HomeMy WebLinkAboutBLD2004-00497 MANUFACTURED/MOBILE HOME INSTALLATION PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT#: BLD04-00497 Received Date: 7/26/20
SITE ADDRESS: 345 PORT HADLOCK HEIGHTS RD Issue Date: 8/4/2C
PORT HADLOCK, 98339
APPLICANT: RON CHASE
C/O BRODERS, INC
4503 OLD GARDINER RD
PORT TOWNSEND WA
SUBDIVISION: PORT HADLOCK HEIGHTS MH9778 PARK Block:
Lot:
PARCEL#: 989500001 Section: 11 Township: 29 N Range: 01 W
CONTRACTOR/ JAIME KOZELISKY PHONE: (360)385-3215
DEALER 1112 S JACOB MILLER RD
PORT TOWNSEND WA 98368
Contractor's License KOZELHS027C3 Expires 01/06/2005
INSTALLER: JAIME KOZELISKY WAINS0626 Expires: 7/31/200i
1112 S JACOB MILLER RD PORT TOWNSEND WA
98368
PROJECT DESCRIPTION: NEW MANUFACTURED HOME
MAKE: GOLDENWEST
YEAR: 2004
SIZE: 52 X 27
THIS PERMIT IS VALID FOR ONE YEAR.
THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR.
THE EXPIRATION DATE IS 8/4/2005.
REQUIRED INSPECTIONS: / /
[ ] /Footing (CONTINUOUS FOOTIN(SLA 0r PADS USED): 2A( g/7/p/
[ ] Stormwater FINAL Approval:[ ] Blocking/Plumbing: KiA- /7•� powriS OK Q/Z414/
[ ] Propane Tank/Lines /
[ ] Zoning Final Approval:
[ ] Septic System Final Approval:
[ ] Road Approach Final Approval:
[ ] Final/Skirting/Vents/porches/Steps: -cor- -Pt yea; l[//5/s
HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION
BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9:00 a.m. -4:30 p.m.
SPECIAL CONDITIONS APPLY- SEE REVERSE
HOT-LINE AVAILABLE 24 HOURS A DAY
• •
SPECIAL CONDITIONS CASE # BLD04-00497
1.) The application was reviewed by the Jefferson County Department of Community
Development staff on July 29, 2004 for the potential presence of Environmentally
Sensitive Areas (ESAs) under the provisions of the Unified Development Code (UDC).
After an initial Geographic Information Systems mapping review and an investigative site
inspection, the following ESAs were confirmed to be present on the subject property:
Special Aquifer Recharge Protection Areas.
2.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological
formations that allow percolation of the surface water into the soils and the underlying
zone of saturation. Aquifers are geologic formations that contain sufficient saturated
permeable material to yield significant quantities of water to wells and springs. Aquifers
serve as the source of drinking water within most of the rural portions of Jefferson County.
3.) Critical Aquifer Recharge Areas are defined as Seawater Intrusion Areas, and Special
Aquifer Recharge Protection Areas and the following land uses located within Susceptible
Aquifer Recharge Areas (1)All Industrial Land Uses (2)All Commercial Uses (3)All Rural
Residential Land Uses requiring a Discretionary Use or Conditional Use Permit (4)All
Rural Residential Land Uses with nonconforming uses that would otherwise require a
Discretionary Use or Conditional Use Permit (5) Unsewered Planned Rural Residential
Developments (6) Unsewered residential development with gross densities greater than
one unit per acre. All of the above listed uses shall be subject to the applicable
requirements and standards of the Jefferson County Unified Development Code.
4.) Critical Aquifer Recharge Areas may require special protection measures to mitigate water
quality degradation. The submitted proposal does not require additional aquifer
protection measures. However, during construction the project shall follow the Best
Management Practices (BMPs) and facility design standards as identified and defined in
the Stormwater Management Manual for the Puget Sound Basin.
5.) The applicant is proposing to create or add 1904 square feet of impervious surface and
4500 square feet of land disturbing activities. Sections 6.6 and 6.7 of the Jefferson
County Unified Development Code requires that your proposal shall adhere to Best
Management Practices (BMPs).
6.) Jefferson County determined that this proposal is categorically exempt from review under
the State Environmental Policy Act (SEPA) pursuant to WAC 197-11-800(1)(b)(i).
7.) The site plan as submitted with the building permit application on July 26, 2004 has been
reviewed for consistency under the UDC, and has been approved by Jefferson County
Department of Community Development. Any modifications, changes, and/or additions to
the stamped, approved site plan dated July 29, 2004 shall be resubmitted for review and
approval by Jefferson County Department of Community Development.
8.) This approval is for a manufactured hime only. Any future permits on this site are subject
to review for consistency with applicable codes and ordinances and does not preclude
review and conditions which may be placed on future permits.
9.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
10.) Not more than two (2) unlicensed or inoperable vehicles shall be stored on any lot less
than one-half acre unless totally screened from view of neighboring dwellings and
rights-of-way. Such screening shall meet all applicable performance and development
standards specific to the district in which the storage is kept, and shall be in keeping with
the character of the area. Screening shall meet the requirements of Unified Development
Code (UDC) Section 6. Outdoor storage of thirteen (13)or more unlicensed or inoperable
vehicles is prohibited except in those districts where specified as an automobile wrecking
yard or junk (or salvage)yard and allowed as a Permitted Use in Table 3-1 of the UDC,
and such storage shall meet the requirements of UDC Section 4.10. In no case, shall any
such unlicensed or inoperable vehiclesbe stored in an Environmentally Sensitive Area
(ESA).
11.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
12.) The building height is not to exceed 35 feet.
13.) Minimum setback from Port Hadlock Heights Rd right-of-way is 20 ft. Minimum side and
rear setbacks are 5 ft.
•
14.) This parcel was created through the Port Hadlock Heights
Plan, filed of record April 15, 1998 under AFN g Mobile in Vol 1, page
28-32 k Binding Site
with t
Jefferson County Auditor's office. The binding site plan was reviewed by Jefferson County
Department of Community Development under BSP94-00001.
15.) Community Drainfield "C" (SEP95-00290)serves this site and was finaled January 4,
2002. A septic permit (SEP04-00168)was approved on August 13, 2004 for a septic tank
and pump chamber to be connected to Community Drainfield "C".
16.) Port Hadlock Heights Rd (P516) is a private road. The road approach is existing and an
address of 345 Port Hadlock Heights Rd has been assigned to Lot 31.
17.) This parcel has been designated as Rural Residential 1:5 under the Jefferson County
Comprehensive Plan Land Use Map effective August 28, 1998.
18.) A minimum of two (2)on-site parking spaces are required for the manufactured home.
19.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP)
Elements#1 through #12 of the Department of Ecology's Stormwater Management
Manual for Western Washington to control stormwater, erosion and sediment during
construction. BMPs shall address permanent measures to stabilize soil exposed during
construction, and in the design and operation of stormwater and drainage control systems.
20.) This parcel is served by a public water system.
APPROVED
SITE PLAN
Stormw ter BMP's
JUL 2 9 2004 Require
•
JEFFERSON COUNTY
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! • i MLA04-00467
Review Type: 1
MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD04-00497 Received Date: 7/26/2004
SITE ADDRESS: 345 PORT HADLOCK HEIGHTS RD
PORT HADLOCK, 98339
APPLICANT: BRODERS INC PHONE: (360) 797-7722
4503 OLD GARDINER RD
PORT TOWNSEND WA 98368-9778
SUBDIVISION: PORT HADLOCK HEIGHTS MH PARK Block: Lot: 37
PARCEL NUMBER: 989500001 Section: 11 Township: 29 N Range: 01 W
CONTRACTOR/ JAIME KOZELISKY PHONE: (360)385-3215
DEALER: 1112 S JACOB MILLER RD
PORT TOWNSEND WA 98368
Contractor's License WAINS0626 Expires 7/31/2004
INSTALLER: JAIME KOZELISKY WAINS0626 7/31/2004 (360)385-3215
1112 S JACOB MILLER RD PORT TOWNSEND WA
98368
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION: NEW MH
TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE:
TYPE OF IMP NEW
MAKE: GOLDENWEST SETBACK:
VALUATION 55,000.00
YEAR: 2004
LABOR & INDUSTRIES APPROVAL? SIZE: 52 X 27 BANK HEIGHT:
SEWAGE DISPOSAL: CMY
WATER SYSTEM: PUD
BEDROOMS: BATHROOMS: PARCEL TAGS: YES NO
Exist: Exist: STORMWATER: YES NO
Prop: 2 Prop: 2 AREA Plat Conditions
Total: 2 Total: 2 Wetland Erosion
Seismic Streams
Flood Way Floodplain
Routing Date: - 7/.-z- nF&WLandslide
/� rg-7t;� Shoreline Aquifer
[r-.IU
Type Amount Paid By: Date: Receipt: A PpprO V E ED
Manufactured Homes $154.00 KAS 07/26/04 66701
Potable Water Application $52.00 KAS 07/26/04 66701 AUG - 4 2004
Total: $206.00 Jefferson County Planning
& Building Department
! LACK WEST- MAN 111 , JtFfrtRNON COUNTY ASSESSOR
ASSEM OR d • JEFFERSON COUNTY COURTHOUSE
09(1
PO BOX 1220, PORT TOWNSEND WA 98368
(360)385-9105
MOBILE HOME INFORMATION FORM
OWNER'S NAME / MAILING ADDRESS:
NAME: Q o n C ase o THIS IS NOTA TAX STATEMENT
iwc
ADDRESS: $63 .1The purpose of this questionnaire is to obtain information
�s��;hsa- mod. regarding either the current location of a mobile home or the
previous ownership and location of a mobile home. This will
0r T c..rs,r� 1 helpour office determine whether the mobile
J �A 8 3gB home is already
obi the tax rolls in Jefferson County_or if it has been moved to
TELEPHONE NO: .360-747 77 2 21 • this county from another area. Please see reverse side for
-- additional information.
i 1 •
•
1) MOBILE HOME DATA:
1
1
(A) MAKE Go Lie 11 •
�U e c 4- (B) MODEL G 4
(D) LENGTH 5'L
D2 (C) YEAR a o �/
(E) WIDTH 2 7
(G) YOUR PURCHASE PRICE(DO NOT INCLUDE SALES TAX (F)SERIAL NUMBER
)_ $S O OD
(H) PURCHASE DATE T ty Zd c cf
2) PREVIOUS OWNER / LOCATION OF MOBILE HOME:
(A) FROM WHOM DID YOU PURCHASE MOBILE
/ t 6ti' e
ADDRESS 2 `
6 / 5 3 3
(B) WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR? y w .2 `,In, As g.3 $
NO (IF NO, WHAT COUNTY?
IF YES,WHAT WAS PREVIOUS ADDRESS OF MOBILE?
3) WHERE MOBILE HOME IS TO BE LOCATED:
(A) WILL THE MOBILE HOME BE IN A MOBILE HOME PARK? ��� N O
(B) IF LOCATED IN A MOBILE HOME PARK:
NAME at ADDRESS OF PARK br-71, .7-a gib cK
He I. fits �o7t-
(C) IF NOT LOCATED IN A MOBILE HOME PARK: 3 S /Do+ fr l�clC Sf"ReeNO. 3 /
t,jlf fJ /eet
NAME OF LAND OWNER:
LOCATION(ADDRESS)
REAL PROPERTY PARCEL NUMBER/DESCRIPTION
HANK YOU FOR YOUR HELP! c
4*' ----ri/.
SIGNATURE r 6 Ift
iLLI LARSON, roperty Technician
THIS FORM CONFORMS TO THE STANDARDS OF THE STATE DEPARTMENT OF REVENUE AND IS SUBJECT TO AUDIT VERIFICATION.
o»4",,:3
JEFFERSON CO1-y
i ` " re
DEPARTMENT OF COMMUNITY DEVELOPMENT A •? ` j
621 Sheridan Street • Port Townsend • r.� _ ��,�` 360/37 jeffer • 360/379 gton 98368 ,� JV lij
4451 Fax �. 2 6 r 6
Nrs` O www.cojefferson.wa.us/commdevelopmentit, ;
Master Permit � 1
,! ----__Application r,� r. nr LF,,. ,011,17y��
rp4 11.+N17.•pr.,
Project Description(include separate sheets as necessary): MLA' E(_P�►trEn�
4r,V i,G(C..v.d
Tax Parcel "K C v�3-�,�t1 .�ioy
p
Number: g q 5 O o b enProperty
o� 31 Size: 7 q 2 7 ��2
Property Owner(s)of Record: 3 C °~� �'�11 be (acres/square feet)
Site Address and/or Directions to Pro
Telephone: ODE E R !N C• �6' h�s d o t cif'
366— 74 7, 7?2
Mailing Address. Z Fax:
tea Old ah d(arr RdN email:
Applicant/Agent(if different from owner): °"� To
Telephone: list-,1 Lc. 3��
Mailing Address: Fax:
email:
What kind of Permit?(Check each box that applies)
❑ Building
0 Demolition Permit ❑ Variance 0 Single Family (Minor,Major or Reasonable Economic Use)
0 Conditional Use fC(a),C(d),or C]**
0 Garage Attached/Detached
Manufactured Home 0 Discretionary"D"or Unnamed Use Classification
O Modular 0 Special Use(Essential Public Facilities)**
❑Commercial* 0 Boundary Line Adjustment
0 Change of Use 0 Short Plat
❑Address 0 Binding Site Plan**
ID Propane
0 Plat Vacation/Alteration**
�— 0 Road Approach 0 Long Plat**
❑Mowed"Yes"Use0 Planned Rural Residential Development
0 Stormwater Management Consistency Analysis (PRRDy'gm�dments**
0 Site Plan ❑0 Shoreline Master Program Exemption/Permit Revisions**
Approval Advance Determination(SPAAD)* ❑ Shoreline Management Substantial Development**
❑Temporary UseShoreline Management Variance
nt
Forest Practices Act/Release of Six-Year Moratorium 0 Comprehensive Plan/UDC/Land Use District Ma
0 Jefferson County Shoreline Master Program Amendmeendrnent
❑Wireless Telecommunication
*Ma re.uire a Pre—A..lication Conference
**Re•wires a Pre-r
Please identify any other local, state or federal permits required for this •1.l
proposal,
ifn Conference
known:
I hereby designate DESIGNATION OF AGENT
OWNER SIGNATURE to act as my agent in matters relating to this application for
Permit(s).
By signing this application form,the owner/agentDate:
Bhiy,her nr ith kapplic o. attests that the information provided herein,and in anyattachments,
may result in this g Any material falsodehood or any omission of a material fact made the o
Permit being null and void, thr is cue and correct toithe best of
I further agree to save,indemnify and hold harmless Jefferson by der/agent with respect to this a
expenses which may P pPGcation packet
y in any way accrue County against all liabilities,judgments,court
I further agree to ay in accessagainst Jefferson County as a result of or in costs,reasonable permit
attome
review and any required later n and right of� consequence of the Ys fees and
try to Jefferson County and its employees, granting of this Permit
hours. inspections.Access and right of en p yam•representatives or agents for the sole u
to this Property shall be requested and shall purpose of application
Signature: occur only during regular business
The action or actions Date: /2 a. .LC•y
endangeredApplicant will undertake as a result of the issuance of this `
species and could lead to a
or
S potential"take"of an endangeredpermit may perms a le impact in the one or more known threatened the
Species Act"or"ESA."Jefferson Coup species as those to
"Endangeredrdu been swill not violate the ESA Any makes no assurancesterms defined is federal law ken e aas
permit has en in you issuedre innotcompliance to the applicant thati the behalf of an will be undertaken because this
y individual,group or agency can file a lawsuit on
and non-transf with the Jefferson County development code.The
ble res bill behalf an endangered species
ty or a erng to and complyln9 with the E Applicant acknowledges that he,she or it holds individual your
Signature: SA. The
Applicant has read this disclaimer and signs and dates it below.
Date:22L.
C:\PermitCencer\FORMS DRD FORMS\Master Permit
Application 7-8-04.doc
OWNER BUILDER STATEMENT
they are the Owners of the par
cel referenced here,they are not licensed contractors and that
signer of this statement does hereby certify 1 Contractor for the proposed project.
:y will be assuming the responsibility of the Genera
Date:
mature:
PHONE: Fes'
ENERAL CONTRACTOR OR MANUFACTURE SHOME INSTALLER: NE: 3 SS 3 4 ( )
'�onto- ° % e L EMAIL:
(AILING ADDRESS: I �'�C.b •1`+Y d 17 WAINS
IUMBECTOR'S LICENSE NUMBER 6-2E L.S M 20 o tor
(UMBER: PHONE ( ) FAX.( )
�RCHRECTIENGINEER: EMAIL
RAILING ADDRESS: Disposal:
Bathrooms:
Shoreline: Type of Sewage I'�
Frame Type: ❑ Sewer
3rojectType: ❑ Wood Existing: �— Bank mmunity System
New p Steel Proposed. —z
L Addition Total: Height: ❑ Individual System
❑ Concrete SEP Permit#
❑ Alteration/Remodel 0 Masonry Water Supply:
O Repair Bedrooms:
❑ Other: Existing: Setback: ❑ Private well ❑ Two Party
❑ Demolition 2, Public Pu D
Proposed:
Type of Heat: Total:
Y Name of System: 'NW- Pi°`^
If this is a Commercial Pro ect ou must answer the----plowosed.--- Number of ADA Parking Spas:
Number of Parking Spaces: Current Current proposed
Number of occupants(includes owners,tenants,employees,etc) Will you have Food Service? __Yes/No
IBC Type of construction:
If this is a Pro
_ all items below that a I -
ff is a Pro are Tank and/or liance Installation rrri �f Propane Tank:
0 Underground Tank 0 Above ground Tank
U Heat Stove ❑ Cook Stove 0 Woodstove o Fireplace
/Mobe(nsert Home?17Yest/Water Tank 0 Pellet Stove ❑ Other s all property
Is When
a li nge bein mitinstalledto i a Manufactured and septic system canp
for a permit to install a propane tank you must also submit a site plan showing all of the buildings,
When applyinglines,buildings
lines,tank location and size,distances from the propane tank to all property
includin! the reserve area. b1�0ffi� p„ly
S•uare Foots
Pr' • ..ed t y 4
Consistency Review: Al ;
.00 Main Floor ... ..
r . .00
2'' Floor , t
3' Floor •)Section:
,JULPlan checkfee:
2 6 �04
• . State Surcharge 1MMIII. _ .65;ign. ,
Heated Basement
'ate //�)f/R�j
i''1.4)0 4 R 'Pot Watet"Revierly 7 V lr/
Unheated Basement D''vY. C '
gt'l/Rd Appitochii 7 h Li..:. Y- � �' .,
` F � Asa
Other Unheated
Garage/Carport 4 pN ij t r P�
Decks
as raz
•; -
Y`: r , � n y3� R a
Other ^,r i. ,
..,...„:t4:,. .....i.,..,,,y„...,„:,....:.:.44 .v....,: .
ESTIMATED COST(REQUIRED) t r ,
` * "
.Fair market value of all labor and materials foundation to finish F i 1,•. : •4,
.\P itCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doe