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HomeMy WebLinkAboutBLD2004-00609 11. 11/1 ML 568 Revieweview Type: MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD04-00609 Received Date: 9/27/2004 SITE ADDRESS: 23 PORT HADLOCK HEIGHTS PL PORT HADLOCK, 98339 APPLICANT: BRODERS INC PHONE: (360)797-7133 4503 OLD GARDINER RD PORT TOWNSEND WA 98368 SUBDIVISION: PORT HADLOCK HEIGHTS MH PARK Block: Lot: 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 7/31/2007 INSTALLER: JAIME KOZELISKY WAINS0626 7/31/2007 (360)385-3215 1112 S JACOB MILLER RD PORT TOWNSEND WA 98368 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION: NEW MFH TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: CHAM/SILVER SETBACK: VALUATION 45,800.00 YEAR: 2005 BANK HEIGHT: LABOR & INDUSTRIES APPROVAL? SIZE: 48 X 26 SEWAGE DISPOSAL: ALT WATER SYSTEM: PUD PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO Exist: Exist: AREA Plat Conditions Prop: 2 Prop: 2 Wetland Erosion Total: 2 Total: 2 Seismic Streams Flood Way Flood plain Routing Date: ;2 9 /ciF&W Landslide lShoreline mm,,- A RP Type Amount Paid By: Date: Receipt: Ar ,9ye2/4aJQt} Manufactured Homes $154.00 KAS 09/27/04 67759 Jefferson County Planning Potable Water Application $52.00 KAS 09/27/04 67759 & Building Department Total: $206.00 C_W UY\ r a-L _ tor 612 40tafi-y) • • 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#: BLD04-00609 Received Date: 9/27/2004 SITE ADDRESS: 23 PORT HADLOCK HEIGHTS PL Issue Date: 10/21/2004 PORT HADLOCK, 98339 APPLICANT: KELLI LARSON PO BOX 1608 PORT HADLOCK WA 98339 SUBDIVISION: PORT HADLOCK HEIGHTS MH PARK Block: Lot: PARCEL#: 989500001 Section: 11 Township: 29 N Range: 01 W CONTRACTOR/ DEALER INSTALLER: WASHINGTON HOME CENTEENSS420 Expires: 2/28/200, PO BOX 176 CHEHALIS WA 98532 PROJECT DESCRIPTION: NEW MFH MAKE: CHAM/SILVER YEAR: 2005 SIZE: 48 X 26 THIS PERMIT IS VALID FOR ONE YEAR. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 10/21/2005. CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. Setbacks/Footing (CONTINUOUS FOOTING, SLAB or PADS USED): ±*„%c 5A)c_res OK PEE' L bi.R-1'/0;c1 /1./ra GlVat) BY f) ,,t,- / /il/c Stormwater FINAL Approval: Blocking/Plumbing: �Z�3.-0 / Propane Tank/Lines NA- Zoning Final Approval: Septic System Final Approval (If not on sewer): Road Approach Final Approval: Final/Skirting/Vents/Porches/Steps: 4 7.1-erA; r .., s to t'n��� �z12//r HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. HOT-LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS APPLY-SEE REVERSE -• __ _ JACK WESTERMR III JEFFERSON COUNTY COURTHOUSE ASSESSOR p yV1A PO BOX 1220,PORT TOWNSEND WA 98368 SEF 2 � 2004 (360) 385-9105 MOBILE HOME INFORMATION FORM OWNER'S NAME / MAILING ADDRESS: THIS IS NOTA TAX STATEMENT NAME: \l C� t 1.1 raw, The purpose of this questionnaire is to obtain information �P� regarding either the current location of a mobile home or the ADDRESS: PC) Y�)( previous ownership and location of a mobile home. This will l Wii 11\\GL help our office determine whether the mobile home is already ��3 on the tax rolls in Jefferson County or if it has been moved to this county from another area. Please see reverse side for TELEPHONE NO: S3 - D 7 i addtional information. 1) MOBILE HOME DATA: e I,,,x m ei m \ (A) MAKE �I I UIXC,CS-- (B) MODEL ', ) x C�`� C ✓� (C) YEAR <(N10`J RIA�NUMBER (D) LENGTH t� (E) WIDTH (F)SE I ' (G) YOUR PURCHASE PRICE(DO NOT INCLUDE SALES TAX) Li 3 UI\O DO (H) PURCHASE DATE 2) PREVIOUS OWNER / LOCATION OF MOBILE HOME: (A) FROM WHOM DID YOU PURCHASE MOBILE ADDRESS (B) WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR? YES 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? y NO (B) IF LOCATED IN A MOBILE HOME PARK:11 I 1 - J I O ' j L.04- NAME ez ADDRESS OF PARK pi'" t�W 1 I o h t C�V�S SPACE NO. —f (C) IF NOT LOCATED IN A MOBILE HOME PARK: NAME OF LAND OWNER: • J LOCATION (ADDRESS) • REAL PROPERTY PARCEL NUMBER/DESCRIPTION THANK YOU FOR YOUR HELP! SIGNATURE KELLI LARSON, roperty Technician THIS FORM CONFORMS TO THE STANDARDS OF THE STATE DEPARTMENT OF REVENUE AND IS SUBJECT TO AUDIT VERIFICATION. S SPECIAL CONDITIONS CASE # BLD04-00609 1.) The application was reviewed by the Jefferson County Department of Community Development staff on October 1, 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 1800 square feet of impervious surface and 4200 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 September 27, 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 October 1, 2004 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 8.) This approval is for a manufactured home installation 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 setbcak fom Port Hadlock Heights PI right-of-way is 20 ft. Minimum setback from the 10-ft water pipeline easement along the north property line is 10 ft. Minimum side and rear setbacks are 5 ft. 14.) This parcel has been designated as Rural Residential 1:5 under the Jefferson County Comprehensive Plan Land Use Map effective August 28, 1998. • 15.) A septic permit (SEP96-00079)was issued on September 10, 2002 for a system of 240 gallons per day. 16.) Port Hadlock Heights PI (P517) is a private road. The road approach is existing and an address of 23 Port Hadlock Heights PI has been assigned to the parcel. 17.) This parcel is served by Jefferson County PUD, a public water system. 18.) This parcel was created through the Port Hadlock Heights Mobile Home Park Binding Site Plan, filed of record April 15, 1998 under AFN 409746 in Vol 1, page 28-32 with the Jefferson County Auditor's office. The binding site plan was reviewed by Jefferson County Department of Community Development under BSP94-00001. 19.) A minimum of two (2) on-site parking spaces are required for the manufactured home. 20.) 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. Stormwater BMPs Required V�� ( i � APPROVED .. N" 0 SITE PLAN 1.-I *' ,i?°1�� 0 1 2004 - '� Sr '`' VQr GI JEFFERSON COUNT .r`" ``fir DEPT.OF C MUNITY VELOPME SIGNATURE: �-- � `� - ' r4 •. ;�_ �\ 3 A 1 ,A va ..._. v 44.1 ( !'_ b" r �, 2 CZ C50 i •'1:' Q s , :; SEP272004 • 1 h • O �({: 1 0 o k: r� I ci 0...o a ,s8 ' w/ ° V, 3 11,c a a cd t� '► 6 m' . s / � !\ ` ea f �1 i I ) ��,�,,r___ `off JEFFERS COUNTY {) 4� sf : , 1 DEPARTMENT OF COMMUNITY DEVELOPMENT `� 621,:Sheridan Streett.!. SAP 2 2004 360/379-4450. 360/379-4451 Washington 98368 �f c,_ www.cojefferson.wa.us/commdevelopment Ji '._t. - Master Permit Application MLA: O'f fi-( Project Description(include separate sheets as necessary): N«-G, I-O M,E 'N ST A>_L A—rt ON Tax Parcel q Property Number. -1 g 1 5-6 b o o / size: I S/5 6 q Pit Z (acres/square feet) Site Address and/or Directions to Property: 2 3 Po P - H 4.k 1 o CK H e%jA1 S 14 tC Property Owner(s)of Record: $r o.1•.s / Pt c L Cal) ` ' �Gl f L4YS yy - (M o b i I) Telephone: 3 6 0 ?q 77,,:. -.3-377_.Fax emet Mailing Address: -f 03 ©!d G O h di vie*" /e 4 P T Y 8'3 SS Applicant/Agent(if different from owner): K PIT L A AS oN Telephone: Fax emat Mailing Address: What kind of Permit?(Check each box that apples) 0 Building 0 Variance(Minor,Major or Reasonable Economic Use) ❑Demolition Permit 0 Conditional Use[C(a),C(d),or C)** 0 Single Family 0 Discretionary'D'or Unnamed Use Classification 0 GarageG Attached/Detached ❑Special Use(Essential Public Facilities)** ctured Home O Modular ❑Boundary Line Adjustment 0 Commercial* ❑Short Plat** ❑Change of Use 0 g Site Plan** 0 Long Plat*• 00�ne ❑Plat V t on/Alteration**0 Road Approach Development( Amendments" ❑Mowed'Yes'Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit ** 0 Stormwater ManagementiDevelopment envisions 0 Shoreline Management Substantial Development`* 0 Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance 0 Temporary Use 0 Comprehensive Plan/UDCJLand Use District Map ❑Wireless Telecommunication* 0 Jefferson County Shoreline Master P Amendment ❑Forest Practices Act/Release of Six-Year Moratorium rogram Amendment *May reguke a Pre-Application Conference **Requires a Conference Please identify any other local,state or federal permits required for this proposal,if known: 1 DESIGNATION OF AGENT I hereby designate R i C 4 is d, B rp cl•er 3 to act as my agent in matters relating to this application for permit(s). OWNER SIB ( Date: 211 Srpi. 21,0 y By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct lo the best of his,her or ifs knowledge. My material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being-nulland void. I expenses a which mayo save this indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorneys fees and y way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose hours. cation review and any • later inspections.Access and t of entry this property be requested and shalloccur only during regula business Signature: � ifLa t„1--, Date: 2 w s-t,.). Zoo Y The action or actions Applicant will undertake as of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the 'Endangered Species Act"or'ESA."Jefferson county makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. My individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you are in compliance with the Jefferson County development code.The Applicant and non-trapsf�fable -. t •,;ty for , a edsd that he,she signs it holds individualibelow. ,��� vdS� � the SA. Applicant has read this disclaimer and and dates it Signature: � Date: .)-`1 .,"repA L°n G:\Pen itCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc OWNER BUILDER STATEMENT The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that -responstrifity .Uontractor.forlhe proposed project, Signature: ; Date: 1 GENERAL CONTRACTOR MANUFACTURED HOME INsrAunt J aim o e ; s (PFIDNE) sEP 2 2004 MAILING ADDRESS: EMAIL: ( ) } • CoNrRAcroR's LICENSE WAINS NUMBER: NUMBER 'I i `` ARCHITECT/ENGINEER: PHONE ( ) FA)C( ) MNUNG ADDRESS: EMAIL T - :-frame Type: 1 Bathrooms: Shoreline: Type of Sewage New ' ❑ Wood Existing: Disposal: jii(Sewer ❑ Addition ❑ Steel Proposed: Bank p�w�y System❑ Alteration/Remodel 0 Concrete Total: Height it Individual System ❑ Repair ❑ Masonry SEP Permit# 116— otoT7 ❑ Demolition ❑ Other Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: 2 Total: 2_ Name Public Name of System: b D Vet — rt.( If this Is a Commercial Protect you must answer the following: Number of Parking Spaces: Cumerrt Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants.employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit mark an items below that apply: ❑ Underground Tank ❑ Above ground Tank Size of Propane Tank ❑ Heat Stove 0 Cook Stove ❑ Woodstove ❑ Fireplace Insert 0 Hot Water Tank ❑ Pellet Stove 0 Other Is this appliance being installed in a Manufactured I Mobile Home? Yes / No When lines,tank applying gtforn and pennit to install a propane tank you must also submit a site plan showing all of the buildln�all property size,distances from the propane tank to al property lines,buildings and septic system components, including the reserve area. } 1 Squar@ '" r r ' `�}a-Y ^�r "' . ;� Current Proposed � n ,.ram ; Main Floor , a s i 4 "� 2; "ti "4 1 17'If' «?: _ ' �''Y '-— '` r .f c.^—'t "L4... } - 'jam 2 Floor £ c K ` a ` t �,JJ rq ��Tt+Mai,.� .'wi�i1 .g-•k t f X .' •'s -Ire"r ::¢,o tYry't_ y.� a3 -w> 3fO Floor R -* - .:, a za.' . } <i ��y f..i i. x ,i. ,..,:.....t.„,,,,.A.:..........-„ft-ta.... . •,,. „, ,,,„..: ....., ...•--.-. ,-,,,, • —— -. , - . -,.. ...,— . ..„. Mezzanine: ,, s�� y — - �> 54- Heated Basement �[ ;1 x r ;`. . ,.u s ,..'p f $3 -� ..r F t .a �, s i5- a gti2 i y r> yi s7 /g/g .9y44'' - s 3 n 4 wn, +l'a -. � . _ �" :k r n+4rwr. - .'+R-im a� r • • fiUnheated Basement i a .�,r 9hr ...t -w«va ,t aM1�+ a .. .i fp, ' - r ?¢e 4 .. =a f .� .sl ._., _. ...2•7 -• v ;� •-4` § �Rv �. . v�x`4J^f ,`�r „ 2 'om" ,Other Unheated ,,st 4,r,2 !' e [ -J. .--.' : tipt.3F tin> . 3 ,t * �{Garage/Carport � = ,,a -. - ,Z , • 1ns � . Decks X8^s <. ; 4 y Y !!i 3 r? w }x 4-. Ke F M w w Other _'' ' k. ,¢,s Nf •w—'+R'> `�4.c`4 -...,,E ,.r i Otter ir- 4f , -'" r t . a, - ,•'z.y "t- ,• v . t-y1 ," ��sA i .1?c hn, use ,, S t,. '3� :E� .- ` >,,0''�,�.. _' "r• �. �t ESTIMATED COST(REQUIRED) ew ,,�>t.j.,, , '* 34 -o ' :_ m ;�,_�, ': _ .Fair/ria/kef Value of all labor and materials foundation to finish 8 rV t"-' r*}Oi � �4,',,,-x;Y >{ a 2,.`: tl,, l G:\PennitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc