HomeMy WebLinkAboutBLD2005-00527 • • MLA05-00488
Review Type: I
MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00527 Received Date: 8/16/2005
SITE ADDRESS: NO NAME RD
PORT LUDLOW, 98365
APPLICANT: CHRISTY N FRANSON PHONE: 360-821-9262
211 NO NAME RD
PORT LUDLOW WA 983658778
SUBDIVISION: Block: Lot: T 13+
PARCEL NUMBER: 821063014 Section: 6 Township: 28 N Range: 01 E
CONTRACTOR/
DEALER:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION: NEW INSTALL OF OLDER MAN. HOME. (SERIAL#11545)
TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE:
TYPE OF IMP NEW MAKE: REX SETBACK:
VALUATION 1,000.00 YEAR: 1971
BANK HEIGHT:
LABOR & INDUSTRIES APPROVAL? SIZE: 57X24
SEWAGE DISPOSAL: ALT
WATER SYSTEM: PWELL
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: 2 Prop: 2
Total: 2 Total: 2
Routing DaterN J
RpEFelOeVL. L.Type Amount Paid Bv: Date: Receipt:
Potable Water Application $53.00 SLE 08/12/05 76285 AUG 3 t 2005
Permit $157.00 SLE 08/12/05 76285 Jefferson County Planning
Total: $210.00 & epartment
Foie_ S
•
14.) This approval is for a manufactured home installation only. Any future perm' s 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.
15.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
16.) 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).
17.) Maximum lot coverage is not to exceed 25(Yo. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
18.) The building height is not to exceed 35 feet.
19.) Exterior lighting for residential uses shall not exceed twenty feet(20') in height from the
finished grade, excepting when such lighting is an integral part of a building or structure.
Ground level lighting is encouraged.
20.) Lighting fixtures shall be designed and hooded to prevent the light source from being
directly visible from outside the boundaries of the property. The intensity or brightness of
all lighting, during construction and after project completion shall not adversely affect the
use of surrounding properties or adjoining rights-of-way.
21.) Minimum setback from No Name Road right-of-way shall be 20 feet. Minimum side and
rear yard setbacks shall be 5 feet. If an ESA is present, then the more stricter setback(s)
shall apply.
22.) A minimum of two (2) on-site parking spaces shall be provided for the manufactured
home.
23.) The parcel has been designated as RR 1:10 under the Jefferson County Comprehensive
Land Use Map effective August 28, 1998.
24.) An address of 420 No Name Road, Port Ludlow has been assigned to the parcel. No
Name Road is a private road (P119).
25.) A septic permit(SEP05-0091)was approved on July 31, 2005. A well review
(USR05-0021) was approved.
26.) L & I Alteration permit must be approved and signed off by L& I prior to Jefferson County
Attempting final inspection
•
SPECIAL CONDITIONS CASE # BLD05-00527
1.) The application was reviewed by the Jefferson County Department of Community
Development staff on August 24, 2005 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
5 stream.
2.) A Type 5 Stream (Fish and Wildlife Habitat Area) has been identified on the subject
property. The stream will require a setback of 50-feet. The setback shall be measured
horizontally from the Ordinary High Water Mark (OHWM). Fish and Wildlife Habitat Areas
shall also have Buffers and Building Setbacks established.
3.) Stream buffers are areas that shall be maintained in their natural condition, however,
minor pruning or alteration of vegetation may be permitted as long as the function and
character of the buffer are not diminished.
4.) Among the native conifer species which may be used in buffers or for re-vegetation
include, but are not limited to: Grand Fir(Aibes grandis), Sitka Spruce (Picea Sitchensis),
Shore Pine (Pinus Contorta), Douglas Fir(Pseudotsuga Menziesii), Western Red Cedar
(Thuja Plicata), and Western Hemlock (Tsuga Heterophylla).
Among native tree species which may be used includes: Vine Maple (Acer Circinatum),
Big-Leaf Maple (Acer Macrophyllum), Red Alder(Alnus Rubra), Pacific Madrone (Arbutus
Menziesii), Quaking Aspen (Populus Tremula), Black Cottonwood (Populus Trichocarpa),
Bitter Cherry (Prunus Emarginata), Oregon White Oak (Quercus Garryana), Cascara
(Rhamnus Purshiana), Pacific Willow (Saliz Lasiandra), and Scouler's Willow (Saliz
Scouleriana).
