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HomeMy WebLinkAboutBLD2007-00495 MANUFAG URED/MOBILE HOME INSTALLATION PERIII1 Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD07-00495 Received Date: 9/6/2007 SITE ADDRESS: 3835 THORNDYKE RD Issue Date: 10/17/2007 PORT LUDLOW, 98365 �� '" V /ICJ- APPLICANT: MICHAEL L BRONK 3835 THORNDYKE RD PORT LUDLOW WA 98365-8242 SUBDIVISION: CEDARHOLM VILLA Block: Lot: TX 10 PARCEL#: 942300059 Section: 19 Township: 27 N Range: 01 E CONTRACTOR/ MIKE'S SETUP INC PHONE: (360)373-3129 DEALER 4201 KELLY RD BREMERTON WA 98312 Contractor's License MIKE SS1011KC Expires 8/2/2008 PROJECT DESCRIPTION: REPLACE SINGLE WIDE MFH W/DOUBLE WIDE MFH SERIAL NO. 09L2834-IXU MAKE: LIBERTY YEAR: 1994 SIZE: 48 X 28 Directions SEE MAP QUEST MAP AND DIRECTIONS IN FILE To Site: THIS PERMIT IS VALID FOR ONE YEAR. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 10/17/2008. CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. Setbacks/Footi g (CONTINUOUS FOOTING, SLAB or PADS USED): l t4GK-5 2lRiDn! Fool-tNGtb &e- to-4--0'2�9e Stormwater FINAL Approval: Blocking/Plumbing: 9Lec/ /N6 c --7,..e._zt.,,05 L7K 9/ic/4s ; Propane Tank/Lines JV/A Zoning Final Approval: Septic System Final Approval (If not on sewer): Road Approach Final Approval: Final/Skirting/Vents/Porches/Steps: f r t na' MO g HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRI 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 • MLA07-00516 Review Type: I MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00495 Received Date: 9/6/2007 SITE ADDRESS: 3835 THORNDYKE RD PORT LUDLOW, 98365 APPLICANT: MICHAEL L BRONK PHONE: 3835 THORN DYKE RD PORT LUDLOW WA 98365-8242 SUBDIVISION: CEDARHOLM VILLA Block: Lot: TX 10 PARCEL NUMBER: 942300059 Section: 19 Township: 27 N Range: 01 E CONTRACTOR/ MIKE'S SETUP INC PHONE: (360)373-3129 DEALER: 4201 KELLY RD BREMERTON WA 98312 Contractor's License MIKE SS1011KC Expires 8/2/2008 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION: REPLACE SINGLE WIDE MFH W/DOUBLE WIDE MFH SERIAL NO. 09L28341XU TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: LIBERTY SETBACK: VALUATION 17,000.00 YEAR: 1994 LABOR & INDUSTRIES APPROVAL? SIZE: 48 X 28 BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: 3 Prop: 2 Total: 3 Total: 2 Routing Date: 9/(P /e' Type Amount Paid Bv: Date: Receipt: A ' * '"° t \E Manufactured Homes $163.00 KAS 09/06/07 93137 _ Potable Water Application $58.00 KAS 09/06/07 93137 OCT ( 2007 Total: $221.00 Jefferson County Planning &Building Department • SPECIAL CONDITIONS CASE # BLD07-00495 1.) THE EXISTING SINGLE WIDE MOBIL OME SHALL BE REMOVED PRIOR TO FINAL INSPECTION. , Q//5/4f3•=- 2.) T O he application was reviewed b the efferson County Department of Community Development staff on October 12, 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 and an investigative site inspection, the following ESAs were confirmed to be present on the subject property: Seismic Hazard Area. 3.) Geologically Hazardous Areas in Jefferson County are characterized by slope, soil type, geologic material, and groundwater that may combine to create problems with slope stability, erosion, and water quality during and after construction or during natural events such as earthquakes or severe rainstorms. 4.) The applicant is proposing to create or add 1288 square feet of impervious surface and 1344 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. 5.) 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. 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 6, 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 October 12, 2007 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.) The parcel has been designated as Rural Residential 1:5 under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. 10.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 11.) Not more than 2 unlicensed vehicles shall be stored on any lot 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 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. 12.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 13.) The building height is not to exceed 35 feet. 14.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 15.) 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. 16.) 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. 17.) Minimum setback from the eof the Thorndyke Rd usage road is 20 ft. •imum side and rear setbacks are 5 ft. 18.) Thorndyke Rd is a minor collector road (C418708). The road approach is existing and an address of 3835 Thorndyke Rd has been assigned to the parcel. 19.) A septic permit(SEP00-00020) was finaled on May 17, 2001 for a system of 360 gallons per day. JACK 'VESTERMAN • Jefferson Courthouse ASSESSOR IF' �' M � PO Ilox 1220. Port Townsend, 98368 A*.-.r' .€ , 4360)311.i-9105 MOBILE HOME INFORMATION FORM OWNER'S NAME/MAILING ADDRESS: NAME: 44/C/a.e'L Z.e e Axv,v,e ADDRESS: ?c S -Tl-'or-Adbvite 1 s7 , T LLI(it s- 1'HONE NO. 34'O 4 3 7 - 4-(-0 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. SEP 2007 1)MOBILE HOME DATA: Priy (A) MAKE L1 AL-'-`C`{ (B) MODEL 1y) /i`% / EAR (D) LENGTH 4 (E) WIDTH :2 F; ' (F) SERIAL # 07Z 2 )3 ' i X U (G) YOUR PURCHASE PRICE (Do not include sales tax) rr-e a PURCHASE DATE '`27/G 2) PREVIOUS OWNER/LOCATION OF MOBILE HOME: (IF NEW MOVE TO QUESTION 3) (A) FROM WVIIOM DID YOU PURCHASE MOBILE Sit io a g,,,Ljet, lip 6,6/o ADDRESS '7e2 CI' 33 1�';, `C�% ` C U L L�y Zc i f ���c C' 3 No (B) WAS MOBILE HOME ASSESSED IN . FFER ON COUNTY LAST YEAR?( ) No If Yes, Previous address of mobile. SE 4+Z- If No. What County was Mobile assessed in last year. 3)WIIEIIE MOBILE HOME IS TO BE LOCATED: (A) WILL THE MOBILE HOME BE IN MOBILE HOME PARK? Yes (No (II) IF LOCATED IN MOBILE HOME PARK: NAME &ADDRESS OF PARK Lot/Space # (C) IF NOT LOCATED IN MOBILE HOME PARK: • NADIF, OF LAND OWNER: �l�O4 t - ��' LOCATION ADDRESS S 5- 76 r y Ke !c � L L ct I t)cJ 1 'Cp �d S,W r REAL PROPERTY PARCEL #/DESCRIPTION C7y Z 3 C c 0 S C)6 Signature of applicant THANK YOU FOR YOUR HELP! 6JOD,Z4/3 i1I COSSELL, Property Technician :. , _.._ . � t�� JEFFERSON UNTY r v g� DEPARTMENT OF COMMUNITY DEVELOPMENT SG `� 007 ' 621 Sheridan Street• Port Townsend •VVashington 98368 360/379-4450 • 360/379-4451 Fax O� www.co.jefferson.wa.us/commdevelopment FANG Master Permit Application MLA: 0 1 J/CD Project Description(include separate sheets as necessary): Tax Parcel Pro Number: Cr�Q C C> G'> `J 9= C�(rs! Property 7. ,7`/ Size: vC acre /square feet) Site Address and/or Directions to Property: 38'-3 Th 0 r A, `i,i t c(, 4.),Y Z i JC�.-,-, wL: 9d'3�S`` Property Owner(s)of Record: /4/1644ec x ,r 13;.ce-,"- Telephone: l sv `}'3 7- C= G>/ -flax: 3(4.c. 3 I t, -t l 0 j email: i ,l),-gin ie (-- e1/07,044'''..c'- Mailing Address: .i ' S 7k .vv-,id171 12.4 VI( `ndi 7 Z.L.•.././ch. l k' . 4'y73c:,:- Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies Building 0 Variance(Minor,Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a),C(d),or CI** kill Single Family ❑ Garage Attached/Detached ❑ Discretionary"D"or Unnamed Use Classification glirManufactured Home ❑ Modular 0 Special Use(Essential Public Facilities)** ❑ Commercial* ❑ Boundary Line Adjustment ❑ Change of Use ❑Short Plat** ❑ Address 0 Road Approach ❑ Binding Site Plan** ❑ Home Business 0 Cottagelndustry ❑ Long Plat** ❑ Propane ❑Planned Rural Residential Development(PRRD)/Amendments** ❑Sign 0 Plat Vacation/Alteration** ❑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 ❑Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment ❑Forest Practices Act/Release of Six-Year Moratorium ❑Tree Vegetaion Request *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 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 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 application hat p,or ,wants prior notice. Si nature: � Date: �/.0 � � - S/ , `Y.> 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 esp srbil"y fo dher'ng to and complying with the ESA. The' Applicant has read this disc imer and signs and dates it below. Signature: /!7'6 `e v'c' IJ4-E'� Date: u< 62�, 1,'7 ? 1 G:\PermitCenter\###FORMS###\DM FfRMC\MoctP.PP«.,;.n...,i:,...,,...70 1n nix,:d-_ ' 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 CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: y1i,E'Qs filcurvL. 9- SQ"tuP ( 3o) 37 3 - 31: ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICEN WAINS NUMBER: NUMBER ARCHITECT/ENGINEE . PHONE ( ) FAX:( ) MAILING ADDRESS: 4 ,t D i 1,1 p/11 1?d i, 01., (,L':L cj Q 3/ZEMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: p-'New Wood Existing: — 0 Sewer O Addition Steel Proposed: Z Bank ❑ Community System O Alteration/Remodel 0 Concrete Total: 2 Height: e'"lndividual System ❑ Repair 0 Masonry N//a SEP Permit# (X) V O Demolition 0 Other: Bedrooms: Water Supply: Existing: - p�Setback: private well 0 Two Party Type of Heat: Proposed: ._ 0 Public E'Ccc-I r_1 Total: 's Rid Name of System: 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: l Underground Tank I Above ground Tank Size of Propane Tank: i Heat Stove i Cook Stove l Woodstove I Fireplace Insert I Hot Water Tank I Pellet Stove I 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. p. Square Footage Current Proposed r „„ice _ _ .. , .:e. 9 .' Main Floor Heated /) r} ; ' , 1'' EH BId App Review: 2nd Floor Heated q,/ ':z4V/ e Consistency Review: Other Heated Y' ro 4 Base fee: a� , ,� y j•A -,-\-- 1 (L3. CC- Mezzanine Additional Section: plot 7 _. Heated Basement A, - Plan Check fee: _ Nil+ Unheated Basement ` ' State Surcharge fee:N' -z- Other Unheated , ' _ ; , Pot Water Review fee: Garage/Carport 114 -..,4 SUBTOTAL Decks �J[��7 IP 911/Rd Approach fee: Other «,i3r TOTAL: $ 4 1 —1 co .t = , ' Receipt Number: q r '] - Cash/Check Number: ‘ 1 ..0 ESTIMATED COST(REQUIRED) Date: ( lfp/07 •Fair market value of all labor and materials foundation to finish -t /'],&,e0. Initials: Ciii G:\PemmitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc .•�.• Y RETURN ADDRESS L l� C��Kitsap Community Federal Credit Union Kathy Willis \ 9481 Silverdale Way Silverdale,WA 98383 L41STATEOFWASHINGTON MANUFACTURED HOME MY,1St:CHECKONL Oepa.mmr g licEnsinc APPLICATION ®TITLE ELIMINATION ❑TRANSFER IN LOCATION ❑REMOVAL FROM REAL PROPERTY Anyone who knowingly makes a false statement of a material fact is guilty 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) %101310 1994 Liberty 28/48 09L28341XU LAND LEGAL DESCRIPTION ON PAGE 2 REAL PROPERTY TAX PARCEL NUMBER MANUFACTURED HOME WILL BE ®AFFIXED ❑REMOVED 942 300 059 LOT BLOCK PLAT NAME OR SECTION/TOWNSHIP/RANGE QUARTER/QUARTER SECTION 71-73 Cedarholm Villa GRANTOR(S)REGISTERED/LEGAL OWNER(S) ADDITIONAL NAMES ON PAGE COUNTY NUMBER NUMBER OF REGISTERED OWNERS NUMBER OF LEGAL OWNERS 1 1 NAME OF REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER Michael L.Bronk NAME OF ADDITIONAL REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE 3835 Thorndyke Road Port Ludlow WA 98365 NAME OF LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER Kitsap Community Federal Credit Union NAME OF ADDITIONAL LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE 9481 Silverdale Way Silverdale WA 98383 GRANTEE NAME Michael L. Bronk 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 Jefferson before me on by Michael L.Bronk Signature PRINTED NAME OF REGISTERED OWNER NOTARY OR AGENT by _ PRINTED NAME OF REGISTERED OWNER PRINTED NAME OF NOTARY County/Office No.OR Title Notary Public AND: Dealer No.OR DEALERSHIP POSITION/AGENTMOTARY Notary Expiration Date © 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 Jefferson Title Company (360)385-2000 SIGNATURE/POSITION DATE Finalize this application with a Licensing Agent within 10 calendar days of the date Title Company Representative signs. ® BUILDING PERMIT OFFICE 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. 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