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Home My WebLink AboutBLD1996-00528 e MOBILE HOME INSTALLATION APPLICATION Jefferson County Permit Center Castle Hill Mall 621 Sheridan St. Port Townsend, WA 98368 360-379-4450 PERMIT # •BLD96-0528 DATE RECEIVED. : 08/27/96 SITE ADDRESS:881 S JACOB MILLER RD :PORT TOWNSEND, WA 98368 APPLICANT. . . :KERRY TAYLOR PHONE: 385-5447 MAILING ADDR:881 S JACOB MILLER RD :PORT TOWNSEND WA 98368 INSTALLER. . . : PHONE: MAILING ADDR: CONTR. LIC #: EXPIRATION DATE: / / CONTRACTOR. . :ALTA HOMES INC PHONE: MAILING ADDR: 30 DRYKE RD :SEQUIM WA 98382 CONTR. LIC #:ALTAHI*066JF EXPIRATION DATE: 03/14/97 ��cc PARCEL NO. . . : 001084011 ALT: ,0 CON : LEGAL DESC. . :STR 08-30-01 WWM, TAX # BY : r` DATE: Q-2.a•e4 LOT , BLOCK , / WATER: DATE: CAR DATE: DESCRIPTION OF IMPROVEMENT: mobile home installation BUILDING TYPE 'MOB BEDROOMS--- BATHROOMS-- CRPT/GAR. . : 0 sf TYPE OF IMPROVEMENT:NEW EXIST. : 0 EXIST. : 0 DECKS 0 sf GARAGE/CARPORT PROP. . : 2 PROP. . : 2 COMMERCIAL: 0 sf UBC OCCUPANCY GROUP: TOTAL. : 2 TOTAL. : 2 INDUSTRIAL: 0 sf EST COST. $: 54000 SEWAGE DISP. . :CON BANK HT. . . : 0 ft PROJ GRP. . : 8334 WATER SUPPLY. :PWELL SH SETBACK: 0 ft MOBILE HOME MAKE:FUGA YR:96 SIZE:26/49 Owner/agent OVErr FEES Signature: type amount by date recpt SEP D q 1996 PRMT $ 125. 00 JM 08/27/96 1124054 Date: B.C. $ 4.50 JM 08/27/96 1124054 Jefferson w€s t Pt�nni _POT $ 25. 00 JM 08/27/96 1124054 Issued By: A Date: $ 154 .50 TOTAL reaK/ S.je ,„‘ JEFFERSON COUNTY PERMIT CENTER, 621 SHERIDAN ST. PORT TOWNSEND WA 98368 MOBILE HOME INSTALLATION PERMIT APPLICATION IN A MOBILE HOME PARK vi NEW/BUILDING ❑ REPLACEMENT SIZE 0(h /X / 9 / YEAR // / C MAKE `ac,Gl S/Ol iy /7I ra COST Y DOO BEDROOMS: BATHROOMS: EXISTING EXISTING PROPOSED "' PROPOSED TOTAL ,Z TOTAL TYPE OF SEWAGE DISPOSAL: WATER SUPPLY: ❑ SEWER ❑ COMMUNITY SYSTEM IX PRIVATE WELL INDIVIDUAL SYSTEM is Conventional ❑ PUBLIC PERMIT # SEP ❑ Alternative Name of water system: IF WATERFRONT PROPERTY, DISTANCE TO BANK OR HIGH WATER LINE ft BANK HEIGHT ft SIGNATURE ✓ DATE K4 0/96 NAME (PLEASE PRINT) //e /0,3.. /0 ►" 1111.111101.1116:iiii6.4"iii.e..:161.iii.41:111.111.11111111:110111111111111111111111101111011101111.111114i. 411 111111111:11.1.1"0.447r1111::::::::::::::::::51:: .;:5 :}:i:::::i'r`i` TKMt .. ./ .. M.# �.....:....................................................::............. 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Y P t ' r JEFFERSON COUNTY MOBILE HOME INSTALLATION PERMIT Jefferson County Permit Center Castle Hill Mall 621 Sheridan St. Port Townsend, WA 98368 360-379-4450 PERMIT # •BLD96-0528 DATE ISSUED. :09/09/96 SITE ADDRESS:881 S JACOB MILLER RD :PORT TOWNSEND, WA 98368 APPLICANT. . . :KERRY TAYLOR PHONE: 385-5447 MAILING ADDR:881 S JACOB MILLER RD :PORT TOWNSEND WA 98368 PROPERTY OWNER IF DIFFERENT FROM ABOVE PHONE: MAILING ADDR: INSTALLER. . . : PHONE: INSTAL LIC #: EXPIRATION DATE: / / CONTRACTOR. . :ALTA HOMES INC PHONE: MAILING ADDR: 30 DRYKE RD SEQUIM WA 98382 CONTR LIC #:ALTAHI*066JF EXPIRATION 03/14/97 PARCEL NO. . . :001084011 LEGAL DESC. . :STR 08-30-01 WWM, TAX # LOT , BLOCK , DESCRIPTION OF IMPROVEMENT: mobile home installation THIS PERMIT IS VALID FOR ONE YEAR ONLY AND IS NOT RENEWABLE. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 09/09/97. ( . . •7 t•or- ( f continuous footings are used) :'¢1'sg,gp3 _ CSC ( ) c ockin• Plumbing:Ei bekime r,c pDcdN0 ©K H.-1,g'rt ( ---•�7I Skirting/Vents/Porches - • - . �1 _�': � / V F F _ r CALL 379-4455 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9 a.m. to 4 : 30 p.m. Inspector's Hours 8 - 9 a.m. 24 Hour Recorder for Inspections . -;+;-'-'''":-- . •.,!",-.••;'-''''',.."'-- -."-•-•;""--., •. . ., "/".: -'.. , , . ,.... , ' 0 E . ... . 0 -, - , a . 3 * F5 C ,. -, •, ) 0 . . ,' ... > : . . . 0 ...4 "CI 0 0 0. E O.' ii B T2113 RIES il SO 21E121 ... v, m r- • m- 0 • a -, . ' 03 03 7" 7 FD- CD -I -a ...a ...a ;',."4 0,) -% ■1. ■1 ...11 . N .." 0 !.0 co :4 0.) 01 .p. c.o N ...h. It• . ■ M 0 "0 • (/) -1 0 -I -. 0 usu > m 'o 8 cp. -0 z * cn _ 0 c 3 0 5 ,— o , rn .° 0 -4. cll -, tu 8 .... 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LU X V• s c ai E - • a y • d .7 0 = J. 'o C Z o° 0 Z _z C° E I 0▪ Oo M •« y • i ' d O y Lti L' •`,a o v3 2G vi Cl) N o +' a) u y m v : Z m' Z o 0, o c t22 ° a O. A a a `° c a� ° a ac) a °f o • d iii aZ = 3 -a c a H D a r -43 ms CD D Gam. v`ct ai y N Q = mQ N V Q ° Q Q' aci�Q O ii U at+ .. -p o�S 0 N > v,0_ 0 '0 C %0 C CD V C a C -� i C ° of▪ Q a) c _ c _ _ .. ;. - _ «._ C p p a) CO L o co •la CO 3 m aci CO o ■0. f0 10 I c �° ii a` vlm _aic'n a a` 2 <.2 < 2 c7 2 0 vl 2 a 2 �t�S PLEASE MAIL TO: �' JEFFERSON COUNTY ASSESSOR • F ' ( JACK WESTERMAN III JEFFERSON COUNTY COURTHOUSE ASSESSOR PO BOX 1220,PORT TOWNSEND WA 98368 .411F-'- (360)385-9105 MOBILE HOME INFORMATION FORM TAX YEAR 1996 PLEASE CORRECT MAILING ADDRESS HERE: NAME: fe r J E TOLL) ( THIS IS NOT A TAX STATEMENT ADDRESS: 6 —.S co►c dI0 ' COMPLETE AND RETURN THIS FORM pa,' l l caw, mid U,4- %'5'3(6 TO THE ASSESSOR'S OFFICE TELEPHONE NO: 3 f5 SYy 2 A) MOBILE HOME DATA(CHECK AND COMPLETE AS APPLICABLE). (1) GENERAL DESCRIPTION (A) MAKE / F&9LIA (B) MODEL �e/ eL° (C) YEAR 74, (D) LENGTH / (E) WIDTH A4 (F)SERIAL NUMBER 00 (G) YOUR PURCHASE PRICE(DO NOT INCLUDE SALES TAX) s Y 0 a-- (H) PURCHASE DATE B) PREVIOUS OWNER OF MOBILE HOME:�A// ,/� (1) PREVIOUS OWNER NAME: /UGN-e_ A e(4/ ADDRESS: (2) WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR? YES NO IF NO,WHAT COUNTY? IF YES,WHAT WAS PREVIOUS ADDRESS OF MOBILE?_ C) LOCATION OF MOBILE HOME: (1) IS YOUR MOBILE HOME IN A MOBILE HOME PARK? YES NO (2) IF LOCATED IN A MOBILE HOME PARK: (A) NAME&ADDRESS OF PARK (B)SPACE NO. (3) IF NOT LOCATED IN A MOBILE HOME PARK: (A) NAME OF LAND OWNER: (B) LOCATION,STREET,ROAD,ETC. (C) REAL PROPERTY PARCEL NUMBER THANK YOU FOR YOUR HELP! SIGNA /OF MOBILE HO OWNER / (IMPORTANT: THIS LISTING AND STATEMENT CANNOT BE ACCEPTED BY THE ASSESSOR IF NOT SIGNED BY OWNER OR HIS DULY QUALIFIED AGENT) KELLI LARSON,DEPUTY ASSESSOR THIS FORM CONFORMS TO THE STANDARDS OF THE STATE DEPARTMENT OF REVENUE AND IS SUBJECT TO AUDIT VERIFICATION. -• a s ✓ Jefferson County Permit Center, 621 Sheridan St, Port Townsend WA 98368 UNIVERSAL PLOT PLAN Fill in the following information as completely as possible. Project Description: /26 b,I �o✓k e- hVI S�u. 9 Digit Parcel Identification Number ( ron, your tax statement) Oa! - 01(471" - 011 Site Address: ■ 91# & Road Name FU' S J Qc u t /Idler pv( Zi p Code ?f'3 6 Legal Description: g got Subdivision Name /fr(/rr ot Block Lot(s) Section Township 3 D North,Range / WM Parcel Size (acres or square footage) CLcI/,z° S Property Owner i - Phone 3g� -5-V47 7 D Mailing Address II�d 3 et/ .6 "1;11 er' Ord er 1 1 Applicant/Occupant Phone (if different) Mailing Address Authorized Rep Phone Mailing Address General Contractor ALT-4- t O tor S Phone Mailing Address 30 OP•1/4-J/4-.<_ T'a4� 5equ '4"/ rW1 g$'1 ■. VI Contractor's State License Number A'L-7-A14.1 046 3'>F Expiration Date Septic Designer J'erry L-tha 5€//,,91 p Phone 315./071 Mailing Address / d2 lb are_ U' ee'v e n� P.1: Architect Phone Mailing Address Loan Lender/General _r; /-e-e. tf'e Sr g dip,k Phone 3 - %WV Contractor's Bond Holder ,./ 1 Mailing Address ; 10/ W dt S 4 iN5 Td n St P. . . .. . .. .. ............. ............ FOR OFFICE USE ONLY Fire District Planning District School District Zone Case Number `I Jefferson County Permit Center Date 621 Sheridan Street Fee Port Townsend WA 98368 Rec # CRITICAL AREAS QUESTIONNAIRE Ck # Case # Applicant Name 4 i / Building Application _ 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 V YES NO on your property or adjacent properties? A If YES, please describe: ,Sovh e w P1fou� 'S 4. Are there any indications on any portion of the property or on any YES X 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) 404 4 0 4 0 / :/ /, I I / / / / / / .0 I / / / / / / / ,, / / / / / / / , I / / /, i i / ,,� -. I / / / / / / i i .„, ,1// I////% ,j 7 ,•” '1 MP I////// / / • ice /////// /,, /' i �i.-- II//////,� ��0 /////////._•.-i- .. !I/////iii-,<: _'_-- ...0 i i qk "�� ---- -----'- (Questionnaire Continues on Back) 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 \ 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 Date "fai °/9) 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 Zone: Parcel Size: Status: Comprehensive Plan Land Use Designation: Reviewed by: Community Plan: Date: