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HomeMy WebLinkAboutBLD1999-00756 - DENIED THIS BUILDING IS NOT FINALED . THIS IS AN INCOMPLETE BUILDING APPLICATION . THE PERMIT WAS NEVER ISSUED . MOBILE HOME INSTALLATION APPLICATION Jefferson County Permit Center CIA70Stle Hill Mall 621 Sheridan St. Ptiil. -Townsend, WA 98368 360-379-4450 PERMIT # •BLD99-0756 DATE RECEIVED. :11/09/99 SITE ADDRESS : E GO-ONNA :QUILCENE, WA 98376 APPLICANT. . . :BONITA PENDL TON PHONE: (360) 377-$863 MAILING ADDR: 9-15 PACIFIC AVE :BREMERTON WA 98337 INSTALLER. . . : OWNER INSTALLER PHONE: LICENSE # : EXPIRATION DATE: / / CONTRACTOR. . : PHONE: MAILING ADDR: CONTR. LIC #: EXPIRATION- DATE: / / PARCEL NO. : 955000023 Landslide — Plat Cond — Wetland _ Flooding _ LEGAL DESC:STR27-26-01 W WM Seismic _ Streams _ Erosion _ F & W T— LOT 23, BLOCK _, TAX # Shoreline Aquifer GO-ONNA BEACH TR DIV 2 Area Com. Forest : Adj . 300"�_ DESCRIPTION OF IMPROVEMENT: ADU mobile home installation installation BUILDING TYPE MOB BEDROOMS--- BATHROOMS-- CRPT/GAR. . , A sf TYPE OF IMPROVEMENT:ADU EXIST. : 0 EXIST. : 0 DECKS 0 sf GARAGE/CARPORT PROP. . : 3 PROP. . : 3 COMMERCIAL: S) sf UBC OCCUPANCY GROUP: TOTAL. : 3 TOTAL. : 3 INDUSTRIAL: 0 sf EST COST.$ : 0 SEWAGE DISP. . :SEPTIC BANK HT. . . : 0 ft PROJ GRP. . : 11488 WATER SUPPLY. :PWELL SH SETBACK: 0 ft MOBILE HOME------ MAKE: INPERIAL600 YR:73 SIZE: 10 X 60 Owner/agent FEES --Signature: type amount by date rpcpt PRMT $ 137 .00 LMB 11/09/99 20163 Date: Issued By: Date: (bld_apmo.txt) $ 137 .00 TOTAL JEFFERSON COUNTY PERMIT CENTER, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 MANUFACTURED HOME INSTALLATION PERMIT APPLICATION NEW BUILDING ❑ REPLACEMENT SIZE /f7 c, c YEAR MAKE _Y COST BEDROOMS: BATHROOMS: EXISTING _ EXISTING Ra PROPOSED PROPOSED TOTAL � TOTAL TYPE OF SEWAGE DISPOSAL: WATER SUPPLY: ❑ SEWER ❑ COMMUNITY SYSTEM PRIVATE WELL ❑ TWO PARY WELL ❑ INDIVIDUAL SYSTEM 4S Conventional ❑ PUBLIC PERMIT # SEP Alternative Name of water system: IF WATERFRONT PROPERTY, DISTANCE TO BANK OR HIGH WATER LINE A;t, ft BANK HEIGHT ft / / SIGNATURE DATE NAME (PLEASE PRINT) 6°72e / /La'/ 2 J.FOR OFFICE USE ONLY (- BASE FEE I RECEIPT # Z' co3 ADDITIONAL SECTIONS CASH/CK # CAS►-� SUBTOTAL 3--)°° DATE I t / q � J POTABLE WATER d.° 911/ROAD APPROACH 256 I �D TOTAL � J H:\HOME\PLNCNTR\FORMS\MOBILEAP.5/97 , , t , 1 1 1 ..,. .,.. , , , ( , ._,... __...k. .._....i.r. 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' 1 '1 , . .' , • t ,• - • 1 ■ , I • t , . . ..., „. , hi, • , \ ' , .( (■, ; „,. * , . , 1 \ifl , -. , ; , f• % - Nt • 1 I 111 s , .. 1 i 1 11■L t' 1 A. . f 1 .... 1 , , . .. ..,... v __......_ . , • '.-..„ . ....,... k3,,› i. ., ,. mmlimmw 4al C:2 g g O Q7 .Y 7 M m r-, og ZI 00 N ti P I co .pis, f,\ 0 0 �� 111 ro ,. ct O N C' q C c C ai a.) �� , a hQ -c Cam. -c -G a .c .c° .c° _� -- �c r1 C c� *,. o Is 03 ��� VVV 1 o i ..... ,, . ) b , v CL. �� M cga .I crl f g (' t - r L; 4J r- dN cu u Q 1„, . ++ O cC O C VC?�' Lr; i •a0 _ ,b 0 aj O G. O b -1 v Q 'U ij w d CL CJ C 4J ,. v A. pp o a ca pv (7 �p U cc;S u I z " N 0 Q+ q bhp H �" V, U cd ``' " N W v, Td`v� , '►3 A ` a b v 0 N 0 b `' 'N v V o " b ca X31' C v 'b o Qno o w do ° ao v ao A Sao III O Q $ v A. to Y • to w 10 Q ,` z SHJVHI3S ''...