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CITY OF PORT TOII/NSEND
PERMIT ACTIVITY LOG
DATERECEIVED: l- lZ-A7
SCOPE OF WORK: ,Nstlr D:PLEV- + gAt7c-]'r dqeade
DATE ACTION TNITIALS
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ESA - to Planning -no evidence of ESA-r
Vested Date
Checked for Completeness
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CUSTOMER ASSISTANCE MEETING
DEVELOPMENT SERVICES DEPARTMENT
250 MADISON STREET, SUITE 3
PORT TOWNSEND, WA 98368 . Tel: (360) 379-5095 Fax: (360) 344-4619
Date submitted: 'E I n lrl
Submittal is required ohe week'prior to the scheduled meeting.
Date requested for conference:
(Conferences are held l{ednesday
o
Lf Pr^
Please suumidDcopies of: Iftls co mpl eted app I icat ion AND
)A Site Plan illustrating the proposal
inent und
PROJBCT INFORMATION:
Staff:
APPlicant: 5<e f? xr e -.t *{ocaqr.,--V
Mailing Address:Po Aov tzlz PA
3es -w{+sPhone:Fax:Vq6 - +T1o Email:AA^.;usroPt ) €.rnAfl-
Property Owner: 5 ^^ tz D €-6cyo ,.-.r T A.D s f
Mailing Address: Ss* a
Fax:EmailPhone
Properfylocation: nrltdD SS Th Sf. e<.
Le lon (tC.,Lo
SiteAddress: ^/ l( crD 95 ftr << A G LGi'6 LA6rDPf .
?arcel No.:9a-o cr rad+ o o ?
Descripti on of proposal. Think of it in terms of the types of questions you want answered
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, {e+,ns f6G. oF 6aeS i- ADD lfro^rrr I Aepc-tcAfr or{
A Customer Assistance Meeting is an informal opporruniry to meet with staff members to discuss preliminary
concepts of a proposed project. The Meeting is intended to take place prior to detailed enginegring work, however
the submittal must be of sufficient clariry and detail to allow staffto review and evaluate the proposal.
P:\DSD\Forms\General Use Form$,Application4ustomer Assistance Meeting.doc
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Cify of Port Townsend
Development Services Department
ENVIRONMENTALLY SENSITIVE AREAS QUESTIONNAIRE
Permit applications are reviewed by our staff to make a preliminary determination of the presence or
absence of an Environmentally Sensitive Area on the property, pursuant to Chapter 19.05 ofthe Port
Townsend Municipal Code. To help us make this determination, please supply the following
information.
General Information:
Sensitive Area
D:\Filing Cabinet\All Data Files\2006 Permanent Data Files 20061212\l100 55th SI\PT Municipal Code &
Forms\2006 I 222. EnvSensAreaQuest.doc
ApplicantName: TltE grs^is -DRA6<r,xr -flzu Sf Phone
-s(o
?32-"*z+t,
Mailing Address Vr:t (3oX f3:. 'Z y2 a et f fo b.r ,JS dND 9 t,3 6 g
Property Address (if different), ,,o o g' -r.h\ sf. p.t.
Description of Proposal (include site plan):
l-1omE ANb 6AFar.G65,
V.it{q 1>l?r v6r^rFy3 ,, 66xCaS, be.ci<(.> Aer3DRs.
The proposed new construction creates +,Cl r o sq. ft. of impervious surface. What best
management practices are proposed?
Is any portion of the property within or near a mapped Environmentally Sensitive Area?
(Maps are available at the Building and Community Development Department)
YES X NO
I
2. Is there any standing or running water on the surface of the site at any time during the year?
Yes Y No If YES, please describe:
Has any portion of the site been identified as a wetland?
If YES, please describe:
XNOYESJ
4. Is the site characterized as:
_Forest Meadow Cleared X tvtixeo
t
a
5. Is the slope of the property: X flat
(0o/o - 5%o)
Critical Slope - 40% or greater
gentle slope
(5o/o - l5o/o)
steep slope
(l5o/o - 40%o)
Cdtical Slope
4096 or greatcr
Stccp Slopc
15 - 4lD.16
Gcntlc 5116 - 1596
Flat-O-5
The applicant hereby certifies that all of the above statements and the information contained in any other
transmittals made herewith are true, and the applicant acknowledges that any action taken by the City of port
Townsend based in whole or in part on this application may be reversed if it develops that any such statement
or other information contained herein is false.
The applicant understands that the determination of the Director may be appealed by the applicant or by any
other party by following the appeal procedure outlined in Chapter l.l4 of the Port Townsend Municipal Code.
Any appeal must be filed within seven calendar days from the Notice of a final decision.
I
Signature of Applicant Date
D:\Filing Cabinet\All Data FilesV006 Permanent Data Files 20061212\l100 55th St\PT Municipal Code &
Forms\2006 I 222.EnvSensAreaQuest.doc
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FOR DEPARTMENT USE ONLY:
Reviewed by:
Site visit Required? NO YES Site visit made on
Exempt per PTMC 19.05.040 (BX NO YES
Threshold Determination (presence/absence of ESA, type of ESA):
Shorelines Jurisdiction?NO YES
' Cify of Port Townsend
Development Services Department
BUILDING FEE SCHEDULE
l. To find your project's valuation, multiply the square footage by the appropriate values below. *
2. Go to the Fee Table below to determine your Building Permit Fee.
3. Multiply the Building Permit Fee by .65 to determine your Plan Review Fee. This is the minimum fee due
upon submittal of your application. You may pay all the fees at submittal time if you wish.
4. Your project may have additional fees, such as Public Works. Pbase see the Public Works permit fees sheet.
RESIDENTIAL FEES Note: Fees quoted before the time of permit apptication may be subject to change
Separate sttuctures will be valued separately.
Foundations: $14.98 x :
Manufactured Homes:$7. 1 5 x
$4.92 x
-: -(ncludes slab/runners, blocking, holddowns, skirting, utility
connections, etc. A separate electrical permit is required)
Patio Slab:
Garages:
Wood Frame
Carports:
$2s.03 "l/75:il,22s,25
Dwellings (includes finished basgmen{s): ^ ,. * Gable $16.10 x
-:
wood Frame $e5.17 x,q1_45 l gryfs,Dsht $t2.r2x _Masonry $99.81 *-:T
Storage Room $56.62 x :
-
Storage Sheds: (Over 200 sq. ft. floor area)
Unfinished, unheated, to be finished in future Insulated $25.84 x _::$37.15x-: un-insulated $20.49x :-
Basements: Pole Buildings:
Semi-Finished $22.50 x : _ Slab (<300 sq.ft.) $3.94 x
-: -
Unfinished $17.17 X
-: -_
Slab (>300 sq:ft.) $2.94 x
-: -covered porches: $25.g4 x : PLUS Building $13'27 x
-: -Townhouses: $71.38 x
Decks:$r2.4g * /so :/-8Ti,50 PLAN RE VIEW FF,E: Z
Stairs, per lineal ft. $129.88 x _: _ BUILDING PERMIT FEE:2
Railings, o' " $15.43 x
TOTAL VALUATION:
TOTAL FEES: 5 21 7, z/
HOUSE NUMBER: $3.00 per address
STATE BUILDING CODE SURCHARGE: $4.50
RECORD RETENTION FEE: $3.00 - $10.00
2
* The Building Department establishes building permit fees based on Section 108 of the Codes. The
fees are calculated using the estimated fair market value of the project (material + professional labor costs). The
value includes the total value of all construction work, including finish work. The Plan Review Fee, which is 65%o
of the Building Permit Fee, is paid at the time of application submittal. The Building Permit Fee, and any additional
fees, is paid at the time the permit is issued.
All fees are based on fair market values. The values may be adjusted to coincide with the quality and individual
characteristics of your project. The Building Department will establish an estimate using "good" values per square
foot for similar buildings in the region. These estimates are updated on a regular basis. The valuations were taken
from the MARSHALL & SWIFT Residential Cost Handbook and Building Standards, March'/April2002, and are
estimated square footage values for residential and accessory buildings.
TOTAL VALUATION BUILDING PERMIT FEE
$ I to $500 $23.50
$501 to $2.000 $23.50 for the fust $500. plus $3.05 for each additional $ 100 or fraction thereof.
$2,001 to $25,000 $69.25 for the first $2,000, plus $14 for each additional $1,000 or fraction thereof
$25.001 to $50.000 $391.25 for the first $25,000. plus $10.10 for each additional $1,000 or fraction thereof
$50.001 to $100.000 $643.75 for the ftrst $50,000, plus $7 for each additional $1,000 or fraction thereof
$100,001to $500,000 $993.75 for the first $100,000, plus $5.60 for each additional $1,000 or fraction thereof
$500.001to $1.000.000 $3,233.75 for the first $500,000, plus $4.75 for each additional $1,000 or fraction thereof
$1,000,000 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof
P:\DSD\Department Forms\Building Forms\Fee ScheduleBuildiirgs.doc / 3/l/2006
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CITY OF PORT TOWNSEND
VELOPMENT SERVTCES DEPARTME,
City Hall,250 Madison Street, Suite 3
Port Townsend, WA 98368
Phone: 360-379-5095 Fax360-344-4619
RESIDENTIAL BUILDING PERMIT APPLICATION
NEW CONSTRUCTION, REMODELS, & ADDITIONS
Owner's Name(s)jiAND D1146o, i s-r s ocl<,qD
MailingAddress Po Eox '3> Z
City, State,l2aE-t' -f'?s\^,NS6F,.rb, '\r'lA 9836 B - ooZS
Phone 76o "7'3"2 +z+z Permit No. ELDOT- 2DS
Property Street Address iloo 5€t+t g.r
ZonngDishict P,2-Parcel# ?l"Zgo o
Legal Description: Addition rlzl o r.J fA"{A Block 4o Lot(s) I 3
General Coritractor's Name avEti, r^Lll uctoaEs irva
MailingAddress bSz-o Zt za$ sT" 5w Lynt t^/bcrl) WA gs20g'o
Phone (+zs) '11g * '31 s I tt'zgCell Phone
City Business License Number -3State License Number
Authorized Representative/ContactPerson: M t Gtu Phone:
Estimated Value of construction $ I +8 oooooo
Financed By
Date Work is to Begin {v1 AR-<++ I t o o Date Work is to be Completed Mp,
Scope of Work:
Please check all items that apply for the type of building permit you are requesting:
Floor Area: the proposed structure is to be used for:
NewHouse I >u pc-E x Addition
New Garage or Carport (,*tt*o,"J Repair/Remodel Garage
Repair/Remodel House Accessory Dwelling Unit
Manufactured Home Other (please describe):Fer.lce , A&B-4
Finished Heated Space sq. ft: 2 3Z o Garage sq. ft: I b1 S
Unfinished Heated Space sq ft:Carport sq. ft:
Unfinished Basement sq ft:Porches sq. ft:
Semi-Finished Basement sq ft:Decks ft: lSo
Storage sq. ft:2 3 Other (please describe):
P:\DSD\Forms\Building Forms\Application-Residential Building permit.doc Page 1 of2
Please check YES or NO as applicable YES NO
1. Is the property within 200 feet of a fresh or saltwater shoreline?X
2. Is the property within the Port Townsend Historical District?.x
3. Is the properfy located within or adjacent to an environmentally sensitive area?.Y
4. Will this proposal involve any sewer, water or other utility extensions that will, or could serve vacant
properties other than the project site? If yes, please attach information identi$ing the utility extensions and
sites.
X
5. Have any special conditions been placed on this property, or has the property been subject to any
conditions on any prior action of the City (if "Yes" to any of the following, attach copies of appropriate
documents):
X
La< e6 I E;ca*zo <.BdefrgrcA-rrutlPe^.r o r N (r Subdivision/Short Plat/Boundary Line Adjustment?X
SEPA (environmental review)?)<
Variance?><
Conditional Use Permit?X
Street Vacation?r(
Planned Unit Development?
^Restrictive Covenant?X
Easement?X
6. Are any properties within 800 feet of the site owned or controlled by the applicant, any relative or
business associate, or any partnership, corporation, or other entity affiliated with the applicant? (If ps,
attach [ist.)
x
7. Have any of the properties listed in item #6 been developed within the last two years? (If yes, attach list.)x
8. Have you previously discussed this project with a City staff member? If yes, who and when?
4US'foF-{\6t< AsS lsfAo.l<6 n'|l\<€f1 al G>
x
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CITY OF PORT TOWNSEND RESIDENTIAL BUILDING PERMIT APPLICATION
NEW CONSTRUCTION, REMODELS, & ADDITIONS
Special Conditions
^ FFlicant Certification
The applicant hereby certifies to have knowledge of those sections of the International Residential Code and the Port
Townsend Municipal Code pertinent to the above project and that the applicant is responsible for constructing in conformance with
these codes; the applicant understands that the permit, if issued, expires in six months unless work is started; that the permit, after
construction has started, will expire after one year if an inspection is not made to show significant progress on the fructure; the
applicant agrees to abide by the ordinances, codes, regulations, restrictive covenants, deed or plat restrictions, and water and sewer
plans attached hereto; the applicant certifies that all information given above and on accompanying plans i complete and accurate to
the best of their knowledge; and the applicant understands that this information will be relied upon in granting permits and that if such
information is later found to be inaccurate any permits may be withdrawn.
P:\DSD\Forms\Building Forms\Apptication-Residential Building permit.doc Page 3 of 3
I,r
u'!*-1
Residential Buildinq Plans Ghecklist
City of Port Townsend
Development Services Department
250 Madison Street, Suite 3
Port Townsend, WA 98368
(360) 379-5095 Fax: (360) 3444619
Name sr6p$6Nr 'ilncuta*y Permit#
This checklist is for new dwellings, additions, remodels and garages. The purpose is to show what you intend to
build, where it will be located on your lot, and how it will be constructed.
Tn addifion fo this form, please srrhmit:
,"-ciResidential Building Permit Application form
,-r'{ensitive Areas Questionnaire
v/'oo 1 Washington State Energy Code forms. Use either prescriptive forms, or component performance
forms with calculations.
,rfWashington State Energy Code Construction Checklist
,r{wo sets of plans. 18" x24" plan sheet size is preferred. Plans must be to scale. Ya": | ft. is preferred.
o If an architect has signed your plans, one set must have an original signature and wet stamp on each page.
o For structures that require engineering (including pole structures, sunrooms, dormers of a certain size,
"irregularly shaped" structures) provide two copies of calculations from a Washington Licensed Architect or
engineer. One set must have an original signature and wet stamp.
For New Residential l)welling Constnrction also srrhmif:
o Street/Utility Development Permit application, or Minor Improvement Permit application if water and sewer
are already stubbed to the property. For any utility extensions, provide engineered plans.
S6C A-TTA.H6D g€.a.^r-r + SOeo6-o66
o Two additional copies of the site plan for Public Works (three sets if a septic system is proposed). Please
also include one reduced 8-ll2' x l l" size site plan.
NOTE: Elecnical Permits are required by the State of Washington Department of Labor & Industries QA,I)
Contact L&I at (360) 417-2700for more information.
P:\DSD\Department Forms\Building Forms\Application-Residential Building Permit Plans Checklist-rtf
Rev- li25l06
Page I of4
2''!Room use- size and souare footase bv floor level
2,3 All room dimensions.
Braced wall panel locations per UBC Section 2320.11.3 and Table 23-IV-C-1(if multi-story include
length per story per Table 23-IV-C-1)
Smoke detector locations.
2,3 Stairwavs: width. rise" run. handrails. euardrails,landings, etc.
213 Window, skylight and door locations and sizes, with egress and safety glaAng, if applicable. (Include
brand/model and U factor on enersv application.)
Rafter and ceiling joist size, material grade, layout and spans. Roof framing plan required if rafters,
optional if trusses.
Attic access location and dimensions.2rz Plumbins fixtures.
Hot water tanks, fumaces, fireplaces, solid fuel appliances and combustion air ducts.
Location of whole house ventilation fan. controls and timer.
Location and cfm of all other exhaust fans (i.e. bathroom, kitchen and laundry).
Type of exhaust duct material, duct path and exterior termination point of appliance vents and
environmental exhaust ducts.
Tvpe and location of all WSEC outside fresh air inlets.
Fire blockins.
l-hr. construction between dwelling & garage on garage side (UBC Sec. 302.4, exception #3).
PAGE# FLOORPLAN
PAGE# WALL SECTION
Footing size, reinforcement (include vertical rebar) depth below natural and final grade.
Foundation wall. heisht. width and reinforcement (rebar), hold-downs if applicable
Anchor bolts. washers Q x 2 x 3116 square, steel) and pressure treated plates
Thickness of floor slab. e,u
Floor ioist size and spacing. under floor clearance from crawl space grade for ioists and beams.
Floor sheathine" type and size
Wall stud size- srade and soacins
Framins to be used: standard, intermediate or advanced
Header, size, srade, spans and insulation (if applicable)
Wall sheathins and sidine and material.
Tvpe & location of weather-resistive barrier (UBC Section 1402).
Tvoe and location of vaoor retarder (WSEC 502.1.O.
Sheetrock: thickness" tvoe and location.
Insulation material and R-value in walls above and below grade, floor, ceiling and slab.
Rafters. ceiline ioists. trusses. with blockins and positive connection of roof system to wall
zt 3.tf Ceiling height.
Roof sheathing, roofing material, roof pitch, attic ventilation (provide calculations).
P:\DSD\Department Forms\Building Forms\Application-Residential Building Permit Plans Checklist.rtf
Rev. li25l06
Page 3 of4
WSEC Residential Construction Checklist
City of Port Townsend
Developrnent Services Department
250 Madisan Street, Suite 3
Port Townsend, WA 98368
(360) 379-s095 Fax: (360) 344-4619
Washington State Energy Code (WSEC)
2001 Residential Construction Checklist
Complete this form in addition to WSEC forms. Please answer the following questions:
TYPE OF PROJECT:
! New construction, or addition over 750 square feet
Must meet whole house and spot ventilation requirements, and show full WSEC compliance as
a stand-alone project. A detached, habitable sfructure such as an Accessory Dwelling Unit
regardless of size must also meet these requirements.
! House addition under 750 square feet
Possible trade-offs qre allowedwith the existing buildingfor WSEC compliance, such as
increasing ceiling insulation. See WSEC component performance forms.
NOTE: A hoase uddition less than 500 sq.ft. does not require whole house ventilstion.
Spot ventilation is still required.
TYPE OF HEATING - Please check all that apply:
Electric
tr Wall Heater I Baseboard ! Forced Air Fumace tr Radiant Floor (B.oiler) ! Other
-'Non-Electric:
Propane:l) Radiant Floor/Baseboard (Boiler) X fpC Stove X I,pC Furnace {Other LPG
! Heat Pump n Oil Furnace tr Woodstove (can only be used as secondary heat source)
VAPOR RETARDERS:
Vapor retarders shall be installed toward the warm surface as represented below. Select one
option for floors, walls, and appropriate ceilings:
o Floors:
! Plywood with exterior glue
EPoly plastic (greater than or equal to 4 millimeter thick) ltl ao*<eefe € t*B FLo<>R-! Backed batts
o Walls:
E Poly plastic (greater than or equal to 4 millimeter thick) fv vq r- o e G r ^,.r c
^,
y1
XFace-stapled, backed batts (oe <yv€Ki rBO
I Low-perm paint
o Ceilings:
tr Nol required where ventilation space averages greater than or equal to 12 inches above
insulation
B Face-stapled, backed batts (.c- <y w6 ( ) f* > )
KPoly plastic (greater than or equal to 4 millimeter thick) trrv cx. o a s' \ r+,LA.(
tr Low-perm paint
SEE BACK
P:\DSD\Department Forms\Building Forms\Application-Residential Energy Code Chechlis.doc
Page I of I
)
Prescriptive Approach - Simple Form
For the Washington State Energy Code (2001 Edition)
Glimate Zone {
Lot:
Site lnformation
/aruD3.,B..--<@
Building Department Use Only
Pernit #:
Notes:Address:ltm 55r[-sF
City:
nYtr(t I ouJ
^ter-dState: \^JA 7jp:qffiu$
Contact:
Phone:7b0 1 >- t+>L+>
Phone 2:
30A) vqD- 4>to
Table6-1
PRESCRIPTWE REQTTIREMENTS 0'r rOn CnOUp R OCCI pAr\Cr
CI,IIT{ATEZONE I
See the code text for footnote references
This proiect compties with the foltowing:
{ tne project is a single fanfly residenoe or duplex.y' tn" project is wood frame OR all of the insulation is interior or extedor of the framing.{ X building componenb meet the requirements listed in Table d1, Oplion lll./ The project will nreet all other provisions of the WSEC and MAQ.
The project will take advantage of the following exceptions to the prescriptive option:
Ef, OOZ.O Exception 1. One door, that is 24 ft.2 or less, that does not meet the standards is allowed.
Location of the door taking this exception 4sa.o.C. e
E 0OZ.O Exception 2. Doors with a llfac{or of 0.40 allowed without calculations, OSion lll only.
Location of the door(s) taking this exception
Copyrigtf 2002, WSUCEEPO2-ffi
Copied by permission from the Wbstrington State University Cooperative b<tension Energy Program
Frescriptive - Simple Fom - Climate Zone 1
GlazingU-Factor
Option
Glazing
Arearo
oZ of Floor Vedical Overheadll
Door'
U.
factor
Ceiline3 Vaultd
Ceilind
Walt
Above
Grade
Wall
Inta
Below
Grade
Wall
Ec4
Below
Grade
Floof
Slab"
On
Grade
m Unlimited
GroupR-3
Occupancy
Onlv
0.40 0.58 0.20 R-38 R-30 R-21 R-21 R-10 R-30 R-10
5/31nfi2
)
tsUILDING PERMIT FEES CITECKLIST
Fees Based on Fair Market Valuation or Submitted Amount Valuation:
FEES DUE AT SUBMITTAL
z,Dqy, zl Plan Review Fee (2010)
MrP $so (2164)
MIP Record Retention Fee $3 (9992)
SDP Fees
Street $62.50 (2164)
Water $62.50 (1201)
Sewer $62.50 (1361)
Storm $62.50 Q40I)
SDP Record Retention Fee $10 (9992)
PW Inspection Fee $70 (2140)
Other
Other
,f ,p7U, ,/rzl TOTAL DUE AT STIBMITTAL
FEES DUE AT PERMIT ISSUANCE3,22,55 Building Permit Fee (2000)
4Z oo Propane Tank/Piping Inspection $47 (2000)
^1 sr>State Building Code Surcharse $4.50 (2005)
Plus $2/unit for multi-familv
-7 ott House Number $3 (2200)
$3 per unit if multi-family
Hamilton Heights Recreation Fee $200 (5030)
Hamilton Heights Transportation Fee S156 (2167)
Lynnesfield OFsite Transportation Fee $231 (2168)
,/O, no Record Retention Fee $3 to $10 (9992)
Other
Others39/.7/TOTAL DUE AT PERMIT ISSUE
Notified Permit is Ready to be picked up (Who/Date/Initials)
P:\DSD\Forms\Building Forms\Cheoklist-Residential Building Plans-Front Counter Sep 06.doc Revsedg/27106