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Permit File BLD-2022-0922 4704 Queen Ann Way
"� C> City of Anacortes Invoice/Permit#: BLD-2022-0922 904 6th's Street Applied date: 12/06/2022 P.O.Box 547 Issue date: 12/20/2022 Anacortes, WA 98221-0547 Expire date: 06/16/2024 ' =z (360) 293-1901 Job Address: 4704 QUEEN ANN WAY Permit Type: Single Family Alteration/Repair Permit ANACORTES WA 98221-3214 Project: APN: P59266 Remarks: Addition to back of home. Owner: JULIE&PETER MERRIAM-WOODWARD Contractor: A WOMAN'S TOUCH RESIDENTIAL AND RV REST Address: 4704 QUEEN ANN WAY Address: 13319 DEANE DR ANACORTES WA98221-3214 ANACORTES WA98221-8408 Phone: (253) 579-3765 Phone: (360)298-1096 License#: General Information: Fees: Deck Square Footage 45 Building Permit Fee 1,592.95 Flood plain development N Plan Review Fee 1,035.42 Building Valuation 207000 State Building Code Fee Resi 6.50 1st Floor Square Footage 499 Mechanical Permit Fees 30.75 New or Replaced Hard Surface 639 Plumbing Permit Fee 69.00 #of Ventilation Fans 1 Stormwater Review 51.12 #of Hose Bibs 2 Total Calculated: 2,785.74 #of Kitchen Sinks 1 Deposits/Receipts: 0.00 #of Hand Sinks 1 #of Showers 1 Total Due: 2,785.74 #of Water Closets (Toilets) 1 #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 a coed t ' application and know the same to be true and correct. SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSU =,t,t,k� ,, PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.D. Box 547, Anacortes, WA 98221 " ..' Office Location. 904 6th Street,Anacortes WA 98821 Phone: (360)293-1901 RESIDENTIAL BUILDING PERMIT APPLICATIO THIS APPLICATION PACKET IS 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. ... .... . 1 . - ... PROJECT ADDRESS(STREET,SUITE#) ASSESSOR PARCEL NUMBER 0 ovl? Mw Z�)Wj SUBDIVISION/LOT# ZONING LOT AREA(SIZE) SQ. FT. TYPE R€ :EC . NEW ADDITION REPAIR REMODEL CHANGE OF USE SFR Duplex FiDeck/Porch Accessory Dwelling Unit: Detached D Attached Retainin Wall v g1:1 g Manufactured Home 1:1 AccessoryStructure ElShoreline Structure dock pilings,floats etc. * ❑Other: *If application is for a shoreline structure,please complete the Shoreline Structure Checklist. IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? YES NO f YES,provide the permit/application number: PROJECT SUMMARY: + PROJECT VALUATION (Cost of Materials&Labor) - UP. ... .WN MATC NAME PHONE ea I'd19,1 ADDRESS(STREET,CITY,STATE,ZIP) EMAIL ADDRESS la ........................ r C �TR ACTOR1"N.-Fonx.: ATE N NAM * PHONE ' CONTRACTOR'S BUSINESS LICENSES STATE LICENSE# EXPIRATION *All Contractors&Subcontractors must have a valid City W� I •- M I RS M of Anacortes business license prior to doing work in the UBI# EXPIRATION City. &0q L03 Q O 11-C).5 ADDRESS(STREET,,CITY,STATE,ZIP) EMAIL ADDRESS Of D&'0107 e A'q 1-1749zl 104 Page 1 of 17 Res.Building Permit Application Submittal Checklist Updated April 20,2021 - -- _==------------____ ._. 1-- _ - -- -- l --- __---___ -- ------ -- - ----- -- - - -- - ---- ----- I i .::,... ...,ONATP..... .. . .. - ;,. ,::•.. ...:.: ...:::.,.: � ?,:fir--:-: ;:.:' .... ::.........:.. r. al 1.....: .: .:- .TRS1 ,.SL �c +... .. APPLICANT [:]PROPERTY OWNER CONTRACTOR []OTHER(LIST BELOW) NA E PHONE ADDRESS(STREET,CITY,STATE,ZIP) EMAIL ADDRESS i ................ ......... ............. MT ... ........... .................... -_ _ ........... 1 dr Viers*.. he. rre..,- .. . .... ........... ....... ................ ..n.. ... . :: :"�. . .� `.Q3 .. res:t , C to v;�t r �n oat�o uvtl�. r crd` ao yen. f _ _ _. .g.,.: .. . .:.. _..... ..:.. .. .:...... ._... /Ft if.:..: +. :.. :: . :: :< :...: e. r. :belw.:: . nvolved.rvh cur ro ectvrt � dr :tie ar ..l.. .. p NAME PHONE ADDRESS(STREET,CITY,STATE,ZIP) EMAIL ADDRESS ACKNO . _. ............... ....... T ATJ. � S # .. ......... ............ ....................... - _ .....a........ ........... ...................... ............... ......................... -. : ++c . � a 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. 1 understand that if I submit incomplete, inaccurate, and/or erroneous information it will take the City longer to process my permits. j 1 understand and acknowledge that 1 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 i i needed i will be required to a or the cost o these inspections. l understand and acknowledge that financial securities could be required as part of the work I am completing and/agree to provide the items needed for the City to calculate these securities and to provide the securities themselves. !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 t he best of knowledge nd belief. r' d SIGNATURE DATE PRINTED NAME i Res. Building Permit Application Submittal Checklist III Updated December 2021 Page 2 of 17 X-:M ........... ............. ..... ....................... ................... ............ ........................::::: ........................... ........................:W.: .............................. .................................................................................... ............................. .............................. .................. ....... ...... ....... .............................. ....... .......... ...... ........... . . ............... 0; ............. ..................... ................. ........... M_ ................... ........................ ..................... ...................... ............................ ............. ............................... ...................... ................. ..... . ....... ....... 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X ......... Residential Building Permit Application Form ........... .............. X .................. .................. M BP-1—attached) (FOR .................................. ................................. ............ ........... ........................... ................ Structure &Site Information Form ...................... ........... . ................ ............... ...................... X X ............ (FORM BP-2—attached) ........... ....................... ................. ................ .................................. ..... ..........I .............................. ..................I....... Mechanical & Plumbing Fixtures Form ............. ..................I......... X ................................ .......... (FORM BP-3—attached) .................................. Architectural Plans .................. .............. X X ............ ............... (requirements listed on FORM BP-4-attached) ............ ...... .............. ................ ......... ...................... ............ .............................. ..................... ....................... Stormwater Management Minimum Requirements X X Determination (FORM BP-5,attached) .............. .............. ..................... X X ....... Stormwater Site Plan .......................... ...... ............. ..................... ................................ ............. ............................. X X Site Plan & Landscape Plans-requirements listed on Form El BP-6 ............. .............................. .............. .... .. ........................... ......... ............. ............ ........... ............. Structural Plans&Calculations X X .......!!7!7..... .......... ...... ............. .......... .................. ............. ................................ .......... Energy Code Plans & Forms X .......... ....... ..................... Manufacturer's Specifications/Cut Sheets X ............................ ................... ...... .................. Copy of recorded survey X .................... X ............. EJ ................. ............... .................... .......... Critical Area Identification Form X X ........... ............... ........ ....................... Shoreline Structure Checklist, if applicable X X El Technical Reports X X ................................ ....................... ....................... ................................ X ............. ................ Other Required Permits, if applicable X .............. ............................... ............. .............................. ADU Affidavit of Owner Occupancy(signed) X ................................... .... ...................... ............................. ............ ........................ .................................... ........................................... .......... ..................... :13MI.T...-TAL1111INFOR .......... ........ ................ ........... ............................................ .................. ........................... ................................... ............................... ......................................................................................................................... ....................... ................................ ............. ..................... ......................... ................................ ......................................... rmj ti In al 0 as . 0 idnis::;_n: o::: Jhgp, a esen; 6:.... .. ....... .............................. ...... ............. ................................................................ ......................... ......................... 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ADDRESS Y A& Uf PARCEL NUMBER(S) I � . ... .- ....L:::7.-... ..--. I ... - T AT ___ ..- -...) TA: � R T i. ........�................... ....... . _. - . :,. .:: . .. .. . : - : . - - _ - .: .. act..Ma.�r .teas.. hbt a .€ � b �t :.: t .ah . t �nfrn. t� . s: . tes t .... 4 ,..,......... 1. .............:..:.......::.:.:.: .:........ Y.: ..._ p.. .:..t.:..... .., . . 1 9(90?4 1 , I .....:.:. .: .......... ..:. ::a ....:........ ,lA..: . . - .: STRUCTURE HEIGHT ..._.......__... :..i.... ; :.. .. i N TY ACC .1 N ' AO .. _ L ARB1. .::I= TALE OTC A ; .;.} I � 't ................. :..:..;..:::...-.... -,-*- :::: .....:............... .. t k...:. :.. . _......... ,... ......... . 1ST FLOOR: q q . n,e � I__ 2ND FLOOR: P 1 3R1 FLOOR: it) ]ft -.. BASEMENT: i r), 'i �.- GARAGE: a -�M_ )) � TOTAL DECK: 16(5 1 , ' , nPeu 2 TOTAL PORCH: /?/A OTHER: OTHER: OTHER: i :::. :::..:.'::.:.: .. Eto:) : T - _�'-.0.'.'.'-_.i_._i:i.' .. . .. . .....�....... - I _1 -.1U-11, :: ::::..::-i;�x:��:i�'.ii'.`. . ._.._.1..__... , I............. #�' O R A C . ., .. �.. .. .;::;i,:�i��:�.,.,-Iiv�........I—: .. .........i'.i�i]�:,:�:.e.'-.-'.*..i:---..�i�i:i :"�.�'.i::-.:-...:.:.-.:!.,;.,....:':-.:-:::.:'.:...__... .............� ...'....o.. �.. -.......... _. .._ ........i, ..:.: ' . . .; x --V-.. : .. ..,, ............. ........... :.: I - i Is a fire sprinkler system being installed? YES NO Is a monitored fire alarm being installed? YES NO Are retaining wall(s) being built? []YES NO i I- Are structural plans required? YES NO p q .,.-.-..:::::. --:::::: .:''- - ' ' ' . _r `ii K: _ ATL .. _...:.r__ . ,� : :; .:..;�,----�.--i�::,...��iii�.-.-".:::::::::: .:!;:::::::::::::::::,,::..:...'............. .:�::.: ::;..::._,:.v::�.,-_-..' .::::: ., ...... ........ .......:.....:.... . ::�:�:i:�;.......;....... "� : . - . -....,..a.... -...':::_...-:-..._::., . 071 . :. - ..... ..-....-. ..,..........:::.:-::-.:.-�:;:;,.�i.��i�..-...:.,]��: �,... ..........._... _. .... __... ................ I.O.N..-.... ..... ....:............. . .. A. Is work within the City's right-of-way proposed? DYES NO 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? DYES NO If YES,your site and building will need to comply with the standards in AMC 19.43.010.C. - Res. Building Permit Application Submittal Checklist Updated December 2021 Page f of 17 i i � ' | � � .. C. Is your project involving an accessory dwelling unit? YES N 0 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 FIES ANO (about 1 log truck load) of timber be harvested? If YES,you may need to obtain a forest practice permit from DNR. E. Is this project subject to the SEPA process? 7— YES NO If YES,you will be required to submit a SEPA checklist. If you have already completed the SEPA process, list the permit number: -K-.*,-C.-.-:..-D.�lls�..:.ISNATU E I hereby declare that/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 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 oil respects, true.., correct, and complete to the best of knowledge and belief. 9c� SIGNATURE DATE PRINTED NAME /^ Res.Building Permit Application Submittal chockkst � � Updated December zn2z | Page xof1x i I f ........ .... .. ::.::•.:...:.a,a,a..•..:.•c.�:t:.:'•;..a,a,::a•.:G:a•,•.•:{•.,c•.i.,+:.' •.•.l:a+}•a:a.a••};.♦:a:•t:•ii}a:.}::rair:r:•r:•r}r:•>}rt}r.r:!.r .r ... ............... ...a.a.a...a.a...a. ...... n a. ........ .................................... .................. ... ... .. ., Y � .a.a n.a.an....v.vn n•n.a•...an n.v.a n,a:♦nx.n..v R;.}:};.5:}:r'•S:R'•r:l:}}}}S:3}T:a:3:^..R.R:.nnnnn.a.a nn n.ann n..a. nnn.n .. ...Y..:}}vay};.v.a:R•xR:r:3.•Y.3:3:r:K..R...:... .::.�:.....:..�. .. ..............�..�.. .. .a. .a..a..a n.v nn.♦. .♦ ♦ .T.Y...........R.....T.a.v .a nnn nn♦w..ann.a nnn n.a.a..a.v.a n.n ♦ ..}..Y.Y...... ..n♦.♦♦nnn. .!..... ...R..R..............� ---------------------------- ......... ........ ........................ ................... .. ...............,................ .:.ria;.}:a}x•a}r}}r:Rx}F}r:a}r}rir}}:R:�r>}Yr:•}:R:•}:•}:•x•}x:a:•}:a::a:•Y•r»:•>:•}}F}};:;.}}r:R:.}.:•.>.:.:.>.. ..........:.:...... ...... .. ........•......a•....a:♦...•♦:a•.•a.a,a:a:a�a�.a�a.a...a.a.a.♦.♦a•..•.a.�.♦�.a�.a.♦.a,a.a.a.a.a.a.a.a.a.a..a,a.a.♦.♦•.a,a♦.a.♦•.,:a.;a.a.a.r:a:};};a:}.}.}}.}.♦:}:.rxr r................:.. ... .. a a a.annn.ann.a n.a.a.an.a..a.a n.a... ......... ... ..5....... ...........}.,:...+............... a.a.a a.a.a.a.♦n.♦.a.a.a.a.a n.a.a.a n...a n.♦.a.a.a.a.a.a.a.a.a n.a.a.a a.♦.. .. ..r..+..+... n.a.a.a a..n..a a.a.an♦. a a.a a.a.a.a..a.an.a.a.a.♦.. ., ., .. .........r.......s... a n..a in.an a. ♦.i a n n.">t:a'ti{"+::i•:i•:':2,,.;.;.;.... 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E�..E�TRi - -#3- _ __ -.::.::':::::::::::...:::::::•::.'::::.:.: Furnace i Wall Heater Water Heater i Heat Pump Air Conditioner/Handler I i- Radiant/Hydronic Heating Exhaust Fans Range Hood i Fireplace Clothes Dryer& Duct i Stove/Range/Oven ! Refrigeration Unit f . Gas Piping/Outlets) Boiler BTUs: i Other TA E # AIL "_ -. : _ TYKE N AI�,O Ci. AO L E- CW:At D RCLATOT1 ... x ' E F P - - -- - _ _- i oilets Refrigerator water supply Kitchen Sink Pressure Reduction Valve/Regulator Utility Sink Water Service Line Tub Water Piping Hand Sink Washing Machine Shower Electric Water Heater:Tank-less? 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I- .SAT I 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. I I - I, • 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. ..:.:................................. A T .. ..AN .C1.TEC R LR. EIT. .A' L..AR. I COMPLETE? REQUIREMENTS PAGE# 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,or ADU) and maximum building height Res. Building Permit Application Submittal Checklist Updated December 2021 Page 9 of 17 --- - - - - I I, I i- 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 front of the building: Show a labeled line 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)). 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. 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T......f....Y.h.!.....}.......}...>.r.........T.........}.r...l.}.........T.....5}.l... .... ��. ... r.}... ..r......t.Y.....r..t...r..>.}.r.r.l.}....}.r.}.l.....r,..r..........�..}....r...t.......t...r ., .,, � r .r r ..... ...............................:................::.................................................................................. :.:Y ........:......k................................:.:F............................r.........,.................,........................................,.........,.......,...............,........... .... �,*�! }�;�1 T �.)... RIAL IN 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). is_HS. U A. o A. . A. A�. . . 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. ` . � ` ..... .............................. ..................................... ......................... ... . ................. -.................. ......................................................... . ... .................. ....... 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 -- -_- - - -� --- --- -- -- ___=L __ - --- --- ----- - - --- ---- - -- -- - - - ------ --------- --- ------ -- t 47%t `'R S.-.1 U' "FAC . . , Piro*:':*,*-* ose i. _.. . .... :: : ,::: :...:::...:::-..:::....:::::: :::........::...... ........................... LCU .......... or ::_: ; ....... :::..: ::.::::. :::. ...:.....::.::.::..::..:: �: F .. .. . ....... .. :::::.:::::::::::::.:::::::::......:::::::.:::::::::: :: ::::::::::::::::::::::: Ne .E. 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A :5 ..RSA... :::::::::::::::::::::::::: : T :W.:::..: ::.:::: :::::::::::::::::: : :::::: :: : ::::::::::::::: ::::::::::::.:::::::::.:.::::::::::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: .::.. :. . . . Site Size Existing Impervious Surface Coverage% o (sq. ft. hard surface/site size) , I .. Use the information in the above table to navigate the flow chart(s) on the next few pages to determine t 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. Minimum Requirements#1-9 Requirement#2 Minimum Requirements#1-S ❑ Minimum Re ❑ q i I! Res. Building Permit Application Submittal Checklist Updated December 2021 Page 12 of 17 - - -- ---- ----- --- - «� -- --- ------ 1-- - --- - ---- - I i I FLOW CHART FOR DETERMINING REQUIREMENTS FOR NEW DEVELOPMENT P ; I :Does the site have,3��o 'j a Re:develgpinent ll�lir imum: Or moire existing: Reguirerne:nts:::and:Flow Chart impo.rvjous:coverage. (Figure 1 2.4:Z . .............................................................. I I i I Does the: t-t project:oonve f acres or:more of uegetato.r to :goes the pr:.oject result in lawn.o.r landscaped>areas,or 5; awarq ©Q0 s e feet,aor- coriert: :5 acres.ar`more native ve station tv astute? greater,of new plus g .-: p ;.. : rpkaced Lard:surface areal ...................... Ves Does the:p rajeet re-Cult in 2,000. ................... ......... soars.feet,.:or greats:r,o:f r ev i plus ........................--_.. -Ala'alllinimum Requirements re:paaced:hard:surface are:a'. a 1 #a the wan.and re [a-ed P y. p .hard-surfaces and converted No Vegetation areas. e D' th`e�p.roject>1eve:tan: Mn]rr�urn Requ[rements#�I distr�rbin activities:.of 7�OQ0 thro-u gh�#&A 'ply.to the.rreiai square feet:or grew eta anyes: d replaced hard'suftaces I and:the land d s.t rbetl. I- I I Min'irflum Re'g:u'iremen:t#2: i Ap.p].ies.- Figure [-2.4.1_ Flow Chart..for: Determint9f� Reel irer�en.-t for New opmen DEPARTMENT OF °Revised:::Une:2-01 ... ... . . .. .__.. ... ... . .... _ ...... .... GY E::C 01:0, P.I.ease.see htfp:/-/Www.ecy:vva:gav�.fcopyr ght:l�tmlfior sop righf:notice including permissions.. Sfatb:of�I is h i n:V.Wfl limitation of liability;.and disclaimer: J1 Res.Building Permit Application Submittal Checklist Updated December 2021 Page 13 of 17 ----------- ---------- li f. FLOW CHART FOR DETERMINING REQUIREMENTS FOR REDEVELOPMENT Does the:Project-msult-]42.000 square feet; or more:.:-of new-vtus mpla-ped:hard.surfae.q.:a-rea? ......... ...... Nes;-.theJand distUrbing adtivity total 7i-.000:.tqObrd fbA: t-grea t et? a ..... . ...... . .... ..... . .... ..... No -yes. ........ . .......... v ..... ........ Mihimu'm Rb_q: uir1e'm':e.n'ts#1__throLigh:.-45- App equ Appfitm�,*. :ly. to new and replacod..*hard wern:6h.-t#2 surFaG i? a nd..-the'land-d i storbed ................ ... ... ........... .. ................ New:10-mie' s-010" .......v.........I.......... ......... ........ ......................... ..... ....... ............................... ....... ..................................... ... ............................ 11....... 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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 i information is shown. ,I • Minimum Plan Size: 11"x 17" and drawn in an engineering or architectural scale. AT ARE GIN ST PAS MI - D COMPLETE? REQUIREMENTS PAGE# ON PLANS COVER SHEET: ` F-I Vicinity Map F� Name of the project ❑ Name address andtele hone number of owner agent(s) � p Name, address, and telephone number of Applicant (if different from the owner) ❑ Zoning designation of the site FlArea, in square feet and acreage, of the project site F� Reference to the Building Code used ;F Proposed use Occupancy group ❑ Construction type ❑ Square footage and height of each individual building F] Percent lot coverage F-1 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 (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. Res. Building Permit Application Submittal Checklist Updated December 2021 Page 15 of 17 -----'----------------- -."