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BLD2015-00125 - 01 PERMIT APPLICATION
s°N co DEPARTMENT OF COMMUNITY DEVELOPMENT + 2� 621 Sheridan Street,Port Townsend,WA 98368 Tel:360.379.4450 Fax:360.379.4451 Web:\vww•.co.jefferson.wa.us/communitydevelopment E-mail_dcdico.jcffcrson.wa.us CERTIFICATE OF OCCUPANCY PERMIT#: BLD15-00125 APPLICANT: SHARON RADOR PHONE: 534 COOK AVE EXT PORT TOWNSEND WA 98368 970-903-3586 SITE ADDRESS: 534 COOK AVE EXT Issue Date: 04/24/2015 PORT TOWNSEND, 98368 Final Date: 5/22/2015 SUBDIVISION: 9990 -TIBBALS LAKE PARK Block: 76 Lot: 2-10+ PARCEL NUMBER: 999007603 Section: 4 Township: 30 N Range: 1W PROJECT DESCRIPTION: COMPLETING BUILDING PERMIT BLD00-00768- THIS PERMIT WAS CANCELED- NEVER RECEIVED FINAL- SHEETROCK & FINAL WERE ONLY ITEMS LEFT TO FINAL THE OLD PERMIT-A WOODSHED WAS BUILT WITH OUT A PERMIT— NEW PROPERTY OWNER- SUBMITTING BUILDING PERMIT TO FINAL OLD PERMIT AND ADD UNPERMIT WOODSHED TO PERMIT. THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2012 EDITION. OCCUPANCY GROUP: R-3 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM yes no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 5/22/2015 \\tidemark\data\forms\F_BLD_Occupancy.rpt 6/10/2015 • BUILDING PERMIT • Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD15-00125 Received Date: 4/14/2015 SITE ADDRESS: 534 COOK AVE EXT Issue Date 4/24/2015 PORT TOWNSEND, 98368 Expiration Date 4/24/2016 OWNER: SHARON RADOR PHONE: 970-903-3586 534 COOK AVE EXT PORT TOWNSEND WA 98368 9990 SUBDIVISION: Block: 76 Lot: 2-10+ PARCEL NUMBER: 999007603 Section: 4 Township: 30 N Range: 11/1 CONTRACTOR: PHONE: PHONE: PROJECT DESCRIPTION: COMPLETING BUILDING PERMIT BLD00-00768- THIS PERMIT WAS CANCELED- NEVER RECEIVED FINAL- SHEETROCK & FINAL WERE ONLY ITEMS LEFT TO FINAL THE OLD PERMIT- A WOODSHED WAS BUILT WITH OUT A PERMIT— NEW PROPERTY OWNER- SUBMITTING BUILDING PERMIT TO FINAL OLD PERMIT AND ADD UNPERMIT WOODSHED TO PERMIT. TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 932 VALUATION 170,956.00 ADD'L: 332 HEAT TYPE: EEE CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: 3 OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: 896 SHORELINE: CONST TYPE: SETBACK: DECK: 296 BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $762.00 SRE 04/14/15 154326 Exist: 0 Exist: 0 Plan Check $495.00 SRE 04/14/15 154326 Prop: 1 Prop: 1 State Building Code $4.50 SRE 04/14/15 154326 Total: 1 Total: 1 Total: $1,261.50 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 Division Permit Number: BLD15-00125 Applicant: RADOR BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2012 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 Framing for shed Miscellaneous sheet rock in house Miscellaneous Septic System Finaled 4/23/2015 sep99-334 A final inspection will not be scheduled until the following are completed and signed off by the applicable Department: • Building Permit Conditions are met • Septic Permit Final/Complete for any building containing plumbing • Land Use Conditions met and signed off • Public Works Permit Final(where applicable) FINAL INSPECTION FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR S CONDITIONS for Building Permit# :BLD15-00125 1.) DWJ 2.) The project shall adhere to the Best Management Practices (BMPs)to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 3.) The site plan as submitted with the Building Permit application on April 14, 2015 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 April 16, 2015 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 4.) No plumbing has been reviewed or approved for this project by Jefferson County Public Health. Additional requirements may apply if plumbing is proposed. \\tidemark\data\forms\F_BLD_Permit_Bidg.rpt 4/24/2015 • • • March 30, 2015 Sharon Rader 6 -2 O q d 3 E 5 jo 534 Cook Ave Ext. Port Townsend, WA 98368 DECEINE Jefferson County Department of Community Development 621 Sheridan St. I MAR 0 2015 Itj Port Townsend, WA 98368 1-1) Ellis JEFFERSON COUNTY Attn: Sally i__ [ PT DEVELOPMENT Dear Sally, The purchase for 534 Cook Ave Ext. (999-007-603)closed today, and I am now the owner of the property. Thank you for your helpful advice and support throughout this difficult process. As you will recall,the property includes a single family residence that had been occupied for a number of years by the owner/builder, Neil Cavette. Despite numerous efforts and accommodations by your department, Neil never scheduled a final inspection.The last communication with him indicated the outstanding fees were$228. I have spoken to Neil and learned that he had a series of challenges, including health problems. In Nov. 2014,the property reverted to the bank. I know that the primary concern that Jefferson County has is that the home is safe and in compliance with reasonable building standards. I would like to propose the following solution to bring this matter to a speedy conclusion. I propose that I bring the previous application (BLD00-00768)to completion. I understand that would be unusual, since the last contact you had with the previous owner was in 2013. However, I believe it is in the best interest of the county to help me resolve this issue as quickly and painlessly as possible. I respectfully request that the DCD consider the following: • The previous building permit shows that all stages of the inspections were approved and completed, with the exception of the Sheetrock and Final Approval. • The electrical permit was approved and remains on file. • The septic design and permit was approved and remains on file with Environmental Health. • The Critical Area Standard Waiver was approved and is still on file. • The easement providing legal access to all parts of the septic system is on file. • The structure shows no signs of inadequate building standards or materials. • The builder is well-known and well-respected in the area, having completed at least 50+ high quality homes. • The buyer's inspection identified no serious deficiencies. (Completed 2-28-15).Attached. • The appraisal also identified no deficiencies. (Completed 3-19-15)Attached. • I have engaged an engineer, Michael Anderson,who is very familiar with the home and the builder and has agreed to certify the soundness of the plan, construction and materials. i„1,k - n 'mr, I am proposing the following to complete this process: 1. I will pay the amount the DCD indicated would be required of the previous owner to complete the process; $228. I am also willing to pay a reasonable amount to cover the costs for transferring the permit and documentation to me. 2. I will obtain certification on the building plan and structure, and any other required documentation, from my engineer, Michael Anderson. 3. I will schedule the final inspection as soon as possible. 4. Although the building code states that a Certificate of Occupancy for a single-family residence is optional, I intend to respect the DCD process, and refrain from occupying the home until the final inspection is complete,assuming your staff is working in good faith to assist me in resolving this matter in a timely and reasonable fashion. It is my hope to complete this process within 2-3 weeks. The DCD staff has already done quite a bit of work to piece together the case information. Given my full commitment to bring this situation to a legal and rational close, I believe this is a realistic time frame. With sincere regard, Sharon Rader 970-903-3586 • gcuker 53v Coo- '- rove a7c-f- :! , . . d . 11 ... -4,!,4.'?. '' 4:7'.- ,.' 4 p II • ' tot,:' '.eNtl .,,' .' :' ',,''141:1 ::'.1,-• ;,'.-." ' '. : ' ; ..'' .' : : . '',.-.' I; . . . .. b' ■ ..,,, .... . .%:! ..-,1 ',..',.'''. ', .' 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Base $ 1524.00 PlanCheck$ 990.60 Consistency Review$234.00 Septic E/H $129.00 E/H Water$170.00 Scanning $ 19.50 State Surcharge$4.50 Total cost of fees $ 3071.60 Per Carl Smith- reduce Building Base and Plan check by 50% and no penalties fee to new owner BLD Base $762.00 Plan Check $495.00 Consistency Review$234.00 Septic Review$ 129.00 Scanning $ 19.50 State $4.50 Total cost of fee's $1644.00 To submit a building permit- you will need a letter from an Engineer stating the 15x8 wood shed is build sound- listing the details of the shed such as details of insulation- framing- materials etc of this shed. Also you will need a new revised floor plan showing the shed on this floor plan. We will also need a new site plan showing all of the requirements listed on the "Checklist for Site plans". i5 x 8 = 5%Ff `from ft-) i r)o.LQ w/ Ocris - - -1r- Plan 13 i!►SPCA-tan - frCtil Mfen'als used ( del i 1-i mss_ ►w - ©n_ of; P)ctvt_S -- C Ecilp + 2-0 ItplLo set) OR x 2 s`4° 3c)2_. 4-0 Name q32 +352 = 12L II I 3c° = l`t0_r_3-59 jarc9, = 2_96x ° _ - At" BkSt .__ 1 52y ' U9 _ Dl ► ✓ G9n b _ zvN f coNV eE = 2-34 Lx) E,/ t. Jcain � 14 `c0 Sic -e 4 • Sc7 BAs Cot' ° S6 Nn I Lt45 •oa 5t '` Cam} 12.9 ' E/ 14 WATT 170 •v° c:r,ni 1Gt 'sa 16P-1 . 0c er _ k e ► � 66 56% Pig / d with a Oe1 Page 2 of 3 No Images Case Number SOM99 00334 III Description Last Name / CAVETTE JR Received Date 12/12/2006 /� SOM99-00334 (If document is unavailable please contact the "��� LaserFiche Links applicable department to view the file.) No Images 91 O �S 1" Case Number • BLDQO-00768 \nG Description ' SINGLE FAMILY RESIDENCE W/ ATTACHED GARAGE - PERMIT CANCELLED DUE TO NON-PYMNT UNDER AMNESTY FROG Last Name CAVETTE JR Received Date 11/29/2000 4:38:04 PM LaserFiche Links BLDOO-00768 (If document is unavailable please contact the applicable department to view the file.) No Images Case Number • CAR00-00513 Description SFR with Attached Garage A•) Last Name CAVETTE Received Date 11/29/2000 10:16:36 AM d LaserFiche Links CAR00-00513 (If document is unavailable please contact the applicable department to view the file.) Images Case Number BLD00-00558 Description MANUFACTURED HOME INSTALLATION Last Name CAVETTE Received Date • 8/25/2000 LaserFiche Links BLD00-00558 (If document is unavailable please contact the applicable department to view the file.) No Images Case Number 'CAR00-00384 Description manufactured home installation L ast Name CAVETTE SA6(P Received Date 8/25/2000 CAR00-00384 (If document is unavailable please contact the LaserFiche Links applicable department to view the file.) No Images Case Number BLD00-00446 Description GARAGE/SHOP BUILDING Last Name CAVETTE Sally Ellis From: Jodi Adams Sent: Thursday, April 02, 2015 2:09 PM To: Sally Ellis Subject: FW: Penalties on bldg permits Jodi Adams Office Coordinator- DCD Phone 360-379-4494 All e-mail sent to this address has been received by the Jefferson County e-mail system and is therefore subject to the Public Records Act,a state law found at RCW 42.56. Under the Public Records law the County must release this e-mail and its contents to any person who asks to obtain a copy(or for inspection) of this e-mail