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HomeMy WebLinkAboutBLD2000-00129i BUILDING PERMIT APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00129 Received Date: 2/23/2000 SITE ADDRESS: KEEFE LN 4t 1.3 PORT LUDLOW, 98365 APPLICANT: GEORGE JOHNSON PHONE: (360)437-9324 JACKIE JOHNSON SUBDIVISION: PORT LUDLOW NO 2 AREA 3 Block: Lot: PARCEL NUMBER: 990600378 Section: 9 Township: 28 N Range: 01 E CONTRACTOR: EDGEWATER HOMES INC PHONE: 437-2660 53 JACKSON LN PORT LUDLOW WA 98365 Contractor's License EDGEWHI066BL Expires 01/04/2000--'?' ARCHITECT/ ENGINEER : PROJECT DESCRIPTION: SINGLE FAMILY RESIDENCE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,892 VALUATION 139,497.00 ADD'L: HEAT TYPE: OIL CODE EDITION: 1997 HEAT BASE: 461 HEAT TYPE: OCCUPANCY: R-3 UNHEATED: 211 #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: 480 SHORELINE: CONST TYPE: DECK: 320 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: SEW WATER SYSTEM: LUDLOW STORMWATER: YES NO AREA BEDROOMS: BATHROOMS: Wetland Erosion Exist: Exist: Seismic Streams Prop: 2 Prop: 2 Flooding Landslide Total: 2 Total: 2 F&W Plat Conditions Routing Date: Shoreline Aquifer Forest: Commercial Rural Proximity Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,217.75 MAM 02/23/00 25282 APPROVED Plan Check $365.33 MAM 02/23/00 25282 State Building Code $4.50 MAM 02/23/00 25282 AR 1 52000 ` Potable Water Application $30.00 MAM 02/23/00 25282 Total: $1,617.58 Jefferson County Pianning C.L i',!iinc Department I:\F_BLD_App_Bld.rpt 10/29/99 I , % = BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 (800) 831-2678 PERMIT #: BLD00-00129 Received Date 02/23/2000 SITE ADDRESS: 63 KEEFE LN Issue Date 03/15/2000 PORT LUDLOW, 98365 Expiration Date 03/15/2001 APPLICANT: GEORGE JOHNSON PHONE: (360)437-9324 JACKIE JOHNSON SUBDIVISION: PORT LUDLOW NO. 2 Block: Lot: 78 PARCEL NUMBER: 990600378 Section: 09 Township: 28 N Range: 01 E CONTRACTOR: EDGEWATER HOMES INC PHONE: 437-2660 53 JACKSON LN PORT LUDLOW WA 98365 Contractor's License: EDGEWHI066BL Expires: 01/04/2001 LOAN LENDER/ WASHINGTON MUTUAL BOND HOLDER: PROJECT DESCRIPTION SINGLE FAMILY RESIDENCE REQUIRED INSPECTIONS: [-]— ootin s/Setbacks,(Shoreline Setbacks): \ LO-3,, n t, -7 ilp , C-----V---A--.- \\) [ ] Foundation: ' C -. L\_.L'?- Undergroundr [ ] Plumbing�Underground Insulations�cc�(-r /,w�" G�� -�� cs 5 ,� 0 V'� [ ] Shear Wall: [/J Framing/Plumbing: a /s/- c ,..,D; [ ] Propan Tank/Lines:? r W&.. -rt a0 All a" [11 Insulation: It' �� 1 0 c �� . -a [�eetrock: ,/I/� W. 2 up-c) [L]-� •anc A e: :.. : MP/ /r V „ . _' , r HEALTH DEPARTMENT APPROVAL REe UIRED PRIOR TO FINAL INSPEC ON. THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. Inspector's Phone Hours 8:00 a.m. - 9:00 a.m. Illik SPECIAL CONDITIONS MAY APPLY - SEE REVERSE HOT LINE AVAILABLE 24 HOURS A DAY . BUILDING PERMIT APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00129 Received Date: 2/23/2000 SITE ADDRESS: KEEFE LN PORT LUDLOW, 98365 APPLICANT: GEORGE JOHNSON PHONE: (360)437-9324 JACKIE JOHNSON SUBDIVISION: PORT LUDLOW NO 2 AREA 3 Block: Lot: PARCEL NUMBER: 990600378 Section: 9 Township: 28 N Range: 01 E CONTRACTOR: EDGEWATER HOMES INC PHONE: 437-2660 53 JACKSON LN PORT LUDLOW WA 98365 Contractor's License EDGEWHI066BL Expires 01/04/2000 ARCHITECT/ ENGINEER : PROJECT DESCRIPTION: SINGLE FAMILY RESIDENCE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,892 VALUATION 139,497.00 ADD'L: HEAT TYPE: OIL CODE EDITION: 1997 HEAT BASE: 461 HEAT TYPE: OCCUPANCY: R-3 OCCUPANCY: UNHEATED: 211 #OF STORIES: CONST TYPE: 5N OTHER: SHORELINE: CONST TYPE: GARAGE: 480 SETBACK: DECK: 320 BANK HEIGHT: • SEWAGE DISPOSAL: SEW 01 Pa_, -7 WATER SYSTEM: LUDLOW STORMWATER: YES NO AREA BEDROOMS: BATHROOMS: Wetland U Erosion Exist: Exist: Seismic Streams Prop: 2 Prop: 2 Flooding Landslide iJ tl Total: 2 Total: 2 F&W ' 0 Plat Conditions ikike.cAtA,' Shoreline k) it Aquifer ' !