«m_«--------"--�------1_ - -=_--__-_----- - ------'----_-__�_=---- u-----------------------------------y---`---- ------------------------�----L------ l I I i i I- I 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 junction boxes, public utility transformers. Stormwater Proposed Temporary Erosion 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 pro osed. 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 Res. Building Permit Application Submittal Checklist Updated December 2021 Page 16 of 17 ------------------ - A table similar to the following with project specific information provided, must be placed on the site plan: X.,0 0 .......... ................ ed.. ............. ........... ....... ........ .................... ................................. Site Area 71500 sq.ft. %of site area to be landscaped(per 20%-R2A zone AMC Tables 19.42.020-.030) 1,500 sq.ft. required 1850 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 December 2021 Page 17 of 17 BeamChek v2022 licensed to:AccuP/an Custom Building Design Reg#427-248 Woodward/Merriam Remodel/Addition New Kitchen window header AccuPlan Job#2215 Prepared by: BJ Date: 11/16/22 Selection 4x 4 HF#2 Lu =0.0 Ft Conditions NDS 2018 Min Bearing Area R1=0.3 in R2=0.3 in (1.5) DL Defl= <0.01 in. Data Beam Span 2.13 ft Reaction 1 LL 77# Reaction 2 LL 77# Beam Wt per ft 2.98 # Reaction 1 TL 121 # Reaction 2 TL 121 # Bm Wt Included 6 # Maximum V 121 # Max Moment 64'# Max V(Reduced) N/A TL Max Defl L/240 TL Actual Defl L/>1000 LL Max Defl L/480 LL Actual Defl L/>1000 Attributes Section (in3) Shear(in 2) TL Defl (in) LL Defl Actual 7.15 12.25 0.00 <0.01 Critical 0.61 1.21 0.11 0.05 Status OK OK OK OK Ratio 8% 10% 4% 4% Fb (psi) Fv(psi) E (psi x mil) Fc (psi) Values Reference Values 850 150 1.3 405 Adjusted Values 1275 150 1.3 405 Adiustments CF Size Factor 1.500 Cd Duration 1.00 1.00 Cr Repetitive 1.00 Ch Shear Stress N/A Cm Wet Use 1.00 1.00 1.00 1.00 Cl Stability 1.0000 Rb=0.00 Le=0.00 Ft Loads Uniform LL: 72 Uniform TL: 111 =A Uniform Load A 0 R1 = 121 R2= 121 SPAN =2.125 FT Uniform and partial uniform loads are Ibs per lineal ft. BeamChek v2022 licensed to:AccuPlan Custom Building Design Reg#427-248 Woodward/Merriam Remodel/Addition Corridor/Laundry Rm. door hdr. AccuPlan Job#2215 Prepared by: BJ Date: 11/16/22 Selection 4x 4 HF#2 Lu =0.0 Ft Conditions NDS 2018 Min Bearing Area R1=0.5 in R2=0.5 in (1.5) DL Defl= 0.01 in Data Beam Span 3.29 ft Reaction 1 LL 119# Reaction 2 LL 119# Beam Wt per ft 2.98# Reaction 1 TL 188# Reaction 2 TL 188# Bm Wt Included 10# Maximum V 188# Max Moment 154'# Max V(Reduced) N/A TL Max Defl L/240 TL Actual Defl L/>1000 LL Max Defl L/480 LL Actual Defl L/>1000 Attributes Section (in3) Shear(in') TL Defl (in) LL Defl Actual 7.15 12.25 0.02 0.01 Critical 1.45 1.88 0.16 0.08 Status OK OK OK OK Ratio 20% 15% 13% 14% Fb (psi) Fv(psi) E(psi x mil) Fc L (psi) Values Reference Values 850 150 1.3 405 Adjusted Values 1275 150 1.3 405 Adiustments CF Size Factor 1.500 Cd Duration 1.00 1.00 Cr Repetitive 1.00 Ch Shear Stress N/A Cm Wet Use 1.00 1.00 1.00 1.00 Cl Stability 1.0000 Rb=0.00 Le=0.00 Ft Loads Uniform LL: 72 Uniform TL: 111 =A Uniform Load A 0 R1 = 188 R2= 188 SPAN =3.292 FT Uniform and partial uniform loads are Ibs per lineal ft. BeamChek v2022 licensed to:AccuPlan Custom Building Design Reg#427-248 Woodward/Merriam Remodel/Addition SGD header AccuPlan Job#2215 Prepared by: BJ Date: 11/16/22 Selection 4x 8 DF-L#2 Lu =0.0 Ft Conditions NDS 2018 Min Bearing Area R1=3.0 in R2=3.0 in (1.5) DL Defl= 0.05 in Data Beam Span 6.13 ft Reaction 1 LL 1317# Reaction 2 LL 1317# Beam Wt per ft 6.17# Reaction 1 TL 1896# Reaction 2 TL 1896# Bm Wt Included 38 # Maximum V 1896# Max Moment 2904'# Max V(Reduced) N/A TL Max Defl L/240 TL Actual Defl L/579 LL Max Defl L/480 LL Actual Defl L/961 Attributes Section (in') Shear(in 2) TL Defl (in) LL Defl Actual 30.66 25.38 0.13 0.08 Critical 29.78 15.80 0.31 0.15 Status OK OK OK OK Ratio 97% 62% 41% 50% Fb(psi) Fv(psi) E (psi x mil) Fc L (psi) Values Reference Values 900 180 1.6 625 Adjusted Values 1170 180 1.6 625 Adiustments CIF Size Factor 1.300 Cd Duration 1.00 1.00 Cr Repetitive 1.00 Ch Shear Stress N/A Cm Wet Use 1.00 1.00 1.00 1.00 CI Stability 1.0000 Rb=0.00 Le=0.00 Ft Loads Uniform LL:430 Uniform TL: 613 =A Uniform Load A 0 0 R1 = 1896 R2= 1896 SPAN =6.125 FT Uniform and partial uniform loads are Ibs per lineal ft. BeamChek v2022 licensed to:AccuPlan Custom Building Design Reg#427-248 Woodward/Merriam Remodel/Addition Bedroom window header AccuPlan Job#2215 Prepared by: BJ Date: 11/16/22 Selection 4x 8 DF-L#2 Lu =0.0 Ft Conditions NDS 2018 Min Bearing Area R1=2.6 in R2=2.6 in (1.5) DL Defl= 0.04 in Data Beam Span 6.13 ft Reaction 1 LL 1130# Reaction 2 LL 1130# Beam Wt per ft 6.17# Reaction 1 TL 1639# Reaction 2 TL 1639# Bm Wt Included 38# Maximum V 1639# Max Moment 2510'# Max V(Reduced) N/A TL Max Defl L/240 TL Actual Defl L/669 LL Max Defl L/480 LL Actual Defl L/>1000 Attributes Section (in3) Shear(in 2) TL Defl (in) LL Defl Actual 30.66 25.38 0.11 0.07 Critical 25.74 13.66 0.31 0.15 Status OK OK OK OK Ratio 84% 54% 36% 43% Fb (psi) Fv(psi) E (psi x mil) Fc I (psi) Values Reference Values 900 180 1.6 625 Adjusted Values 1170 180 1.6 625 Adiustments CIF Size Factor 1.300 Cd Duration 1.00 1.00 Cr Repetitive 1.00 Ch Shear Stress N/A Cm Wet Use 1.00 1.00 1.00 1.00 Cl Stability 1.0000 Rb=0.00 Le=0.00 Ft Loads Uniform LL: 369 Uniform TL: 529 =A Uniform Load A 0 0 R1 = 1639 R2= 1639 SPAN =6.125 FT Uniform and partial uniform loads are Ibs per lineal ft. BeamChek v2022 licensed to:AccuPlan Custom Building Design Reg#427-248 Woodward/Merriam Remodel/Addition Bedroom window header AccuPlan Job#2215 Prepared by: BJ Date: 11/16/22 Selection 4x 4 HF#2 Lu =0.0 Ft Conditions NDS 2018 Min Bearing Area R1=0.4 in R2=0.4 in (1.5) DL Defl= <0.01 in. Data Beam Span 2.13 ft Reaction 1 LL 84# Reaction 2 LL 84# Beam Wt per ft 2.98# Reaction 1 TL 153# Reaction 2 TL 153# Bm Wt Included 6# Maximum V 153# Max Moment 81 '# Max V(Reduced) N/A TL Max Defl L/240 TL Actual Defl L/>1000 LL Max Defl L/480 LL Actual Defl L/>1000 Attributes Section (in3) Shear(in 2) TL Defl (in) LL Defl Actual 7.15 12.25 0.00 <0.01 Critical 0.76 1.53 0.11 0.05 Status OK OK OK OK Ratio 11% 12% 5% 4% Fb (psi) Fv(psi) E (psi x mil) Fc L (psi) Values Reference Values 850 150 1.3 405 Adjusted Values 1275 150 1.3 405 Adiustments CF Size Factor 1.500 Cd Duration 1.00 1.00 Cr Repetitive 1.00 Ch Shear Stress N/A Cm Wet Use 1.00 1.00 1.00 1.00 Cl Stability 1.0000 Rb=0.00 Le=0.00 Ft Loads Uniform LL: 79 Uniform TL: 141 =A Uniform Load A 0 R1 = 153 R2= 153 SPAN =2.125 FT Uniform and partial uniform loads are Ibs per lineal ft. BeamChek v2022 licensed to:AccuPlan Custom Building Design Reg#427-248 Woodward/Merriam Remodel/Addition Wet Bar window header AccuPlan Job#2215 Prepared by: BJ Date: 11/16/22 Selection 4x 4 HF#2 Lu=0.0 Ft Conditions NDS 2018 Min Bearing Area R1=0.8 in R2=0.8 in (1.5) DL Defl= 0.05 in Data Beam Span 4.13 ft Reaction 1 LL 163# Reaction 2 LL 163# Beam Wt per ft 2.98# Reaction 1 TL 322# Reaction 2 TL 322# Bm Wt Included 12 # Maximum V 322# Max Moment 332'# Max V(Reduced) N/A TL Max Defl L/240 TL Actual Defl L/636 LL Max Defl L/480 LL Actual Defl L/>1000 Attributes Section (in3) Shear(in 2) TL Defl (in) LL Defl Actual 7.15 12.25 0.08 0.03 Critical 3.12 3.22 0.21 0.10 Status OK OK OK OK Ratio 44% 26% 38% 31% Fb (psi) Fv(psi) E(psi x mil) Fc L (psi) Values Reference Values 850 150 1.3 405 Adjusted Values 1275 150 1.3 405 Adiustments CF Size Factor 1.500 Cd Duration 1.00 1.00 Cr Repetitive 1.00 Ch Shear Stress N/A Cm Wet Use 1.00 1.00 1.00 1.00 Cl Stability 1.0000 Rb=0.00 Le=0.00 Ft Loads Uniform LL: 79 Uniform TL: 153 =A Uniform Load A 0 R1 =322 R2= 322 SPAN =4.125 FT Uniform and partial uniform loads are Ibs per lineal ft. BeamChek v2022 licensed to:AccuPlan Custom Building Design Reg#427-248 Woodward/Merriam Remodel/Addition Wet Bar door header AccuPlan Job#2215 Prepared by: BJ Date: 11/16/22 Selection 4x 6 HF#2 Lu =0.0 Ft Conditions NDS 2018 Min Bearing Area R1=2.5 in R2=2.5 in (1.5) DL Defl= 0.01 in Data Beam Span 3.29 ft Reaction 1 LL 711 # Reaction 2 LL 711 # Beam Wt per ft 4.68# Reaction 1 TL 1022# Reaction 2 TL 1022# Bm Wt Included 15# Maximum V 1022# Max Moment 841 '# Max V(Reduced) N/A TL Max Defl L/240 TL Actual Defl L/>1000 LL Max Defl L/480 LL Actual Defl L/>1000 Attributes Section (in') Shear(in2) TL Defl (in) LL Defl Actual 17.65 19.25 0.03 0.02 Critical 9.13 10.22 0.16 0.08 Status OK OK OK OK Ratio 52% 53% 18% 22% Fb(psi) Fv(psi) E(psi x mil) Fc I (psi) Values Reference Values 850 150 1.3 405 Adjusted Values 1105 150 1.3 405 Adiustments CF Size Factor 1.300 Cd Duration 1.00 1.00 Cr Repetitive 1.00 Ch Shear Stress N/A Cm Wet Use 1.00 1.00 1.00 1.00 CI Stability 1.0000 Rb=0.00 Le=0.00 Ft Loads Uniform LL:432 Uniform TL: 616 =A Uniform Load A 0 0 R1 = 1022 R2= 1022 SPAN =3.292 FT Uniform and partial uniform loads are Ibs per lineal ft. BeamChek v20221icensed to:AccuPlan Custom Building Design Reg#427-248 Woodward/Merriam Remodel/Addition Sun Room window header AccuPlan Job#2215 Prepared by: BJ Date: 11/16/22 Selection 4x 8 DF-L#2 Lu=0.0 Ft Conditions NDS 2018 Min Bearing Area R1=2.4 in R2=2.4 in (1.5) DL Defl= 0.02 in Data Beam Span 5.13 ft Reaction 1 LL 1025# Reaction 2 LL 1025# Beam Wt per ft 6.17# Reaction 1 TL 1482# Reaction 2 TL 1482# Bm Wt Included 32 # Maximum V 1482# Max Moment 1898'# Max V(Reduced) N/A TL Max Defl L/240 TL Actual Defl L/>1000 LL Max Defl L/480 LL Actual Defl L/>1000 Attributes Section (in') Shear(in 2) TL Defl (in) LL Defl Actual 30.66 25.38 0.06 0.03 Critical 19.47 12.35 0.26 0.13 Status OK OK OK OK Ratio 63% 49% 23% 27% Fb(psi) Fv(psi) E (psi x mil) Fc L (psi) Values Reference Values 900 180 1.6 625 Adjusted Values 1170 180 1.6 625 Adiustments CF Size Factor 1.300 Cd Duration 1.00 1.00 Cr Repetitive 1.00 Ch Shear Stress N/A Cm Wet Use 1.00 1.00 1.00 1.00 Cl Stability 1.0000 Rb=0.00 Le=0.00 Ft Loads Uniform LL:400 Uniform TL: 572 =A Uniform Load A 0 0 R1 = 1482 R2 = 1482 SPAN =5.125 FT Uniform and partial uniform loads are Ibs per lineal ft. BeamChek v2022 licensed to:AccuPlan Custom Building Design Reg#427-248 Woodward/Merriam Remodel/Addition Sun Room window header AccuPlan Job#2215 Prepared by: BJ Date: 11/16/22 Selection 4x 4 HF#2 Lu=0.0 Ft Conditions NDS 2018 Min Bearing Area R1=0.7 in2 R2=0.7 in' (1.5) DL Defl= 0.07 in Data Beam Span 5.13 ft Reaction 1 LL 182# Reaction 2 LL 182# Beam Wt per ft 2.98# Reaction 1 TL 300# Reaction 2 TL 300# Bm Wt Included 15# Maximum V 300# Max Moment 384'# Max V(Reduced) NIA TL Max Defl L/240 TL Actual Defl L/461 LL Max Defl L/480 LL Actual Defl L/909 Attributes Section(in3) Shear(ink TL Defl (in) LL Defl Actual 7.15 12.25 0.13 0.07 Critical 3.61 3.00 0.26 0.13 Status OK OK OK OK Ratio 51% 24% 52% 53% Fb(psi) Fv(psi) E(psi x mil) Fc (psi) Values Reference Values 850 150 1.3 405 Adjusted Values 1275 150 1.3 405 Adiustments CF Size Factor 1.500 Cd Duration 1.00 1.00 Cr Repetitive 1.00 Ch Shear Stress N/A Cm Wet Use 1.00 1.00 1.00 1.00 Cl Stability 1.0000 Rb=0.00 Le=0.00 Ft Loads Uniform LL: 71 Uniform TL: 114 =A Uniform Load A 0 R1 = 300 R2= 300 SPAN = 5.125 FT Uniform and partial uniform toads are Ibs per lineal ft. Storm Water Drainage Report m Minimum Requirement #2 !"Cnog Cpg ENGINEERING DEPARTMENT �1210FIELo�se� 904 6t" Street Anacortes, WA 98221 www.anacorteswa.gov Official Use Only: (Information to Inspectors) Required Storm Water Facility and other related requirements: High sediment score, so additional inspections may be required during early phases. Small site is constrained by existing structures, slope, and pavement. Excavated area will be entirely covered by the new building. Project Address: 4704 Quene Ann Way Submittal Date: 12/19/22 Parcel Number: Revision Number: Permit Number: Reviewer: Rob F. Acceptance Date (COA): 12/19/2022 FRONT OF REPORT: Submittal Checklist: (All items listed below are required for a complete submittal) o Cover Sheet (Preparer to Provide): Project title, Location, Revision dates, Engineer's Stamp o TAB 1: Minimum Requirement#1 — Preparation of Stormwater Site Plans o TAB 2: Minimum Requirement#2 — Construction Stormwater Pollution Prevention (SWPP) o APPENDIX 1 - Survey performed by a Professional Land Surveyor o APPENDIX 3 - Model Soil Management Plan for BMP T5.13 o APPENDIX 4 - Determining Construction Site Sediment Damage Potential (Appendix 7) o APPENDIX 5 - Site Plan with all applicable information (Minimum Size 11x17 — 30 scale) o APPENDIX 6 - Documented Site Photos (North, South, East and West) Stormwater Management Requirements: o Refer to the 2019 Department of Ecology Manual o See also, City of Anacortes Municipal Code 19.76 for additional information o See also, current Engineering Development Standards, Chapter 2- Storm Drainage for additional information. Version Date: August 30, 2022 Project Description and Summary: Summary Table Existing Proposed Development Type SFR SFR Number of Lots 1 1 Lot Acreage in SF 10 077 10,077 Soil Type(s) Site Sediment Transport Score Hi h\Low High, but very small site. Depth to Ground Water Table (Feet and Inches) See completed Soils Analysis Volume 1, Chapter 3.1.1 Infiltration Rate during Rainy Season Inch\Per Hour Impervious Surface on-site 4688 n Impervious Surface off-site New and Replaced Hard Surface Total SF Lot Coverage (Percentage) 46 4 BMP (Required Minimum Requirement 5) BMP T5.13 Post Construction Soils Area surrounding site is paved so this is Water Quality Method Minimum Requirement 6 Water Quantity Method Minimum Requirement 7 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 Phasing l Sequence) Flat paved area on sloping developed lot. Developed Conditions Summary: (Additionally, to be shown on the site plan. Identify cut and fill areas, proposed slopes of all hard surfaces , proposed contours) Flat paved area with a 600 square foot addition in the middle. Drainage Basin (2007 Storm Comp Plan — City website\publicworks\engineering\comprehensive plans): What Drainage Basin are you in? Rl 1 Identify any downstream drainage issues (Storm Comp Plan: 2007 If so, describe: No downstream issues recorded in 2007 comp plan. Complete the Applicability Requirements — Flow Chart (See next page(s) - Highlight the path and attach Version Date: August 30, 2022 Start Fier Does the �10 See Redevelopment Project Ite have 35 Thresholds and the Figure Flow or more of existing hard surrace coverage? cart forermtrfr, Requtremenfs for RedevefopmenC. o Does the Project convert q acres or more of vegetation to Does the Project result in lawn or landscaped areas, or 5,000 square feet, or N9 convert 2.5 acres or more of greater, of new plus native vegetation to pasture? replaced hard surface area? . No Yes Yes Does the Project result In 2:000 square feet, or greater, of new plus All Minimum Requlrement:s replaced hard surface area? apply to the new and replaced hard surfaces and cuniverted vegetation areas. Yes No Does the Project have hand 00�' rMInImnurn Requlremet�s #1 disturbing activities of 7,000 through #5 apply to the new square feet or greater? and replaced hard surfaces and the land disturbed. No Minimum Requirement# applies. -� Flow Chart for Determining Requirements for New Development DEPARTMENT OF Revised March 2019 ECOLO Please see hVp;/Avww.ery.w&_--qav opyrkgN,h1mf far copyright notice IneludIng permisslons, IlPta:-a of V%?ashington limitation of Ilabllivy,and dlwalmer, Version Date: August 30, 2022 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 squigre feet or greaten? Vies No Minimum Requirements#1 through #5 IF apply to the new and replaced hard (41lnimurn Requirement #2 applies. surfaces and the land dlstuFbod. Next Queftion IF Dues the Project add 5,000 square feet or more of new hard surfaces? OR convert 4 acres or more of vegetMIon 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 00related project? converted vegetation areas, No Yes Does the Project add 5,000 square feet or more of new hard surfaces? Yes Is the total of new plus replaced hard sUrfaees 5,e00 square feet or more, Do the new hard AND U rFa d oes the va lu a or the p roposed Im prov&ments- Surfaces aid 5 0' 0 to the e5€Istln9r o No additional O Includln-q Interlor Improvements-exceed 50%ofmore the requirements. assessed value(or replacement value)of# w: hard surfaces wlthIn the Ike? + existing Project Site Improvements(For oamnierclal or Ir►Qus[dAl projects)OR • existing Site Improvemems(for all other projects) Yes 10 All Minimum Requirements apply to the new and replaced hard surfaces and converted vegetation areas. Yes Flow Chart for Determining Requiremerts for Redevelopment Re,.-:lsed March 2019 DEFARTIVIEN- ECOLO Please see hf p:1Arww.ecy.w&.-1ovUpyrr9frt,hW for copyright notice Including permissions, Star of 1+lrash In..;to Ilrnitatlon of I101llty,and disclaimer, Version Date: August 30, 2022 TAB 2 (MINIMUM REQUIREMENT#2) • 1-3.4.2 Minimum Requirement#2 — Construction Stormwater Pollution Prevention Plan (SWPP) All new development and redevelopment projects are responsible for preventing erosion and discharge of sediment and other pollutants into receiving waters. Projects which result in 2,000 square feet or more of new plus replaced hard surface area, or which disturb 7,000 square feet or more of land must prepare a Construction Stormwater Pollution Prevention Plan (SWPPP) as part of the Stormwater Site Plan (see MR1: Preparation of Stormwater Site Plans). Projects below those thresholds (listed above) are not required to prepare a Construction SWPPP, but must consider all of the Construction SWPPP Elements (listed below) and develop controls for all Construction SWPPP Elements that pertain to the project site. General Requirements: The Construction SWPPP shall include a narrative and drawings. All BMPs shall be clearly referenced in the narrative and marked on the drawings. The Construction SWPPP narrative shall include documentation to explain and justify the pollution prevention decisions made for the project. Each of the 13 Construction SWPPP Elements (listed below) must be considered and included in the Construction SWPPP unless site conditions render the Element unnecessary and the exemption from that Element is clearly justified in the narrative of the SWPPP. Clearing and grading activities for developments shall be permitted only if conducted pursuant to an approved site development plan (e.g., subdivision approval) that establishes permitted areas of clearing, grading, cutting, and filling. These permitted clearing and grading areas and any other areas required to preserve critical or sensitive areas, buffers, native growth protection easements, or tree retention areas, shall be delineated on the site plans and the development site. The Construction SWPPP shall be implemented beginning with initial land disturbance and until final stabilization. Sediment and Erosion control BMPs shall be consistent with the BMPs contained in II-3 Construction Stormwater BMPs. Seasonal Work Limitations: From October 1 through April 30, clearing, grading, and other soil disturbing activities shall only be permitted if shown to the satisfaction of the local permitting authority that silt-laden runoff will be prevented 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; and 2. Limitations on activities and the extent of disturbed areas; and 3. Proposed erosion and sediment control measures. 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, and 3. Activities where there is one hundred percent infiltration of surface water runoff within the site in approved and installed erosion and sediment control facilities. Version Date: August 30, 2022 Construction Storrrwater Pollution Prevention Plan Checklist Project -Nani e: City Reference Na_ Constnution Permit No_ Review Date: On-site Inspection Review Date: Canstmction SUTPP Reviewer: Section I —Construction SNNIPPP Nm ative Construction Storm water Pollution Prei-ention Elements I_ Describe hove each of the Constnictien Stormwite-r Pollution Prevention Elements has been addressed though the Comtruction S FPPP_ I Identify-the type and location of BMPs used to satisfy-the requilaA elen t. 3_ Provide v]ITithm justification identifying the reason an element is not applicable to the proposal_ Thirteen &Lquh-ed Elements - Cmistruc Lion Sturrnr€a ter Ponution Prevention Plan I_ Mark Cle='z Linits I Establish ConsTactian Access 3_ Control Flaw Rates 4_ hGtall Sediment controls 5_ Stabilize Soiis 6_ Protect Slopes ?_ Protect Drain Inlets 8_ Stabilize Cbantrls and C�Aers 9_ Control Pollutants 10. Control De-Watering 11. Maintain BMW& 12. Waage the Project 13_ Protect Low Iurpact I]ew-lopme It BNIPs Project Desc»ptiou I_ Total proj ect area I Total proposed impen-iotu area 3_ Total proposed area to be disturbed, including off site borrow and fill areas 4_ Total valames of proposed Ct3t and f11 Revised Febniary 2016 EIIstine, Site CGIAitiens 1_ Description of the emisting topography 2_ Description of the emisting,,egetatim 3_ Description of the existing drainage Adjacent U,ea 1_ Description of adjacent areas which may be affected by site disturbance or drain to prof ect site_ a_ Streams b_ Lames c_ Wetlands _ d.. Residential Areas e. beads f. Other I Description of the doiAustream drainage path leading frain the site to the recei-�iug body of%rater. (N iniinum distance of 400 yards_) Critical yeas 1_ Description of critical areas that are on or adjacent to the site. I Description of special ran �� for %�wking iu or near critical arms- Soils 1_ Description of on-site soils_ a_ Soil name(s) b_ Soil mapping twit c_ Erodibilit I Sddeability e_ Pennetibility f. Depth g. Texture h_ Soil Structure R,e-�ised Febntary 2016 Version Date: August 30, 2022 Erosion Problem -Axeas 1- Description of potential erosionpioblems on site. Construction Pha dug 1- Construction sequence I Construction phasing (if proposed) Cionstmcdon Schedule 1- Pro,,A,de a proposed constniction sc e&-le- I 'Wet Season C~onstnction Activities a- Proposed wet sewn constniction aetivities- b- Proposed wet season aonstruetion restraints for enyiro nientall y sensitive/critical areas- Fivaneia Ownership Responsibilities 1- Identify the property-oi�mer re? n<ible for the initiation of bonds andfor other financial securities. I Describe bonds and-or other evidence of financial responsibility for hability associated%pith erosion and sedimentation ivapacts. Engiueeiing Calculations 1- Pro,side Design Calculations- a- Sedi.ument Pon&-Traps b- Diversions c- Wata}`s I RunofPStarnnwater Detention Calculations Re��ised FebnLary 2016 Version Date: August 30, 2022 Section 11-Erosion and Se(Umeitt Control Plans General 1. Vicinity. ap 2_ _Cit-V.!CoIrnty of Cleariag and Grading Appro al Block 3- Erosion and Sediment Control-Notes Site Plan 1_ Note legal description of subject property_ I Show Forth An-oar. 3_ Indicate boundaries of existing vegetation- e.e. tree fines, pasture areas. etc. 4- Ideutif�and label areas of potential erosion problerus- 5- Identify on-site or adjacent surface waters, critical areas and associated biffers. 6- Identify FEMA base flood boundaries and Shoreline Management boundaries (if applicable)- (- Show existing and proposed contours- 8- Indicate drainage basins and direction of flow for mdn uktal dram age areas- 9- Label final grade contours and identify developed condition drainage basins. 1 0- Delineate areas that are to be cleared and graded. 11- Shaky all cut and fill slopes indicating tcrp and bottom of slope catch lines- Collive ance systems 1_ Designate locations for swales- interceptor trenches,or ditches. 2_ _Show all temporary andpermanent drainage pipes_ ditches_ or cut-off tr€aches required for erosion and sediment control. 3_ Pro-IlYde rnu,m- tun slope and cover for all temporary pipes or call(nit pipe mverts- 4_ Show gades, dinmisi : and direction of flow in all ditches_ sw ales. cWverts and pipes- 5_ Pr(Mde details for bypassing off--site rtmoff armmid dishubed areas_ 6_ Indicate locations and(nrtlets of any de%�atering systems_ Location of Detention B11Ps 1_ Identify location of detention B.MPs. Rey,ised Febntary 2016 Version Date: August 30, 2022 Erosion and Sediment Control Facilities 1_ Show the locations of sediment traps). l s), pipes and str utures_ I Dimension pond berm widths and inside md outside panel slopes. 3_ Indicate the trap pond storage required and the depth, lengtb_ and,%idth dimensi 4_ Provide typical section Views through pond and cutlet stmicrure. 5_ Provide typical details of gt,vel cane and standpipe- and.- r other filtering devices. 6_ Detail stabilization tcchniques for cudet;`inlet_ 7_ Detail control-'restrktcr device location and details. 8_ Specify mulch an,d.or rffommmdled cm er of berms and slopes- 9- Provide rock specifications and detail for rock check dams), if applicable_ 1 0_ Specify spacing for rack check dams as required.. 11_ Provide front and side sections oftvpical rock check dates_ 1 2_ Indicate the locations and provide details and specifications for silt fabric. 13_ Locate the construction entrance and provide a detail_ Detailed Draiiings 1_ strucku-al practices used that are not referenced in the Ecology-Nlanual mould be explained and illustrated with detailed drawings_ Other Pollutant BOWS 1. lndicate on the site plan the location of B Ps to be used for the control ofpoll=mts other t m sedivaent_ e.g_. concrete %v-ash water_ MonitoAng Locations 1_ Indicate on the site plan the cuter quality sampling locatims to be med for Monitoring outer quality an the comtmichm site. if applicable- Revised February 2016 Version Date: August 30, 2022 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 2019 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: 4707 Queen Ann Way Prepared By: The Stormwater checklist or building permit determined that: 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, provide the BMP's that will be applicable to your project. Use the attached Tables provided. 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. Suggested BMPs for Element 1: • BMP C101: Preserving Natural Vegetation BMP C102: Buffer Zone • BMP C103: High-Visibility Fence • BMP C233: Silt Fence How did you comply with this section? Area is surrounded by pavement that will be swept as it is soiled. Version Date: August 30, 2022 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. Additional Guidance for Element 2 Minimize construction site access points along linear projects, such as roadways. Street washing may require local jurisdiction approval. Suggested BMPs for Element 2: BMP C105: Stabilized Construction Acces • BMP C106: Wheel Wash • BMP C107: Construction Road / Parking Area Stabilization How did you comply with this section? Area is surrounded by pavement that will be swept as it is soiled. 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. Version Date: August 30, 2022 Additional Guidance for Element 3 • Conduct a downstream analysis if changes in flows could impair or alter conveyance systems, streambanks, bed sediment, or aquatic habitat. See III-3.2 Preparing a Stormwater Site Plan for off-site analysis guidelines. • Even gently sloped areas need flow controls such as BMP C235: Wattles or other energy dissipation / filtration structures. Place dissipation facilities closer together on steeper slopes. These methods prevent water from building higher velocities as it flows downstream within the construction site. • Control structures designed for permanent detention BMPs are not appropriate for use during construction without modification. If used during construction, modify the control structure to allow for long-term storage of runoff and enable sediment to settle. Verify that the BMP is sized appropriately for this purpose. Restore BMPs to their original design dimensions, remove sediment, and install a final control structure at completion of the project. • Erosion has the potential to occur because of increases in the volume, velocity, and peak flow rate of stormwater runoff from the project site. The local permitting agency may require infiltration or detention BMP designs that provide additional or different stormwater flow control than the designs detailed in this manual. These requirements may be necessary to address local conditions or to protect properties and waterways downstream. • Velocity of water leaving the site should not exceed 3 feet/second, if the discharge is to a stream or ditch. Install velocity dissipation, such as BMP C207: Check Dams or BMP C202: Riprap Channel Lining to ensure reduction of the flow velocity to a non-erosive level. • If the discharge from a project site is to a municipal storm drainage system, the allowable discharge rate may be limited by the capacity of the public system. It may be necessary to clean the municipal storm drainage system prior to the start of the discharge to prevent scouring solids from the drainage system. Obtain permission from the owner of the collection system before discharging to it. Ensure that no downstream pipes are surcharged as a result of increased flows from the project site. • If the discharge from a project site is directly to a flow control exempt receiving water listed in Appendix I-A: Flow Control Exempt Receiving Waters or to an infiltration system, there is no discharge flow limit. Suggested BMPs for Element 3 • BMP C203: Water Bars • BMP C207: Check Dams • BMP C209: Outlet Protection • BMP C235: Wattles • BMP C240: Sediment Trap • BMP C241: Sediment Pond (Temporary) • See also V-12 Detention BMPs How did you comply with this section? 600 sq ft disturbed area will infiltrate on site. Retained concrete and structures surrounding project will keep soil and sediment from millratin2. Version Date: August 30, 2022 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. ❑ 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. Additional Guidance for Element 4 • Outlet structures that withdraw impounded stormwater from the surface to avoid discharging sediment that is still suspended lower in the water column are for the construction period only. If installing a floating pump structure, include a stopper to prevent the pump basket from hitting the bottom of the pond. • If a sediment trapping BMP utilizes a control structure that will also be used in a permanent detention BMP application, the control structure construction must be finalized for the permanent BMP application upon project completion. • Install sediment controls in a manner that protects the sensitive areas and their buffers marked in accordance with Element 1: Preserve Vegetation / Mark Clearing Limits. • Where feasible, direct stormwater to vegetated areas to increase sediment removal and maximize stormwater infiltration. • Seed and mulch earthen structures such as dams, dikes, and diversions according to the timing indicated in Element 5: Stabilize Soils. • Full stabilization includes concrete or asphalt paving; quarry spalls used as ditch lining; or the use of rolled erosion products, a bonded fiber matrix product, or vegetative cover in a manner that will fully prevent soil erosion. • The Local Permitting Authority may inspect and approve areas fully stabilized by means other than pavement or quarry spalls. Version Date: August 30, 2022 Suggested BMPs for Element 4: • BMP C231: Brush Barrier • BMP C232: Gravel Filter Berm • BMP C233: Silt Fence • BMP C234: Vegetated Strip • BMP C235: Wattles • BMP C240: Sediment Trap • BMP C241: Sediment Pond (Temporary) • BMP C250: Construction Stormwater Chemical Treatment • BMP C251: Construction Stormwater Filtration How did you comply with this section? 600 sq ft disturbed area will infiltrate on site. Retained concrete and structures surrounding protect will keep soil and sediment from mi2ratinI!. 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: August 30, 2022 Additional Guidance for Element 5 • Soil stabilization BMPs should be appropriate for the time of year, site conditions, estimated duration of use, and potential water quality impacts that stabilization agents may have on downstream waters or ground water. • Ensure that gravel base used for stabilization is clean and does not contain fines or sediment. Suggested BMPs for Element 5: • BMP C120: Temporary and Permanent Seeding • BMP C121: Mulching • BMP C122: Nets and Blankets MP C123: Plastic Cover' • BMP C124: Sodding • BMP C125: Topsoiling / Composting • BMP C126: Polyacrylamide (PAM)for Soil Erosion Protection • BMP C130: Surface Roughening • BMP C131: Gradient Terraces • BMP C140: Dust Control How did you comply with this section? 600 sq ft disturbed area will infiltrate on site. Retained concrete and structures surrounding project will keep soil and sediment from migrating. 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 slope drains or protected channels to prevent erosion. Temporary pipe slope drains must be sized to convey the flow rate calculated by the one fo the following methods: • Single Event Hydrograph Method: The peak volumetric flow rate calculated using a 10-minute time step from a Type 1A, 10-year, 24-hour frequency storm, or; • Continuous Simulation Method: The 10-year peak flow rate, as determined by an approved continuous runoff model with a 15-minute time step. 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. Version Date: August 30, 2022 If using the Western Washington Hydrology Model (WWHM) to predict flows, bare soil areas should be modeled as "landscaped" area. 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. Additional Guidance for Element 6 • Consider soil type and its potential for erosion. • Stabilize soils on slopes, as specified in Element 5: Stabilize Soils. • BMP combinations are the most effective method of protecting slopes with disturbed soils. For example, use both BMP C121: Mulching and BMP C122: Nets and Blankets in combination. Suggested BMPs for Element 6: • BMP C120: Temporary and Permanent Seeding • BMP C121: Mulching • BMP C122: Nets and Blankets BMP C123: Plastic Coverin • BMP C124: Sodding • BMP C130: Surface Roughening • BMP C131: Gradient Terraces • BMP C200: Interceptor Dike and Swale • BMP C201: Grass-Lined Channels • BMP C203: Water Bars • BMP C204: Pipe Slope Drains • BMP C205: Subsurface Drains • BMP C206: Level Spreader • BMP C207: Check Dams • BMP C208: Triangular Silt Dike (TSD) How did you comply with this section? 600 sq ft disturbed area will infiltrate on site. Retained concrete and structures surrounding project will keep soil and sediment from migrating. Version Date: August 30, 2022 ELEMENT 7: Protect Drain Inlets ❑ 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). Additional Guidance for Element 7 • 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 (as defined above) 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. Suggested BMPs for Element 7 • MP C220: Inlet Protection How did you comply with this section? Silt sock will be placed in catch basin closest to site. Sock will be removed at end of project. ELEMENT 8: Stabilize Channels and Outlets Design, construct, and stabilize all on-site conveyance channels to prevent erosion from the flow rate calcultated by one the following methods: o Single Event Hydrograph Method: The peak volumetric flow rate calculated using a 10-minute time step from a Type 1A, 10-year, 24-hour frequency storm, or; o Continuous Simulation Method: The 10-year peak flow rate, as determined by an approved continuous runoff model with a 15-minute time step. 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. ❑ Provide stabilization, including armoring material, adequate to prevent erosion of outlets, adjacent streambanks, slopes, and downstream reaches at the outlets of all conveyance systems. Additional Guidance for Element 8 The best method for stabilizing channels is to completely line the channel with BMP C122: Nets and Blankets first, then add BMP C207: Check Dams as necessary to function as an anchor and to slow the flow of water. Version Date: August 30, 2022 Suggested BMPs for Element 8 • BMP C122: Nets and Blankets • BMP C202: Riprap Channel Lining • BMP C207: Check Dams • BMP C209: Outlet Protection How did you comply with this section? No channels planned. ELEMENT 9: Control Pollutants Design, install, implement and maintain effective pollution prevention measures to minimize the discharge of pollutants. The project proponent must: ❑ 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, or to the sanitary sewer, with local sewer district approval. ❑ 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: recycled concrete stockpiles, 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 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 truck drums or concrete handling equipment onto the ground, or into storm drains, open ditches, streets, or streams. Washout of small concrete handling equipment may be Version Date: August 30, 2022 disposed of in a formed area awaiting concrete where it will not contaminate surface or ground water. Do not dump excess concrete on site, except in designated concrete washout areas. Concrete spillage or concrete discharge directly to ground water or surface waters of the State is prohibited. Do not wash out to formed areas awaiting infiltration BMPs. ❑ Obtain written approval from Ecology before using chemical treatment other than COz, dry ice, or food grade vinegar to adjust pH. ❑ Uncontaminated water from water-only based shaft drilling for construction of building, road, and bridge foundations may be infiltrated provided the wastewater is managed in a way that prohibits discharge to surface waters. Prior to infiltration, water from water-only based shaft drilling that comes into contact with curing concrete must be neutralized until pH is in the range of 6.5 to 8.5 (su). Additional Guidance for Element 9 • Wheel wash and/or tire bath wastewater can be combined with wastewater from concrete washout areas if the wastewaters will be properly disposed of at an offsite location or treatment facility. • Do not use upland land applications for discharging wastewater from concrete washout areas. • Woody debris may be chopped and spread on site. • Conduct oil changes, hydraulic system drain down, solvent and degreasing 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. Suggested BMPs for Element 9 • BMP C151: Concrete Handling • BMP C152: Sawcutting and Surfacing Pollution Prevention • BMP C153: Material Delivery, Storage, and Containment BMP C154: Concrete Washout Area • BMP C250: Construction Stormwater Chemical Treatment • BMP C251: Construction Stormwater Filtration • BMP C252: Treating and Disposing of High pH Water • Also see the Source Control BMPs detailed in Volume IV How did you comply with this section? Trucks will be returned to yard for cleaning, or washout water will be contained in kiddee pool on site. Version Date: August 30, 2022 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 BMP C240: Sediment Trap or BMP C241: Sediment Pond (Temporary). Discharge foundation, vault, and trench dewatering water, which have similar characteristics to stormwater runoff at the site, into a controlled conveyance system before discharge to Discharge clean, non-turbid dewatering water, such as well-point ground water, to systems tributary to, or directly into surface waters of the State, as specified in Element 8: Stabilize Channels and Outlets, provided the dewatering flow does not cause erosion or flooding of receiving waters. Do not route clean dewatering water through stormwater sediment BMPs. 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. ❑ Handle highly turbid or otherwise contaminated dewatering separately from stormwater. Other dewatering 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. Additional Guidance for Element 10 • Channels must be stabilized, as specified in Element 8: Stabilize Channels and Outlets. • 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 violation of water quality standards for turbidity. The easiest way to avoid discharging muddy water is through infiltration and preserving vegetation. • Dewatering water from contaminated sites must be handled separately from stormwater. Direct contaminated stormwater to a sanitary sewer where allowed by the local sewer authority, or to other approved treatment. Suggested BMPs for Element 10 • BMP C203: Water Bars • P C236: Ve etative Filtratio How did you comply with this section? If dewatering is required,it will be pumped to upland grassy area. Version Date: August 30, 2022 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. Additional Guidance for Element 11 • Some temporary erosion and sediment control BMPs are biodegradable and designed to remain in place following construction. BMP C122: Nets and Blankets is an example of a BMP with biodegradable options. • 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. • Remove or stabilize trapped sediment on site. Permanently stabilize disturbed soil resulting from removal of BMPs or vegetation. Suggested BMPs for Element 11 BMP C150: Materials on Hand • BMP C160: Certified Erosion and Sediment Control Lead How did you comply with this section? Existing buildings and paved areas cork the site. A broom will be kept at the ready to sweep up soil that migrates to paved areas. ELEMENT 12: Manage the Project ❑ Phase development projects to the maximum degree practicable and take into account seasonal work limitations. ❑ Inspect, maintain and repair all BMPs as needed to assure continued performance of their intended function. Projects regulated under the Construction Stormwater General Permit (CSWGP) must conduct site inspections and monitoring in accordance with Special Condition S4 of the CSWGP. ❑ Maintain, update, and implement the Construction SWPPP. ❑ Projects that disturb one or more acres must have site inspections conducted by a Certified Erosion and Sediment Control Lead (CESCL). Project sites disturbing less than one acre may have a CESCL or a person without CESCL certification conduct inspections. By the initiation of construction, the Construction SWPPP must identify the CESCL or inspector, who must be present on site or on-call at all times. Version Date: August 30, 2022 Additional Guidance for Element 12 The project manager must ensure that the project is built in such a way to comply with all Construction SWPPP Elements, as detailed in this section. Considerations for the project manager include, but are not limited to: • construction phasing • seasonal work limitations • coordination with utilities and other contractors • inspection • monitoring • maintaining an updated construction SWPPP Phasing of Construction Phase development projects where feasible in order to prevent soil erosion and transporting of sediment from the site during construction. Revegetate exposed areas and maintain that vegetation as an integral part of the clearing activities for any phase. Clearing and grading activities for developments shall be permitted only if conducted using an approved site development plan (e.g., subdivision approval) that establishes permitted areas of clearing, grading, cutting, and filling. Minimize removing trees and disturbing or compacting native soils when establishing permitted clearing and grading areas. Show on the site plans and the development site permitted clearing and grading areas and any other areas required to preserve critical or sensitive areas, buffers, native growth protection easements, or tree retention areas as may be required by local jurisdictions. Inspection All BMPs must be inspected, maintained, and repaired as needed to assure continued performance of their intended function. Site inspections must be conducted by a person knowledgeable in the principles and practices of erosion and sediment control. The person must have the skills to 1) assess the site conditions and construction activities that could impact the quality of stormwater, and 2) assess the effectiveness of erosion and sediment control measures used to control the quality of stormwater discharges. For construction sites one acre or larger that discharge stormwater to surface waters of the state, a CESCL must be identified in the construction SWPPP; this person must be on-site or on-call at all times. Certification must be obtained through an approved training program that meets the erosion and sediment control training standards established by Ecology. See BMP C160: Certified Erosion and Sediment Control Lead. Appropriate BMPs or design changes shall be implemented as soon as possible whenever inspection and/or monitoring reveals that the BMPs identified in the Construction SWPPP are inadequate, due to the actual discharge of/or potential to discharge a significant amount of any pollutant. The CESCL or inspector must examine stormwater visually for the presence of suspended sediment, turbidity, discoloration, and oil sheen. They must evaluate the effectiveness of BMPs and determine if it is necessary to install, maintain, or repair BMPs to improve the quality of stormwater discharges. Based on the results of the inspection, construction site operators must correct the problems identified by: • Reviewing the Construction SWPPP for compliance with the 13 elements and making appropriate revisions within 7 days of the inspection. • Immediately beginning the process of fully implementing and maintaining appropriate source control and/or treatment BMPs as soon as possible, addressing the problems no later than within 10 days of the inspection. If installation of necessary treatment BMPs is not feasible within 10 days, the construction site operator may request an extension within the initial 10-day response period. • Documenting BMP implementation and maintenance in the site log book (applies only to sites that have coverage under the Construction Stormwater General Permit). Version Date: August 30, 2022 The CESCL or inspector must inspect all areas disturbed by construction activities, all BMPs, and all stormwater discharge points at least once every calendar week and within 24 hours of any discharge from the site. (For purposes of this condition, individual discharge events that last more than one day do not require daily inspections. For example, if a stormwater pond discharges continuously over the course of a week, only one inspection is required that week.) The CESCL or inspector may reduce the inspection frequency for temporary stabilized, inactive sites to once every calendar month Maintaininq an Updated Construction SWPPP Retain the Construction SWPPP on-site or within reasonable access to the site. Modify the Construction SWPPP whenever there is a change in the design, construction, operation, or maintenance at the construction site that has, or could have, a significant effect on the discharge of pollutants to waters of the state. The Construction SWPPP must be modified if, during inspections or investigations conducted by the owner/operator, or the applicable local or state regulatory authority, it is determined that the Construction SWPPP is ineffective in eliminating or significantly minimizing pollutants in stormwater discharges from the site. Modify the Construction SWPPP as necessary to include additional or modified BMPs designed to correct problems identified. Complete revisions to the Construction SWPPP within seven (7) days following the inspection. Suggested BMPs for Element 12 • MP C150: Materials on Hand • BMP C160: Certified Erosion and Sediment Control Lead BMP C162: Schedulin How did you comply with this section? This is a small site surrounded by pavement. The soil will be trucked off site as the hole is dug. Soil will be open to the weather for a minimal time. ELEMENT 13: Protect Low Impact Development BMPS The primary purpose of On-Site Stormwater Management is to reduce the disruption of the natural site hydrology through infiltration. BMPs used to meet 1-3.4.5 MRS: On-Site Stormwater Management (often called LID BMPs) are permanent facilities. ❑ Protect all LID BMPs (including, but not limited to BMP T7.30: Bioretention, BMP T5.14: Rain Gardens, and BMP T5.15: Permeable Pavements) from sedimentation through installation and maintenance of erosion and sediment control BMPs on portions of the site that drain into the LID BMPs. Restore the BMPs to their fully functioning condition if they accumulate sediment during construction. Restoring the BMP must include removal of sediment and any sediment-laden Bioretention/Rain Garden soils, and replacing the removed soils with soils meeting the design specification. ❑ Maintain the infiltration capabilities of LID BMPs by protecting against compaction by construction equipment and foot traffic. Protect completed lawn and landscaped areas from compaction due to construction equipment. ❑ Control erosion and avoid introducing sediment from surrounding land uses onto BMP T5.15: Permeable Pavements. Do not allow muddy construction equipment on the base material or pavement. Do not allow sediment-laden runoff onto permeable pavements or base materials. Version Date: August 30, 2022 Permeable pavement fouled with sediments or no longer passing an initial infiltration test must be cleaned using procedures in accordance with this manual or the manufacturer's procedures. Ll Keep all heavy equipment off existing soils under LID BMPs that have been excavated to final grade to retain the infiltration rate of the soils. Additional Guidance for Element 13 See Chapter 5: Precision Site Preparation, Construction & Inspection of LID Facilities in the LID Technical Guidance Manual for Puget Sound(Hinman and Wulkan, 2012) for more detail on protecting LID integrated management practices. Note that the LID Technical Guidance Manual for Puget Sound(Hinman and Wulkan, 2012) is for additional informational purposes only. You must follow the guidance within this manual if there are any discrepancies between this manual and the LID Technical Guidance Manual for Puget Sound (Hinman and Wulkan, 2012). Suggested BMPs for Element 13 • BMP C102: Buffer Zones • BMP C103: High-Visibility Fence • BMP C200: Interceptor Dike and Swale • BMP C201: Grass-Lined Channels • BMP C207: Check Dams • BMP C208: Triangular Silt Dike (TSD) • BMP C231: Brush Barrier • BMP C233: Silt Fence • BMP C234: Vegetated Strip How did you comply with this section? No LIDS proposed. Applicant Signature Date Version Date: August 30, 2022 TAB 5 (MINIMUM REQUIREMENT #5) Site is surrounded by concrete. T5.13 is not applicable. • 1-3.4.5 Minimum Requirement#5 —On-site Stormwater Management Projects shall employ Stormwater Management BMPs in accordance with the following thresholds, standards, and lists to infiltrate, disperse, and retain stormwater runoff on site to the extent feasible without causing flooding or erosion impacts. Project thresholds that trigger Minimum Requirements #1 through #5, shall utilize the On-site Stormwater Management BMP's from List#1 for all surfaces within each type of surface in List#1; or, Demonstrate compliance with the LID Performance Standard. Projects selecting this option cannot use Rain Gardens. They may choose to use Bioretention BMP's as described in Chapter V-7 — Infiltration and Bioretention Treatment Facilities to achieve the LID Performance Standard. Refer to this section of the reference Manual for all Feasibility or Infeasibility Criteria for List#1 and List#2. Is this project Flow Control Exempt? (Yes\No) (See Appendix 1-E: Flow Control-Exempt Surface Water). If yes, provide reasoning from the applicability section of 1-2.5.7 Minimum Requirement#7: Flow Control). If No, then the project triggers Minimum Requirement#7 (1-2.5.7) and possibly Minimum Requirement #8 (1-2.5.8). If the project is Flow Control Exempt, select from the List 3 below: (Skip List 1 and List 2) o BMP T5.13 Post Construction Soils Quality and Depth o BMP T5.10A: Downspout Full Infiltration, or; o BMP T5.10B Downspout Dispersion Systems, or; o BMP T5.10C: Performated Stub-out Connections, or; LID Performance Standard The LID Performance Standard compliance method for Minimum Requirement#5 requires modeling the proposed Flow Control BMPs to demonstrate the flow reduction as described below. Note that in order to meet the LID Performance Standard, the chosen Flow Control BMPs will most likely need to include infiltration. Stormwater discharges shall match developed discharge durations to pre-developed durations for the range of pre-developed discharge rates from 8% of the 2-year peak flow to 50% of the 2-year peak flow. Refer to the Flow Control Performance Standard section in 1-3.4.7 MR7: Flow Control for information about the assignment of the pre-developed condition. Project sites that must also meet 1-3.4.7 MR7: Flow Control must match flow durations between 8% of the 2-year flow through the full 50-year flow. Designers selecting this option cannot use BMP T5.14: Rain Gardens to achieve the LID Performance Standard. They may choose to use BMP T7.30: Bioretention to achieve the LID Performance Standard. Version Date: August 30, 2022 The List Approach The List Approach compliance method for Minimum Requirement#5 requires evaluating the BMPs in Table 1-3.2: The List Approach for MR5 Compliance. For each surface, evaluate the feasibility of the BMPs in the order listed, and use the first BMP that is considered feasible. The designer must document the site conditions and infeasibility criteria used to deem BMPs infeasible. Once a BMP is deemed feasible and used for a surface, no other BMP from the list is necessary for that surface. If all BMPs in the list are infeasible, then the designer must document the site conditions and infeasibility criteria used to deem each BMP infeasible. This documentation will demonstrate compliance with Minimum Requirement#5. Feasibility shall be determined by evaluation against: • Design criteria, limitations, and infeasibility criteria identified for each BMP in this manual; and • Competing Needs Criteria as listed below. 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.orq/pdf/Soil BMP Manual.pdf See Appendix 3 for the "Model Soil Management Plan for BMP T5.13" to be submitted with Drainage Report and Application Material. An alternate document acceptable to the City of Anacortes is a Test Report provided by the Soils Supplier that identifies the soils to be used meet the specifications outlined under Minimum Requirement 5. The specifications are in both WSDOT and CSI Formats. For specifications, refer to the above referenced PDF. This submittal can be a deferred submittal since most projects are not sure who the supplier will be at the time of building permit application. For projects that trigger Minimum Requirements 1 through 5, the Test Report will be provided to the Building Department. Projects triggering Minimum Requirements 1 through 9, the Test Report will be provided to the Engineering Department. Site is surrounded by concrete. T5.13 is not applicable. Version Date: August 30, 2022 APPENDIX 1 —Survey performed by a Professional Land Surveyor The object of this appendix is to ensure that the property has a minimum of 3 out of 5 property corners visible to ensure that the structures are placed within the required setbacks. A = 1 00-1'26" N-2-00121$O R = 1345,00' w / �0 l 14.81' +/_ BUILDING SETBACK LINE_ / REMOVE EXIST. PAVEMENT EXISTING PAVED REBUILD PATIO $ PROPOSED ADDITION I I DRIVEWAY (SAME FOOTPRINT) Fk/ST RO C I 0 ' / 3,/ 9L 4 NDgCApF A WALL I , ADDIONEPORGH SEE NOTE 1 8' I EXISTING CONC. N PROP. DECK PROPOSED l PATIO MAIN FLOOR 1 \ADDITION00 IA / EXISTING RESIDENCE Z (DAYLIGHT BSMT, r I m I / 8 MAIN FLOOR) ° EXISTING GONG.I WALK/STEPS ► L__ + SEE NOTE •1 EXIST. MAIN- I O I FLOOR DECK J^ O / EXIST. J I / PAVED LINE OF ROOF / DRIVE O OVERI-IANGs 3°17 4 1� - O SEE NOTE 02 't = 1470 0,.L _ 84- 4 QuEiN . ANN Ligr a 6 1 TE FLAN SCALE: 1" = 20'-011 Version Date: August 30, 2022 APPENDIX 3 — Model Soil Management Plan for BMP T5.13 An alternate document acceptable to the City of Anacortes is a Test Report provided by the Soils Supplier that identifies the soils to be used meet the specifications outlined under Minimum Requirement 5. The specifications are in both WSDOT and CSI Formats. For specifications, refer to the above referenced PDF. This submittal can be a deferred submittal since most projects are not sure who the supplier will be at the time of building permit application. For projects that trigger Minimum Requirements 1 through 5, the Test Report will be provided to the Building Department. Projects triggering Minimum Requirements 1 through 9, the Test Report will be provided to the Engineering Department. Site is surrounded by concrete. T5.13 is not applicable. Version Date: August 30, 2022 DEFERRED SUBMITTAL: PROVIDE A TEST REPORT FROM SOILS SUPPLIER TO THE BUILDING DEPT. 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. Si ddress/Lot No.: Permit e: Permit Number: Permit Holder: Phone: Mailing Addilk. AW Contact Person:XPhone: Plan Prepared B ATTACHMENTS REQUI D Check qff required items that are attached to thisplan) _Site Plan showing,to sc Areas of undisturbed native vegetation(no a ndment required) New planting beds and turf areas(amendment required) Type of soil improvement proposed for each area Soil test results(required if r sing custom amendment rates Product test results for proposedWWendments AREA# (should match Area#o\Plan) PLANTING TYPE _Turf _Undisturbed nat' vegetation Planting Beds )v Other: SQUARE FOOTAGE OF THIS AREA: square feet SCARIFICATION inches(depth)of scarific on needed to achieve finished total 12"loosened depth. Subsoil will be scarified PRE-APPROVED inches of compost or i orted topsoil applied AMENDMENT METHOD: X 3_1 (conversion fa r, in to cubic yards) PRODUCT: _Topsoil import =cu.yards pe 000 sq. _Amend with compost X _,000s sq.ft this area _Stockpile and amend =cubic y s of amendment QUANTITY: CU.YDS. cu.yds. stockpiled) needed to ver this area to design d depth) CUSTOM AMENDMENT Attach test sults and calculations. Topsoil import inch 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 ANTITY: CU.YDS. MULCH ,000 sq.ft. PRO CT: X 6.2 (conversion, to give 2 inch mulch depth) =cubic yards of mulch QUANT CU.YDS. TOTAL AMENDMENT/ PSOIL/MULCH FOR ALL AREAS(complete on page 1 only, totaling all areas/ a es in this Plan ❑ Product#1: If — El Quantity: cu.yds. ❑ Test Results: /o organic matter C:N ratio<25:1 exce t mulch,or<35:1 for native plants) "stable" es/no ❑ Product#2: ❑ Quantity: cu.yds. ❑ Test Result %organic matter C:N ratio<25:1 exce t mulch,or<35:1 for nativeplants) able" es/no ❑ Product# ❑ Quantity: cu.yds. ❑ Test Re ts: % or anic matter C:N ratio<25:1 exce t mulch,or<35:1 for native lants "sta es/no Date: Inspector: Approved: Revisions Required: Dat Inspector: Approved: Revisions Required: Version Date: August 30, 2022 APPENDIX 4— Determining Construction Site Sediment Damage Potential (Appendix 7 — NPDES Phase II Permit) Note: See attached. All projects within the City of Anacortes are required to complete that document under Appendix 4. Version Date: August 30, 2022 Western Washington Phase H 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, Modified January 16, 2015 Appendix 7- Determining Sediment Damage Potential Page 1 of 3 Version Date: August 30, 2022 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 Low 11100 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 extents Points 2% or less ...0 >2-5% ..............................................................................................5 >5-10% .......................................................................................... 15 >10-15% ........................................................................................30 >15% .............................................................................................50 B. Site Area to be cleared and/or graded: <5,000 sq. ft .................................................................................. OO 5,000 sq. ft. — 1 acre.....................................................................30 >1 acres .......................................................................................50 C. Quantity of cut and/or fill on site: <500 cubic yards ........................................................................... 0 500 — 5,000 cubic yards ................................................................... >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 soilgroup A....................................................................................0 Hydrologic soil group B.................................................................10 Hydrologic soil group C.................................................................20 Hydrologic soil group D...............................................................J 40 E. Erosion Potential of predominant soils (Unified Classification System): GW, GP, SW, SPsoils..........................................................................................0 Dual classifications (GW-GM, GP-GM, GW-GC, GP-GC, SW-SM, SW-SC, SP-SM, SP-SC).......................... GM, GC, SM, SC soils................................................................. 20 ML, CL, MH, CH soils................................................................... F. Surface or Groundwater entering site identified and intercepted l: Yes................................................................................................ OO No ................................................................................................25 G. Depth of cut or height of fill >10 feet: Yes...............................................................................................25 No...........................................................................................................0 H. Clearing and grading will occur in the wet season (October 1 — May 1): Yes 50 No...........................................................................................................0 TOTAL POINTS............................................................................................. 160 High, but site is very small. If no surface or groundwater enters site, give 0 points. APPENDIX 5 — Site Plan with all applicable information (Minimum Size 11x17 at a legible scale) A = 1 0012ro" Ng o , r 12 p w R = 1345,00 L = 2(o.38' o ' BUILDING SETBACK LINE�_ I 2 � REMOVE EXIST. PAVEMENT I � EXISTING PAVED EBUILD PATIO `n t��, w PROPOSED ADDITION I DRIVEWAY TAME FOOTPRINT) _ , Ek/Sr, ROCS I • Q 3��8 ��LaNpSCApZ w4LL I , ADDI ON PORGI I ,EE NOTE 1 _ :XISTING GONG. PROECK PROPOSED ATIO P. D MAIN FLOOR I I IO �. ADDITION 00 I N ' EXISTINGIo.o' ,b RESIDENCE Z. j (DAYLIGHT BSMT, r 'm 1 1 d MAIN FLOOR) I I� :XISTING CONC. JALK/STEPS L _ / Z + SEE NOTE "1 :XIST. MAIN- LOOK DECK ' EXIST. J I PAVED LINE OF ROOF DRIVE O OVERHANG 1 O .3°�7#1 II SEE NOTE 02 �F �4"7O"CC) L _ 154, � CNN Q SITE FLAN &GALE: 1" = 20'—O" APPENDIX 6 — Documented Site Photos (Show all directions of the site, including frontage) (Insert Photo Here) Location: Description of the photo: Photo taken by: +� f A ` dP 4� r I