 Overhead Glazing: Plan Component Glazing Width Height ID Description Ref. U Qt. Feet Inch Feet Inch Area UA v 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 Sum of Area and UA 0 0 Copyright 2013,WSUEEP10-009(Version 11)Copied by permission from Washington State University Extension Energy Program. (see copyright restrictions) 6/29/2015 2 of 6 2012 Washington State Ener ode: UA Alternative Worksheet, Type fjOccupancies Vertical Glazing Plan Component Glazing Width Height ID _ Description Ref. U Qt. Feet Inch Feet Inch Area UA PlyGem 400 Series Single Hung HPSC • 0 0.30 12 2 8 5 ° 160 48 PlyGem 400 Series Single Hung HPSC V 0 0.30 5 2 8 4 2 56 17 PlyGem 400 Series Fixed HPSC • I 0 0.29 3 2 4 2 4 16 5 PlyGem 400 Series Fixed HPSC • 0 0.29 2 1 4 2 4 6 2 PlyGem 400 Series Fixed HPSC • 0 0.29 1 4 8 2 4 11 3 PlyGem 400 Series Fixed HPSC • 0 0.29 1 2 ° 2 D 4 1 • 0 0.00 0 0 • 0 0.00 0 0 V 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 I• 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 V 0 0.000 0 • 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 ,I • 0 0.00 0 0 ' • 0 0.00 0 0 '• 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 I• 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 V 0 0.00 0 0 Copyright 2013,WSUEEP10-009(Version 11)Copied by permission from Washington State University Extension Energy Program. (see copyright restrictions) 6/29/2015 3 of 6 2012 Washington State Ener ode: UA Alternative Worksheet, Type Occupancies • 0 0.00 0 0 • ' 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 • 1 0 0.00 0 0 • 0 0.00 0 0 • I 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 vl 0 0.00 0 0 • 0 0.00 0 0 • 0 0.00 0 0 Sum of Area and UA 253 76 Glazing Area Weighted U 0.299 FlatNaulted Ceilings Plan Component Attic ID Description Ref. U Area UA R49 blown Attic STD baffled • 10-7 0.027 1,495 40 • Custom 0.000 0 • ! Custom 0.000 0 • Custom 0.000 0 Sum of Area and UA 1,495 40 Walls (Above Grade) Plan Component Wall ID Description __ Ref. U Net Area UA R21 cavity+RO foam STD 2X6W Lap • 10-5 0.057 1,485 85 Custom 0.000 0 0 • l Custom 0.000 0 0 • Custom 0.000 0 0 Sum of Area and UA 1,485 85 Floor(over crawl or exterior) Plan Component Floor ID Description Ref. U Area UA R38 vented Joist 16oc • 10-3 0.025 1,495 37 • 0 0.000 0 • l 0 0.000 0 Copyright 2013,WSUEEP10-009(Version 11)Copied by permission from Washington State University Extension Energy Program. (see copyright restrictions) 6/29/2015 4 of 6 2012 Washington State Enerode: UA Alternative Worksheet, Type.Occupancies V I 0 0.000 0 Sum of Area and UA 1,495 37 Slab on Grade(less than 2 feet below grade) Plan Component Slab Slab ID Description Ref. F Length UA V I Custom 0.000 0 V 0 0.000 0 V 0 0.000 0 VI 0 0.000 0 Sum of Area and UA 0 0 Below Grade Walls and Slabs Plan Component Wall Wall Wall Slab Slab Slab ID Description Ref. U Area UA F Length UA 0 0.000 0.0 0.000 0 0 0.000 0.0 0.000 0 0 0.000 0.0 0.000 0 0 0.000 0.0 0.000 0 Sum of Area, Length and UA 0 0.0 0 0 Copyright 2013, WSUEEP10-009(Version 11)Copied by permission from Washington State University Extension Energy Program. (see copyright restrictions) 6/29/2015 5 of 6 2012 Washington State Ener ode: UA Alternative Worksheet, Type•Occupancies Table R406.2 Summary Opt. Description Credit(s) 1a Efficient Building Envelope la 0.5 ❑ 1b Efficient Building Envelope 1b 1.0 ❑ 1c Efficient Building Envelope lc 2.0 ❑ 2a Air Leakage Control and Efficient Ventilation 2a 0.5 ❑ 2b Air Leakage Control and Efficient Ventilation 2b 1.0 ❑ 2c Air Leakage Control and Efficient Ventilation 2c 1.5 ❑ 3a High Efficiency HVAC 3a 0.5 ❑ 3b High Efficiency HVAC 3b V 1.0 ❑ 1.0 3c High Efficiency HVAC 3c 2.0 ❑ 3d High Efficiency HVAC 3d 1.0 ❑ 4 High Efficiency HVAC Distribution System 1,0 ❑ 5a Efficient Water Heating 0.5 2 0.5 5b Efficient Water Heating 1.5 ❑ 6 Renewable Electric Energy 0.5 3448 kWh ❑ Total Credits 1.5 *Please refer to Table R406.2 for complete option descriptions Copyright 2013,WSUEEP10-009(Version 11)Copied by permission from Washington State University Extension Energy Program. (see copyright restrictions) 6/29/2015 6 of 6 • • Simple Heating System Size: Washington State This heating system sizing calculator is based on the Prescriptive Requirements of the 2012 Washington State Energy Code(WSEC)and ACCA Manuals J and S.This calculator will calculate heating loads only.ACCA procedures for sizing cooling systems should be used to determine cooling loads. The glazing(window)and door portion of this calculator assumes the installed glazing and door products have an area weighted average U-factor of 0.30. The incorporated insulation requirements are the minimum prescriptive amounts specified by the 2012 WSEC. Please fill out all of the green drop-downs and boxes that are applicable to your project.As you make selections in the drop-downs for each section, some values will be calculated for you.If you do not see the selection you need in the drop-down options,please call the WSU Energy Extension Program at(360)956-2042 for assistance. Project Information Contact Information Lot 20-Kingston(G6)Garage Left Waterfront Port Ludlow Associates LLC '.x Ludlow Cove Phase 2 ';� Cliff Obrien °: ` 360-437-8242 Heating System Type: 0 All Other Systems ®Heat Pump To see detailed instructions for each section,place your cursor on the word"instructions". Design Temperature Instructions — Design Temperature Difference(ST) 45 Port Townsend A=Indoor(70 degrees)-OutdoorDesgn Temp Area of Building Conditioned Floor Area err Instructions Conditioned Floor Area(sq ft) 1,495 Average Ceiling Height Conditioned Volume Instructions Average Ceiling Height(ft) 9.0 13,455 Glazing and Doors U-Factor X Area = UA Instructions 0.30 337 101.10 Skylights U-Factor X Area = UA natructions 0.50 0 --- Insulation Attic X Area = UA Instructions R-49 D.026 1,495 38.87 Single Rafter or Joist Vaulted Collin 93 U-Factor X Area UA Instrucrx: s R-38 Vented ♦ 0.027 0 Above Grade Walls(see Figure 1) U-Factor X Area UA Instructions R21Irtermedlate 0.056 1,485 83.16 Floors U-Factor X Area UA Instructions R-38 0.025 1,495 37.38 Below Grade Walls(see Figure 1) U-Factor X Area UA InstructionsNo may Grade Walls In this project. 0 --- Slab Below Grade(see noun.l) F-Factor X Len.th UA Instructions ..--� No Slab Below Grade in this project. ♦ --- Slab on Grade(seeF-rouret) F-Factor X Length UA Instructions No Slab on Grade In this project. ♦ --- 0 Location of Ducts Instructions Duct Leakage Coefficient 0 No Ducts ♦ 1,00 Sum of UA 260.51 Envelope Heat Load 11,723 Btu/Hour Figure 1. Sum ofUAX AT Air Leakage Heat Load 6,539 Btu/Hour volume 0.6 XATX.O18 Above Grade Building Design Heat Load 18,262 Btu/Hour Air Leakage+Envelope Heat Loss Building and Duct Heat Load 18,262 Btu/Hour Ducts in unconditioned space.'Sum or Building Heat Loss X 1.10 Ducts in conditioned space.Sum of Building Heat Loss X 1 Maximum Heat Equipment Output 22,827 Btu/Hour Building and Duct Heat Loss X 1 40 for Forced Air Furnace Building and Duct Heat Loss X 1.25 for Heat Pump (07/01/13) I • • r<?...$0N w DEPARTMENT OF COMMUNITY DEi PA _.I::�t �,� 621 Sheridan Street,Port Townsend,W.1 98368 , Tel 360 379.4450 I Fax 360379 4451 JUN 3 0 2015 Wch:www.co.jeffcrson.wa.us/communitydevelopment w j �. �� F.