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HomeMy WebLinkAboutBLD1991-00862 • ., 410 .TFF'F'1r. F 1 C)T' C C")TiT'IPV Ri7TT.T1TTTC3 APPT. TGATTC)N Jefferson County Planning and Building Department courthouse, 3rd Floor PO Rnx 1220 / Port Townsend, WA 98368 /�� 206-385-9141 PERMIT # •BT.D91 -0862 DATE RECEIVED. : 12/03/91 STTF. ADDRESS : yR'iS'CHF.RRY AVE. : CHTMACTTM, WA 98325 OWNER -NTT.S NORDSTROM PHONE : 732-4359 MATT.TNG ADDR: PO BOX 24 :CHTMACUM WA 98325 CONTRACTOR. . :NO CONTRACTOR PHONE: MATLTNG ADDR: CONTR. LTC #: EXPTRATTON DATE: ARCHITECT/ . . : PHONE: DF.S TGNF.R MAILING ADDR: PARCEL NO. . . : 963000-204 HEALTH: At , LEGALDRSC . . :STR 10-29-01 WWM, TAX # BY: !SAI .: i LOT 9 , BLOCK 2 , TRONDALE ORCH TRA SHORF.T.TNF.S : BY: DATE: DESCRTPTTON OF TMPROVEMENT: replace a mobile home BUILDING TYPE -MOB BEDROOMS--- BATHROOMS-- MATN FT.. . . : 0 sf TYPE OF IMPROVEMENT:NEW EXIST. : 0 EXTST. : 0 2ND FT. 0 sf GARAGE/CARPORT • PROP. . : 2 PROP. . : 1 3RD FT. • 0 sf WOODSTOVE TOTAL. : 2 TOTAL. : 1 BASEMENT. . : - 0 sf UBC OCCUPANCY GROTTP:R3 SEWAGE DTSP. . :SE.PTTC CARPORT. . . : 0 sf TYPE OF CONST WATER SUPPLY. :CTTY GARAGE 0 sf UNITS. : 0 STORTES : O HEAT TYPES . : F.F.E/WOD/ DECKS • 0 sf DIMENSIONS : MOBILE HOME COMMERCIAL: 0 sf FRAME TYPE:STET. MAKE:LAMPT.TGHTER YR:R 1 TNDTTSTRTAT.: 0 sf EST COST. $ : 30000 SIZE : 14X56 BANK HT. . . :0 ft PROJ GRP. . : 2306 SH SF.TRACK:O ft Owner/agent FRES signature: type amount by date recpt PRMT $ 75 .00 MM 12/03/91 61885 ate: / f R.C. $ 4 . 50 MM 12/03/91 61885 ;sued By: Air . � 11�� }p• tL. 3 in Jefferson County Planning & Building Department /6 /9/ $ 79 . 50 TOTAL l (44/° / LA JEFFERSON' COUNTY SUI LDS NG PEF2M= T Jefferson County Planning and Building Department Courthouse, 3rd Floor PO Box 1220 Port Townsend, WA 98368 206-385-9141 PERMIT # •BLD91-0862 DATE ISSUED. : 12/13/91 SITE ADDRESS : 184 CHERRY AVE :CHIMACUM, WA 98325 OWNER •NILS NORDSTROM PHONE : 732-4359 MAILING ADDR: PO BOX 24 :CHIMACUM WA 98325 CONTRACTOR. . :NO CONTRACTOR PHONE: MAILING ADDR: CONTR. LIC #: EXPIRATION DATE : PARCEL NO. . . :963000-204 LEGAL DESC. . : STR 10-29-01 WWM, TAX # LOT 9 , BLOCK 2 , IRONDALE ORCH TRA DESCRIPTION OF IMPROVEMENT: replace a mobile home ( ) Footin /Setbacks (Shoreline Setback) /Mobile Home Blocking: Pit -Ea- �lam )AA-IZ / I / ( ) Foundation: ( ) Underground Plumbing/Underground Insulation: ( ) Framing/Plumbing/Chimney: ( ) Insulation: ( ) Sheetrock: ( ) Sewage Disposal System Final : ( ) CALL 385-9141 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9 a.m. to 5 p.m. Inspector ' s Hours 9 - 10 a.m. 24 Hour Recorder for Inspections. d6./2" A4,'e J. r_IZSON :CUNT BULLLI".TG P'_RMIT e1PPLICATI• ` _ I _.