unless it is also exempt from production to the requester according to state law, including RCW 42.56 and other state laws. From: Carl Smith Sent:Thursday,April 02, 2015 10:35 AM To:Jodi Adams Subject: RE: Penalties on bldg permits I authorized Sally to charge 50%of the normal permit fee for the new permit for the house. Sally can waive the penalty fee, because the new owner was not responsible for the unpermitted addition. • From:Jodi Adams Sent:Thursday, April 02, 2015 10:20 AM To: Elizabeth Williams; Sally Ellis; Carl Smith Subject: Penalties on bldg permits In lieu of a meeting I thought I'd e-mail out about the penalty policy and see what everybody feels regarding this. I know a lot of customers have been coming in trying to bring their unpermitted structures up to code. We have a penalty process that seems to be working well when this happens. My question is regarding unpermitted structures when it's a new home owner. Sally brought me a new one,for an amnesty permit—on Cook Ext. —and asked me to verify her calculations to be sure she was doing her penalty percentages correctly. This is a cancelled amnesty permit that had all but a couple inspections done. We are making her apply for a brand new permit, as she should, since the previous one has been cancelled. She bought the home knowing the permit had been cancelled so a new permit is not a surprise to her. My question is on whether or not we should charge the new home owner a penalty fee for something the previous owner did wrong? Most of these new home owners are willingly coming in and trying to correct a problem and I'd hate to penalize them for doing that. In this particular case the new homeowner doesn't even need to permit the house, she had no problems with the mortgage company like some do, she is doing this on her own. It seems having her pay full price on a new permit for a building that has already been reviewed and permitted and had all the inspections done would be penalty enough. If this were the previous owner I can definitely see penalizing them. I'm afraid we will be deterring people from doing the right thing when they purchase a house if we implement penalties for something the previous owner did wrong. 1 This is just a thought I'd like to put out there and see how everybody else feels about this? Jodi Adams Office Coordinator Jefferson County Department of Community Development 621 Sheridan Street Port Townsend,WA 98368 Phone 360-379-4494 Fax 360-379-4451 jadams @co.jefferson.wa.us All e-mail sent to this address has been received by the Jefferson County e-mail system and is therefore subject to the Public Records Act,a state law found at RCW 42.56.Under the Public Records law the County must release this e-mail and its contents to any person who asks to obtain a copy(or for inspection) of this e-mail unless it is also exempt from production to the requester according to state law,including RCW 42.56 and other state laws. 2 • Up Front Parcel Reviewer 3( c(14--- Parcel 999007603 Printed: April 15, 2015 FEDERAL HOME LOAN MORTGAGE Site Address(es): C/O BANK OF AMERICA 534 COOK AVE EXT PORT TOWNSEND, WA 98368 2001 NE 46TH ST KANSAS CITY, MO 64116-2051 Parcel Number: 999007603 S-T-R: 4-30N-1W TotalAcreag,(l J Legal Description TIBBALS LAKE PARK BLK 76 TAX 91 BND TGTH THRU Land Use: - 1100 BLA#112160 Flood District: Fire District: 1 Planning Area: 2 Flood Map(FIRM)Panel No: School District 50 Zoning: t_.-0 COMP PLAN DESIGNATION: COMMUNITY PLAN: UGA: UGA Trans [fir Plot plan states "property line" [ t/4' Assessor's Map (Property lines on submitted plot plan must match the property lines as identified on the Assessor's 1/4 map) [ t/r Legal Access to Property YES NO [ V]' Parcel Tags or Scanned Documents YES NO [ V1 ESA's: Special Reports Nearby YES NO [ Designated Ag YES NO [ L Shoreline Designation: YES NO [ Shoreline Slope Stability: YE 0 Stream Type:YES NO - Q ��✓�-�t�'��1 FWHCA: YES NO We [at Wetlands: YES NO �Nt (\ r _ Rare Plants:YES NO �� Seismic: YES NO " p • e Landslide: YES NO Flood: YES NO 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 submitted: YesNo [ Forest Lands: YES 0 Adjoining Forest Lands: Commercial/ Rural/ Inholding [ r/ Mineral Lands: YES [ ,4 Agricultural Lands: YES It.,44 [ Ler Archaeology: YES NO [ Lk' No Shooting Zone: S Flo !� Tidal) � 7� [ jtormwater: New Impervious Surface L lb Land Disturbing Activity -7` 7-0 E$A's Stormwater Req's:Min Req#2 Min R-q.#1 thru#5 Min Req#1 thru#10' Engineering [:/jam Notice Provisions/Disclosure: •'port YES NO MRL YES NO Forest Lands YES NO [vi Landscaping Required: Yes No [ f Parking Spaces Re wired NO Other I V Building Height: 35 UBC Standard [ (' Impervious Surface coveww percentage: Resource Lands& Public: yr Rural Residentia 25°/ Rural dal: Per UDC Sec 6.7 Rural Commercial: 60% Area of Building ov age:60%in Rural Industrial Lands only [ 1I Total Building (s) Size: RVC: 20,000 SF CC: 5,000 SF NC: 7,500 SF GC: 00 SF All others:subject to se tic&water constraints/Noneified [ Cj- Setbacks: Front: Z-0 Left Side: 5 Right Side: Rear: Shoreline Setback: LSHA Setback: [ yr Road Classification:___ Road ApproaclEx1STIN T REQ'D RAP [ t]' SEPA Required: YES EXEMPT) [ 14' Flood Certificate: [ 1)-- Existing Case(s) & Condition(s): Violations: Yes No [yr' Recorded Date of Subdivision: AFN Over 5yrs=UDC Plat Conditions: <5yrs=Plat Conditions on plat or Old Ordinance [ Lots/Require Declaration of Restrictive Covenant YES submitted: YES NO [ UGA