Among the native shrub species which may be used are: Sevice-Berry(Amalanchier
Alnifolia), Red Osier Dogwood (Cornus Stolonifera) Salal (Gaultheria Shallon), Ocean
Spray (Holodiscus Discolor), Indian Plum (Oemlaria Cerasiformis), Pacific Ninebark
(Physocarpus Capitus), Red Flowering Currant(Ribes Sanguineum), Wild Rose (Rosa
Nutkana), Swamp Rose (Rosa Pisocarpa), Willows (Salix ssp.), Red Elderberry
(Sambucus Racemosa), Snowberry (Symphoricarpos Albus), Evergreen Huckleberry
(Vaccinium Ovatum), Red Huckleberry(Vaccinium Parvifolium).
5.) All construction activities shall not encroach upon the stream buffer. This includes the
storage or preparation of materials.
6.) The identified Fish and Wildlife Habitat Area (Type 5 Stream), shall maintain a vegetative
buffer setback of 50 feet. The setback shall be measured horizontally from the Ordinary
High Water Mark (OHWM) to the proposed manufactured home.
7.) An additional setback of five (5) feet is required from the edge of the buffer area to the
proposed manufactured home.
8.) A permanent physical separation along the boundary of the stream buffer area shall be
installed and permanently maintained. Such separation can include installing logs, trees,
a hedgerow, or any other prominent physical marking approved by the UDC Administrator.
9.) Stream buffer perimeters shall be marked with temporary signs at an interval of one per
parcel or every one hundred (100) feet, whichever is less. Signs shall be in place prior to
and during construction activities. The signs shall contain the following statement: "Buffer
- Do Not Remove or Alter Existing Vegetation."
10.) The applicant is proposing to create or add 1744 square feet of impervious surface and
1744 square feet of land disturbing activities.
11.) The project shall adhere to the Best Management Practices (BMPs) 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.
12.) 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).
13.) The site plan as submitted with the manufactured home application on August 16, 2005
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 August 24, 2005 shall be resubmitted
for review and approval by Jefferson County Department of Community Development.
• 0
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#: BLD05-00527 Received Date: 8/16/2005
SITE ADDRESS: 420 NO NAME RD Issue Date: 8/31/2005
PORT LUDLOW, 98365
APPLICANT: CHRISTY N FRANSON
211 NO NAME RD
PORT LUDLOW WA 983658778
SUBDIVISION: Block: Lot: T 13+
PARCEL#: 821063014 Section: 6 Township: 28 N Range: 01 E
CONTRACTOR/
DEALER
PROJECT DESCRIPTION: NEW INSTALL OF OLDER MAN. HOME. (SERIAL#11545)
MAKE: REX
YEAR: 1971
SIZE: 57X24
THIS PERMIT IS VALID FOR ONE YEAR.
THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR.
THE EXPIRATION DATE IS 8/31/2006.
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
'etbackl/Footing (CONTINUOUS FOOTIN , SLAB)r PADS USED): , "z.e //
Stormwater FINAL Approval:
Blocking/Plumbing: f3izicklij4 4 /7F Ir.wNS ZX /01765, IANBAuc ore I%q/o5k
Propane Tank/Lines i•VA
Zoning Final Approval:
Septic System Final Approval (If not on sewer):
Road Approach Final Approval:
Final/Skirting/Vents/Porches/Steps: Vans T SKtKT' 05/7
0 -t-cr r4 1//,ll
HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL -4I EQUIRED 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
• •
OWNER'S NAME/MAILING ADDRESS:
NAME: 2Ye k �i�l_ Soft
ADDRESS: Mar) No Na wit Roc 1, 'PGrt Lu tD41 `t'83ti5
PHONE NO. 5(oo - S2 1
The purpose of this questionnaire is to obtain information regarding either the
current location of a mobile home or the previous ownership and Iocation of a mobile
home. This will 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 fro another area.
1)MOBILE HOME DATA: GOV
(A) MAKE Rex r
(B►MODEL C— e 5 4° re_ (C► YEAR I
q 7
(D) LENGTH 4E) WIDTH 2 y- (F)SERIAL # ( 1 5 ,15
4G)YOUR PURCHASE PRICE (Do not include sales tax) V 1 T f- PURCHASE DATE 3- 1"2 0C
2) PREVIOUS OWNER/LOCATION OF MOBILE HOME: (IF NEW MOVE TO QUESTION 3)
(A) FROM WHOM DID YOU PURCHASE MOBILE RU S S a k1c1 5 h err
ADDRESS Cf 4 c? SLtnrts( Bead-) j)rivre A,'E- _ tv A
4B► WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR?Yes c.211.0
If Yes, Previous address of mobile.
