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HomeMy WebLinkAboutBLD2006-00163 Ii ILDING PERMIT APPLICATIN MLA06-00152 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00163 Received Date: 4/4/2006 SITE ADDRESS: 3078 CHICKEN COOP RD SEQUIM, 98382 OWNER: DAVID A PETERSON PHONE: (760) 949-5903 DEBRA PETERSON 3078 CHICKEN COOP ROAD SEQUIM WA 98382 SUBDIVISION: Block: Lot: T 28+ PARCEL NUMBER: 002333011 Section: 33 Township: 30 N Range: 02 W CONTRACTOR: BUY RITE HOMES PHONE: (360)479-0795 3543 W STATE HWY 16 PORT ORCHARD WA 98367 Contractor's License BUYRIH*08406 Expires 05/20/2006 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NEW MFH (MODEL KS38012/SERIAL NO. 270506X) TYPE OF WORK MOB SQUARE FOOTAGE TYPE OF IMP NEW MAIN: VALUATION 56,583.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: 2 Prop: 2 Total: 2 Total: 2 Routing Date: I;. . t-� Type Amount Paid Bv: Date: Receipt: AO� /r c D Manufactured Homes $163.00 KAS 04/04/06 80883 V Potable Water Application $55.00 KAS 04/04/06 80883 MAY Ace 2006 Total: $218.00 Jefferson County Planning &Building C1 c4-441-Department °tir-xod 41111111 • 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#: BLD06-00163 SITE ADDRESS: 3078 CHICKEN COOP RD Received Date: 4/4/2006 SEQUIM, 98382 Issue Date: 5/26/2006 APPLICANT: DAVID A PETERSON DEBRA PETERSON 3078 CHICKEN COOP ROAD SUBDIVISION: SEQUIM WA 98382 PARCEL#: Block: Lot: T 28+ 002333011 Section: 33 Township: 30 N Range: 02 W CONTRACTOR/ BUY RITE HOMES DEALER 3543 W STATE HWY 16 PHONE: (360)479-0795 PORT ORCHARD WA 98367 Contractor's License BUYRIH*0840B Expires 5/20/2008 PROJECT DESCRIPTION: NEW MFH (MODEL KS38012/SERIAL NO. 270506X) 14KE: KARSTEN /YEAR: 2006 SIZE: 38 X 28 THIS PERMIT IS VALID FOR ONE YEAR. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 5/26/2007. CALL IN FOR THE REQUI D INSPECTIONS THAT APPLY TO YOUR PROJECT. Setbacks/Footing ONTINUOUS FOOTING SLAB or PADS USED . 6-6 Stormwater FINAL Approval: Blocking/Plumbing: Propane Tank/Lin s Zoning Final Approval: Septic System Final Approval (If not on sewer): _ Road Approach Final Approval: Final/Skirting/Vents/Porches/Steps: HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWE SPECTION D 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 oloomm • • SPECIAL CONDITIONS CASE # BLD06-00163 1.) The application was reviewed by the Jefferson County Department of Community Development for the presence of Environmentally Sensitive Areas (ESAs). The Department conducted a review and has concluded that the property DOES NOT contain Environmentally Sensitive Areas. However, future proposals will be subject to a new ESA review and conditions may be added if new ESAs are found on the property. 2.) The applicant is proposing to create or add 1,592 square feet of impervious surface and 1,592 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. 3.) 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). 4.) The site plan as submitted with the Building Permit application on April 4, 2006 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 May 1, 2006 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 5.) This approval is for a Single Family Residence (manufactured home) 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. 6.) The parcels are designated as RR 1:5 under the Jefferson County Comprehensive Plan Land Use Map effective August 28, 1998. 7.) A septic permit(SEP06-00101) has been approved on May 24, 2006 for a system of 240 gallons a day. 8.) Chicken Coop Road is a private access road (P32). An address of 3078 Chicken Coop Road has been assigned to the parcel. 9.) A private on-site well shall provide potable water to the parcel. 10.) 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. 11.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 12.) 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). 13.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 14.) The building height is not to exceed 35 feet. 15.) The front yard building setback is 20 feet. The road frontage buildling setback from Chicken Coop Road is 20 feet. The side and rear building setbacks are 5 feet. Nv -4 8f3 ' .