HomeMy WebLinkAboutBLD2007-00176 • •
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 #: BLD07-00176 Received Date: 4/26/2007
SITE ADDRESS: 40 MASON ST Issue Date: 4/30/2007
PORT HADLOCK, 98339
APPLICANT: FOSTINE BR TALLTREE
40 MASON ST
PORT HADLOCK WA 983399584
SUBDIVISION: PHILLIPS ADDN TO IRONDALE Block: 14 Lot: 3-4
PARCEL#: 986401402 Section: 2 Township: 29 N Range: 01 W
CONTRACTOR/ CANTERBURY CONSTRUCTION PHONE: (360) 277-3045
DEALER PO BOX 2714
E 1350 TRAILS END DR
Contractor's License CANTEC*021NC Expires 2/5/2009
PROJECT DESCRIPTION: REPLACEMENT MAN HOME/ CHAMPION 48X24 SERIAL#
42900462977UTCBC
MAKE: CHAMPION
YEAR: 1979
SIZE: 48X24
THIS PERMIT IS VALID FOR ONE YEAR.
THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR.
THE EXPIRATION DATE IS 4/30/2008.
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
Setbacks/Footing (CONTINUOUS FOOTING, SLAB or PADS USED):
Stormwater FINAL Approval: pBlocking/Plumbing: 5Lc�-KIti� =� T,r. - '17G):.oA.'S Lak S/Zz/G'7 -7i.voialax OK 0-p °7
Pro ane Tank/Lines
Zoning Final Approval:
Septic System Final Approval (If not on sewer):
Road Approach Final Approval:
Final/Skirting/Vents/Porches/Steps: ---/ ?,r%"r-'-j+->1 i"`'-(—
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
bil#ILDING PERMIT APPLICATICTi�I MRAOW0020�
Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD07-00176 Received Date: 4/26/2007
SITE ADDRESS: 40 MASON ST
PORT HADLOCK, 98339
OWNER: FOSTINE BR TALLTREE PHONE: 360-531-0424
40 MASON ST
PORT HADLOCK WA 983399584
PHILLIPS ADDN TO IRONDALE
SUBDIVISION: Block: 14 Lot: 3-4
PARCEL NUMBER: 986401402 Section: 2 Township: 29 N Range: 01 W
CONTRACTOR: COANTERBURYO CONSTRUCTION
P B X 2714 PHONE: (360) 277-3045
E 1350 TRAILS END DR
BELFAIR WA 98528
Contractor's License CANTEC*0 21 NC Expires 2/5/2009
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOIF REPLACEMENT MAN HOME / CHAMPION 48X24 SERIAL #
42900452977UTCBC
TYPE OF WORK MOB SQUARE FOOTAGE:
TYPE OF IMP NE\N
VALUATION MAIN:
CODE EDITION: 20C13 ADD'L: HEAT TYPE: EEE
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: # OF STORIES:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL: CON _
WATER SYSTEM: PUD
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: 3 Prop: 2
Total: 3 Total: 2
Routing Date: 1/...ale/
o 7 ?5----
Type Amount Paid 13v: Date: Receipt: AppyRemED
Total: APR - 2007
Jefferson County Planninr
&Building Department
JACK WVESTERMAN HO Jefferson('ouii • Courthouse
ASSESSOR PO (lox 1220. Port Townsend,%IA 98368
(360)385-9105
MOBILE HOME INFORMATION FORM
OWNER'S NAME/MAILING ADDRESS:
NAME: PI'5 t-:1 i)e-,BY t3ht -1 c:;LL:t re c
ADDRESS: 40 i1Ao.sc 0 _S-t v-ce .E PO 1-1- tiGJ (ock 'vt.!� 1 X 33`1
PHONE NO. 3t,C, ..cj 1 ----c. ttr),t(
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.
'MOBILE HOME DATA:
(A) MAKE A-nA.(�i. L.,(\J (B) MODEL (C)YEAR1911 C)
'LJ(D) LENGTH O ` (E) WIDTH g 'Y (F)SERIAL # Sjo CZ%y- ).,..95'rf-U-T-Gt
(G► YOUR PURCHASE PRICE (Do not include sales tax)/3 9 OO PURCHASE DATE4/JO t7
2) PREVIOUS OWNER/LOCATION OF MOBILE HOME: (IF NEW MOVE/ TO QUESTION 3)
I
(A) FROM WHOM DID YOU PURCHASE MOBILE UM' MI'1/ /71G'I1ie s, L1'Tf..-
ADDRESS 345C II t. y lU 14 - fall?r7]ei I'IC ti 4 cis-'3)a
(B) WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR?Yes CNo
If Yes, Previous address of mobile.
If No, What County was Mobile assessed in last year. ki f Sar CA U4t tf
3)WHERE MOBILE HOME IS TO BE LOCATED:
(A) WILL THE MOBILE HOME BE IN MOBILE HOME PARK? Yes No
(B) IF LOCATED IN MOBILE HOME PARK:
NAME &ADDRESS OF PARK Lot/Space#
(C) IF NOT LOCATED IN MOBILE HOME PARK:
NAME OF LAND OWNER: Fc St tPk. ei()Vitt. Tv Lt-'t VET
LOCATION ADDRESS LO kik SC'V\ ca. a E( t t)r,u-t ad( Lk- wA;'4 q(g33`1
REAL PROPERTY PARCEL #/DESCRIPTION "/ F(a ' O /Ai OA
. < . Zirf ' 'Z'K---- '
Signature of applicant
THANK YOU FOR YOUR HELP!
Ns14 _cc_ ''''r' 1 25
JO COSSELL, Property Technician —J
DEVELOPMEN f
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i HUNT HOMES/VICTORIRN MTG. (360) 377 2999 p. z
2f2S/280� 13:20 360379561� IASU JEFFERSON COON• PAGE 02/02
1
BUILDER STATEMENT
The signer of this statement does hereby certlylhat they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they wti be naming the responsiblity of the General Contractor for the pro/mead protect.
Signature: Date: 4
{ GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAx:
( MIA"r /1 u u Alto 4 rise ii /yd#wjk'9' (so 3 7t3• fm'l (360) 177• '19q
MtuLINo A0o0E7: EMAIL:
�•��ra�grzei ecv'T. _
�ONTRAOTOR'SLICENSE WAINS i
{ NUMBER; H C44, 77 4 ' 02_,0 • NUMS`rR S'od 7Sr
ARCFl-"eCT/ENDINEER: PHONE ( FAx:(
','mus:a ADDRESS: EMAIL '
• ^rw;rrct Type: Frame Type: Bathrooms! Sh aline: Type of Sewage Disposal:
'F' New ❑ Wood Existing: _._-- ❑Sewer
Addition ❑ Steei Proposed —I. Bak ❑Community System
rJ Atteraflon/Remodel Q Concrete Total: HelgM: CP Indlvtduai System
O Repair p Masonry .--1.--- SEP Permit#
7 De..n olition O Other: Bedrooms: Water Supply:
Existing: _ Setback: 0 Private well Q Two Party
Heat: Proposed: a - EA Public
Total: Name of System:
i"this Is a Commercial Preiett you mustatLar the fol c vtna:
i Number of Parking Spaces: Current: Proposed:_ Number of AD^Parking Spaces:
• Number of occupants(Includes owners,tenants,employees,etc) Current Proposed
?' C Occupancy: IBC Type of construction: Will you hiive Food Service? Yes 1 Nn
'`this la sLPN:mane Tank and/or Appliance Installation nermlt,erects all items below that spiny;
nderground Tank ❑Above ground Tank Size of Propane Tank:
D moat Stove Cook Stove D Woodstove OFlreplaco Insert D Hot Water Tank d Pblet Stove d Other
this aoetrance_belna Installed In a Manufactured/Mobile Home? Yes / No
Own applying for a permit to install a propane tank you must also submit a site pistil showing all of the buildings,all property
"nes,tank location and sire,distances from the propane tank to all property linos,blrlldinga and septic system components,
_'"wtlti'dir►g MT:Warm area.
•
7,nuare Fop I Current Proposed m ? • •1..,..;.:•;' -, ,;'..'�.,, lit s. ,r''•,
Footage p �r t;lif((olr�1latt °�'°�'' .'„ I'` 1<�'i>: a v' lal f t'„�,
''•�.Vested • EH : .App guise
I : T=co-Heated Consistency Review:
..e._. �.:- ' Base lee:
Additional Section:
-'watt+:lia,se,m^,: �' ' • ..-Plan Check fee:
tUnheated Basement State Surcharge fee:
Ct'•. r Jnheeted Pot Water Review kw:
. . ' SUBTOTAL
•
,sn • .. 911/Rd Approach fee:
,Actor .. '. TOTAL: I $
"Y'• Receipt Number:
' • Cash/Check Number:
FiSTIMATED COST(REQUIRED) — Date:
•
1 .Fac-ma/het Value or all labor end materials foundation to — ,a
"} Initials:
I' `;;; I
-
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. : . •°;,RMS\7RD FORMS\t AHAc NM*Appiioeion t2-30.05-2.doc 2 J ........i
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1;Viii.OPh1ENT
r •
SPECIAL CONDITIONS CASE # BLD07-00176
1.) The application was reviewed by the Jefferson County Department of Community
Development staff on April 27, 2007 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, the following ESAs were
confirmed to be present on the subject property: Special Aquifer Recharge Protection
Area (SARPA).
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 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.
6.) The applicant is proposing to create or add 1,152 square feet of impervious surface and
1,152 square feet of land disturbing activities. JCC 18.30.060 and 18.30.070 require 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.
7.) 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.
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.) The site plan as submitted with the building permit application on April 25, 2007 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 April 27, 2007 shall be resubmitted for review and
approval by Jefferson County Department of Community Development.
10.) This approval is for a manufactured home demolition and manufactured home
replacement 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.
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 2 unlicensed vehicle all be stored on any lot unless totally screefTed
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 Chapter 18.30 JCC. Outdoor storage of 3 or more junk motor
vehicles is prohibited except in those districts where specified as an autormobile wrecking
yard or junk (or salvage) yard and allowed as a permitted use in Table 3-1 or Chapter
18.18 JCC, and such storage shall meet the requriements of JCC 18.20.100, Automobile
wrecking yards and junk (or salvage) yards. In no case, shall any such junk motor
vehicles be stored in a critical area.
13.) Setback from Mason St. right-of-way is no less than 20 ft., setback from First St.
right-of-way is no less than 20 ft., side setbacks are no less than 5 ft. If an
environmentally sensitive area (ESA) is present, then the more restrictive setback shall
apply.
14.) 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.
15.) Pre-existing legal lots of record less than one acre in size in rural residential districts are
subject to the stormwater requirements in Chapter 18.30 JCC and must meet the "Area of
Impervious Surface Coverage" to the maximum extent practicable as determined by the
administrator. Lot coverage is defined as amount of impervious surface, which includes
rooftops, driveways, concrete, etc.
16.) Stormwater shall be retained and infiltrated on site. The owner shall control all
sedimentation and erosion on the property.
17.) A minimum of two (2) on-site parking spaces is required for the single-family residence.
18.) This is a legal nonconforming parcel designated as Rural Residential 1:5 under the
Jefferson County Comprehensive Plan Land Use Map effective August 28, 1998.
19.) A septic permit (SEP75-00127) was approved October 31, 1975 for a capacity of 360
gallons per day. This permit was finalled October 31, 1975.
20.) This parcel is served by a public water system.
21.) Mason St. (C637809) is a county local access road. A road approach exists and an
address of 40 Mason St. has been assigned to the parcel.
22.) This parcel was created through Phillips Addition under AFN 29103, recorded January 3,
1910, Volume 2, page 130 with the Jefferson County Auditor's office.
23.) A Declaration of Restrictive Covenant was recorded April 30, 2007 under AFN 522952
with the Jefferson County Auditor binding lots 3 &4 of Block 14, Phillips Addition to
Irondale for the purpose of meeting bulk and dimensional requirements and minimum land
area.
24.) A Restrictive Covenant for Irondale/Hadlock Sanitary Sewer System No Protest
Agreement was recorded April 30, 2007 under AFN 522951 with the Jefferson County
Auditor.
25.) BLD not to be finaled until RESERVE area approved & corrections noted on EES have
been completed.
• ••
c:97o�, JEFFERSON COUNTY,� DEPARTMENTOFCOMMUNITYDEVELOPMENT`� 621 Sheridan Street• Port Townsend •Wash ingtpn 98368
360/379-4450. 360/379-4451 Eax
�,q www.co.jefferson.wa.us/commdevelopment
S�NG� _
Master Permit Application y' MLA: 0 Q0-1
Project Description(include separate sheets as necessary):
- €, i rA�� c. C Ai c- .+- o'Nob: I t /Aruof1tE 1r sE .;b,.1
Tax arcel C u / � 2 , .„ Property
Number: 4 U Co"Y (J f -/� Size: 1 UC= ) G U (acres/square feet)
Site Address and/or Directions to Property: .--C, h1e,5c;ttt S'r..- NG t-t 14 0,ti 1 c i,ti,
Property Owner(s)of Record: r`C .t i iq e. i:y,-+l`�t't•( . ti i., t--L.]. K it i
Telephone: `3tL^G -. 5 3 I -�,i-.A.14 Fax:
email:
Mailing Address: q0 1,10,s �t .•E4,Ct t)cr'L (`lc.c\k, K v., t "$.. Y i
Applicant/Agent(if different from owner): A/:1
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies)
CilBuilding ❑Variance(Minor,Major or Reasonable Economic Use)
d Demolition Permit ❑Conditional Use[C(a),C(d),or C]**
d Single Family °Discretionary"D"or Unnamed Use Classification
❑Garage Attached/Detached ❑Special Use(Essential Public Facilities)**
RI Manufactured Home °Boundary Line Adjustment
El Modular °Short Plat**
❑Commercial* °Binding Site Plan**
0 Change of Use °Long Plat**
Ei Address I Road Approach °Planned Rural Residential Development(PRRD)/Amendments**
E Propane ❑Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions**
DStormwater Management ❑Shoreline Management Substantial Development**
OSite Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance
OTemporary 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 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. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the applj lion t at he or she wants rior nose.
Signature: T Zvt.. . ,t f tc.1.-e—" Date: Eir. I/r /() 7
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-transferable sponsibility or adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature , , •
, c �' r�C • c Date: ),9 /f [,
D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc
• •
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:
GENERAL ONTRACTOR� OR OR MANUFACTURED{� _ HOME INSTALLER: PHONE: FAX:
WAS —t"[JIJ'l`. tin i',',G' ' j ( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTORS LICENSE G t/ „E--14.4y WAINS
NUMBER: J L.� NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
'g New 0 Wood Existing: I ❑Sewer
❑ Addition ❑ Steel Proposed: -4 Bank sall Community System
❑ Alteration/Remodel 0 Concrete Total: 0"1 Height: Individual System
❑ Repair 0 Masonry v�- SEP Permit# .75 -/-/' 7
❑ Demolition 0 Other: Bedrooms: Water Supply:
Existing: , . Setback: p Private well 0 Two Party
Type of Heat: Proposed: El Public
C 4 t7gIC- Total: Name of System:
0
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:
E]Underground Tank 0 Above ground Tank Size of Propane Tank:
d Heat Stove ❑Cook Stove 0 Woodstove ❑Fireplace Insert 0 Hot Water Tank 0 Pellet Stove p 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 Current Proposed For Office Use Only Amount Revision
Main Floor Heated EH Bld App Review: r
2"°Floor Heated Consistency Review: 1 53
Other Heated Base fee:
Mezzanine Additional Section:
IG3
Heated Basement Plan Check fee:
Unheated Basement State Surcharge fee: ___.__,
Other Unheated Pot Water Review fee:
Garage/Carport SUBTOTAL 3 53A
Decks 911/Rd Approach fee:
Other TOTAL: $
Receipt Number: 3'G1 1 I
Cash/Check Number:
ESTIMATED COST(REQUIRED) Date: _ . (a5/C57"
.Fair market value of all labor and materials foundation to finish
Initials:
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