If No, What County was Mobile assessed in last year. K ► "S 0. .
cl 49c'rso, .l Prep -r j ►~
3►WHERE MOBILE HOME IS TO BE LOCATED: ,,44r' K%
. C�0,a c2 r.cZ ?�-C?� a r n
w A 'herk. �C-
(A) WILL THE MOBILE HOME B inki IA.E HOME PARK? Yes No Tr¢k wt, S
(B)IF LOCATED IN MOBILE HON PARK: Tra. >" rr
NAME arc ADDRESS OF PARK Lot/Space #
(C) IF NOT LOCATED IN MOBIL HOME P RK:
NAME OF LAND OWNER: h r 15 N • Jy-ex vi S y)
LOCATION ADDRESS +3U N o N) Levi e_ R0ccr Pori- Lvov ow) wA
REAL PROPERTY PARCEL #/BESCRIPTION 2
,,,.'° ignatur o applicant
THANK YOU FOR YOUR HELP!
NSA t
JODI COSSELL, Property Technician
AUG 16 2005
r__- , , •
Department of Labor&Industries AUG 1 6 2005 MANUFACTURED/MOBILE HOME
Factory Assembled Structures Section ' ALTERATION PERMIT
s ,, ;; (-Permit#
INSTRUCTIONS:
1. Complete all spaces,including the signature box(marked with an X). _ •^E,�l Do not MH
2. Draw a map on reverse side of WHITE copy only. complete Invoice#
shaded
3. Forward completed permit and fees to the nearest L&I office. See list on reverse.
4. Contact and schedule the inspection(s)with the same L&I office per the checklist. areas Insignia#
c
Owner • last name first name Day time phone Date
Address I City State ZIP
Installer/Contractor/Dealer s s f 1 1 Phone Contractor's registration number
Address City State ZIP+4
Serial Number(s) HUD Number(s)
Place fee amount in proper box Place fee amount in proper box
Mechanical
Heat Pump Electrical
Air Conditioning Heat pump
Furnace Installation(gas or electric) Air Conditioner
Gas Piping Furnace Installation(gas or electric)
3/.9C Wood Stove---- Serial No. Wood Stove(if applicable)
Pellet Stove ---- seriaLNo. Pellet Stove(if applicable)
Gas Room Heater Gas Room Heater
Gas Decorative Appliance Gas Decorative Appliance(if applicable)
Range:changing from electric to gas Range:changing from gas to electric
Gas Water Heater replacement Electric Water Heater replacement
Water Heater:changing from electric to gas Electric Water Heater replacing Gas Water Heater
Plumbing Each added or modified circuit
LiFire sprinkler system (also requires a plan review) Hot Tub or Spa(power from home electrical panel)
Each added fixture Replace main electrical panel
Replacement of water piping system Low Voltage Fire/Intrusion Alarm
Structural Fire Safety
Inspection as part of a mechanical installation
(cut truss/floor joist,sheet rocking) Miscellaneous
Reroofs(may require a plan review)Li
Plan review
Changes to home when additions bear loads on home per Reinspection- - -- Original Permit
the design of a professional(also requires a plan review) /O. Insignia
Other structural changes(may require a plan review) Other
awl Fire Safety
Note: This permit expires one year after date of purchase. (Non-refundable)
Work is completed at this time. An inspection is requested.
Work is NOT completed at this time,I will call when ready.
Make check payable to: Dept.of Labor&Industries rSi nat e. appt.
•f thorized representative
FEES DUE
Request approved or [:i Request denied becaus• • specific violations of Washington rules and regulations.
s Violations must be corrected and remspection requested within 20 days of the notice of violation date, Failure to comply
o I may result in penalties per chapter 43.22'RCW. All violations noted are shown on an "Alteration/Factory Permit
Continuation Form".
JEFFERSON CONTY .
DEPARTMENT OF COMMUNITY DEVELOPMENT
,44
1"4 621 Sheridan Street • Port Townsend •Washington 98368 '
360/379-4450 • 360/379-4451 Fax
�q p� www.co.jefferson.wa.us/commdevelopment AG u 1 6 2005
S�N�rS
Master Permit Application MLA: C,
Project Description(include separate sheets as necessary): ---- c
N/\Ct.I'"1 l; Zt crtv/ c. E3
Tax Parcel Property
Number: g,Z ) 0 ( 3 0 124 Size: ) Q C c S (acres/square feet)
Site Address and/or Directions to Property: No Nci vn e Rocs P I L u at I o t.J
Property Owner(s)of Record: C k rj 5 ]v Fra o.Sc'y� �-
Telephone: 3C,C—7 32- *145 Fax: 11 email: (, Ira A.• Ctlyine;)S.(1e
MailingAddress: 9/1 No ��w�Q �o / LUo1(p,AJ) 9I gg365
Applicant/Agent(if different from owner):�Mobt le owner- — pe ve k fra rs ovj
Telephone: ,?4. a x`2-l Cr Fax: email:
Mailing Address: 4f3O N) d N a,,,,t e Ron. r%�r'A- Lk)at I vbJ, t,J A 7 '5
What kind of Permit?(Check each box that applies)
Building ❑Valiance(Minor, Major or Reasonable Economic Use)
❑ Demolition Permit ❑ Conditional Use[C(a),C(d),or C]**
❑ Single Family ❑ Discretionary"D"or Unnamed Use Classification
❑ Garage Attached/Detached ❑ Special Use(Essential Public Facilities)**
I Manufactured Home 0 Boundary Line Adjustment
0 Modular ❑ Short Plat**
❑ Commercial* ❑ Binding Site Plan*"
❑ Change of Use ❑ Long Plat**
❑Address ❑ Road Approach 0 Planned Rural Residential Development(PRRD)/Amendments**
❑ Propane ❑ Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions*"
❑ Stormwater Management 0 Shoreline Management Substantial Development*"
❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance
❑Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment
❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment
❑ Forest Practices Act/Release of Six-Year Moratorium
*May require a Pre—Application Conference **Requires a Pre-Application Conference
Please identify any other local, state or federal permits required for this proposal, if known:
��''' DESIGNATION OF AGENT
I hereby designate De ✓e k /- rci vi sv n to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE Date:
By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of
his,her or it's knowledge. Any 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 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 its employees,representatives or agents for the sole purpose of application
review and any required later inspections.Access and right of entry to this property shall be requested and shall occur only during regular business
hours. r7-
Signature: = Date:
The action or actions Applicant will undertake as a result 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. Any 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 acknowledges that he,she or it holds individual
and non-transferabl rbilit o ering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature:_ ( �n�oY� Date: ( —/2�t✓',
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
OWNER BUILDER STATEMENT Or-
The .._
signer of this statement does hereby certify that try are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be assuming the responsibility of the General Contractor for the proposed project. 1
AUG Signature: C _74. 7=-i-,1 /
l r"— 4 " 7-4�',._sJs.=�'„", l)Date: —f 1 ZQQ�J
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
MAILING ADDRESS: EMAIL: ti
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
N, New -I etSf z I I-ette ❑ Wood Existing: ❑ Sewer
❑ Addition b'n lI t-,(Steel Proposed: Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: 2 Height: ,i Individual System"
❑ Repair ❑ Masonry SEP Permit# 0.5-LJ/
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: 2 Setback: K Private well ❑ Two Party
Type of Heat Proposed: ❑ Public
�,`;(;C.,, Total: _ Name of System:
r, , l
If this is a Commercial Project you must answer the following:
Number of Parking Spaces: Current: 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 all items below that apply:
❑ Underground Tank ❑ Above ground Tank Size of Propane Tank:
[I Heat Stove ❑ Cook Stove ❑ Woodstove ❑ Fireplace Insert ❑ Hot Water Tank LI Pellet Stove ❑ Other
Is this appliance being installed in a Manufactured/Mobile Home? Yes / No
When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property
lines, tank location and size,distances from the propane tank to all property lines,buildings and septic system components,
including the reserve area.
Square Footage For Office Use Only
Current Proposed Amount
Main Floor Consistency Review: 4 1,
2"o Floor Base fee:
I J '7• rib
3fd Floor Additional Section:
Mezzanine: Plan Check fee:
Heated Basement State Surcharge fee:
Unheated Basement Pot Water Review fee:
Other Unheated 911/Rd Approach fee:
Garage/Carport TOTAL $ d
Decks Receipt Number: C'
Other Cash/Check Number:
ESTIMATED COST(REQUIRED) Date: -
•Fair market value of all labor and materials foundation to finish I ' l� �
Initials:
i5,..'
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
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