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1704 Melody Circle
1704 Melody Circle CUP 15-03 cv G1,2� ao� 7 cup c -- i D -P © 9 LA) 1 s5z�� f�.5r • E [ 1, ril jN'G EIES W A -S H I N G T O N, U. S. A. -Economic & Community Development Mfr i . r i k t �y F i Qo � 1 i l � Outlook.com Print Message Page 1 of 2 Print Close From: Kent Myers (Kmyers@cityofpa.us) Sent: Thu 4/12/12 1:42 PM To: willadsen716@msn.com (willadsen716@msn.com) Cc: Cherie Kidd(Ckidd@cityofpa.us); Brad Collins (Bcollins@cityofpa.us); Brooke Nelson (Bnelson@cityofpa.us); Dan DiGuilio (Ddiguilio@cityofpa.us); Sissi Bruch (Sbruch@cityofpa.us); Max Mania(Mmania@cityofpa.us); Patrick Downie (Pdownie@city@a.us); Glenn Cutler(GCUTLER@cityofpa.us) Edna, In response to your recent concerns, I wanted to let you know that Terri Partch and Kathryn Neal in our Engineering Division have been working on this issue once it was identified. A notification has been made to the State Department of Ecology. Although Terry Partch has recently left the City other staff members are currently following up by tracing back from the outfall the potential source of the discharge. This is part of our Illicit Discharge Detection and Elimination (IDDE) program. The ammonia levels are only slightly elevated and it will take a period of time to determine the source. I also wanted to mention that there is the potential that the discharge is occurring from natural conditions. Water quality samples are being taken and being analyzed and I will provide you an update once this analysis has been completed. Kent Myers From: EDNA WILLADSEN [mailto:willadsen7160msn.com] Sent: Thursday, April 05, 2012 11:59 AM To: Max Mania; Sissi Bruch; ddigulio(dcityofpa.us; Patrick Downie; Brooke Nelson; Cherie Kidd Subject: Ammonia found in City Drainages Pipe in White Creek Good Morning: I have stated in the past that I would not work with the City Public Works Department, therefore, I filed a complaint(over a month ago) with the State DOE, and after the conversation I had with Mr. Rockett on 4/4/12 I feel I need to ask the council what procedures are being implemented to correct this problem. https:Hblul 71.mail.live.com/ol/mail.mvc/PrintMessages?mkt--en-us 8/10/2015 1 Outlook.com Print Message Page 2 of 2 Mr. Rockett had been working with the Storm Water Engineer who since has left the city, but he finally touched base with Ms. Neil and she stated that the City has found Ammonia in the water, and they have done a dye test and cannot determine the source. (that is troublesome) Ms. Neil also stated that there is no erosion. That statement is non factual. The council meeting of May 19, 1992 states that the city is to obtain an easement from the owner of the ravine, (research has proven that no easement exist) it also states that the "Portions of lots A15, A25 and A26 has a Conservation easement which cannot be disturbed. It also states that the "Drainage improvements shall include channeling storm water down to the bottom if White Creek ravine in a pipe". (this noted document is recorded and is attached to all of our deeds in The Highland Estates.) My biggest concern is that White Creek which flows into Ennis is said to be in the Rainer cleanup, and this pipe is releasing toxic ammonia would never pass as it is classified as dangerous for the environment. Ammonia is known to kill aquatic life. Thank you for your attention to this matter, Edna Willadsen willadsen716@msn.com I https://blul 7l.mail.live.com/ol/mail.mvc/PrintMessages?mkt--en-us 8/10/2015 Outlook.com Print Message rage i or u Print Close FW: ER 5632®125 a White Creek From: Kathryn Neal (Kneal@cityofpa.us) Sent: Mon 7/02/12 6:31 PM To: EDNA WILLADSEN (willadsen716@msn.com) 1 attachment 2012-03-271-lighland C.onimons - Whites Creek.pdf(463.7 hh) Edna,these are the complete water testing results, at the various locations in the stormwater system. I am attaching a copy of the map that we looked at during our site visit. It is helpful in seeing how we traced the high ammonia and potassium to an underdrain below the 36" diameter ABS pipe in the parking lot NE at Highland Commons.The soil results also showed high ammonia and potassium.We believe that is the result of decaying organic matter in an area that originally had boggy soils,with a layer of peat. Kathryn From. Kathryn Neal Sent: Tuesday, April 24, 2012 11:49 AM To: Derek Rockett(droc461@ecy.wa.gov) Cc: Mike Puntenney; Eric Wheatley; Roger Vess Subject: FW: ERTS632-125 - White Creek Derek, We are continuing to investigate the matter. Below are the latest results,forwarded by our Streets/Stormwater superintendent. Kathryn Neal, P.E. (360)417-4821 Engineering Manager https://blul71.mail.live.com/ol/mail.mvc/PrintMessages?mkt=en-us 8/4/2015 Outlook.com Print Message Page 2 of 8 City of Port Angeles From: Eric Wheatley Sent: Tuesday, April 24, 2012 11:40 AM To: Kathryn Neal Subject: RE: ERTS632-125 - White Creek Kathryn, Soil samples have been sent in and we are awaiting test results.The last test out of the outfall on 4/12/12 showed: Surfactants: .360 Ammonia/Potassium Ratio: .319/.09=3.544 Eric From: Rockett, Derek(ECY) [mailto:droc461@ecy.wa.aov] Sent:Tuesday, April 24, 2012 9:54 AM To: Kathryn Neal Cc: Roger Vess; Eric Wheatley Subject: RE: ERTS632-125 -White Creek Good morning Kathryn. Any update on this potential issue? Thank you. Derek Derek Rockett Nonpoint Specialist https:/iblul7l.mail.live.com/ol/mail.mvc/PrintMessages?mkt=en-us 8/4/2015 Uunook.com Pnnt Message Page 3 of 8 Department of Ecology PO Box 47775 Olympia, WA 98504-7775 360.407.6697 Derek.RockettCaD-ecy.wa.gov From: Kathryn Neal [mailto:KnealCa)cityofpa.usl Sent:Tuesday, April 03, 2012 10:07 AM To: Rockett, Derek(ECY) Cc: Roger Vess; Eric Wheatley Subject: ERTS632-125 -White Creek Derek, Here are the sampling results I was telling you about.You will see,some are from the outfall pipe to the ravine. Upstream of the pipe is an open swale,then more pipe system leading from a manhole.The 6" PVC pipe empties into the MH and is under the 36"storm drain under the parking lot near 1703 Melody Circle. I'm attaching a map too,that might be helpful.The whole area was originally boggy,with a layer of peat. Kathryn Neal, P.E. (36o)417-4821 Engineering Manager City of Port Angeles From: Eric Wheatley Sent: Monday, March 26, 2012 11:42 AM To: Kathryn Neal Cc: Roger Vess; Mike Brockopp Subject: RE: Stormwater sample https://blul7l.mail.live.com/ol/mail.mvc/PrintMessages?mkt—en-us 8/4/2015 Uutlook.com Ynnt Message Page 4 of 8 Kathryn, Test results are emailed to us from the lab at the WWTP. I have included all testis, the results, and any other information that we have captured with the Cltyworks work order for this IDDE`event.The lab does have an official record of the results. If what I have included below is not enough and you would like it either contact me and I can see if I can have it forwarded to you,or contact Ken Loghry directly.We have been waiting for the flow from the outfall to match that of the initial test so we could take another sample to see if it has continued to dissipate but we have not reached that point yet and the forecast for rainfall does not look favorable. Let me know if you need anything else. Eric Wheatley Street/Stormwater Superintendent City of Port Angeles 360-417-4825 ewheatle@cityofpa.us By WSD, WSD: 2/29/2012 12:02:05 PM A sample was taken from behind the address above. Will enter sample#'s when results from the lab come back. By WSD, WSD: 3/6/2012 12:04:05 PM The results in custom fields are from the initial sample taken at the outfall. By WSD,WSD: 3/6/2012 12:16:56 PM Test results from intial sample at the outfall are as follows: Sampled Feb 29th Surfactants .360 Ammonia/Potassium Ratio 4.68 https://blul7l.mail.live.com/ol/mail.mvc/PrintMessages?mkt=en-us 8/4/2015 vutlook.com Print Message Page 5 of 8 Catch Basin #554 'i Sampled 3/1-Sample taken from floww-aut-of-6"-PVC-pipe-� Surfacants .360 Ammonia 1.33 Potassium .09 Ratio 14.8 3/1 Dye testing and video'd with hand camera to try to determine origin of 6" PVC pipe in catch basin#554. No response to dye testing and hand video camera was inserted approx. 106'. Pipe was full of water limiting results. Appears to be 6'ABS perferated drain pipe. Manhole#555 Sampled 3/1-sample=taken-fr6h--min—t ole=sump-in-no=flow-conditions- Surfactant .360 Ammonia 1.76 Ppotassium .207 Ratio 8.50 Catch Basin#554 Resampled on 3/5 -Sample-taken-from-flow-out of-6"--PVC pipe Surfactant.360 Ammonia 1.58 Potassium .109 Ratio 14.5 NO Fecal Coliform detected in test results By WSD, WSD: 3/6/2012 12:21:20 PM https://blul 7l.mail.live.com/ol/mail.mvc/PrintMessages?mkt=en-us 8/4/2015 uutlook.com Vrmt Message Page 6 of 8 Turbidity/color of water is related to natural soil conditions. By WSD, WSD: 3/8/2012 10:44:59 AM Met with Roger Vess on 3/7/12 to review the issue. Roger has taken over the issue and will be dealing with the property owner as he has found that the 6" pipe in question is an underdrain for a detention pipe on the property commonly known as 1703 Melody Circle. By WSD,WSD: 3/16/2012 12:42:54 PM We took another sample today(3-16-12)from the outfall behind 732 Currier Ct. Here are the results: Surfactants: .360 Ammonia/Potassium ratio: .270/.122=2.2 From: Kathryn Neal Sent: Monday, March 26, 2012 11:24 AM To: Eric Wheatley Cc: Roger Vess Subject: RE: Stormwater sample Eric, Do you have a list/table of all the sarnples that have been taken for this investigation?Or you could just scan the lab results and send them to me. Or you can bring thea: to me and I will turn them into .pdfs. Kathryn From: Eric Wheatley Sent: Friday, March 16, 2012 12:59 PM To: Roger Vess Cc: Mike Brockopp; Kathryn Neal; Mike Puntenney Subject: RE: Stormwater sample https://blu 171.mail.live.com/ol/mail.mvc/PrintMessages?mkt=en-us 8/4/2015 Uutlook.cOm Ynnt Message The results from the sample taken behind 732 Currier Court this mornin 3/16/12 Surfactant results: .360 Ammonia/Potassium ratio: .270/.122=2.2 The original sample taken on 2/29/12 came back as: Surfacant results: .360 Ammonia/Potassium ratio:4.68 This shows the levels diminishing but this could be due to the amount of rainfall yesterday and last night and the increase in the volume of water at the outfall due to the rainfall. I suggest that another sample be taken during a short period of dry weather to verify if the levels continue to diminish. I am still proceeding with sampling the soil in this area and will be discussing this with both NTI,as a professional service, and also Edge Analytical,the lab we use to test the sweeping/educting spoils in hopes of finding an approved sampling method that will allow us to take the sample. Thanks, Eric From: Mike Brockopp Same$° Friday, March 16, 2012 12:28 PM To: Eric Wheatley Cc: Roger Vess Subject: FW: Stormwater sample Gentlemen, Here are the results for the sample we took this morning at the discharge by 732 Currier Ct. https://b1u171.mail.live.com/ol/mail.mvc/PrintMessages?nikt=en-us 8/4/2015 Outlook.com Pnnt Message Page 8 of 8 Mike Brockopp Stormwater Leadworker City of Port Angeles 360-565-3854 mbrockop(@ci!yof pa.us From: Ken Loghry Sent: Friday, March 16, 2012 10:47 AM To: Mike Brockopp Subject: Stormwater sample Mike, Surfactant results: .360 Ammonia/potassium ratio: .270/.122=2.2 Have a great St. Patrick's Day! Ken Ken Loghry Lab Analyst Port Angeles Waste Water Treatment Plant City of Port Angeles, PO Box 1150, Port Angeles,WA 98362 360.417.4845 kloghry@cityofpa.us https://blu171.mail.live.com/ol/mail.mvc/PrintMessages?mkt=en-us 8/4/2015 Uutlook.com runt Message Page 1 of 2 Print Close FW. Ammonia fount] in City Drainages Pipe in White Creek From: ]Kent Myers (Kmyers@cityofpa.us) Sent: Thu 4/12/12 1:42 PM To: willadsen716@msn.com (willadsen716@msn.com) Cc: Cherie Kidd(Ckidd@cityofpa.us); Brad Collins (Bcollins@cityofpa.us); Brooke Nelson (Bnelson@cityofpa.us); Dan DiGuilio (Ddiguilio@cityofpa.us); Sissi Bruch (Sbruch@cityofpa.us); Max Mania(Mmania@cityofpa.us); Patrick Downie (Pdownie@cityofpa.us); Glenn Cutler(GCUTLER@cityofpa.us) Edna, In response to your recent concerns, I wanted to let you know that Terri Partch and Kathryn Neal in our Engineering Division have been working on this issue once it was identified. A notification has been made to the State Department of Ecology. Although Terry Partch has recently left the City other staff members are currently following up by tracing back from the outfall the potential source of the discharge. This is part of our Illicit Discharge Detection and Elimination (IDDE) program. The ammonia levels are only slightly elevated and it will take a period of time to determine the source. I also wanted to mention that there is the potential that the discharge is occurring from natural conditions. Water quality samples are being taken and being analyzed and I will provide you an update once this analysis has been completed. Kent Myers From: EDNA WILLADSEN [mailto:willadsen716@msn.com] Seat: Thursday, April 05, 2012 11:59 AM To: Max Mania; Sissi Bruch; ddiQulio@citvofpa.us; Patrick Downie; Brooke Nelson; Cherie Kidd Subject: Ammonia found in City Drainages Pipe in White Creek Good Morning: I have stated in the past that I would not work with the City Public Works Department, therefore, https://blu 171.mail.live.com/ol/mail.mvc/PrintMessages?mkt=en-us 8/4/2015 Uutlook.com Ynnt Message Yage 2 ot-2 I filed a complaint(over a month ago) with the State DOE, and after the conversation I had with Mr. Rockett on 4/4/12 I feel I need to ask the council what procedures are being implemented to correct this problem. Mr. Rockett had been working with the Storm Water Engineer who since has left the city, but he finally touched base with Ms. (Veil and she stated that the City has found Ammonia in the water, and they have done a dye test and cannot determine the source. (that is troublesome) Ms. (Veil also stated that there is no erosion. That statement is non factual. The council meeting of May 19, 1992 states that the city is to obtain an easement from the owner of the ravine, (research has proven that no easement exist) it also states that the"Portions of lots A15, A25 and A26 has a Conservation easement which cannot be disturbed. It also states that the "Drainage improvements shall include channeling storm water down to the bottom if White Creek ravine in a pipe". (this noted document is recorded and is attached to all of our deeds in The Highland Estates.) My biggest concern is that White Creek which flows into Ennis is said to be in the Rainer cleanup, and this pipe is releasing toxic ammonia would never pass as it is classified as dangerous for the environment. Ammonia is known to kill aquatic life. Thank you for your attention to this matter, Edna Willadsen willadsen716@msn.com I https:/Iblul 71.mail.live.com/ol/mail.mvc/PrintMessages?mkt=en-us 8/4/2015 July 20,2004 City of Port Angeles To: City Attorney From: Gary LeSarge 803 E. 2°d St. Port Angeles, WA 360-457-1829 RE: Lot 26A—Highland Estates Development, City of Port Angeles This will serve to memorialize the conversation I had yesterday, July 19,2004, with your office. I'm sorry I did not get the name of the lady I talked to about this. I summarized the problem we have been having since we purchased this lot in January,2004. In February, 2004 we discovered a drainage culvert that ended on the back of our lot and had already caused considerable erosion. We believe this is an environmental issue in a sensitive area. The enclosed correspondence will give you most of the information on what has already transpired. I am also enclosing a copy of the drawing prepared by Gary Kenworthy of the Department of Public Works and a sketch prepared by Bob Leach of Northwestern Territories, Inc. On Friday, July 16,2004 my wife and I had a conversation on the phone with Rick Anderson,the developer, regarding the City's position on this culvert. Rick told us that he had met with Gary Kenworthy on the lot and that the work the City has had done as of this date is all the City plans to do. We are not satisfied with either the extension of pipe that has been installed(because we feel there will be more erosion) and that there are no plans to fill the huge hole caused by erosion. We feel this hole is dangerous to both people and animals walking in the area. At this point, we feel the solution is to remove the culvert and direct this water elsewhere and then fill the hole caused by erosion with enough fill material to bring the landscape back to it's natural state. We would like to have this done so that we can proceed with our original plans to build a new house in a planned retirement development, with all the city services and no problems. We would like to do this without legal intervention as we enjoy living in Port Angeles and hope to continue to do so for the rest of our lives. We are very disappointed with the experience we have had thus far with this City approved development. We feel, at our age,we have dealt with this problem ourselves as long as we can without success. Please get back to us by the first of August and let us know what your intentions are with respect to this problem. Very truly yours, Gary LeSarge Cc: Rick Anderson by fax .�''++��� f-" , y YX r 1 y + �����,� A+ #II i ��xTr i •v ��`ra :��V"• Z' 1'°T [ � �' rV '�� b� lei riff ,.* �. � 't•�� ,y � Y.�_ �� �r";,� / �'�� � •: �f.-� .'I r,a.,,.t., r:�.A..� k �...,. .�+'., ^a1!.. �'f � ^.R" b w' .ti�"I�.�►. �r,�' '�µ{ to 4���~�y�'��^+�+b���i�'a.•.... 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'ate(, .,fir. a `: -,fir ���Y 1``�z 6p I- f� / f _ -J { .. r ,� J/am,�. �; + � ¢"♦r 40 9 7 i 1 ►' •[j '1 ��+` L i aAt�'i. .rl ti% i.K 7111 "off ntf'�� 14•�` 7• a_Y�{� �' t ,, t. �•, � . � ����� r � 5 r� - /w�-• �` � .�{� fr t,1,� e;< �� .r�-1'`�, . o:�". .p� ���.rt '�'�?1ri ��✓,l.,.l°r'�l�n ��r/,," s�/��� r�.l! . 1..4L 'i T �►"t�for'•���?� t, ¢ % •�,�-:�'� ,:�r�•4,I .•ems ?�'�,, :,�< ..�.� 4� ♦A . t� ' /� (J•r( er r 44 s�i i•iz! ...-�/ L. Gti�. ..�+.•Cs, f�s/'�...+.♦ �.f - .�i .. •P' I.�' tt. ,^�i�{.� ��. �► V' 1.