-mail:dcd a co.jeffcrson.wa.us �SHI N CSC) OF COMMUNITY DEVJEFFERSON ELOPMENT t __DEPT. PERMIT FEES WORKSHEET Name PLA Parcel# 968900020 Estimated Cost of Project $246,675.00 Permit# Building Base Fees Building Base $2,056.00 Plan Check Review $1,336.40 Land Use Review $234.00 Septic Review Potable Water $170.00 Technology/Scan $19.50 State Fee $4.50 Other Fees Shoreline Exemption $546.00 Zoning I Zoning New Address $234.00 Public Works otal Fees $4,600.40 Use Only ` Number: ,ck/CC: • ON oG� DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street,Port Townsend,WA 98368 `U — Tel:360.379.4450 I Fax:360.379.4451 Web:www.co.iefferson.wa.us/communitydevelopment E-mail:dcd@co.jefferson.wa.us Ij� f1J N3 � c C c R V c PERMIT APPLICATION ? Ijn JUN 3 0 2015 Steps in the Permit Process: L i -Review application checklist to ensure all information is completed prior to submitting a(iplica JEFFERSON EY -Make sure septic has been applied for and water availabilityhas been proven. �___ DEPT OF COMMUNITY DEVELOPMENT -Make an appointment to meet with the Permit Technician by calling 360-379-4450. -This is not a standalone application;it must be accompanied by a project specific supplemental application. -Fees will be collected at intake. Additional fees may apply after review and payment is required before permit is issued. For Department Use Only Building Permit# Related Application#s: MLA# Site Information Assessor Tax Parcel Number: 968900020 Site Address and/or Directions to Property: Property is located in the Ludlow Cove Subdivision on Lot 20 Access (name of street(s)) from which access will be gained: Paradise Bay Road,Anchor Lane Present use of property: 9100 -Vacant Land Description of Work (include proposed uses): Construction of a single family home with detached garage Wastewater-Sewage Disposal This property is served by Port Townsend or Port Ludlow sewer system? YES ✓ NO If not served by sewer identified above, identify type of septic system below: Type of Sewage System Serving Property: Septic Septic Permit#: Community Septic Name of System: Case#: Are other residences connected to the septic system? Additions or repairs to sewage system: Is it a complete or partial system installation: Complete _ Partial _ — Has a reserve drainfield been designated? Yes _ — No Date of Last Operations& Maintenance check: Attach last report to application Describe or attach any drainfield easements, covenants or notices on title, which may impact the property: • • The authorized agent/representative is the primary contact for all project-related questions and correspondence. The County will mail /e-mail requests and information about the application to the authorized agent/representative and will copy(cc)the owner noted below. The authorized agent/representative is responsible for communicating the information to all parties involved with the application. It is the responsibility of the authorized agent/representative and owner to ensure their mailbox accepts County email(i.e., County email is not blocked or sent to"junk mail"). Applicant/Property Owner Information Property Owner: Name: Port Ludlow Associates Address: 70 Breaker Lane, Port Ludlow,WA 98365 Phone#: (360)437-2101 E-mail Address: ✓— _ 2 Please contact Authorized Agent/Representative with project info. (select only one)/ //Property Owner Signature: H7\ Date: 5 Note: For projects with multiple owners,attac a separate sheet with each owner(s)information and signatures. Applicant: Authorized Agent/Representative(if other than owner) Name: Cliff OBrien Address: 70 Breaker Lane, Port Ludlow,WA 98365 Phone#: (360) 301-3179 E-mail Address: cobrien@westharborhomes.com Professional: Is this an Authorized Agent/Representative for this project? NO YES ✓ Engineer Architect Surveyor Contractor ✓ Consultant Name: Port Ludlow Associates License# PORTLAL994L8 Address: 70 Breaker Lane,Port Ludlow,WA 98365 Phone It: (360) 301-3179 E-mail Address: cobrien@westharborhomes.com Professional: Is this an Authorized Agent/Representative for this project? NO YES ✓ Engineer 7 Architect Surveyor Contractor Consultant Name: Michael Anderson License# Address: 330 Cleveland Street,Port Townsend,WA 98368 Phone#: (360)531-1011 E-mail Address: santiago2@cablespeed.com Professional: Is this an Authorized Agent/Representative for this project? NO YES Engineer Architect 1 Surveyor Contractor Consultant Name: Union Studio License# Add ress: 140 Union Street,Providence, RI 02903 Phone#: (401) 272-4724 E-mail Address: 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 or her 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 making any issued permit null and void. I further agree to that all activities I intend to undertake or complete associated with this permit will be performed in compliance with all applicable federal,state and county laws and regulations and I 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 inspections. Applicant may request noticeof the County's intent to enter upon the property for visits related to this application and subsequent permit issuance. Signature:c j '7/ ""► ' Print Name: Larry Smith Date: 06/30/2015 Pcrmrz\pphcation P;g*c 2 of 2 s • ��sySON coy DEPART621 Sheridan rMENT OF COMMUNITY DEVELOP 7•eet,Port Townsend,WA 98368 L_ CEIWIE W Tel:360.379.4450 I Fax:360.379.4451 D I 1 -< Web:www.co.jefferson.wa.us/communitydevelopment { I E-mail:dcd@uico.jefferson.wa.us 1 n i ! JUN 3 0 2015 I I S� �ISHI NG. .O SUPPLEMENTAL APPLICATIONi JEFFERSON COUNTY RESIDENTIAL OR COMMERCIAL BLDG 1 RABT COMMUNITY DEVELOPMENT For Department Use Only Receipt#: Date: Related Application#5: Payment#: Site Information Owner Name: Port Ludlow Associates Assessor Tax Parcel#: 968900020 Type of Building New x Replacement Relocated Addition Repair Demolition * *A separate permit is required Select One: Single Family Residence x Modular Other list Proposed Building/Project Number of floors 1 # new bedrooms 2 existing 0 total bed 2 # new bathrooms 2 existing 0 total bath 2 Heat Source Select all that apply: Electric x Heating Oil Wood Propane Enter the square footage(sq/ft)that applies in each field: Structure Existing Sq/Ft Proposed Sq/Ft ICC Valuation (Office Use) Residential/Commercial Main Floor 0 1495 I 1pilJ 1411 - }C--- Residential/Commercial Second Floor 0 0 Additional Floors- heated/unheated 0 0 Basement- unfinished 0 0 Basement-finished space or habitable 0 0 Detached Garage- heated/ unheated 0 260 1 2.-t0S • Uv Attached Garage- heated/unheated 0 0 Garage 2nd fl- unfinished storage 0 0 Garage 2nd fl-finished space or habitable 0 0 Carport- 2 walls or less 0 0 Deck- uncovered 0 16 3!- - Covered porch 0 174 34 5 2_ I So Other(shed, barn, pole bldg,etc.) 0 0 Estimated Cost of Project (Required): $246,675 $ I $ '1j 11-1- 7'U° i • List existing buildings on property(i.e. house, garage,accessory dwelling unit, shed, barn, mobile home, other): All Existing Buildings on Property Use Builders Statement The signer of this statement certifies 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: Print Name: 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 or her 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 making any issued permit null and void. Signature: v� �/ ) Print Name: Larry Smith Date: 06/30/15 For Department Use/rOnly Building Permit Fees Building Base Ds(Q ' O0 Plan Check Review � 317 .L# 0 Land Use Review $234.00 Septic Review $80.00 Potable Water $109.00 Technology/Scan $19.50 State Fee $4.50 Other Fees Shoreline Exemption 51-41,'° Zoning Zoning Other New Address 234 c7 ° Road Approach Total Fees Receipt# Date: Cash/Check/CC: , Parcel Details4111/ • Page 1 of 2 9' Jefferson County ,r,R = s S ,yo- II �� H e �County Info ��Departments arch , I Parcel Number: 968900020 SEARCH Parcel Number: 968900020 Printer Friendly Owner Mailing Address: PORT LUDLOW ASSOCIATES LLC 70 BREAKER LN PORT LUDLOW WA98365-9766 Site Address: Section: 17 School District: Chimacum (49) Qtr Section: NE1/4 Fire Dist: Port Ludlow (3) Township: 28N Tax Status: Taxable Range: 1E Tax Code: 0231 Planning area: Port Ludlow (7) Sewer: Drainage: PLDD - YES Bank: View 1: View 2: Zoning 1: Zoning 2: Zoning 3: Sub Division: 9689 - LUDLOW COVE DIVISION 2 Assessor's Land Use Code: 9100 - Vacant Land Property Description: LUDLOW COVE DIVISION 2 LOT 20 Sales, Photos, and Tax, A/V. No Permit Data Bldg Data Map Parcel No records Available returned. j � e Cpjt HOME I COUNTY INFO I DEPARTMENTS I SEARCH Best viewed with Microsoft Internet Explorer 6.0 or later Windows- Mac http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?value=968900020 6/30/2015 • • Jefferson County Permit Center 621 Sheridan Avenue Port Townsend, WA 98368 SEWER AVAILABILITY NOTIFICATION RE: Lot 20, Ludlow Cove 2 TPN 968900020 To Whom It May Concern: Olympic Water and Sewer, c. will i rovide urrentl i rovides domestic sewer service to one single family residence at the .ove refe ed lot. b/ /i5 LarryTS) . 11 Date President Olympic Water and Sewer, Inc. 70 Breaker Lane Port Ludlow, WA 98365 • • JEFFERSON COUNTY PERMIT CENTER 621 SHERIDAN ST. PORT TOWNSEND WA 98368 (360) 379-4450 WATER AVAILABILITY NOTIFICATION PUBLIC WATER SYSTEM TO: Jefferson County Environmental Health Department FROM: Water System Name OLYMPIC WATER& SEWER, INC. System Operator OLYMPIC WATER & SEWER, INC. State ID Number 68700L Total Connections for which system is approved 2,169 Number of service connections existing 1,543 Number of service connections committed 1,543 Date and results of most recent water bacteriological analysis June 2015 = SATISFACTORY OLYMPIC WATER AND SEWER, INC; water syst will provid / currently provides potable water service at the following location: Assessors Parcel ID 968900020 Legal Description Lot 20, Ludlow Cove 2 Site Address Operator Signature V �l "' 1,7 Date June 30, 2015 II �sOv �� DEPARTMENTOFC MMUNITY DEVELOPMENT � l Sheridan Street,Port Townsend, 98368 Te1:360.379.450Fax:360.379. 451 �E C E Q V E� I -< Web:www.co.jefferson.wa.us/communitydevelopment JN� E-mail:dcd@co.jefferson.wa.us 302015 s11i NO 0 1 SUPPLEMENTAL APPLICATION U'dDETERMINATION OF ADEQUATE POTABLE ,7'.._,A, FFERSONC0UNnLOPM "EPI.OF COMMUNITY DEVFrNT j Owner Name: Port Ludlow Associates Parcel No. 968900020 Q as Site Address: Lot 20, Ludlow Cove ro It Water Source Existing Proposed Attach Copies of: 1) Well Logs Private well (if no log report on file,a 1 hr stabilization test may be substituted.) 