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HomeMy WebLinkAboutBLD2004-00722 0 • SEP04-00643 Review Type: t MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD04-00722 Received Date: 11/12/2004 SITE ADDRESS: 3161 DUCKABUSH RD BRINNON, 98320 S BEGGS PHONE: (360) 275-3163 APPLICANT: PAMALRICHARIA DJ BEGGS 881 E LAKESHORE DR ALLYN WA 98524-9737 SUBDIVISION: Block: Lot: T 42+ PARCEL NUMBER: 502072021 Section: 7 Township: 25 N Range: 02 W CONTRACTOR/ WASHINGTON HOME CENTER INC PHONE: (800) 648-1113 DEALER: PO BOX 176 CHEHALIS WA 98532 Contractor's License WASHIHC0770A Expires 3/19/2005 INSTALLER: WASHINGTON HOME CENTER INC WASHIHC0770A 3/19/2005 (800) 648-1113 PO BOX 176 CHEHALIS WA 98532 REPRESENTATIVE: WASHINGTON HOME CENTER, INF PHONE: (800) 790-9424 61 SE RYAN RD SHELTON WA 98584 PROJECT DESCRIPTION: REPLACEMENT MANUFACTURED HOME RE 4603 F TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: CHAMP/DISC SETBACK: VALUATION 62,900.00 YEAR: 2002 BANK HEIGHT: SIZE: 26.8X60 LABOR & INDUSTRIES APPROVAL? SEWAGE DISPOSAL: CON WATER SYSTEM: PWELL PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO Exist: 0 Exist: 0 AREA Plat Conditions Prop: 3 Prop: 2 Welland Erosion Total: 3 Total: 2 Seismic Streams Flood Way Floodplain F&W Landslide Routing D te: Aquifer r t f C 4 Shoreline q (} �� .,.....—,,.,.,..,.,,-..,„i APP'R OV E[ Approved/Date Type Amount Paid By: Date: Receipt: DEC O to Manufactured Homes $154.00 BAC 11/12/04 68694 2004 Potable Water Application $52.00 BAC 11/12/04 68694 Jefferson County Planning Total: $206.00 ( � p�� & Building Department W L JLQ-'rl v.CLe--K C Ck.C2 -.-- << COM • 0 • JEFFERSON COUNTY MUNITY DEVELOPMENT 621 SHERIDAN ST, PORT TOWNSEND WA 98368 MANUFACTURED HOME INSTALLATION PERMIT APPLICATION 0 NEW BUILDING UV REPLACEMENT SIZE c ' X 60 , YEAR AJ/UO 0-- MAKE (� �/ r CJMr&ip10/1r I5CO1 61 R E / (o U .3 1 COST tc 9 `�O O JJ BEDROOMS: BATHROOMS: TYPE OF HEAT: EXISTING A EXISTING a electricity 0 Oil PROPOSED 3 PROPOSED 2 ❑ Woodstove liPropane TOTAL 3 TOTAL 2 ❑ Heat Pump 0 Other TYPE OF SEWAGE DISPOSAL: WATER SUPPLY: 0 SEWER 0 COMMUNITY SYSTEM III/PRIVATE WELL 0 TWO PARTY WELL IR INDIVIDUAL SYSTEM Conventional 0 PUBLIC Name of water system: PERMIT # SEPOil- 001'13 0 Alternative IF WATERFRONT PROPERTY, fey A ' DISTANCE TO BANK OR HIGH WATER LINE ft BANK HEIGHT ft By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner with respect to this application packet may result in this permit being null and void. I further agree to save, indemnify and hold harmless Jefferson County against all liabilities,judgments, court costs, reasonable attomey's fees and expenses which may in any 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 it's employees,representatives or agents for the purpose of application review and any required later inspections. Access and right of entry to the applicant's property or structure shall be requested and shall occur during regular business hours. �;, SIGNATURE / I -)2-� .637 �_^ Q� "_' - -' rep-, DATE II"" /02 - 0 y NAME (PLEASE PRINT) I�,C14ti-le-D 5. Bj2.665 AND (RMRL'A d-. BE.46s FOR OFFICE USE ONLY 2__CONSISTENCY REVIEW FEE . RECEIPT# 4a_3_ -4 BASE FEE 151 CASH/CK# L_57O ADDITIONAL SECTIONS