No Protest Agreement YES 10Dsubmitted: YES NO [ i;1- Site Visit conducted YES C '"O [ fr Require Final Zoning Approval ?ES IO [ ADM1N: Setbacks entered in Permit Plan case N/A ` YES New Parcel Tags entered i mit Plan N/ YES Special Reports Scanne N/ YES No parcel tags found for parcel Cases Associated with APN 999007603 Review Cases Name Type Status Planner SEP08-00216 HENDRICKS & QUERRY TRUST F Application Received: 10/15/2008 Permit Issued/Case closed: 11/26/2008 Case Finaled: 9/17/2009 Has small drainfield protective easement on 999007603 BLD00-00558 CAVETTE C Application Received: 8/25/2000 Permit Issued/Case closed: Case Finaled: MANUFACTURED HOME INSTALLATION BLD00-00768 CAVETTE JR C Application Received: 11/29/2000 Permit Issued/Case closed: 12/12/2000 Case Finaled: SINGLE FAMILY RESIUENCL W/ATTACHED GARAGE - PERMIT CANCELLED DUE TO NON-PYMNT UNDER AMNESTY PROG CAR00-00384 CAVETTE F Application Received: 8/25/2000 Permit Issued/Case closed: 8/29/2000 Case Finaled: 8/29/2000 manufactured home installation CAR00-00513 CAVETTE F Application Received: 11/29/2000 Permit Issued/Case closed: 12/12/2000 Case Finaled: 12/12/2000 SFR with Attached Garage BLD15-00125 RADOR I P David Wayne Johnson Application Received: 4/14/2015 Permit Issued/Case closed: Case Finaled: COMPLETELY BUILDING PERM! I BLD00-00768- THIS PERMIT WAS CANCELED- NEVER RECEIVED FINAL- SHEETROCK& FINAL WERE ONLY ITEMS LEFT TO FINAL THE OLD PERMIT-A WOODSHED WAS BUILT WITH OUT A PERMIT— NEW PROPERTY OWNER- SUBMITTING BUILDING PERMIT TO FINAL OLD PERMIT AND ADD UNPERMIT WOODSHED TO PERMIT. CAM15-00096 RADER NA M Joel Peterson Application Received: 2/25/2015 Permit Issued/Case closed: 2/25/2015 Case Finaled: Purchase of house with cancelled permits. • M LA08-00428 SUB08-00031 MLA08-00428 CAVETTE JR I F Michelle Farfan Application Received: 10/2/2008 Permit Issued/Case closed: 11/14/2008 Case Finaled: 11/20/2008 Boundary Line Adjustment M LA12-00070 11 tidemark\data\forms\R_Parcel_CRMLA.rpt 4/15/2015 Paste 2 of 3 SUB12-00005 MLA12-00070 CAVETTE JR +� I W Colleen Zmolek Application Received: 4/2/2012 ermit Issued/Case closed: 6/20/2012 ase Finaled: BOUNDARY LINE ADJUSTMENT OTH98-00051 CAVETTE P Application Received: 12/31/1998 Permit Issued/Case closed: Case Finaled: SEP99-00334 CAVETTE F Application Received: 12/17/1999 Permit Issued/Case closed: 1/14/2000 Case Finaled: 12/12/2006 This system now has its sandtllter on 999007602, part of SUB08-31 SEP12-00059 CAVETTE JR C Application Received: 6/4/2012 Permit Issued/Case closed: 6/15/2012 Case Finaled: Cancelled & Now filed w/ SLI'99-334 BLD00-00446 CAVETTE C Application Received: 7/7/2000 Permit Issued/Case closed: Case Finaled: GARAGE/SHOP BUILDING CAR99-00517 CAVETTE F Application Received: 12/22/1999 Permit Issued/Case closed: 12/22/1999 Case Finaled: 1/14/2002 SOM99-00334 CAVETTE JR RCD Application Received: 12/12/2006 Permit Issued/Case closed: 2/25/2015 Case Finaled: \\tidemark\data\forms\R_Parcel_CRMtA.rpt 4/15/2015 Page 3 of 3 • • March 30,2015 a t Sharon Rader ; .'.� 1\k-, 3 n1°5 534 Cook Ave Ext. Port Townsend, WA 98368 Jefferson County —} Department of Community Development 621 Sheridan St. :f I Port Townsend, WA 98368 ,} Attn: Sally Ellis '11) Dear Sally, The purchase for 534 Cook Ave Ext. (999-007-603) closed today, and I am now the owner of the property.Thank you for your helpful advice and support throughout this difficult process. As you will recall,the property includes a single family residence that had been occupied for a number of years by the owner/builder, Neil Cavette. Despite numerous efforts and accommodations by your department, Neil never scheduled a final inspection.The last communication with him indicated the outstanding fees were$228. I have spoken to Neil and learned that he had a series of challenges, including health problems. In Nov. 2014,the property reverted to the bank. I know that the primary concern that Jefferson County has is that the home is safe and in compliance with reasonable building standards. I would like to propose the following solution to bring this matter to a speedy conclusion. I propose that I bring the previous application (BLD00-00768)to completion. I understand that would be unusual, since the last contact you had with the previous owner was in 2013. However, I believe it is in the best interest of the county to help me resolve this issue as quickly and painlessly as possible. I respectfully request that the DCD consider the following: • The previous building permit shows that all stages of the inspections were approved and completed,with the exception of the Sheetrock and Final Approval. • The electrical permit was approved and remains on file. • The septic design and permit was approved and remains on file with Environmental Health. • The Critical Area Standard Waiver was approved and is still on file. • The easement providing legal access to all parts of the septic system is on file. • The structure shows no signs of inadequate building standards or materials. • The builder is well-known and well-respected in the area, having completed at least 50+ high quality homes. • The buyer's inspection identified no serious deficiencies. (Completed 2-28-15). Attached. • The appraisal also identified no deficiencies. (Completed 3-19-15)Attached. • I have engaged an engineer, Michael Anderson, who is very familiar with the home and the builder and has agreed to certify the soundness of the plan, construction and materials. • I am proposing the following to complete this process: 1. I will pay the amount the DCD indicated would be required of the previous owner to complete the process; $228. I am also willing to pay a reasonable amount to cover the costs for transferring the permit and documentation to me. 2. I will obtain certification on the building plan and structure, and any other required documentation, from my engineer, Michael Anderson. 