2) Lab analysis tested within 3 years of application. -Total Coliform, Nitrate-N,Chloride 2-Party Well Items above AND recorded Operations& Maintenance agreement and recorded Easement. Alternative Provide justification and design per Jefferson County System: Environmental Health policy 97-01 www.jeffe rsonco u ntyp u blichealt h.org/pdf/Pa licy_97-01_Ra i n water_Collection.pdf Valid Water Right Generally applies to springs,attach copy. Permit: Public Water: Name of Water Provider: Olympic Water&Sewer Inc -Submit Water Availability Notification form completed by your water purveyor. NOTE: If any of the above utilities need to be installed and disturbance will occur in a public maintained or unmaintained County road and/or Right-of-Way easement,then a Right-of-Way application will be needed. Resolution#99-90 requires building permit applications to provide evidence of an adequate potable water supply per the conditions of RCW 19.27.097 and the Guidelines for Determining Water Availability for New Buildings. 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 making any issued permit null and void. I further agree to that all activities I intend to undertake or complete associated with this application will be performed in compliance with all applicable federal,state and county laws and regulations and I 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 inspections. Applicant may request notice of the County's intent to enter upon the property for visits related to this application and subsequent permit issuance. Signature: /�Print Name: Cliff OBrien Date: `-P 3c7 '<---- FOR OFFICE USE ONLY 1) Water Right Permit 4* 3)Individual Well 2)Public Water Supply WS ID# Meets Water Quality Standards? Yes No In Compliance Yes No WRIA 17 Subbasin SIPZ -Coastal/Moderate/High Yes No Based upon information provided by the applicant,it appears that the potable water supply: Meets Conditionally Meets Does not Meet II • . 4.4oN coU DEPARTMENT OF COMMUNITY DEVELOP�1{ ,- 621 Sheridan Street Port Townsend WA 98368 -I, 621 Tel:360.379.4450 Fax:360.379.4451 '!�� ) JUN 0 ;01 i �v�5I ) Web:uulv.co.Jefferson.wa.us/communitydevelopment H i'' ' E-mail:dcdCa.co.jefferson.wa.us i JEFFERSO coy Y l`s/I1 N C)r D1-Pi OF COMML'nITY DBIEIOPPj ENT STORMWATER CALCULATION WORKSHEET MLA# 07-00593 PROJECT/APPLICANT NAME: Lot 20 Ludlow Cove/Port Ludlow Associates 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 '15 acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet 6706 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: 1786 Does the project convert 3/4 acres or more of Construction site for structures sq/ft native vegetation to lawn or landscaped areas? Drainfield, septic tank, etc. 0 sq/ft Circle: Yes No Well, utilities,etc. 0 sq/ft Does the project convert 2'/acres or more of native vegetation to pasture? Driveway, parking, roads, etc. 500 sq/ft Circle: Yes No Lawn, landscaping, etc. 4420 sq/ft Other compacted surface, etc. O sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance 6706 sq/ft Cut 0 Fill 0 (cu/yd) 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 calc worksheet—REV.10/20/2014 1 • • STORMWATER CALULATIONS—IMPERVIOUS SURFACE NEW EXISTING Structures (all roof area) 1786 sq/ft Structures (all roof area) sq/ft Sidewalks sq/ft Sidewalks 0 sq/ft Patios 0 sq/ft Patios 0 sq/ft Solid Decks 174 sq/ft Solid Decks 0 sq/ft (without infiltration below) (without infiltration below) Driveway, parking, roads, etc 0 sq/ft Driveway, parking, roads, etc sq/ft Other 0 sq/ft Other 0 sq/ft Total New 1960 sq/ft Total Existing 0 sq/ft TOTAL NEW+TOTAL EXISTING* 1960 sq/ft *This amount will be used 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: 29 Does the site have 35% or more of existing impervious surface? Circle: Yes I• I 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 Storm water 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. 6/30/15 (LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) FOR OFFICE USEONLY- SMALL MEDIUM LARGE REDEVELOPMENT Stormwater Site Plan: Yes No stormwater calc worksheet—REV.10/20/2014 2 • 441- Gray &r sborne, Inc. CONSULTING ENGINEERS E July 21, 2015 C ll v JUL 2 4 2015 lb Mr. David Wayne Johnson J 1 JEFFERSON COUNTY Planner Dm OF COMMUNITY DEVELOPMENT Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, Washington 98368 SUBJECT: SITE PLAN REVIEW, BUILDING PERMIT APPLICATION BLD15-00221, LOT 20, LUDLOW COVE II SUBDIVISION PORT LUDLOW DRAINAGE DISTRICT, JEFFERSON COUNTY, WASHINGTON G&O #14559.00 Dear Mr. Johnson: Thank you for the opportunity to review the Master Permit Application and Stormwater Calculation Worksheet for the proposed single-family residential structure on Lot 20 (Permit BLD15-00221) in the Ludlow Cove II Subdivision. We have the following comments regarding the information provided: 1. Stormwater Calculation Worksheet a. The table titled"Land Disturbing Activity, Conversion of Native Vegetation and Volume of Cut/Fill"requires correction. b. The "Construction site for structures"totals 1,929 square feet (House— 1,495 square feet, Garage—26 square feet, Covered Porch— 174 square feet). c. The amount of lawn/landscaping is 4,261 square feet. d. The table titled"Stormwater Calculations—Impervious Surface" requires corrections as shown on the attached Stormwater Calculation Worksheet. The total new plus total existing impervious surface is 2,145 square feet. 701 Dexter Avenue N. Suite 200 Seattle, Washington 98109 (206) 284-0860 Fax (206)283-3206 ! Printea on recpcletl paper • • Mr. David Wayne Johnson July 21, 2015 Page 2 e. The table titled "Development v. Redevelopment"requires correction. There is no existing impervious surface; therefore, the percentage of the parcel covered by impervious surface is 0. The site does not have more than 35 percent existing impervious surface. f. The project is New Development, not Redevelopment, since the existing amount of impervious surface is 0. The Figure 1 flow chart must be followed to determine the minimum requirements that should be applied to the project. According to Figure 1 (see attached)this project should be required to comply with Minimum Requirements#1 through#5 since the project will result in the installation of more than 2,000 square feet of new impervious hard surfaces. 2. Site Plan a. Minimum Requirement#2 requires Construction Stormwater Pollution Prevention(S WPP)measures. The site plan should indicate the nature and location of erosion control measures that will be employed to prevent discharge of sediment to the downstream storm collection system and Ludlow Bay. b. Minimum Requirement#5 requires On-Site Stormwater Management BMPs meeting the Low Impact Development BMPs included in List 1 (Ecology 2012 Manual, Volume I,page 2-30). The site plan must indicate how these requirements will be met. List#1 includes the use of full dispersion(BMP T5.30), full infiltration (BMP T5.10A), rain gardens, downspout dispersion systems, or perforated stub-out connections for management of roof runoff. The site plan indicates that stormwater collected in the footing drains and presumably the roof drains will discharge to dry wells for infiltration. For dry wells to function properly,they require the appropriate soils and a minimum of 1 foot of separation between the bottom of the dry well (minimum depth of the dry well is 4 feet) and the seasonal high groundwater level or impermeable soil layer. These conditions are most likely not available adjacent to Ludlow Bay; therefore,the proponent should propose, and provide a design for, an alternative approved method for on-site stormwater management. Printed on recycled paper ...- • • • 1 ��ft-`�N Coy DEPARTMENT OF COMMUNITY DEVELOPMENT - `' G21 Sheridan Street,Port.Townsend,W A 98368 ti) { ' Tea 36,t�'"94W Fax 363379.4451 j ttie1J w�iuc �c£t w u i 7 1 -sal:dCdf co f' o va.us I �f I4�R piJ lV�}��.1 . ' . YV;_ i'. ...,,.,....J 1 STORMWATER CALCULATION WORKSHEET MLA 1f 07-00593 PROJECT/APPLICANT NAME: Lot 20 Ludlow Cove/Port Ludlow Associates 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 '15 acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet 6706 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 f Calculate the total area to be cleared,graded,filled, Answer the following two questions related to 'Ic excavated,and/or compacted for proposed development conversion of native vegetation: cL'�� project. Include in this calculation the area to be cleared for: tIA`tv"r { Does the project convert'A acres or more of (fes' a (' Construction site for structure I 1 sq/ft native vegetation to lawn or landscaped areas? P ! Grainfield,septic tank,etc. sq/ft Circle: Yes . 1II 2 Well,utilities,etc. 0 sgHt Does the project convert 2'/2 acres or more of native vegetation to pasture? Driveway, parking, roads, etc. 500 sq/ft Circle: Yes Lawn,landscaping,etc. ' sq/ft GIO Other compacted surface,etc sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance 6706 sq/ft Cut 0 Fill 0 (cuiyd) 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. stun,water oak worksheet-REV.W/2012014 1 gewat. �et idbr �i --, �0 7--(i� r STORMWATER CALULATIONS—IMPERVIOUS SURFACE NEW 1y�{/ EXISTING Structures(all roof area) �" " //01 sglft Structures(all roof area) 0 sq/ft Sidewalks 0 sq/ft Sidewalks 0 sq/ft Patios fk I(a sq/ft Patios 0 sq/ft Solid Decks 0 sq/ft Solid Decks 0 sq/ft (without infiltration below) (without infiltration below) o^y� Driveway, parking, roads,et ' v�yf V 0 sq/ft Driveway,parking, roads, etc 0 sq/ft Other 0� p sq/ft Other 0 sq/ft Total New ,/ °21 J� ' sgfft Total Existing 0 sq/ft TOTAL NEW+TOTAL EXISTING'— "/ i/ �tt-sq/ft 'This amount will be used 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 to . e !sting it pervious surface above by the size of the parcel and convert to a percentage:X° % Does the site have 35%or more • 7 pervious surface? Circle: Yes X No fC// 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 I 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. �,,�'.—_ .-_ — _'" 6/30/15 (LANDOWNER OR AUYnORIZED RPRESENTATIVE SIGNATURE) (DATE) Fog Orcin USE ONLY 7,;;.,;i.}. SMALL MEDIUM _ LARGE__ REDEVELOPMENT Storrnwater Site Plan. Yes No „ siormwaim caiE worksheet—REV 10/20/2014 FIGURE 1 : NEW DEVELOPMENT Start Here i - Does the site have Yes See Redevelopment 35% or more of Minimum existing impervious Requirements and coverage? Flow Chart (Figure 2) I o Does the project convert% acres or more of native ----- vegetation to lawn or Does the project add No landscaped areas, or 5,000 square feet or convert 2.5 acres or more o more of new of native vegetation to impervious surfaces? pasture? Yes Yes No Does the project have • 2,000 square feet or "LARGE" PROJECT more of new,replaced, All Minimum Requirements or new plus replaced apply to the new impervious impervious surfaces? surfaces and converted pervious surfaces. 0 No • "MEDIUM" PROJECT Does the project have Minimum Requirements#1 land-disturbing through#5 apply to the new Yes activities of 7,000 and replaced impervious . square feet or more? surfaces and the land disturbed. No "SMALL" PROJECT See Minimum Requirement#2, Construction Stormwater Pollution Prevention Based on Fig.2.2 from 2001 Ecology Stormwater Management Manual for Western Washington