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BLD2014-00195
• • BLD14-00195 Review Type: I MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD14-00195 Received Date: 6/6/2014 SITE ADDRESS: 54 PORT HADLOCK HEIGHTS PL PORT HADLOCK, 98339 APPLICANT: BRODERS INC PHONE: 360-797-7722 4503 OLD GARDINER RD PORT TOWNSEND WA 98368-9778 SUBDIVISION: 9895 Block: Lot: 1-45 PARCEL NUMBER: 989500001 Section: 11 Township: 29 N Range: 1W CONTRACTOR/ HERITAGE HOME CENTER PHONE: (800) 446-1166 DEALER: 259335 HWY 101 SEQUIM WA 98382 Contractor's License 602099664 Expires 12/31/2017 INSTALLER: HERITAGE HOME CENTER 602099664 12/31/2017 (800)446-1166 259335 HWY 101 SEQUIM WA 98382 REPRESENTATIVE: DON NELSON HERITAGE HOMES PHONE: 360-683-0920) 259335 HWY 101 SEQUIM WA 98382 PROJECT DESCRIPTION: New Manufacture home TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: MARLETTE SETBACK: VALUATION YEAR: 2014 BANK HEIGHT: LABOR& INDUSTRIES APPROVAL? SIZE: 48x28 SEWAGE DISPOSAL: OSS WATER SYSTEM: 05783 BEDROOMS: BATHROOM F, �� gz.Lo Exist: Exist:xist: SEP 17 2014 Prop: 2 Prop: 2 Total: 2 Total: 2 Jefferson County DCD Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $689.00 SRE 06/03/14 148757 State Building Code $4.50 SRE 06/03/14 148757 Potable Water Application $67.00 SRE 06/03/14 148757 Plan Check $102.05 SRE 06/03/14 148757 Total- 5862 55 \\tidemark\data\forms\F_BLD_App_Mob.rpt 8/5/2014 4�sON ec.) DEPARTMENT OF COMMUNITY DEVELOPMENT � 621 Sheridan Street,Port Townsend,WA 98368 Tel:360.379.4450 Fax:360.379.4451 Web:www.co.jefferson.wa.us/communitydevelopment ,s,/, so-s.0 E-mail:dcd @co.jefferson.wa.us CERTIFICATE OF OCCUPANCY PERMIT#: BLD14-00195 APPLICANT: BRODERS INC PHONE: 360-797-7722 4503 OLD GARDINER RD PORT TOWNSEND WA 98368-9778 SITE ADDRESS: 54 PORT HADLOCK HEIGHTS PL Issue Date: 09/18/2014 PORT HADLOCK, 98339 Final Date: 4/30/2015 SUBDIVISION: 9895- PORT HADLOCK HEIGHTS MH Block: Lot: 1-45 PARCEL NUMBER: 989500001 Section: 11 Township: 29 N Range: 1W PROJECT DESCRIPTION: New Manufacture home THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2012 EDITION. OCCUPANCY GROUP: TYPE OF CONSTRUCTION: SPRINKLER SYSTEM yes THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 4/30/2015 \\tidemark\data\forms\F_BLD_Occupancy.rpt 5/7/2015 Sally Ellis From: Susan Porto Sent: Wednesday, September 17, 2014 11:22 AM To: Sally Ellis Subject: RE: BLD14-00195, this one is ready to issue. From: Stacie Hoskins Sent: Wednesday, September 17, 2014 9:57 AM To: Susan Porto Cc: Sally Ellis; Elizabeth Williams Subject: BLD14-00195 Hi, Susan & Sally, I just spent twelve minutes on the phone with Don Nelson of Heritage Homes regarding BLD14-00195 for Broders Inc at 54 Port Hadlock Heights PI. Susan, once you're done with your review and can sign off the septic activity and add'I info request, please let Sally know. David has completed his review. Sally, if you have any concerns with issuance of the permit, please let me know. Thank you, Stacie 4. Wad thld Planning Manager,Jefferson County Department of Community Development 621 Sheridan Street * Port Townsend,WA 98368 Phone 360-379-4463 * Fax 360-379-4451 shoskinsc co.jefferson.wa.us Jefferson County DCD Mission: To preserve and enhance the quality of life in Jefferson County by promoting a vibrant economy, sound communities and a healthy environment. All e-mail sent to this address has been received by the Jefferson County e-mail system and is therefore subject to the Public Records Act,a state law found at RCW 42.56.Under the Public Records law the County must release this e-mail and its contents to any person who asks to obtain a copy(or for inspection)of this e-mail unless it is also exempt from production to the requester according to state law,including RCW 42.56 and other state laws. 1 ®guise Cascade Single 3-1/8" x 9" BOISE GLULAM® 24F-V4/DF Roof Beam\RB01 Dry 11 span I No cantilevers 1 0/12 slope Thursday, May 22, 2014 BC CALC®Design Report- US File Name: BC CALC Project Build 2627 Description: Designs\RB01 Job Name: Heritage Homes Specifier: Address: Port Hadlock Heights Place Designer: Annie O'Rourke City, State, Zip: Port Townsend, WA 98368 Company: Drafting Solutions Customer: Code reports: AITC 117-2004, LA- FB02035 Misc: 0 12 ?i—._e r 4 V V s V __T__ 'Y T Y �_,V V V V V 1 y_—.V V V V V I I V V V ♦ F V V V S_ 1— 4 ---— -- — — — 10-09-00 61 BO Total Horizontal Product Length=10-09-00 Reaction Summary(Down/Uplift) (Ibs) Dead Snow Wind Roof Live Bearing Live BO, 3-1/2" 950/0 1,523/0 950/0 1,523/0 Live Dead Snow Wind Roof Live Load Summary Start End 100% 90% 115% 160% 125% Tag Description Load Type Ref. 1 Standard Load Unf. Area(Ib/ft^2) L 00-00-00 10-09-00 15 25 11-04-00 Disclosure Controls Summary Value %Allowable Duration Case Location Completeness and accuracy of input must ft-lbs 6,092, 62.8% 115% 4 05-04-08 be verified by anyone who would rely on Pos. Moment 6 34.9% 115% 4 01-00-08 output as evidence of suitability for End Shear 1,994 lbs 49 5% n/a 4 05-04-08 particular application.Output here based Total Load Defl. U363 (0.34") on building code-accepted design 0590 (0.209") 40.7% n/a 5 05-04-08 properties and analysis methods. Max ve Load Defl. ( ) 34/o n/a Installation of BOISE engineered wood Span Defl. 0.34" n/a n/a 0 00-00-00 products must be in accordance with Span/Depth 13.7 current Installation Guide and applicable %Allow %Allow building codes.To obtain Installation Guide or ask questions,please call Bearing Supports Dim.(L x W) Value Support Member Material (800)232-0788 before installation.\n\nBC BO Post 3-1/2"x 3-1/8" 2,473 lbs n/a 34.8% Unspecified CALC®,BC FRAMER®,AJSTM, 61 Post 3-112"x 3-1/8" 2,473 lbs n/a 34.8% Unspecified BOISEIGLUULAMT"',SIMPLE DFRAMING Cautions SYSTEM®,VERSA-LAM®,VERSA-RIM PLUS®,VERSA-RIM®, For roof members with slope(1/4)/12 or less final design must ensure that ponding instability t RSA-Ss oAND,Vas ads Wood are will not occur. Products L.L.C. For roof members with slope(1/2)/12 or less final design must account for Rain-on-Snow surcharge load. Notes Design meets Code minimum (U180)Total load deflection criteria. Design meets Code minimum (U240) Live load deflection criteria. Design meets arbitrary(1") Maximum total load deflection criteria. i.� _ Calculations assume Member is Fully Braced. i� � Design based on Dry Service Condition. '. 4' 1 Deflections less than 1/8 were ignored in the results. • ,. JUN - 2014 , ` 1 � ERSCNCOUi DEPT.Cf COMMUNITY DEVELOPMENT Page 1 of 1 SIMPSON Simpson Strong-Tie ■ 2012 IRC Required Braced-Wall-Line Length Calculations PROJECT INFORMATION NAME:Heritage Homes ADDRESS:Port Hadlock Heights Place,Port Townsend,98368 WALL DIRECTION:Front to Back SEISMIC DESIGN CATEGORY:132 BASIC WIND SPEED:85 mph WIND EXPOSURE CATEGORY:C STONE OR MASONRY VENEER:No Wall Line A-1 Wall Line B-1 Inputs Braced-Wall-Line Location 1st of I-story 1st of 1-story Eave to Ridge Height 5 ft 5 ft Braced-Wall-Line Spacing 17.00 ft 17.00 ft Braced-Wall-Line Length 20 ft 20 ft Wall Height 8 ft 8 ft Bracing Method WSP WSP GB Construction Type N/A N/A Gypsum Wall Board on Inside No Yes Horizontal Joints Blocked Yes Yes Holdown Device Used No No >8 psf&=15 >8psf&=15 Wall Dead Load psf psf Roof/Ceiling Dead Load =15 psf =15 psf \\I\D Tabulated Wind Bracing Amount 3.05 ft 3.05 ft Exposure Height Factor 1.2 1.2 Eave-to-Ridge Height Factor 0.7 0.7 Wind Wall Height Factor 0.9 0.9 Number of BWL Factor 1 1 Holdown Factor 1 1 Blocked Joint Factor 1 Gypsum on Inside Factor 1.4 I Wind GB Construction Factor 1 I Required Wind Bracing Amount 3.23 ft 2.31 ft SI-.bAIII Tabulated Seismic Bracing Amount 5 ft 5 ft Seismic Wall Height Factor 1 BWL Spacing Factor 1 Blocked Joint Factor 1 Gypsum on Inside Factor 1.5 Seismic GB Construction Factor 1 I Wall Dead Load Factor 1 Roof Dead Load Factor 1 I Veneer Factor I I Required Seismic Bracing Amount 7.5 ft 5 ft RI-:SI'I IS www.strongtie.com/webapps/bracedWall This is page 1 of 2 SIMPSON Simpson Strong-Tie C Length of Wall Bracing Required 7.5 ft 5 ft NOTES 1. This wall-bracing evaluation is based on the 2012 International Residential Code.The user is responsible for ensuring that the project fits within the scope of the IRC and complies with the wall-bracing requirements of Sections R602.10,R602.11 and R602.12 as applicable. 2. One-and two-family dwellings and townhouses in Seismic Design Category DO,Dl,or D2 are subject to the wind and seismic requirements of the IRC. The length of wall bracing shall be the greater of that required by Table R602.10.3(1)based on wind speed,and Table R602.10.3(3)based on seismic design category,including all applicable adjustment factors. 3. Braced-wall panel construction shall be in accordance with the requirements of Section R602.10.4 and Table R602.10.4 and the minimum length requirements of Section R602.10.5. 4. Braced-wall panels shall be located at each end of braced-wall lines.Braced-wall panels constructed of Methods WSP,BV-WSP,or continuous sheathing methods may begin up to 10 feet from each end when the additional requirements of Section 8602.10.2.2.1 are satisfied. 5. The distance between braced wall panels shall not exceed 20 feet in accordance with Section R602.10.2.2. 6. Interior braced-wall-line spacing is the greater of the distance between two adjacent braced-wall lines or the average of the distance as selected by the designer. 7. Refer to the Strong-Wall Shearwalls-Presciptive Design Guide for pre-engineered solutions when the required bracing amounts cannot be satisfied with prescriptive braced-wall panels.Simpson Strong-Tie®Wood and Steel Strong-Wall®shearwalls maybe considered equivalent to the code braced-wall panel construction method WSP with gypsum board applied on the inside. 8. Braced-wall-line spacing shall not exceed 25 feet on center in each story in both longitudinal and transverse directions in accordance with Table R602.10.1.3.However,the spacing between two adjacent braced wall lines shall not exceed 35 feet on center in order to accomodate one single room when the provisions in Table R602.10.1.3 are satisfied. 9. Horizontal panel joints in braced-wall panels shall be blocked in accordance with Section R602.10.10. 10. Braced-wall lines shall have a minimum of two braced wall panels unless the provisions of Section R602.102.3 are satisfied. WARNINGS 1. For buildings in SDC DO,DI,and D2 the user must ensure braced wall line spacing greater than 25 feet satisfies the requirements of Table R602.10.1.3. 2. Different intermittent bracing methods are not permitted to be mixed within a braced wall line for Townhomes in Seismic Design Category C and all structures in Seismic Design Category DO,D1,or D2 in accordance with Section R602.10.4.1 item#3. mrow.strongtie.com/webapps/bracedWall This is page 2 of 2 ■ , r , 1 Beams/Joists Analysis and Design wwpa.org AN'How to Order Pro VVVV�� Enter Data Print Version Setup __6- Beam or Girder r Joist or Rafter Member# Man Door Hdr Member at Floor 9 Roof Location : Main Floor Repetitive Use?1 No Yes Nominal Size : (2) 2 x 6 Incised for PT? No Yes Species= Douglas Fir-Larch Flat Use: No Yes Grade= No.2 Moisture Content: <19% >19% Span(L)= 3 ft - 0 in Temperature(°F): <100 100-125 125-150 I Tributary Width(B)= 11 ft - 8 in - Unsupported Length(lu)= 1 ft - 0 in Set Duration Factors ; r with Cantilever Set Deflection Limits r with Point Load(s) 1 r with Sloped Load(s) Reset Loads to Zero L w as 111111111111111111111111111 11 11111111111111111111111111111111111111111111111111111111111 LOADING Load Type �,4 Max.Span = f, 0 3 '.r Dead Load; Uniform w(psf)= 17 R1 735 lb 735 lb Stress and/or Deflection Check ° OK A c t u a l A I 1 o w a b I e Ratio Snow Load Uniform w(psf)= 25 Max fv(psi)&V(lb) 46 510 207 2277 22% r CD=1.15 Max fb(psi)&M(lb-ft) 437 551 1343 1693 33% Total Load Max.Defl.(in) -0.01 L/2683 0.20 7% Live Load Max.Defl.(in) -0.01 U4507 0.15 5% Adjustment Factors 1000, for Fb for Fv for E 000 Wet Service CM= 1.00 1.00 1.00 o Temperature Ct= 1.00 1.00 1.00 _500! Beam Stability CL= 1.00 N/A N/A -woo Size CF= 1.30 N/A N/A Flat Use Cf.= 1.00 N/A N/A Shear Force,V(Ib) Incising C;= 1.00 1.00 1.00 Repetitive Member Cr= 1.00 N/A N/A 600 Buckling Stiffness CT= N/A N/A 1.06 400 1 (CT for Emin only) Design Values in psi 200 Fb Fv E Emin 0 Reference 900 180 1600000 580000 Adjusted 1343 207 1600000 580000 Bending Moment,M(lb-ft) Section Properties breadth(b)= 3 in 000.1 \ depth(d)= 5.5 in Area(A)= 16.5 in^2 °'s Section Modulus(Sx)= 15.1 inA3 Moment of Inertial(Ix)= 41.6 in^4 Total Load Deflection(in) • 030\ cb k = ? JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Date: --1, Time Received: /.2 7 am t i Mon. 01110 Wed. Thur. Fri. Date: /Pr7 BLD: /41 - /q�'— Contact Name: Owner: Contact Number: 360 p0,J Address: 5-44 PO 1414D YTS PL 206 We Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block &Tile Ceiling JEFFERSON COUNTY !`� DEPARTMENT OF COMMUNITY DEVELOPMENT Dater/C)/ 0)5 Time Received: /6.,�5e am/pm Mon. Tue. Wed. Thur. Fri. �_ Date: 41/C/A CS BLD: I /`"/ 5 Contact Name: Owner: ��� ��►� Contact Number: 360 Address: All. "03��/III��i/!/G�I 206 te, /(471/,f Notes: 4-ir�,X r"/1 L 194 // U Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection�. Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling na)V<-1 ' /,5, / ,1"1 (-7 I as, 2-t 0 I C EUVI �, /2' '_.a JUN - 3 2014 i 0-1 ?B --1*. JEFFERSON COUNTY 7 , DEPT.OF COMMUNITY DEVELOPMENt -0 9 � 4 � / � I Q 1-1(,)_'3 -HOM 0 L.• � 6 � m 2, 4 Q N S CD 9 �� Y i ci Y /*OW .1i / ), F D, / N , As 1-1 'i =- / < •�� �Z 4 te ``b rVJ- 1 S F?>---T --;AD,_eff-,L- 4 0 --_____Ie-___Ha_6LtIAL_ ir'rik. ----7T- \f) . _ ._ __ LOT 811 VI P30 '1 D9 500c70 I Drci-P-17iNek Lehor. 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'� CL3 • L 6 %60-M`09C) wJnoc 3 o sewoH e6e4I1 H d Z £0 bl S� 4 e90/90 39dd -41 1 7'lv■+i., • • BLD14-00195 Review Type: MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD14-00195 Received Date: 6/6/2014 SITE ADDRESS: 54 PORT HADLOCK HEIGHTS PL PORT HADLOCK, 98339 APPLICANT: BRODERS INC PHONE: 360-797-7722 4503 OLD GARDINER RD PORT TOWNSEND WA 98368-9778 SUBDIVISION: PORT HADLOCK HEIGHTS MH PARK Block: Lot: 1-45 PARCEL NUMBER: 989500001 Section: 11 Township: 29 N Range: 01 W CONTRACTOR/ HERITAGE HOME CENTER PHONE: (800) 446-1166 DEALER: 259335 HWY 101 SEQUIM WA 98382 Contractor's License 602099664 Expires 12/31/2017 INSTALLER: HERITAGE HOME CENTER 6121•96•• 12/31/2017 (800)446-1166 259335 HWY 101 SEQUIM WA 98382 REPRESENTATIVE: DON NELSON HERITAGE HOMES I PHONE: 360-683-0920 259335 HWY 101 SEQUIM WA 98382 PROJECT DESCRIPTIO1I--New Manufacture home with attached Garage TYPE OF WORK 7 MOB ANUFACTURED HOME: SHORELINE: ` TYPE OF IMP NEW > AKE: MARLETTE SET-BACK: VALUATION EAR: 2014 BANK HEIGHT: LABOR & INDUSTR S APPROVAL? 48x28 SEWAGE DISPOSAL: ASS WATER SYSTEM: ■ 783 BEDROOMS: BATHf�,•S I S: Exist: Exist: Prop: 2 Pr. Total: 2 otal: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $689.00 SRE 06/03/14 148757 State Building Code $4.50 SRE 06/03/14 148757 Potable Water Application $67.00 SRE 06/03/14 148757 Plan Check $102.05 SRE 06/03/14 148757 Total- $86255 \\+IrlcmorL\rin+o\form c\I= RI fl Ann F,Anh rn+ F/RI'N11A SON ro iNiiiiiq - IGa� �4w JIWERSON COUNTY - )G is-- DEPARTMENT OF COMMUNITY DEVELOPMENT , it 621 Sheridan Street I Port Townsend,WA 98368 I Web:www.co.iefferson.wa.us/communitydevelopment Tel:360.379.4450 I Fax:360.379.4451 I Email:dcd(a).co.iefferson.wa.us Building Permits&Inspections I Development Consistency Review I Long Range Planning I Watershed Stgyvardsh p Resole Center F..�. Ht.-c'-'- Master Permit Application h�O -t,\ I„�.�,,,... p ,.me_ ,, ,( p,,r, -ML Proj Descri on(include separate sheets as necessary : \ 1 ti tv, tL c s ¶'1 &LE. ell*PAIL L-1^0l 3-t (Stt. f�i►f ) fsc 4 Tax Parcel Number: 0A0)_) 0000 I Property Size:12 5 (acres/square feet) Site Address and/or Directions to Property:614 9D ft( ,kQQ\C.v..\\E,k(pKxSPL . (FRS, \\ •cj Go WbfrSik 150 `\AA'A p i ∎Nwo �V• V ∎frets L,�Li, S\.•R o to g.1 CAA. t l J t.b ,t.N tip Nis to. Property Owner(s)of Record: ?J *SL' i-rm .. Ct,t up.ifVAbtfL' Telephone: 3 1/4.10 171 717-1-7.'1. Fax: email: Mailing Address: • O3 OLD (.,il1(IU Mia—'{l )Of .4( "CO NAtyS640 �NQ r°MS(, Applicant/Agent(if different from owner):MP.(T Ado G H ton ti 4 St c�uv� (DON EELS ) Telephone: 3 \s o O 6%3 7..13‘k Fax: b 0 ( ' 3 0910 CE fi,,email:4-ZC 73 %'M Mailing Address: 2 ' • lh, 0 5 tri A • What kind of Permit?(Check each box that applies ❑ Lot or Road Segregation nuilding ❑ Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use) ❑Single Family ❑Garage Attached/Detached ❑ Conditional Use[C(a), C(d),or C]** ,1t ,Manufactured Home ❑ Modular El Discretionary"D"or Unnamed Use Classification El Commercial* ❑Special Use(Essential Public Facilities)** ❑ Change of Use ❑Boundary Line Adjustment El Address El Road Approach El Short Plat** El Home Business ❑Cottage Industry ❑ Binding Site Plan** ❑ Propane ❑Long Plat** ❑Sign ❑Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes" Use Consistency Analysis El Plat Vacation/Alteration** El Stormwater Management El Shoreline Master Program Exemption/Permit Revisions** ❑Site Plan Approval Advance Determination(SPAAD)* El Shoreline Management Substantial Development** ❑Temporary Use El Shoreline Managem: a'. -TIT - I ❑Wireless Telecommunication* ❑Comprehensive Pla •• :-•a. 117::1'l , r - ❑ Forest Practices Act/Release of Six-Year Moratorium El Jefferson County Shr• 4 . 7=- - .• • i II *May require a Pre—Application Conference ❑Tree Vegetation R-• !_- **R•.uires a Pr- 11.-don •.j erence Please identify any other local,state or federal permits required for this pr. •�,*F , if •it n: I ' I DESIGNATION OF AGENT t ` JEFFERSON COt1NTYcjp6 I hereby designate 0 h4 10.., L hl to act as my agent in matte,s rel.l'.,�; �p�9,...± r-��r�t mit( ■. OWNER SIGNATURE'( MI /i 2L_ _ Date: as. .. 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 its 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 ape' - . • , n. prior n,,;;� Signature: ��_A, /"m v _ 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-transferab- - ••. 'bili o I • eeng to .•: complyin•with the ES'. The Applicant has read this disclaimer and signs and dates it below. Signature: _ �� 11• . .. Date: 1 _1 07/24/2013 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 esponsibility the Ge ral Contractor for the proposed p ject. Signature: Date: L.19^3— GENERAL CONTRACTOR OR MANUFACTU ED HOME INSTALLER: PHONE: FAX: \A U.\ Q( la %o S A0171 4. \,uG �>��)to2'VL t 17 tj(599>a�*[°�r jb A MAILING ADDRESS: Z4PA774 %A C : NATA*'\�Y 51E-MAIL:\ktrit t."� Vto,g�Wq tu) tt . 1 I r`l CONTRACTOR'S LICENSE WAINS NUMBER: tOilktO It Q$S if NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: 1,404 rn Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: u New ilhultc n Wood Existing: .4cSewer Sri Addition a Steel Proposed: Bank Community System Alteration/Remodel H Concrete Total: Height: a Individual Syste u Repair a Masonry SEP Permit#l9 .-00S11 0 ti V Demolition Li Other: Bedrooms: Water Supply: Existing: Setback: r I Private well r Two Party T pe of Heat: . Proposed: a Public v00-14.-0 P•1 1.1.a Total: Name of Systerr> ut1fl L Q 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 o If this is a Propane Tank and/or Appliance Installation permit,mark all items below that a p Underground Tank Above ground tank Size of Propane Tank: ' [_,/i Heat Stove Cook Stove Woodstove Fireplace.nsert rehtO I evottpff,IeP I n T retaWtoH I Is this appliance being installed in a Manufactured I Mobile Home? Yes / No ki LL - 3 2014 When applying for a permit to install a propane tank you must also submit a site plan s7p�vfprt all of the buildings,all p L:,, ity lines,tank location and size, distances from the propane tank to all property lines,buildings er compehents, including the reserve area. LEERS N COUNTY I"PI OF COMM!NIIY UEVILOPMENT Square Footage Current Proposed For Office Use Only Amount Revision Main Floor Heated EH Bld App Review:, UU 2"0 Floor Heated Consistency Review: /''Y) " 0, Other Heated Base fee: "_ )G. Mezzanine Additional Section: • . 0, t et) Heated Basement Plan Check fee: ._ i V° )c� Unheated Basement State Surcharge fee: i 1 ,5-3 l Other Unheated Pot Water Review fee: `� .do IDS G ge/Carport Q A/ 22 ` s al toil t SUBTOTAL 1 9.Ne .cc Decks f ^��1 ( ,� 911/Rd Approach fee: r '�[ Lj� Other TOTAL: $ Receipt Number: 1 Jib 3S---1-- Cash/Check Number: a b[ ESTIMATED COST(REQUIRED) Date: 1 ';/ .I 0 .Fair market value of all labor and materials undation to finish c �� �1 Initials: c ^ 07/24/2013 JACK WESTERMAN • Jefferson Lily t'.o rth.me ASSESSOR Po 11.x 1220, 060►:185.9105 1 MOBILE HOME INFORMATION M ----1 1H JUN - 32014 i 1 j OWNER'S NAME/MAILING ADDRESS: i 11 NAME: \ V_ • Q.1, I JEFFERSON COUNTY ADDRESS: 2.1..