°f Routing Date: --a1 Forest: Commercial I11Pr- Rural Proximity — Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,217.75 MAM 02/23/00 25282 elenniVaterp+; e , Plan Check $365.33 MAM 02/23/00 25282 altillavd CO State Building Code $4.50 MAM 02/23/00 25282 Potable Water Application $30.00 MAM 02/23/00 25282 Critical .N4 Total: $1,617.58 i V Review______ I:\F_BLD_App_Bld.rpt 10/29/99 / r 'VJ " / STORMWATER CALCULATIONS Owner/Applicant: (� - ' C Cc r/(J///t/.-fQ/t/ ❑ PROPOSED LAND DISTURBING ACTIVITY Site Address: / Drainfield area cleared "� sq.ft. e `vozo i/ , /9 3' Driveway Length ,'2 7SJ ft. Arerv6wc s X Width/0 �,)' ft. 9 Digit Parcel Identification No.: % �j U� � = Total Driveway /-/-• �/6 sq.ft. Permit Number: Clearing and Grading for Site Development PLOT PLAN (Well/Structures/Utilities/etc.) sq.ft. 6. 0 02 D sq.ft. INDICATE the following information. Total Land Disturbance M. / 6 sq.ft. Draw entire parcel to scale. Indicate scale of plot plan: / One inch equals rk L' ❑ IMPERVIOUS SURFACE Proposed Structures (all roof area),? ?'O sq.ft. a 1. North arrow Existing Structures (all roof area) sq.ft. 2'2. All property boundaries and dimensions - (/ r, Sidewalks sq.ft. O 3. Names of adjacent streets (J� rete Patios sq.ft. C3'4. Driveway/s & parking spaces ?(( >,Coo posed: 0 5. Major features such as ravines, � (514jDriveway Length _ is ft. 62-D/PIV6.01(4 S seasonal creeks, bodies of water, etc. X Width X ft. � O 6. Septic tank, drainfield and reserve area location, ( = Total Driveway /f //6 sq.ft. existing or proposed, and distance to �J Total Impervious Surface / 7 0 sq.ft. closest structure 13V7. Sewer lines The Stormwater Manual sets forth the following Small Parcel Minimum Requirements: 2" 8. Wells and/or water lines • Construction Access Route Stabilization: O 9. Neighboring wells within 150 feet Construction vehicle access shall be, whenever feasible, limited to one route. Access points shall be stabilized with ❑ 10. Paved surfaces (patios) quarry spalls or crushed rock to minimize the tracking of ❑ 11. Structures, existing and/or proposed sediment onto public roads. If sediment is inadvertently transported onto public roads, roads shall be cleaned El'12. Setbacks (distances to property thoroughly at the end of the day by shoveling or sweeping. Street washing should only be done after the bulk of the boundaries, structures, banks, sediment has been removed by sweeping. and shorelines) • Stabilization of Exposed Soil: All exposed and unworried soil shall be stabilized by sodding, ❑ 13. Easements for access or utilities seeding, mulching, plastic covering, application of gravel base • 14. Arrows showing direction of slope-- on roads and driveways, or other appropriate means within seven days during the period from May 1 to September 30 assume an elevation of 100 feet at one and within two days during the period from October 1 to April lot corner and indicate the other lot 30. Mulch shall be applied to a minimum depth of two inches. • Protection of Adjacent Properties: corner elevations in relation to it Adjacent properties shall be protected from sediment deposition by appropriate use of vegetative buffer strips, sediment barriers or filters, dikes, mulching, or by a FOR APPLICATIONS ADJOINING SHORELINES, combination of these measures and other appropriate Best INDICATE: Management Practices (BMPs). • Maintenance: ❑ 15. Ordinary high water mark All erosion and sediment control BMPs shall be regularly inspected and maintained to ensure continued performance of ❑ 16. Top of.bank, if o er 10 feet high their intended function. ❑ 17. Slope of bknk in deg es • Other Appropriate BMPs as required by Jefferson County to mitigate the effects of increased runoff shall be applied. H:\HOME\PLNCNTR\FORMS\PLOTPLN.FRM9/97 r 1fferson County Department of Community Development 621 Sloan Street,Port Town nd WA 0836813601378-4450 0 p Ap © o n Project Description: S i f\GJ -t 1'e- - pvyA`i 1,1 eiLs I(,€/t(e....., Building Type: Project Type: Frame Type: Single Family % New Nt Wood O Garage-Attached/Detached ❑ Addition 0 Steel 0 Modn ar — ❑ Alteration/Remodel ❑ Concrete ❑ Commercial ❑ Repair ❑ Masonry ❑ Multi-family/#of Units ❑ Demolition ❑ Other: ❑ Industrial ❑ Other: Bedrooms: Bathrooms: Type of Sewage Disposal: Type of Heat: Choose one: Existing: Existing: 'Sewer ❑Community System ❑ Electricity Oil Proposed: =2 Proposed: r ❑ Individual System ❑ Woodstove ❑ Propane Total: 2 Total: If not sewer,fill out the following: ❑ Heat Pump 0 Conventional ❑ Alternative ❑ Other Permit# SEP Water Supply: } O Private well ❑ Two Party Welly( Public:Name of water system: L Obi-0 W ' Square Footage: For Office Use Only Main Floor /F y0-"? G I 0 7 l 1 UBC OCCUPANCY GROUP 2ND Floor Base fee 1 Z 1 1 • i 3rd Floor Plan Check fee %' . 3'3 Htd Basement h Oa5a7-l'- State Surcharge fee 4. Unhtd Basement ? // 2,50 co Subtotal I S%-7,, Garage/Egert CY ��'� � Pot Water Review fee `J� .O-J Decks 3 0 3\ZW 911/Rd Appro c eel . Commercial TOTAL . 7 7• Industrial — Receipt # ZS 2Z Other - < Cash/Check# '' IS `3 ,'' Total Valuation: ` Initials LLB Or Date 2'Z.• c)rb Estimated Cost: ' If within 200' of the Shoreline, Distance to Bank or Ordinary High Water Mark ft.Bank Height ft. By signing the application form,the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attomey's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson Co and it's employees,representatives or agents for the purpose of application review and any required later inspections. Access and right of entry to the applicant's pr petty o e requested dd and shall occur during regular business hours. Signature:/ �1-��L Date: 'i ?3' r`2C� 40. APPROVED BY Q.— 1 JEFFERSON COUNri MAC 3 200Q ECEOVE ►, j 'U '� RSON COUNTY FEB 2 5 2000 F UT .i. .. ER MANAGEMENT ORDINAN SMALL PARCEL EROSION AND SEDIMENT CONT • ,* PERSON COUNTY EROSION AND SEDIMENT CONTROL WORKS:� ` +' IMMUNITY QEVELOPMENT Property Owner: � ' 4��� fl./' Telephone:,,.?6? 7 Address: _5 . /Uz),6-4 Ii Assessor's Parcel Number: ?5'c 6690 77 7 6 Building Permit or Septic Permit Application Number(if applicable): Brief Project Description: Site Location: /o'7 •4,41„; �r,C �!� fit/ ;/52 Person Responsible for BMP Installation and Maintenance: j�J j� /, 7-' Address: e,S& AR'r Zc/,)46 J-e'er Telephone: 7 6�0 1. Describe/check the Best Management Practices (BMPs) that you will implement during land disturbing activities or construction to control erosion and prevent sediment from entering water bodies (marine waters, streams, rivers, lakes, or wetlands) or impacting adjacent property or roads. Please check the measures you plan to implement and show their approximate location on the site plan. You may also propose measures other than those listed. Attach additional sheets, if more space is required. [Xj Stabilize construction access route. Limit construction vehicles to one route, if feasible. Provide a stabilized construction access by applying quarry spalls, ballast, or crushed rock to minimize tracking sediment onto roads. (See attached illustration from Stormwater Management Manual.) If sediment is transported onto roads, they will be cleaned thoroughly. [] Minimize the extent of land disturbing activity and preserve existing vegetation. Preserve buffers of well-established vegetation between disturbed areas and property boundaries, roads, water bodies, and designated critical areas (wetlands, fish and wildlife habitat areas,landslide or erosion hazard area,etc.). SPESC Instructions—Short Form Revised June 3, 1999 3 A EROSION AND SEDIMENT CONTROL WORKSHEET Phase clearing so that only areas that are actively being worked are uncovered. N Start and complete land disturbing activities and stabilize the site between April 1 and September 30. Stabilization means that disturbed areas will have well-established plant cover or be landscaped to minimize erosion. [] Stabilize exposed soil Exposed and unworked soil will be covered within 2 days between October 1 and March 31 and within 7 days between April 1 and September 30. [ ] Cover exposed soil with a minimum of 2 inches of straw or hay or other material approved for this purpose. pc]. Cover soil stockpiles with plastic sheeting and locate away from water bodies, roads, and property lines. Place gravel base on roads,driveways,and parking areas after clearing and subgrade preparation. [] Protect adjacent properties and water bodies from sediment deposition: [] Place straw or hay bales in ditches and drainage ways down slope from areas of land disturbing activity to filter runoff before it leaves the project site or enters water bodies. (See attached illustrations from Stormwater Management Manual.) Install a filter fence down slope from areas of land disturbing activity to filter runoff before it leaves the project site or enters water bodies. (See attached illustration from Stormwater Management Manual.) [ Regularly inspect and maintain all BMPs especially after storms events. [] Describe other erosion and sediment control Best Management Practices. Be specific as to design and specifications. SPESC Instructions—Short Form Revised June 3, 1999 4 EROSION AND SEDIMENT CONTROL WORKSHEET 2. Describe how disturbed areas will be permanently stabilized(seeded, landscaped, apply gravel base to roadways,etc.) 7/1'6 /*C/is 6 /�(�f° /3C-6 eg /' 67t--49 //%°//C" rd4/6C--76- ee)A tc--etto.ra7/1// / /Tc 1y D/P/ /62,1/1y "9-A',?�A# ZeZ 3. Describe how runoff from impervious surfaces will be controlled (disperse to vegetated areas to infiltrate,dry well,infiltration trench,route runoff to existing drainage facilities,etc.). SPESC Instructions—Short Form Revised June 3, 1999 5 • EROSION AND SEDIMENT CONTROL WORKSHEET 4. Specify your construction sequence. Describe the timing of all land disturbing activities (clearing and grading, construction, installation of drainage facilities, landscaping, etc.) and Best Management Practices.Describe proposed maintenance of BMPs. t A)6 '/7 cc /9" i�'E _t a/WC/16�' //66,06D -Moo. C,'P/,4 2/Pr r9 X",7��, Cote u 77Y p•/. 77C — LoT 0/0 A' R, -e % re,--. o /V/..F' P &cr,f' eat/ CCPE7e -,/,i' �' o 1J '�744 J'D ? ,A ,7P/43° The Best Management Practices proposed above will be implemented to control erosion, sediment, and stormwater runoff.I will noti the Permit Center for inspections as required. y ighature of Owner/Agent Date SPESC Instructions—Short Form Revised June 3, 1999 6 Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 CRITICAL AREAS QUESTIONNAIRE Applicant Name q6- 7,,-;-.. 6 cY&M4',_f&/1/ Building Application _ Land Use Application _ Shoreline Application On-site Sewage Application _ Subdivision Application _ Other: 1 . Is there any standing or running water on the surface of the _ Yes X No property or on any nearby property at any time during the year? If YES, please describe: 2. Has any portion of the property or any nearby property ever been _ Yes ?, No identified as a wetland or swamp? If YES, please describe: 3. Are any willows, skunk cabbage, alders, or cottonwoods present _ Yes 'X No on your property or adjacent properties? l If YES, please describe: 4. Are there any indications on any portion of the property or on any YES X No nearby property of rockslides, earthflows, mudflows, or landslides? If YES, please describe: 5. Please indicate which line best represents the steepest slope found on your property. (Check appropriate box) g a g Q o o , , , , , , , / , , , , , , , , , r , , , , , ♦ ,♦ �,- , , , , , . , , , , , , , , , , , , , , , , ♦ . ,' .� , , , , , , , . . , ,tiii,,rif ,,,,,, ,♦' ,,�/,,'�. isi ., (Questionnaire Continues on Back) Page 1 of 2 6. Does the site have steep slopes with little to no vegetation? _ YES No If YES, please describe: 7. Does the site contain high percentages of silt and/or very fine _ YES X NO sand? If YES, please describe: 8. Does the site contain ground water seepage or springs near the _ YES ,, " NO surface of the ground? If YES, please describe: By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner with respect to this application packet may result in this permit being null and void. I further agree to save, indemnify and hold harmless Jefferson County against all liabilities, judgments, court costs, reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and it's employees, representatives or agents for the purpose of application review and any required later inspections. Access and right of entry to the applicant's property or structure shall be requested and shall occur during regular business hours. Signature -. ,, v 7 ,- r� Date �'— a )() 6 FOR OFFICE USE ONLY ❑ Wetlands ❑ Seismic CRITICAL AREAS ON OR ❑ Aquifer Recharge Area (zone ) ❑ Fish & Wildlife Area 1 IMMEDIATELY ADJACENT TO SITE: ❑ Frequently Flooded Area ❑ Fish & Wildlife Area 2 ❑ Erosion ❑ Landslide :Seismic ❑ Commercial Forest Section Township North Range Parcel Number: Parcel Size: Comprehensive Plan Land Use Designation: Reviewed by: Community Plan: Date: Page 2 of 2 h:\home\pincntr\forms\car.doc 1/00 I Jefferson County Department of Community Development ,�So ooG 621 Sheridan Street,Port Townsend WA 98368 (360) 379-4450 14 W `1:'\ �So ITING Universal Plot Plan Fill in the following blanks as completely as possible: Project Description: 9 Digit Parcel Identification Number (from your tax statement): 6-676. Site Address 911#: Road Name: 6 Z Zip Code: ? e` Legal Description Subdivision Name: r /40, °;i, F Section: ClTownship:"� � � Block: Lot(s): � 124 Range: ' i Ez Parcel Size (acres or square footage): Property Owner 04, 5c 1c f Phone: Mailing Address: Applicant/ t: _ Phone: (if different from owner)6� 1,p l& / .®° p 3' 3 4 6 o Mailing Address: _ r zfre„ Authorized Rep: ` Phone: Mailing Address: -- "--•- General Contractor: Or Manufactured Home Installer: Phone: Mailing Address: rit Contractor's State License Number Expiration Date: Septic Designer: Phone: �,-✓' .— ��-- ""`�� Mailing Address: ", '''`� Architect:/Engineer: Phone: Mailing Address: „w'..---"' _, -- Loan Lender/General G/ArMi �� 7- /94. Phone: T Contractor's Bond Holder: � �����`� ��® ��'� - i i_„;OO 79 ? Mailing Address: FOR OFFICE USE ONLY Fire District: 02 Planning Area: 1.. 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