>. M.. OPERT( OWNER NAME1_tl_LI_S__g_ a_WL)€_ 1f�_QLW1 -PHONE___232 - /3 ,. ILIHG ADDRESS n . . __--~SSA~ .5-3 9 ._____ , �' -Pte--2- -------- p� - • oil, raQcV ZIP 90_ 5-~ .. .-:.... .CNTRACTOR ----- ~-------~- x - -- ',AILING ADDRESS /Y . PHONE STATE LICENSE NUMBER EXPIRATION DATE FEDERAL I.D. NUMBER ARCHITECT � _ PHONE ,TAILING ADDRESS 'I LOAN LENDER NAME/BOND HOLDER NAME MAILING ADDRESS ~� __---- z_________~_ __PHONE~_~ ~_________ SITE LOCATION__-22-Q___�'1_ieRR_Y____.Cz`it_g__ Cl2rY1QC12- ---ZIP CODE 9?3125— LEGAL DESCRIPTION:,,,r-_ j 1 SU80IlISION NAME_ Q CQ _r_ „j fn -6Oi p BLOCK ---DIVISION TAX NUMBER_ __( _� DIGIT PARCEL NUMBER SECTION /0 TOWNSHIP a9 NORTH RANGE____. WM 8UI DING TYPE IMPROVEMENT TYPE SINGLE FAMILY 0 NEW BUILDING HK MOBILE 0 ADDITION 500+/500- -J MODULAR 0 ALTERATION • GARAGE ATTACHED/DETACHED Q REPAIR TY W000STOVE 0 DEMOLITION n Q MULTI-FAMILY/UNITS CV--CV-- RELOCATION - TO Rea.12On 3- PR©ftaejj O COMMERCIAL O INDUSTRIAL MOBILE HOME O HOTEL/MOTEL/DORM/UNITS SIZE ) 1x_6 OTHER YEAR___-- -1__R_$L_ .-- -----~--------- MAKE----1SS?:M P-T- 'k.LL--------~ UBC OCCUPANCY GROUP COST:;7[0,-474OZ_1:G211 DESCRIPTION OF IMPROVEMENT: - PLEASE COMPLETE BOTH SIDES OF APPLICATION li ScUARE FOOTAGE PRINCIPLE TYPZ OF HEATING FUEL r` h T MALI FLCCR -- Y__— -]_ • 12".> ELECRICITY G OIL Lsr 2`DO FLOOR --- WCCDSTCVE ❑ GAS 3RDFLGOR— G HEAT PUMP 0 OTHER HTD BASEMENT UNHTD BASEMENT DECKS __ _ _ PRINCIPLE TYPE OF FRAME CARPORT __�— WOOD G MASONRY GARAGE ____—___—____ MANUFACTURED G OTHER COMMER""""--- _____ ___ STRUCTURAL STEEL INDUSTRIAL----------------=---- TOTAL VALUATIGI044 r ___—_ OR ESTIMATED COST TYPE OF SEWAGE DISPOSAL: ❑ SEWER INDIVIDUAL SEPTIC TYPE OF WATER SUPPLY: 11 PUBLIC ❑ PRIVATE ❑ COMMUNITY WELL G INDIVIDUAL WELL NUMBER OF EXISTING BEDROOMS .9 NUMBER OF EXISTING BATHROOMS I NUMBER OF PROPOSED BEDROOMS NUMBER OF PROPOSED BATHROOMS TOTAL NUMBER OF BEDROOMS _ a TOTAL NUMBER OF BATHROOMS / NAME OF ADJACENT 80OY OF WATER BANK HEIGHT / SETBACK SIGNATURE 1471110(eLi DATE /01- a - 9/ BASE FEE 75 v 0 PLAN CHECK RECEIPT x _� O� STATE SURCHARGE r �0 TOTAL 7q0_ 56 CASH/CHECK ; Z 7 95 G:\GROUP\PLANNING\BLOAPP.FRM 1 MOBILE HOME LOCATION - NOT IN A PARK , • Do you own (or are buying) land on which mobi home is located or do you rent the land? (CIRCLE) OWN •BUY RENT Assessor's Real Property account (parcel) number (The 9 digit number on the tax statement or valuation notice). . 911,3 -coo ,Qoc4 What is the� Qsstreet/�address of this land? O Street ' o . iERR.y A�)ve ff�� . City C'_h Ion aL c? U ✓-1 LOA)/ R' 3 c- If you rent the land what is the name �and mailing address of the land owner? ( Name • '` fi Street or Box City State/Zip , . Telephone number *********** MOBILE HOME HISTORY ` Date you purchased /7— -1 q 9'D Purchase price ` ./Qi Q001 D 0 How did this mobile home get to its present location: Moved into Jefferson County from • (County or State) Delivered by dealer (name) Moved from another, Jefferson County location? YES or NO. If yes, please give previous address/location. Didn't move - pruchased in place. es or�,NO •/ Name of previous owner 0i h'1 Ali ./O-h G�we ,7 Address Pr 0 b o X , s S City /`-/Q-cI /ock State/Zip 1.1.1A) 9S--.3 _ If moved,was advance tax paid? YES or NO. If yes, to which County Doesthe mobile home replace a previous mobile home at this new location? YES o NO If this is a replacement, to whomand where did the previous mobile home go? _ e;`Nq (PP1r�CCJ cJ RC'a .=W: g� ee2�Y4 u sed 4s cz- Thank you for your assistance. If you need help or informatLenboutstlheoe assessment of your mobile home call the Assessor's Office at 385-9105. 4ea call the Treasurer's Office at 385-9150. (NOTE: If mobile home Is new to this county a valuation notice will be mailed to you when it's valued and added to the assessment roll.) i. JEFFERSON COUN'T'Y ASSESSOR OFFICEPlease send completed form to: PO Box 1220 PORT TOWNSEND, WA 90368 r p/'19/o‘h> 0,e • OFFICE OF TUE ASSESSOR, JEFFERSON COUNTY • NOBLE HOME QUESTIONNAIRE RP Account 0 PP Account ll DATE 12 — 199 y • *******************************A************************************************** Please read the entire form and provide as much information as possible. This will help us identify the unit correctly and avoid double assessments. It will also aid • in placing a correct value on your property. ******************************* • REASON FOR INQUIRY: Field visit Excise tax wilding Moving by deputy affidavit ermi permit Dealer report Application Delinquent State transfer by sale for title taxes report NOR[LE ROMEOWNERSlllF/OCCCU['AAmT DATAy� p ) �/ Name(e) "Ods G -]'- &Rol/;me / /V0Rd ST/QOY'1 Street orfir Box (7 , (3.)„, &/ ori City ` "ml 1 Yr a,e.. i.yr n State/Zip OA) l O 3 02 5" Nome phone '9 3,Q =`•f 3S q Work phone' ip ' 3 +� S/ - 5- 7 mac 7 5 0 Best time to call Oc!/2di'.ue 110/17 e C4+" 14,0 K. (specify home. or work) NOTE: If you rent the mobile home give�� yyname, address, and telephone number of N owner here /A ***************** MOBILE HONE DATA: if Length (exclude hitch) 5-60 Width I 't Model Year Make ka..er, pModel �i%/1!�)e Wick 4 / v Serial number 70 l ***************** MOBILE HONE LOCATION — IN PARK - Park name _ / Space A _ ,_ Date placed in park (PLEASE COMPLETE REVERSE SIDE) U. ...............• ......M.0.111.11,....-_..T......,_....: _______.... Itc, -„,... 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