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Permit File BLD-2021-0337 805 24th Street
1 Y City of Anacortes Invoice/Permit#: BLD-2021-0337 904 6th Street Applied date: 05/03/2021 P.O.Box 547 Issue date: 06/24/2021 _ '0: Anacortes, WA 98221-0547 Expire date: 12/21/2022 Job Address: 805 24TH ST Permit Type: Single Family Residence Permit ANACORTES WA 98221 Project: APN: Remarks: NEW SFR Owner: RANDY CLICK Contractor: CLICK CONSTRUCTION LLC Address: 1308 33RD ST Address: 1004 COMMERICAL AVE#267 ANACORTES WA 98221-3312 ANACORTES WA 98221 Phone: (360)999-0733 Phone: (360)999-0733 License#: General Information: Fees: #of Range Hoods 1 Plan Application Fee 200.00 #of Clothes Dryers 1 Building Permit Fee 1,525.75 New or Replaced Hard Surface 1452 Plan Review Fee 991.74 Use Zone R4 Mechanical Permit Fees 145.70 #of Heat Pumps<= 3 Hp 1 Plumbing Permit Fee 111.00 #of Gas Piping 1 State Building Code Fee Resi 6.50 #of Gas Water Heaters<= 100k 1 Sewer Inspection Fee 52.14 Building Valuation 195000 Storm Drain GFC-Residential 1,746.97 Occupancy Group it-1 Sewer GFC-Residential 9,331.86 1st Floor Square Footage 1027 Park Impact Fee 615.00 Lot Area 3000 Traffic Impact Fee 2,817.69 Stove, Appliance 1 Non Sprinklered SFR Fire Fee 102.58 #of Tubs, bath 1 EMS Impact Fee 363.70 #of Water Closets(Toilets) 2 SFR/duplex: site plan/design 60.00 Stormwater Review 116.16 #of Showers 1 #of Dishwashers 1 Total Calculated: 18,186.79 #of Hand Sinks 2 Deposits/Receipts: 0.00 #of Kitchen Sinks 1 #of Clothes Washers 1 Total Due: 18,186.79 #_of_Gas Outlets 2 #of Water Piping 2 #of Hose Bibs 2 #of Air Conditioning Units 1 #of Wall Heaters 2 #of Ventilation Fans 3 Flood plain development N 1 Y City of Anacortes Invoice/Permit#: BLD-2021-0337 904 6th Street Applied date: 05/03/2021 P.O.Box 547 Issue date: 06/24/2021 _ ;' 0, Anacortes, WA 98221-0547 (360) 293-1901 Expire date: 12/21/2022 The issuance or granting of this permit shall not be construed to be a permit for,or approval of, any violation of this Code or any other ordinance or order of the City, of any state or federal law, or of any order, proclamation, guidance advice or decision of the Governor of this State. To the extent the issuance or granting of this permit is interpreted to allow construction activity during any period of time when such construction is prohibited or restricted by any state or federal law, or order, proclamation, guidance advice or decision of the Governor of this State, this permit shall not authorize such work and shall not be valid. The building official is authorized to prevent occupancy or use of a structure where in violation of this Code, any other City ordinances of this jurisdiction or any other ordinance or executive order of the City,or of any state or federal law,or of any order, proclamation, guidance advice or decision of the Governor. The building official is authorized to suspend or revoke this permit if it is determined to be issued in error or on the basis of incorrect, inaccurate or incomplete information, or in violation of any City ordinance, regulation or order, state or federal law, or any order, proclamation, guidance or decision of the Governor.This permit becomes null and void if work or construction authorized is not commenced within 180 days or if construction work is suspended or abandoned for a period of 180 days at any time after work is commenced. I have read and examined this application and know the same to be true and correct. 7 `-/ SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT sr' � Mailing Address: P.O. Box 547, Anacortes, WA 98221 Office Location: 904 6th Street, Anacortes WA 98821 1/4?,() o"; Phone: (360)293-1901 �'\ •,� MITTAL INFORMATION AdcLitiockald4ails on certain submittal items is provided below to ensure Applicants are fully aware what'City"stafi;,4r\ill be looking for when an application is submitted to the City. FORMS AND PLANS • FORM BP-1: RESIDENTIAL BUILDING PERMIT APPLICATION FORM. Provides key information about your project, including type of permit you are applying for, and property owner, contractor, and contact information. • FORM BP-2: STRUCTURE AND SITE INFORMATION FORM. Provides key information about the proposed structure, including height,floor areas, fire protection proposed, and asks questions about site characteristics that are used to determine whether your project requires any other information or additional permit applications to be submitted. • FORM BP-3: PLUMBING AND MECHANICAL INFORMATION. Form BP-3 provides space for you to fill in fixture information for plumbing and mechanical appliances and equipment that are included as part of your project. • FORM BP-4: ARCHITECTURAL PLAN REQUIREMENTS. Form BP-4 contains a list of all the items required to be shown on Architectural Plans. • FORM BP-5: STORMWATER MANAGEMENT DETERMINATION FORM. Most development within the City of Anacortes that involves disruption of soils, or construction of buildings, streets, parking lots, etc. requires a Stormwater review. Stormwater review requirements are based on either the amount of soil to be disturbed (grading,vegetation removal), or the amount of hard surface that is created or replaced on a site (building footprint, concrete, asphalt or gravel parking, sidewalk, etc.). Form BP-5 assists you in determining the level of stormwater review (applicable Minimum Requirements) required for your project. • STORMWATER SITE PLAN. The Stormwater Site Plan is the comprehensive report containing all of the technical information and analysis necessary for regulatory agencies to evaluate your project for compliance with stormwater requirements. The level of stormwater review and contents of the Stormwater Site Plan will vary with the type and size of the project, and individual site characteristics. Use Form BP-5 to determine the level of stormwater review and then complete the applicable Stormwater Minimum Requirements Form on the Public Works - Engineering Department Forms website and provide required submittal items/plans. • FORM BP-6: SITE PLANS & LANDSCAPE PLANS. Form BP-6 contains a list of all the items required to be shown on Site and Landscape Plans. • STRUCTURAL PLANS: Plans prepared and stamped by a State of Washington licensed professional structural engineer drawn at a scale approved by the Building Official clearly indicating the information required by the "Permits" section of the currently adopted International Building Code and Chapter 19.27 RCW (State Building Code Act, Statewide amendments), and City submittal forms including: structural members labeled as to size and spacing as well as bracing, blocking, bridging, special connectors, and anchor bolts; cross-section details, as needed,to show typical foundation,floor, wall, ceiling and roof construction; insulation of walls,floors and roof/ceiling; and details of stairs, fireplaces and special construction, if any. Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 2 of 18 { G1 .n PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.O. Box 547, Anacortes, WA 98221 k -- Office Location:904 6th Street, Anacortes WA 98821 ,, c0 {one: (360) 293-1901 J G LZ.1 C x rri � ,� o tial Building Permit Application Ste' (Packet New Single Family Residences (SFR) Duplexes Additions and Remodels (SFR & Duplex) Accessory Dwelling Units Manufactured Homes Residential decks and retaining walls SUBMITTAL CHECKLIST x a' a o .YY ,� ' n a = _ Residential Building Permit ro 0 I- 'a L C , 0 L L Sco .viubmittal Requirement Checklist to T L Q u _ D in 'Ej in y — O c 3 al -E .E u Qam See pages 2-3 of this handout for information about each 3 m cui E Cr) = E to :� U submittal item listed below. Z . Q ❑ CC u 2 a L O Residential Building Permit Application Form X X X X X (FORM BP-1—attached) Structure &Site Information Form (FORM BP-2—attached) X X X X X Mechanical& Plumbing Fixtures Form X X X (FORM BP-3—attached) Architectural Plans X X X X X (requirements listed on FORM BP-4-attached) Stormwater Management Minimum Requirements Determination X X X X (FORM BP-5,attached) Stormwater Site Plan X X X X Site Plan & Landscape Plans X X X X X (requirements listed on Form BP-6) Structural Plans&Calculations X X X X X Energy Code Plans& Forms X X Manufacturer's Specifications/Cut Sheets X Copy of recorded survey X X X X Technical Reports X X X X Other Required Permits X X X X X ADU Affidavit of Owner Occupancy (signed) X Required Number of Copies and Plan Size Fees 2 paper copies of each item above • Plan review deposit is taken at time of Plans must be minimum 11" x 17",to scale, and legible application submittal. 1 reduced size copy(maximum size 11"X 17") of the Site • Permit fees are paid prior to building Plan, Floor Plan and complete Building Plans permit issuance. Page 1 of 18 Res.Building Permit Application Submittal Checklist Updated October 10,2019 o PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.O. Box 547, Anacortes, WA 98221 t "� Office Location:904 6th Street,Anacortes WA 98821 ��' 'Rhone: (360)293-1901 O Qy n • T UR L ALCULATIONS: An analysis of loads, materials,etc., prepared and stamped by a e of ton licensed professional structural engineer. • ` E n ioE FORMS: The standard Washington State Energy Office form requesting the �`` informaF1�L tn required under Chapter 51-11 WAC detailing building components used to comply with the State Residential or Nonresidential Energy Code, as applicable. • MANUFACTURER'S SPECIFICATIONS/CUT SHEETS: A document that summarized the performance and other technical characteristics of a product, machine, component, material, or subsystem (e.g., a power supply) in sufficient detail that allows the City to determine the product will be incompliance with applicable codes. • COPY OF RECORDED SURVEY. A survey of your property is needed so that conformance with minimum setback requirements and other development standards can been confirmed and verified on site by the inspectors. Property markers must be visible on your property. If they are not at the time an inspection is requested, you may need to have a new survey completed. OTHER SUBMITTALS DETERMINED ON A CASE-BY-CASE BASIS TECHNICAL REPORTS Following is a list of technical reports that will be required to be submitted to the City when certain circumstances exist on or near a site an Applicant is planning on making improvements to. The general triggers for each of the listed technical reports I provided below: A. CRITICAL AREAS REPORTS: In general, Critical Area reports are required when wetlands and/or streams are located on or near a site. Critical area mitigation plans may also be required, depending on the project proposal. See Anacortes Municipal Code Ch. 17.70 for additional information. B. GEOTECHNICAL REPORT: In general, Geotechnical Reports are required when work is proposed on or near slopes in excess of 15% and/or known landslide hazard areas. See Anacortes Municipal Code Ch. 17.70 for additional information. OTHER PERMITS DETERMINED ON A CASE-BY-CASE BASIS OTHER FORMS Following is a list of other permits that could be required in certain circumstances. The general triggers for each of the listed permits is provided below. A. FILL AND GRADE PERMIT: Grading(importing, exporting, and/or moving material on a site)of more than 50 cubic yards and/or if grading modifies the existing flow of stormwater or groundwater. B. RIGHT-OF-WAY PERMIT: A right-of-way permit is required anytime the public right-of-way is disturbed or obstructed in any way by private development or the general public. Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 3 of 18 - ,,I y U� PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT i Mailing Address: P.O. Box 547, Anacortes, WA 98221 {`"°•°A7' Office Location: 904 6th Street,Anacortes WA 98821 `�4" :� , k c ne: (360)293-1901 .i" Ali( '71, rTI 7 1891 Nil✓, 4COg1�`o) or to FIELD x1.4S Page left blank intentionally. Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 4 of 18 lT y O PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT `,4141,,x,r' Mailing Address: P.O. Box 547, Anacortes, WA 98221 „ k c Office Location:904 6tn Street,Anacortes WA 98821 " ' :fir ° one: (360)293-1901 O� 9� rn FOR" '• lD-1: RESIDENTIAL BUILDING PERMIT APPLICATION 0 ' ' -(INFORMATION 7r)!-1J]S`VAL.' Project Address(Street,Suite#): Assessor Parcel Number: 60 a Szz z? 1.3 5y/6 Subdivision/Lot#: Zoning Designation: Lot area (size): 2_ ) sq. ft. 2. TYPE OF PROJECT j" New SFR ❑ New Accessory Dwelling Unit: ❑ Deck/porch (new/repair) CI New Duplex ❑ Attached to Primary Unit 0 Interior remodel 0 Detached from Primary Unit ❑ New Addition to SFR ❑ Garage, carport or accessory building ❑ Fence or retaining wall or duplex (new/repair) ❑ Other: Project Summary: & ) CO2 i5r/' Er fx,- f-A_ Project Valuation: $ /9S 650-0 3. PROPERTY OWNER INFORMATION Name: Ph ne: Address(Street,City,State,Zip): Email Address: �ppe/ „.44/-'6 C� �' 9 l � 4. CONTRACTOR INFORMATION Name:*„.., Phone: L5 and vim 3GQ 9,� 67.e Contractor's Business Licenses State License#: City License#: *All Contractors&Subcontractors must have a valid City (I/L JCJ- 3 /X ' too'/ of Anacortes business license prior to doing work in the Expiration Dale: Expiration Date: Cary. 5'�2�tOZY-' 51/ Address(Street,City,State,Zip): Email Address: e 5. CONTACT PERSON Select one person the city will contact for anything nA related to this project: Applicant ❑ Property Owner El Contractor ❑ Other(list below) Name: Ala, Phone: iGo 192 21q YS92_ Address(Stre t,City,State,Zip): Email Address: / 7OT g l YCez_ Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 5 of 18 ( G y PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.O. Box 547, Anacortes, WA 98221 '""I' Office Location:904 6th Street, Anacortes WA 98821 T- ems. y c one: (360)293-1901 0 Cy CC. rrl 6. L ' i F s RMATION R ► I9S r- , tt he City to obtain information with regard to lenders. If there are no lenders involved with your project, wri 4lrr(e s'.:,n'tti Name Line below. C,, _ - Name:it, Phone: Address(Street,City,State,Zip): Email Address: 7. ACKNOWLEDGEMENTS & SIGNATURE Read and initial each of the following statements prior to signing this application: I understand that when a building permit application is taken in over the counter it does not mean the application has been deemed technically complete and sufficient for staff review. I understand that if I submit incomplete, inaccurate, and/or erroneous information it will take the City longer to process my permits. I understand and acknowledge that I could be responsible for providing as-built drawings (on paper or electronically)as part of the project's certificate of occupancy process. I understand and acknowledge that Special Inspections could be required as part of my project, and if needed I will be required to pay for the cost of these inspections. I understand and acknowledge that financial securities could be required as part of the work I am completing and I agree to provide the items needed for the City to calculate these securities and to provide the securities themselves. I understand that if permits are reviewed concurrently such as design review,site plan,traffic concurrency, etc., any required revisions to one permit may affect the entire plan set and could add costs and time to the project. I hereby declare that I am either the owner of the property listed on this application or the owner of this property has authorized me to be their representative to act for them. I also declare under penalty of perjury under the laws of the State of Washington that all of the statements and answers contained herein, and the information submitted with this application form is in all respects, true, correct, and complete to the best of knowledge and belief. Za,„Ae,5 AIL,2 ////1/2-6fi-,/ 5igna, re Date Printed Name Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 6 of 18 y o PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT '` Mailing Address: P.O. Box 547, Anacortes, WA 98221 (-49E° Office Location: 904 6th Street, Anacortes WA 98821 " °4 one: (360)293-1901 FORRA ko .2: STRUCTURE AND SITE INFORMATION HERE WORK IS OCCURRING if I I) ADDRESS: tide o 5' v2A/ 5 e-4-7-- PARCEL ,/ r NUMBER(S) C 27i/6 2. DETAILED PROPOSED STRUCTURE INFORMATION Complete the following information as it relates to your project. Mark items that are not applicable with "NIA". Structure height: AREA SQUARE FOOTAGE OCCUPANCY GROUP CONSTRUCTION TYPE OCCUPANT LOAD 1"Floor: / 7 q 2"d Floor: 3rd Floor: Basement: Garage: Total deck: Total porch: Other: Other: Other: 3. QUESTIONS ABOUT THE PROPOSED STRUCTURE Is a fire sprinkler system being installed? ❑ YES CI NO Is a monitored fire alarm being installed? ❑ YES NO Are retaining wall(s) being built? ❑ YES © NO Are structural plans required? ❑ YES ® NO 4. PROJECT SITE INFORMATION A. Is work within the City's right-of-way proposed? If yes,you will be required ❑ YES M NO to submit a right-of-way permit application. If you have already submitted a ROW permit, list the permit number here: B. Is the property located in a flood zone? ❑ YES NO If yes, list the flood zone designation: C. Are there slopes in excess of 15%on or abutting the site? If yes, a ❑ YES El NO geotechnical report will likely need to be submitted. Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 7 of 18 y O PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.O. Box 547, Anacortes, WA 98221 Office Location: 904 6th Street, Anacortes WA 98821 10, c9 one: (360)293-1901 APW A rn D. 1'r- . - - tic areas or buffers on or abutting(within 300-feet of)the ❑ YES ® NO N b9i ' f_xes, a critical areas report will likely need to be submitted. E. is the lot lesTr'than 5,000 sq.ft. in area? YES ❑ NO If yes,your site and building will need to comply with the standards in AMC 19.43.010.C. F. Is your project involving an accessory dwelling unit? ❑ YES ® NO If yes,your site and building will need to comply with the standards in AMC 19.47. G. Will more than 2-acres be cleared and/or more than 5,000 board feet ❑ YES 13 NO (about 1 log truck load) of timber be harvested? If so you may need to obtain a forest practices permit from DNR. H. Is this project subject to the SEPA process? If yes,you will be required to ❑ YES Q' NO submit a SEPA checklist. If you have already completed the SEPA process, list the permit number here: 5. REQUIRED SIGNATURE I hereby declare that I am either the owner of the property listed on this application or the owner of this property has authorized me to be their representative to act for them. I also declare under penalty of perjury under the laws of the State of Washington that all of the statements and answers contained herein, and the information submitted with this application form is in all respects,true, correct, and complete to the best of knowledge and belief. („1/1,j Signature Date 2-� Printed Name Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 8 of 18 ‘1 y O PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT ',' '{' Mailing Address: P.O. Box 547, Anacortes, WA 98221 : ,y` Office Location:904 6th Street, Anacortes WA 98821 •' °-- ""_`' Phone: (360)293-1901 NG ,%t, w`o LUMBING AND MECHANICAL FIXTURES MMECNAi\iICAL Equipment Type: Appliance/Equipment Information(new and relocated): Total#: Furnace: Gas if: Elec#: BTU: Other#: Wall Heater: Gas#: Elec#: , Other:#: Location(s): 2 Gas Water #: / Location(s): / ,_,/,. / Heat Pump: Elec#: Other#: Capacity: oil, Air Conditioning: Elec#: Other#: Capacity: J-44 + ft Radiant/Hydronic Gas#: Elec#: Other:#: Location(s): Exhaust Fans: Bath#: Laundry#: / Other: 7 Range Hood: #: / Location(s): 4(40/ / Fireplace: Gas#: Elec#: Other:#: Location(s): Clothes Dryer& Duct: Gas#: Elec#: / Other:#: Location(s): Stove/Range/Oven: Gas#: Elec#: / Other:#: Location(s): Gas Piping/Outlet(s): #: Location(s):A¢We*,e, — 41 ./.44. . Boiler Gas#: Elec#: BTUs: Location(s): Other: #: Location(s): TOTAL MECHANICAL OUTLETS: PLUMBING Fixture Type (new and relocated): Total#: Fixture Type(new and relocated): Total#: Water Closet(Toilet): a Refrigerator water supply(for water/ice Kitchen Sink: / Pressure Reduction Valve/Pressure Regulator: Utility Sink: Water Service Line: / Tub: / Water Piping: Hand Sink: , Clothes Washer: t Shower: / Electric Water Heater: Tank-less? Yes 0 Dishwasher: / Backflow Prevention Assembly: Hose Bib: A Other: TOTAL PLUMBING FIXTURES: Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 9 of 18 -0 y ( PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT I Ile Mailing Address: P.O. Box 547, Anacortes, WA 98221 iv- Office Location:904 6th Street, Anacortes WA 98821 r CAT, . o ne: (360)293-1901 IFORi' I 1 7 ARCHITECTURAL PLAN REQUIREMENTS 1. `roRQPE,t' " WHERE WORK IS OCCURRING ADDRESS: '. 80 b - 7 Jr/ 7' PARCEL 3c'//„ NUMBER(S) f 2. GENERAL INFORMATION This form is intended to assist applicants in creating complete, code compliant architectural plans. Please check the plans you wish to submit to make sure they contain each of the listed items. To the right of the Requirements column is space for you to list the sheet number of the plan set where the listed information is shown. • Minimum Plan Size: 11" x 17" and drawn in an architectural scale. • Architectural plans for structures 4,000 square feet or larger are required to be prepared and stamped by an architect licensed in the State of Washington. • Structural plans must be stamped by a structural engineer licensed in the state of Washington. 3. REQUIREMENTS FOR ALL ARCHITECTURAL PLANS COMPLETE PAGE#ON REQUIREMENTS ? YOUR PLANS Cover(or 1st page) must include: • Site address • Parcel number • Lot number(if applicable) • Lot size • Lot coverage • % impervious surface coverage Floor plans with existing (if applicable) and proposed building layout with square footages and with the use of each room/area labeled. Window and door sizes labeled and window ventilation area. Commercial, Multi-Family, and Mixed-Use Structures must also include door and window schedules. Plumbing, duct, and electrical layout. Penetration protection must be shown. Opening headers, size, and material. Cross section details, showing typical foundation,floor,wall,ceiling and roof construction and insulation. Structural members labeled as to size and spacing as well as bracing, blocking, bridging,special connectors, and anchor bolts. Details documenting energy code compliance. Exterior building elevations demonstrating compliance with applicable structure type design standards (small lot,duplex,orADU) and maximum building height Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 10 of 18 GAT y O� PLANNING,COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.O. Box 547, Anacortes, WA 98221 Office Location:904 6th Street, Anacortes WA 98821 tiY O P one: (360)293-1901 a M 1111100 in height(see AMC 19.42.120 for measurement methods,exceptions and modifications). sG 1891 kt Label the building height at the highest point of the structure from the average C 0'it-, �°of the natural topography at the foundation at the front of the building. �rTi7f>rt .v`��cY Label the average elevation of the natural topography at the front of the building. • Label the elevation at the center of all exterior walls of the proposed building. • For ADUs only,include elevations demonstrating compliance with the height/setback plane(see AMC 19.47.030(C)(6)). Special details as needed (i.e.,stairs,fireplaces,special construction). Insulation and insulation values of walls,slab,floors,and roof/ceiling. Existing and proposed grades with slope of lot shown. Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 11 of 18 NA y PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT 1A Mailing Address: A.O. Box 547, Anacortes, WA 98221 y '"' Office Location: 904 6th Street, Anacortes WA 98821 ,'* o° one: (360)293-1901 Agee FORM kP-5: STORMWATER MANAGEMENT MINIMUM REQUIREMENTS DETERMINATION 1. PROPERTY WHERE WORK IS OCCURRING ADDRESS: 605 y�� PARCEL NUMBER(S) / /?may/, 2. GENERAL INFORMATION Most development within the City of Anacortes that involves disruption of soils, or construction of buildings, streets, parking lots, etc.requires a Stormwater review. Stormwater review requirements are based on either the amount of soil to be disturbed(grading,vegetation removal),or the amount of hard surface that is created or replaced on a site(building footprint,concrete, asphalt or gravel parking,sidewalk,etc.) This form is largely targeted for small projects and single family residences. For larger projects and more information please refer to the Anacortes Municipal Code(Chapter 19.76 Stormwater Management)and the latest Washington State Department of Ecology Stormwater Management Manual for Western Washington (Ecology Manual). 3. HARD SURFACE AREA CALCULATION Please calculate your project's hard surface amount;guidance is provided on the next page of this document. Use your project's total hard surface calculation to follow the flow chart(s)in this packet and determine the level of stormwater management required for you project. When determining your permit level or if stormwater thresholds are met or exceeded the entire project must be considered. A project is that portion of a property, properties,or right of way subject to land disturbing activities, new hard surfaces and replaced hard surfaces. The hard surface on your property will determine the storm water utility fees and the stormwater general facility charge. All new or replaced hard surfaces should be accounted for. Below are excerpts from the Anacortes Municipal Code and Ecology Manual that may assist you in preparing this information. "Hard surface area"means an impervious surface, a permeable pavement,or a vegetated roof. "Impervious surface"means a non-vegetated surface area which either prevents or retards the entry of water into the soil mantle as under natural conditions prior to development. A non-vegetated 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. "Replaced impervious surface"means,for structures, the removal and replacement of impervious surfaces down to the foundation. For other impervious surfaces, the removal down to bare soil or base course and replacement. Res. Building Permit Application Submittal Checklist Updated October 10,2019 Page 12 of 18 y � PLANNING,COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT i ' Mailing Address: P.O. Box 547, Anacortes, WA 98221 k Office Location:904 6th Street, Anacortes WA 98821 0 ne: (360)293-1901 � M n1r d �' bance <�4, C Total torn :c scrip tion (SF) Total Area of Land disturbing activity // to Total area converted from vegetation to lawn or landscaped areas Hard surface area calculation Existing Removed Proposed Proposed Description (SF) (SF) Replaced New (SF) (SF) Non Pollution Generating Hard Surface Area - (Sidewalks, paths, patios,etc.) Pollution Generating Hard Surface Area (Driveways, parking areas,etc.) Total Hard Surface Site Size 3 Existing impervious surface coverage% 3 �% (sq.ft. hard surface/site size) Use the information in the above table to navigate the flow chart(s) on the next page and determine the applicable stormwater management minimum requirements for your project. Then complete the applicable Stormwater Minimum Requirements Form on the Public Works - Engineering Department Forms website and provide required submittal items/plans. Check applicable box Minimum Requirements Determination Minimum Requirements #1-9. Minimum Requirements #1-5. Res.Building Per Application 5ubmiltal Checklist Updated October,2019 Minimum Requirement#2. Page 13 of 18 AV y O� PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT t Mailing Address: P.Q. Box 547, Anacortes, WA 98221 1.5-wk- 44.—Gspr Office Location:904 6th Street, Anacortes WA 98821 1, O gone: (360)293-1901 F 'a ' ' FO' TERMINING REQUIREMENTS FOR NEW DEVELOPMENT 1891 C.) rOFIELD ~e� Start Here Does the site have 35% Yes See Redevelopment Minimum or more of existing ► Requirements and Flow Chart impervious coverage? (Figure 1-2.4.2). No Does the project convert 3/4 acres or more of vegetation to Does the project result in lawn or landscaped areas,or 5,000 square feet,or No convert 2.5 acres or more of greater,of new plus to native vegetation to pasture? replaced hard surface area? No Yes Yes Does the project result in 2,000 V square feet,or greater,of new plus All Minimum Requirements replaced hard surface area? apply to the new and replaced hard surfaces and converted vegetation areas. Yes No I. Does the project have land Minimum Requirements#1 disturbing activities of 7,000 through#5 apply to the new 41 Yes square feet or greater? and replaced hard surfaces and the land disturbed. No V Minimum Requirement#2 applies. 11■„;,"'1111 Figure I-2.4.1 Flow Chart for Determining Requirements for 4111 ll�l New Development DEPARTMENT OF Revised June2015 ECOLOGYPlease see httplAvww ecy.we gov/copyrighl.html for copyright notice including permissions, State of Washington limitation of liability,and disclaimer Res. Building Permit Application Submittal Checklist Updated October 10,2019 Page 14 of 18 Y o PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT I tG � Mailing Address: P.D. Box 547, Anacortes, WA 98221 t rW Office Location: 904 6th Street,Anacortes WA 98821 Oo one: (360)293-1901 9 W .2 x M F .. CHA' Fs' ETERMINING REQUIREMENTS FOR REDEVELOPMENT 1891 �y } • Does the project result in 2,000 square feet,or more,of new plus replaced hard surface area? ` OR - \` Does the land disturbing activity total 7,000 square feet or greater? Yes ("1,, No Minimum Requirements#1 through#5 apply to the new and replaced hard Minimum Requirement#2 applies. surfaces and the land disturbed. J jr Next Question _ Does the project add 5,000 square feet or more of new hard surfaces? OR Convert 3/4 acres or more of vegetation to lawn or landscaped areas? OR Convert 2.5 acres or more of native vegetation to pasture? Yes No All Minimum Requirements apply Next Question Is this a road to the new hard surfaces and the 0 related project? - No converted vegetation areas. Yes Does the project add 5,000 square feet or more of new hard surfaces? Yes No is the total of new plus replaced hard surfaces Do the new hard 5,000 square feet or more, surfaces add 50%or No No additional NO AND more to the existing requirements. 4 does the value of the proposed improvements hard surfaces within -including interior improvements-exceed the project limits? 50%of the assessed value(or replacement value)of the existing site improvements? Yeses ► All Minimum Requirements apply to the new and replaced hard surfaces and converted vegetation areas. Yes rr' 1011111 Figure 1-2.4.2 Flow Chart for Determining Requirements for Redevelopment DEPARTMENT OF Revised June2015 ECOLOGY Please see hllplhvww ecy we gov/copynght.html for copyright notice including permissions, State of Washington limitation of liability.and disclaimer Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 15 of 18 1�y o PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT 4' Mailing Address: P.O. Box 547, Anacortes, WA 98221 "" """"' Office Location: 904 6th Street,Anacortes WA 98821 .� Y O one: (360)293-1901 Asit, FORM 6P-6: SITE PLAN REQUIREMENTS 11. `a. • iv,. IP <` WHERE WORK IS OCCURRING ADDRESS:1t " PARCEL /) /15, NUMBER(S) �" 2. GENERAL INFORMATION This form is intended to assist applicants in creating complete, code compliant site plans. Please check the plans you wish to submit to make sure they contain each of the listed items. To the right of the Requirements column is space for you to list the sheet number of the plan set where the listed information is shown. • Minimum Plan Size: 11"x 17" and drawn in an engineering or architectural scale. 3. INFORMATION REQUIRED ON ALL SITE PLANS COMPLETE? REQUIREMENTS PAGE#ON YOUR PLANS Cover sheet must contain all of the following: • Vicinity Map • Name of the project • Name, address, and telephone number of owner and agent(s) • Name, address, and telephone number of Applicant(if different from the owner) • Zoning designation of the site • Area, in square feet and acreage, of the project site • Reference to the Building Code used • Proposed use • Occupancy group • Construction type • Square footage and height of each individual building • Percent lot coverage • Percent impervious surfaces Scale and North Arrow Property features: Location, identification, and dimensions of all property lines and easements. All easements shown on the title report, Record of Survey,or plat must be dimensioned and shown. Location and dimensions of existing critical areas(wetlands, streams, steep slopes) and their associated buffers. Location of Ordinary High Water Mark and shoreline jurisdiction limits (if adjacent to a shoreline). Existing and proposed contours and site elevations (i.e. finished grades) at 5-foot minimum increments. The horizontal and vertical control datum must be clearly shown. Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 16 of 18 AT y Toe PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT V Mailing Address: P.O. Box 547, Anacortes, WA 98221 9 ,, (b Office Location:904 6th Street, Anacortes WA 98821 Id9\ 4i� n e: (360)293-1901 roc ures: s4,„, COg�w `2 LoocatoioQ�identification, and other structures.size of all existing and 1°rra= ) proposed g Location of existing and proposed retaining walls, rockeries, and Location, identification, and dimensions of all setbacks. Show proposed projections into required setbacks, including dimensions (see AMC 19.44.140) Utilities & Easements: Location and dimensions of existing and proposed stormwater, sanitary sewer, potable water, and fiber lines/facilities. All wells and septic systems located on or near the project site must also be identified. Location of all existing and proposed fire hydrants within 300 feet of the boundary of the project site. Location and dimensions of existing and proposed freestanding lighting fixtures, utility junction boxes, public utility transformers. Stormwater Proposed Temporary Erosion and Sediment Control Measures, if not located on other plans. Proposed permanent stormwater management BM Ps. Access, Circulation & Parking Location, identification, and dimensions of all existing and proposed on-site and adjacent streets and alleys, including the location and dimensions of all existing and proposed curbs, gutters,sidewalks, median islands, and street trees. Show existing and proposed vehicular access to the site, including the size and location of driveways and curb cuts. Show existing and proposed parking spaces, including surface material and dimensions of spaces. Open Space (ADUs, Small Lots, and Duplexes) Show calculations, location, dimensions and provided square footage of required open space area per AMC 19.43.010.C, E, or AMC 19.47, as applicable. Landscaping Show the location and design of landscape areas to be preserved and planted, and a plant list to include the location, number, size and type of plant material by botanical and common name. Location of irrigation system if a permanent or temporary system is proposed. Show the location of existing trees to be retained in conformance with AMC 16.50, and tree protection measures to be implemented, when applicable. Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 17 of 18 0�� Y �� PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.O. Box 547, Anacortes, WA 98221 ( ,. Office Location:904 6th Street, Anacortes WA 98821 ', k e-ft n e: (360)293-1901 o • m Provide a maintenance plan for any infiltration-based stormwater gam Provide best management practices (BMPs) built as part of the landscaping N etx 891 .'S� o�design, including the specifications maintenance procedures of lc , �� g g p oFic -tti e� any soil amendments. Show new trees to be planted and tree unit credit calculations, in conformance with AMC 16.50 Tree preservation,when applicable The following table,with project specific information filled in, must be placed on the site plan: Required Landscaping For Example Calculations Site Area 7,500 sq.ft. of site area to be landscaped (per 20%-R2A zone AMC Tables 19.42.020-.030) 1,500 sq.ft. required 1,850 sq.ft. provided Compliance with AMC Ch. 16.50 Tree unit credits required: Tree Preservation. • 8 tree units required Tree unit credits retained: • 2 trees 6"dbh=4 tree unit credits retained Tree unit credits provided: • 2 new deciduous trees(min.2" caliper @ 6"above ground) • 2 new evergreen trees(8'in height) Number of required street trees 1 per 30'of frontage 60 lineal feet of frontage=3 street trees Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 18 of 18 Ovpg CODE O 446 w4< 1T Y O(Arnie ., CODECO 891 ��7. y � jO. 4Co •orR ,,?, M III �FIELS7 mil, 1891 -C4,r�lik- Q��r0 FIELD[�S Structural Calculations for the 805 24th St. Residence City of Anacortes VFRItm 41: t I .NForSi310 ft, ER ` `• 40NAL .� JJN2:41011 , 1-Pe OF ANACORTES By: X-SOUND ENGINEERING P.O. Box 1265 Freeland,WA 98249 (360)331-3113 Job No. 7120 i -soul V V JOB E3(77 ZAr-v -i -" NO. 1 ,2"0 ENGINEERING BY A !-"1--^ DATE 6" Z'2"Z P.O.Box 1265 Freeland,WA 99249 FOR CODE co 1..-Ath"5� rA i_ (360)331-3113(0)4i7 ,.r Y `1,A{ (360)331-7114(Ti Cs. ,4,, it • 7( rri 1891 w� e — ' t t 1 att • +� i t �1 t tvf �, y .... i i i i i i P 't iIt ' i 3 . ' I i i .. • - '9;:C\i3:) ,c,t)p5-)-(--.C\M_,3.,....536a,) 1 .1: iir I t i i i i i t t i i I = I ( i I i ' i i t :may tz4? i ' .' s ....,. .. , s ` � , `— _,��, :�-,,c .I,u 3 4 •1, CJ' v• • i i `�:-.1-- - --47:--1.4,7_ i �� F 1 i : .''�� u. . . . . . 1 • . L. - �:'Alt,�t�) t i i S i i I I I I I I I i I i I I t i t I i i I 1 I I 1 I 1 s i t i I I I { I = I 1 I t i i 1 ' I I I i I 1 i 1 t 1 I i i i 1 I 1 j 2018 IntP C A Bus (ding Code i, ,,e}T -I Project Name 805 24th St. Residence . ,., / Floor(1,2,etc) 1 ©Geo ; , r J 1 g (s reserved Jurisdiction City of Anacortes Date: 6/22/21 15:37 By: AGT Deesigntgfor,I� �w�o� no- f:'(y o3�i 6,, 40 psf Root i4' 0-' 25 psf Group 59144 oad 25 psf Basic Wind Speed(3-sec gust),(mph) 110 mph Seismic Design Category D Table 1613.5.6(1) Site Class D Table 1613.5.5 Snow Flat Roof Snow Load,Pf(psf) 25 psf Snow Exposure Factor,Ce 1.00 Table 1608.2 Snow Importance Factor,Is 1.00 Thermal Factor,Ct 1.00 Wind 110 mph Basic Wind Speed(mph) Wind Importance Factor,Iw 1,00 Building Category C Applicable internal Pressure Coeff Building Height 13.67 ft Eave Height 10 ft Longitudinal Width 1,W1 63 ft Transverse Width(Gable End),W2 18 ft a __ 3 ft Roof Rise in 12in 4 In Roof Pitch,(deg) 18° x 1.21 ps30 ps=XIwps30 Zone A 14.4 17.42 psf i Zone 8 -4,8 10.00 psf Zone C 9.6 11.62 psf Zone D -2.7 10,00 psf Longitudinal Wind Base Shear,V=Ep:DH 2,950 # Transverse Wind Base Shear,V =FpsDH 9,977 # Longitudinal Components and Cladding Area pnet30 pnet=XIwpnet3o Zone 1 (+) 0 _ 0 __Y_ 0.00 psf (-) 360 -11.9 -14.40 Zone 2(+) 0 0 0.00 psf (-) 759 -14.1 -17.06 Zone 3(+) 0 0 0.00 psf (-) 76 -19.7 -23.84 Zone 4(+) 142 11.1 13.43 psf (-) 1282 -10.8 -13.07 Zone 5(+) 142 11.1 13.43 psf (-) 1282 -10.8 -13.07 Transverse Components and Cladding Area pnet30 pnet=?Iwpnet30 Zone 1 (+) 180 4.2 10 psf (-) 180 -11.9 -14.399 Zone 2(+) 379 4.2 10 psf (-) 379 -14.1 -17.061 Zone 3 (+) 38 5 10 psf (-) 38 -27.2 -32.912 Zone 4(+) 570 9.7 11.737 psf (-)_ 854 -10.8 -13.068 Zone 5(+) 142 11.1 13.43 psf (-) 1282 -10.8 -13.07 Overhang Length 2.00 ft Overhang Area 126 sf Roof Overhang Zone 2 -19.8 psf Zone 3 -10.0 psf garthquake.OFOR CODE co 5* , •••actor 1.00 1 L*o Shy= 6 se • 9,t I ap• d Spectra •e .to se Acceleration 111111611, 1.25 Figure 1613.5(2) - 0.5 Figure 1613.5(2) - a 1891 ,....�l D i��' �e 1.00 Table 1613.5.3(1) o FiiSii§7. 2/3(Fa)(Ss) 0.83 (eq 16-39) Fy 1.60 Table 1613.5.3(2) SDI =2/3(Fv)(S1) 0.53 (eq 16-40) Seismic Design Category D Table 1616.3(1) Basic Seismic-Force-Resisting System(s) Shear Walls Weight of Struct.Above,W 33,210 # Design Base Shear,V =1.2SosW/R 5,109 Redundancy Factor,p 1.00 E=pQe+0,2SosD 10,644 Seismic Response Coeff.,Cs= SUS/(R/I) 0.13 Response Modification Factor, R 6.5 Analysis Procedure Used Simplified Shear Walls Longitudinal Design Base Shear I 10,64417# (Seismic Controls) Wall Line 1 Total Length of Walls 38 ft Trib.Area% 50 V/ft= _ 140 .If SW-1 Wall Line 2 Total Length of Walls 44 ft Trib.Area% I 501 V/fl=MI= SW-1 Wall Line 3 Total Length of Walls ft Trib.Area% I V/ft= _ 0 *If Wall Line 4 Total Length of Walls ft Trib.Area% 01 V/ft= 0 •If Transverse Design Base Shear 10,644 I# (Seismic Controls) Wall Line 1 Total Length of Walls 8 ft Trib, Area% I 301 V/ft= 399 .If SW-6 Wall Line 2 Total Length of Walls ft Trib.Area% 30I V/ft = • • SW-2 Wail Line 3 Total Length of Walls ft Trib.Area% I 401 V/ft= SW-1 Wall Line 4 Total Length of Walls ft Trib.Area% L 01 V/ft = 0 .If Shear Wall Schedule Wall Sheathing Nail Size Nail Pen. Edge Spacing in Framing SW-1 15/32"OSB 8d 1-1/2" 6 in SW-2 15/32"OSB 8d 1-1/2" 4 In See Note 3 SW-3 15/32"OSB 8d �. 1-1/2" 3 In See Note 3 SW-4 15/32"OSB 8d 1-1/2" 2 in See Note 3 SW-5 15/32"OSB 10d 1-5/8" 6 in SW-6 15/32"OSB 10d 1-5/8" 4 In See Note 3 SW-7 15/32"OSB 10d 1-5/8" 3 in See Note 3 SW-8 15/32"OSB l0d 1-5/8" 2 in See Note 3 Note 3 Foundation sill plates and all framing members receiving edge nailing from abutting panels shall not be less than a single 3-Inch nominal member(or double 2x nailed at w/2-16d @ 6"O.C.). Sheathing joint nailing shall be staggered in all cases. 3-IN VERT STUDS REQ'D ov_e_turatfic,4DR CODE c04 A 1, ,.4 Y R e�Voices avalaiabie. Disreagrd If not shown on plans. 7��� H P= HV Holddowns 18s I 44> _SW-1 9 1,261 LSTHDB/RJ OR STHDB/RJ OR HD2A �„ 1c II iit:‘ ��o SW-1 9 1,089 LSTHD8/RJ OR STHDB/RJ OR HD2A H �r0Fir vl,'-' SW-6 9 3,592 STH014/RJ OR HDSA SW-2 9 3,193 STHD14/RJ OR HDSA SW-1 9 2,129 STHDB/RJ OR HD2A P Anchor Bolts Provide 1/2"anchor bolts with minimum 7"embedment at 48"O.C. minimum. Provide minimum of 2 bolts per mud sill piece. Provide minimum distance from end of 3.5 inches,maximum distance of 12 Inches. 6i22121 PP• Wood Beam Calculator " Ca�Ik,S RUCTION CALC .,..r., 70 F.+ ;aanploapan P(ooverhangs,ela.J.Full npihof top*Ibeam is Wafeer&warred No I":_ is,, . .tiding in snow sots only No wet use or high moisture content.No mph tomperehne • st loalin, eruct oesipn values nem 1097 Na tonal Design Specification for Wood 1riNH.S411SIsLSL4Jiii*Sam •AU users,-V� "� •:rCji shell comply win State Ogttearing Lew,which specie"who may perform Lt1 wig end deities,is ;- ad-ormp'needn0. e, 8052481S1 N1 ,1, �+ 1891 r -= G,� " ".c '' 800 Load and Span Nag mOrosToSate) D Frfil.D[ Span,L=i 5.00n ) 600 Max.Allowed Live Deflection,Ll l..__.-. ___..-1•0+V^ Igo Max.Allowed Total Deflection,L I I - 240 !=oar, '20D Load Duration I7en Yeats(Litre) rgi 3 0 _. 1 Add Self Vita Q Yes 0 tie I -200 I 2 3 4 6 Loads Other Than r� -400 Span In) Uniform Loads? IYes 1�I Uniform Loads Over Full Length of Member Tributary Uniform Live Reduced Live Unit.Dead Load, Live,pat ,_....,Dead-net width,ft Load,pit Load,pll. pit. Floor Loads' I ^1 1 - - Load Subtotals Total Uniform Loads 'Ali=► - I nn=t_I Combined Total Uniform Load 1vu= - Concentrated(Point)Loads Live Load pot 12pad Load oaf Igg.ffalib.L Trib.Length.ft l_Ive.l6s Road.WS L00111241.4. Point Load A 75 psf - xx= Point Load B�T — 75 psf - '4'_ Point Load C S Dsacdp'n,. p i 1 100 lb 080 lb xc= 3,00 n Point Load D i_,_0,audoin,opD, x03 Point Load E t___Qt?MPA.01f1; xe --- Note:Location Measured From Left Support Partial Uniform Loads Live Load.ost Dead Load.usf Tdjpi 'rid_ Live Load,of( Dead Load.plf(.9mbodfLoud. Start Point 0 End Polrtl.(L Partial Load A - - - Partial Load B - - Partial Load C . - Partlal Load D ' orxdp_h l: 76.0 bit 46.01bhft 120.01b/fl . . 0.0011 3,00 ft Partial Load E t _Snot°,,yat1; 275,0lblft 185.0 Ibfi 440.01b It 3.00 ft 5,00 ft Note:Start and End Points Measured From Left Support Wedge Loads(Max at Left End,Zero at Right End) Live Load.oaf Dead t gaad.Dot Tributary wklib.,11 i ton I oad,tit Aaad_wad.plt CombpolfLoad. Total a Wedge Load Al _I__ I I - - - 4x And Smaller ILumbert 5x And Larger(Tlmbetf) Lumber Material INem•ftr it limber Material INem-Fir T Lumber Grade I No.2 )oI Timber Grade FWWPA-No.1 — 1T Repetitive - 3 x 14 - - - Member Uso? (2)2x12 4x 10 a x 8 - o 11 [ (3,2xa axe - - fgLU,nd Laminated Members 2,0E Parallam PSL Gtulam Grade I241••V4 l i 1.314"r 9.114" 5.114"r 9.114" 2-41/1 fi"s 9.114" 7"r 94i4" 2.6 x 6 6,125 x 6 3-112"),9-414" ' 3x6 a,75x7.5 3.125 x 6 6,75 x 9 TrussJolat.MacMIllan h)olata 6 x 6 - - (Applies Only To Western Spades Glued•Laminaled Boars) _ - Final Member: Reactions Including Selt•Walaht Addy.Detall_,.Incl,Self WI. ISawn Wood L�Z_t g1 B: Ma%Wawa:2.57811-lb Final Size: Live Load: 7061b I,168 lb Member Design Shear, 1,541 lb 14 x 10 Dead Load: 4.42ja 7J681 Total fefxcllon:0036 In Minimum Bearing Total Load; 1,150 lb 1,8116lb live Deflection:0.023In Length-1.50 In ERiclnnc.v 90M0m4er: Req'd El,no seltsveigM added 4.300E+07 (Assuming Full-%Mdih Bearing) Bonding Overdesign•47 A% 5n"2.11d Shear Overdesigrr 5.0°% Approx Solt Woken 7.12 pit Final Member Selected:4 x 10,Hem Deflection Overdoaign:501.4% Min.Calc'd 848569lonplh 1,33ln Fir, No.2 This member makes it by: 5.0 ti Controlling criteria Is: Shear Doanaxls ` volt CODE e_ Co‘t. reS v,,ti, it Storm Water Minimum Requirements #2 ENGINEERING DEPARTMENT 904 6th Street Anacortes,WA 98221 .'<7, 44, ��¢1LIC „�' oz www.anacorteswa.gov ). 0 to FIELD Nt45'6' Official Use Only: (Information to Inspectors) Required Storm Water Facility and other related requirements: Project Address: 3O gr7i5/ Submittal Date: �Ij 7/}-6� Parcel Number:/ �G Revision Number: Permit Number: ¢l) - 2 2-I — 0337 Acceptance Date(COA): 5/26/21 Reviewer: Rob F. FRONT OF REPORT Submittal Checklist: o TAB 1 - Drainage Analysis—Minimum Requirement#2 o APPENDIX 1 - Survey performed by a Professional Land Surveyor o APPENDIX 2 - Model Soil Management Plan for BMP T5.13 o APPENDIX 3 - Determining Construction Site Sediment Damage Potential (Appendix 7) o APPENDIX 4 - Site Plan with all applicable information (Minimum Size 11x17—30 scale) o APPENDIX 5 - Documented Site Photos (North, South, East and West) Project Description: (What is it you are looking to do?Provide details regarding, but not limited to, Lot SF, Home SF, New and Replaced Hard Surface) 5 IZ Existing Site Conditions Summary: (Additionally, provide information on previous permits, if any, like Grade and Fill, Clear and Grade, topography, vegetation, drainage, Critical Areas adjacent to the site and how it may affect this project if soils are disturbed, Soils Type (Included in Soils Analysis Report), Erosion Problem Areas, Construction PhasinglSequence) Version Date: December 19, 2018 Developed Conditions Summary: (Additionally, to be shown on the site plan. Identify cut and fill areas, proposed slopes of all hard surfaces , proposed contours) Site Sediment Transport Score: Total Points (High\Low) (See Determining Construction Site Sediment Damage Potential(Appendix 7) Complete the Applicability Requirements—Flow Chart (Figure 1-2.4.1 Attached, Figure 1-2.4.2 Attached and Figure 1-2.5.1 Attached) - Highlight the path and attach DOE Stormwater Management Manual Minimum Requirements: (MR#1 to MR#5 only). Refer to the 2012 Department of Ecology Manual, as amended in 2014 for further required information. Version Date: December 19, 2018 Start Here viv Does the site have 35% Yes See Redevelopment Minirrur7- or more of existing ► Requirements and Flow Chart impervious coverage? (Figure 1-2.4.2). No Does the project convert 34, 't acres or more of vegetation to Does the project result in lawn or landscaped areas, or 5,0O0 square feet, or 4.,) convert 2.5 acres or more of greater. of new plus ► native vegetation to pasture? replaced hard surface area? Yes ''''' ---; Yes Does the project result in 2.00C -- V square feet, or greater, of new plu r All Minimum Requirements replaced hard surface area? c,-- apply to the new and replaced hard surfaces and converted Yes N vegetation areas. T Does the project have land Minimum Requirements ? t ' disturbing activities of7,O00 through #5 apply to the new , square feet or greater? and replaced hard surfaces Yes and the land disturbed. O f Minimum Requirement#2 applies. ,-, -M Figure 1-2.4. 1 Flow Chart for Determining Requirements for ligiOlik Nev. Development DEPARTMENT OF Revised June2a15 ECOLOGY Tease see MT;./,veyrw.ecy.wa.govicopyrtgr!.hrrI tor copyright nonce Inctuding permissions. Mate of Was';1 gto 1 riItabon of IlaDlttty.and dlscIaPrer. version uate: uecemoer wy, zu•io TAB 2 (MINIMUM REQUIREMENT#2) • 1-2.5.2 Minimum Requirement#2—Construction Stormwater Pollution Prevention Plan (SWPP) - All projects are required to complete Minimum Requirement 2. - Refer to the 13 Elements of the SWPP (See document below, complete and attach) - See attached Table 4.1.1, Table 4.2.1 and Table - Provide Engineering Calculations as an attachment for Sediment Ponds\Traps, Diversions, Waterways and Runoff/Stormwater Detention Calculations. Version Date: December 19, 2018 Table 4.1.1 Source Control BMP's by SWPPP Element Element#1 Element#2 Element#5 Element#6 Element#9 Element#11 Element#12 Element#13 BMP or Element Name Preserve Establish Stabilize Protect Control Maintain Manage the Protect Low Vegetatlon?dark Construction Soils Slopes Pollutants BM Ps Project Impact Clearing Limits Access Development BMP C101: Preserving Natural Vegetation ✓ BMP C102:Buffer Zones ✓ ✓ BMP C103:High Visibility Plastic or Metal ✓ �/ Fence BMP C105: Stabilized Construction V Entrance/Exit BMP C106: Wheel Wash ✓ BMP C107: Construction Road/Parking ✓ Area Stabilization BMP C120:Temporary and Permanent ✓ ✓ Seeding BMP C121: Mulching ✓ ✓ BMP C122: Nets and Blankets ✓ ✓ BMP C123: Plastic Covering ✓ BMP C124: Sodding ✓ BMP C125: Topsoiling/Composting ✓ BMP C126: Polyacrylanide for Soil Erosion ✓ Protection BMP C130: Surface Roughening ✓ ✓ BMP C131: Gradient Terraces ✓ ✓ BMP C140: Dust Control ✓ BMP C150: Materials On Hand ✓ ✓ BMP C151: Concrete Handling ✓ BMP C152: Sawcutting and Surfacing ✓ Pollution Prevention BMP C153: Material Delivery,Storage and ,/ Containment BMP C154: Concrete Washout Area ✓ BMP C160: Certified Erosion and ✓ ,/ Sediment Control Lead BMP