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Permit File BLD-2022-0448 1214 37th Street
t C} City of Anacortes Invoice/Permit#: BLD-2022-0448 904 6th Street Applied date: 06/07/2022 P.O.Box 547 Anacortes, WA 98221-0547 Issue date: 06/14/2022 _� t►�: (360) 293-1901 Expire date: 12/11/2023 Job Address: 1214 37TH ST Permit Type: Single Family Alteration/Repair Permit ANACORTES WA98221-4237 Project: APN: P57101 Remarks: Addition to an SFR. Owner: TIMOTHY&AMBER MOFFITT LIVING TRUST Contractor: TBD Address: 1214 37TH ST Address: ANACORTES WA 98221-4237 Phone: (360)421-1543 Phone: License#: General Information: Fees: Use Zone R3 Building Permit Fee 993.75 Flood plain development N Plan Review Fee 645.94 Building Valuation 100000 State Building Code Fee Resi 6.50 1st Floor Square Footage 410 Plumbing Permit Fee 55.00 New or Replaced Hard Surface 556 Stormwater Review 44.48 #of Hand Sinks 2 Total Calculated: 1,745.67 #of Refrigeration Units 1 Deposits/Receipts: 0.00 #of Showers 1 #of Water Closets(Toilets) 1 Total Due: 1,745.67 #of Water Piping 1 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. SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY Y 0� PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT CO) Mailing Address. P.O. Box 547, Anocortes, WA 98221 COtL Office Location: 904 Gth Street, Anocortes WA 98,921 Phone. (360) 293-1901 RESIDENTIAL BUILDING PERMIT APPLICATION THIS APPLICATION PACKET 15 USED FOR THE FOLLOWING PROJECT TYPES: Single-Family Residences (SFR), Duplexes, Additions & Remodels, Accessory Structures (i.e. garages, carports), Accessory Dwelling Units, Manufactured Homes, Residential Decks & Retaining Walls, and Docks& Pilings. Ct ;$P '4 RJDNTIg1 BUtILDIRl`�7,APRLIATIO °ft'; PROPERTY INFORMATION j PROJECT ADDRESS(STREET,SUITE#) ASSESSOR PARCEL NUMBER 1214 37th Street P571 01 SUBDIVISION/LOT# ZONING LOT AREA(SIZE) 1180 TYPE OF PROJECT _ NEW ADDITION REPAIR REMODEL Lj CHANGE OF USE SFR Duplex beck/Porch Accessory Dwelling Unit: HDetached ❑Attached Retaining Wall ❑Manufactured Home ❑Accessory Structure ❑ Shoreline Structure (dock, pilings,floats etc.) * ❑Other; *if application is fora shoreline structure,please complete the Shoreline Structure Checklist. IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? PIES ✓ IVO If YES, provide the permit/application number: PROJECT SUMMARY; PROJECT VALUAT10N Adding a closet, bathroom and dining room to the back wall of (Cast of Materials & Labor) the existing structure. 1005000 PROPERTY OWNER INFORMATION DAME PHONE Moffitt Living Trust 360.421 .1543 ADDRESS(STREET,CITY,STATE,ZIP) EMAILADDRESS -� 1214 37th Street amberlmofFitt a protonmail.corn CONTRACTOR INFORMATION NAME" PHONE t Jeremy ����'� dt�l'ti l' "r1(%t' � c CONTRACTOR'S BUSINESS LICENSES J STATE LICENSE# EXPIRATION "All Contmaors&Subcontroctors must have a valid City of Anacortes business license prior ra doing work in the USI# EXPIRATION city, ADDRESS(STREET,CITY,STATE,ZIP) EMAILADURESS Page 1 of 17 Res.Building Permit Application Submittal Checklist Updated April 20, 2021 CONTACT PERSON -select one person the city will contact for anything related to this project: r APPLICANT DPROPERTY OWNER ACONTRAcTOR OTHER(LIST BELOW) NAME � PHONE ..� Amber Moffitt 360.421 .1543 ADDRESS(STREET,CITY,STATE,ZIP) EMAIi,ADDRESS 1214 37th Street amberlmoffitt@protonmall.com LENDER INFORMATION RCW 19,27.095 requires the City to obtain information with regard to lenders, if there are no lender involved with your project, write "no lenders"on the Name tine below, NAME PHONE no (enders ADDRESS(STREET,CITY,STATE,ZIP) EMAILADDRESS ACKNOWLEDGEMENTS & SIGNATURE Read and initial each of the following stateinentS prior to signing this application: AM I understand that when a building permit application is taken in over the counter it does not mean the ap2lication has been deemed technically complete and suffocient or ste review. AM I understand that if i submit incomplete, Inaccurate, andlar erroneous information it will rake the City longer to process my permits. AM I understand and acknowledge rhat l could be responsible for providing as-built drawings ion paper or electronicail as part of the ro'ect's certificate of occyeancy proces5. AM I understand and acknowledge that Special inspections could be required as port of my project, and if needed I will be required to pa or the cost of these Inspections, AM I understand and acknowledge rhat financial securities could be required as part of the work I am completing and I agree to provide the items needed for the Clty to calculate these securities and to rovide the securities themselves. AM I understand that if permits are reviewed concurrently such as design review,site pion, traffic concurrenty, etc., any required revisions to one permit may affect the entire plan set and could add casts and time to the ro'ect. 