DATE 11 /a,l D - POTABLE WATER 8`/5 . (- __ - 911/ROAD APPROACH / �"�5'n� ,n (i L ` �'•---i;_ PROPANE TANK .1 3 \I < lNOV 1 2 2004 TOTAL �� \0 �O g:\permitcenter\forms\bldg forms\mobileap revised 2-11-04.doc I • • • • 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#: BLD04-00722 Received Date: 11/12/2004 SITE ADDRESS: 3161 DUCKABUSH RD Issue Date: 12/10/2004 BRINNON, 98320 APPLICANT: RICHARD S BEGGS PAMALIA J BEGGS 881 E LAKESHORE DR ALLYN WA 98524-9737 SUBDIVISION: Block: Lot: T 42+ PARCEL#: 502072021 Section: 7 Township: 25 N Range: 02 W CONTRACTOR/ DEALER INSTALLER: WASHINGTON HOME CENVEICCIPIWIC0770A Expires: 3/19/2005 PO BOX 176 CHEHALIS WA 98532 PROJECT DESCRIPTION: REPLACEMENT MANUFACTURED HOME RE 4603 F MAKE: CHAMP/DISC YEAR: 2002 SIZE: 26.8X60 THIS PERMIT IS VALID FOR ONE YEAR. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 12/10/2005. CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. Setbacks/Footing (CONTINUOUS FOOTING, SLAB or PADS USED): 2/ Stormwater FINAL Approval: Blocking/Plumbing: 9)2), Propane Tank/Lines NL, ^ 0.-6:--; v . Zoning Final Approval: Septic System Final Approval (If not on sewer): Road Approach Final Approval: Final/Skirting/Vents/Porches/Step 9;244 COS 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 • . • SPECIAL CONDITIONS CASE # 1.) The application was reviewed by the Jefferson County Department of Community Development staff on December 8, 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: Type 9 Stream and Fish &Wildlife habitat (spotted owl). 2.) This proposal is to replace an existing manufactured home with a new manufactured home in the same location. As no new clearing or construction is proposed outside of the existing cleared area, this application has not been sent to Washington State Department of Fish & Wildlife nor Washington State Department of Natural Resources for review. The stream location is mapped approximately 400 feet from the proposed manufactured home. The owner should note that spotted owl habitat and a stream may exist on this parcel and limit the potential for clearing land or cutting trees. 3.) The applicant is proposing to create or add 360 square feet of impervious surface and 1,518 square feet of land disturbing activities. Sections 6.6 and 6.7 of the Jefferson County Unified Development Code requires that your proposal comply with Minimum Requirement#2 (Construction Stormwater Pollution Prevention) of the Department of Ecology 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. 4.) 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. 5.) The site plan as submitted with the building application on November 12, 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 December 8, 2004 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 6.) No additional clearing shall be conducted outside of the immediate vicinity of the existing manufactured home unless reviewed by Washington State Department of Fish & Wildlife and Jefferson County Department of Community Development. 7.) 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. 8.) 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). 9.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 10.) The building height is not to exceed 35 feet. 11.) Minimum setback from Duckabush Rd right-of-way is 20 feet. Minimum side and rear setbacks are 5 feet. 12.) A minimum of two (2) on-site parking spaces are required for the manufactured home. 13.) This parcel is a legal conforming parcel designated Rural Residential 1:5 under the Jefferson County Comprehensive Plan Land Use Map effective August 28, 1998. 14.) Potable water is provided by an on-site well. 15.) A septic permit (SEP90-00652)was finaled July 2, 1991 for a system with capacity of 240 gallons per day. A septic permit (SEP04-00243)for expansion of the existing system to 360 gallons per day was approved November 4, 2004. SEP90-00652 is now filed with SEP04-00243. 16.) A building permit (BLD91-00502)was approved July 16, 1990 for a mobile home installation. The permit was cancelled July 2, 1991. 17.) Duckabush Rd is a county minor collector road identified as C227408. The road approach is existing, and an address of 3161 Duckabush Rd has been assigned to the parcel. 18.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 19.) Not more than two (2) unlicensed *operable vehicles shall be stored oily ISess 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). JEFFERSON COUNTY ASSESSOR JACK WESORMAN III JEFFERSON COUNTY COURTHOUSE ASSESSOR COP PO BOX 1220,PORT TOWNSEND WA 98368 (360) 385-9105 MOBILE HOME INFORMATION FORM OWNER'S NAME / MAILING ADDRESS: THIS/S NOTA TAX STATEMENT NAME: RI C l t#9 2� S, AND TAM A 1.?A 3- b EE6S The purpose of this questionnaire is to obtain information regarding either the current location of a mobile home or the ADDRESS: g g I !, i A); 1- eE 1)K previous ownership and location of a mobile home. This will L y n� r✓JA. �S a� help our office determine whether the mobile home is already 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 NOc3( o) (275-31 63 additional information. 1) MOBILE HOME DATA: (A) MAKE C///1/ryi4f)/ (B) MODEL DiSCOV ` IE (C) YEAR g7Uva (D) LENGTH (DI O (E) WIDTH o2 6 FS fi (F)SERIAL NUMBER //b'a c/ 5 (G) YOUR PURCHASE PRICE(DO NOT INCLUDE SALES TAX) 83 3 dv (H) PURCHASE DATE re, } 2) PREVIOUS OWNER/ LOCATION OF MOBILE HOME: (A) FROM WHOM DID YOU PURCHASE MOBILE C AS 4)6 To Al /-/°ME ADDRESS Co/ 5E /,y4A1 J//ELro j jvR `�� -SY (B) WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR? YES 0(IF NO,WHAT COUNTY? IF YES,WHAT WAS PREVIOUS ADDRESS OF MOBILE? 3) WHERE MOBILE HOME IS TO BE LOCATED: ,,� " I; f (A) WILL THE MOBILE HOME BE IN A MOBILE HOME PARK? YES NO " „tfl NOV 1 2 2004 (B) IF LOCATED IN A MOBILE HOME PARK: NAME 8i ADDRESS OF PARK E,._,i -.SPACE NO. (C) IF NOT LOCATED IN A MOBILE HOME PARK: NAME OF LAND OWNER: R i((4/RT ) 5. AND LOCATION (ADDRESS) 31 (p I 'DuCkaBLts/( R2 -Z12in5/uor.1 cog, 983a0 REAL PROPERTY PARCEL NUMBER/DESCRIPTION .5o, 0'7 Q d o2 ' I-I ucKLEK-2.12y H 6HTS Lor 5 S7) Ta 5 n(, K2 vJ ) THANK YOU FOR YOUR HELP! izzjt /� A SIGNATURE � O 61.4 is KELLI LARSON, roperty Technician THIS FORM CONFORMS TO THE STANDARDS OF THE STATE DEPARTMENT OF REVENUE AND IS SUBJECT TO AUDIT VERIFICATION. MopEitly 't? Lio6 TO DRIOELAYIY 0 'DLACKABI-51-1 R.D 30o/ 0_, /4•-• I 1 3' L i 5(00 -DR,oetznj (=_Y)• 4 0 FA"A , . i ' fRopEIZ7y , ;!'.,'''/ •' ' ,L,oc-: To cottmak or Houscs , . i' i ,.• N i,,,. /,•2.6 '•3 1 ELECT, IC METER , I , fRopE.27 ( , Lkl e: ro , r WELL ,, . N vs 4-14'1 • '/G 'TA A.3 K .4 A.+ .A., 6-rv),..,,..4 . ...,,,,,.. . , c,e,, (o .25, , 6/, tRiAJK iveki . 6-4,cy ,. . - - .... , Res,.../.4f-4- .. NA,-e.-e, . • \ / / PERMIT # OLD 579 6 ll 04 — JEFFIRS0111 COUN7TY22 DCD v \..) APPROVED SITE PLAN DEC - I:, 2004 JEFFERS eN COUNTY DEPT.OF COM*,JNITY DEV ilvj 0 SIGNATURE: (Afj____„,..anotolourAink , 7 ___ StOrniWater Bii Pi 1 - 0 ReqUired,-07,, ih. o -.. ,. ' •'' '-' .. 1,i.,:o . ''' A id) ......... r U NOV 1 2 2004 :1.-:,. •• ToTPIL pis opERTI A CRE G E ::.-- 6..Z AC- N 1 A ',('- C. L 1.0 /x1 ec 7z_ — c-0 2, (...) 7 2.(-'. Z I a lc 1-1/i42 b i- ri3ffiri.e..//q 6 C,-6-) .._.. ...,-..S' 3 2...c' diem ”., ..... ...."-1 --.3 i C.: I 9 c cg<ti"3 k" tf g...z4 , 6 4.,A)-v•L,:,,, LAI It -ct" ,*(3 1 t = E x)s• ri to G i-1 6 114 EL 1.,_ ..... ..-... - I 1 .,/ _. , 6, RETURN ADDRESS `H/rhm CA'.11-,,t__GLC__. i /,5 7 q ccZO f- LO"- (8)VVY '"— 3 7 ElSTATE OF WASHfNGTON iwr��w,/{q.`.� , Department of MANUFACTURED HOME ,,��,`�- �r '[+ `-1 '` '� lIcEnsinG APPLICATION EITRAN ELIMINATION ❑TRANSFER IN LOCATION Anyone who knowingly makes a false statement of a material fact is guilty ❑REMOVAL FROM REAL PROPERTY of a felony, and upon conviction may be punished by a fine,imprisonment,or both.(RCW 46.12.210) D MANUFACTURED HOME TPO/PLATE NUMBER YEAR MAKE Jot,kpv,er_ENGTH/WIDTH(FEET) VEHICLE IDENTIFICATION NUMBER(VIN) © LAND c'5- 61 PION 4P`-�(.4 /� - , e/a.S-e�-/9-8 LEGAL DESCRIPTION ON PAGE I REA MANUFACTURED HOME WILL BE [AFFIXED 0 REMOVED LIQPTY TO pAL NME� I�B LOT I BLOCK I PLAT NAME ` G.1.L SECTION/TO WNSHIP/RANGE ) © GRANTOR(S)REGISTERED/LEGAL OWNERS ri-- N„2A ( ) ADDITIONAL NAMES ON PAGE COUNTY NUMBER NUMBER OF REGISTERED OWNERS NUMBER OF LEGAL OWNERS NAME OF ISTERED OWNER NAME OF DITIONAL REGISTERED OWNER 61-rn 4-) i 4 6se-”*S ADDRESS CITY ZIP 4. 9SUP i Ou Abush it &/ ,� /) f NAME OF LEG OWNER 6416--/_L om /92 -ty--) _ NAME OF ADDITIONAL LEGAL OWNER ADDRESS CITY STATE ZIP CODE / O A)I e7 ) )4cl si 3©a /r2.K44-w A)i a GRANTEE NAME I DO SOLEMNLY ATTEST UNDER PENALTY OF PERJURY THAT I/WE AM/ARE THE REGISTERED OWNER(S)OF THIS VEHICLE AND THIS INFORMATION IS ACCURATE: (� /� r `,`iii11 �'�,��istered Owner and Title,IF APPLICABLE / - J .. i ,a117— Sign— , red Ownerand Title,IF APPLICABLE (j (I„„_-i 6.- i , �, • A NOTARIZATION/CERTIFICATION FOR REGISTERED OWN RJ NATURE sestNATAlgy state of Washington .�• County of miS�� Signed or attested �9�J 11, -ts•� before me on /�`2S .^�► /R- '� 5S Signature�s t V.\hive. PRINT NAME OF REGISTERED OWNE t. � �� NOTARY OR AGENT op osswite" by PRIN N M OF REGISTERED OWNER PRINTED NAME OF NOTARY Title - County/Office No.OR _ �/p`� DEALER HIP POSITIO6/AGENT/NOTARY AND: Dealer No.OR Notary Expiration Date 4 TITLE COMPANY CERTIFICATION I certify that the legal description of the land and ownership is true and correct per the real property records. NAME(TYPED OR PRINTED) TITLE COMPANY/PHONE NUMBER SIGNATURE/POSITION DATE Finalize this application with a Licensing Agent within 10 calendar days of the date Title Company Representative signs. 0 BUILDING PERMITOFFICE CERTIFICATION I certify that: the manufactured home has been affixed to the real property as described. a building permit has been issued for this purpose and the attachment will be inspected upon completion. NAME YPED OR PRINTED) BLDG PERMIT OFFICE/PHONE# BLDG PERMIT# • 4i) R.. /hf,L k-z4-�- (can())676) - y5,5r) 04- oa`-Qa _ SI URE/PO 4TION ATE TD-420-7 9 MANUF HOME PPL(R/8/98 Page 1 of 2 la SIGNATURE OF LEGAL OWNER \ . SIGNATURE OF LEGAL OWNER INDICATES CONSENT FOR ELIMINATION OF TITLE/•;f4EMliAl QM L PROPERTY. Signature of Legal Owner and Title,IF APPLICABLE i�' •- • ; y Signature of Additional Legal Owner and Title,IF APPLICABLE NOTARY SEeL•OR STAh1Fti I NOTARIZATION/CERTIFICATION FOR LEGAL OWNER(S)SIGNATURE "•41 s ... ....'.� . I State of Washington [/ Signed or attested n air' �v.\\SSIO�''•:''; County of A.i,l)g--.-N before me on 0�/C t 'o £ T / 'L� f U t\0TA '-'9.:--.to L- , emu-' Eea c � 9}- ;}a:I b '•;, I)C�'-{J,c, 1,L/i;S ,v e- Signatu .,... a ITI I y` RINT NA�F,oF LEGAL OW ER /' ROTARY OR AGENT /� r'"a% r Li LIG -I e "p 14r� !/L�"Pe f 6-/ff,�Qit L• t A4e.//(-A �— Y�'•. •• PRINTED NAME OF NOTARY PRINT AME OF LEGAL OWNER County/Office No.OR (� c� ag O..--. o 4: rJ AND: Dealer No.OR [' ", F •. elm' •,. k Title ci et2 I1',;1�/ I�` - I DEALER HIP P SITION/AGENT/NOTARY Notary Expiration Date DLAND DESCRIPTION (A legal description of the land can be obtained from the local County Assessor's Office /2Si .11 ,9cC-1> aDEALER'S REPORT OF SALE I CERTIFY THAT THIS INFORMATION IS CORRECT.THE VEHICLE IS CLEAR OF ENCUMBRANCES EXCEPT AS SHOWN. ANY REQUIRED SALES TAX HAS BEEN COLLECTED. DEALER NAME(TYPED OR PRINTED) m WA DEALER NUMBER DATE OF SALE L���S-'IA PURCHASE PRICE TAX JURISOIC ION/TAX RATE DEALERS A THORIZED SIGNATURE 4.c- 72) [j USE TAX EXEMPT Sale to a Certified Tribal member on the reservation(attach notarized statement of delivery). 9 COUNTY AUDITOR/AGENT LICENSING OFFICE APPROVAL: (Not for use by Subagents) 0,,4:11,x00.6 Icertifythattheaboveapplicationappearstohavebeencompletedcorrectly,andtheapplicanthassufficientdocur tatidt1tppeedwith the recording of this form. ...�°"h* - r#1. NAME(TYPED OR PRINTED) r, COUNTY OFFICENFS ooERAT,OR NUMBER • — — DATE SIGNATURE InTITLE FEES FILING FEE APPLICATION MOBILE HOME FEE ELIMINATION FEE USE TAX SUBAGENT FEES TOTAL FEES 8,TAX IMPORTANT: Once the application has been approved by the County Auditor/Vehicle Licensing Office, take your application form to the County Recording Office. Retain proof of the recording fees paid. If the Recording Office retains your original application form, obtain a certified copy of the recorded form. APPLICANTS: Once recorded, you must return to a Vehicle Licensing office to file the Manufactured Home Application, paying all required fees. Vehicle licensing subagents charge a service fee. For full instructions on completing this form for Title Elimination, Removal from Real Property or Transfer in Location, see form TD-420-730, Manufactured Home Application Instructions. The Department of Licensing has a policy of providing equal access to its services. If you need special accommodation,please cal(360)902-3600 or TDD(360)664-8885. TD-420.729 MANUF HOME APPL(R/8/98)OR Page 2 of 2