\-10 A P\mac P1l. ,'Vic S L.`r l< •• • _ • PHONE NO. 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. 1}MOIRIVE HOME DATA: (A) MAKE `'MOG,\...`fCC, (B)MODELCORNAS A2v414?4‘ (C)YEAI2P14 . (D) LENGTH 4 6 (E)WIDTH 7-2 (F)SERIAL#C16 (G)YOUR PURCHASE PRICE(Do not include sales tax) PURCHASE D 2)PR I S OWNER/LOCATION OF MOBILE HOME: (IF NEW MOVE r! I I ESTION 3) (A) FROM WHO ■ I YOU PUNCH• i 1 ILE ---_____`- ADD ' .. (B) , • ,- .' OBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR?Yes No If Yes, Previous address of mobile. If N., 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 PAR ' lift N. )qX� (II)IF LOCATED IN MOBILE HO PAR •BA Ss°R" 14'41 43- \'►t'1 C?L.�2 .1� NAME &ADDRESS OF PARKIN'C Rig WC,1i. t,?w1A-S Lot/Space#r (C) IF NOT LOCATED IN MOBILE HOME PARK: NAME OF LAND OWNER: 'Mt•Dtki S`IN C (TA CVACiPt 41 LOCATION ADDRESS �5al L) G) (131NtQ,iLiJ r-OM'i-TOjlvStiND Wit nt REAL PROPERTY PARCEL #/DESCRIPTION ' ) ('.:)v00 I -Wi A t♦ ■ Signature of applicant THANK YOU FOR YOUR HELP! 44 JO COSSELL. Property Technician HERITAGE HOMES OF SEQUIM• • Page 1 of 1 0 Washington State Department of Labor & Industries HERITAGE HOMES OF SEQUIM INC Owner or tradesperson 259335 HWY 101 DON NELSEN SEQUIM,WA 98382 Doing business as HERITAGE HOMES OF SEQUIM INC WA UBI No. Governing persons 602 099 664 DON E NELSEN JOYCE M NELSEN; Workers' comp Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. L&I Account ID Account is current. 0889200 Doing business as HERITAGE HOMES OF SEQUIM INC Estimated workers reported Quarter 1 of Year 2014"1 to 3 Workers" L&I account representative T2/CINDY MORGAN (360)902-4825 -Email: MOCI235 @lni.wa.gov Workplace safety and health No inspections during the previous 6 year period. ©Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. 1CCE'-Ss AM 11'raliinglon'' ,T.y. V vas.,i..±,.,rnrFrri'M'kr�sn Ili https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602099664&SAW= 6/6/2014 Results • • Page 1 of 1 ABOUT US I CONTACT US iogon Espanol register Department of "WWord i�ni together to Revenue tGxlc�W s fLrture" Washington State Search DOING BUSINESS REGISTER MY BUSINESS LOOKUP BUSINESS INFORMATION RESULTS Home Results Back to search results File&pay taxes If "Non-revenue"appears after Tax Registration Number,the account is not registered with the Department of Revenue.However,it Doing business may be registered with other agencies in the state. Business types Register my business Washington State Department of Revenue My account State Business Records Database Detail Audits TAX REGISTRATION NO: 602099664 ACCOUNT OPENED: 03/01/200112:00:00 AM Find taxes&rates UBI: 602099664 ACCOUNT CLOSED: OPEN ENTITY NAME: HERITAGE HOMES OF SEQUIM INC Workshops&education BUSINESS NAME: MAILING ADDRESS: BUSINESS LOCATION: Get a form or publication 259335 HIGHWAY 101 259335 HWY 101 SEQUIM,WA 98382-7429 SEQUIM,WA 98382-0000 Find a law or rule ENTITY TYPE: CORPORATION RESELLER PERMIT NO: A07 7361 17 PERMIT EFFECTIVE: 01/01/2014 NAILS CODE: 453930 I PERMIT EXPIRES: 12/31/2017 NAILS DEFINITION:MANUFACTURED(MOBILE) i' HOME DEALERS We Ta improve! FOR NON-COMMERCIAL USE ONLY Take our Survey 06/06/2014 9:52 AM CONTACT US I ABOUT US I QUESTIONS&ANSWERS I PRINTER FRIENDLY I CAREERS tT9d Eopanoi I Pyc00uu I EIS Tagalog I rang Viet I Wiff 4,114.acoesswasFlnyton Your Privacy I 02010 WASHINGTON STATE DEPARTMENT OF REVENUE AND ITS LICENSORS.ALL RIGHTS RESERVED. Voter registration assistance(SECRETARY OF STATE) http://dor.wa.gov/content/doingbusiness/registermybusine ss/brd/Results.aspx?Reque stType... 6/6/2014 HERITAGE HOMES OF SE INC • Page 1 of 1 IIMf OF WONINGTON Department of Labor& Industries Certificate of Workers' Compensation Coverage June 6, 2014 WA UBI No. 602 099 664 L&I Account ID 889200 Legal Business Name HERITAGE HOMES OF SEQUIM INC Doing Business As HERITAGE HOMES OF SEQUIM INC Workers' Comp Premium Status: Account is current. Estimated Workers Reported Quarter 1 of Year 2014 "1 to 3 (See Description Below) Workers" Account Representative T2/CINDY MORGAN (360)902-4825 - Email: MOC1235 @Ini.wa.gov Licensed Contractor? No What does "Estimated Workers Reported" mean? Estimated workers reported represents the number of full time position requiring at least 480 hours of work per calendar quarter. A single 480 hour position may be filled by one person, or several part time workers. Industrial Insurance Information Employers report and pay premiums each quarter based on hours of employee work already performed, and are liable for premiums found later to be due. Industrial insurance accounts have no policy periods, cancellation dates, limitations of coverage or waiver of subrogation (See RCW 51 .12.050 and 51 .16.190). https://secure.lni.wa.gov/verify/Details/liabilityCertificate.aspx?UBI=602099664&SAW=&... 6/6/2014 MAY-15-2014 13:23 FROM:9R 360 797 7133 TO:13606830920 P.3 • . I • , 4. c SEWAGE DISPOSAL PERMIT j ,► % Jefferson County Department of Community Develops t `,„ , n 2014 i 621 Sheridan Street, Port Townsend WA 98368 (360) 379-4450! L 00) 831-2678 PERMIT#: SEP04-00077 Date Received: KKF .'. NTY c T_f F '. `_�FLOPMENT SITE ADDRESS: 54 PORT HADLOCK HEIGHTS PL Date Issued Date HADLOCK. WA 98339 ate Expires: 04/05/07 APPLICANT: SMOLDERS INC PHONE: (360)797-7722 4503 OLD GARDINER RD PORT TOWNSEND WA 98308-9778 SUBDIVISION; PORT HADLOCK HEIGHTS MH PARK BLOCK: LOT: 37 PARCEL#: 989500001 Section: 11 Township; 29N Range: 01 W DESIGNER: MIKE DEENEY PHONE: (800)395-7296 CREATIVE DESIGN SOLUTIONS PO BOX 2787 PORT ANGELES WA 98362 DISCLAIMER- This approval is for an on-site sewage system that meets the state and county standards in effect on the date of application. This approval for an on-,site sewage system DOES NOT assure you of any other County approvals. For example, it DOES NOT GUARANTEE that you will later obtain permission to build a permanent residence or other structure on this parcel. Any future application will be separately Judged by the rules and laws in effect at that time. Permit issued to CONSTRUCT,ALTER, REPAIR OR MODIFY AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM IN JEFFERSON COUNTY,WASHINGTON This permit is issued for a period of three years(unless otherwise stated above) in accordance with Jefferson County Rules and regulations for on-site sew systems, ifie 8.15 amended per ordinance no.08-0921-00. This permit may not be renewed. INS,Jefferson County Environmental Health Specialist The property owner is responsible for the accurate location of all property lines.Any removal of or major disturbance of soil in the primary or reserve drainfield area may create site conditions that are unacceptable forthe installation of a sewage disposal system,Any chango in drainfield or tank location may invalidate this permit unless prior approval is obtained from the Jefferson County Environmental Health Division.If during excavation or development of the site an area of potential arteological significance is uncovered, al activity in the immediate area shall be halted, and the UDC Administrator shall be notified at once. HEALTH DEPARTMENT MUST BE CALLED FOR FINAL INSPECTION. SYSTEM DESCRIPTION: 290-SEPTIC TANK TO COMMUNITY SYSTEM No. of Gallons per Day: Type of work: NEW -------------Drainfield-------------- .».----------Trench--__------- ---------Septic Tank.--_---- Length: feet Width: feet Depth: inches Size: 1,000 gallons SPECIAL CONDITIONS APPLY - SEE REVERSE FORT T I L(d LOCK 1L J11Le11 G1L 1(. TASl . d V'1(OBIP e11.e HO V'111C.e Jl ARIc I:}VDING 511Th FLAW BSF94,_00011 SECTION 1 1, TOWNSHIP 29 NORTH, RANGE 1 WEST, W.M. JEFFERSON COUNTY, WASHINGTON FOUND 1-1/2•IRON---^ •�;. PIPE WITH WOOD PLUG AND TACK. Q'R 2 S ST\6•DB E- — — — 3 87'58'08" E' — —670.63 24.1:911111143•44t ii. 7. 20I,.E9. , r '4"I IiW 7i 21 ��„RETE POSTIND .F. IND. ' ♦, `�� 1.5'ABOVE THE GROUND ��. �, o �/ `O I PER VOLUME IJ OF 26 75.00• SURVEYS,PAGE 89. 20 NAT08'JV"W • - ..._.., ' _ �'.* LAST VISITED 7/7/76. , ,�% L N 88.09 56 W / �F� .,)p .120.00' R'S' PORT HAOCOCK HEIGHTS ROAD dddy 'P 1•4 PRIVATE W 1 9 ` l: ROAD P $ . ■ 4 30 . i . 39 airy ' i __..--.___. , . IND. D.F. VICINITY MAP SEE SHEET 2 FOR ^° ( 30 30' 18 NO SCALE SECTION SUBDIVISION g 40 CJN✓ Al -LEGEND ^" a: \ 1 , 17 / SET S/8•RESIN WITH SURVEY UP STAMPED•Nn-SCOTT " \\ (S 2 400'AND r•x 2•WOOD srAKE IF pc 33 A SET 3/8•RESIN WITH SURVEY CAP STAMPED N71-SCOTT POND 2 \I' •p.. 36 --PRIVATE .. 1.4_�. P,L h LS 23400•AND PLASTIC GUARD STAKE : ,♦. it NI- SET PK NAIL WIN PLASTIC SURVEY CAP STAMPED•Nn- �' FI \ � � � SJ51'S.)" 1 B / t7 O SCOTT LS 23400• APPROXIMATE LOCATION 0 I 4 '''•• ..i R-386 95 �1; V ONE EASEMENTAPER AUDITOR'S\ L X34 78' 25•NATURAL VEGETATED BUFFER ALE N0. 127037 AND 1?Y7790 –– . 94500 ON FIELD TIES TO I L' _ g+NO 15 EXISTING 6"PIPE LINE. -_ _ 1c IND O F.- �� EASEMENT FOR DRAINAGE PURPOSES PER AUDITORS = \ V.:1 --44' l ; , FLE NUMBER 406715 �I-� 42 R• TB6'95 + +- r-'I EASEMENT FOR SEPTIC 406244 D PURPOSES PER 1 I L\T rE E EASEMENT FOE NUMBER 406244 ^ 1 L `. I. / PDND J [ J EASEMENT FOR INGRESS. EGRESS,AND UTILITY I� p 3?52'3.Y O J PURPOSES R-lJ.18l' L ,' 1.33.81' / 1 �- AREA FOR FUTURE USE/PRIVATE PARK/ I p Z • RECREATIONAL FACIC/ncs ���iii x {•i. IND. D.F DENOTES LOT SERVICED BY'NMI/DUAL DRA/NF1EL0 •.y0 \ \ •,,.0, , POND/ DENOTES DRAINAGE DETENTION POND (� \\\ 1 1 3•f_ ► • �� 0 100 200 n S ,lo I. _ ' ��� x /;/D S8T43•IO"E 150.00' I SCALE IN FEET r - 2 •�\\ --- s- /;�•- •- • '� ��:. •' S 87'46 55" E I \' \\'.' \� I/ 669.65' I �+ (� L \\\\\\\\\1 +�T '•• k OPEN I SPACE WL[EYBALL COURT AREA I - '� ISPADE S. 8 \\\\\\\\\\\ •++ • w \\\\\\\\\\\'� ,/ •,I+' •I$ p -97'4270 I 41 OBI . JJ \\\\\\\\\\\\ V �+ •I° /,1 R-260.00' I�.- N0. 0F. 1 ) y/. . - : \\\\\\\\\\\\\i 1. e'. .' '\+ .N•�. i i 92'46'01• \\\\\\\\\\\\\ •OR11NF/ELD' I„ µ r687,y t• .�j,7T Il ,\\\\\\\\\\\\\ 1UTERALS + vl kJ ; JTJd?' + LATERALS , �I�\\\\\•\•\\\\\•\\I + *+ + •++I= SELF 1 O • TERALSO ` \\\\\\\\\\\\ SlORACE yN•• • j/ E/� ')yam LATERALS / \•�\\\\\\\\\ ♦I+♦ •.I Ztl' IND,D.F. I I IND.O.F. 4 / r\� \\\\I + .1* I ;∎ POND• 1 I IND. D.F. I INL} D.F. 'r °L �\ 4++I++ I.I • I 2 IND,D.F. I D.O.F •1 Cf �\ "\•JI - -�•• - 4 PRNATf 6 / \S8T43•10"£ 150.00• `\ I 3 15 I /,/j/ (I I O ' / i !lI/�`I I-- //_ .."-- I f A l LATERALS D H I C '� 124,•9 -__-_A.----f6s�W 7,o -.._—� ' �� ., I /, -=�•�—_.'==--- -- - N 8 43'10" W � �/ I 11 /'" �E�K.-' --� 1338.65' I — — —3 . ' 1 8\ I PA G. SC i ;n r n APPROXIMATE LOCATION OF— �. 0e�\ eat i N N "BASED CALCULATED ES BY EXISTING RIGHT-OF-WAY PER •I " BASED ON TIES BY COMMISSIONER'S RESOLUTION A'a%-�, ,1v', \ i l r? A.DUCIAF.K PER U NO. 69-78 ' –• i• '- -- ` SURVEY 1.1 OE "$ ; / SURVEYS, PAGE E C-) A Vii. \ SEE ALSO VOLUME �f`f%Gh,A(53/W� 79OFOR SURVEYS. rJ O:\9s`0129\I I\BRO0940I\SHEET-1.0WG %MKS IL/TI/IY z z8 114 CLOTTEC: 2/20/98 SHEET 1 OF 5 11%,,,,,,,,,,,,,,,,,,,,,,411 C NORTHWESTERN TERRITORIES, INC. 1998 SCALE: AS SHOWN ,DATE 6,,5,97 - PORT HADLOCK HEIGHTS DRAM BY: OJT&RCC ■�� NORTHWESTERN TERRITORIES, INC. PLAT CHECKED 8Y: EVE ■•� 'rl EnpNIx1•Lind SLrrlyal•PNrmen MOBILE HOME PARK �� ���' Construction Coordination•Materials Turing FINAL RENEW: 8G5 SHEET 1 OF 5 BINDING SITE PLAN BSP94—000 1 11124/-1WI NT 1 717 SOUTH P148001,00117 ANGELES.WASII8O70N 1111707.MO/457'.11491 r— / C-3 C A m _z z 1 ���n� H W (1 u U p C= TV A m IUUI lul Iu1 • 4097y(a Ot elje`kt Sete - DRAWING NUMBER DRAWING NUMBER , Vot / P. Si E PLAN HDL)CORRORATION • IRVINE,CALIFORNIA DEAN NOLO CORPORA-ION • IRVINE GAE'�ORNIA F REORDER BY Nll.1BfB 3754H REORDER EP NUMBER 075AR I. 4 \L2 N:0( •bv/, 3(n '17 T127- ‘PA49 Isto t 30 ci,bo Ls? POMTHADLOCKJPJIIEIG]RITS 0 MOIa3IllLE HOME pAlluK- 1 suns FLAN ISP94=0001 SECTION 1 1, TOWNSHIP 29 NORTH, RANGE 1 WEST, W. M. JEFFERSON COUNTY, WASHINGTON S 87°58:08" E 1 -__-- 6 0. 63 ( /.78 - 5 t 4 .._I.-1/1 -r, 1/08.00 /e • ? } 1/j -- - - -L - -Y _. �J 88.17 -.L�� r - - 1 IND. D.F. 70708 S0. FT. - - -�- - - /I•• /1 N 8618 SQ. fT. - Y,, W 4r 2 9 N 10309 S0. fT. q� ?os ��. S:)-wN. 24o� � � 23 �_ � ;5ti 22410 S0. FT. •°'��� U 1vo o lli ^, V, 2 b�hv e, \6�6 I '•o CP. 2 10499 S0. FT. IND. D.F oe, 4v 2 cri_i.',. Dy4 ( /o, /' 20, 26' 10040 S0. FT G '37 q 4353.44" t•-, ' 'I.5 71*J' 86.83 ,� 46.45 - s t 1 Ok,,54, S 88'09'56• E t4�00 4&, r Q = 3B•3 I Q S 88.09'56" E S0 /45►5� ' 5p 10382 S0. FT. I 202.88 PORT HAOLOCK.HEIGHTS ROAD R� ' : A N 88'08'45` W Ze, ..... PRIVATE ROAD T 102.08 = 2g33' 13878 S0. FT. = 25'79 (�_1'r*• - S 88'09' 6" E .130.00 \oJ I /^I L !' Yp. 11037 S0. FT / I 2 7 4$ E �, 49.23 80.77 d 63 4\ 69 5�'S 7927 S0. FT. 00 ! ,,-0 I / N \\5• y 56 ,t) C f �°. g6pp0 I *6�,./s ***P. g � N 90'00'00" E D�'b .59 ky p ��`ern' a y ti3\�Z _ _ ° / V ��to W, 104.55 Al: ,h^ W 0 ,A m °L �\'s - I NSI ro / � 13826 5'Q. FT. C/�8 ~ 3 1 . h /// �I o J fv V J)p � o m n g - - °o N 88'08'45` W I t tJ `" 8395 S0. f7 °v o ° 3 0 ^� 122.04 IND. D.F. a, IV--____1_'79'0 `.° O') 1 l\ °" 2 q 2 '� • Q Z ^ Q1 sT ^ lv V 10233 SO. FT. ,9 �S•,� I I j(-^(� '' / 1 <' 6522 S0. FT 1'S 6 •sg 18 I/ .°o 50.45 2 8.00 5 5 55 '" ti• W 0 g N 90'00'00" E Y 1 60.00 2 r m 1 61.83 89. 106.23 11391 SQ. FT. p -- C) 0 9762 S0. FT. m N 88'09'56" W N 88'09'56" W 3 V) 2 1 Ct ;n i ° 4r N 88'08'45" W O I 87H 1 SO. FT. 7212 SQ. Ff. $ o 0 32 v U ti >. 0 C.* N . 38 3 12536 S0. FT. m o° 2 )72.02 I ° lJ N!n A = 01'26'41" w 4 O >D ro o o R = 356.95 ° t` -%+ ,v.-N ,^7y.__- _. p m - 37 vt 1 = 9.00 C - _ h 11673 S0. FT,NO' 'la \b S 88'09'56" F �� - ,/ 7 Q N 90'00'00" E \ "8,--c;% "�n h gk 119.89 -4 l I 59.50 ° .t °'o II 11 555r�0 ,� = 08'08'10" rn 3` ! °�. 4-+ b `I• 3 10868 S0. FT. R = 416.95 I I ".c. a o p b d'56 Nk L = 59.21Y/ N Js�7.. �`so�'• 5 5 ■tip p o 0 A = 15'29'40" I I I i1s. 6255 S0. FT. 0 4 6 R = J56.95 0 3W',w°2 q ,C 3" n`n L = 96.53 N 88'08'45' W I 2 4 1 0 2 I 0„ sa' s 35.14'23" �75 y-� o 33 126.18 I pW20 lJ I I ti 2 J o 40 5 8725'10" E 12244 S;9 FT. a 1` 2 93.80 = 50 S66„3, . . S 88'09'56" E S 88'09'56` E I ,// {/'��R I ,4aoH 3' - -:.2f. 84.50 104.5) R 4f6.950r / V ° g �Z'W 3 10882 S0. FT. �II - L = 91.16 I /� k Q°n 10 ,/ \ �// - �". ` l *oJ� 3 ,3p,T .5i . 3p• S �� = 11742 - - I .4 3 a w t` s 81e 11 N h h o N 88'08'45" W ' Q� 2 DL s 1 36 ��N w .l 3 5 m o o 3 4 149.48 ; q \ �� .Z. N0. 6420 S0. FT / ik- N p l y 8575 S0. FT O = 09'07'50" I Lk: _ I -- L._ - • • S 8431'41' E 16214 \ �. L O - .a+ M N Q - __- T 1 - R = 416.95 h -t--- N__ _ n. 4 27 ti'gh L : 65.72 n 2t\ _ 747.07_- - 7�. S B4'31'4 E 93. 0 �0 �Oi -: _---_- °'_"�- -�' -- 0_56 52.71 0 bcj°',5, /' _ - 10639 S0. FT. I/ w .� I o 01 cam----- �"-`^ B 7 (I' w 5 -- D N 84'31'43" {y �^ UO 15569 S0. FT �- : 621'09 ---�-1- _ ____--'J7 I _ J 2 u; o. = 55.7w _�I w O0� w o o IND. D.F. _, v -0 c, •P£N SPACE -7..--771-. __ ('J 1` `', I I o 4 fv \ N .� £ ./ o C r I�' T '^� 1 Z SEE DETAIL B Q Op [R a 410 547?. 20660 SQ. FT I v J Q v J 1 ON SHEET 4 ' ��A �'��. ° 7g35 S ,// o I 5 8642'25" W . , FAG / 4 \� 1N\, I 191.87 R 30 00 175"� Q���P Q o��.? ,4. I ( r V L = 46.98 \ h�0kry. (n C ° �P d C b' I �/) Ns-, I POND 3 N 64'0155- - •( 4' o S ,� itr E O ppESPACE 36.64 Q0� !a�,'ra��.. _j5:15:;40-,• - la •1 , A = 20'4070" R a 175.00 .-.. 4 vil Vj 0.71 SEE SHEET 1 FOR LEGEND _D u u u 0 y }. '4'0,---. ,o j DETAIL 8 o u u .5, ;7�":+ �' 4 D 50 loo NO SCALE o 1-3-1 C- it\ C N \,C ,SCALE IN FEET O j �'AL LAND ):\SS\0129 7 1\BRCD9401\SHEET-4.DWC SHEET 4 OF 5 p -- %EXPIRES 12/21/99 Z/23 . Orr ER: 2/20/98 NORTHWESTERN TERRITORIES, INC. 1998 � � 1',�\%\\\NN\��V��2//��///////�1` ('-' "" I THWESTERN TERRITORIES, INC. CALF: AS SHOWN DATE: 8/15/97 PORT HADL 0CK HEIGHTS =� -,__.�, ;�, , HAWN BY: DJF& RCC g� -I w Enpneers-Lend Surveyors-P(snners .AT CHECKED BY: DJF MOBILE HOME PARK I1 `akir th Jj (onshucNon Coordination •Materials Testing NAL REVIEW: �S BINDING SITE PLAN BSP94 DOO J___-Z17-SOUTH PEABODY,PORT ANGELES,WASHINGTON 96362,(380)452-8491 1557 4 OF 5 11(2• -1W) +ri op , #00e 14, elk 3 • C,(: 1'0:1FIOORJAI.':?:1' I'OI' G1:11 a5. U $ti 1 'Z— _„ � I i t o e J ;I I i ri 1, 1 ..- .1 w i die° A /\ . .,. ; 0 9019 d :z `_'• d r 1 i a �` 1 L-t -i4_2___ 01 _44_ de:a 11Q _ • • jErIi _s'�-= I yam///� ^'Qnar'(it Vred NIP . . . n:r ''I ! f 7 L3 b i :9 -+ - -- i m o r F +/. ! I ` 1� s d _ _ ._ . . Q1 �r v I _ _ r Y t _i q i �. • "Al I f :;',E-•S-.-- :01.. ellimonor Z-7. 1— q�,Y _. = 1- i I T `is r- Q. ..i '4i 7 I i . ' , . . D 1 g.. 4 1 JUN — 3014 I JEFFERSON COUi,ITY 1 DEPT.OF COMMUNITY DE ELOPMENT I I • • � ■ 43 -� OC ol Vr 0 ___.7! 1111 (',11([' .t -, - . ' . ."- -Ai . z '' Or s d 1 3 N _ I:41 i i 0 1) 1 111* c4.Ati-� . A i \ i €1/4.--1:\s7216- �,,\ -\ •s�o�CS k '``° f 'l 'P t-'t 7i`' .4._ ‘ :_"i"r • \i‘ 9. IA r-4 V'''' 'ir } .(43,1r..Z,.....A i;ek_ .."' ' .)'k tA ‘‘I.Vi 1 Z % 2 ",C.-.' T TM li/L • If qtr— I A, ra t is I. Z'd OZ64-C99 i096? w 90/90 39Vd nnc 3;0 sewoH e6e4■JaH dZ L 60 b l S' Rey -q I 1 7-lvrn.i iipt2D • BLD14-00195 Review Type: MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD14-00195 Received Date: 6/6/2014 SITE ADDRESS: 334 PORT HADLOCK HEIGHTS RD PORT HADLOCK, 98339 APPLICANT: BRODERS INC PHONE: 360-797-7722 4503 OLD GARDINER RD PORT TOWNSEND WA 98368-9778 SUBDIVISION: PORT HADLOCK HEIGHTS MH PARK Block: Lot: 1-45 PARCEL NUMBER: 989500001 Section: 11 Township: 29 N Range: 01 W CONTRACTOR/ HERITAGE HOME CENTER PHONE: (800)446-1166 DEALER: 259335 HWY 101 SEQUIM WA 98382 Contractor's License 602099664 Expires 12/31/2017 INSTALLER: HERITAGE HOME CENTER 602099664 12/31/2017 (800) 446-1166 259335 HWY 101 SEQUIM WA 98382 REPRESENTATIVE: DON NELSON HERITAGE HOMES I PHONE: 360-683-282® 259335 HWY 101 SEQUIM WA 98382 PROJECT DESCRIPTION: New Manufacture home with attached Garage TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: MARLETTE SETBACK: VALUATION YEAR: 2014 LABOR & INDUSTRIES APPROVAL? SIZE: 48x28 BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: 05783 BEDROOMS: BATHROOMS: Exist: Exist: Prop: 2 Prop: 2 Total: 2 Total: 2 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $689.00 SRE 06/03/14 148757 State Building Code $4.50 SRE 06/03/14 148757 Potable Water Application $67.00 SRE 06/03/14 148757 Plan Check $102.05 SRE 06/03/14 148757 Total: $862 55 +irlomorIArIn+a+nrmc\C RI 11 Ann PAnk rn+ (/(f)(11 A • • ^¢SON c r"n C� a w JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT ' JUN - 3 2014 621 Sheridan Street • Port Townsend • Washington 98368 j 360/379-4450 • 360/379-4451 Fax JEFFERSON COUNTY HINO http://www.co.jefferson.wa.us/commdevelopment/ PrPT.OF COMMUNITY DEVFIO'MENT Stormwater Calculation Worksheet MLA# PROJECT/APPLICANT NAME: DETERMINING STORMWATER MANAGEMENT REQUIREMENTS: This stormwater calculation worksheet should be completed first to classify the proposal as"small," "medium," or"large." The size determines whether a Stormwater Site Plan is required in conjunction with a stand-alone stormwater management permit application, building permit application, or other land use approval application that involves stormwater review. The basic information will also be helpful for completing a Stormwater Site Plan, if required. PARCEL SIZE(I.E.,SITE) Size of parcel acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet l 2 Fj 1) l4 sq/ft Land-disturbing activity is any activity that results in movement of earth, or a change in the existing soil cover (both vegetative and non-vegetative) and/or the existing soil topography. Land disturbing activities include, but are not limited to clearing, grading, filling, excavation, and compaction associated with stabilization of structures and road construction. Native vegetation is vegetation comprised on plant species, other than noxious weeds, that are indigenous to the coastal region of the Pacific Northwest and which reasonably could have been expected to naturally occur on the site. Examples include species such as Douglas fir,western hemlock,western red cedar, alder, big-leaf maple, and vine maple; shrubs such as willow, elderberry, salmonberry, and salal; herbaceous plants such as sword fern, foam flower, and fireweed. LAND DISTURBING ACTIVITY,CONVERSION OF NATIVE VEGETATION,AND VOLUME OF CUT/FILL Calculate the total area to be cleared, graded,filled, Answer the following two questions related to excavated, and/or compacted for proposed development conversion of native vegetation: project. Include in this calculation the area to be cleared for: Does the project convert 3/4 acres or more of Construction site for structures ` Z� sq/ft native vegetation to lawn or landscaped areas? Drainfield, septic tank, etc. sq/ft Circle: Yes No Well, utilities,etc. sq/ft Does the project convert 2'/2 acres or more of native vegetation to pasture? Driveway, parking, roads, etc. sq/ft Circle: Yes No Lawn, landscaping, etc. sq/ft Other compacted surface, etc. sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance \\2' sq/ft Cut Fill (cu/yd) [over] stormwater calc worksheet—REV.11/1/2013 CoiSIon 6/544 _ ap,2.3' O APPROVED • /21 SITE PLAN , / s „. } AUG H 1 2014 Jc i o rot op-13; ,1":"`+� :-t •:• ,i:4 ' 1CR SIGNA �'A -��� -' o_ I J0F) 1 a. IA o iN 0 N CD j r z 0 • --1 ( �. I/ 6,i e t, ' { / .U. 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'T''' h z 1 . . ."---•-a\: ''',/:?..",,... -, -,!, _ li- t, '-' i . ; :-_,:-. ,„r•-•-'. .r',\4-?'-'''. *-- S.- _1 ,..,.. i,r-') I : C kl V -, c;' '.7.1,.., ■,-; - III 1 ;t"-..,."--:: : ;:- ..:N ....ic-•. ,L.)/ I --I-7 7---, r` P= — t; 7'..- '' rr -- ' ,.. --, — --,. : , I.:t...,,, ''1 1 I I ... - . ! . L...../ ---•.::: •--, -:.5. JIFIERSON COUNTY — .,___DEPT.Or CW.IM("ArrY niThrUt-NT 1 __. • _ . . . .. ._ . ..1.-vCLG I I t ` deb 15 14 03 12p Heritage horn;eauim PAGE 06/06 (363-0920 P.7 1 sr-.. ' )1. �A' 4 � ' . leio iiii..s\N4 c... \--% -11.5\ts ,-. .1. tk.- Qua A -t ,: \ -. A% `e::: a,.,... ikt .,:t I Ir---t. %,? — (--- \,-.Cr-r o. mss. , r • J'1�� �� t e ►-L Q ..._1_, N'■ ,is '�- '-� EZ 1 tAiii j, . iii Vt (\;.. \ QZ ' ' 1 '111,72.44k".4.1?1-4.'%,, sma :I ow* !! Acid i i t 1 It v4 y q 64 '44Ez;-?-.7 I T �tt7 � _.y. ' N ! Q • fi 3Z ..:-.1.. .0:IN N M od �� Impervious surface is a hard surface that either prevents or retards the entry of water into the 50JI hantle as under natural cci • it s prior to development. A hard surface area which causes water to run off the surface in greater qui r'It ties pr,at an ir1Crea$e rat: • o from the flow present under natural conditions prior to development. Common impervious surface ►include, but are not limitew • to f tops, walkways, patios. driveways, parking lots or storage areas, concrete or asphalt paving,;graVell roads, packed earthen m`: - lal . and oiled, macadam or other surfaces which similarly impede the natural infiltration of stormwater. JEFFERSON COUNTY ni�T nr r•114 MIT`!fVVROPMENT STQ/RMWATER CALULATIONS–IMPERVIOUS SURFACE NEW ff EXISTING Structures(all roof area) 1 3 (4, 4 sq/ft Structures(all roof area) sq/ft Sidewalks sq/ft Sidewalks sq/ft Patios sq/ft Patios sq/ft Solid Decks r-- sq/ft Solid Decks sq/ft (without infiltration below) (without infiltration below) )(IP t■lew VD'AV' DO Driveway, parking, roads, etc Z sq/ft Driveway, parking, roads,etc a o sq/ft Other Cz>7 (lA Cot U"! sq/ft Other sq/ft Total New t a) 13 sq/ft Total Existing sq/ft TOTAL NEW+TOTAL EXISTING* Z a t sq/ft "This amount will be used to check total lot coverage. The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT v. REDEVELOPMENT Divide the total existing impervious surface above by the size of the parcel and convert to a percentage-3 . Does the site have 35%or more of existing impervious surface'? Circle Yes o FURTHER INSTRUCTIONS: If the answer is yes, the proposal is considered redevelopment and the attached Figure 2 should be used to determine the applicable Minimum Requirements. If the answer is no, the proposal is considered new development and the attached Figure 1 should be used. At this juncture, the applicant should refer to the applicable Flow Chart to determine the Minimum Requirements for stormwater management. DCD staff will help verify the classification of the project and the application requirements. For proponents of "small" projects who must comply only with Minimum Requirement #2—Construction Stormwater Pollution Prevention—an additional submittal is not required. The proponent is responsible for employing the 12 Elements to control erosion and prevent sediment and other pollutants from leaving the site during the construction phase of the project. Pick up the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet. Proponents of"medium" projects—those that must meet only Minimum Requirements #1 through #5—and for "large" projects—those that must meet all 10 Minimum Requirements—are required to submit a Stormwater Site Plan. DCD has prepared a submittal template of a Stormwater Site Plan. principally for rural residential projects. Complete the template in the Stormwater Site Plan Instructions and Submittal Template or prepare a Stormwater Site Plan using the step-by-step guidance in the Stormwater Management Manual. APPLICANT SIGNATURE By signing the Stomiwater Calculation Worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected property. A s A, ✓�a��� ( • - -OR AUTNO'IZ'n R;',•R - NATURE) (DATE) FOR OFRCE USE ONLY SMALL MEDIUM LARGE REDEVELOPMENT Stormwater Site Plan: Yes No stormwater caic worksheet-REV 11/12013 ,� 1` J.iiiL} -. 1(-i �,) 1 SON `� JEARSON COUNTY � DEPARTMENT OF COMMUNITY DEVELOPMENT 4. 621 Sheridan Street I Port Townsend,WA 98368 I Web:www.co.iefferson.wa.us/communitydevelopment '1`r-ll1 ivc;c Tel:360.379.4450(Fax:360.379.4451 I Email:dcd(a)co.iefferson.wa.us Building Permits &Inspections I Development Consistency Review I Long Range Planning I Watershed Stewardsh p ResouLce Center Q1,.", �` 1--4� Master Permit Application ,i5 A\ ry�c.,,�. p co,,e ,.J( 'y�-LMLA: Proj Descrie on(include separate sheets as necessary : 1 (Li. 1 iOAD f.v..AL IA%i s 1 DPALW.1crnt,Vi . ..o i �T1 (S'E.L MI F ( ) f'c , Tax Parcel Number: 0)50) e,0000 l Property Si(z�e:12 ' 2,� (acres/square feet) Site Address and/or Directions to Property:6dt 9D Mt WI t)2 c,',L AtAko iS' 1. . tc(t 1 \kwy %Cj (Go Nbn4it oo (►1�1�r11m,v4xn i,L0 1vrut4 R\cbm-t D N l.14ANS Ro LI.FZ DA PSit 1 �Le4i,HC14 WIS A.O. \.S�F: Dr+ Pb� \‘AP1,b L\� \fits\ 4w\c Ut, \.•'t o N 0.t,(.N%. Property Owner(s)of Record: ZROTACtS •TAAL. (TM CM-.%W AIL) Telephone: 3 k.10 1°) l 111.1. Fax: email: Mailing Address: 1k•,OS Ot.to Ct%t2Dt n ati4 "coy.*As wO WD °1 86 Applicant/Agent(if different from owner):INER Vc l (c k H DMZ,S ot St \),\M (•fl DN MCLSEI) Telephone: 3 \90 (Al 2.:e . Fax73140 ( ?3 0920 C'EL, email:47.4 "Z3 %IA Mailing Address: 2 ■ 0 S \M A What kind of Permit?(Check each box that applies ❑ Lot or Road Segregation nuilding ❑Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use) ❑Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a), C(d),or C]** 4 Manufactured Home ❑ Modular ❑ Discretionary"D"or Unnamed Use Classification ❑ Commercial* ❑ Special Use(Essential Public Facilities)** ❑ Change of Use ❑Boundary Line Adjustment ❑ Address ❑ Road Approach ❑Short Plat** ❑Home Business ❑Cottage Industry ❑Binding Site Plan** ❑Propane ❑ Long Plat** ❑Sign ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration*" ❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions** ❑Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Substantial Development** ❑Temporary Use ❑Shoreline Managem: &T. -i•r - ❑Wireless Telecommunication* ❑Comprehensive Pla •• L.I. I1••=•I'� . _, ' �� - ❑ Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Sh4• 0 - •=- - ' , j *May require a Pre-Application Conference ❑Tree Vegetation R-•. - **R-•uires a Pr- al.,tion •q erence Please identify any other local,state or federal permits required for this pr• • •I if • n: J , i DESIGNATION OF AGENT JEFfERSOiV COtMoR I hereby designate 0 h1 - L �tJ to act as my agent in matte s rel ��yy�('r�t mit(s)• a1PR�!biz�� m � I OWNER SIGNATURE ►''a!�� /\ 2 � 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 its 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 inspectio s. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the a •' • ,,n. prior n,,;;, Signature:- �i_Lp� 0 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-transferabl- - ••• 'bili o I •r eeng to .•: complyin•with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: _ �� ,► ■ . Date: V 2) l k 07/24/2013 { • • • 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 -sponsibility• the Ge ral Contractor for the proposed pJooject. OF Signature: , /' .. Date: \y w 3— ' GENERAL CONTRACTOR OR MANUFACTU ED HOME INSTALLER: PHONE: FAX: \. .(Lkt Q 1101)e%o$ S uC�'17J0c- �>tgi. Szal‘ tai�9�9 e MAILING ADDRESS: 'ZS"/'; 5 \\4\14\1 VA V rlf1 U 7VIEMAIL:\�ti-s\Alit,— e Vk01 Ww"AiI%• tI r'` CONTRACTOR'S LICENS WAINS ' NUMBER: CCUC•0- 7r oS`3l.P NUMBER ARCHITECT/ENGINEER: \ PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: 14 Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: • New C Wood Existing: .. Sewer N�m� ��►s�Pu C Addition - Steel Proposed: Bank Community System C Alteration/Remodel i Concrete Total: Height: i Individual Syste i ❑ Repair Masonry SEP Permit#l9 .003-]l '' ' ❑ Demolition Other: Bedrooms: Water Supply: Y: Existing: Setback: - Private well 0 Two Party T Vpe of Heat: . Proposed: CC: Public 0 n r y,Q At IL Em.a Total: Name of Systen>C vA 11.(k If this is a Commercial Protect 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 hav F d ear o,q (� If this is a Propane Tank and/or Appliance Installation permit,mark all items below that 't :{I Z = B V Underground Tank Above ground tank Size of Propane Tank: I ,H / ( ! Heat Stove Cook Stove Woodstove Fireplace.nsert rehtO I evot 'tel($F1 I knaT retaWtoH I I Is this appliance being installed in a Manufactured/Mobile Home? Yes / No v?; _ Z.014 When applying for a permit to install a propane tank you must also submit a site plan sh wig all of the buildings,all p il :. • lines,tank location and size,distances from the propane tank to all property lines,buildings em-semnpehents, including the reserve area. ■ 'UPS'N COUNTY U'')i.OFCU"1rt NIIYUntil-tUPMENI Square Footage Current Proposed For Office Use Only Amount Revision Main Floor Heated EH Bld App Review. IICI b U 2ntl Floor Heated Consistency Review: Other Heated Base fee: c. Mezzanine Additional Section: - . 4, 3 tuj Heated Basement Plan Check fee: 1(.3". C, 1 Unheated Basement State Surcharge fee: 1 j ° 1 Other Unheated Pot Water Review fee: ` `'_ ,c)3 , Garage/Carport i SUBTOTAL f Decks 911/Rd Approach fee: • c_- Other TOTAL: $ Receipt Number: 1 1 b.3S---/- Cash/Check Number: r ESTIMATED COST(REQUIRED) Date: ) - 1 J j ■Fair market value of all labor and materials undation to finish I "1 (l u u J Initials: 07/24/2013 JACK WESTERMAN I) • Jeiiergen County Cwnrthowse ASSESSOR 1'O Hox 122e. s (3600185.9105' } C '\\(./ MOBILE ROME INFORMATION FORM 11 6JH ' OWNER'S NAME/MAILING ADDRESS: (I Lid !(_EFERSON COI;PTY NAME: : 3 2.‘M r 11 .,r C (11DV T ADDRESS: 2.‘k. v P e 5 - • t r�'"" tiMICASIiV `1 PHONE NO. 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. 1}MORIEE HOME DATA: (A) MAKE \.Rtl\,.. ., (B) MODELCOR40311)1'11284$/ (C) YEA2' 44 (D)LENGTH 14 6 (E)WIDTH 2-2) (F)SERIAL# `i‘D 1 G►YOUR PURCHASE PRICE (Do not include sales tax) PURCHASE D• 2) PR • I IS OWNER/LOCATION OF MOBILE HOME: (IF NEW MOVE k! i I ESTION 3) (A)FROM WHO i I YOU PURCH• I I ILE ADD ' • (II) . • • OBILE HOME ASSESSED IN JEF ' . I COUNTY LAST YEAR? Yes No If Yes, Previous address of mobile. If No, What County was Mobile assessed in last year. 3)WRERE MOBILE HOME IS TO BE LOCATED: r� (A)WILL THE MOBILE HOME BE IN MOBILE HOME PAR Yes No \1)0(1101'\I) ,S 7 (B)IF LOCATED IN MOBILE HO PEAR Ilk Purr °��- ��041 I?1.. NAME & ADDRESS OF PARK L ct WC, 4. (e1V1S Lot/Space#�� (C) IF NOT LOCATED IN MOBILE HOME PARK: NAME OF LAND OWNER: ')4SDOZRS`3.1v C cN)1(,14.3)(tPtA.g.. LOCATION ADDRESS 4523 C) LA vPR tQ �btt.C-TO 1VS'r .4D Nck`A 1Q REAL PROPERTY PARCEL #/DESCRIPTION CP Signature of applicant THANK YOU FOR YOUR HELP! 4JO COSSELL, Property Technician To schedule inspections, call (360)379-4455 no later than 3:00 PM the day before the inspection is needed. i Requests received after 3:00 PM wiii not be scheduled for the next day's inspections. Office Hours 9:00 - 4:30 MONDAY -THURSDAY ELECTRICAL PERMITS are issued by the Washington State Department of Labor & Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes / Setbacks 10-1 ,(C ,,,/ Setbacks Erosion Control Erosion Control MH Foundation (0—'1'ICI Foundation Stern Wall Straps(hold downs) Ext. Shear Wall Nailing Framing Blocking&Tie Down Skirting &Ventilation Pressure Test Drywell/Alt Drainage Address Posted Address Posted (1'10 )S Septic System Finaled 11 see sep04-77 and sep95-289 A final inspection will not be scheduled until all of the following are completed and signed off by the applicable Department: • Building Permit Conditions are met • Septic Permit Final/Complete for any building containing plumbing • Land Use Conditions met and signed off • Public Works Permit Final(where applicable) FINAL INSPECTION y/0/5-- ?____ FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR SPECIAL CONDITIONS APPLY - SEE REVERSE (---Doem„ ne I%0 fir) • • SPECIAL CONDITIONS CASE # BLD14-00195 1.) 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. 2.) The site plan as submitted with the Building Permit application on June 3, 2014 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 June 6, 2014 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 3.) This approval is for a New Manufactured Home with Garage 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. 4.) DWJ 5.) This parcel is within a no shooting area per JCC 8.50. 6.) 10' minimum separation required between the water line and any onsite sewage system components including sewage transport lines. II \\tidemark\data\forms\F_BLD_Permit_Mobile.rpt 9/18/2014 • • 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 #: BLD14-00195 Received Date: 6/6/2014 SITE ADDRESS: 54 PORT HADLOCK HEIGHTS PL Issue Date: 9/18/2014 PORT HADLOCK, 98339 APPLICANT: BRODERS INC 4503 OLD GARDINER RD PORT TOWNSEND WA 98368-9778 SUBDIVISION: 9895 Block: Lot: 1-45 PARCEL#: 989500001 Section: 11 Township: 29 N Range: 1W CONTRACTOR/ HERITAGE HOME CENTER PHONE: (800) 446-1166 DEALER 259335 HWY 101 SEQUIM WA 98382 PROJECT DESCRIPTION: New Manufacture home MAKE: MARLETTE YEAR: 2014 SIZE: 48x28 II "'-44 7 P-dF z11 I"", fX & J1, J,, mY LM 50, ar sp at ot all Ir AA 49 r4r, too CO N 17 DEPtO UN IIy j, IIL I Fl. II'LAM ip I�e� IULM WMT.� I , __ - -1 "1 � ; , _- d�,A, A,,-w Utt tF x. v7 4 Z" Z� Y 4*_ -47 kr N V, J,� 42 _-J.4 p ALI IEO 0 2 z 04 4, k A9 i.V 4 F1 7 77 7 W V1. 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