HomeMy WebLinkAboutBLD2000-00648 ,
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 #: BLD00-00648 Received Date 10/3/2000
SITE ADDRESS: 311 CENTER CEMETERY RD Issue Date 01/19/2001
CHIMACUM, 98325 Expiration Date 01/19/2002
APPLICANT: CHARLES HUMPHREY PHONE: 360-732-4579
PO BOX 161
CHIMACUM WA 98325
SUBDIVISION: MT TOWNSEND VISTA Block: Lot: 15
PARCEL NUMBER: 801105009 Section: 10 Township: 28 N Range: 01 W
CONTRACTOR: OWNER PHONE:
LOAN LENDER/
BOND HOLDER:
PROJECT DESCRIPTION ATTACHED CARPORT
REQUIRED INSPECTIONS:
[v,,]- 4 back. (Shoreline Setbacks): e)k .1/ 3 /�/G'- ,
[ 4 *otitis •/h/�i<-67V/ 17 EP 6 40/e //3/c)C 1. I ,
[ie---- our�da : teleDAtO SLdd !YJ K. 2// / / 1!r
[ ] Underground Plumbing/Underground Insulation:
[ ] Shear Wall:
[ ] amii Plumbing: /< //'-0 z
( ] Propane Tank/Lines:
[ ] Insulation: /
[ ] Sheetrock: 1457,2-A
[ ] Final/Occupancy Approval: 0 ///2.5A- i r
HEALTH DEPARTMENT A ROVAL REQUIRED PRIOR TO FINAL INSPECTION.
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.
HOT LINE AVAILABLE 24 HOURS A DAY
is\F_BLD_Permit_Buildng.rpt 10/29/19
BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368 "
PERMIT #: BLD00-00648 Received Date: 10/3/2000
SITE ADDRESS: 311 CENTER CEMETERY RD
CHIMACUM, 98339
APPLICANT: CHARLES HUMPHREY PHONE: 360-732-4579
PO BOX 161
CHIMACUM WA 98325
SUBDIVISION: MT TOWNSEND VISTA Block: Lot: 15
PARCEL NUMBER: 801105009 Section: 10 Township: 28 N Range: 01 W
CONTRACTOR: OWNER PHONE:
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: ATTACHED CARPORT
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ADD MAIN: 864
VALUATION 10,040.00 ADD'L: 140 HEAT TYPE: WOD
CODE EDITION: 1997 HEAT BASE: HEAT TYPE:
OCCUPANCY:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: PWELL PARCEL TAGS: YES NO
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Exist: 1 Exist: 1 Wetland Erosion
Prop: Prop: Seismic Streams
Total: 1 Total: 1 Flood Way Flood Plane
Routing Date: / F&W Landslide
/0 ` (J O Shoreline Aquifer
Forest: Commercial Rural
—Proximity - flat Gc/d tions
Type Amount Paid By: Date: Receipt: A rovc
o c
Permit $195.25 MAM 10/03/00 34391 AP1Rc 'IED
Plan Check $58.58 MAM 10/03/00 34391
State Building Code $4.50 MAM 10/03/00 34391 I 8 M 1 9 MU
Total: $258.33
1 E . •1'r
DEPT. OF CO UNITY DEVELOPMENT
SIGNATURE: LkS
is\F_BLD_App_Bld.rpt 10/29/99
,
¢SON c Jefferson County (�:.i artntant of Community Development
w� , , °I. 6213teridan Street,Part Townsend WA 88368[3601318-4450
'k>. ,�
4- -Pkt",---------''. . PErmOY A
S�YG� ppil : cal,fon
Project Description:
Building Type: Project Type: Frame Type:
= Single Family _ New ��
Garage Attached/Detached 21-Addition = Steel
Modular = Alteration/Remodel = Concrete
= Commercial = Repair 2 Masonry
= Multi-family/#of Units 2 Demolition = Other.
Industrial
Y.'Other: A rrn.t kf-40 C•k,o.fb i .
Bedrooms: Bathrooms: Type of Sewage Disposal: Type of Heat:
Choose one:
Existing: _______L Existing. ___t_— = Sewer =Community System = Electricity = Oil
Proposed: Proposed: 'lndividual System
Total:
Total y 'C�/oodstove = Propane
If not sewer,fill out the following: 2 Heat Pump
Conventional Alternative = Other
Permit # SEP
Water Supply:
✓Private well = Two Party Well ii Public:Name of water system:
Square Footage: For Office Use Only
•
Main Floor fa 4, 0 UBC OCCUPANCY GROUP
2ND Floor v Base fee l 95. "LS I
3rd F1cor
Plan Check fee _ • '. SY
I Itd Basement State Surcharge fee L- s l7
Unhtd Basement Subtotal Z S . 3 3
Garage/Carport Pot Water Review fee ---(9"-'
Decks 911/Rd Approach fee
Commercial TOTAL 252. 33
Industrial i
! Other / _
Receipt # j��9
Cash/Check# 31 g'
T,)tal Valuation: _ 0 Initials --�
Or
Date co(31 oz.- --
EstimatedCost: SDcea
a If within 200' of the Shoreline,
Distance to Bank or Ordinary High Water Mark i A,r ft.Bank Height ft.
By signing the application form,the applicant/owner attests that the information provided herein is true and coil eu.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 CO 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 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: - Date: ea-r: 3, 2 oc•z>
f
BUILDING PERMIT APPLICATION
HOC) CX)
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00648 Received Date: 10/3/2000
SITE ADDRESS: 311 CENTER CEMETERY RD
CHIMACUM, 98339
APPLICANT: CHARLES HUMPHREY PHONE: 360-732-4579
PO BOX 161
CHIMACUM WA 98325
SUBDIVISION: MT TOWNSEND VISTA Block: Lot: 15
PARCEL NUMBER: 801105009 Section: 10 Township: 28 N Range: 01 W
CONTRACTOR: OWNER PHONE:
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: ATTACHED CARPORT
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ADD
VALUATION 10,040.00 MAIN: 864
CODE EDITION: 1997 ADD'L: 140 HEAT TYPE: WOD
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER:
GARAGE: SHORELINE:
CONST TYPE: SETBACK:
DECK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT ,
WATER SYSTEM: PWELL
PARCEL TAGS: YES NO
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Exist: 1 Exist: 1 Wetland V(_ Erosion
Prop: Prop: Seismic Streams ►v.(
Total: 1 Total: 1 Flood Way Flood Plane
Routing Date: F&W Landslide
/0 -- Y--- 60 Shoreline Aquifer lit`>`>C_
Forest: Commercial Rural
Type Amount Paid B —Proximity PlatNlat G dr�ttlons
y Date: Receipt: Approves/uate
Permit $195.25 MAM 10/03/00 34391
Plan Check
$58.58 MAM 10/03/00 34391 � / ; �`� �
State BuildingCode $4.50 MAM 10/03/00 34391 , �` I
Total: $258.33 y___Or
\\: ,') '
0- t
i:\F_BLD_App_Bld.rpt 10/29/99
•
• STORMWATER CALCULATIONS
Owner/Applicant: u p 4-4�`y
❑ PROPOSED LAND DISTURBING ACTIVITY
Site Address: °-51 l L e ,�t2 C e �-T�cz.f Drainfield area cleared sq.ft.
Driveway Length ft.
X Width ft.
9 Digit Parcel Identification No.: e3v I t c; r 9 = Total Driveway sq.ft.
Permit Number: ��z ls; , ,,� Clearing and Grading for Site Development
PLOT PLAN (Well/Structures/Utilities/etc.) sq.ft.
sq.ft.
INDICATE the following information. Total Land Disturbance sq.ft.
Draw entire parcel to scale. Indicate scale of plot plan: J+
One inch equals IMPERVIOUS SURFACE
Proposed Structures (all roof area) 5 7 sq.ft.
a 1. North arrow Existing Structures (all roof area) ( 1 Lg sq.ft.
2. All property boundaries and dimensions Sidewalks � � sq.ft.
,ar 3. Names of adjacent streets Concrete Patios sq.ft.
4. Driveway/s & parking spaces Proposed:
.'5. Major features such as ravines, Driveway Length qoc; ft.
seasonal creeks, bodies of water, etc. X Width 1 S ft.
. 6. Septic tank, drainfield and reserve area location, = Total Driveway i 3 5 cc' sq.ft.
existing or proposed, and distance to Total Impervious Surface Ij 6O(4 sq.ft.
closest structure
2./7. Sewer lines The Stormwater Manual sets forth the following Small Parcel
Minimum Requirements:
Wells and/or water lines • Construction Access Route Stabilization:
/9. Neighboring wells within 150 feet Construction vehicle access shall be, whenever feasible,
limited to one route. Access points shall be stabilized with
2i)-0. Paved surfaces (patios) quarry spalls or crushed rock to minimize the tracking of
'1 1. Structures, existing and/or proposed sediment onto public roads. If sediment is inadvertently
transported onto public roads, roads shall be cleaned
Y12. Setbacks (distances to property thoroughly at the end of the day by shoveling or sweeping.
boundaries, structures, banks, Street washing should only be done after the bulk of the
sediment has been removed by sweeping.
and shorelines) • Stabilization of Exposed Soil:
All exposed and unworried soil shall be stabilized by sodding,
Kfi3. Easements for access or utilities seeding, mulching, plastic covering, application of gravel base
r14. 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:
11 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 over 10 feet high their intended function.
17. Slope of bank in degrees • Other Appropriate BMPs as required by Jefferson
County to mitigate the effects of increased runoff shall be
applied.
1:\HOME\PLNCNTR\FORMS\PLOTPLN.FRM9/97
Pr
Jefferson County Department of Community Development
j ox cod 621 Sheridan Street,Port Townsend WA 98368 (360) 379-4450
Aso Universal Plot Plan
RING'
Fill in the following blanks as completely as possible:
Project Description:
9 Digit Parcel Identification Number (from your tax statement):
0S �c� 9
Site Address C
911#: i i Road Name: Zip Code: 9 2,3 z�;
Legal Description
Subdivision Name: µ T. Tow a 5-C) Y s z,, Block: Lot(s): 1 ,
Section: ,3 Township: 2 g Range: I M
Parcel Size (acres or square footage):
Property Owner: Phone:
Mailing Address:
Pc, C t L.c) A 9 r3 25
Applicant/Occupant: Phone:
(if different from owner) 9/A. ,n t
Mailing Address:
Authorized Rep: Phone:
/�
Mailing Address:
General Contractor:
Or Manufactured Home Installer: '/A Phone:
Mailing Address:
Contractor's State License Number: Expiration Date:
Septic Designer: I Phone:
- ( L L w.+�a. `,.�G Cca yu po L c 7. " ,sl n+tpl 01,3 Ft
Mailing Address:
L`TY Cat' cd -
Architect:/Engineer: Phone:
N/ n.
Mailing Address:
Loan Lender/General Phone:
Contractor's Bond Holder: „pn._
Mailing Address:
FOR OFFICE USE ONLY
Fire District: Planning Area: School District: Zone:
1/00 H:\home\pincntr\forms\universal plot plan
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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 _ 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
wayaccrue against Jefferson Countyas a result of or in consequence
9 se ue ce of the grantingof this permit.
q
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 Date
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.docl i00
, Jefferson County Department of Community Development
. 621 Sheridan Street, Port Townsend, WA 98368
CRITICAL AREAS QUESTIONNAIRE
r;
Applicant Name _/-.!
Applicant /T ,%,,v,,,,,z,,,,
----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 —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 _ No
on your property or adjacent properties?
If YES, please describe:
/d "'a-u.+ A r/.�a,-2 .5fr'+2 /3 r3 c�,w„v� 1 d C.Kra
, c- Ttrn C�c� z c.,.- 7
4. Are there any indications on any portion of the property or on any _ YES _/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)
a a 4 Q a a c
/ / / / / /
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-----
(Questionnaire Continues on Back)
Page 1 of 2