\4.-2.. ) q Z c O A O PI N Q O Z .-J ° Q a 3 O CD J CC A. t ,t k. 3 Cd ''^^ J ,(7` .(- 1\ n N. J LP Q O 5 �b Y �y F w z W �f z cl NCac i, Y ( i ,(4... 1 a°d u�i OJ Y 1 by J 1/ Q .....\-...., J Jo a a O v a Z cco Y' O w a .- —1 c d Q Q. m Y O u, co co J A E MOBILE HOME INSTALLATION APPLICATION Jefferson County Permit Center Castle Hill Mall 621 Sherjdan St . Pv.L 'Townsend, WA 98368 360-379-4450 PERMIT # •BLD99-0756 DATE RECEIVED. :11/09/99 SITE ADDRESS : E GO-ONNA :QUILCENE, WA 98376 APPLICANT. . . :BONITA PENDLETON PHONE: (360) 177-8863 MAILING ADDR:9.15 PACIFIC AVE :BREMERTON WA 98337 INSTALLER. . . : OWNER INSTALLER PHONE: LICENSE # : EXPIRATION DATE : / / CONTRACTOR. . : PHONE: MAILING ADDR: Critical Are' tit Cj �7 �47 . evreu� 1 � CONTR. LIC EXPIRATION- DATE: / / r f 7 f PARCEL NO. :955000023 Landsli �4 Plat Cond L Wetla d � : Floo ing i-"� LEGAL DESC:STR27-26-01 W WM Seismic /& i Erospi . �� F & W LOT 23, BLOCK _, TAX„ # Shoreline /\c ` Aquifer .10/Lt GO-ONNA BEACH TR DIV 2 Area Cam. Forest : Adj . h = 300"T S/3 y LP DESCRIPTION OF IMPROVEMENT: ADU mobile home installation installation BUILDING TYPE -MOB BEDROOMS--- BATHROOMS-- CRPT/GAR. .; A sf TYPE OF IMPROVEMENT:ADU EXIST. : 0 EXIST. : 0 DECKS 0 sf GARAGE/CARPORT. . . ., PROP. . : 3 PROP. . : 3 COMMERCIAL: D sf UBC OCCUPANCY GROUP: TOTAL. : 3 TOTAL. : 3 INDUSTRIAL: 0 sf EST COST. $ : 0 SEWAGE DISP. . :SEPTIC BANK HT. . . : D ft PROJ GRP. . : 11488 WATER SUPPLY. :PWELL SH SETBACK: 0 ft MOBILE HOME------ MAKE: INPERIAL600 YR: 73 SIZE: 10 X 60 Owner/agent FEES Signature : type amount by date rpcpt PRMT $ 137 .00 LMB 11/09/99 20163 Date: Issued By: Stormw er r' Date : (bld_apmo.txt) /� $ 137 . 10 OTAL Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 CRITICAL AREAS QUESTIONNAIRE � ' -7 Applicant Name - �;%� /u ( - is ,,....,../4 y1i.+-;,._ 'Building 44pplication _ Land Use Application _ Shoreline Application On-site Sewage Application _ Subdivision Application Other: 1 . Is there any standing or running water on the surface of the _ Yes No property or on any nearby property at any time during the year? If YES, please describe: 2. Has any portion of the property or any nearby property ever been _ Yes No identified as a wetland or swamp? If YES, please describe: 3. Are any willows, skunk cabbage, alders, or cottonwoods present _ Yes ,X No on your property or adjacent properties? If YES, please describe: 4. Are there any indications on any portion of the property or on any _ YES ,)<,, No nearby property of rockslides, earthflows, mudflows, or landslides? If YES, please describe: 5. Please indicate which line best represents the steepest slope found on your property. (Check appropriate box) 4 Q o . . . . r r � / . . , ,/ /I / i / / .. „/ , r /I r i // . , �/ �'� i / i / i . /. ,� .' I / / / / / / / ,, �.*0 I r i i/ / / / / / . rriii . . ,” �� .ate rriii . , , �/ .' Ia► r, , , , . . , rii • 6. Does the site have steep slopes with little to no vegetation? YES ' No , If YES, please describe: 7. Does the site contain high percentages of silt and/or very fine YES V NO sand? If YES, please describe: 8. Does the site contain ground water seepage or springs near the YES NO surface of the ground? If YES, please describe: The applicant hereby certifies that all of the above statements and the information contained in any other transmittals made herewith are true, and the applicant acknowledges that any action taken by Jefferson County based in whole or in part on this application may be reversed if it develops that any such statement or other information contained herein is false. Signature c,, t J`a�rtL(- Date j1 - FOR OFFICE USE ONLY ❑ Wetlands ❑ Seismic CRITICAL AREAS ON OR ❑ Aquifer Recharge Area (zone ) ❑ Fish & Wildlife Area 1 IMMEDIATELY ADJACENT TO SITE: ❑ Frequently Flooded Area ❑ Fish & Wildlife Area 2 ❑ Erosion ❑ Landslide ❑Seismic ❑ Commercial Forest Section Township North Range Parcel Number: Parcel Size: Comprehensive Plan Land Use Designation: Reviewed by: Community Plan: Date: Page 2 of 2 h:\home\pincntr\forms\car.doc 10/99 ♦ STORMWATER CALCULATIONS Owner/Applicant: , j ' k . z ' ❑ PROPOSED LAND DISTURBING ACTIVITY l _� , 1, l Site Address: l G �> � ---C�t�x.a Drainfield area cleared a sq.ft. (:(9 � � ��� y2d ' < Driveway Length Z. /0 ft. X Width I�,., ft. 9 Digit Parcel Identification No.: 9,S75.- 00C, (_)= .,*3 = Total Driveway 2,/5 L J sq.ft. Permit Number: Clearing and Grading for Site Development PLOT PLAN (Well/Structures/Utilities/etc.) sq.ft. sq.ft. e INDICATE the following information. Total Land Disturbance 2' 7 sq.ft. Draw entire parcel to scale. Indicate scale of plot plan: r One inch equals 2 LI IMPERVIOUS SURFACE Proposed Structures (all roof area) 12 0 Gsq.ft. I"1. North arrow Existing Structures (all roof area) sq.ft. L/2. All property boundaries and dimensions Sidewalks 0 sq.ft. if 3. Names of adjacent streets Concrete Patios ( 4 0 sq.ft. E'4. Driveway/s & parking spaces Proposed: V5. Major features such as ravines, Driveway Length / 5— ft. seasonal creeks, bodies of water, etc. X Width 1 r ft. L6. Septic tank, drainfield and reserve area location, = Total Driveway 2 Z ' sq.ft. existing or proposed, and distance to Total Impervious Surface L d Z S sq.ft. closest structure k 7. Sewer lines The Stormwater Manual sets forth the following Small Parcel Minimum Requirements: t' 8. Wells and/or water lines • Construction Access Route Stabilization: 9. Neighboring wells within 150 feet Construction vehicle access shall be, whenever feasible, limited to one route. Access points shall be stabilized with i/10. Paved surfaces (patios) quarry spells or crushed rock to minimize the tracking of 1. Structures, existing and/or proposed sediment onto public roads. If sediment is inadvertently transported onto public roads, roads shall be cleaned [4'12. Setbacks (distances to property thoroughly at the end of the day by shoveling or sweeping. Street washing should only be done after the bulk of the boundaries, structures, banks, sediment has been removed by sweeping. and shorelines) • Stabilization of Exposed Soil: All exposed and unworried soil shall be stabilized by sodding, 4/13. Easements for access or utilities seeding, mulching, plastic covering, application of gravel base 14. Arrows showing direction of slope on roads and driveways, or other appropriate means within L. seven days during the period from May 1 to September 30 assume an elevation of 100 feet at one and within two days during the period from October 1 to April lot corner and indicate the other lot 30. Mulch shall be applied to a minimum depth of two inches. • Protection of Adjacent Properties: corner elevations in relation to it Adjacent properties shall be protected from sediment deposition by appropriate use of vegetative buffer strips, sediment barriers or filters, dikes, mulching, or by a FOR APPLICATIONS ADJOINING SHORELINES, combination of these measures and other appropriate Best Management Practices (BMPs). INDICATE: • Maintenance: 0 15. Ordinary high water mark All erosion and sediment control BMPs shall be regularly inspected and maintained to ensure continued performance of ❑ 1 6. Top of bank, if over 10 feet high their intended function. ❑ 17. Slope of bank in degrees • Other Appropriate BMPs as required by Jefferson County to mitigate the effects of increased runoff shall be applied. H:\HOME\PLNCNTR\FORMS\PLOTPLN.FRM9/97 PLEASE MAIL TO: JEFFERSON COUNTY ASSESSOR JACK WESTERMAN III JEFFERSON COUNTY COURTHOUSE • ASSESSOR PO BOX 1220, PORT TOWNSEND WA 98368 (360) 385-9105 MOBILE HOME INFORMATION FORM . OWNER'S NAME / MAILING ADDRESS: THIS IS NOTA TAX STATEMENT NAME: C7u 4 J_ The purpose of this questionnaire is to obtain information ,� _ regarding either the current location of a mobile home or the ADDRESS: j3% ��P- -S/__,e: CC€ , previous ownership and location of a mobile home. This will �' _. �. /`� help our office determine whether the mobile home is already Sh-1. 7c.e- C,v cr 9si3 on the tax rolls in Jefferson County or if it has been moved to this county from another area. Please see reverse side for TELEPHONE NO: -Yla ci J77 S S Y additional information. 1) MOBILE HOME DATA: (A) MAKE ..,.. (B) MODEL (C) YEAR /77:3 ? (D) LENGTH 6 C (E) WIDTH /0 (F) SERIAL NUMBER e,(t,f4_ L yti (G) YOUR PURCHASE PRICE(DO NOT INCLUDE SALES TAX) c L(' (H) PURCHASE DATE 2) PREVIOUS OWNER / LOCATION OF MOBILE HOME: (A) FROM WHOM DID YOU PURCHASE MOBILE ","' C SyS�-7rc�-P O' Alfa, B 0n ,ss.12 , ADDRESS �f-c. G�t S c9-� _ ���L.74;4_'- b .r a 7 3 (B) WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR? YES YES L (IF NO,WHAT COUNTY? A.-';7015 ) IF YES, WHAT WAS PREVIOUS ADDRESS OF MOBILE? (/U.� — 3) WHERE MOBILE HOME IS TO BE LOCATED: (A) WILL THE MOBILE HOME BE IN A MOBILE HOME PARK? YES NO (B) IF LOCATED IN A MOBILE HOME PARK: NAME a ADDRESS OF PARK T,({ SPACE NO. (C) IF NOT LOCATED IN A MOBILE HOME�PARK: /�� �� NAME OF LAND OWNER: 7Li9 t22' die-94A--1 LOCATION (ADDRESS) /A. (C-Z4-51--- -2. • 071`1 /.4t%I i '-, 2CAr G REAL PROPERTY PARCEL NUMBER/DESCRIPTION /�. ©QO 6 a7- THANK YOU FOR YOUR HELP! &CP-4eCt4- Q SIGNATURE KELLI LARSON, 'roperty Technician THIS FORM CONFORMS TO THE STANDARDS OF THE STATE DEPARTMENT OF REVENUE AND IS SUBJECT TO AUDIT VERIFICATION. J