�r "1 4/.may T;�''Y` �•!y't� '�f`7 �� ;[� ��.n i 4'Y�-Ij��i � � .r'► i 1. x Hotmail Print Message Page 1 of 1 Fw: City of PA 3 2 04.d®c From: Jeanne LeSarge (lesarge@olypen.com) Sent: Thu 1/05/12 11:41 AM To: Edna Willadsen (willadsen716@msn.com) 1 attachment City of FA 3 2 04.doc (20.5 KB) ----- Original Message----- Frons: Jeanne LeSarQe To: Rick Anderson Sent: Wednesday, March 03, 2004 11:23 AM Subject: City of PA 3 2 04.doc Dear Rick, Thanks for meeting with us yesterday at Lot 26A. We went to the City this morning with attached letter and talked to the Public Works engineering dept. One of their people went to the Lot with us to look at the culvert. Gary Kenworthy was not in but we have asked for an appointment with him. We also went and talked with Bob Leach at NT1 at the suggestion of the City. Bob agreed that now was the time to "fix" the culvert and hole. He suggested some type of extension (in order to fill rock in the hole) and a sock to slow the flow. He says he and Gary Kenworthy talked about doing this some years ago. He seems to feel it is "the cities water" and they should take care of it. Our next step is to meet with Gary Kenworthy and also talk to the Building Department at the City. We will keep you updated. Jeanne LeSarge http://sn 115w.snt 115.mail.live.com/mail/PrintMessages.aspx?cpids=324aeOfb-37d5-11 e 1-8... 1/5/2012 Gary &Jeanne LeSarge 803 E 2nd Street Port Angeles WA 98362 457-1829 lesargegolypen.com February 26, 2004 Rick Anderson Anderson Homes Via Fax 360-452-0924 618 South Peabody St. Suite I Port Angeles WA 98362 rick(agandersonhomesllc.com RE: Lot 26A Highland Estates Subject: Drainage Culvert Dear Rick, Paul Eyestone and I were up to the lot yesterday and noticed you had put some fill on the bank. Gary and I went back and walked down the bank and saw the big drainage culvert. It appears to drain some of the property above as lots of water is coming out of it. Our concern is the water drops from the end of the culvert down several feet and appears to have caused some erosion on the slope. There is a big drop-off near where the water comes out of the culvert that seems to us to be a danger to anyone walking in this area. We see that the purchase documents mention "drainage improvements shall include channeling storm water down to the bottom of White Creek's ravine in a pipe, which requires obtaining easement from the owner of the ravine". Is this the pipe that is referred to in this statement? If not,then who installed this culvert and who is responsible for it? Who is responsible for any erosion it may cause? Is this culvert going to be extended down to the bottom of the ravine? If so, who is responsible for doing that? Is it safe for us to build on this lot? We think this problem needs to be addressed or we need assurance from someone that it is safe and will not cause further erosion or danger to the houses above it. We want to try to address any problems before we build, as it will be easier to fix them now than after we build. We don't want any delays, once we start this project. Very truly yours, Gary & Jeanne LeSarge Gary &Jeanne LeSarge 803 E 2nd Street Port Angeles WA 98362 457-1829 March 3, 2004 City of Port Angeles Department of Public Works RE: Highland Estates—Lot 26A Subject: Drainage Culvert Gentlemen, In January, 2004 we purchased Lot26A in the "over 50"community off of Golf Course Road called Highland Estates. Please see the enclosed letter dated February 26, 2004 that we wrote to Rick Anderson of Anderson Homes/LBR Construction that outlines our concerns. Yesterday, March 2, 2004 we met with Rick Anderson, one of the developers of Highland Estates. Rick says that, to his knowledge, the culvert that concerns us was already installed before they developed the property. The culvert that concerns us ends on the back of the lot we purchased above White Creek, and appears to be causing erosion in this "sensitive area". There are now several dead trees in the area apparently due to the exposure of their roots by the erosion. It is our understanding that Peninsula College owns the property adjoining ours on the West in the ravine. We have the following questions: 1. Will you issue a building permit for our lot with this culvert the way it is? Was this culvert addressed in the development stage of this community? 2. If it causes further erosion or damage to the ravine or White Creek below, who is responsible? 3. If it erodes the back of our property and endangers our proposed new house,who is responsible? For your information there is a new house, nearly completed, on Lot 25A next to ours. We are in the planning stage for our new home and would like this issue cleared up so that we can immediately proceed with our plans. Very truly yours, Gary &Jeanne LeSarge Cc: Rick Anderson,Anderson Homes Gary &Jeanne LeSarge 803 E 2"d Street Port Angeles WA 98362 360-457-1829 lesarge n,olypen.com March 4, 2004 Rick Anderson Anderson Homes/LBR Construction Via Fax 360-452-0924 618 South Peabody Street Suite 1 Port Angeles WA 98362 RE: Lot 26A Highland Estates Subject: Drainage Culvert and erosion Dear Rick, As per my message yesterday, we have attempted to arrange a meeting with Gary Kenworthy with the City of Port Angeles to discuss the culvert and erosion. We left him a message on March 2, 2004 and again on March 3, 2004. He has not returned our calls. We are coming to the conclusion that the City is not going to fix the culvert and the erosion on the back of our lot, at least not in the near future. They apparently have been aware of the situation and have continued to let the water erode the ravine. It is our understanding that this water comes from the City's drainage ditches along Golf Course Road and Melody Lane as well as other sources in the area. The drainage culvert does not appear on their maps, but they have been aware of it for a number of years. When we purchased the lot, we thought it was a well developed community and that we would be able to proceed immediately with building a new house in a safe and secure environment on the lot we chose. We understood that all utilities were in place and there would be little or no site work other than landscaping. It was not disclosed to us prior to closing that this drainage culvert and a large hole caused by erosion was located on the back portion of our lot,just over the bank. We discovered this problem after the closing, on our own, and therefore feel the property was misrepresented. At this point, we do not feel confident that we can build a new house on this property in its current state, nor do we feel it is our responsibility to try to convince the City of Port Angeles to fix it. We are not sure if they would issue a building permit, but even if they would we don't feel safe in spending more money in a location where there are obvious signs of erosion and more erosion to come. Therefore, we have no choice but to ask you to refund the money we paid for this lot and transfer the title back to you and/or the various entities involved. Needless to say, we are very upset about this situation. We have spent a lot of time and energy on plans to build a new home on this lot, but we are too old to negotiate this problem with the city and wait for them to take action. Please get back to us at your very earliest convenience. Very truly yours, Gary&Jeanne LeSarge June 9, 2004 TO: Rick Anderson Anderson Homes From: Gary LeSarge Dear Rick, My conclusion is the same as it was 5 months ago. The culvert, hole caused by erosion, dead trees caused by erosion and the bank have to be fixed before we can go any further. In my opinion,the dead trees are a danger and are so unstable they could fall at anytime. I will not be responsible for someone getting hurt on this property. I went to the property on Monday and the neighbor, Tom, had a 4 year old grandson visiting. Tom has been working within 20 feet of some of the dead trees. You agreed to fix the problem at no cost to us. I want you to go ahead and do it now. You told Jeanne that it would save us money if you could use the dirt from our footing excavation to fill the eroded area(so we wouldn't be paying to remove the dirt from the premises later). You have our permission to excavate for our footings and use the dirt. In addition, you can excavate for a buried propane tank and use that dirt. I assume this would be at no cost to us. If it was your intention to use the same subcontractor and his equipment to dig sewer and water lines or do any other preliminary site work, you can do that too. Just break out M of this cost included in the tentative bid you have given us. Let us know how much before you start and we will pay for this item if we are agreeable. You told Jeanne we wouldn't know if we could have the decks until we submitted for a building permit because of the "sensitive"area. This may have been called a"sensitive" area when the City approved this development,but now I feel it is a hazardous area. As to your bid, Jeanne will be working with you on firming up some of the "allowances" you have in the bid such as the tile, hardwood, and vanity tops, etc. Maybe if we can't have the deck behind the sunroom, we might eliminate the sunroom and change it back to a deck (you might break this cost out so we can review that item). Obviously, before we can agree on a contract it will have to be firmed up so there won't be any surprises down the road. Your bid tops out what we are willing to pay in this area for a home. We are still considering items we could cut and other ways of reducing the cost. July 20,2004 City of Port Angeles To: City Attorney From: Gary LeSarge 803 E. 2°d St. Port Angeles, WA 360-457-1829 RE: Lot 26A—Highland Estates Development, City of Port Angeles This will serve to memorialize the conversation I had yesterday,July 19, 2004,with your office. I'm sorry I did not get the name of the lady I talked to about this. I summarized the problem we have been having since we purchased this lot in January, 2004, In February, 2004 we discovered a drainage culvert that ended on the back of our lot and had already caused considerable erosion. We believe this is an environmental issue in a sensitive area. The enclosed correspondence will give you most of the information on what has already transpired. I am also enclosing a copy of the drawing prepared by Gary Kenworthy of the Department of Public Works and a sketch prepared by Bob Leach of Northwestern Territories, Inc. On Friday,July 16,2004 my wife and I had a conversation on the phone with Rick Anderson,the developer, regarding the City's position on this culvert. Rick told us that he had met with Gary Kenworthy on the lot and that the work the City has had done as of this date is all the City plans to do. We are not satisfied with either the extension of pipe that has been installed(because we feel there will be more erosion)and that there are no plans to fill the huge hole caused by erosion. We feel this hole is dangerous to both people and animals walking in the area. At this point,we feel the solution is to remove the culvert and direct this water elsewhere and then fill the hole caused by erosion with enough fill material to bring the landscape back to it's natural state. We would like to have this done so that we can proceed with our original plans to build a new house in a planned retirement development,with all the city services and no problems. We would like to do this without legal intervention as we enjoy living in Port Angeles and hope to continue to do so for the rest of our lives. We are very disappointed with the experience we have had thus far with this City approved development. We feel, at our age,we have dealt with this problem ourselves as long as we can without success. Please get back to us by the first of August and let us know what your intentions are with respect to this problem. Very truly yours, Gary LeSarge Cc: Rick Anderson by fax Gary& Jeanne LeSarge 803 E. 2nd Street Port Angeles, WA 98362 Phone 457-1829 Fax 417-0117 July 30, 2004 John L. Scott Real Estate 934 E Front Street Port Angeles WA 98362 Attention: Don Edgmon RE: Lot 26A—Highland Estates Dear Don, As you are aware,we discovered an"undisclosed" culvert on the back of Lot 26A shortly after we purchased the property (in January 2004). Coldwell Banker Real Estate listed the property. On March 4, 2004 we asked Rick Anderson for our money back on the lot. See our letter of that date, copy enclosed. In response to that letter Rick told us that he would work with the City of Port Angeles to fix the problem, so that we could proceed with our plans. On April 16, 2004 Rick faxed to us a drawing,prepared by Gary Kenworthy of the City of Port Angeles showing a"Pipe Installation Plan View"for our lot. Rick told us that between him and the City they were going to fix the problem of the culvert and the erosion caused by the water from the culvert. Rick encouraged us to go ahead with our plans. We did. We completed our drawings with Eyestone Building Design and paid them $2,254.50 for a design that would fit our lot. Prior to June 9, 2004 we had a bid from Rick Anderson to build a house for us. On June 28, 2004 the pipe was installed on the end of the culvert. Dead trees caused by the erosion were removed and we were then told the work was complete. We told Rick we were not satisfied and he said he would talk to Gary Kenworthy. On July 16, 2004 Rick told us he had met at the lot with Gary Kenworthy and that Gary told him the work the City had done as of this date was all the City plans to do. We called the City Attorney's office on July 19d'and the next day hand delivered to the City Attorney's office a letter dated July 20, 2004 explaining the problem with attached correspondence. As of this date, we have had no response. Needless to say, this entire process has caused us endless stress,time, money and disappointments. At this point,we feel we must again request our money back. We are ready to give up any expectation that this lot will be fixed in the near future so that we could feel safe to build. We're not sure how this process should go,but we are assuming we need to start with you as you represented us in the purchase. Please advise us how to proceed. Very truly yours, Gary& Jeanne LeSarge Cc: Rick Anderson, L.B.R. Construction, Inc. & Tim German, Steward Land Company via Fax 360-452-0924 Coldwell Banker Pili Meyer via fax 452-8665 STORM WATER CONTROL SYSTEM MAINTENANCE AND OPERATION AGREEMENT AREAS, the streets of Melody Lane and Melody Circle as improved by the Highland Commons subdivision drain into a wetland system upon private property in the Southwest corner of the Highland Commons subdivision; and WHEREAS, building and other impervious surface improvements on the Highland Commons Subdivision site will contribute to the mass and velocity of storm water discharging from the site into the White's Creek stream system, and WHEREAS, a significant area surrounding Melody Lane is a drainage basin releasing water into the wetlands system, and WHEREAS, the outlet from the wetland system discharges directly into the White's Creek and its stream system through an existing piped outfall; and WHEREAS, detention/treatment is needed to protect the quality of the wetlands system and the White's Creek stream system; and WHEREAS, the on-going performance of the wetland system is very important to the capacity of the basin storm water drainage system and to the environmental quality of the White's Creek ecosystem and fish habitat as well as the wetlands themselves; NOW THEREFORE, let it be agreed as follows: Section 1. The main channel of the wetland system beginning at the east boundary of the Highland Commons Subdivision will be protected by erosion control devices approved by the City Engineer and maintained in proper working order by the property owner(s), Highland Commons Developer, heirs or assigns. Section 2. The wetlands buffer enhancement areas in the Environmental Sensitive Areas Tract will be restored, including required fencing and signage, per the wetland permit and the City's Wetland Protection Ordinance prior to occupancy of any building in the Highland Commons Subdivision, and then kept undisturbed and free of debris by the property owner(s), Highland Commons Developer, heirs or assigns. Section 3. This maintenance and operation agreement shall continue in perpetuity. Highland Commons: ,% - _ ' 2 /Tim German Ri k Anderson President, Steward Land Co. President, LB R Construction 4 Richard Winters President, Harstone Group City of Port Angeles Gary Ken orthy, PE; City Engineer misc\sd-agre4 ` D� �.6�e �7il� 72 r "/as@%2. } G�' } 1.7-11_Lambert Ln nch p,�C �� 1 %d �9 275 262 2 Inch P 1502 ��� 7 7 Sample �O 707 704_ 8 Inch.Asbestos C 71 1.7237Lambert n %~711 106 95 1814 [�� G r 111 J 1822 q2099160 Yn 150 1502 ytp 2 2 r�ZG�j', 715 710 ft 705 ?(1836 d 2 Opeln (�_,•JJ � )en Open Open !�J`�> ,- 719 IB 3 ,; 71 . 248. 710 V =a G7 72 14 2�3' Q -c 711 722 21 1 c 202 0 � 279 � -..__ e0 � 8 inch PVC 723 724 109 8 Inch p ` 27 08 £ VC 3 33 21 1704 8�nch� rn o 30 33 csoo 5 �� 25 33 810 D 36 Inch Corr Metal pp 736 739 chs Q 81 1702 V Off+ 1809 1815 1833 1839 �f 6_Inch_P�V_C 18 inch Concrete x + 78 81 Melody Ln 18 inch HD P01y cu v 1 x62 m 00 772 f i 1826 1830 U� 1834 1838 � 1842 d ULID 215 e Cylinder c l HIGHLAND COMMONS STORMWATER CONTROL SYSTEM MAINTENANCE AND OPERATION AGREEMENT WHEREAS, the streets of Melody Lane and Melody Circle as improved by the Highland Commons Subdivision drain into a wetlands system on private property in the Southwest corner of the Highland Commons Subdivision;and WHEREAS, budding and other impervious surface improvements on the Highland Commons Subdivision site will contribute to the mass and velocity of stormwater discharging from the site into the White's Creek stream system;and WHEREAS,a significant area surrounding Melody Lane is a drainage basin releasing water into die wetlands system;and WHEREAS, the outlet from the wetland system discharges directly into White's Creek and its stream system through an existing piped outfall;and WHEREAS, detention/treatment is needed to protect the quality of the wetlands system and the White's Creek stream system;and WHEREAS, the on-going performance of the wetland system is very important to the capacity of the basin stormwater drainage system and to the environmental quality of the White's Creek ecosystem and Fish habitat as well as the wetlands themselves;and NOW, THEREFORE, let it be agreed as follows: Section 1. The main channel of the wetland system beginning at the east boundary of the Highland Commons Subdivision will be protected by erosion control devices including on-site detention treatment systems approved the City Engineer and maintained in proper workingdb the owner (s),order y property owne (s),H,ghland Commons Developer, heirs or assigns. Section 2. The wetlands and buffer enhancement areas in the Environmental Sensitive Areas Tract will be restored, including required fencing and signage, per the wetland permit and the City's Wetland Protection Ordinance prior to occupancy of any building in the Highland Commons Subdivision,and then kept undisturbed and free of debris by the property owner(s), Highland Commons Developer,heirs or assigns. Section 3. This maintenance and operation agreement shall continue in perpetuity. Highland Commons Developers and Property Owners: *`Pr T-4-Germ. an,President, Steward Land Co. Ric4nderson,Presid nt,LBR Construction, Inc. Date: Date: City of Port Angeles: Date: Gary Kenworthy, PE,City Engineer 1 JUN ' 21997 ; 1 r1i:u:LES ptarij,'.�C OLP,:;7,,'_.'T STORM WATER CONTROL SYSTEM MAINTENANCE AND OPERATION AGREEMENT WHEREAS, the streets of Melody Lane and Melody Circle as improved by the Highland Commons subdivision drain into a wetland system upon private property in the Southwest corner of the Highland Commons subdivision; and WHEREAS, building and other impervious surface improvements on the Highland Commons Subdivision site will contribute to the mass and velocity of storm water discharging from the site into the White's Creek stream system, and WHEREAS, a significant area surrounding Melody Lane is a drainage basin releasing water into the wetlands system, and WHEREAS, the outlet from the wetland system discharges directly into the White's Creek and its stream system through an existing piped outfall; and WHEREAS, detention/treatment is needed to protect the quality of the wetlands system and the White's Creek stream system; and WHEREAS, the on-going performance of the wetland system is very important to the capacity of the basin storm water drainage system and to the environmental quality of the White's Creek ecosystem and fish habitat as well as the wetlands themselves; NOW THEREFORE, let it be agreed as follows: Section 1. The main channel of the wetland system beginning at the east boundary of the Highland Commons Subdivision will be protected by erosion control devices approved by the City Engineer and maintained in proper working order by the property owner(s), Highland Commons Developer, heirs or assigns. Section 2. The wetlands buffer enhancement areas in the Environmental Sensitive Areas Tract will be restored, including required fencing and signage, per the g an p e wetland permit and the City's Wetland Protection Ordinance prior to occupancy of any building in the Highland Commons Subdivision and then kept undisturbed and free of debris by the property owner(s) , Highland Commons Developer, heirs or assigns. Section 3. This maintenance and operation agreement shall continue in perpetuity. Highl6i,d Co=ons: G rman Ri k Anderson President, Steward Land Co. Pr�sident, LB R Construction 4 Richard Winters President, Harstone Group City of Port Angeles Gary Keny Orth , PE; Cit Y _ Engineer misc\sd-agre4 HIGHLAND COMM UNI TIES PHASE A"Z> _ PLANNED RESIDENTIAL DEVELOPMENT PHASE Zr SECTION 14 , TOWNSHI P 30 NORTH , RANGE 6 WEST, W.M. PORT ANGELES , WASHINGTON dP fS�ca\ c \ � f`'•a�-,� w, iv 0 / h ON 1 ACOMMON .PEA "N" a L/tiQ���^✓ � SCALE/N FEET ti 92 5 AIJ i g` 9�.9S,�.R'�, � \"fi Vin° arz.o� y`� ,: ...,,•g';. - 3 3 � � 3 � !n '•a. �� 6g u� y`�A ��'� a 0 A/1 r 8� �� �•�� `N.�E.BB& �/ h � � a A/54s �2. r` 4 ro.� ao h•, h� 0 �'' ry84c/O�� rs.A/o♦ NO /o. SJ' ( row�✓rr re 0 ` + JouuMCUT 8 94 95 41 %xv 3o T � F so.� <:4. }� sag- ,p p ua xs 4 J4 sE'E� •./ ® �. ��`.." •3•. - rz.s h A2 �l �` /F..aJEW z�h, a/9' BENCH � 8 � �� �I A p �/L•/ 9 s59'3^`c /y�V �� J ,� Bo�s•'ee.E s.or zo 0 3� �N� /0/.40 O�`M1.11 a4typ3. 35 d� �wJ/') q1 FO Q' yp Sh•.3 /p ^ � .Q. p D •Ayhd�OP.a^u JIY V<rn,,�c 63 ss OI. �� /0392'mac e � �.. 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ASSOC. /2223 ANO 3"x3" WOOD POST. 20 /r�;�' I O •� AFM CLALLAM COUNTY AUL)/YOB'S F/LE NUMBER. 1'94/ NOTE 3 (� F' THE TEMPORAR✓EASE FaR ROAOWAv TEMPoRAR✓ EASEMENT FOR ROAOWAv. 1 ANO TEM7 OPEN SPACE SN WN WILL HEREON W RM/NATE WHEN T E HI TE AOJO/N/NG LMLANO COMMON/TIES CSE TAI L PHASE I /5 APPROVED AND RECOROEO. NO SCALE ((pp 66 S p�/� E' NO/ Sr.LE0E5/OENNG LNAPge Q�ER,RR 3TC E. �11�1) NOTE 3 AG LtpT9 q EA g6-/ G.p TE I('�'� .pp 9CR}�gTO U//•/F/SfT,p✓rR/d/N EASEOROEO /�4Ud*OQS /LE st 694B2BR SHEET / ar 9 DESIGNED Br• NORTHWESTERN TERRITORIES,INC. DRAWN BY.K.P/ST/ aA7TE•PSON H/GHLANO COMMUN/T/ES PLAT CHECK BY- K L P. �ry n•rxv.snw,.•�•fin, FINAL CHECK BYf PHASE Z ANO HIGHLAND COMMUNITIES PA/V0 _ PLANNED RESIDENTIAL DEVELOPMENT PHASE a SECTION 14 TOWNSHIP 30 NORTH , RANGE 6 WEST, W.M. PORT ANGELES , WASHINGTON i A C K N O W L E D G E M E N T STATE OF WASHINGTON ) SS COUNTY OF O,A�LA ) THIS IS TO CERTIFY THAT ON THIS ZqN DAY OF Tf.AKC 195 . BEFORE ME, THE UNDERSIGNED, A NOTARY PUBLIC, PERSONALLY APPEARED RICK ANDERSON, TO ME KNOWN TO BE THE PRESIDENT OF LBR CONSTRUCTION, INC., THE CORPORATION WHICH EXECUTED THE FOREGOING INSTRUMENT, AND ACKNOWLEDGED THE SAID INSTRUMENT TO BE THE FREE AND VOLUNTARY ACT ANO DEED OF SAID CORPORATION FOR THE USES AND PURPOSES HEREIN MENTIONED, AND ON OATH STATED THAT THEY ARE AUTHORIZED TO EX THE SAID INSTRUMENT AND THAT THE SEAL AFFIXED IS TME CORPORATE SE (sA,I RPORATION. WITNESS MY HAND AND OFF[ AFP1 OWN( FIXED THE DAY AND YEAR FIRST ABOVE WRITTEN. X,O NoraR, _ NµOoTA P ELIC IN AND FOR THE STATE N� ft3Lt1f W 581�+GToN Al AT II r..r f s =ss ♦� a'ra.l Nil Ow VL;SN'• THIS PLAT IS BASED ON A SURVEY ON THE WASHINGTON COORDINATE SYSTEM GRID. NORTH ZONE. ALL BEARINGS ARE RELATIVE TO SAID GRID. ALL DISTANCES ARE A C K N O W L E D G E M E N T REDUCED TO SAID GRID. STATE OF WASHINGTON ) SS THIS SURVEY WAS ACCOMPLISHED BY FIELD TRAVERSE METHODS USINGA 1 SECOND COUNTY OF GLAt3.BM ) AND/OR A 5 SECOND THEODOLITE AND AN INFRARED DISTANCE MEASURING DEVICE THIS IS TO CERTIFY THAT ON THIS Z'�TW DAY OF 3N—I 19 , WITH SOME DISTANCES MEASURED WITH A STEEL CHAIN. BEFORE ME, THE UNDERSIGNED, A NOTARY PUBLIC IN AND FOR THE STATE OF WASH IADTON. DULY COMMISSIONED AND SWORN, PERSONALLY APPEARED TIMOTHY G. GERMAN AND NANCY K. GERMAN TO ME KNOWN TO BE THE INDIVIDUALS WHO THIS SURVEY MAY BE SUBJECT TO EASEMENTS OR OTHER EXECUTED THE FOREGOING INSTRUMENT AND ACKNOWLEDGED TO ME THAT THEY ENCUMBRANCES EITHER RECORDED OR UNRECORDED NOT SHOWN HEREON. SIGNED AND SEALED THE SAME AS THEIR FREE AND VOLUNTARY ACT AND DEED FOR THIS SURVEY HAS NOT CETERMINED THE EXISTENCE OF ALL SUCH THE USES AND PURPOSES THEREIN N EASEMENTS OR ENCUMBRANCES OR THEIR EFFECT ON THE SURVEYED plClq h PARCEL EXCEPT AS SPECIFICALLY SHOWN HEREON. WITNESS MY HAND AN OFF[CIA 9�R D YEAR FIRST ABOVE WRITTEN. X,O , pOTAII OTA Y BLIC IN AND FOR THE STATE D E S C R I P T I 9-H NQf w H NGTON A "1BLIRES AT Peas ANasLas LOT 1 OF GERMAN SHORT PLAT RECORDED ON DECEMBER 11, 1992, IN VOLUME 24 9 OF SHORT PLATS, PAGE 66, UNDER AUDITOR'S FILE NUMBER 679061, BEING A A\( VtYD1,1v V' O'L PORTION OF GOVERNMENT LOT 1 IN SECTION 14, TOWNSHIP 30 NORTH, RANGE 6 <,VA \{\N WEST, W.M., CLALLAM COUNTY. WASHINGTON. E X A M I N E 12 A A D A P {HIS IS DAY OF pECEMEEIL� 1993 I--' ' N I ION THIS=t DAY OF 0115"Ce"06M1 1993 Y N LAR'" L. NESARY, OF NORTHWESTERN TERRITORIES, INC., HEREBY CERTIFY T.' , THAT 7 AM REGISTERED AS A LAND SURVEYOR BY THE STATE OF WASHINGTON, AND THIS DAY OF] , 199J DECLARE THAT THIS LANG DIVISION IS BASED ON AN ACTUAL SURVEY OF THE LAND '^ DESCRIBED HEREIN, CONDUCTED BY WE OR UNDER MY SUPERVISION; THAT THE THIS DAV OF_�O r -y 1993 DISTANCES, COURSES AND ANGLES ARE SHOWN THEREON CORRECTLY; AND. THAT MONUMENTS OTHER THAN THOSE MONUMENTS APPROVED FOR SETTING AT A LATER THIS 2 DATE, NAVE BEEN SET AND LOT CORNERS STAKED ON THE GROUND AS DEPICTED ON _�DAY OF DGCen1eCR , 1993 L4. IaEG THE PLAT. ��Jf �� ../ /1 TH15 '4 DAY OF , 1993 L'aNL,Pzf' UT //LAa... //���� o, Oft- L N RONALD L. NESARY TulS Zg DAY OF f��C r' 1993 T"�W xT REGISTERED LAND SURVEYO •Q LICENSE NUMBER 22344 As TO POIBA' Pi\P.0 DATE: (X HFt IR-x, I9-23_ APPROVED DY TYE ITY(RANCIL OF THEE,CITY OF P0FZr ANGeLEST WASMIH16101d 1993. d ATTEST:1QLAQ✓ti, ,�J IdT �. C ALIS MAY GITV C -7� \ FKanE9 L16'M1 Q ) RI m I, gcctlL lY1 , TREASURER OF CLALLAM COUNTY, WASHINGTON, HEREBY CERTIFY THAT A DEPOSIT TO COVER ANTICIPATED TAXES ON THE ABOVE D E C L A R A T I 0 N PROPERTY TO AND INCLUDING THE YEAR 19g� HAS BEEN MADE/[TO MY OFFICE. KNOW ALL MEN BY THESE PRESENTS THAT WE. THE UNDERSIGNED, OWNERS OF THE LAND �' ��CLALLAM aCOUNTY TREA U / /� HEREBY PLATTED, HEREBY DECLARE THIS PLAT. THE PLATTORS HEREBY ACCEPT ALL RESPONSIBILITY FOR ALL CLAIMS AND DAMAGES WHICH MAY BE OCCASIONED TO ANY -"'-"-----"" OTHER LAND OR PERSONS BY THE ACTION OF SAID PLATTORS AUTHORIZED BY THE CITY FI1 L 1 N G R E C D R O IN RELATION TO THIS PLAT, WE HEREBY CONSENT TO THIS PLAT. FILED FFORR RECORD AT THE REQUEST OF "I OWNERS THIS�L{G J_DAY OF 19�A.D. AT LBR CONSTRUCT101I,' C.. A WASHINGTON CORPORATION MINUTES PAST 'CLOCK • .M. AND RECORDED IN VOLUME OF //J I f PUTS, PAGE�, RECORDS OF CLALLAM CO NTY, WASHINGTON. RIC NDERSAO�N�,/PRESIDENTI � . ,� ''// 'TIMOTHY/G. GERMAN NAN Y MAN COYNTY AUDITOR &EPUTY sneer z a.3 DESIGNED BY, NORTHWESTERN TERRITORIES,INC. DRAWN BY, -.- f,lIG14LAN40 COMMUN/T/ES P.A2 O. PLAT CHECK BY, D.Kr,.r drr•Av�AnW4 FINAL CHECK BY, PHASE I ANO 74(30-6 Et1■ , PHASE X HIGHLAND COMMUNITIES NITIES PHASE ff / PLANNED RESIDENTIAL DEVELOPMENT SECTION 14, TOWNSHIP 30 NORTH, RANGE 6 WEST, W.M. PORT ANGELES, WASHINGTON COMMON ARE4 I N `\ V n• F Aro •„ A9 S p O q SCALE.nI FEET E M 4/ \\ 4 Is I Io �e�'PT e � ,� 301 s• O � �I Ae7 � A9 � <f••\ V ® O \ 43 es• �1 DMZ 8 P J II _\ S ® P as :-JL"A rs, /-IC"./F., � I 9 Ab � I I I 47 I / rEMPO.pgRY OPEN SPACE / I / NOTE: THIS MAP/S PAIOV/OEO FOR PC.4-S .. PURPO5E.'9 ONLY IT ODES NOT REFLECT 5•/!�- -�'�'lf � �'-`'�� `�/-�c''rt / THE u^URVEYORS OPINION OL NOW THE F- :.i-i T5 P(3- 6M BU/LO/N6 SETBACKS SHOULD 7 S"ow"THIS MAO SHOWS THE PROPOSED BU/LO/NG ,", 1 H6 OIMENS/ONS SHOWN B6r,B[IILO/NO FOOTPRINTS ANO LOT LIN63 MAY NOT BE TO SCALES BUT CREPRESENT THE M/NIMVM BU/LOIA/G ^O I 9ETBq CK O/STANCE ONLY I C I I rn m SHEET 3 OF,� DESIGNED ev. NORTHWESTERN TERRITORIES,INC. DRAWN RY, AKARE-A N4HMOV09 N/GHL.AAIO COMMUN/T/EA:'S • T4;�j.O. CHECKED BY, .uvm.•...e4vw••nuw r nnp FINAL CHECK BY. PHASE T ANO alio-w �� �• sfh sr i �au�;ds �Blvd. .N �Lll i A t0 F U • o a Lo m 0 Melod Y Cir. — C9 -IvltflUUY Ln • 1 _ W ^ "PORTANGELES Filing Fee: *$ 350.00 • Admin. $ 125.00 WASH I N G T O N, U. S. A. CITY.OF PORT ANGELES ENVIRONMENTAL CHECKLIST Purpose of Checklist: Chapter 43.21C RCW the State Environmental Policy Act (SEPA) requires all governmental agencies to consider the environmental impacts of a proposal before making decisions. The purpose of this review is to provide information to help you and the reviewing agency identify impacts that may result from your proposal and to identify methods to reduce or avoid impacts from the proposal if they exist. The review will help the agency decide whether further information is necessary or whether an environmental impact statement (EIS) is necessary. Instructions for Applicants: This environmental checklist asks you to describe some basic information about your proposal. Answer each question to the best of your knowledge.with the most precise information known. Provide the best descriptions you can. In most cases you should be able to answer the questions from your own observations or project plans without the need to hire experts. If you do not know the answer, or if a question does not apply to your proposal, write "do not know" or "does not apply (N/A). Complete answers to the questions will avoid unnecessary delays later. Some questions ask about governmental regulations, such as zoning, shoreline, and landmark designations. Answer these questions if you can. If you have problems please ask the City Department of Community & Economic Development employees to assist you. The checklist questions apply to all parts of your proposal, even if you plan to phase them over a period of time or on different parcels of land. If phasing is proposed, please provide that information in Item 11, the description section. Attach any additional information that will help describe your proposal or its environmental effects and include a site map. BACKGROUND 1) Name of project: Highland Courte Memory Care Conversion 2) Address or general location of site: 1704 Melody Circle; Port Angeles, WA 3) Applicant: Name: Ankrom Moisan Architects, Inc. / Mark Miller Address: 6720 SW Macadam Ave., Suite 100; Portland, OR 97219 Phone number: 503-952-1397 E-mail: markcm@ankrommoisan.com 4) Contact Person (If different than Applicant) Name: Address: 0 Phone number: E-mail: Date checklist prepared: 07/01/2015 5) Agency requesting checklist: CITY OF PORT ANGELES Environmental Checklist EVALUATION FOR Page 2 AGENCY USE 6) Proposed timing or schedule (including phasing, if applicable): Site is fully developed; building interior work is scheduled for completion March 2016. 7) What is the long term objective of this proposal? Re-license the existing building on site as a Memory Care facility. i 8) How does this project relate to long-term plans? This project is to upgrade interior finishes and spaces to get licensure as a memory Care facility. 9) Do you have any plans for future additions, expansion, or further activity related to or connected with this proposal? If yes, explain. No. 10)List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal: None. 11) Do you know whether applications are pending for governmental approvals of other proposals directly affecting the property covered by your proposal? If yes, explain. No. 12)List any government approvals or permits that will be needed for your proposal, if known. City of Port Angeles Conditional Use Permit, City of Port Angeles building Permit, Washington State Dept. of Health Construction.Review and License process. 13)Give brief, complete description of your proposal, including the proposed uses and the size of the project and site. There are several questions later in this checklist that ask you to describe certain aspects of your proposal. You do not need to repeat those answers on this page. (Lead agencies may modify this form to include additional specific information on project description.) The development on site was constructed around 1998 and includes a 16,700 sf building and associated parking/landscaping on a 2.5 acre site. The facility was licensed by the State as a Memory Care facility for a number of years, changed licensure to an Alcohol Treatment facility, and has been vacant for the past few years. This project is to upgrade interior finishes and add interior support spaces to again license the building for Memory Care. No exterior construction or change in footprint will occur. 14)Location of the proposal. Give sufficient information for a person to understand the precise location of your proposed project, including a street address, if any, and section, township, and range, if known. If a proposal would occur over a range of area, provide the range or boundaries of the site(s). Provide a legal description, site plan, vicinity map, and topographic map, if reasonably available. While you should submit any plans required by the agency, you are not required to duplicate maps or detailed plans submitted with any permit applications related to this checklist. (answer on next page) 1704 Melody Circle; Port Angeles, WA. Legal Description: LOT 3 OF HIGHLAND COMMONS AS RECORDED IN VOL. 13 OF PLATS, PAGES 43, 44, AND 45. Environmental Checklist EVALUATION FOR Page 3 AGENCY USE RECORDED UNDER AUDITOR'S NO. 747409 RECORDS OF CLALLAM COUNTY, WA. PROJECT SPECIFIC ACTIONS: Complete this section if your proposal involves a project specific action such as a subdivision, new construction, a new or expanding business, a site specific rezone (not area-wide), a conditional use permit, a shoreline permit, or similar action.- ENVIRONMENT: ction.ENVIRONMENT: EARTH 1. General description of the site (Check one): Flat ® Rolling '❑ Hilly ❑ Steep ❑ Slopes ❑ Mountainous ❑ Other ❑ 2. What is the steepest slope on the site (approximate percent slope)? 0% at development; 18% in Conservation Area. 3. What general types of soils are found on the site (for example, clay, sand, gravel, peat, muck)? If you know the classification of agricultural soils, specify them and note any prime farmland. Clallam gravelly sandy loam. 4. Are there surface indications or history of unstable soils in the immediate vicinity? Yes ❑ No ® If yes, describe: 5. Describe the purpose, type, and approximate quantities of any Filling or grading proposed. Indicate source of fill: None. 6. Could erosion occur as a result of clearing, construction, or use? Yes ❑ No X If yes, generally describe: 7. About what percent of the site will be covered with impervious surfaces after project construction (for example, asphalt or buildings)? 42% 8. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: None. Developed site is fully landscaped. ENVIRONMENT: AIR 1. What types of emissions to the air would result from the proposal (i.e., dust, automobile, odors, industrial wood smoke) during construction and when the project is completed? If any, generally describe and give approximate quantities if known. Automobile emissions from parking lot. None from construction activities. 2. Are there any off-site sources of emissions or odor that may affect your proposal? Yes ❑ No ® If yes, describe: 3. Proposed measures to reduce or control emissions or other impacts to air, if any: r Environmental Checklist EVALUATION FOR Page 4 AGENCY USE None. ENVIRONMENT: WATER F 1. Surface: a. Is there any surface water body on or in the immediate vicinity of the site (including year-round and seasonal streams, saltwater, lakes, ponds, wetlands)? Yes ® No ❑ If yes, describe type and provide names. If appropriate, state what stream or river it flows into. There is a wetlands identified in the southwest corner of the property, entirely within the Conservation Easement/Area. Ultimately, stormwater is collected on the project site and daylights at a rockway to the south of the property that then gets piped to White Creek (approx. 280' away from property line). The City of Port Angeles installed the piping system at the rockway to White Creek, and the property has b. Will the project require any work over, in, or adjacent to (within 200 feet) the described waters? Yes ® No ❑ If yes, please describe and attach available plans. Per A1.01, we will be creating new sidewalks to link the courtyards to egress paths. We will also be extending the fence at the south courtyard to enclose/secure an existing building exit. c. Estimate the amount of fill and dredge material that would be placed in or removed from surface water or wetlands and indicate the area of the site that would be affected. Indicate the source of fill material: None. d. Will the proposal require surface water withdrawals or diversions? Yes ❑ No ® Give general description, purpose, and approximate quantities if known. e. Does the proposal lie within a 100-year floodplain? Yes ❑ No X If yes, note location on the site plan. f. Does the proposal involve any discharges of waste materials to surface waters? If so, describe the type of waste and anticipated volume of discharge. No. 2. Ground: a. Will ground water be withdrawn, or will water be discharged to ground water? Yes ❑ No ® Give general description, purpose, and approximate quantities if known. b. Describe waste material that will be discharged into the Ground from septic tanks or other sources, if any (for example: Domestic sewage; industrial, containing chemicals; agricultural wastes; etc.). Describe the general size of the system, the number of such systems, the number of houses to be served (if applicable), or the number of animals or humans the system(s) are expected to serve. None. Environmental Checklist EVALUATION FOR Page 5 AGENCY USE 3. Water Runoff(including storm water): a. Describe the source of runoff (including storm water) and method of collection " and disposal, if any (include quantities, if known). Where will this water flow? j Will the water flow into other waters? If so, describe.. Storm water runoff from roof and parking. Roof is collected by existing gutters/downspouts and discharged through an existing underground storm sewer that daylights to an existing rockery/retention area serving the entire subdivision. Surface runoff is collected by existing area drains and discharged through an existing underground storm sewer that daylights to an existing rockery/retention area serving the j entire subdivision. b. Could waste materials enter ground or surface waters? Yes ❑ No If so, generally describe how and what. 4. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any: N/A. ENVIRONMENT: PLANTS 1. Check the type of vegetation found on the site: ® deciduous tree: alder, maple, aspen, other: ® evergreen tree: fir, cedar, pine, other: ® shrubs' ® grass ❑ pasture ❑ crop or-grain ❑ wet soi4l'plants: cattail, buttercup, bullrush, skunk cabbage, ❑ water plants: water lily, eelgrass, milfoil, other: ❑ Other types of vegetation: 2. What kind and amount of vegetation will be removed or altered? None. 3. Proposed landscaping, use of native plants, or other measures to preserve or enhance vegetation on the site, if any. No additional landscaping. ENVIRONMENT: ANIMALS 1. Check any birds and animals which have been observed on or near the site or are known to be on or near the site: Birds: ❑ hawk ❑ heron ❑ eagle ® songbirds ❑ other: Mammals: ® deer ❑ bear ❑ elk ❑ beaver ❑ other Fish: ❑ bass ❑ salmon ❑ trout ❑ herring ❑ shellfish ❑ other threatened or endangered species known to be on or near the site. (please identify): 2. Is the site part of a migration route? Yes ❑ No ® If so, explain. 3. Proposed measures to preserve or enhance wildlife. Environmental Checklist EVALUATION FOR Page 6 AGENCY USE N/A. ENVIRONMENT: ENERGY AND NATURAL RESOURCES 1. What kinds of energy (electric, natural gas, oil, wood stove, solar) will be used to meet the completed project's energy needs? Describe whether it will be used for heating, manufacturing, etc. Electric and natural gas used for heating and cooking. 2. Would your project affect the potential use of solar energy by adjacent properties? Yes ❑ No ® If so, generally describe. 3. What kinds of energy conservation features are included in the plans of this proposal? List other proposed measures to reduce or control energy impacts, if any. New LED and CF light fixtures. ENVIRONMENT: ENVIRONMENT HEALTH 1. Are there any environmental health hazards, including exposure to toxic chemicals, risk of fire and explosion, spill, or hazardous waste that could occur as a result of this proposal? If so, describe. No. a. Describe special emergency services that might be required. N/A. b. Proposed measures to reduce or control environmental health hazards, if any. N/A. . ENVIRONMENT: NOISE 1. What types of noise exist in the area which may affect your project (for example: traffic, equipment, operation, other)? N/A. 2. What types and levels of noise would be created by or associated with the project on a short-term or a long-term basis (for example: traffic, construction, operation, other)? Indicate what hours noise would come from the site. Conversational tones by residents in the enclosed courtyards. Generally during daylight hours only. 3. Proposed measures to reduce or control noise impacts, if any: N/A. ENVIRONMENT: LAND AND SHORELINE USE 1. What is the current use of the site and adjacent properties? The use of the site and surrounding sites is multi-unit residential. 2. Has the site been used for agriculture? Yes ❑ No ® If so, describe. 3. Describe any structures on the site. Environmental Checklist EVALUATION FOR Page 7 AGENCY USE 16,700 sf, one-story Memory Care facility and 180 sf maintenance shed. 4. Will any structures be demolished? Yes ❑ No ® If so, what? 5. What is the current zoning classification of the site? RHD 6. What is the current Comprehensive Plan designation of the site? High Density Residential 7. What is the current Shoreline Master Program.designation of the site? N/A 8. Has any part of the site been classified as an "environmentally sensitive" area? Yes ❑ No ® If so, specify. i 9. How many people would reside or work in the completed project? 60 I 10. Approximately how many people would the completed project displace? 0 11. Proposed measures to avoid or reduce displacement impacts, if any: N/A i 12. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if any: N/A ENVIRONMENT: HOUSING 13. Approximately how many units would be provided, if any? 28 Indicate whether high, middle, or low-income housing. Senior/Memory Care i 14. Approximately how many units, if any, would be eliminated? 0 Indicate whether high, middle, or low-income housing. N/A 1. Proposed measures to reduce or control housing impacts, if any. N/A i ENVIRONMENT: AESTETICS i 1 What is the tallest height of any proposed structure(s), not including antennas, what is the principal exterior building material(s) proposed? Max. height = 19' (existing). Exterior material = vinyl lap/shake siding (existing) i 2. What views in the immediate vicinity would be altered or obstructed? N/A 3. Proposed measures to reduce or control aesthetic impacts, if any. N/A ENVIRONMENT: LIGHT AND GLARE 1. What type of light or glare will the. proposal produce? What time of day would it mainly occur? Environmental Checklist EVALUATION FOR Page 8 AGENCY USE Site lighting (during nighttime) with cut offs to reduce light pollution in adjacent properties. 2. Could light or glare from the finished project be a safety hazard or interfere with views? No. 3. What existing off-site sources of light or glare may affect your proposal? N/A 4. Proposed measures to reduce or control light and glare impacts, if any. j N/A ENVIRONMENT: RECREATION 1. What designated and informal recreational opportunities are in the immediate vicinity? Peninsula Golf Club; walking path with overlook area to White Creek. i 2. Would the proposed project displace any existing recreational uses? j Yes ❑ No ® If so, describe. 3. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any. N/A ENVIRONMENT: HISTORIC AND CULTURAL PRESERVATION 1. Are there any places or objects listed on, or proposed for, national, state, or local preservation registers known to be on or next to the site? Yes ❑ No If so, generally describe, 2. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural importance known to be on or next to the site. N/A 3. - Proposed measures to reduce or control impacts, if any: N/A ENVIRONMENT: TRANSPORTATION 1. Identify public streets and highways serving the site and describe proposed access to the existing street system. Show on site plans, if any. Melody Circle is accessed via curb cut from the parking lot. From Melody Circle, turn onto Melody Lane, then onto S Golf Course Rd., and then onto US 101. 2. Is site currently served by public transit? Yes ❑ No ® If not, what is the approximate distance to the nearest transit stop? 350'. i 3. How many parking spaces would the completed project have? 30 4. How many would the project eliminate? 0 Environmental Checklist EVALUATION FOR Page 9 AGENCY USE 5. Will the proposal require any new roads or streets, or improvements to existing roads or streets, not including driveways? If so, generally describe (indicate either public or private). No. 6. Will the project use (or occur in the immediate vicinity of) water, rail, or air transportation? Yes ❑ No ® If so, generally describe. 7. How many vehicular trips per day would be generated by the completed project? (#) 21 If known, indicate when peak volumes would occur(dates/times). 8. Proposed measures to reduce or control transportation impacts, if any. N/A ENVIRONMENT: PUBLIC SERVICES 1. Would the project result in an increased need for public services (for example?: fire protection, police protection, health care, schools, other)? Yes ❑ No If so, generally describe. 2. Proposed measures to reduce or control direct impacts on public services, if any. N/A ENVIRONMENT: UTILITIES 1. Check any utilities currently available at the site: electricity ® natural gas ® water ❑ refuse service ® telephone ® sanitary sewer septic system ❑ other ❑: 2. Describe the utilities that are proposed for the project, the utility providing the service, and the general construction activities on the site or in the immediate vicinity which might be needed. All existing and hooked up. ENVIRONMENT: ECONOMICS 1. If the proposal will result in expansion of an existing business, please describe the nature of the expansion: (e.g., additional land and/or buildings, new equipment, new employees). N/A 2. If the proposal is the creation of a new business, please describe (e.g., re-use of an existing building and site, construction of a new building). An existing facility being re-used and re-licensed for its original function. 3. Describe if the proposal is the first of its type in the community, or what the similar uses are. This is a re-opening of a facility for its intended use. There are 2 other Memory Care facilities in the area, both located in Sequim. Environmental Checklist EVALUATION FOR Page 10 AGENCY USE 4. How many people will the proposal provide employment for at its completion and what types of jobs will be created (e.g., sales clerks, factory workers, etc.)? 35; admin staff�and caregivers. (Jobs created by the construction of the proposal should be reported separately.) 10-20 5. Where will the materials, goods or services utilized by the proposal come from? Locally for lumber and paint, etc.; likely Seattle area for flooring and other finishes. i 6. Where will the goods or services produced by the proposal be utilized? N/A i 7. Who will utilize the goods or services produced by the proposal? Residents of the facility. 8. Will the proposal alter the tax assessments of the area? No. t Environmental Checklist EVALUATION FOR Page I 1 AGENCY USE Endangered Species Act (ESA) Supplemental Checklist Answer to the best of your knowledge. This checklist was developed to help project proponents and government agencies identify when a project needs further analysis regarding potential adverse effects on Endangered Species as required by the Endangered Species Act (ESA). For our purposes, "ESA listed species" are any species listed as endangered, threatened, or being considered for listing. This supplemental checklist is for all development within ESA Potential Impact Areas, which include the following locations: • Federal Emergency Management Act (FEMA) designated floodplain and/or floodway areas; • Riparian Buffer Zones (RBZ) as described by the Dept of Natural Resources 2007 stream typing system and WDFW's 1997 stream buffer guidelines; and/or • Channel Migration Zones (CMZ) plus 50' as identified according to Dept of Ecology 2003). If ESA listed species are present or ever were present within the ESA Potential Impact Area where your project will be located, your project has the potential for affecting them, and you must comply with the ESA. The questions in this section will help determine if your proposed project could have an impact. The Port Angeles regional watershed is an area where several endangered species have historically been present. Please answer the following questions to the best of your knowledge to assist the city in determining if your project will have adverse impacts to ESA species or their habitats. Port Angeles Community and Economic Development Department staff can provide technical assistance in answering the following questions in this checklist. If necessary, the Washington Department of Fish and Wildlife (WDFW) regional office can also provide information to help you answer these questions. PROJECT SPECIFICS: The questions in this section are specific to the project and vicinity. 1. Do you know of any endangered species or WDFW priority species on or in the vicinity of your project? Yes ❑ No 2. If yes, identify those species: 3. Name of waterbody nearest to your project: White Creek 4. What is the distance from your project to the nearest body of water? Approx. 280' Often a buffer between the project and a stream can reduce the chance of a negative impact to fish. 5. What is the current land use adjacent to the potentially affected water body (developed including commercial, parking lots, residential, paved and/or graveled surfaces, agriculture, forestry,etc)? Single and multi-family housing, parking, Peninsula College. 6. What is the predominant vegetative cover between the project and the potentially affected water body (dense forest, woodland, scrub, grasses,etc)? Woodland along steep creek bank. 7. Is the project above a barrier to fish passage: natural permanent barrier (waterfall): Yes ❑ No natural temporary barrier (beaver pond): Yes ❑ No human-made barrier (culvert, dam): Yes ❑ No other: Yes ❑ No ® If yes, explain: i Environmental Checklist EVALUATION FOR Page 12 AGENCY USE If you answered yes to the questions above, describe the barrier and source of information: 8. If you answered yes to question 7 above, are there any resident salmonid populations above the blockage?Yes ❑ No ❑ Don't know ❑ 9. Percent of the project as impervious surface (includes pavement & roof area)? 42% FISH MIGRATION: The questions in this section will help determine if this project could interfere with the migration of adult and juvenile fish. (Both increases and decreases in water flows can affect fish migration.) T. Does the project require the withdrawal of: i. Surface water? Yes ❑ No Amount Name of surface water body i ii. Ground water? Yes ❑ No Amount From where Depth of well (If you answered yes to any of the above questions, you will need to contact the Washington Department of Fish and Wildlife and the Washington Department of Ecology to obtain appropriate approvals) 2. Will any water be rerouted? Yes ❑ No If yes, will this require a channel relocation? Yes ❑ No ❑ Please describe: 3. Will there be retention or detention ponds? Yes ❑ No If you answer yes, will this be an infiltration pond or a surface discharge to either a municipal storm water system or a surface water body? Yes ❑ No ❑ If you answer "yes" to a surface water discharge, please give the name of the waterbody that will receive the discharge: 4. Will this project require the building of any temporary or permanent roads? Yes ❑ No ® (Increased road distance may affect the timing of water reaching a stream and may impact fish habitat.) 5. Are any new or replacement culverts or bridges proposed as part of this project? Yes ❑ No 6. Will topography changes affect the duration/direction of runoff flows? Yes ❑ No ® If yes, describe the changes: 7. Will the project involve any placement of fill within the ESA Potential Impact Area? Yes ❑ No If you answered yes, describe expected impacts on flood storage and/or flood conveyance and how these impacts will either be avoided or mitigated: Environmental Checklist EVALUATION FOR Page 13 AGENCY USE WATER QUALITY: The questions in this section will help determine if this project could adversely impact water quality for either surface or groundwater. Such ,mpacts can cause problems for listed species. (Water quality can be made worse by runoff from impervious surfaces, altering water temperature, discharging contaminants, etc.) 1. Do you know of any problems with water quality in any of the streams within ESA Potential Impact Areas? Yes ❑ No (Information on impaired water bodies can be obtained from Washington Department of Ecology) If you answered yes, describe: 2. Will your project either reduce or increase shade along or over a waterbody? Yes ❑ No ® (Removal of shading vegetation or the building of structures such as docks or floats often result in a change in shade). If you answered yes, please describe: Will the project introduce any nutrients or other contaminants (fertilizers, other waste discharges, or storm water runoff) to the waterbody? Yes ❑ No 3. Will turbidity be introduced to a water body by construction of the project or during operation of the project? Yes ❑ No (In-water'vor near water work will often increase turbidity.) If you answered yes, consult with Washington Department of Ecology to ensure compliance with water quality regulations. 4. Will your project require long term maintenance that could affect water quality in the future, e.g., bridge cleaning, highway salting, chemical sprays for vegetation management, clearing of parking lots? Yes ❑ No ® If yes, please describe: VEGETATION: The following questions are designed to determine if the project will affect riparian vegetation, thereby, adversely impacting salmon. 1. Will the project involve the removal of any vegetation from the stream banks? Yes ❑ No ® If you answered yes, please describe the existing conditions, and the amount and type of vegetation to be removed: If any. vegetation is removed from a riparian area, a mitigation plan will be required, please provide a copy of the plan if available. Describe briefly what your proposed mitigation would consist of: NOTE: Most applicants should have the information necessary to answer most of the questions in this checklist. Additional information will need to be obtained from local and state agencies if it appears that the project is likely to affect ESA listed species. RESOURCE AGENCIES: Washington Department of Fish and Wildlife Website httL)://wdf,A,,.wa.gov/ This site has useful information on fish habitat. Washington Department of Ecology Website ww�.v.ccv.wa..*ov National Marine Fisheries Services Website Evolutionarily Significant Unit(ESU)maps can be found at www.nwnnoaa.gov Environmental Checklist EVALUATION FOR Page 14 AGENCY USE NON-PROJECT SPECIFIC ACTIONS: Complete this section only if your proposal involves a non-project specific action such as a` Comprehensive Plan Amendment, Zoning Code Amendment, area-wide rezone (City-wide or large sub area),or other similar action.- When ction.When answering these questions be aware of to what extent the proposal or the types of activities likely to result from the proposal would affect the item at a greater intensity or at a faster rate than if the proposal were not implemented. Respond briefly and in general terms. 1. How would the proposal be likely to increase discharge to water; emissions to air; production, storage, or release of toxic or hazardous substances; or production of noise? Proposed measures to avoid or reduce such increases: 2. How would the proposal be likely to affect plants, animals, fish, or marine life? Proposed measures to protect or conserve plants, animals, fish, or marine life: 3. How would the proposal be likely to deplete energy or natural resources? Proposed measures to conserve energy and natural resources: 4. How would the proposal be likely to use or affect environmentally sensitive areas or areas designated (or eligible or under study) for governmental protection; such as parks, wilderness, wild and scenic rivers, threatened or endangered species habitat, historic or cultural sites, wetlands, floodplains, or prime farmlands? Proposed measures to protect such resources or to avoid or reduce impacts: 5. How would the proposal be likely to affect land and shoreline use, including whether it would allow or encourage land or shoreline uses incompatible with existing plans? Proposed measures to avoid or reduce shoreland and land use impacts: 6. How would the proposal be likely to increase demands on transportation or public services and utilities? Proposed measures to reduce or respond to such demand(s): 7. Identify, if possible, whether the proposal may conflict with local, state, or federal laws or requirements for the protection of the environment. Environmental Checklist EVALUATION FOR Page 15 AGENCY USE By affixing my signature hereto, I/we certify and declare under penalty of perjury that the information .furnished herein is true and correct to the best of my knowledge and that I am the owner of the 'premises where the work is to be performed or am acting as the owner's authorized agent. I further agree to hold harmless the City of Port Angeles as to any claim (including costs, expenses and attorney's fees incurred in the investigation of such claim) which may be made by any person, including the undersigned, and filed against the City of Port Angeles, but only where such claim arises out of the reliance of the City, including its officers and employees, upon the accuracy of the information provided to the City as a part of this application. further agree that City of Port Angeles staff may enter upon the subject property at any reasonable time to conerits 7rlication, to take photographs and to post public notices. SIGNED: DATE:07/01/2015 PHONE:503-952-1397 BEFORE THE HEARING EXAMINER FOR THE CITY OF PORT ANGELES In the Matter of the Application of ) NO. CUP 15-03 HIGHLAND COURTE MEMORY) CENTER ) FINDINGS OF FACT, for a Zoning Conditional Use Permit ). CONCLUSIONS OF LAW AND DECISION SUMMARY OF DECISION The application for a zoning conditional use peri-nit to operate a memory care center in a Residential High Density (RHD) zoning district is APPROVED, subject to conditions. SUMMARY OF RECORD Request: The applicant is proposing to operate a memory care center in an already existing building which had previously housed a drug and alcohol treatment center and an Alzheimer Care Facility. Hearing Date: On August 5, 2015,. a public hearing on the application was conducted before Lauren Erickson, City of Port Angeles Hearing .Examiner. Testimony: At the open record hearing the following individuals presented testimony under oath: Scott Johns, AICD, City of Port Angeles Nathan West, Community and Economic Development Director Mark Miller, applicant representative Edna.Willadsen Exhibits: Exhibit I Overhead diagram of area Exhibit 2 Staff Report City of Port Angeles 321 East Fifth Port Angeles, WA 98362 ' • • Having reviewed the record in full, including the above referenced exhibits and the testimony of the witnesses, the Hearing Examiner enters the following Findings of Fact and Conclusions of Law: FINDINGS OF FACT 1. The applicant, Mark Miller of Ankrom Moisan Architects, is seeking a conditional use permit in order to operate a memory care center. The proposal includes minor modifications to an existing vacant building, which most recently functioned as a drug and alcohol treatment center. Prior that, the building was used as an Alzheimer care facility. 2. The subject property is approximately 106,914 square feet in area, measuring 300' by 370' and is located at 1704 Melody Circle, Port Angeles, Washington. 3. The subject property is located in the City's East Planning District and is zoned Residential High Density. 4. Surrounding properties are zoned Public Buildings and Parks (PBP) to the west, Residential Single Family (RS- 9)to the south, Residential Single Family (RS-7) to the east, with the Planned Residential Development (PRD) to the north. 5. No major physical change to the building exterior or site is being proposed other than some changes in fencing and the addition of some pathways. 6. Most of the modifications to the property will take place in the interior of the building, including adding some additional office and bed space. The proposal is for the facility to have 43 beds. 7. The subject property currently contains 29 - 30 parking spaces. The Port Angeles Municipal Code (hereafter, PAMC), requires one parking space for each three sleeping units. As such, the facility will need a minimum of 14 parking spaces. 8. On August 5, 2015, a public hearing was held to address the project application. On July 21, 2015, notice of the application and public hearing was published in the Peninsula Daily News, a local newspaper of general circulation. On July 20, 2015, notice of the application and hearing was mailed to all property owners located within 300 feet of the exterior boundary of the subject property. On July 20, 2015, notice of the application and public hearing was posted on the property. 2 City of Port Angeles 321 East Fifth Port Angeles, WA 98362 9. On August 4, 2015, a Determination of Non-Significance was issued. 10. The proposal should not create in any increase in traffic over the facility's prior uses. 11. A memory care facility is not listed as a permitted or conditional use in the RHD zone; however, assisted living facilities, group homes, nursing and convalescent homes and residential care facilities are listed as conditional uses. 12. A memory care facility is essentially an assisted living facility with an additional endorsement from the Department of Health. 13. Copies of the proposal were circulated to City Departments and the following comments were provided: the Fire Department had no comment because no changes to the building are proposed. The Public Works and Utilities Department had no comments or objections to the proposed use. The Building Division of the Department of Community Development had no comment. 14. No written comments were received from members of the public. CONCLUSIONS OF LAW 1. The Hearing Examiner has jurisdiction to hear this matter. 2. Notices of the application and public hearing were properly given. 3. Pursuant to PAMC 17.96.050, conditional use permits may granted if consistent and compatible with the purpose and the zone in which the use is located, consistent with the Comprehensive Plan and not contrary to the public use and interest. 4. In applying the law the to facts of the application herein,the undersigned concludes the proposal is consistent and compatible with the purpose of the zone in which it is located. As indicated, a memory care facility is essentially an assisted living facility with an endorsement for memory care. Pursuant to PAMC 17.08.010, an assistant living facility is defined as "any home or other institution providing housing, basic services . . . (for seven or more residents) . . ." (emphasis added). The purpose of the RHD zone is to provide high density multi- family residential structures. PAMC 17.15.010. Here the proposal is to provide housing for people with memory issues in a high density living situation. 3 City of Port Angeles 321 East Fifth Port Angeles, WA 98362 • • Further, the other conditional uses listed as potentially permitted uses in this zone include nursing and convalescent homes, group homes and residential care facilities, all of which extraordinarily similar to the facility being proposed here. 5. In applying the law to the facts of the application herein,the undersigned concludes the proposal*is consistent with the Comprehensive-Plan. One of the goals of the Comprehensive Plan is "to provide or allow the opportunity for services and facilities which enhance the quality of life for citizens of all ages, characteristics, needs, and interests and to achieve the desired urban design of the City." One of the policies of the Comprehensive Plan is to provide a variety of housing types and sizes and to ensure that public facilities are adequate. Under the Plan, "residential services" include special needshousing andadult care homes; "essential public facilities" include in-patient facilities such as substance abuse facilities, mental health facilities and group homes. Here the proposed facility will.provide housing for citizens with special needs, thus addressing the goals and policies of enhancing quality of life for all citizens, including those individuals in need of specialized care as well as their families. Further, this facility will provide jobs. As indicated in the Comprehensive Plan, declines in the resource industrieshas had a major impact on the City of Port Angeles and Clallam County. In light of this decline, it is important for Port Angeles to develop other economic assets, including capitalizing on the Olympic Peninsula's popularity as a retirement community. The proposed facility will help promote the kind of economic activity the Comprehensive Plan indicates that is needed. 6. There is nothing to indicate the proposal is in any way contrary to the public use and interest. DECISION Based upon the foregoing Findings of Fact and Conclusions of Law, the application for a zoning conditional use permit application(CUP15-03) is APPROVED, subject to the following conditions: DECIDED this 1 I th day of August, 2015. . l n Lauren Erickson, Hearing Examiner 4 City of Port Angeles 321 East Fifth Port Angeles, WA 98362 CONDI'T'IONS 1. The applicant shall obtain all necessary permits from local, state and federal agencies, including but not limited to the City Building Department, County Health Department. 2. All conditional use or unclassified use permits shall become void one year from the date of granting such use of the land or buildings or applying for necessary building permits has not taken place in accordance with provisions in granting such request. 5 City of Port Angeles 321 East Fifth Port Angeles, WA 98362 THE PORT N AL0 ES CITY OF W A S H I N G T O N, U. S. P'"U"BLIC-1 HEARING ATTENDANCE AND TESTIMONY SIGN IN ROSTER PLEASE SIGN IN IF you plan to testify, by signature below, you certify that the testimony given is true and correct under penalty of perjury by the laws of the State of Washington. If you do not plan to testify, your signature only acknowledges your presence at the meeting. Thank you! MEETING DATE: 05-- Zb t�;- Name Address Agenda Item # 1756 fff Gly" f ..._ ..`! i,�. e .� �t+1 ,. � rte• _ ^^i ti rich p�C ��•"'!��: 1 itu'. 71 ,J• r:t!"�y',{X �R'S�t"�,} �!.' ',v ��,Aat"Y.:: 1703 �'1 p �a'+�i► '�,'�i •�. L`�� � ',• �V / � 1707 rx 11 ,�..�„• t,'b•,. ,•1H �4 �1�?r• jtv "4' L'U J •. , I/ J^ .! 171$ i C-... f(r��t!' 28;24 172 *' xis +{ ' r Gk�, r.'`s'- ”t t ► 701 a �kJlyi►t -; len ', Yt Ra�.�� •.L I,14 , i0 s �y.:,,:4 .i• �' �. +f :''��'` 'r' l 1710 1718 ,125 t ':1{ �':>•' *'; ' ;.�./a, �: o N+i 1122 r. t •. •'`.� ,'` .�, .`�1 .< -�4 � 712 ` � • 72 726 1. 715 j ! ��• g ' !. /724 \fit �,r .c:•'x•,.� ,,! ° {+, / il! 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(. 1703 Q$� { .n •=a .M' ..!'�I t`j+eFi i� e.'' .i c.'�(1f1�Ctt� i r,�� - ' - _,7� . t f, e Crrnmc(t c). 1 ' If 8,41 rrtcz) As IL !�!����1�/�i.d x ,��, '�,(. , � � J r-+I un�ht te�9 m c►F,t� f1'r". �'�, N �, � 6–1- �• ;1� e' �-� i ---- 3b.l,N:h.(:r, 'h Cqn A',• _ - � i1 Pf LCO4 AUG 05 2015 Ui'dIT��, pMEN7 F�G�li�, r ! 1_F_U L CLASSIFIED ADVERTISING PROOF/RECEIPT Client: PDN4900481 CITY OF PORT ANGELES/LEGALS Phone: (360) 417-4613 Address: PO BOX 1150 PORT ANGELES, WA 98362 Ad# 646534 Requested By: Fax: Sales Rep.: Weider, Pam Phone: (360) 452-2345 pweider@peninsuladailynews.com Fax: Class.: 9932 City of Port Angeles Legals Start Date: 07/21/2015 End Date: 07/21/2015 Nb.of inserts: 1 PO#: MEMORY CARE FACILITY Publications: Peninsula Daily News Paid Amount: $0.00 Balance: $60.04 Total Price: IS60.04 I Page 1 of 1 CITY OF PORT ANGELES NOTICE OF DEVELOPMENT APPLICATION AND PUBLIC HEARING NOTICE IS HEREBY GIVEN that on July 13,2015, the CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY&ECONOMIC DEVELOPMENT re- ceived an application to permit a Memory Care fa- cility in the Residential High Density Zone. The ap- plication was determined to be complete on July 13, 2015. Interested parties are encouraged to com- ment on the proposal and to attend the public hear- ing that will be conducted on August 5.2015, at 1:00 PM,in the Council Chambers at City Hall,321 East Fifth Street, Port Angeles,Washington. Writ- ten comment must be submitted no later than Au- gust 3 2015,to be included in the staff report on this matter. Verbal testimony will be taken during the public hearing. Information may be reviewed at the City Department of Community&Economic De- velopment,City Hall,P.O.Box 1150,321 East Fifth Street,Port Angeles. City Hall is accessible to per- sons with disabilities.Interested parties are invited to attend the meeting. STATE ENVIRONMENTAL POLICY ACT: It is an- ticipated that a Determination of Non Signficance (DNS)will be issued per WAC 197-11-355 for the project following the public comment review period that will end on August 4 2015 APPLICANT:Mark Miller for Ankrom Moisan Archi- tects,Inc. LOCATION:1704 Melody Circle For further information contact:(360)417-4752 Pub:July 21,2015 Legal No: Scott Johns From: Jeff Young Sent: Wednesday, July 29, 2015 3:03 PM To: Scott Johns Cc: David Freed; Jason Hart Subject: RE: Proposed memory care centrer Hi Scott, David,Jason and I have discussed this facility at 1704 Melody circle and have no comments on the proposed improvements. We appreciate that it was sent because we did not have them on our grease trap list. Thanks Jeff From: Scott Johns Sent: Tuesday, July 28, 2015 11:27 AM To: Jeff Young; David Freed Subject: Proposed memory care centrer Jeff, and Dave, please review the attached plans for a memory care center at 1704 Melody Circle. This building was originally approved and constructed for the purpose of Alzheimer treatment, so I don't think there will be any new impacts. Please forgive my lateness of sending these plans. They just today have become available electronically. The comment period will close on August 4, 2015, with a public hearing to follow on August 5, 2015. Please provide comments by the end of this week so we can close the SEPA review, issue a determination prior to the hearing. Thanks for your extra efforts on this application. I will be more prompt in the future. Scott 1 CITY OF PORT ANGELES *** CUSTOMER RECEIPT *** Oper: ACYGANON Type: CT Drawer: 1 Date: 7/13/15 01 Receipt no: 67360 Year Number Amount 20 PZ 2015 PLANNING & ZONING $850.00 Trans number: 1801624 Tender detail 87861 $850,00 CK CHECK $850.00 Total tendered $850.00 Total payment Trans date: 7/13/15 Time: 15:03:39 *** THANK YOU FOR YOUR PAYMENT *** FOR INQUIRIES 033660-457-6PAIUSRESS 1 ANKROM MOISAN 087861 ASSOCIATED ARCHITECTS,INC. Check Date: 7/9/2015 Invoice Number Date Voucher Amount Discounts Previous Pay Net Amount 151190 7/9/2015 1000000058824 850.00 850.00 City Of Port Angeles TOTAL 850.00 850.00 Chase-Checking 1 PORTANGELES CLASSIFIED A®VERTI ING PROOF/RECEIPT Client: PDN4900481 CITY OF PORT ANGELES/LEGALS Phone: (360) 417-4613 Address: PO BOX 1150 PORTANGELES, WA 98362 Ad# 646534 Requested By: Fax: Sales Rep.: Weider, Pam Phone: (360) 452-2345 pweider@peninsuladailynews.com Fax: Class.: 9932 City of Port Angeles Legals Start Date: 07/21/2015 End Date: 07/21/2015 Nb.of Inserts: 1 PO 9: MEMORY CARE FACILITY Publications: Peninsula Daily News Paid Amount: $0.00 Balance: $60.04 Total Price: Page 1 of 1 4 CITY OF PORT ANGELES NOTICE OF DEVELOPMENT APPLICATION AND PUBLIC HEARING NQTICE IS HEREBY GIVEN that on July 13,2015, the CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY&ECONOMIC DEVELOPMENT re- ceived an application to permit a Memory Care fa- cility in the Residential High Density Zone. The ap- plication was determined to be complete on July 13, 2015. Interested parties are encouraged to com- ment on the proposal and to attend the public hear- ing that will be conducted on August 5 2015, at 1:00 PM,in the Council Chambers at City Hall,321 East Fifth Street, Port Angeles,Washington. Writ- ten comment must be submitted no later than Au- gust 3 2015,to be included in the staff report on this matter. Verbal testimony will be taken during the public hearing. Information may be reviewed at the City Department of Community&Economic De- velopment,City Hall,P.O.Box 1150,321 East Fifth Street,Port Angeles. City Hall is accessible to per- sons with disabilities.Interested parties are invited to attend the meeting. STATE ENVIRONMENTAL POLICY ACT: It is an- ticipated that a Determination of Non Signficance (DNS)will be issued per WAC 197-11-355 for the project following the public comment review period that will end on August 4 2015 APPLICANT:Mark Miller for Ankrom Moisan Archi- tects,Inc. LOCATION:1704 Melody Circle For further information contact:(360)417-4752 Pub:July 21,2015 Legal No: CITY OF PORT ANGELES AFFIDAVIT OF POSTING RE: Conditional Use Permit 15-03 I, Pat Bartholick, state that on the 20"' day of July 2015, I posted said notice, a true copy of which is hereto attached and made part hereof at the Public Library Port Angeles bulletin board. AFFIANT Subscribed to me this day of 2015. NOTARY PUBLIC for the State of Washington, residing in Port Angeles T/forms/affidavitpostingj im CITY OF PORT ANGELES AFFIDAVIT OF POSTING RE: J.5 - I PAT BARTHOLICK, state that on the day of 2015, I posted said notice, a true copy of which is hereto attached and made part hereof, on the property proposed for a land use action pursuant to Section 17.96.140 of the Port Angeles Municipal Code. AFFIANT Subscribed to me this day of 2015. NOTARY PUBLIC for the State of Washington, residing in Port Angeles '171'o ms/affidavit post ingjini • • CITY OF PORT ANGELES AFFIDAVIT OF MAILING RE: Conditional Use Permit 15-03 I, ar state that on the 20`" day of July 2015, I mailed said notice, a true copy of which is hereto attached and made part hereof, to property owners within 300 feet of the property proposed for a land use action pursuant to Section 17.96.140 of the Port Angeles Municipal Code. �&aAk ,? n AFFIANT Subscribed to me this day of 2015. �°1 VEN,!410, ;�a � or - NOTARY PUBLIC for the State of `� ��®* � M Washington, residing in Port Angeles r 00 ft f 0 Vfonns/affidavitpostin2jint • • CITY OF POINT ANGELES NOTICE OF DEVELOPMENT APPLICATION AND PUBLIC HEARING NOTICE IS HEREBY GIVEN that on July 13, 2015, the CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT received an application to permit a Memory Care facility in the Residential High Density Zone. The application was determined to be complete on July 13, 2015. Interested parties are encouraged to comment on the proposal and to attend the public hearing that will be conducted on August 5, 2015, at 1:00 PM, in the Council Chambers at City Hall, 321 East Fifth Street, Port Angeles, Washington. Written comment must be submitted no later than August 3, 2015, to be included in the staff report on this matter. Verbal testimony will be taken during the public hearing. Information may be reviewed at the City Department of Community & Economic Development, City Hall, P.O. Box 1150, 321 East Fifth Street, Port Angeles. City Hall is accessible to persons with disabilities. Interested parties are invited to attend the meeting. STATE ENVIRONMENTAL POLICY ACT: It is anticipated that a Determination of Non Signficance (.DNS) will be issued per WAC 197-11-355 for the project following the public comment review period that will end on August 4, 2015. APPLICANT: Mark Miller for Ankrom Moisan Architects, Inc. LOCATION: 1704 Melody Circle For further information contact: (360) 417-4752 PUB: 7/21/15 POST: 7/20/15 MAIL: 7/20/15 T:\CUP\2015\CUP 15-03 HIGHLAND COURT MEMORY CENTER\NOTICE OF ACTION.DOC i F • • CITY OF PORT ANGELES AFFIDAVIT OF POSTING RE: Conditional Use Permit 15-03 I, Scott K. Johns, state that on the 20th day of July 2015, I posted said notice, a true copy of which is hereto attached and made part hereof on the City's Public Notice Bulletin Board and at the Clallam County Cou mouse lobby bulletin board. /AFFIANT Subscribed to me this 2-1 day of 2015. ,��evueuat►i®'® � ®®oo®�®r� VEaNtra�°i®.,,,® NOTAR PUBLIC for the State of ;S- 2,1 Washington, residing in Port Angeles ®e m 000, 00 00 T:\CUP\2015\CUP I5-03 HIGHLAND COURT MEMORY CENTER\AFFIDAVIT POSTING GENERAL,2.DOC _ a CITY OF PORT ANGELES NOTICE OF DEVELOPMENT APPLICATION AND PUBLIC HEARING NOTICE IS HEREBY GIVEN that on July 13, 2015, the CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT received an application to permit a Memory Care facility in the Residential High Density Zone. The application was determined to be complete on July 13, 2015. Interested parties are encouraged to comment on the proposal and to attend the public hearing that will be conducted on August 5, 2015, at 1:00 PM, in the Council Chambers at City Hall, 321 East Fifth Street, Port Angeles, Washington. Written comment must be submitted no later than August 3, 2015, to be included in the staff report on this matter. Verbal testimony will be taken during the public hearing. Information may be reviewed at the City Department of Community & Economic Development, City Hall, P.O. Box 1150, 321 East Fifth Street, Port Angeles. City Hall is accessible to persons with disabilities. Interested parties are invited to attend the meeting. STATE ENVIRONMENTAL POLICY ACT: It is anticipated that a Determination of Non Signficance (DNS) will be issued per WAC 1.97-11-355 for the project following the public comment review period that will end on August 4, 2015. APPLICANT: Mark Miller for Ankrom Moisan Architects, Inc. LOCATION: 1704 Melody Circle For further information contact: (360) 417-4752 PUB: 7/21/15 POST: 7/20/15 MAIL:7/20/15 T:\CUP\2015\CUP 15-03 HIGHLAND COURT MEMORY CENTER\NOTICE OF ACTION.DOC Ankrom Moisan Transmittal JUL 13 2015 #001 - Conditional Use Application CITY OF POW ANGELES COMMLNITY&ECONOMIC DEVELOPMENT Date: July 9, 2015 Project: Highland Courte Memory Care AM Project #: 151190 To: Scott Johns, Associate Planner City of Port Angeles, Planning Department 321 E. 5th Street Port Angeles, WA 98362 cc: From: Mark Miller Sent via: Second Day - Express Carrier Phone Number: 360-417-4750 Purpose: For your use Remarks: Enclosed is the application package for Highland Courte Memory Care. This is an existing facility that was built and licensed for memory care in 1998, but the facility has been vacant for the past several years. My client is working through the purchase of the property with the intent to re- license it for memory care, so because the license lapsed and the building's been vacant, we are going back through the Conditional Use process. Contents Quantity: Dated: Description: 1 7.9.2015 Drawings - full size (cover, site, floor plan) 1 7.1.2015 Conditional Use Application 1 SEPA Checklist 1 List of property owners within 300' 1 Address labels for property owners within 300' 1 7.9.2015 Check for permit fees Signature: Ankrom Moisan Architects, Inc. Mark Miller, Associate Please note: Only hard copy deliveries will be signed ARCHITECTURE INTERIORS URBAN DESIGN BRANDING Ankrom Moisan Architects Portland&Seattle 6720 SW Macadam Ave Suite 100 Portland,OR 97219 503.245.7100 117 S Main St Suite 400 Seattle,WA 98104 206.576.1600 ankrommoisan..com page 7 of 1 File # (;0 P . APPLICANT/OWNER INFORMATION: Applicant:Ankrom Moisan Architects, Inc. / Mark Miller Applicant Address:6720 SW Macadam Ave., Suite 100; Portland, OR 97219 Daytime phone#: 503-952-1397 E-mail: markcm@ankrommoisan.com Applicant's representative (if other than applicant): Contact Address: Daytime phone#: E-mail: Property owner(if other than applicant): Highland Courte Memory Care Operating Company, LLC/Terri Waldroff Address: 20300 S South End Road; Oregon City, OR 97045 Contact phone#:503-706-0878 PROPERTY INFORMATION: Street address: 1704 Melody Circle Zoning: RHD Lot 3 of Highland Commons as recorded in Vol.13 of Plats,Pages 43,44,and 45. Recorded under Auditor's No.747409 Records of Clallam County,WA. Legal description: Property dimensions 312' x 369' Property area(total square feet): 109,771 sf Physical characteristics (i.e., flat, sloped, vacant, developed, etc.): Developed land, mostly flat at building location. To west of building there is a nature trail and a conservation area with a slight valley. PROPOSED USE: Please describe the proposed conditional use:The existing facility was originally licensed for Memory Care(circa 1998). Since then,the facility was converted into an Alcohol Rehabilitation Clinic,and then sat vacant for the past 3-4 years. It is proposed to re-open as a Memory Care facility with upgraded interior finishes and renovated interior support spaces(within existing footprint). Number of employees: 35 total;approx. 17 on largest shift Hours of operation:24/7 Number of on-site parking spaces:30 Total square foot of floor area for the proposal: 16,700 sf % Site coverage:42% SIGNATURES: Applicant: Mark Miller, Ankrom Moisan Architects, Inc. Date:07/01/2015 I certify that all of the above statements are true and complete to the best of my knowledge and acknowledge that wilful m 496 i srepresentatio n of information will terminate this permit application. A licant Signature: a. ° `' Date: q - I-( Pp (If the applicant is NOT the property owner, th:t�hi pro erty owner must sign this application or provide a separate note that he/she is/are aware of /epplication). Owner's Signature (if other than applicant): G�'f/ Q%��� Date: 1 tJEC'4 Parcel-GP dbo.vw PNUM-owners Flle as name l GP dbo vw_ PNUM owners flrst I'I GP dbo—vw_PNUM owners.last_` Parcel_GP.dbo.vw PNUM_owees. ddr linel .dbo.vw ONO w M-oner-PNUMt,Lw PNUM m 1 RADIO PACIFIC INC RADIO PACIFIC INC _ PO BOX 1450 PORT ANGELES WA 98362 2 OLYMPIC VIEW PROPERTIES INC OLYMPIC VIEW PROPERTIES INC PO BOX 1750 SEQUIM WA 98382 3 WA PENINSULA COLLEGE WA PENINSULA COLLEGE 1502 E LAURIDSEN BLVD PORT ANGELES WA 98362 4 JAMES M AND DONA R CLOUD JAMES M AND DONA R CLOUD 724 ELIZABETH LN PORT ANGELES WA 98362 5 MAYNARD AND BETTY J ALLEY MAYNARD AND BETTY J ALLEY 2110 BELMONT PL #3 GARDEN CITY KS 67846 6 HOWARD E CUNNINGHAM III AND TAMARA L KELLER HOWARD E III AND TAMARA L CUNNINGHAM AND KELLER 718 ELIZABETH PL PORT ANGELES WA 98362 7 HIGHLAND ESTATES HOMEOWNERS ASSOCIATION OF FOR HIGHLAND C/O VIRGINIA TURNER 1718 E LAMBERT LN PORT ANGELES WA 98362 8 SYLVIA HARGREAVES SYLVIA HARGREAVES 711 S CURRIER CT PORT ANGELES WA 98362 9 EDWARD G AND ANNE D HORNOR TTES EDWARD G AND ANNE D HORNOR TTES 924 BELLWOOD DR SPOKANE WA 99218 10 CHERYL ANN NIELSON CHERYL ANN NIELSON 7322 YOLANDA DR SW OLYMPIA WA 98512 11 SANDRA L FRANKFURTH SANDRA L FRANKFURTH 40 ASPEN CREEK CT SEQUIM WA 98382 12 THOMAS E CLARKE THOMAS E CLARKE 727 CURRIER CT PORT ANGELES WA 98362 13 THOMAS E CLARKE THOMAS E CLARKE 727 CURRIER CT PORT ANGELES WA 98362 BETTE M SIEBENS BETTE M SIEBENS 1706 LAMBERT LANE PORT ANGELES WA 98362 RUTH M FOX RUTH M FOX PO BOX 2033 PORT ANGELES WA 98362 EDWARD AND HARRIET HAUFF REV TRUST EDWARD AND HARRIET HAUFF REV TRUST 1714 LAMBERT LN PORT ANGELES WA 98362 17 JAE L AND VIRGINIA TURNER JAE L AND VIGINIA TURNER 1718 E LAMBERT LN PORT ANGELES WA 98362 18 CATHY J STEINHORST CATHY J STEINHORST 3507 NE 78TH VANCOUVER WA 98665 19 JOSEPHINE H O'NEILL JOSEPHINE H O'NEILL 712 S CURRIER CT PORT ANGELES WA 98362-4966 20 EUGENE DUTTON EUGENE DUTTON 724 S CURRIER CT PORT ANGELES WA 98362 21 OMER AND RETA VIGOREN OMER AND RETA VIGOREN 726 CURRIER CT PORT ANGELES WA 98362 22 GARY AND JEANNE LESARGE GARY AND JEANNE LESARGE 1100 S ROSEWOOD DR UNIT#101 ELEENSBURG WA 98926 23 TOM AND CATHY M F JANSSEN TOM AND CATHY M F JANSSEN 730 CURRIER CT PORT ANGELES WA 98362 24 ALICE E HEATH ALICE E HEATH 732 CURRIER CT PORT ANGELES WA 98362 25 HIGHLAND COMMONS APARTMENTS LLC HIGHLAND COMMONS APT LLC 718 GRIFFIN AVE#238 ENUMCLAW WA 98022 26 HIGHLAND COMMONS APRATMENTS LLC HIGHLAND COMMONS APT LLC 718 GRIFFIN AVE#238 ENUMCLAW WA 98022 27 HIGHLAND COURTE ALZHEIMER COMM HIGHLAND COURTE ALZHEIMER(4699 NE WOODSON LN STE 319C BAINBRIDGE ISLAND WA 98110 28 HIGHLAND ESTATES HOMEOWNERS ASSOCIATION OF FOR HIGHLAND C/O VIRGNINIA TURNER 1718 E LAMBERT LN PORT ANGELES WA 98362 select—ownerstemp Address: 11704 Melody Circle PREPARED 5/09/16, 12:17:10 , INSPECTION TICKET PAGE 8 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 5/09/16 ----------------- ------------- ----- ADDRESS . : 1704 MELODY CIR SUBDIV: CONTRACTOR YORKE & CURTIS INC PHONE (503) 646-2123 OWNER HIGHLAND COURT HOLDING COMPANY PHONE PARCEL 06-30-14-6-6-0030-0000- APPL NUMBER: 16-00000396 FENCE ------------------------------------------------------------------------------------------------ PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS -------—-----------------------—----- -—-- BL99 01 6 JL BLDG FINAL May 3, 2016 12:01:52 PM pbarthol. Dale 971-317-6292 -----—--------—--------------------- COMMENTS AND NOTES -------------------------------------- �� CITY OF PORT ANGELES ` � DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT- BUILDING DIVISION t. r� 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 16-00000396 Date 3/28/16 Application pin number . . . 821564 Property Address . . . . . . 1704 MELODY CIR ASSESSOR PARCEL NUMBER: 06-30-14-6-6-0030-0000- Application type description FENCE REPORT SALES TAX Subdivision Name . . . . . . On your state excise tax foul] Property Use . . • . . . . Property Zoning . to the City of Port Angeles Application valuation 5000 (Location Code 0502) Application desc extend existing fence to approx 712" for resident ---------------------------------------------------------------------------- Owner Contractor ----------------------- ------------------------ HIGHLAND COURT HOLDING COMPANY YORKE & CURTIS INC .20300 S SOUTH END RD 4480 SW 101ST AVE OREGON CITY OR 97045 BEAVERTON OR 97005 - ---------(503) 646-2123 ------------------------------=.- ---------------------------- Permit . . . . . . BUILDING PERMIT - COMMERCIAL Additional desc . . EXTEND FENCE FOR RESIDENT SAFE Permit Fee . . . . 137.75 Plan Check Fee 89.54 Issue Date . . . . 3/28/16 Valuation . . . . 5000 Expiration Date . . 9/24/16 Qty Unit Charge Per Extension BASE FEE 95.75 3.0014.0000 THOU BL-2001-25K (14 PER K) 42.00 ---------------------------------------------------------------------------- Special Notes and Comments . C March 28, 2016 10:41:46 AM pbarthol. Adding height of existing fence. Fence is interior to property at memory care facility so the finished side of fence faces in for the safety of the residents. March 28, 2016 10:43:18 AM pbarthol. S— ---------------------------------------------------------------------------- 4 . Other Fees . . . . . . . . . STATE SURCHARGE 4.50 --------------------------- --------------- -------------- -------------------- Fee summary Charged Paid Credited Due Permit Fee Total 137.75 137.75•. .00 .00 Plan Check Total 89.54 89.54 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 231.79 231.79 .00 .00 MIN 1 Separate Permits are required for electrical work,SEPA,Shoreline,ESA,utilities,private and public improvements. This permit becomes null and void if work or construction authorized isnot commenced within 180 days,if construction or work is suspended or abandoned for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give aut only t violate or cancel the provisions of any t t or local law regulating construction or the performance of construc Date, G Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder) T:Forms/Building Division/Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS— Building Inspections 417-4815 Electrical Inspections 417-4735 Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886 IT IS UNLAWFUL TO COVER,INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION: Footings Stemwall Foundation Drainage/Downspouts Piers Post Holes(Pole Bldgs.) PLUMBING: Under Floor/Slab Rough-in Water Line Meter to Bldg) Gas Line Back Flow/Water AIR SEAL: Walls Ceiling FRAMING: Joists/Girders/Under Floor Shear Wall/Hold Downs Walls/Roof/Ceiling Drywall Interior Braced Panel Only) T-Bar INSULATION: Slab Wall/Floor/Ceiling MECHANICAL: Heat Pump/Furnace/FAU/Ducts Rough-In Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts MANUFACTURED HOMES: Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT. Separate Permit#s SEPA: Parkin /Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE Inspection Type _ Date Accepted By Electrical 417-4735 Construction - R.W. PW I Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 THEPOR GET E� For City Use CITY OF1 1. Permit# W A s H I N G ,T O N, U. S. Date Received: '3 321 E Sth Street Date Approved Port Angeles,WA 9836 P:360-417-4817 F:360-417-4711 Email:permits(Mcityofpa.us BUILDING PERMI PLICATION Project Address: 170 M FLO D 9 C/P i(C-- 11 FbA r— 'O-V69� w+4 Pho e: / 3/7 6 2, '11'- Primary Contact: I/�1.� S�}v>�12 Email: ALL yoRkci&-o C06"ll , 6 /?-) Name Phone Property Mailing Address Email CU Owner City State Zip 02E-60�-' NamePhoneCvaT/S /^��- 5 63 G'�G-2/23 Contractor Address � Email ��o �4LC- S@C-U')7 Z/ GO Information City xE-f�rdState 02 Zip Contractor License# Exp.Date: Legal Description: Zoning: Tax Parcel# Project Value (materials and labor) IL $ .S 00 C)o Residential ❑ Commercial 0 Industrial ❑ Public ❑ Permit Demolition ❑ Fire ❑ Repair ❑ Reroof(tear off/lay over) ❑ Classification For the following,fill out both pages of permit application: (check New Construction ❑ Exterior Remodel ❑ Addition ❑ Tenant Improvement ❑ appropriate) Mechanical ❑ Plumbing ❑ Other ❑ Fire Sprinkler System Proposed FIrrigation System Proposed or Proposed Bathrooms Proposed Bedrooms or Existing? Yes 0 No D 1 Existing? Yes E3 No D In addition to standard hard copy submittals please send a PDF copy of all Stormwater plans and Engineering to www.stormwaterocityofga.us Project Description fl-DV Y9- SIC-2O01- v t:)</J7—/k-c SltEr d- REtrn l-mzr DA- 7a0PE-4r Is project in a Flood Zone: Yes ❑ No❑ Flood Zone Type: If in a Flood Zone, what is the value of the structure before proposed improvement? $ I have read and completed the application and know it to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required and to obtain permits prior to work. I understand that plan review fees are not refundable after review has occurred. I understand that I will forfeit review fees if I withdraw the application before the permit is issued. I understand that if the permit is not picked up/issued within i8o days of submittal,the application will be considered abandoned and the fees will be forfeited. P74�L(:'5-- f)q pl DaJL/ / Print Name Si ature Residential Structures Existing Proposed Construction For Office Use Area DescriptiphiJSQ FT) Floor area Floor area $Value new area Basement First Floor Second Floor Covered Deck/Porch/Entry Deck(over 30"or i" floor) Garage Carport Other(describe) Area Totals Commercial Structures Area Descriptions(SQ FT) Existing' Proposed Construction For Office Use Floor area Floor area $Value new area Existing Structure(s) Proposed Addition Tenant Improvement? Other work(describe) Site'Area Totals Lot/Site Coverage Calculations Lot Size(sq ft) Lot Coverage(sq ft)foot print of %Lot Coverage(Total lot cov_lot size) Max Bldg Height all structures sq ft Site Coverage(Sq Ft of all impervious) %of Site Coverage(total site cov_lot size) Mechanical Fixtures Indicate how many of each type of fixture to be installed or relocated as part of this project. Air Handler Size: # Haz/Non-Haz Piping Outlets: Appliance Exhaust Fan # Heater(Suspended,Floor,Recessed wall) # Boiler/Compressor Size: # Heating/Cooling appliance # repair/alteration Evaporative Cooler(attached,not # Pellet Stove/Wood-burning/Gas ' # portable) Fireplace/Gas Stove/Gas Cook Stove/Misc. Fuel Gas Piping #of Outlets: Ventilation Fan,single duct # Furnace/Heat Pump/ Size: # Ventilation System # Forced Air Unit Plumbing Fixtures Indicate how many of each type of fixture to be installed or relocated Plumbing Traps # Water Heater # Plumbing Vent piping # Medical gas piping #of Outlets: Water Line # Fuel gas piping #of Outlets: Sewer Line # Industrial waste pretreatment interceptor Grease Trap) Size Other(describe): T:\Forms\2015 CED Form Updates\Building&Permitting\BP\Building Permit 20150415.docx AAA Ankrom Moisan Architect's Supplemental Instructions ASI#02- Privacy Screen and New Gate at Existing Fence Date Issued: 18 March 2016 Project: Highland Courte Memory Care AM Project#: 151190 Owner: Highland Court Holding Company, LLC Contractor: Yorke&Curtis, Inc. Architect: Ankrom Moisan Architects, Inc. To: Phil Shuart, Dale Shuart(Yorke&Curtis), Terri Waldroff(Benicia Senior Living) cc: The following supplemental instructions are issued in accordance with the Contract Documents.The Contractor shall carry out the Work in accordance with these supplemental instructions without change in the Contract Sum or the Contract Time. Performance of the Work in the accordance with these supplemental instructions indicates Contractor's acknowledgement that there will be no change in the Contract Sum or Contract Time. Supplemental Instructions: 1. Add a privacy screen to the top of the existing fence as shown in drawing 1-1. 2. Demo the existing gate at the West Courtyard and provide new per drawing 1-2. 3. Modify access from West Courtyard per revised sheet A1.01. Attachments(if necessary): 1. A1.01 (modified) 2. 1-1 3. 1-2 2 g Issued by: F / 03/18/16 Signature: f Name: Mark Miller, Associate Date Firm: Ankrom Moisan Architects, Inc. Accepted by: Signature: 0 �/z 2r, Name: � �� ��2! Date Firm: J ARCINTESIT CT s�.a� til MOPS URBAN�URBAN DESIGNMN� FILE RRANn;N CITY OF PORT ANGELES-CatstnWO Putts O f f &c1 Ar s F A C Ankrom Moisan Architec%e Issuance of this permit based upon these plans On �..� Portland s Seattle specifications and other dais shall not prevent the S �'�a?'[ rv� 6720 S `bac adarr;,ave building official from thertaftr teyuirtng the Suite.loo correction of errors in said plans,speoifliicetions and Z q Portland,OR 97219 other data or from preventing building operations so s.2^s.ri'° being carried on thereunder when in violation*f1A 11-7 S Mair,Qt codes and ordinances of this jurisdiction. s suite 4010 ALL T�l Ll� TTO PIEi.D Seattle,WA9810-1 'By IITo- '' ankrommoisan.com J.age;of I �- C41--o UL l'S �- ^at",lrl V GENERAL NOTES 77,11 ZZ r 0-1 / KEYNOTES I a ! Q—� j �, wsnnc rxns�t EraowxE ro xu...�n 1 _ / I 0^nn,..«n..Ill c,P,o,Er«r,. I e ' Q,xlsnne^c«ssieuscN,a w.uin�ac�u^�,wsnve sr..ce so>•e.,s.� .sure.ao 0 xms N'F.V.'PfiGGGSEC FMR[us,mC.rPnvs.iv siGH,siF J^t,oi a.1 11 „A iESICE•NALt ::%'AnL.N M O nFW srxiMn•fusnvl.l^RUN[:svM.ssns Vs[nto EXISTING ONE-STORY STRUCTURE �snnc nuwrsn^v«su,o,o nnu�r ! nc caAsr�.nx«nox ro.E.u�n nu,nm uiKu Q,mun,.cn^,sew^r.,n e.vn�s+ruu 0 = ; 'O' eztnme sEracc uns w:n^cE e.muEcs O E .unn `�Rw Wx n� ot W rn 1-1.,.r,x / GWtiUl.AL Y1 iHA1f EW,s 11--E n•woxo 111s 1 > "(3A;Ix:^ulf)F.WAIK tUCMVeOFUsr ru Z / �ecencm _ .ucw�cw,w. eisn�eeEnu..,o. O \ ^ _ a O oeMn exisn.c.e^ie •� / `—V - rvEW:rrevcEro.,.rcnexsn.c SITE DATA W z MONUMENT SIGN SECTION 0o 3 c c,..sEcn. O ZOw o g z Z LEGAL DESCRIPTION = g EXISTING "'r"s uua�ua oxswFa+,+usnacw, ur cu,uu ca.+rv.w^ APARTMENT HIGHLAND BUILDING COURTE MrSITE PLAN i c'mol E, nF"I.— CONSTRUCTION 15JAN.16 Ivo- SITE PLAN MONUMENT SIGN ELEVATION CURB RAMP 'Ti Ir --mroZp Zr IORTLAND, M ACAD AM A VEN UE 0 O R 97219 1O d 45-700 U < O zU 117 SOUTH MAIN STREET, 400w O < p w SEATTLE, WA 98104 O F Q 2 ti <•_ N �_ Q w T 206-576-1600 !] a p U UU p O U J U I-I 11 v� ©ANKROM MOISAN 3 r 3 Z N 3 LL N Z I I I O O ARCHITECTS,INC. .o Z Z LJ Z v¢i vii w w Z H w w D U II�I1 =_��III W Lu II o u � v O vi Q >- w l v v z w O LU Q W _j 0 v a a Lu U, Z a' — O o = u N93?135/JVAI?Id M3N 3JN31 DOOM?IV033 9NIISIX3 �NI1003 31RIDNOD DN11SIX3 TITLE .0-,l =1 =1 I1 I PRIVACY x _ _ SCREEN ASI 02 o DATE REVISION w x 10/12/15 f,o, u� 5 PROJECT# E 151190 o Y p u SCALE i f E3 .- - / 6720 SW MACADAM AVENUE ^ .(,.;1!a� �4 �� • SUITE 100 ��. PORTLAND,OR 97219 T 503-245-7100 ` 117 SOUTH MAIN STREET, SUITE 400 SEATTLE,WA 98104 T 206-576-1600 O ANKROM MOISAN .,�. ARCHITECTS,INC. 4 ` 7-061filc , - W � {Kj�t,�iG�iEJ OD t Q G f U Z u O LuLA LUL; W o J w Z 2 U r� CLO TITLE I x<j FENCE GATE y �x ASI 02 f .. .. ._ 2 to'e r smE- TE Gvfk REVISION 10/12/15 0 _ w Y J �;��"���—ry.�•3""(�D E �l DE wR L�:�_ 1 on 2!,s x a PROJECT# '<? 151190 o i p c SCALE N.T.S. Address: 1704 Melody Circle PREPARED 5/19/16, 9:00:50 INSPECTION TICKET PAGE 5 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 5/19/16 ----------------------- ---- -- ADDRESS . : 1704 MELODY CIR SUBDIV: CONTRACTOR AUBURN SHEETMETAL INC PHONE (360) 825-0800 OWNER HIGHLAND COURT HOLDING COMPANY PHONE PARCEL 06-30-14-6-6-0030-0000- APPL NUMBER: 16-00000316 COMM MECHANICAL PERMIT ------------------------------------------------------------------------------------------------- PERMIT: ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ ME99 01 5/09/16 JLL MECHANICAL FINAL 5/10/16 DA May 3, 2016 12:02:37 PM pbarthol. May 10, 2016 8:55:11 AM jlierly. Items reqd are exit signage and em lighting electrical final and state dept finals/jll ME99 02 5/13/16 JLL MECHANICAL FINAL 5/13/16 DA May 13, 2016 9:00:10 AM jlierly. ALI 360-825-0800 May 13, 2016 3:41:44 PM jlierly. HVAC balance report required and electrical final for unit required/jll ME99 03 5/19/16 L MECHANICAL FINAL . May 19, 2016 8:52:50 AM jlierly. Dale --------------------- -------- COMMENTS AND NOTES -------------------------------------- - PREPARED 5/13/16, 9:01:17 INSPECTION TICKET PAGE 6 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 5/13/16 ADDRESS : 1704 MELODY CIR SUBDIV: CONTRACTOR AUBURN SHEETMETAL INC PHONE (360) 825-0800 OWNER HIGHLAND COURT HOLDING COMPANY PHONE PARCEL 06-30-14-6-6-0030-0000- APPL NUMBER: 16-00000316 COMM MECHANICAL PERMIT ------------------------------------------------------------------------------------------------ PERMIT_ ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ----------—-------------------------------------------—------——---------------------—------ ME99 01 5/09/16 JLL MECHANICAL FINAL 5/10/16 DA May 3, 2016 12:02:37 PM pbarthol. May 10, 2016 8:55:11 AM jlierly. Items reqd are exit signage and em lighting electrical final (/\J-�I\�� and state dept finals/ill ME99 02 5/13/16 MECHANICAL FINAL May 13, 2016 9:00:10 AM jlierly. ALI 360-825-0800 -------------------------------------- COMMENTS AND NOTES -------------------------------------- C, Cis' ------------------------------------- CHCS CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY& ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 16-00000316 Date 3/11/16 Application pin number . . . 661124 Property Address . . . . . . 1704 MELODY CIR ASSESSOR PARCEL NUMBER: 06-30-14.5-6-0030-0000- Application type description COMM MECHANICAJ, PERMIT REPORT SALES TAX Subdivision Name . . . . . . on your state excise tax form Property Use . . . . , . . . Property Zoning . . . . . . , to the City of Port Angeles APP - __.._ ..,._-_- '---- Application valuation 25000 (Location Code 0502) ----------- --------- __...-- ----_ j� Application desc MODIFY DUCT\ ---------------------- POR REMODEL AS NEEDED, Owner Contractor HIGHLAND COURT HOLDING COMPANY AUBURN S14EETMETAL INC 20300 S SOUTH END RD P O BOX 1354 O OREGON CITY OR 97045 ENUMCLAW WA 98022 (360) 825-0800 ---------------------;---------'------------------------------- PermitMECHANICAL PERMIT Additional desc MODIFY DUCT WORK Perm1L Fee . . . . 100.00 Plan Check Fee .00 Issue Date . . . . 3/11/16 Valuation 0 Expiration Date 9/07/16 © Qty Unit Charge Per Sxtension BASE FEE 50.00 1.00 50.0000 HR ME-INSPECTION, MIN 1 HR 50.00 '--------- -----------------••_•_--__-_-_• --------•--_ --'---•------- --- B Fee summary Charged Paid Credited Due --- ----- ---------- ------.--- Permit Fee Total :00.00 100.00 .00 .00 t Plan Check Total .00 .00 .00 .00 Grand Total 00.00 100.00 .00 .00 `q Separate Permits are required for electrical work,SEPA,Shoreline,ESA,utilities,private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days,if construction or work is suspended or abandoned for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. Therantin of permit does 9 9 a not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Mlhl, .1-411 IA)WAIVW, - Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder) T:Forms/Building Division/Building Permit L crr Y or G For City Use W A s l-r N G r a r; u . s. FApproved /fs 321E 5�Street - Port Angeles,WA 9836 P:360-417-4817 F:360-417-4711 Email:p BUILDING PERMIT APPLICATION Project Address: 1704 Melody Circle;.Port Angeles, WA 98382 Justin Treat Phone:(360)825-0800 Prima Contact: ExnaiI:'ustin treatsheatin .com Name Highland Court Hldng Cmpny LLC Phone Property Mailing Address Email Owner 20300 S. Southend Rd c`tyOregon City State OR zip 97045 NarneAuburnSheet Metal, Inc [;"�'�':6 )825-0800 Contractor Address$44 MT Villa Dr esk@treatsheating.com Information city Enumclawzi p 98022 Contractor Licenses!AUBURI.222RQ 0/2017 Legal Description: Zoning: Tax Parcel# Project Value: (materials and labor) Highland Commons Lot 3117 67483 $ 25,000 Residential ❑ Commercial EJ Industrial ❑ Public ❑ Permit Demolition ❑ Fire ❑ Repair ❑ Reroof(tear off/lay over) ❑ Classification For:the following. fill out both Pages of permit application: (check New Constructi n. 11 Exterior Remodel ❑ Addition 11 Tenant Improvement ❑ appropriate) Mechanical WPlumbing ❑ Other ❑ Fire Sprinkler System Proposed .Irrigation System Proposed or Proposed Bathrooms Proposed Bedrooms or Existing? Yes ❑ No ❑ Existing? Yes ❑ No .0 In addition to standard hard copy submittals please send a PDF copy of all Stormwater pians and Engineering to www.storn�uatet'Ca-czt of2a:us Project Description. Modify ductwork to accommodate minor floor plan changes. Is project in a Flood Zone: Yes ❑ No❑ Flood.Zone Type: If in.a Flood Zone, what is the value of the structure before proposed improvement? $ I have read and completed the application and know it to be true and correct.I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required and to obtain.permits prior to work. I understand that plan review fees are not refundable after review has occurred. I understand that I will forfeit review fees if I withdraw the application before the permit is issued. .I understand that if the permit is not picked.up/issued within i8o days of submittal,the application will be considered abandoned and the fees will be forfeited. Date 2I26/2oi6 AW for J. Treat C,` �� Print Name Signature—T. Residential Structures Existing Proposed Construction For Office Use Area Descriptions(SQ FT) Floor area Floor area $Value new area Basement . First Floor Second Floor Covered Deck/Porch/Entry Deck(over 30"or z" floor) Garage Carport Other(describe) Area totals Commercial Structures Area Descriptions(SQ FT) Existing Proposed Construction For Office Use Floor area Floor area $Value new area Existing Structure(s) Proposed Addition Tenant Improvement? Other work(describe) Site Area Totals Lot/Site Coverage Calculations Lot Size(sq ft) Lot Coverage(sq ft)foot print of %Lot Coverage(Total lot cov T lot size) Max Bldg Height all structures s ft Site Coverage(Sq Ft of all impervious) %of Site Coverage(total site cov_lot size) Mechanical Fixtures Indicate how man of each a of fixture to be installed or relocated as art of this project. Air Handler Size: # Haz/Non-Haz Piping P g Outlets: Appliance Exhaust Fan # Heater(Suspended,Floor,Recessed wall) # Boiler/Compressor Size: # Heating/Cooling appliance # repair/alteration Evaporative Cooler(attached,not # Pellet Stove/Wood-burning/Gas # portable) Fireplace/Gas Stove/Gas Cook Stove/Misc. Fuel Gas Piping #of Outlets: Ventilation Fan,single duct # Furnace/Heat Pump/ Size: # Ventilation System # Forced Air Unit Plumbing Fixtures Indicate how many of each typa of fixture to be installed or relocated Plumbing Traps # Water Heater # Plumbing Vent piping # Medical gas piping #of Outlets: Water Line # Fuel gas piping #of Outlets: Sewer Line # In ndustrial waste pretreatmet interce for Grease Trap) Size .Other describe T:\BUILDING\APPLICATION FORMMUrrent BP Application\Building Permit 4-17.13.docc PREPARED 3/03/16, 16 : 17 : 31 PAYMENT DUE CITY OF PORT ANGELESPROGRAM BP820L Yom/ ----- ���'1�-� APPLICATION NUMBER: 16-00000316 1704 MELODY CIR PEE DESCRIPTION AMOUNT DUE -------------------------------------------------------------------------- MECHANICAL PERMIT 100 . 00 TOTAL DUE 100 . 00 Please present this receipt to the cashier with full payment. i City of Port 321 Angeles StnePoint PoS Port Angeles NA 98362 Telephone: 366-457-0411 *+�+� SALES SLIP *** Op'r: JLEHON Type: CT Drawer: 1 Date: 3/11/16 01 Receipt no: 26176 Seq no. 1688780 Merch ID #: 0001 Cross ref#: 267415 Card no: ************9162 Card type: VISA CARD Auth code: 077116 Date: 3/11/16 Time: 11:08:12 Payment total: $100.00 CARDHOLDER ACKNOWLEDGES RECEIPT OF GOODS AMD/OR SERVICES IN THE AMOUNT OF THE TOTAL SHOWN HEREON AND AGREES TO PERFORM G n� THE OBLIGATIONS SET FORTH IN THE CARD- HOLDER'S AGREEMENT WITH THE ISSUER. Signature: DAVE TREA1 CUSTOMER COPY CITY OF PORT ANGELES *** CUSTOMER RECEIPT *** Oper: JLEMON Type: CT Drawer: 1 Date: 3/11/16 01 Receipt no: 26176 28 b Number Amount 1704 MELODY CIR PORT ANGELES WA 98362 BP BUILDING PERMITS $100.00 Trans number: 1895905 Jender detail OP CREDIT CARD $100.60 ° `Total tendered $100.00 Total payment $100.00 Trans date: 3/11/16 Time: 11:08:12 ***THANK YOU FOR YOUR PAYMENT*** FOR INQUIRIES 360-457-0411 PRESS 1 WWW.CITYOFPA.US Address: 1704 Melody Circle PREPARED 5/19/16, 9:00:50 INSPECTION TICKET PAGE 4 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 5/19/16 ----------------------- ------ --- ADDRESS . : 1704 MELODY CIR SUBDIV: CONTRACTOR KIMCO PLUMBING INC PHONE (360) 394-7702 OWNER HIGHLAND COURT HOLDING COMPANY PHONE : PARCEL 06-30-14-6-6-0030-0000- APPL NUMBER: 16-00000042 PLUMBING PERMIT PERMIT: PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ----------------- PL2 01 1/28/16 JLL PLUMBING ROUGH-IN 1/28/16 AP January 28, 2016 8:39:32 AM jlierly. mich 206-999-3076 January 28, 2016 4:40:27 PM jlierly. Partial underslab rough in/jll PL1 01 2/02/16 JLL PLUMBING UNDER SLAB 2/02/16 AP February 2, 2016 10:10:00 AM jlierly. Mich 206-999-3076 ' February 2, 2016 4:12:30 PM jlierly. PL2 02 2/19/16 JLL PLUMBING ROUGH-IN 2/19/16 AP February 19, 2016 8:48:03 AM jlierly. Mitch 206-799-30767 February 19, 2016 4:02:25 PM jlierly. PL99 01 5/09/16 JLL PLUMBING FINAL 5/10/16 DA May 3, 2016 12:03:14 PM pbarthol. May 10, 2016 8:55:11 AM jlierly. Items reqd are exit signage and em lighting electrical final and state dept finals/jll PL99 02 5/19/16 JLj4a PLUMBING FINAL May 19, 2016 8:52:12 AM jlierly. Dale --------------------- ---- --------- COMMENTS AND NOTES -------------------------------------- CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY& ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 16-00000042 Date 1/12/16 Application pin number . . . 511998 Property Address . . . . . . 1704 MELODY CIR ASSESSOR PARCEL NUMBER: 06-30-14-6-6-0030-0000- REPORT SALES TAX Application type description PLUMBING PERMIT Subdivision Name . . . . . . on your state excise tax form Property Use . . . . . . . . to the City of Port Angeles Property Zoning . Application valuation . . . . 174925 (Location Code 0502) --. ------------------------------------------------ Application desc ' RPL 2 WATER HEATERS /' RE CONFIG. 5 ADA BATHROOMS. --'-------------------------------------------------------------------------- Owner Contractor �\ HIGHLAND COURT HOLDING COMPANY KIMCO PLUMBING INC 20300 S SOUTH END RD 20714 STATE HWY 305 NE w OREGON CITY OR 97045 SUITE #3A POULSBO WA 98370 q - (360) 394-7702 - --------------------------------------------------------------------------- Permit PLUMBING PERMIT Additional desc COMM REMODEL PLUMBING " Permit Fee . . . . 211.00 Plan Check Fee .00 Issue Date . . . . 1/12/16 Valuation . . . . 0 Expiration Date 7/10/16 Qty Unit Charge Per Extension BASE FEE 50.00 21.00 7.0000 EA PL-PLUMBING TRAP 147.00 s 1.00 7.0000 EA PL-WATER LINE 7.00 1.00 7.0000 PL-WATER HEATER -� -------- -----. -- --- ------------- - -7.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 211.00 211.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 211.00 211.00 .00 .00 1 �Q Separate Permits are required forelectrical work,SEPA,Shoreline,ESA,utilities,private and public improvements. This permit becomes null and void if work or construction authorized isnot commenced within.180 days,if construction or work is suspended or abandoned for a period of 180 days after the work has commenced,or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. F Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder) T:Forms/Building Division/Building Permil BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS— Building Inspections 417-4815 Electrical Inspections 417-4735 Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION: Footings Stemwall Foundation Drainage/Downspouts Piers Post Holes(Pole Bldgs.) PLUMBING: Under Floor/Slab Rough-in Water Line Meter to Bldg) Gas Line Back Flow/Water AIR SEAL: Walls Ceiling FRAMING: Joists/Girders/Under Floor Shear Wall/Hold Downs Walls/Roof/Ceiling Drywall Interior Braced Panel Only) T-Bar INSULATION: Slab Wall/Floor/Ceiling MECHANICAL: Heat Pum /Furnace/FAU/Ducts Rough-In Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts MANUFACTURED HOMES: Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT. Separate Permit#s SEPA: Parkin /Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE Inspection Type _ Date Accepted By Electrical 417-4735 Construction -R.W. PW I Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 THE 4 OF 1 J 1 E For City Use Permit# W AS H I N G T O N, U . S. Date Received: `& 321 E SthStreet Date Approved Port Angeles,WA 9836 P:360-417-4817 F:360-417-4711 Email:permits0cilyofl2a.us BUILDING PERMIT APPLICATION Project Address: 004 Mdodq Urbe , POT+-Am eAeQ, ,Int a a ?Z(oa,, Phone: 3kD0- lay-"1"102 Prima Contact: W\\k1 om V-\Mler Email: X11 a VIMCD QkWm,b ma C Name Phone PropertyihngAddres Email Owner 'ty _ State ZipVffft !13$J MOR 41bu Name Phone `� tim � 310 -Say-��o2 Contractor Address n -D Email kh @ V-imco �� bn • C0TY1 Information City State zip 3� Contractors License# Exp.Date: Legal Description: Zoning: Tax Parcel# Project Value: (materials and labor) O(c'3�Itl-lu-to-D030- $ t-14 q25 •b0 Residential ❑ Commercial 191� Industrial ❑ Public ❑ Permit Demolition ❑ Fire ❑ Repair Reroof(tear off/lay over) ❑ Classification For the following,fill out both pages of permit application: (check New Construction ❑ Exterior Remodel ❑ Addition Tenant Improvement ❑ appropriate) Mechanical 11 Plumbing 63' Other ❑ - Fire Sprinkler Sys em? Irrigation Syste ? •Proposed BathroomsT Proposed Bedrooms Yes 13 No U Yes 13 No � 5 — Project _Project Descri tion 2 ula;a " -help? 817 190"451- 4?Jf 46WS b raan-r s 6� Is project in a Flood Zone: Yes ❑ NoR) Flood Zone Type: f If in a Flood Zone,what is the value of the structure before proposed improvement? $ I have read and completed the application and know it to be true and correct.I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required and to obtain permits prior to work. I understand that plan review fees are not refundable after review has occurred. I understand that I will forfeit review fees if I withdraw the application before the permit is issued. I understand that if the permit is not picked up/issued within 18o days of submittal,the application will be considered abandoned and the fees will be forfeited. Date Print Name Signature Residential Structures For Office Use Area Description(SQ FT) Existing Proposed $$value Basement First Floor Second Floor Covered Deck/Porch/Entry Deck(over 30"or 2'd floor) Garage Carport Other(describe) Area Totals Commercial Structures For Office Use Area Descriptions(SQ FT) Existing Proposed $$Value Existing Structure(s) Proposed Addition Tenant Improvement? Other work(describe) f Site Area Totals j Lot/Site Covera a Calculations Lot Size(sq ft) Lot Coverage(sq ft) %Lot Coverage(Total lot coverage_lot size) Site Coverage(Sq Ft of all impervious) %of Site Coverage(total site coverage=lot size) Mechanical Fixtures Indicate how many of each type of fixture to be installed or relocated as part of this project. Air Handler Size: # Haz/Non-Haz Piping Outlets: Appliance Exhaust Fan # Heater(Suspended,Floor,Recessed wall) # Boiler/Compressor Size: # Heating/Cooling appliance # re air/alteration Evaporative Cooler(attached,not # Pellet Stove/Wood-burning/Gas # portable) Fireplace/Gas Stove/Gas Cook Stove/Misc. Fuel Gas Piping #of Outlets: Ventilation Fan,single duct # Furnace/Heat Pump/ Size: # Ventilation System # Forced Air Unit Plumbing Fixtures Indicate how many of each type of fixture to be installed or relocated Plumbing Traps # Fuel gas piping #of Outlets: Water Heater # Medical gas piping #of Outlets: Water Line # Plumbing Vent piping # Sewer Line # Industrial waste pretreatment interceptor Grease Trap) Size Other(describe): T:\BUILDING\APPLICATION FORMS\Current BP Application\Building Permit 4-17-13.docx Address: 1704 Melody Circle i P PREPARED 5/19/16, 9:00:50 INSPECTION TICKET PAGE 2 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 5/19/16 ------------------------------------------------------------------------------------------------ ADDRESS . : 1704 MELODY CIR SUBDIV: CONTRACTOR YORKE & CURTIS INC PHONE (503) 646-2123 OWNER HIGHLAND COURTE ALZHEIMER COMM PHONE PARCEL 06-30-14-6-6-0030-0000- APPL NUMBER: 15-00000992 COMM REMODEL PERMIT: BPC 00 BUILDING PERMIT - COMMERCTAT• REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ----------—---------------------------------—----------------------—----—------------------ BLDR 01 2/22/16 JLL BLDG DRYWALL IBWP 3/11/16 AP February 22, 2016 11:02:00 AM jlierly. Dale 971-317-6292 March 11, 2016 8:20:47 AM jlierly. BL3 01 2/26/16 JLL BLDG FRAMING 2/26/16 AP February 26, 2016 9:02:33 AM jlierly. Dale 971-317-6292 February 26, 2016 4:23:38 PM jlierly. BL99 02 5/09/16 JLL BLDG FINAL 5/10/16 DA May 3, 2016 12:03:41 PM pbarthol. May 10, 2016 8:55:11 AM jlierly. Items reqd are exit signage and em lighting electrical final and state dept finals/jll BL99 01 5/09/16 JLL BLDG FINAL 5/10/16 DA May 3, 2016 12:00:53 PM pbarthol. Dale 971-317-6292 May 10, 2016 8:55:11 AM jlierly. Items reqd are exit signage and em lighting electrical final and state dept finals/ill BL99 03 5/19/16 L BLDG FINAL May 19, 2016 8:50:17 AM jlierly. Dale 971-317-6292 -------------------------------------- COMMENTS AND NOTES -------------------------------------- CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT- BUILDING DIVISION `ri 321 EAST 5TH STREET, PORT ANGELES,WA 98362 Application Number . . . . . 15-00000992 Date 9/25/15 Application pin number . . . 391040 AddressProperty ASSESSOR PARCELNUMBER: 06030-14-6 -6 -0030-0000- REPORT SALES TAX Application type description COMM REMODEL Subdivision Name . . . . . On your state excise tax form Property Use . . . . . . . . to the City of Port Angeles Property Zoning (Location Code 0502) Application valuation 907500 Application desc INTERIOR REMODEL FOR MEMORY CARE FACILITY ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ _ HIGHLAND COURTE ALZHEIMER COMM YORKE & CURTIS INC 385 ERICKSON AVE #123 4480 SW 101ST AVE BAINBRIDGE ISLAND WA 98110 BEAVERTON OR 97005 (503) 646-2123 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT - COMMERCIAL Additional desc INTERIOR REMODEL Permit Fee . . . . 5198.25 Plan Check Fee 3378.86 Issue Date . . . 9/25/15 Valuation . . . . 907500 1 Expiration Date 3/23/16 Qty Unit Charge Per Extension BASE FEE 3260.25 408.00 4.7500 THOU BL-500,001-1M (4.75 PER K) 1938.00 Special Notes and Comments September 16, 2015 9:31:43 AM pbarthol. Mechanical and Plumbing permits will be applied for separately. Prior to any mechanical or plumbing work being started permits will be applied for and r1� issued.pb va August 14, 2015 11:40:21 AM tamiot. ELECTRICAL PERMIT REQUIRED FOR ANY AND ALL ELECTRICAL WORK. IF THERE ARE ANY CHANGES TO THE ELECTRICAL LOAD CALCULATIONS REQUIRED. IF THE ELECTRICAL SERVICE INCREASES THERE MAYBE ADDITIONAL COST TO UPSIDE THE TRANSFORMER. August 17, 2015 7:24:02 AM rbecker. After you get the fire sprinkler system up and going again. You will need to have the backflow tested. Next year you will need to have the backflow on the lawn sprinkler tested. If you have any questions call Ron Becker at 360-417-4886, Fax:360-452-4972, or E-mail:rbecker@cityofpa.us This project will require seperate permit and fire sprinkler plans for review. This project will require a seperate permit and fire alarm plans for review. August 18, 2015 8:53:42 AM kdubuc. Separate Permits are required forelectrical work,SEPA,Shoreline,ESA,utilities,private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days,if construction or work is suspended or abandoned for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. J Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder) T:Forms/Building Division/Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS— !' Building Inspections 417-4815 Electrical Inspections 417-4735 . Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886 16 IT IS UNLAWFUL,TO COVER,INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. IW POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION: Footings Stemwall Foundation Drainage/Downspouts Piers Post Holes(Pole Bldgs.) PLUMBING: Under Floor/Slab Rough-in Water Line Meter to Bldg) Gas Line 1 Back Flow/Water FINAL Date Accepted b AIR SEAL: Walls Ceiling FRAMING: Joists/Girders/Under Floor Shear Wall/Hold Downs Walls/Roof/Ceiling Drywall Interior Braced Panel Onl T-Bar INSULATION: Slab Wall/Floor/Ceiling MECHANICAL: Heat Pum /Furnace/FAU/Ducts Rough-In Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts FINAL Date Accepted b MANUFACTURED HOMES: Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT. Separate Permit#s SEPA: Parkin /Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE Inspection Type Date Accepted By Electrical 417-4735 Construction-R.W. PW /Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 T:Forms/Building Division/Building Permit CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY&ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES,WA 98362 Page 2 Application Number . . . 15-00000992 Date 9/25/15 Application pin number 391040 -_-_ REPORT SALES TAX ------ Special Notes and Comments on your State excise tax form Any changes to fire alarm or fire sprinkler systems will require plans. to the City of Port Angeles Public Works Utility Engineering has no requirements for (Location Code 0502) this plan review. ---------------------------------------------------------------------------- Other Fees . . . . . STATE SURCHARGE 4.50 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 5198.25 5198.25 .00 .00 Plan Check Total 3378.86 3378.86 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 8581.61 8581.61 .00 .00 Separate Permits are required forelectrical work,SEPA,Shoreline,ESA,utilities,private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within.180 days,if construction or work is suspended or abandoned for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder) T:Forms/Building Division/Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS— Building Inspections 417-4815 Electrical Inspections 417-4735 Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886 IT IS UNLAWFUL.TO COVER,INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION: Footings Stemwall Foundation Drainage/Downspouts Piers Post Holes(Pole Bldgs.) PLUMBING: Under Floor/Slab Rough-In Water Line Meter to Bldg) Gas Line Back Flow/Water FINAL Date Accepted b AIR SEAL: Walls Ceiling FRAMING: Joists/Girders/Under Floor Shear Wall/Hold Downs Walls/Roof/Ceiling Drywall Interior Braced Panel Only) T-Bar INSULATION: Slab Wall/Floor/Ceiling MECHANICAL: Heat Pum /Furnace/FAU/Ducts Rough-In Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts FINAL Date Accepted b MANUFACTURED HOMES: Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT. Separate Permit#s SEPA: Parkin /Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE Inspection Type Date Accepted By Electrical 417-4735 Construction- R.W. PW /Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 T:Forms/Building Division/Building Permit �r THE � For City Use CITY C!F ��� ► E ,. - � Q E Permit# /'6- !?P— W A s M I N G T © N, U . S . Date.Received: 321 E 5th Street ate Approved r� Port Angeles,WA 9836 P:360-417-4817 F:360-417-4711 Email:permits@cityofpa.us BUILDING PERMIT A PLICATION Project Address: p ,FYI f.1-0/J -1 Phone:503-952-1397 Prima Contact: Mark Miller/Ankrom Moisan Archite 92 Email:markcm@ankrommoisan.com NamePhoneCourte Holding Co., LLC Phone503-706-0878 Property Mailing Address 20300 S. South End Rd. Emati Owner terriw@beniciallc.com c'tyOregon.City State OR Zlp 97045 Name Yorke & Curtis, Inc. Phone503-646-2123 Contractor Address 4480 SW 101 st Ave. Email phillips@yorkeandcurtis.com Information city Beaverton state ORI Zip 97005 Contractor.License#YORKEC11 26DT Exp.Date:09/21/2016 Legal Description: Zoning: Tax Parcel# Project Value: (materials and labor) Highland Commons Lot 3 RHD 0010-PA 121 PORT STCNTYH2LWMP Residential ❑ Commercial 8 Industrial ❑ Public ❑ Permit Demolition ❑ Fire ❑ Repair ❑ Reroof(tear off/lay over) ❑ Classification For the'following.fill out both pages of permit application: (check New Construction ❑ Exterior Remodel ❑ Addition ❑ Tenant Improvement 8 appropriate) Mechanical ❑ Plumbing ❑ Other ❑ Fire Sprinkler System Proposed Irrigation System Proposed or Proposed Bathrooms Proposed Bedrooms or Existing? Yes N No ❑ Existing? Yes N No ❑ 1. In addition to standard hard copy submittals please send a PDF copy of all Stormwater plans and Engineering to www.stormwater ci o a.us Project Description The existing facility was originally licensed for Memory Care (circa 1998). Since then, the facility was converted into an Alcohol Rehabilitation Clinic, and then sat vacant for the past 3-4 years. It is proposed to re-open as a Memory Care facility with upgraded interior finishes and renovated interior support spaces (within existing footprint). No new square footage is being added to the site with the exception of approximately 270 sf of new sidewalk extensions. Mechanical, Electrical, and plumbing will be under separate trade permits. Is project in a Flood Zone: Yes ❑ No8 Flood Zone Type: If in a Flood Zone, what is the value of the structure before proposed improvement? $ I have read and completed the application and know it to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required and to obtain permits prior to work. I understand that plan review fees are not refundable after review has occurred. I understand that I will forfeit review fees if I withdraw the application before the permit is issued. I understand that if the permit is not picked up/issued within 18o days of submittal,the application will be considered abandoned and the fees will be forfeited. Mark Miller Date 07/24/2015 Print Name Signa ure •f' Residential Structures Existing Proposed Construction For Office Use Area Descriptions(SQ FT) Floor area Floor area $Value new area Basement First Floor Second Floor Covered Deck/Porch/Entry Deck(over 30"or a° floor) Garage Carport Other(describe) Area Totals Commercial Structures Area Descriptions (SQ FT) Existing Proposed Construction For Office Use Floor area Floor area $Value new area Existing Structure(s) 16,700 16,700 Proposed Addition N/A N/A Tenant Improvement? 16,700 16,700 Other work(describe) Site Area Totals 16,700 16,700 Lot/Site Coverage Calculations r Lot Size(sq ft) Lot Coverage(sq ft)foot print of %Lot Coverage(Total lot cov-lot size) Max Bldg Height 109,771 all structures 16,880 sq ft 15% 120'+/- Site Coverage (Sq Ft of all impervious) %of Site Coverage(total site cov_lot size) 45,430(16,880 buildings+28,550 sidewalks,etc.) 42% Mechanical Fixtures Indicate how many of each type of fixture to be installed or relocated as part of this project. Air Handler Size: # Haz/Non-Haz Piping Outlets:. Appliance Exhaust Fan # Heater(Suspended,Floor,Recessed wall) # Boiler/Compressor Size: # Heating/Cooling appliance # repair/alteration Evaporative Cooler(attached,not # Pellet Stove/Wood-burning/Gas # portable) Fire lace/Gas Stove/Gas Cook Stove/Misc. Fuel Gas Piping #of Outlets: Ventilation Fan,single duct # Furnace/Heat Pump/ Size: # Ventilation System # Forced Air Unit Plumbing Fixtures Indicate how many of each type of fixture to be installed or relocated Plumbing Traps # Water Heater # Plumbing Vent piping # Medical gas piping #of Outlets: Water Line # Fuel gas piping #of Outlets: Sewer Line # Industrial waste pretreatment interce for Grease Trap) Size Other(describe): T:\BUILDING\APPLICATION FORMS\Current BP Application\Building Permit 4-17-13.docx ZZGENERAL NOTES ----------- KEYNOTES C) F—&7 EXISTING ONE-STORY STRUCTURE 0 SITE DATA z 0 O LD LEGAL DESCRIPTION = "o I 1101HICH-1-101-1 EXISTING APARTMENT BUILDING SITE PLAN CRS REVIEW& PERMIT SET o 'A' SITE 30JULY 15 PLAN o A1.01 CrL Community&Economic Development City of Port Angeles 321 E.S'h Street Port Angeles,WA 98362 August 6,2015 To all concerned parties: As Managing Member of Highland Courte Alzheimer's Community LLC, I am authorizing Highland Court Holding Company, LLC to submit for building and land-use permits related to the property at 1704 Melody Circle, Port Angeles,WA. Highland Court Holding Company, LLC is under contract to purchase this property,and the transaction is scheduled to close on or about October 1, 2015. Rick Anderson STATE OF WASHINGTON COUNTY OF CLAU AM I certify that I know or have satisfactory evidence that l person who appeared before me and said person ac nok wl�e�ge tat e is the p ppe , signed this instrument and acknowledged it to be free and voluntary act for the uses and purpose mentioned in this instrument. Dated: r to name: Kidiy Grice s 74oq� ��' State of Notary Public: Washington : Residing in: Port Angeles Expires: 2/28/2019 r ?