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 art far them. i also declare under pem74 taf pw4wry 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. 5/24122 SlG TIJ E DATE Amber offitl PRINTED NAME Res, Building Permit Application Submittal checklist Updated December 2021 Page 2 of 17 SUBMITTAL CHECKLIST r ;a G � ar a a ro CD CD FA Residential Building Permit C6 a LA Submittal Requirement Checklist a c 9- o r n ro V5 Residential Building Permit Application Form x x x x x (FORM BP-1—attached) Structure&Site Information Form x x x x x (FORM Big-2—attached) Mechanical&Plumbing Fixtures Farm x x x (FORM BP-3—attached) Architectural Plans x x x x x (requirements listed on FORM BP-4-attached) 5tarmwater Management Minimum Requirements x x x x Determination(FORM BP-5,attached) Stormwater Site Plan x x x x Site Plan & Landscape Plans-requirements listed an Form x x x x x 9 P-6 Structural Plans & Calculations x x x x x V Energy Code Plans & Forms x x Manufacturer's Specifications/Cut Sheets x v Copy of recorded survey x x x x Critical Area Identification Farm x x x x x Shoreline Structure Checklist, if applicable 1 I x x Technical Reports x x x x Other Required Permits, if applicable !,4 A x x x x x ADU Affidavit of Owner Occupancy(signed) x SUBMITTAL INFORMATION Please send applications in PDF format to buildingpermit2citVofanacorLes.org Send applications in PDF format with a file and message size no greater than 30 MB. An email with a link to a file share site (Dropbox,Google Drive, OneDrive, etc.) is acceptable. Paper copies Inay be requested after initial review. FEES Once application is received, staff will reach out if a deposit is required. Otherwise, permit fees are paid prior to building permit issuance. Res. Building Permit Application Submittal Checklist Updated December 2021 Page 3of17 REQUIRED SUBMITTAL INFORMATION Additional details ❑n certain submittal items are provided below to ensure Applicants are fully aware what City staff will be looking for when an application is submitted to the City, FORMS AND PLANS FORM 8P-7: 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. t FORM BP-2: STRUCTURE AND 51TE 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. I FORM 13P-4:ARCHITECTURAL PLAN REQUIREMENTS. Farm 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 5tarmwater review. 5tormwater 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 5tormwater Site Plan fs 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 5tormwater review and contents of the 5tormwater Site Plan will vary with the type and size of the project, and individual site characteristics. use Form 313-5 to determine the level of stormwater review and then complete the applicable 5tormwater Minimum Requirements Form on the Public Works- Engineering department Forms website and provide required submittal items/plans. y FORM RP-G: SITE PLANS & LANDSCAPE PLANS. Form BP-6 contains a list of all the items L required to be shown on Site and Landscape Plans. +r' 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 Clty 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. * STRUCTURAL CALCULATIONS: An analysis of loads, materials, etc., prepared and stamped by a State of Washington licensed professional structural engineer. Res.Building Permit Application Subrnittal Checklist Updared decerriber 2021 Page 4 of 17 ENERGY CODE FORMS: The standard Washington State Energy Office form requesting the information 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 Lime an inspection is requested,you may creed to have a new survey completed. • CRITICAL AREA IDENTIFICATION FORM. Use this frorn to determine and/or identify if critical areas or critical area buffers are located on or within 300 ft.of the development area. if critiial areas are determined to be present, a Critical Area Permit may be required. ir SHORELINE STRUCTURE CHECKLIST. This checklist is required to supplement the building permit application if the proposed structure or development is waterward or within 200 ft.from the shoreline.This checklist will also assist in determining what ather approvals or permits may be required for the proposed work. OTHER SUBMITTALS DETERMINED ON A CASE-BY-CASE BASIS TECHN CAL 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. 19.70 for additional information. B. GEOTECHNICAL REPORT. In general, Geotechnical Reports are required when work is proposed on or near slopes in excess of 25%and/or known landslide hazard areas. See Anacortes Municipal Code Ch, 19.70 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 Appllration Submittal Checklist Updated Decernber 2021 Page 5 of 17 FORM BP-2: STRUCTURE AND. SITE INFORMATION PROPERTY WHERE WORK IS OCCURRING ADDRESS 1214 37th Street PARCEL NUMI3ER(S) P57101 ~--- - DETAILED PROPOSED STRUCTURE INFORMATION Complete the following information as it relates to your project. Mark items that are not applicable with "N/A„ STRUCTURE HEIGHT , FLrit r1 AREA SQUARE FOOTAGE OCCUPANCY GROUP CONSTRUCTION TYPE OCCUPANT LOAD 11T FLOOR: 410 2""FLOOR: NA NA NA NA 31a FLOOR: NA NA NA NA BASEMENT: NA NA NA NA GARAGE: NA NA NA NA TOTAL DECK: TOTAL PORCH: OTHER: OTHER- OTHER: r QUESTIONS ABOUT THE PROPOSED STRUCTURE Is a fire sprinkler system being installed? DYES ®NO is a monitored fire alarm being installed? YES ONO Are retaining wall(s) being built? DYES �NO Are structural plans required? YES LJNO PROJECT 517E INFORMATION A. Is work within the City's right-of-way proposed? ❑YES ONO If YES, you will be required to submit a right-of-way permit application. If you have already submitted a ROW permit_, list the permit number here: B. Is the lot less than 5,000 sq.ft, in area? _ OYES [ZNO If YES, your site and building will need to comply with the standards in AMC 19.43.010.C. Res.Building Permit Anpkabon Submittal Checklist Updated December 2021 Page 6 of 17 C, Is your project involving an accessory dwelling unit? DYES FA No If YES, your site and building will need to comply with the standards in AMC 19.47,030, D. Will more than 2-acres be cleared and/or more than 5,000 board feet OYES N[D (about 1 log truck load)of timber be harvested? If YES, you may reed to obtain a forest practice permit from DNR. E. Is this project subject to the SEPA process? 1,.,-, YES XtJO If YES,you will be required to submit a SEPA checklist. if you have already completed the SEPIA process, list the permit number. REQUIRED SIGNATURE 1 hereby declare that l 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. !also declare under penalty of perlury Under the laws of the State of Washington that ail of the statements and answers contained herein, and the information submitted with this application farm is in all respects, true, correct, and complete to the best of knowledge and belief, 0' kAc� 5/24/22 N U E DATE f _Amber Moffitt PRINTED DAME - --•. - Res.Building Permlt Application Submittal Checklist Updated December2021 Page 7of17 FORM BP-3: PLUMBING & MECHANICAL INFORMATION MECHANICAL APPLIANCE/EQUIPMENT INFORMATION (NEW AND RELOCATED) EQUIPMENT TYPE Indicate.the number of fixtures for each equipment type TOTAL GA5 ELECTRIC OTHER-Please specify COMMENT Furnace Wall Heater Water Heater Heat Pump Air Conditioner/Handler Radiant/Hydronic Heating Exhaust Fans Range Hood Fireplace Clothes Dryer&Duct Stove/Range/Oven Refrigeration Unit Gas Piping/ Outlet(s) Boiler BTUs: Other TOTAL MECHANICAL OUTLETS PLUMBING FIXTURES FIXTURE TYPE(NEW AND RELOCATED) TOTAL FIXTURE TYPE(NEW AND RELOCATED) TOTAL Toilets I Refrigerator water supply 1 Kitchen Sink Pressure Reduction Valve/Regulator Utility Sink Water Service Line 1 Tub Water Piping Band Sink 2 Washing Machine Shower Electric Water Heater:Tanis-less? Yes No Dishwasher Backflow Prevention Device Urinal Hose Bib Floor Drain/ Floor Sink Drinking Fountain Hydronic Heat In:©Floor ]Wall Grease Interceptor Other-please specify; TOTAL PLUMBING FIXTURES 5 Res. 6uild1ng permit Application subnlltta!Checklist Updated December 2021 Page 8 of 17 FORm BP-4: ARCHITECTURAL PLAN REQUIREMENTS GENERAL INFORMATION _ This form is intended to assist applicants in creating complete, code compliant architectural plans, Pleas 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, REQUIREMENTS FOR ALL ARCHITECTURAL PLANS COMPLETE? REQUIREMENTS PAGE# Cover or 1st page) must include: Site address Parcel number Lot number(if applicable) Lot size Lot coverage impervious surface coverage ---- T 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. Commerciai, X Multi-Family,and Mixed-Use Structures must also include door and window schedules, X Plumbing,duct, and electrical layout, Penetration protection must be shown. X Opening headers, size, and material. Cross section details,showing typical foundation, floor,wail, ceiling and roof construction and insulation. X Structural members labeled as to size and spacing as well as bracing, blocking, bridging,special connectors, and anchor bolts. x Details documenting energy code compliance. Exterior building elevations demonstrating compliance with applicable "�[ structure type design standards (small lot, duplex, or ADU) and maximum /� building height Res.BuildinE Permit Application-Submittal Checklist Updated December 2021 Page 9 of 17 Building height (see AMC 19.42.120 for measurement methods, exceptions and modifications), * Show a line representing, and label the elevations of, the existing natural topography at the foundation at the front of the building. • For corner lots and lots that slope downhill from the property line at the froth of the building: Show a labeled lime representing the elevations at the center of all exterior walls of the building. • For ADUs only, include elevations demonstrating compliance with the height/setback plane (see AMC 19.47.030(C)(6)). X Special details as needed (i.e., stairs,fireplaces, special construction). X Insulation and insulation values of walls,slab, floors, and roof/ceiling, X Existing and proposed grades with slope of lot shown. Res.guOding Permit Application Subrnittal Checklist tapdated Oecembar 2021 Page 10 of 17 HARD SURFACE AREA CALCULATION Existing Removed Proposed Proposed Exl DESCRIPTION sti (5F) Replaced New (5F) i5F) Non Pollution Generating Hard Surface Area (sidewalks, paths,patios, etc.) GJ t Pollution Generating Hard Surface Area (Driveways, parking areas,etc.) v TOTAL HARD SURFACE Site Size Existing Impervious Surface coverage % � 1 (sq,ft. hard surface/site size) MINIMUM REQUIREMENTS CALCULATIONS Use the information in the above table to navigate the flow chart(s)on the next few pages to determine the applicable stormwater management minimum requirements for your project. Then complete the applicable Stormwater Minimum Requirements Form on the Public Works Engineering Department corms website and provide required submittal items/plans. ❑ Minimum ire uirernents#1-9 ❑ Minimum Requirements 41-5 Minimun+ Requirement q2 Res.Buiiding Permit Applicatlon Submittal Checklist Updated December 2021 Page 12 of 17 FORM BP-5.: STORMWATER MANAGEMENT MINIMUM REQUIREMENTS DETERMINATION 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. 5tormwater 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 5tormwater Management) and the latest Washington State Department of Ecology 5tormwater Management Manual for Western Washington (Ecology Manual). 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 fallow the flow chart(sj in this packet and determine the level of stormwater management required for you project. When determining your permit level or if stormwatertilresholds 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. Hord 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 coures water to run off the surface in greater quantities or at an irlcreused rate of flow f rom 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. LAND DISTURBANCE DESCRIPTION TOTAL(SQ. FT.) Total Area of Land Disturbing Activity Total Area Converted from Vegetation to Lawn or Landscaped Area Res,Building Permit Application Submittal Checklist Updated December 2021 Page 11 of 17 FLOW CHART FOR DETERMINING REQUIREMENTS FOR NEW DEVELOPMENT Start Mere Does the bile have 35% Yes See Redevelopment Minimum or more of existing Requirements and Flow Chart impervious eoverage7 (Figure 1-2.42). NO Does the project convert 1/4 acres or more or vegetation to Does the project result in lawn or landscaped areas,or 5,000 square feet,or convert 2.5 acres or more of greater,of new plus native vegetation to pasture? replaced hard surface area? Na ZYesY@fDoes the proJ$ot result in 2,000 Ir square feet,or greater,of new plus All Minimum requirements replaced hard surface area? apply to the new and replaced hard surfaces and converted Y$! 0 vegetation areas. Doeu the project have land Minimum Requirements 01 disturbing activities of 7,000 through#5 apply to the new Y � square feet orgreaterl and replaced hard surfaces and the land disturbed. ON tt��� Figure 1-2.4,9 Flow Chart for Determining Requirements for New Development ❑EPARTMEIVT OF' ReYlssd June M15 ECOLOGY hleryse asp http:�Nrvnv.eay.wa.�raufiropytipril.hfml for ropynght notlee including permwiorig. StAla of WdShiflS]lUfi IimZalipnptliahlhp,,and disClawner Res.Building permit Application Submittal Checklist updarnd December 2021 Puge 13 of 17 FLOW CHART FOR DETERMINING RIEQUIRLIVIEN'rS FOR REDEVELOPMENT 0oos 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? Yet Co Minimum Raquirements 41 through#5 apply to the new and replaced hard Minimum Requirement#2 applies. surfaces and the land disturbed. Next Question Does the project add 5,000 square feet or more of new hard surfaces? OR Convert YA 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 le this a road to the new hard surfaces and the related project? � converted vegetation areas. Yet Does the project add 5,000 square feet or more of new hard Surfaces? Yes �o Is the total of new plus replaced hard surfaces Do the new hard 5,000 square feel or more, surfaces add 5096 or N� - No ANO more to the existing I No additional does the value of the proposed improvements hard surfaces wlthln I requirements. _Including interior improvements-exceed the project limits? 50%of the assessed value (or replacement value)of the existing site improvements? yesLo All Minimum Requirements apply to the new and replaced hard surfaces and converted vegetation areas, Figure 1-2.4.2 Flow Chart for Determining Requirements for Redevelopment OFPARTIVEN7 OF RevisedArne2015 ECOLOGY' PIeaae see rlldplmww&y.vm.gov/oayyrigm.htmi Ior rmpyrgnt notice ineluaing pafmimalons, Slnte of Washington Iimitaticn cr 10014Y,and disclaimer Res-Ruilding Permit Application Submittal Checkllst Updated December 2021 Page 14 of 17 FORM BP-6: SITE PLAN REQUIREMENT'S 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. a Minimum Plan Size: 11"x 17"and drawn in an engineering or architectural scale. INFORMATION REQUIRED ON ALL SITE PLANS COMPLETE? REQUIREMENTS PAGE# ON �L kN5 COVER SHEET: 91 �Name icinity Map ame of the project ame, address, and telephone number of owner and agents) , 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 t Reference to the Building Code used Proposed use Occupancy group Construction type S uare footage and height of each individual building lercent 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 b 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 (i 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. Structures Location, identification, dimensions and size of all existing and proposed buildings and other structures. Iles.13dilding Permit Application Submittal Checklist updbted December 2021 Page 15 of 17 Location of existing and proposed retaining walls, rockeries, and fences, 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)unction boxes, public utility transformers. Storrnwater Proposed Temporary Erasion and Sediment Control Measures, if not located on other plans. Proposed permanent stormwater management BMPs. 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 pm posed. Show the location of existing trees to be retained in conformance with AMC 16,50, and tree protection measures to be implemented,when applicable. Provide a maintenance plan for any infiltration-based stormwater best management practices (BMPs) built as part of the landscaping design, Including the specifications and maintenance procedures of any soil amendments. Show new trees to be planted and tree unit credit calculations, in conformance with AMC 16.50 Tree preservation,when applicable Nos.Building permit Application 5uhmittal Checklis# Qpda[ed December 202I Page 16 of 17 A table similar to the following with project specific information provided, must be placed on the site plan: Required Landscaping For Example Calculations Site Area 7,500 s .ft. _ %of site area to be landscaped (per 20%- R2A zone AMC Tables 19.42.020-.030) 1,500 sq.ft_required 1,850 s .ft. Provided Compliance with AMC Ch. 16,50 Tree unit credits required: Tree Preservation. • 8 tree units required Tree unit credits retained: • 2 trees G"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 AppOCChinn subrnittal Checklist Updated December 2021 Page 17 of 17 X x x FENCEx x - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8' SEWER EASEMENT AR #614395 8' ss SS TREE HOUSE 1�11 CONC SS ss xGREEN o �� w HOUSES S 8 9 5 9 3 8 W 117.99 z ES7' tl X - - - -7T7- - W CK w 14.0 11 ,- 00 � W S 01 ,�-, x 5 71 =1 o) 0 181.4 3 / TH o X w W STREET 61,7' " o o Q 9 x o 0 3 �� o z z w 29,7' x x z o D 2,2' S 89059/38 W 114,00' FENCE - x x x EDGE OF ASPHALT GRAPHIC SCALE 37TH STREET 10 0 10 20 40 ( IN FEET ) 1 inch = 20 ft. HERRIGSTAD ENGINEERING & SURVEYING House and Boundary Survey 4320 WHISTLE LAKE ROAD 1214 37th Street, Anacortes ANACORTES, WA 98221 299-8804 December 8, 2021 :i Back •f structure (where most of the addition •- J i I� Rear deck that will be part of the addition �OFOgCODE Storm Water Minimum ENGINEERING Requirements eqirement #T 904 6" Street Anacortes,WA 98221 www.anacorteswa.gov lCQ-�L �TorIELU trse Official Use Only: (Information to Inspectors) Required Storm Water Facility and other related requirements: Project Address: I l l� `f� � Submittal Date: l-I'L 2- Parcel Number: "'I t 01 Revision Number: 6/14/22 P Acceptance Date Permit Number: 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) Proiect 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) J Existing Site Conditions Summary: p y (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) M ►yt►Yyl tk l i nA vo ci Gi Yl k o n'l e'�( Site Sediment Transport Score: ` 05) Total Points (High ow) (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: Refer to the 2012 Department of Ecology Manual, as amended in 2014 for further required information. Version Date: December 19, 2018 $'#art dare Does the site have 35% "des See Redevelopmen Minimum or more of existing Requirements and Flow Chart impendous garage"? (F-igure 1- A.2)_ N+ Does the project convert} ,acres or more of vegetation to Cues the project reel* in lawn or landscaped areas, or 5,1200 square feet, or No convert -5 acres or more of greaser, of new plus native ve-geta ion to pasture's replaced hand surface ,area? ' No ,f Yes • Ves Does the project resulz in 2,0011 1 IF square feet, or g reater, of new pi us replaced hard surface,area' ,AIM Minimum Requirements apply to the new.and replaced Bard surfaces and converted Ves No vegetation areas_ Does ,he project have land disturbing activities of 7,000 Minimum Requirements #1 square fee:or greater?through#5 apply to the new ��� and replaced hard surfaces and the land disturbed. No IF Minimum requirement#2 applies_ Figure 1-2.4_1 Flo Ch�-i l for Determining Requirements for ��� New Development WWWA DEPARTMENT OFF2e.�e+7�w�lne �4715 ECO L le.3se see tiro w.e } v►a.gc r'cor�}yrrg t.hrM,,r0rc*pyr1 tr�a��c�Incl4ctlr:g Ferml�slo�s., wasoiingtol r tlt3tOr O`IIaDlllty,old 416r.131°r3r. Version Date: ueceMDer ly, Lu 10 Does the projec- result in '?,COO square fee% or more,of new plus replatoed hard surface area? OR lo---s the land disturbing acbvi,,y total 7,1100 square feet or greater?. IYes IF No Mi nim un-, Requ iremenz#1 through#-') apply to the new and replaced hard Minimum Requirement#2 applies- suffa-ces and the land disturbed. INext Question Does the project add 5,000,square feet or more of new hard surfaces? OR Conv� acres or more of vagetabon to lawn or landscap�ed areas? 019 Convert 21.5 acres or more of native vegetation to pasture? Yes No All Minimum Requirements apply N-ext QNwstion Is this a road to the new hard surfaces and the F No elaied project? converted vegetation areas- I Yes Does the project add 5,0130 square fee:. or more of new hard surfaces? Y Yes No Is the iotal of new plus replaced hard surfaces Do the nEhard 5,NQ square feet or more, ,�.3,J,Z�r AND 5urlaces add 50%or N N Loaid, No does 7ile va lue or'the propos;-ad improvements more to the exis:i ng requirements. re _ including interior improvements-exceed hard surfaces within -00%of the assessed value (or replacement the project limits? value) of the existing site improvements? Yes All Minimum Requirements apply to the new and replaced Ves hard surfaces and converted vegetation areas- Figure 1-2.4-2 Flow Chaft for Determining Requirements for Redevelopment DEPARTMENT OF R F.,is E-J ,j n E Z ECOLOGY :,,ease see ror copyrignt notice Including pn--nnissions, I S7ate 0' W-381 11 gto,l rIlUtor, V,fla�lltry,3rnd dlWatTer. Version Date'. December 19, 2018 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. ()1 f(i yyl- d'" cs'l I (k-1 (f�,V i fh 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 Preserve Establish Stabilize Protect Control Maintain Manage the Protect Low BMP or Element Name Impact Vegetation/Mark Construction SoOs SlopesPollutants BMPs Project Clearin Limns Access Develo meat BMP C101: Preserving Natural Vegetation ✓ Elements listed here, match the sections of ✓ BMP C102:Buffer Zones ✓ the stormwater BMP C103:High Visibility Plastic or Metal ✓ application. Each ✓ Fence column under the BMPC105: Stabilized Construction ✓ element, lists the E ntrance/E xit applicable options for BMP C106: Wheel Wash controlling stormwater. BMP C107:zC tuctin Road/Parking Area Stabilor BMP C120:Temporary and Permanent ✓ �/ Seeding The Best Management BMP C121: Mulching ✓ ✓ Practices, defined by the BMP C122: Nets and Blankets ✓ ✓ Department of Ecology are listed in this column, with a BMPC123: Plastic Covering ✓ number, like C107. These names and numbers need to BMP C124: Sodding ✓ be referenced in the stormwater application , and BMP C125: Topsoiling/Composting ✓ on the stormwater Errosion BMP C126: Polyacrylamide for Soil Erosion ✓ and sediment control plan. Protection BMP C130: Surface Roughening BMPC131: 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 �ment*4 i Eicrtecrltty8 BI16men!iy13 EtmnseteE� ElerlSeM fFFi 'El+snleriC IV7, BtaUillae �t1*nt A�J �Elerr�nt�1[1 F'rota�eR IRA- BMP MP or Element Natnr Go1liPol ht3tall i�rabosl Pi�t�ot Control Central as Impact Flow Rates 39dirneal Slopes gain Inlets� Chanr�ls PaaaNrtants V1�teril�p Nverlu writ centrals � and Outlets. c=o- betarceptor Dike and G—Ic ✓ ✓ P C201: €irasis-t_tnad Channels 6A.1P C202;Channel LI*V V SWP C203: Water Bars 6MP Ulm pipe Slope Drains � l t3MP GXA: Subsurface thraims 'f BrOP C20C Level 9preadef E1h1P C2117. Chock tarns Emcasod Check Darn) i 8MP'C2110: outlet Proteclian scow C220: Storm Drain Inlet Prvtecilon- WAR 4G231: Brush Barrier ' BrAP,C232: Orav+eI Filter Berth *� DrnF"G;Cb3; Sit Fence ✓ �� ,r" BfAP C234: V#Q*4A1+d 5,ixiP AMP G295: lFtatiles � BMP C23w Vegitmtive Fil"lon BN1PC240. SedicnantTrap ,/ BMP C24V Temporary st4kwlt Pond ✓ +� BMP C25&. Ccn tltUttien StOfUr mAt-r rf Cl1wical Treatn'let W_._, BMP C251.Construction St r Flliratlon BMP C252:HIP pH,,veutrgeauon lksina ✓ F3MP C25� pH Control far High pH ftty 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: Site Address: Prepared By: � ;�I`ylPer The Stormwater checklist or building permit determined that: EX 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 iustifv 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. /7 11,Pt,Lt �I 0/r 'T s n W'pe y r %cy n X-a :�1�t,v t 1 I 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. Existing alley will be used for construction access Mud tracked off site will be swept ra N rom 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. f , i Version Date: December 19, 2018 ELEMENT 4: Install Sediment Controls ❑I 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. r from the site. The design, installation and maintenance of erosion and �I Minimize sediment discharges 9 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. 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. ❑ 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. ❑ 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. i S VWD'A y i e N ckvC)j 1 fc`ti\S1YU� vv\ C�V'Fl. ��� USFt� mac SC' \vv.iy�-1 • VVIIY� 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. ❑ 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. ❑ Stabilize soil stockpiles from erosion, protect with sediment trapping measures, and where possible, be 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. Version Date: December 19, 2018 ELEMENT 6: Protect Slopes ❑ 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). ❑ 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. Version Date: December 19, 2018 ELEMENT 7: Protect Drain Inlets Li 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. G 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. n Inlets should be inspected weekly at a minimum and daily during storm events. -Ryyy nt 17 I i o ELEMENT 8: Stabilize Channels and Outlets u 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. Provide stabilization, including armoring material, adequate to prevent erosion of outlets, adjacent streambanks, slopes, and downstream reaches at the outlets of all conveyance systems. ❑ 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. WQAYOJ�G ;,!n Version Date: December 19, 2018 ELEMENT 9: Control Pollutants ❑ Design, install, implement, and maintain effective pollution prevention measures to minimize the discharge of pollutants. ❑ 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. ❑ 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. ❑ 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. c v �t fi GI i VI 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. 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. ❑ 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. 7),2 4 vzj j CA-1 Y7t;, k-1 0' C j_1-CAlLfJ- �'Zl 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. ❑i 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 control BMPs are bio-degradable and designed to remain in place following construction such as compost socks. 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 Version Date: December 19, 2018 shall be removed and the facility shall be returned to the conditions specified in the construction documents. ❑ Remove or stabilize trapped sediment on site. Permanently stabilize disturbed soil resulting from removal of BMPs or vegetation. W 41 it 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). [I 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. j f Version Date: December 19, 2018 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. 