3. I will schedule the final inspection as soon as possible. 4. Although the building code states that a Certificate of Occupancy for a single-family residence is optional, I intend to respect the DCD process, and refrain from occupying the home until the final inspection is complete, assuming your staff is working in good faith to assist me in resolving this matter in a timely and reasonable fashion. It is my hope to complete this process within 2-3 weeks. The DCD staff has already done quite a bit of work to piece together the case information. Given my full commitment to bring this situation to a legal and rational close, I believe this is a realistic time frame. With sincere regard, Sharon Rader 970-903-3586 „any UI1lTl- IS!pp . ,•. : .... , -' ---, I %.-‘11CiPer•fi.- ! ../K.--r • . , „... .,.. , ',-°.•' ',.-.1 t., 7 -"-----.•'- ' ;•••' . ,_ , .....„ .. , . .. . . .„, ,'4• •e ' ' -' 0 . • i . Er .:1--.'.,,):1;. '' ,'. ' . ' A 1. , I' r '•'. '.'' -; •• '''. W., ' ' ,' 71 f'.1-.....F , , ,,„ -,... 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I i'l ,...-..„. ,-, , .... ........ . ..... , „, ,,,. , 0R BUILDING PERMIT APPLICATION B Reeview view 0 Typpe:e: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD15-00125 Received Date: 4/14/2015 SITE ADDRESS: 534 COOK AVE EXT PORT TOWNSEND, 98368 OWNER: SHARON RADOR PHONE: 970-903-3586 534 COOK AVE EXT PORT TOWNSEND WA 98368 9990 SUBDIVISION: Block: 76 Lot: 2-10+ PARCEL NUMBER: 999007603 Section: 4 Township: 30 N Range: 1V1 CONTRACTOR: PHONE: PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP COMPLETELY BUILDING PERMIT BLD00-00768- THIS PERMIT WAS CANCELED- NEVER RECEIVED FINAL- SHEETROCK & FINAL WERE ONLY ITEMS LEFT TO FINAL THE OLD PERMIT- A WOODSHED WAS BUILT WITH OUT A PERMIT— NEW PROPERTY OWNER- SUBMITTING BUILDING PERMIT TO FINAL OLD PERMIT AND ADD UNPERMIT WOODSHED TO PERMIT. TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 932 VALUATION 170,956.00 ADD'L: 332 HEAT TYPE: EEE CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: 3 OCCUPANCY: OTHER: CONST TYPE: SHORELINE: CONST TYPE: �ECRAKGE' 296 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 1 Prop: 1 Total: 1 Total: 1 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $762.00 SRE 04/14/15 154326 Plan Check $495.00 SRE 04/14/15 154326 State Building Code $4.50 SRE 04/14/15 154326 Total: $1,261.50 1l tidemark 1data\forms\F_BLD_App_Bld.rpt 4/14/2015 • • w45°N cod DEPARTMENT OF COMMUNITY DEVELOPMENT W� 621 ',h i d:iu lacer.Port 1 'v—rr:d,W.%9S 16 Td:360.3-9.4450 ; Fax 360379.4451 Web:a-nw.eo.ieffer;omwa.usi corm unin-ticvelopmem LE n ■/j E w E-mail:dcd@.co.ieffersomwa.us -Is H1 �-co ��. � APR X15 i 3 �. j1 . PERMIT APPLICATION I I V I Li Steps in the Permit Process: Ji JOY -Review application checklist to ensure all information is completed prior to submitting applica CCOh4PiUNITYDEVEtOPMENT -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 t' Related Application#s: MLA# Site Information Assessor Tax Parcel Number: g g ct 00 7 Co 0 3 Site Address and/or Directions to Property: 5 3 4.4 0 ook, ,Au€ Access (name of street(s)) from which access will be gained: Cop\[ - 'e. E 1( - Present use of property: 5;Y\9\e .f e,ci 6,esiee Description of Work (include proposed uses): (.a re\ \p 4f j * ' fha 'PCoc. -�-b \DC v1 ex:s\,'rqq b„ r.�o iht� C l; kycs . N CanarnoteS 'to ?e o�JS\y c:csrr‘p■eA-e-rl sc`rsu c-ki Wastewater Sewage Disposal This property is served by Port Townsend of 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: _ f Q Septic Septic Permit#: `c Community Septic Name of System: EN-Na oh Case #: Pq q- 00 3' Are other residences connected to the septic system? Mil Additions or repairs to sewage system: N o Is it a complete or partial system installation: Complete ✓ Partial Has a reserve drainfield been designated? Yes ✓ No Date of Last Operations & Maintenance check: Or -q\e 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 Counn-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: �Niry '0r' 'R.a.4 e,∎c- Address: _5,3 y Cook. rove, tY+. 'Work- —C'o n Qx ) LAm- 98 3b5' .Phone#: _ °170 qo3 358(0 E-mail Address: Sh0.ron . re:16\elr' e. live . cool Please contact Authorized Agent/Representative with project info. (select only one). Property Owner Signature: pc�gJ.` Date: Note: For projects with multiple owners,attach a separate sheet with each owner(s)information and signatures. Applicant: Authorized Agent/Representative (If other than owner) Name: Address: Phone#: E-mail Address: Professional: Is this an Authorized Agent/Representative for this project? NO YES Engineer Architect Surveyor Contractor Consultant Name: er\cc))Ea_\ Pc r & eir S O n Address: 3 3 0 C le,re-1 O.AN ck. _c# -7 9 8 3 Co k Phone#: 36,0 — 5 2 k - 10 \\ E-mail Address: Professional: Is this an Authorized Agent/Representative for this project? NO Engineer rcc 11- Surveyor Contractor Consultant Name: I—a v C i e. V T-2.,t.w9 oor+ '% Os0`f e.*Des the r , Y►_ -\ & -ed-- Address: )(o.OL1 U racO i It ar. PT 4123 to g Phone#: 3(e O - 3 85 - J/y a E-mail Address: Professional: Is this an Authorized Agent/Representative for this project? _ NO CES' Engineer Architect Surveyor Contractor Consultant Name: -Tea K'[1a jss Address: e 0 f ox �q f c-4- -.)-c act l oc - Cam ' 41.2 3 35% Phone#: 3/00 3)q g 60 E-mail AddressTI. t Fer1Lata9fnl , C,pry‘ • Professional: Is this an Authorized Agent/Representative for this project? NO YES Engineer Architect Surveyor Contractor Consultant Name: Address: Phone#: E-mail Address: Attach additional pages if necessary 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 w I be assuming the responsibility of the General Contractor for the proposed project. Signatur : Print Name: S� y (`0 y- Re4a 1r- Date: j --'3 0 IS • • DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street.Port Townsend,WA 98368 Tel- 360.379 4450 Fax:360.3'9.445l -< Web:wv.rw.co.iefferson.wa.us:communin-development '1 \\9 E E-mail:dcd(dfco.jcfferson.'aa.us -C-7 skrNG�o� SUPPLEMENTAL APPLICATION' pH, 1 3 7(11 RESIDENTIAL OR COMMERCIAL BLDG PERMIT For Department Use Only Receipt#: Da r Related Application#s: Payment#: Site Information Owner Name: S 0.3rQ,n -Ck‘0.A. Assessor Tax Parcel #: 'j 9 9 - O07 - _ Type of Building New ikk;,941% uY Replacement Relocated Addition Repair Demolition `A separate permit is required Select One: Single Family Residence / Modular Other list Proposed Building/Project Number of floors 3 # new bedrooms existing / total bed # new bathrooms existing / total bath Heat Source Select all that apply: Electric ✓ Heating Oil Wood Propane Enter the square footage(sq/ft)that applies in each field: Structure Existing Sq/Ft Proposed Sq/Ft Residential/Commercial Main Floor 11)E}. Residential/Commercial Second Floor 33 a__ N 4 Additional Floors- heated/unheated Basement - unfinished Basement -finished space or habitable Detached Garage-heated/unheated Attached Garage-heated/unheated B `}(a N Ir Garage 2nd fl - unfinished storage Garage 2nd fl -finished space or habitable Carport- 2 walls or less l Deck-uncovered Covered porch a7_6 NA Other(shed, barn, pole bldg,etc.) Estimated Cost of Project (Required): $ NA- E c■t-k-mq <'iY`uCA-u re ©C7oJ�na) Co s-sr - It' SI • a, 4 �- • • • List existing buildings on property (i.e. house, garage, accessory dwelling unit, shed, barn, mobile home, other): All Existing Buildings on Property Use Prove S n`yIe -FRVniI r'e,s■cle.nc� 41-t-or-li,etk 0,-(' wra_o5e- 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 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 notice of the County's intent to enter upon the property for visits related to this application and subsequent permit issuance. Signature: � Print Name: C ,\/.-l04'6 1r\-14Ci tr.Date: 3 -3(a-15-- Estimated Cost of Project $ tJA' RYic51 9 c5'.-1-1eNv crUr� 6A Vl.O (1vIrtS es' For Department Use Only Building Base Fees Building Base Plan Check Review Land Use Review $234.00 Septic Review $86.00 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: ' • • ��orrco ( -rte ( f1 \\9f n 'w o. JEFFERSON COUNTY in, , 1 �\ 1- DEPARTMENT OF COMMUNITY DEVELOPMENT n,,,r &. /"` .. .. 621 Sheridan Street • Port Townsend • Washington 98368 I --_■ /s,hrIN6C O 360/379-4450 • 360/379-4451 Fax http://www.co,jefferson.wa.us/commdevelopment/ ,r'i r,Tn RENT Stormwater Calculation Worksheet MLA# __ PROJECT/APPLICANT NAME: Sh ace In "--R, 'a.cl, cx 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 I . 11 acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet 14 g 3 5'D. 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 , Q SO sq/ft native vegetation to lawn or landscaped areas? Drainfield, septic tank, etc. 9O0 sq/ft Circle: Yes No Well,utilities,etc. I O D () sq/ft Does the project convert 2%acres or more of native vegetation to pasture? Driveway, parking,roads, etc. 4 0 0 0 sq/ft Circle: Yes \_J Lawn, landscaping, etc. J sq/ft Other compacted surface, etc. 1- ,D 6 sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance P> 3 S6 sq/ft Cut � Fill 0 (cu/yd) Cx:S- i n5 Six iFvfe__ [over] ■-._,..a-..nn nn.n on, nonn•n ' • 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) sq/ft Structures(all roof area) /b 5 O sq/ft Sidewalks sq/ft Sidewalks 1 0 0 sq/ft Patios sq/ft Patios sq/ft Solid Decks sq/ft Solid Decks sq/ft (without infiltration below) (without infiltration below) Driveway, parking, roads,etc sq/ft Driveway, parking, roads, etc 40 0 0 sq/ft Other sq/ft Other 19 0 o sq/ft Total New sq/ft Total Existing 73 sq/ft TOTAL NEW+TOTAL EXISTING" 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: J5 % Does the site have 35%or more of existing impervious surface? Circle: Yes • 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. (LANDOWNER 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 9/972010 B LD 15-00125 BUILDING PERMIT APPLICATION Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD15-00125 Received Date: 4/14/2015 SITE ADDRESS: 534 COOK AVE EXT PORT TOWNSEND, 98368 OWNER: SHARON RADOR PHONE: 970-903-3586 534 COOK AVE EXT PORT TOWNSEND WA 98368 9990 SUBDIVISION: Block: 76 Lot: 2-10+ PARCEL NUMBER: 999007603 Section: 4 Township: 30 N Range: 1V1 CONTRACTOR: PHONE: PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION COMPLETELY BUILDING PERMIT BLD00-00768- THIS PERMIT WAS CANCELED- NEVER RECEIVED FINAL- SHEETROCK & FINAL WERE ONLY ITEMS LEFT TO FINAL THE OLD PERMIT- A WOODSHED WAS BUILT WITH OUT A PERMIT— NEW PROPERTY OWNER- SUBMITTING BUILDING PERMIT TO FINAL OLD PERMIT AND ADD UNPERMIT WOODSHED TO PERMIT. TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 932 VALUATION 170,956.00 ADD'L: 332 HEAT TYPE: EEE CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: 3 OCCUPANCY: OTHER: CONST TYPE: SHORELINE: CONST TYPE: GARAGE: 296 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 1 Prop: 1 Total: 1 Total: 1 Routing Date: Type Amount Paid By: Date: Receipt: �r � d/Date Permit $762.00 SRE 04/14/15 154326 iw� t Plan Check $495.00 SRE 04/14/15 154326 APR 2 4 2015 State Building Code $4.50 SRE 04/14/15 154326 Total: $1,261.50 Jefferson County DCC \\tidemark\data\forms\F_BLD_App_Bld.rpt 4/14/2015 • (? LDE•O 2- 4��5 0 N coy DEPARTMENT OF COMMUNITY DEVELOPMENT 4 '1, 621 Sheridan Street,Port Townsend,WA 98368 W Tel:360.379.4450 I Fax:360 379.4451 Web:www.co.jef fesson.wa.us/commnnutydevelopment E-mail:dcd :co.iefferson.wa.u, I' 9SNI NGfc9 � _ �' 0 ID;, PERMIT APPLICATION 1 � '; Oh 1 3 2015 iL Wn Steps in the Permit Process: I L Ls _—� -Review application checklist to ensure all information is completed prior to submitting application. lttl`{''( ''C;Oidli r''-"t 07 COMMUNITY DEVELOPMENT -Make sure septic has been applied for and water availability has been proven. -Make an appointment to meet with the Permit Technician by calling 360-379-4450. -This is not a standalone application;it must be accompanied by a project specific supplemental application. -Fees will be collected at intake. Additional fees may apply after review and payment is required before permit is issued. For Department Use Only Building Permit# Related Application#s: MLA# Site Information Assessor Tax Parcel Number: c( Q 9 0 0 7 G 0 3 Site Address and/or Directions to Property: Jr 3 '4 C ook i: v e tic-- _ Access (name of street(s)) from which access will be gained: C mp� A-ve. ay.-k- Present use of property: _ , at. r,P Description of Work(include proposed uses): (� e�„`•,k emu;Shy ? } PcOC e.s -'-p occdno\ ax.sk1'�nq ,:1d:'1tt.�O iv*o covrk 1CaYtco . No onarno5es -to X-ctovsky Q..a. vvcic-4-e-d s''cru -u re Wastewater-Sewage Disposal This property is served by Port Townsend of Port Ludlow sewer system? YES _ NO V — If not served by sewer identified above, identify type of septic system below: Type of Sewage System Serving Property: f c�Septic Septic Permit#: `Ct — 3-3 Li- Community Septic Name of System: G1e�n&o\n Case #: 3el /- MI 3 iy Are other residences connected to the septic system? N o Additions or repairs to sewage system: No 1 Mpe ion due 2/'2-$.11t, Is it a complete or partial system installation: Complete V Partial _ _ Has a reserve drainfield been designated? Yes No No Date of Last Operations& Maintenance check: Oh.i 1p 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: r o.,Con 'R 0.G` e_kr- Address: 5$ y Cook, ?Nye, t'-V: -Wo( r rt9 W Ins ovta,) WA- 9g36y Phone#: q-70 903 3 5 g! E-mail Address: Sharon . t'Qdel-`i 'ive . corn — _ Please contact Authorized Agent/Representative with project info. (select only one). Property Owner Signature: pc _ Date: Note: For projects with multiple owners,attach a separate sheet with each owner(s)information and signatures. Applicant: Authorized Agent/Representative(if other than owner) Name: Address: Phone#: E-mail Address: Professional: Is this an Authorized Agent/Representative for this project? NO _ YES' Architect p Surveyor Contractor Consultant Name: if�RcG c 11ec�� 'r cIA eirS 0 n Address: 3 3 0 Q.,te_)reA ow.dk .mss - T ' 1 $ 3 6 k Phone#: 3(. O — 5' — , Q \1 E-mail Address: Professional: Is this an Authorized Agent/Representative for this project? NO Engineer Architects ` Surveyor Contractor Consultant Name:' L a♦t ri e. S#-EkA?aX'+ 4- 04:rale.DeS i Pf j Molt' W(CW:4-ea-- Address: (aOLk U rha. ll a {�T `183 6 g Phone#: 3 In O - 3$5 - jig a E-mail Address: Professional: Is this an Authorized Agent/Representative for this project? NO CIE ) Engineer Architect Surveyor Contractort9('ll Consultant Name: Te K`c' o js ' y Address: Q 0 6 . • 14 r . _ 0 L of - U J Pr 15 2n Phone#: (d) 371 85 00 E-mail Address:, ,8� e ?ey,L0.090, . CO»^. • Professional: Is this an Authorized Agent/Representative for this project? NO YES Engineer Architect Surveyor Contractor Consultant Name: Address: • Phone#: E-mail Address: Attach additional pages if necessary 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 • I be assuming the responsibility of the General Contractor for the proposed project. Signatur • Print Name: ki-)art R et ex- Date: _?) -`- © ---- C� • • SON c DEPARTMENT OF COMMUNITY DEVELOPMENT �/ (� tt� Lt. 621 Sheridan Street,Port Townsend,WA 98368 ' \\'J Tel:360.379.4450 I Fax:360.3794451 j 0.0 Web:www.co.iefferson.wa.us/communitydevelopment E-mail:dcd(dtco.jefferson.wa.us • ' jR13 ,^rtl 5 �sHl N oho SUPPLEMENTAL APPLICATION 13 ti RESIDENTIAL OR COMMERCIAL BLDG PERMIT } r, wn oEVFIOPM,riT orr� For Department Use Only Receipt#: Date: Related Application#s: Payment#: Site Information Owner Name: S1nO`x—p,n �p�& Assessor Tax Parcel#: 99 9- 007 - 3 Type of Building New �c�.S'f, , Replacement Relocated Addition Repair Demolition Jy *A separate permit is required Select One: Single Family Residence ✓ Modular Other list Proposed Building/Project Number of floors 3 #new bedrooms existing / total bed #new bathrooms existing / total bath Heat Source Select all that apply: Electric / Heating Oil Wood Propane Enter the square footage(sq/ft)that applies in each field: Structure Existing Sq/Ft Proposed Sq/Ft Residential/Commercial Main Floor rV 4 Residential/Commercial Second Floor - 3 3 N �} Additional Floors-heated/unheated Basement-unfinished Basement-finished space or habitable Detached Garage- heated/unheated Attached Garage- heated/unheated $ 1(42 of �- Garage 2nd fl- unfinished storage Garage 2nd fl-finished space or habitable Carport-2 walls or less Deck uncovered Covered porch a `VG Aigy Other(shed, barn, pole bldg,etc.) Estimated Cost of Project (Required): $ NQ- Ext ‘,2q cS4-1-('uCi-vre (� �no. cep • 0 List existing buildings on property(i.e. house, garage, accessory dwelling unit, shed, barn, mobile home, other): All Existing Buildings on Property Use 170use s n` Ie_ -Fi..mcIx res∎dexic . 5h eA, 5 rot 2 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 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 notice of the County's intent to enter upon the property for visits related to this a plication and subsequent permit issuance. s� Signature: aiLA-- Print Name: C !'' lea h� Date: 3-30.--i5 Estimated Cost of Project $ l(fi�3 Str kl ( . no Gov tSeS For Department Use Only Building Base Fees Building Base C.Z- '0 Plan Check Review 2 99, • C3° Land Use Review $234.00 cte wor lc,al.ce - Septic Review I 2q •00 Potable Water ._ Technology/Scan $19.50 State Fee $4.50 Other Fees Shoreline Exemption Zoning Zoning Other New Address Road Approach Total Fees ` / ( LI4 - 06 Receipt # Date: Cash/Check/CC: • • SON (� 1' �`I �4i� ca�� JEFFERSON COUNTY L -� ,xi �., r3 DEPARTMENT OF COMMUNITY DEVELOPMENT ti � � APR 1S 9015 0 & , ate,$ 621 Sheridan Street • Port Townsend • Washington 98368 IA" OK.O 360/379-4450 • 360/379-4451 Fax )E�--- FEtt,p; r,,Ditty HIN http://www.co.jefferson.wa.us/commdevelopment/ � ?TOFCOMMDNITYDEUFLOPMEM Stormwater Calculation Worksheet MLA# PROJECT/APPLICANT NAME: Sh a ire In �o..d„[ 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 1 - I I acres An acre contains 43,560 square feet. Multiply the acreage by this figure. 'T Size of parcel in square feet 83 5 a 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 a/4 acres or more of Construction site for structures \ Q So sq/ft native vegetation to lawn or landscaped areas? Drainfield,septic tank, etc. 9 0o sq/ft Circle: Yes No Well,utilities,etc. I (9 OD sq/ft Does the project convert 2'/2 acres or more of native vegetation to pasture? Driveway, parking,roads, etc. 0 O 0 sq/ft Circle: Yes Lawn, landscaping, etc. sq/ft Other compacted surface, etc. 440 b sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance d sq/ft Cut ® Fill O (cu/yd) EX.:s-t-t n c, s-1r uc-A-ure_ [over] ,! Stormwater talc worksheet Rev 9-9-2010-REV.9/92010 1 • 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) sq/ft Structures(all roof area) lb 5 O sq/ft Sidewalks sq/ft Sidewalks Y d 0 sq/ft Patios sq/ft Patios sq/ft Solid Decks sq/ft Solid Decks sq/ft (without infiltration below) (without infiltration below) Driveway, parking, roads,etc sq/ft Driveway, parking, roads,etc 46 00 sq/ft Other sq/ft Other / 9 c 0 sq/ft Total New sq/ft Total Existing 73 5 'D sq/ft TOTAL NEW+ TOTAL EXISTING* 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: 155 Does the site have 35%or more of existing impervious surface? Circle: Yes CP 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. (LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) FOR OFFICE USE ONLY SMALL___ MEDIUM LARGE REDEVELOPMENT Stormwater Site Plan: Yes No stormwater cal°worksheet Rev 9-9-2010—REV 9/9/2010 • • �k�� °N COGS JEFFERSON COUNTY I I� �c 1s M•Tzl T." +-; DEPARTMENT OF COMMUNITY DEVELOPMENT i '� f-' j pt-:.,,t7.-x...52', . 621 Sheridan Street • Port Townsend • Washington 98368 I Hr I`` 1 3 ; . ,,, O 360/379-4450 • 360/379-4451 Fax i �I l L)� 1`�HINO< http://www.co.jefferson.wa.us/commdevelopmenU 1 --t 1 -.Li:;, , C.diJ re C. COM1^.iUNITYDEVELOPMENT Stormwater Calculation Worksheet C MLA# PROJECT/APPLICANT NAME'. Sh ire)e) n ct.do( 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 I . I 1 acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet if 8 3 5 a 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 `\ CI SO sq/ft native vegetation to lawn or landscaped areas? Drainfeld,septic tank, etc. 1©O sq/ft Circle: Yes No Well,utilities,etc. I Q C) t) _______ sq/ft Does the project convert 2%acres or more of native vegetation to pasture? Driveway, parking,roads, etc. 4 0 O sq/ft Circle: Yes N Lawn, landscaping, etc. _ sq/ft Other compacted surface, etc. 410 6 sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance "2 3 S6 sq/ft Cut ( Fill d (cu/yd) 0")‹. S-\--1'n) SItUC-Iufia_. lover] • • Impervious surface is a hard surface that either prevents or retards the entry of water into the soil mantle as ulhder 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) sq/fl Structures(all roof area) /b 5 O sq/ft Sidewalks sq/ft Sidewalks 'Y a 0 sq/ft Patios sq/ft Patios sq/ft Solid Decks sq/ft Solid Decks sq/ft (without infiltration below) (without infiltration below) Driveway, parking, roads, etc sq/ft Driveway, parking, roads, etc 1 O 0 0 sq/ft Other sq/ft Other / g O O sq/ft Total New _sq/ft Total Existing 73 5 '0 sq/ft TOTAL NEW+TOTAL EXISTING* 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: 1 Does the site have 35%or more of existing impervious surface? Circle: Yes • 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 applicanUowner 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. (LANDOWNER 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