C162:Scheduling ✓ Version Date: December 19, 2018 Table 4.2.1 Runoff Conveyance and Treatment BMP's by SWPPP Element Earrnntit4 Element l8 Element it13 Bement 03 Element NS Element N7 Element fie Element St 13t P or Element Name Control install StabilizePtotoct Stabiltxo Control Control Da- Protect Low Flow Rates Sediment Slopes Drain Inlets Channala Polhrtmts Watering Impact Controls and Outlets 3oteloprnent OUP P C200: Interceptor Dike and Swale ✓ ✓ BI P C201: Gran-Lined Channels ✓ BIUP C202:Channel Lining BINP C202: Vt',tor Oars ✓ ✓ BMP C204: Pipe Slope Drains ✓ liMP C206: Subsurface Dralrw ✓ 8MP C206: Level Spreader ✓ PIMP C202: Chock Dams ✓ ✓ BMP C204: Triangular Silt Dike(Geotext$e ✓ V Encased Check Dam) AMP C204: Outlet Protection ✓ BMP C220: Storm Drain Inlet Protection. ✓ 8MP C231: Brush Barrier ✓ ✓ BMP C232 Oravel Filter Berm V BMP C231: Snit Fence ✓ BMP C234: Vegetated Strip ✓ - ✓ BMP C236:Wattles BMP C236z Vegitativo Filtration ✓ 8MP C240: Sodimont Trap ✓ ✓ BMP C241:Temporary Sedinront Pond ✓ ✓ OMP C250:Construction 3aornm tier ✓ Chemical Troatrnant BMP C251:Construction Stornwrater ✓ Filtration BMP C25Z High pH Neutraltcstlon Using ✓ CO2 • i BMP C253:pH Control for High pH Watar ✓ Version Date: December 19, 2018 13 Elements of SWPPP (Construction Stormwater Pollution Prevention Plan) Please check off boxes to show that each element has been read and understood. Provide details where applicable and if certain aspects are unnecessary or exempt, clearly justify. Details of the 13 Elements and the correlating BMPs are listed Above from the 2014 Stormwater Management Manual for Western Washington (SWMMWW). A link is provided on the City of Anacortes website, under Planning, Community, & Economic Development Department, as well as under Stormwater on the Engineering Division of Public Work's page. Owner Name: j44j,5 C/-I Site Address: 9 � ym` Prepared By: R ,v5 C/<- 1 The Stormwater checklist or building permit determined that: ifEC The 13 elements must be addressed ❑ These elements must be addressed for construction activity adding under for construction activity adding 2,000 2,000 sq. ft. of hard surface area. sq. ft. or more of hard surface area. This means that an attached narrative and site plan are required with this document. Under each element, explain the best management practices (BMPs) used or justify reasoning for those that will not be used. If needed, please attach a narrative to further explain plans or justification. ELEMENT 1: Preserve Vegetation/Mark Clearing Limits ❑ Before beginning land disturbing activities, including clearing and grading, clearly mark all clearing limits, sensitive areas and their buffers, and trees that are to be preserved within the construction area. ❑ Retain the duff layer, native top soil, and natural vegetation in an undisturbed state to the maximum degree practical. .3'q/ G/c7 Version Date: December 19, 2018 ELEMENT 2: Establish Construction Access ❑ Limit construction vehicle access and exit to one route, if possible. ❑ Stabilize access points with a pad of quarry spalls, crushed rock, or other equivalent BMPs, to minimize tracking onto roads. ❑ Locate wheel wash or tire baths on site, if the stabilized construction entrance is not effective in preventing tracking sediment onto roads. ❑ If sediment is tracked off site, clean the affected roadway thoroughly at the end of each day, or more frequently as necessary (ex: wet weather). Remove sediment from roads by shoveling, sweeping, or pick up and transport the sediment to a controlled sediment disposal area. ❑ Conduct street washing only after sediment is removed in accordance with the above bullet. ❑ Control street wash wastewater by pumping back on site or otherwise preventing it from discharging into systems tributary to waters of the State. �/ O, C-/8S 1rnD C /C) ('r�-y € ,. ��G �ff 1//0 V7/7/ be 'QQ7J !r /1 U•eku J2., c4-1-vy spy,//r /7Pi/ LDSDor l -Sao -/o -O a. ELEMENT 3: Control Flow Rates ❑ Protect properties and waterways downstream of development sites from erosion and the associated discharge of turbid waters due to increases in the velocity and peak volumetric flow rate of stormwater runoff from the project site. ❑ Where necessary to comply with the bullet above, construct stormwater retention or detention facilities as one of the first steps in grading. Assure that detention facilities function properly before constructing site improvement(e.g. impervious surfaces). ❑ If permanent infiltration ponds are used for flow control during construction, protect these facilities from siltation during the construction phase. o'C c( 6P o//e ' i 7149-.eic-P )4>e wspor 1 -?n, /5 - Version Date: December 19, 2018 ELEMENT 4: Install Sediment Controls ❑ Design, install, and maintain effective erosion controls and sediment controls to minimize the discharge of pollutants. ❑ Construct sediment control BMPs (sediment ponds, traps, filters, etc.) as one of the first steps in grading. These BMPs shall be functional before other land disturbing activities take place. ❑ Minimize sediment discharges from the site. The design, installation and maintenance of erosion and sediment controls must address factors such as the amount, frequency, intensity and duration of precipitation, the nature of resulting stormwater runoff, and soil characteristics, including the range of soil particle sizes expected to be present on the site. O Direct stormwater runoff from disturbed areas through a sediment pond or other appropriate sediment removal BMP, before the runoff leaves a construction site or before discharge to an infiltration facility. Runoff from fully stabilized areas may be discharged without a sediment removal BMP, but must meet the flow control performance standard in Element#3, bullet#1. O Locate BMPs intended to trap sediment on-site in a manner to avoid interference with the movement of juvenile salmonids attempting to enter off-channel areas or drainages. ❑ Provide and maintain natural buffers around surface waters, direct stormwater to vegetated areas to increase sediment removal, and maximize stormwater infiltration. O Where feasible, design outlet structures that withdraw impounded stormwater from the surface to avoid discharging sediment that is still suspended lower in the water column. ?m/0 /0 /0?-, C�5�0 , Iry is �Q Si71- e c� w, (( 6.p / n r7e/' 6 -e ELEMENT 5: Stabilize Soils ❑ Stabilize exposed and unworked soils by application of effective BMPs that prevent erosion. Applicable BMPs include, but are not limited to: temporary and permanent seeding, sodding, mulching, plastic covering, erosion control fabrics and matting, soil application of polyacrylamide (PAM), the early application of gravel base early on areas to be paved, and dust control. ❑ Control stormwater volume and velocity within the site to minimize soil erosion. ❑ Control stormwater discharges, including both peak flow rates and total stormwater volume, to minimize erosion at outlets and to minimize downstream channel and stream bank erosion. O Soils must not remain exposed and unworked for more than the time periods set forth below to prevent erosion. o During the dry season (May 1 —Sept 30): 7 days o During the wet season (Oct 1 —Apr 30): 2 days ❑ Stabilize soils at the end of the shift before a holiday or weekend if needed based on the weather forecast. O Stabilize soil stockpiles from erosion, protect with sediment trapping measures, and where possible, be Version Date: December 19, 2018 located away from storm drain inlets, waterways, and drainage channels. ❑ Minimize the amount of soil exposed during construction activity. ❑ Minimize the disturbance of steep slopes. ❑ Minimize soil compaction and, unless infeasible, preserve topsoil. G �4.o!/.erg L )/ -Feh r S/7'.ee¢ *a 1,36 P dam'--, 'C t✓./7 A,Q 4/ 7s2 /h5 7zir//-e�G /3 'f wre)a7 / - `(o,- ).z , vU / s 4.34/ e'"v d�p h 6 ,/ b/<ej v is 9/44Kx (-(r0 G/�/ �/lam . ' F"x,o r P_eQ S o ELEMENT 6: Protect Slopes O Design and construct cut-and-fill slopes in a manner to minimize erosion. Applicable practices include, but are not limited to, reducing continuous length of slope with terracing and diversions, reducing slope steepness, and roughening slope surfaces (Ex: track walking). O Divert off-site stormwater(run-on) or ground water away from slopes and disturbed areas with interceptor dikes, pipes, and/or swales. Off-site stormwater should be managed separately from stormwater generated on the site. ❑ At the top of slopes, collect drainage in pipe slop drains or protected channels to prevent erosion. o *Temporary pipe slope drains must handle the peak volumetric flow rate calculated using a 10- minute time step from a Type 1A, 10-year, 24-hour frequency storm for the developed condition. Alternatively, the 10-year, 1-hour flow rate predicted/indicated by an approved continuous runoff model, increased by a factor of 1.6, may be used. The hydrologic analysis must use the existing land cover condition for predicting flow rates from tributary areas outside the project limits. For tributary areas on the project site, the analysis must use the temporary or permanent project land cover condition, whichever will produce the highest flow rates. If using the Western Washington Hydrology Model (WWHM) to predict flows, bare soil areas should be modeled as "landscaped" area. o Where 15-minute time steps are available in an approved continuous runoff model, they may be used directly without a correction factor. ❑ Place excavated material on the uphill side of trenches, consistent with safety and space considerations. ❑ Place check dams at regular intervals within constructed channels that are cut down a slope. ❑ Consider soil types and its potential for erosion. ❑ Stabilize soils on slopes, as specified in Element 5. ❑ BMP combinations are the most effective method of protecting slopes with disturbed soils. Ex: Use both mulching and straw erosion control blankets. ?Ai/ /2-7 s 0/7 s �l -2,--/ 6 �� �/f p,/ ee-A w�/l /s, Version Date: December 19, 2018 ELEMENT 7: Protect Drain Inlets El Protect all storm drain inlets made operable during construction so that stormwater runoff does not enter the conveyance system without first being filtered or treated to remove sediment. ❑ Clean or remove and replace inlet protection devices when sediment has filled one-third of the available storage (unless a different standard is specified by the product manufacturer). ❑ Where possible, protect all existing storm drain inlets so that stormwater runoff does not enter the conveyance system without first being filtered or treated to remove sediment. ❑ Keep all approach roads clean. Do not allow sediment and street wash water to enter storm drains without prior and adequate treatment unless treatment is provided before the storm drain discharges to waters of the State. ❑ Inlets should be inspected weekly at a minimum and daily during storm events. ( J)G/d(4,to 12 �i /7 fro I v //.44 2.J/ t I 5 f✓pP C�Q/djcJP� i ELEMENT 8: Stabilize Channels and Outlets ❑ Design, construct, and stabilize all on-site conveyance channels to prevent erosion from the following expected peak flows: o *Channels must handle same peak volumetric flow rate as temporary pipe slope drains listed in Element 6, above. O Provide stabilization, including armoring material, adequate to prevent erosion of outlets, adjacent streambanks, slopes, and downstream reaches at the outlets of all conveyance systems. O The best method for stabilizing channels is to completely line the channel with a blanket product first, then add check dams as necessary to function as an anchor and to slow the flow of water. Version Date: December 19, 2018 ELEMENT 9: Control Pollutants ❑ Design, install, implement, and maintain effective pollution prevention measures to minimize the discharge of pollutants. O Handle and dispose of all pollutants, including waste materials and demolition debris that occur on-site in a manner that does not cause contamination of stormwater. D Provide cover, containment, and protection from vandalism for all chemicals, liquid products, petroleum products, and other materials that have the potential to pose a threat to human health or the environment. On-site fueling tanks must include secondary containment. Secondary containment means placing tanks or containers within an impervious structure capable of containing 110% of the volume contained in the largest tank within the containment structure. Double-walled tanks do not require additional secondary containment. ❑ Conduct maintenance, fueling, and repair of heavy equipment and vehicles using spill prevention and control measures. Clean contaminated surfaces immediately following any spill incident. ❑ Discharge wheel wash or tire bath wastewater to a separate on-site treatment system that prevents discharge to surface water, such as closed-loop recirculation or upland land application, or to the sanitary sewer, with local sewer district approval. Wheel wash or tire bath wastewater should not include wastewater from concrete washout areas. ❑ Apply fertilizers and pesticides in a manner and at application rates that will not result in loss of chemical to stormwater runoff. Follow manufacturers' label requirements for application rates and procedures. O Use BMPs to prevent contamination of stormwater runoff by pH-modifying sources. The sources for this contamination include, but are not limited to: bulk cement, cement kiln dust, fly ash, new concrete washing and curing waters, waste streams generated from concrete grinding and sawing, exposed aggregate processes, dewatering concrete vaults, concrete pumping, and mixer washout waters. Adjust the pH of stormwater if necessary to prevent violations of the water quality standards. ❑ Assure that washout of concrete trucks is performed off-site or in designated concrete washout areas only. Do not wash out concrete trucks onto the ground, or into storm drains, open ditches, streets, or streams. Do not dump excess concrete on site, except in designated concrete washout areas. Concrete spillage or concrete discharge to surface waters of the State is prohibited. Do not use upland land applications for discharging wastewater from concrete washout areas. ❑ Obtain written approval from Ecology and provide to the City before using chemical treatment other than CO2 or dry ice to adjust pH. ❑ Woody debris may be chopped and spread on site. ❑ Conduct oil changes, hydraulic system drain down, solvent and de-greasing cleaning operations, fuel tank drain down and removal, and other activities which may result in discharge or spillage of pollutants to the ground or into stormwater runoff using spill prevention measures, such as drip pans. ❑ Clean contaminated surfaces immediately following any discharge or spill incident. Emergency repairs may be performed on-site using temporary plastic placed beneath and, if raining, over the vehicle. flm/°/ C /5-% CAL ew f /31-(/0 G 20.c cpc,zr—fr• s -//< Version Date: December 19, 2018 ELEMENT 10: Control De-Watering ❑ Discharge foundation, vault, and trench dewatering water, which have characteristics similar to stormwater runoff at the site, into a controlled conveyance system before discharge to a sediment trap or sediment pond. ❑ Discharge clean, non-turbid de-watering water, such as well-point ground water, to systems tributary to, or directly into surface waters of the State, as specified in Element 8, provided the de-watering flow does not cause erosion or flooding of receiving waters or interfere with the operation of the system. Do not route clean dewatering water through stormwater sediment ponds. Note that"surface waters of the State" may exist on a construction site as well as off site; for example, a creek running through a site. ❑ Handle highly turbid or contaminated dewatering water separately from stormwater. E Other treatment or disposal options may include: 1. Infiltration 2. Transport off-site in a vehicle, such as a vacuum flush truck, for legal disposal in a manner that does not pollute state waters. 3. Ecology-approved on-site chemical treatment or other suitable treatment technologies. 4. Sanitary or combined sewer discharge with local sewer district approval, if there is no other option. 5. Use of a sedimentation bag with outfall to a ditch or swale for small volumes of localized dewatering. ❑ Construction equipment operation, clamshell digging, concrete tremie pour, or work inside a cofferdam can create highly turbid or contaminated dewatering water. O Discharging sediment-laden (muddy) water into waters of the State likely constitutes a violation of water quality standards for turbidity. The easiest way to avoid discharging muddy water is through infiltration and preserving vegetation. I36e1l' c2V' .De • a f 10y/ / s N ell E'>7,.e c7' j & ELEMENT 11: Maintain BMPs ❑ Maintain and repair all temporary and permanent erosion and sediment control BMPs as needed to assure continued performance of their intended function in accordance with BMP specifications. ❑ Remove all temporary erosion and sediment control BMPs within 30 days after achieving final site stabilization or after the temporary BMPs are no longer needed. Some temporary erosion and sediment Version Date: December 19, 2018 control BMPs are bio-degradable and designed to remain in place following construction such as compost socks. 0 Provide protection to all BMPs installed for the permanent control of stormwater from sediment and compaction. All BMPs that are to remain in place following completion of construction shall be examined and placed in full operating conditions. If sediment enters the BMPs during construction, it shall be removed and the facility shall be returned to the conditions specified in the construction documents. 0 Remove or stabilize trapped sediment on site. Permanently stabilize disturbed soil resulting from removal of BMPs or vegetation. /f P eter:t..-5 , /( j) 5 4t-0- Q� z'pLon c. , s//ee . V i2i >/c ELEMENT 12: Manage the Project—Projects subject to Minimum Requirements 1-9 must have a Certified Erosion and Sediment Control Lead (CESCL) for site inspections. Projects subject to Minimum Requirements 1-5 do not require the inspector to be certified. By the initiation of construction, the SWPPP must identify the CESCL or inspector, who shall be present on-site or on-call at all times. ❑ Phase development projects to the maximum degree practicable and take into account seasonal work limits to prevent soil erosion and prevent transporting sediment from the site during construction. ❑ Inspection and monitoring— Inspect, maintain, and repair all BMPs as needed to assure continued performance of their intended function. ❑ Maintain, update, and implement the SWPPP. ❑ Clearing and grading activities for developments shall be permitted only if conducted using an approved site development plan (e.g., subdivision approval). ❑ From Oct 1 through Apr 30, clearing, grading, and other soil disturbing activities is permitted only if shown that the site operator will prevent silt-laden runoff from leaving the site through a combination of the following: 1. Site conditions including existing vegetative coverage, slope, soil type, and proximity to receiving waters. 2. Limit activities and the extent of disturbed areas. 3. Proposed erosion and sediment control measures. Weather conditions can influence the seasonal limitation on site disturbance. The City of Anacortes has the authority to take enforcement action per AMC 19.76 Stormwater. ❑ The following activities are exempt from the seasonal clearing and grading limitations: 1. Routine maintenance and necessary repair of erosion and sediment control BMPs; 2. Routine maintenance of public facilities or existing utility structures that do not expose the soil or result in the removal of the vegetative cover to soil 3. Activities where there is 100% infiltration of surface water runoff within the site in approved and installed erosion and sediment control facilities. Version Date: December 19, 2018 44-6 /e-/ wr 71lir s C't ELEMENT 13: Protect Low Impact Development BMPS ❑ If implementing any bioretention facilities or rain gardens, refer to the applicable BMP sections of the Manual for requirements. /14,-te ie7cx7e,s,Pam/ 17?"-/Z-o 2 i Applica t Sign ure Date Version Date: December 19, 2018 TAB 5 (MINIMUM REQUIREMENT#5) 6 Minimum Requirement#5—On-site Stormwater Management All sites are required to utilize BR/IP T5.13— Post Construction Soil Quality and Depth. For each surface, consider the BMP's in the order listed for that type of surface. Use the first BMP that is considered feasible. No other on-site Stormwater Management BMP is necessary for that surface. Feasiblity shall be determined by evaluation against: 1. Design criteria, limitations and infeasiblity criteria identified for each BMP in this manual, and; 2. Competing needs criteria listed in Chapter V-5 —On-site Stormwater Management. Lawn and Landscaped Area: ® BMP T5.13: Post-Construction Soil Quality and Depth. (Attach Detail in Report) Refer to this site for requirements and specifications. All projects are required to utilize this BMP. http://www.soilsforsalmon.orq/pdf/Soil BMP Manual.pdf See below for the "Model Soil Management Plan for BMP T5.13" to be submitted with Drainage Report and Application Material. Version Date: December 19, 2018 PROJECT INFORMATION "Model Soil Management Plan for BMP T5.13" age# of pages Complete all information on page 1;only site address and permit number on additional pages. Site Address/ I.ot No.: Vic ,Zy'/t Permit Type: Sr-/Z Permit Number: Permit Holder: Phone: Mailing Address: / os //-vets,P 01.4 p- Contact Person: /1 Phone: 3ke 999 0?-37 ACeb ?99 Plan Prepared By: (71,1 ATTACHMENTS REQUIRED(Check off required items that are attached to this plan) Site Plan showing,to scale: Areas of undisturbed native vegetation(no amendment required) New planting beds and turf areas(amendment required) Type of soil improvement proposed for each area Soil test results(required if proposing custom amendment rates) Product test results for proposed amendments AREA# (should match Area#on Site Plan) PLANTING TYPE Turf _Undisturbed native vegetation Planting Beds _Other: SQUARE FOOTAGE OF THIS AREA: square feet SCARIFICATION _inches(depth)of scarification needed to achieve finished total 12"loosened depth. Subsoil will be scarified PRE-APPROVED inches of compost or imported topsoil applied AMENDMENT METHOD: X 3_1 (conversion factor, inches to cubic yards) PRODUCT: Topsoil import =cu.yards per 1,000 sq.ft. _Amend with compost X _,000s sq.ft.in this area _Stockpile and amend =cubic yards of amendment —>—>—>—,—' QUANTITY: CU.YDS. ( cu.yds.stockpiled) (needed to cover this area to designated depth) CUSTOM AMENDMENT Attach test results and calculations. _Topsoil import inches organic matter or topsoil import PRODUCT: Topsoil&compost lift X 3_1 _Amend =cu.yards/1,000 sq.ft. _Stockpile and amend X _,000s sq.ft.in this area ( cu.yds.stockpiled) =cubic yards of amendment —>—>—>—>—> QUANTITY: CU.YDS. MULCH _,000 sq.ft. PRODUCT: X 6.2 (conversion, to give 2 inch mulch depth) =cubic yards of mulch —>——>— —> QUANTITY: CU.YDS. TOTAL AMENDMENT/TOPSOIL/MULCH FOR ALL AREAS(complete on page.l only, totaling all areas/pages in tins flan) O Product#1: 0 Quantity: cu. ds. Version Date: December 19, 2018 ❑ Test Results:_%organic matter C:N ratio<25:1(except mulch,or<35:1 for native plants) "stable"(yes/no) LI Product#2: ❑Quantity: cu.yds. ❑ Test Results:_%organic matter C:N ratio<25:1 (except mulch,or<35:1 for native plants) "stable"(yes/no) l Product#3: ❑Quantity: cu.yds. ❑ Test Results:_%organic matter C:N ratio <25:1 (except mulch,or<35:1 for native plants) "stable"(yes/no) Date: Inspector: Approved: Revisions Required: Date: Inspector: Approved: Revisions Required: APPENDIX 1 —Survey performed by a Professional Land Surveyor Version Date: December 19, 2018 APPENDIX 2— Model Soil Management Plan for BMP T5.13 Note: Document is provided under Minimum Requirement 5 in this document Version Date: December 19, 2018 APPENDIX 3— Determining Construction Site Sediment Damage Potential (Appendix 7 —NPDES Phase II Permit) Note: See attached Version Date: December 19, 2018 Western Washington Phase II Stormwater Permit APPENDIX 7 - Determining Construction Site Sediment Damage Potential The following rating system allows objective evaluation of a particular development site's potential to discharge sediment. Permittees may use the rating system below or develop alternative process designed to identify site-specific features which indicate that the site must be inspected prior to clearing and construction. Any alternative evaluation process must be documented and provide for equivalent environmental review. Step one is to determine if there is a sediment/erosion sensitive feature downstream of the development site. If there is such a site downstream complete step two, assessment of hydraulic nearness. If there is a sediment/erosion sensitive feature and it is hydraulically near the site then go to step three to determine the construction site sediment transport potential. ii. STEP 1 —Sediment/Erosion Sensitive Feature Identification Sediment/erosion sensitive features are areas subject to significant degradation due to the effect of sediment deposition or erosion. Special protection must be provided to protect them. Sediment/erosion sensitive features include but are not limited to: i. Salmonid bearing fresh water streams and their tributaries or freshwater streams that would be Salmonid bearing if not for anthropogenic barriers; ii. Lakes; iii. Category I, II, and III wetlands; iv. Marine near-shore habitat; v. Sites containing contaminated soils where erosion could cause dispersal of contaminants; and vi. Steep slopes (25% or greater) associated with one of the above features. Identify any sediment/erosion sensitive features, and proceed to step two. If there are none the assessment is complete. iii. STEP 2—Hydraulic Nearness Assessment Version Date: December 19, 2018 Sites are hydraulically near a feature if the pollutant load and peak quantity of runoff from the site will not be naturally attenuated before entering the feature. The conditions that render a site hydraulically near to a feature include, but are not limited to, the following: i. The feature or a buffer to protect the feature is within 200 feet downstream of the site. ii. Runoff from the site is tight-lined to the feature or flows to the feature through a channel or ditch. August 1, 2013, Modified January 16, 2015 Appendix ' - Determining Sediment Damage Potential Page 1 of 3 • Version Date: December 19, 2018 A site is not hydraulically near a feature if one of the following takes place to provide attenuation before runoff from the site enters the feature: iv. Sheet flow through a vegetated area with dense ground cover v. Flow through a wetland not included as a sensitive feature vi. Flow through a significant shallow or adverse slope, not in a conveyance channel, between the site and the sensitive feature. Identify any of the sediment/erosion sensitive features from step one that are hydraulically near the site, and proceed to step three. If none of the sediment/erosion sensitive features are hydraulically near the site, the assessment is complete. vii. STEP 3—Construction Site Sediment Transport Potential Using the worksheet below, determine the total points for each development site. Assign points based on the most critical condition that affects 10% or more of the site. If soil testing has been performed on site, the results should be used to determine the predominant soil type on the site. Otherwise, soil information should be obtained from the county soil survey to determine Hydrologic Soil Group (Table of Engineering Index Properties for step 1.D) and Erosion Potential (Table of Water Features for step 1.E) When using the county soil survey, the dominant soil type may be in question, particularly when the site falls on a boundary between two soil types or when one of two soil types may be present on a site. In this case, the soil type resulting in the most points on the rating system will be assumed unless site soil tests indicate that another soil type dominates the site. Use the point score from Step 3 to determine whether the development site has a high potential for sediment transport off of the site. Total Score Transport Rating <100 ❑100 High A high transport rating indicates a higher risk that the site will generate sediment contaminated runoff. Construction Site Sediment Transport Potential Worksheet A . Existing slope of site ( average , weighted by aenal extent) : Points 2 % o r less . . . 0 > 2-5 % > 5- 10% 15 > 10- 15 % 30 > 15% 50 B . Site Area to be cleared and /or graded : < 5 , 000 sq . ft 0 5 , 000 sq . ft . — 1 acre 30 > 1 acres 50 C . Quantity of cut and/or fill on site : < 500 cubic yards 500 — 5 , 000 cubic yards 5 > 5 , 000 — 10 , 000 cubic yards 10 > 10 , 000 — 20 , 000 cubic yards 25 > 20 , 000 cubic yards 40 D . Runoff potential of predominant soils ( Natural Resources Conservation Service) : Hydrologic soil group A 0 Hydrologic soil group B 10 Hydrologic soil group C 20 Hydrologic soil group D 40 E. Erosion Potential of predominant soils ( Unified Classification System) : GW, GP , SW , SP soils 0 Dual classifications (GW-GM , GP-GM , GW-GC , GP-GC , SW-SM , SW-SC , SP-SM , SP-SC) 10 GM , GC , SM , SC soils 20 ML , CL , MH , CH soils 40 F . Surface or Groundwater entering site identified and intercepted / : Yes 0 N o 25 G . Depth of cut or height of fill > 10 feet: Yes 25 N o H . Clearing and grading will occur in the wet season (October 1 — May 1 ) : Yes 50 No TOTAL POINTS 1 If no surface or groundwater enters site , give 0 points . APPENDIX 4—Site Plan with all applicable information (Minimum Size 11x17 at a legible scale) APPENDIX 5— Documented Site Photos (Show all directions of the site, including frontage) (Insert Photo Here) Location: Description of the photo: Photo taken by: