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BLD2007-00607
MANUFAPURED/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#: BLD07-00607 Received Date: 12/17/2007 SITE ADDRESS: 50 SUNROCK DR Issue Date: 1/3/2008 BRINNON, 98320 APPLICANT: ANNA M WALLER TRUSTEE WALLER FAMILY TRUST PO BOX 671 BRINNON WA 983200671 SUBDIVISION: SUN ROCK MOBILE HOME PARK Block: Lot: 1+ PARCEL#: 602352026 Section: 35 Township: 26 N Range: 02 W CONTRACTOR/ OWNER/BUILDER PHONE: DEALER PROJECT DESCRIPTION: NEW MAN HOME -PEERLESS 1977 SERIAL#L09P11422 MAKE: PEERLESS YEAR: 1977 SIZE: 14x54 Directions DOSE-RIGHT OFF CHURCH-TO SUNROCK To Site: THIS PERMIT IS VALID FOR ONE YEAR. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 1/3/2009. CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. Setbacks/Footing (CONTINUOUS OOTI G, SLAB or PADS USED): „/ rAns b K eV/ oi3 iftsStormwater FINAL Approval: 1 SeEtinetilca9 /Blocking/Plumbing: ,�Ll.�kli�C) 111'r.-�w+�5 i ��crwlFs�NC �� � j 168 i Propane Tank/Lines IJoPe Zoning Final Approval: Septic System Final Approval (If not on sewer): Road Approach Final Approval: Final/Skirting/Vents/Porches/Steps: /)A -Pr-r g 1 na.1 8h-4El HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED RIOR 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 MLA07-00654 IllUILDING PERMIT APPLICAN Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00607 Received Date: 12/17/2007 SITE ADDRESS: 50 SUNROCK DR BRINNON, 98320 OWNER: ANNA M WALLER TRUSTEE PHONE: 360-796-4813 WALLER FAMILY TRUST PO BOX 671 BRINNON WA 983200671 SUN ROCK MOBILE HOME PARK SUBDIVISION: Block: Lot: 1+ PARCEL NUMBER: 602352026 Section: 35 Township: 26 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI` NEW MAN HOME - PEERLESS 1977 SERIAL #L09P11422 TYPE OF WORK MOB SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 500.00 ADD'L: HEAT TYPE: E.EE CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: #OF STORIES: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: 2 Prop: 1 Total: 2 Total: 1 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $163.00 CJZ 12/17/07 95523 State Building Code $4.50 CJZ 12/17/07 95523 AFTROVEr Potable Water Application $58.00 CJZ 12/17/07 95523 laTotal: $225.50 3 2007 ( Jefferson County Planning &Building Department • • SPECIAL CONDITIONS CASE # BLD07-00607 1.) A MINIMUM OF 10' MUST BE MAINTAINED BETWEEN BUILDING FOUNDATION AND EDGE OF DISPOSAL COMPONENT AND RESERVE AREA. 2.) MUST COLLECT AND DIVERT ALL SOURCES OF DRAINAGE AWAY FROM SEPTIC TANK, RESERVE & DRAINFIELD. MUST COMPLY WITH ALL PERMIT CONDITIONS, STATE AND LOCAL CODE. 3.) 10' SEPARATION REQUIRED BETWEEN A WATER LINE AND ALL PORTIONS OF THE ONSITE SEWAGE SYSTEM; EFFLUENT TRANSPORT LINE, TANKS, TREATMENT AND DISPOSAL COMPONENTS. 4.) The 50 foot vegetated paths for stormwater encroach on the septic reserve drainfield area. AT SUCH TIME THAT THE RESERVE DRAINFIELD AREA IS NEEDED FOR SEWAGE DISPOSAL, THE STORMWATER PLAN SHALL BE REVISED AND SUBMITTED TO THE DEPARTMENT OF COMMUNITY DEVELOPMENT FOR REVIEW AND APPROVAL. 5.) The application was reviewed by the Jefferson County Department of Community Development staff on (date) 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: SUSC aquifer recharge area. 6.) 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. 7.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 8.) 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. 9.) The applicant is proposing to create or add 756 square feet of impervious surface and zero 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. 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.) 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). 12.) The revised site plan dated December 26, 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 December 31, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 13.) This approval is for a 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. 14.) The parcel has been designated as RR 1:5 under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. 15.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. mot 16.) Not more than 2 unlicensed Itles shall be stored on any lot unless total•reened 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. 17.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 18.) Minimum setback from Sunrock Drive right-of-way shall be 20 feet. Minimum side and rear yard setbacks shall be 5 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.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 22.) The building height is not to exceed 35 feet. 23.) An address of 50 Sunrock Drive, Brinnon has been assigned to the parcel. Sunrock Drive is private (P465). 24.) The lot was created through the Sun Rock Mobile Home Park on November 26, 1984 under AFN 292424. 25.) The parcel is served by an off-site public water supply for this Binding Site Plan. 26.) A septic permit(SEP77-0263) for Lots 5 &6 was finaled on April 10, 1978. An EES was completed in 2005 and a Designation of Reserve Drainfield completed in 2006. 27.) A VEGETATED FLOWPATH OF AT LEAST 50 FEET SHALL BE MAINTAIN BETWEEN THE DISCHARGE POINT AND ANY PROPERTY LINE, STRUCTURE, OR OTHER IMPERVIOUS SURFACE. 28.) A MAXIMUM OF 700 SQUARE FEET OF ROOF AREA MAY DRAIN TO EACH SPLASHBLOCK. 29.) A SPLASHBLOCK OR A PAD OF CRUSHED ROCK(2 FEET WIDE BY 3 FEET LONG BY 6 INCHES DEEP) SHOULD BE PLACED AT EACH DOWNSPOUT DISCHARGE POINT. 30.) THE STORMWATER DISCHARGE POINT MUST BE DOWNSLOPE OF THE PRIMARY AND RESERVE DRAINFIELD AREAS. JACK IVESTERMAN O Jefferson talty Courthouse ASSESSOR Po no. 1. Port Townsend, W 98368 (360)3115-9 105 MOBILE HOME INFORMATION FORM DEC 1 7 2007 OWNER'S NAME/MAILING ADDRESS: NAME: A 11 11 a_ UM // (^ ADDRESS: fc9. f c^ x 7 ( -3G Sccnrote nhoar , i>.•14 PHONE NO..,36 29 -4/6P/ 5' W3 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. 144.0 ', • -: `,a 1)MOBILE HOME DATA: (A) MAKE 1 ce_ r le 6s (B) MODEL (C)YEAR / ! 7 ` (D) LENGTH (E) WIDTH / / ' (F)SERIAL # (G) YOUR PURCHASE PRICE (Do not include sales tax) See), PURCHASE DATE -/S-e; 2) PREVIOUS OWNER/LOCATION OF MOBILE HOME: (IF NEW MOVE TO QUESTION 3) (A) FROM WHOM DID YOU PURCHASE MOBILE P /4 4- .J Qu ADDRESS / - 3 / () (ke 5 t-( sh i • ��;t,ntc i t.a1- 9P-3 0 (B) WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR? 'es 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? lar. No (B)IF LOCATED IN MOBILE HOME PARK: NAME &ADDRESS OF PARK .S601 N itA- Lot/Space#J r,'yi Rt 0 yt z...e.}0 9a'3 a_c (C) IF NOT LOCATED IN MOBILE HOME PARK: NAME OF LAND OWNER: LOCATION ADDRESS REAL PROPERTY PARCEL #/DESCRIPTION 6 0 A. .ci �Z 2 R. 6 Signature of applicant THANK YOU FOR YOUR HELP! JO COSSELL, Property Technician • U ,.:Ii= - E-' , - ,, kTy.• :.VE LOP,.,ENT i I r • S\ \ Ric .1----\ .).:1..11s w . ..-6.'" '''K c4 ‘1-*Is -7( . . 1 - { , 3 (..? I , _ i 4/ , ___ _______, r ------ --D , , . i§ • iF ..z , ;2.,:ii- _ (s. / � oI - - 't 3 CA,So o �`' p 4 ':Mt� ._..., ,, ) ,.„,.._ up 1,1,--., , , i--' -2. P 10 4 a `1 -0 frit- ,..:,... ,. - ,I.4 ,_.,a-- 2 '( z_l it4 c...) .\ 1 A:: v) . . 7.,..:..., czlw : _..., i 1„.4 , , : . .s 0.4 ;38 3 ,...T.,7) c-'„, 1 -0 % t r] f W18,>,-,. , ( " .a th J �T # � 3,• I ;, 0 l - J I • r-- �` 4. s \ cdc., , ` ;4- . • d91. Ste. . 1. / /As - \ii4__ ,I s 'fir 6. _ / -1 'I,4Bs �_SL / .. j,`. 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Pfiii4. ��.a No D A/..11 fit #" I 0 a .— a 0 7 a W �� �w�SON Cor, JEFFERSOOUNTY • f �q DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax 4"" o� www.co.jefferson.wa.us/commdevelopment DEC 17 2007 Master Permit Application MLA: 0 ri - to - Project Description(include separate/ sheets as necessary): ;fJ , l .�a tlX/c.cYCJ✓t I floor e `G‘1-\ &Df Tax Parcel Property Number: oh ( -f- 5 Size: (acres/square feet) Site Address and/or Directions to Property: TAco4-k 013130-t\ia- 4a�J,--1 r`»At" ,5o - - o ' .cal-kPs _p I ° l Property Owner(s)of Record: • , , Telephone: . Fax: email: Mailing Address: 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 0 Conditional Use[C(a),C(d),or C]** ❑ Single Family 0 Garage Attached/Detached ❑ Discretionary"D"or Unnamed Use Classification d Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment ❑ Change of Use 0 Short Plat** ❑ Address 0 Road Approach 0 Binding Site Plan** ❑ Home Business ❑ Cottagelndustry 0 Long Plat** ❑ Propane 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Sign 0 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 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium 0 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: t DESIGNATION OF AGENT I hereby designate , , to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE ! ,' ,l ; 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 that he or she wants prior notice. /, ._ /7- c 7 Signature: .. r _ . ., t 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-transferable responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: ._ 1 k_il r Date: - G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.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: �� — ✓� I C 7 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX: ( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: JA New ❑ Wood Existing: _ [1 Sewer ❑ Addition ❑ Steel Proposed: - 1 Bank C1 Community System ❑ Alteration/Remodel ❑ Concrete Total: _ t - Height: F1 Individual System ❑ Repair 0 Masonry SEP Permit# t,6 r3 77- L3 ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: Z pd Public bal r d-ci-C Total: '7 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: i Underground Tank i Above ground Tank Size of Propane Tank: i Heat Stove I Cook Stove i Woodstove i Fireplace Insert i Hot WatPr Tank i Pellet Stove 1 Other Is this appliance being installed in a Manufactured/Mobile Home? t 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 C EH Bid App Review: / - 2 2"°Floor Heated Consistency Review: 15 > 2 Other Heated Base fee: l r^ 3 Mezzanine Additional Section: lV Heated Basement Plan Check fee: --- Unheated Basement State Surcharge fee: 1 Other Unheated Pot Water Review fee: —Garage/Carport SUBTOTAL9;.):, Decks 911/Rd Approach fee: Other mad TOTAL: $ Receipt Number: °t 55 3 Cash/Check Number: I (4‘O ESTIMATED COST(REQUIRED) Date: I al 1-1a- .Fair market value of all labor and materials foundation to finish S 00 `)--/' Initials: "7 J G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc 4 i MU ©5o� . c" Zed n t � !1SC31%:. CO . rt ` 4 _ v C :; �.J . ///1 c. F.11 )r9-C-'1 r . 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