0 V"' ?2&4pS ifsl i'CA-11-61 tell. -�"6?"' G 1 L'7" Applica t Si atu a I Date Version Date: December 19, 2018 TAB 5 (MINIMUM REQUIREMENT#5) • Minimum Requirement#5 —On-site Stormwater Management All sites are required to utilize BMP 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.org/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 Com lete all information on page 1; only site address and permit number on additional pages. Site Address/Lot No.: 51 Permit Type: Permit Number: Permit Holder: Phone: Mailing Address: Contact Person: Phone: Plan Prepared By: ATTACHMENTS REQUIRED Check off required items that are attached to thisplan) _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 1 only, totaling all areas/ a es in this Plan ❑ Product#1: ❑ Quantity: cu.yds. ❑ Test Results:_IV.organic matter C:N ratio<25:1(except mulch,or<35:1 for nativeplants) "stable" es/no ❑ Product#2: ❑ Quantity: cu.yds. ElTest Results: %organic matter C:N ratio<25:1 (except mulch,or<35:1 for nativeplants) "stable" es/no) ❑ Product#3: ❑ Quantity: cu.yds. ❑ Test Results: %organic matter C:N ratio<25:1 (except mulch,or<35:1 for nativeplants) "stable" es/no) Date: Inspector: Approved: Revisions Required: Date: Inspector: Approved: Revisions Required: Version Date: December 19, 2018 APPENDIX 1 — Survey performed by a Professional Land Surveyor V-.CtUaI a � at, �10vSQ 5vyv&o ?-UF i v) gw A& Version Date: December 19, 2018 X F ENCE — — — — — — — — — — — — — — — — — — — — — — — — 8' SEWER EASEMENT AF #614395 8 SS .................................................. ........ ISS SS I C 0—NC S'S HOUSE X -7 L-------J GREEN A F1 HOUSES S 89059'38" W 117.99 27.7' w J1 I DECK LJ, 14 00 Ln CTll °OX P57101 crl� 0-' 1 1214 37TH x CTIS L.L-i STREET F61Y CD�D CD J z x C=)0 C=) <: CD LLJ 29.7' rV --j 2.2' S 89059'38 W 118.00 FENCE x- X---- X— EDGE OF ASPHALT GRAPHIC SCALE 10 0 10 20 40 37TN STREET IN FEET 1 inch = 20 ft. HERRICSTAD ENGINEERING & SURVEYING House and Boundary Survey 4320 WHISTLE LAKE ROAD 1214 37th Street, Anacortes ANACORTES, WA 98221 299-8804 December 8, 2021 APPENDIX 2 — Model Soil Management Plan for BMP T5.13 Note: Document is provided under Minimum Requirement 5 in this document J� IA Version Date: December 19, 2018 APPENDIX 3— Determining Construction Site Sediment Damage Potential (Appendix 7 — NPDES Phase II Permit) Note: See attached If Version Date: December 19, 2018 Western Washington Phase II Stormwater Permit i. 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. STEP 2— Hydraulic Nearness Assessment 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, Modifiers January 16. 2015 Appendix 7- Detet-irdning Sediment Dattiage 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 C<100 Low 1100 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 aerial extent): Points 2% or less .-�a--� >2-5% ............................................................................................ .5 >5-10% .......................................................................................... 15 >10-15% ........................................................................................30 >15% .............................................................................................50 B. Site Area to be cleared and/or graded: <5,000 sq. ft ................................................................................ 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 interceptedl Yes..............................................................................................' No ................................................................................................25 G. Depth of cut or height of fill >10 feet: Yes...............................................................................................t) No....................................................................................................... 0 H. Clearing and grading will occur in the wet season (October 1 — May 1): ')Ces 50 No........................................................................................................k.0 TOTALPOINTS............................................................................................. 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) PDF rJ d A (x y �� \ _- s _ o«22C _>@us Ao �e �ZZ96'VM' a +�aam gem*AA'SGIJ eev Ngl§]§ ]Hoff avgzEA& ( k SNOT«6]]] p-aAm 91joi I|~x|� eu�samL,mu ¥y } \ g 2 ) § 2 - - - - § : jj � \) o cm4 » � iaw §! § 2 ! » « R«;l ,e } -- q §§ k O ®® § § \) ) q / § . ! \ Q§ & § ) \\ 2 \ o F- ® ) 2 § / ; $ ) ( g } ) \ /[ / \ 2 O . � _ < 2 � / O_ > » q El O ; / / \ .. . ± 2 m� El \} \j (o \\ °Q F2 r= o0 � . 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