�L,ji- , frees 51.00' . . If _Li 1 frees frees - tV ' Q i M 4 illf0 I �5.00' - JEFFERSON COUNTY JCR sect ® 1 6.:3i),.1) ` dome — AV I 28x38 � i - 1 drain to. t.531 _ 3 K� roposed 555.55 I / / / / v i 280 87' _ - . drLveway aFProV \ V4)}il'y 225' / / �, (7J I / / � iii cur atn drain ✓J Q - _ - _ _ _ _ An, til / / [well] / / - - - - I v. ansformerA- ? 1 Power culvert Phone 30.56 50.00' frees _ _ _ _grave road 3833' --- —� - -- - - - - -- - - - - heterson, 2av�d — - - - - - - - - - - - - 5078 Chicken Coo 2d 5 �u�" 2i,te Homes P equl,m Contact• 13LrdL rcel #002 55� 011 25940Pldwq 101 5equLm WA 98582 scaak I"= 0' ---- --A-P--P-Rp -r ._ ''81- 0777 5et backs: SITE PLAN/ front 20' revised as 4/3/06 5tdes 5' -�-� k*ear 5' MAY ; 1 2006 ., -., • SIGNA r-•4 • 'LL f,f 4111,0111wr/1111 • liE,cVE, • It Hb 917 A ` - 4 Q9G Nag r-- 'i ,% 4 � , Al ir 1 . 1 s, iii. �� › $ t-},", 1011,47,:allillinlirallh' - 3 Jf . . .. , .,•, ".... . 1 . , . , . „ ' -I: is_ 0" thl irci • 2 1111 ,.] inn- 11111111111111110 .,,, CO It 'riga t0f 'pril.,,, raw .rx.wr �-i..,1601111111111111tEri , O INK AIrl.0 I Q § . =/ 0 45 g 4' 2 I ; , 1 , . . _ ,,. ...... . ‘,. L- Hb€X9L "' 1 $_ . I �9L JACK WESTERMAN Il Jefferson C h-Courthouse ASSESSOR PO Box I2 Port Tonnsend, 11A 98368 (360)3115-9105 MOBILE HOME INFORMATION FORM OWNER'S NAME/MAILING ADDRESS: NAME: kE"1`kSdv , Gii GK ADDRESS: ,30 7c- (t1/('4-,J (2p /2 ,-d ylt/b-) /4 98 'z. PRONE NO. The purpose of this questionnaire is to obtain information regarding either the current location of a mobile home or the previous ownership and location 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 from another area. 1)MOBILE HOME DATA: (A)MAKE 'S 7z-ni X v � (B)MODEL /�` -gg6i Z.- (C)YEAR De9(o (D)LENGTH s r-)y 38 (E)WIDTH 23 (F)SERIAL# 4iii2 Z 70s04 , (G)YOUR PURCHASE PRICE(Do not include sales tax)i4 J5 '3,O1) PURCHASE DATE 2/4 /D 4, 2)PREVIOUS OWNER/LOCATION OF MOBILE HOME: (IF NEW MOVE TO QUESTION 3) (A) FROM WHOM DID YOU PURCHASE MOBILE ADDRESS (B)WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR?Yes No If Yes, Previous address of mobile. If No, What County was Mobile assessed in last year. 3)WHERE MOBILE HOME IS TO BE LOCATED: (A) WILL THE MOBILE HOME BE IN MOBILE HOME PARK? Yes N (B)IF LOCATED IN MOBILE HOME PARK: NAME ale,ADDRESS OF PARK Lot/Space# (C) IF NOT LOCATED IN MOBIL HOME PA NAME OF LAND OWNER: .I1/oa/ /E_C&'AJ LOCATION ADDRESS 34 7c5 ('P�CAJ !,J 0/0 d REAL PROPERTY PARCEL #/DESCRIPTION 00 2. 3 D// F IøcanKj THANK YOU FOR YOUR HELP! 05o&I-d JO COSSELL, Property Technician ¢, ON cod JEFFERS�COUNTY • l N COMVEO '� 621 SheridanDEPARTME T StreetOF • Port TownsendMUNITYDE E. LWashingPMENTton 98368 �_ 360/379-4450 • 360/379-4451 Fax �.y �NO�O� www.co.jefferson.wa.us/commdevelopment �tI Master Permit Application MLA: Q(o^ I3,-), Project Description(include separate sheets as necessary): , Lf.",-S 774 /7/n/r `69A.-/cl714 C Tom/e-01 ,/7D/776-- Tax Parcel Property Number: 66 w 3.-5 j 07/ Size: / 2, 1/ 4C,e-s (acres/square feet) Site Address and/or Directions to Prpperty: 3(j 7 9 /G�E.t� �o�J /Gr . I /,,, //,f1 %; ,� Property Owner(s)of Record: CTe °SOi�, , i9U,& C Telephone: 77,Q •- i/q - 596 3 Fax: email: Mailing Address: 3a 76 �1//C�..tl I,9 7,, ,5-,ui/;-_) G,,1,� 9A58;.Applicant/Agent(if different from owner): ACC/ T�. /t,n-7 -'_",!3 Telephone: ,g6,O -- 6 P/-0 7 7 7 Fax: ,3/,,0 - 68/=O 7c'0 email: Mailing Address:7 S Cf 4/D3 ,\)/44 ,/ /D I (v' b),0 vjc R 2 What kind of Permit?(Check each box that applies) iurgwilding 0 Variance(Minor, Major or Reasonable Economic Use) El Demolition Permit 0 Conditional Use[C(a), C(d),or C]** 0 Single Family El Discretionary"D"or Unnamed Use Classification ❑Ga�rage Attached/Detached 0 Special Use(Essential Public Facilities)** G�Nlanufactured Home 0 Boundary Line Adjustment ❑ Modular ❑ Short Plat** ❑ Commercial* ❑ Binding Site Plan** ❑ Change of Use ❑ Long Plat** El Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑ Propane 0 Plat Vacation/Alteration** 0 Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management ❑ Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance 0 Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment El Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment 0 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: • ESIGNATION OF AGENT I hereby designate. / S d /,t'a(/ to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE /' ' Date: 3 C.e, 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 attorney'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 pr ide access a ight of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review an any re red later in c ons.Access and right of entry to this property shall be requested and shall occur only during regular business hour,: 4__ Date: '�/ /I Sigrtur do t )` /�w t" _ 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 vielate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your actio s)even ifeu are in pli nce with the Jefferson County development code.The and, -trans ble re Applicant acknowledges that he,she or it holds individual ponsibi f adhering tp and complying with the ESA. The Applicant has read this disc) inter nd signs and dates it below. Signatu e: " -_cam 6 Date: 21 Q 6 G:\PermitCenter\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 they will be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: GEN L CON,T 'CTOR 0 MANUFACTURED HOME INSTALLER: PHONE: Fax: ch lbcci, ok) )b(91-62 7-1 (366 ) /08 I--o 7e4 o MAILIN�ADDRESS. 2 5 61 VO 3 i-hU/Jo/ , cL-- /{/!;.) EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: Z21 Y T4- DRzfD 6 NUMBER LC)kJin/S o? SCE ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: -Frame Type: ' Bathrooms: Shoreline: Type of Sewage Disposal: E / (New 0'Wood Existing: ❑ Sewer E Addition ❑ Steel Proposed: ? Bank 0 Community System 0 Alteration/Remodel 0 Concrete Total: Z- Height: V dividual System 0 Repair ❑ Masonry SEP Permit# 0 Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: tYPrivate well 0 Two Party Type of Heat: Proposed: 0 Public tZE-cr I lc_ Total: 4 Z- lame of Se S/11L a&c/ fa$. 1eizc ystdm: Sr - If this is a Commercial Proiect 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: ❑ Heat Stove 0 Cook Stove ❑ Woodstove ❑ Fireplace Insert ❑ Hot Water Tank Cl 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 (=1-(SEp/Krshd (O`J' co Current Proposed Amount Main Floor Consistency Review • 2Nu Floor Base fee: r� ' "7" '` 3`" Floor Additional Section ``� Mezzanine: A` Plan Check fee: Heated Basement State Surcharge fee: Unheated Basement Pot Water Review fee: o-4C Other Unheated 911/Rd Approach fee: rbie/ Garage/Carport TOTAL: $. ,4--1 OD Decks T— Receipt Number: � +- Other — Cash/Check Number: c�. 1 a ESTIMATED COST(REQUIRED) Date: .Fair market value of all labor and materials foundation to finish Y' 5 , 60 Initials: +� G:\Peru itCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc RETURN ADDRESS WASNIN6TON STATE DEPARTMENT OF Manufactured Home 'L A CH CKONE �' LICENSING ApplicationTITLE ELIMINATION OTRANSFER 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 LENGTH/WIDTH(FEET) VEHICLE IDENTIFICATION NUMBER(VIN) +430092 2006 KARST 28 X 38 TKCSTOR030627506 © LAND LEGAL DESCRIPTION ON PAGE MANUFACTURED HOME WILL BE [AFFIXED REAL PROPERTY TAX PARCEL NUMBER ❑ REMOVED 002333011 LOT BLOCK PLAT NAME OR SECTION/TOWNSHIP/RANGE QUARTER/QUARTER SECTION 33-30-2 NW 1/4 © GRANTOR(S)REGISTERED/LEGAL OWNER(S) ADDITIONAL NAMES ON PAGE COUNTY NUMBER NUMBER OF REGISTERED OWNERS NUMBER OF LEGAL OWNERS 2 1 NAME OF REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER DAVID A PETERSON NAME OF ADDITIONAL REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER DEBRA K PETERSON ADDRESS CITY STATE ZIP CODE 133 RAPTOR WAY SEQUIM WA 98382 NAME OF LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER GLOBAL ADVISORY GROUP, INC,DBA MORTGAGE ADVISORY GROUP NAME OF ADDITIONAL LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE 2902 COLBY AVENUE EVERETT WA 98201 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: Signature of Registered Owner and Title, IF APPLICABLE Signature of Additional Registered Owner and Title,IF APPLICABLE NOTARY SEAL OR STAMP NOTARIZATION/CERTIFICATION FOR REGISTERED OWNER(S)SIGNATURE State of Washington Signed or attested County of before me on by Signature PRINT NAME OF REGISTERED OWNER NOTARY OR AGENT by PRINT NAME OF REGISTERED OWNER PRINTED NAME OF NOTARY County/Office No.OR Title AND: Dealer No.OR DEALERSHIP POSITION/AGENT/NOTARY 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 PERMIT OFFICE CERTIFICATION I Certify that: g.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(TYPED OR PRINTED) BLDG PERMIT OFFICE/PHONE# BLDG PERMIT# \a./c\r..t.. 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