HomeMy WebLinkAboutBLD1991-00561 •
.TF.F'1 1 F CTN C;C)T7N' Y 1VU7T T.T)T NC "P'FRNfT T
Jefferson County P,l ann i ng and Building Department
Courthouse; 3rd Floor
PO Rox 1220
Port Townsend, WA 98368
206-385-9141
PERMIT # •RT,D91 -0561 DATE. ISSUED. -09/12/91
SITE ADDRESS ! 71 MAPLE AVE
-RRTNNON. WA 98320
OWNER •t,ARRY OLSON PHONE. 845-7921
MATT,TNO ADDR 10716 123 ST CT E
-PUYAT,T,TTP WA 98374
CONTRACTOR . . -NO CONTRACTOR PHONE.!
MATT,TNO ADDR
CONTR. LTC #- EXPIRATION DATE-
PARCET, NO. . . ! 971100-339
T,E(,AT, DF.SC. . : STR 31 -25-02 WWM. TAX #
LOT 38 ; BLOCK 3 ; MARSHALL ADDTTTON
DESCRIPTION OF IMPROVEMENT: mobile home installation
( ) Fontino/Sethacks (Shoreline Sethac: ) /Mnhile ROMP Blocking!,
( ) Foundation !
( 1 Underground Plumbing/Underground Insulation .
( ) Framing/Plumhinn/Chimney.
( ) Insulation .
( ) Sheetroc.k
( ) Sewage Disposal System Final :
( ) Final /Occupancy Approval :
r//1/> /2-- 742-- 4>-;%?'`
CALL 385-9141 24 HOURS TN 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.
S ` S
_TT:r-F'r. rT 5 t-57V (i3TiPN r' iT3 I T.7i i '1c R. 1=1Ri T ( 1.1.Ti T' (3T3
Jefferson County Planning and Ru i i d i ng Department
Courthouse, 3rd Floor
PO Box 1220
Port Townsend , WA :-Its.SC)ti
206-385-9141
PERMTT # • RLTl9 i -056 1 DATE RECETVET}. : 05 /0 i /9 i
S T TE ADIDRESS : 7 1 MAPT,E. AVE
:RRTNNON. WA 98320
OWNER •GARRY OT.SON PHONE : 845-7921
TvTATT,T Nt( ADD)R : 1 0J7 i E 122 ST CT F.
: PTUYAT,T,T}P WA 983774
CONTRACTOR . . :Nkr//-��"_�; jJ,� ,"r cJ PRO-Ph-ell? Dw � PHONE :
MAT T,T NC ADJIJR : UL.141 D,
S
CONTR . LTC 3#: 'PTRATTON DATE :
ARCH T TF.CT/ . . - PHONE :
D1ESTONER •
MAILING AD1DR :
1
PARCEL NO. . . 7 97 i 100-339 HF.ALTH: r le
LEGAL DESC; . . • STR 31 -25-02 WWivi TAX # y f it i m :
/12,---
LOT 38 • BLOCK 3 • MARSHALL ADTJTT T ON SHORELINES :
BY: DATE :
iJ .SCRTPTTON OF TMPROVEMENT : mobile home installation
RUTLDJ T NO TYPE -MOB BEDROOMS--- BATHROOMS-- MATN FT. . . . . 0 sf
TYPE OF TMPROVEMENT:NEW F.XTST. . 0 EXTST . - 0 2NDJ FT. • 0 sf
GARAGE/CARPORT- • PROP. . • 2 PROP. . - 2 3RD FTC 0 sf
WOOTJSTOVF. • TOTAL. : 2 TOTAL. : 2 BASEMENT 0 sf
TTRC OCCUPANCY OROTTP:R3 SEWAGE DTSP. . :SF.P T T C CARPORT. . . ! 0 sf
TYPE. OF CONST WATER SUPPT,Y. :PUT) GARAGE 0 sf
TTNTTS . : 0 STORTFS : 0 HEAT TYPES . : DECKS 0 sf
DTMF.NS T ONS : MOB T T,E HOME COMMERCIAL: 0 sf
FRAME TYPE: MAKE. :FLEE T WOODJ YR : zs3 T NDTiSTRTAT, : 0 sf
EST COST. $ : 19903 STZE: 14 X 70 BANK H"T. . . : 0 ft
PROJ ORP. . . 1837 SH SETBACK: 0 ft
Owner/aaen t APPR '�� ' - FEES
__
Signature: t pe amount by date rPrnt
P MT $ 75 . 00 AK 08/01 /9 i 57425
:::en
4 . h0 AK O8/O1i91 57425
By: �`
____ Jefferson De artrrde�t
Date ! at Building P
79 . 50 TOTAL
AWDING :ERMIT APPLICATION .
Jefferson County Building Department'P .O . Box 1220•Port Townsend, WA 98368
M •
t,ocAT 1 ory t
SPECIFIC LOCATION - .SITE ADDRESS 71 i"Y �r1p C/, 1 f1 p
POSTAL DISTRICT /SUBDIVISION s'ng4,9 ` _ . Cttk
LEGAL DESCRIPTION LOT 39 BLOCK DIVISION TAX NUMBER
•
)PARCEL NUMBER 7. /. r, 1339 1 / 4 SECTION 54
Y SECTION 'b' TOWNSHIP �CiA NORTH RANGE r GL2 WM
BUILDING INFORMATION
BUILDING TYPE TYPE 'OF IMPROVEMENT SQUARE FOOTAGE,/
❑ NGLE FAMILY 0 NEW BUILDING MAIN FLOOR
MOBILE HOME ❑ ADD1 ' ION 2ND FLOOR '�
❑` MODULAR HOME 0 ALTERATION BASEMENT 3
❑ DETACHED/ATTACHED 0 REPAIR\ CARPORT ---2// 1
( GARAGE [j REPLACEMENT GARAGE
j WOODSTOVE ❑ WRECKING/DEMOLITION COMMERdIAL _
❑ MULTI -FAMILY 0 RELOCATION/MOVING INDUSTRIAL
NUMBER OF UNITS DECKS
MOBILE HOMES
❑ COMMERCIAL S I XE j, 1)( •7U/ (,�/U], 'R $-/10
I ❑ INDUSTRIAL
YEAR `JC/ I @ $ 2-0
❑ HOTEL/MOTEL/DORMITORY
NUMBER OF UNITS MAKE 7.P_ i,,,e),c. 0 a7 $ _-1 p _
❑ OTHER - SPECIFY ESTI/MATED COST OF $ 1U
IMPROVEMENTS TOTAL FAIR MARKET VALUE
UBC OCCUPANCY GROUP $ - $
SELECTED CHARACTERISTICS OF BUILDING
PRINCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL
O WOOD FRAME CI ELECTRICITY 0 COLLECTIVE SOLAR
,MANUFACTURED 0 WOODSTOVE 0 PASSIVE SOLAR
❑ STRUCTURAL STEEL 0 GAS ❑ COAL
❑ REINFORCED CONCRETE ❑ OIL 0 OTHER - SPECIFY
❑_ MASONRY ( WALL
tt� 4BE RING ) DIMENSIONS
a. OTHER - S,i�?"l7I LL- c,'`'_. NUMBER OF STORIES s TOTAL LAND AREA c2/
DEPARTMENTAL REVIEW
HEALTH DEPARTMENT TYPE OF SEWAGE DISPOSAL / NUMBER OF PROPOSED BEDROOMS
❑ PUBLIC OR PRIVATE NUMBER OF EXISTING BEDROOMS
INDIVIDUAL ( SEPTIC ) NUMBER OF PROPOSED BATHROOM-3
APPROVED DATE ❑ INDIVIDUAL WELL NUMBER OF EXISTING BATHROOM
PUD TYPE OF WATER SUPPLY
tr PURL 1 C ( NAME OF WATER SUPPLY) ( Q,„,,, r.1/2 k 2
APPROVED DATE 0 PRIVATE (NAME OF WATER SUPPLY-
PLANNING DEPT . WITHIN SHORELINE JURISDICTION
❑ YES NAME OF ADJACENT WATER BODY
O NO
APPROVED DATE BANK HEIGHT PL/tt. SETBACK Ala_
PUBLIC WORKS DEPT ROAD RIGHT-OF -WAY WIDTH
NAME OF PUBLIC ROAD /Y 101gJ1-C .A.e
NAME OF PRIVATE ROAD i4A,
APPROVED DATE ROAD ACCESS PERMIT REQUIRED ❑ YES D' NO 1
IDENTIFICATION '
NAME MAILING ADDRESS ZIP TEL NO
• WNER �.
t
42
►ILW - 1 .
CONT
ARCH
rHE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS;
I
l S),BNAT E APPLICANT APPLICATION DATE RECEIPT� /� NUMBER CHECK NUMBER
UUMBBE RR" OR CASH
�' / ` , 7 ?C"ICl / r .1% ' ;-J�12
API#ROVED BY PERMIT FEES
, . 7 BASE FEE INSPECTION
BLDG SURCHARGE PLAN CHECK
ENERGY SURCHARGE -27r6)
TOTAL
911 NUMBER REFUND DATE DATE ISSUED
BUILDING orFICIAL
d, a
OFFICE OF TILE ASSESSOR, JEFFERSON COUNTY
MOBILE HOME QUESTIONNAIRE
RP Account f c '00
PP Account 9E
DATE
**
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Please read the entire form and provide i...,,, �e as much information as possible. This will
el us identify the unit correctly and avoid double assessments. It will also aid
h p
in placing a correct value on your property.
*******************************
REASON FOR INQUIRY:
Building Moving
Field visit Excise tax permit permiC
by deputy affidavit
Delinquent State transfer
Dealer report Application report
by sale
for title taxes
*******************************
• MOBILE HOME OWNERSHIP/OCCUPANT DATA
Name(s)
Street cr Box Q —� Py..1,—
State/Zip _LILY_ 7
City
,
Home phone ( Work phone '
n' `7 ` ----
A
Best time to call / 0
(specify home or work)
NOTE: If you rent the mobile home give name, address, and telephone number of
owner here
*****************
MOBILE HOME DATA:
1 Width Model Year ��
Length (exclude hitch) ---
,% Model
Make - =-�-�`
Serial number
*****************
MOBILE HOME LOCATION - IN PARK
Park name
Date placed in park
Space 1� .
(PLEASE COMPLETE REVERSE SIDE)
•
•
MOBILE HOME LOCATION - NOT IN A PARK
Do you own (or are buying) land on which mobile home is located _fir do you
rent the land? (CIRCLE) OWN BUYING RENT:i .
Assessor's Real Property account (parcel) number (The 9 digit number on the tax
statement or valuation notice) .
'.�;! /;;1 i,,,,/ 2/' • • cj 71 lC 3 � .
What is the street address of this land? -
A
`
• Street / / l/1 Lae ��!
.
city �ti Vl a10 v1 1 (1 A 7;74- C12 3(RO
If 'you rent the land what is the name and mailing address of the land owner?
Name �'
1 ± Liicryl , •h L2 ' ,11, `) . /--� r
Street or Box /944 , gi 7.4at
City l4 State/Zip tr :/l g1Lg',
Telephone number J A ALI La (p Z q ,
***********
MOBILE HOME HISTORY •
Date you purchased i / - 3- ,
Purchase price ici 9o3C.Y)
How did this mobile home get to its present location:
w;li ...Moved into Jefferson County from Imo- '.
(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. :Yes or N0 .
Name of previous owner
•
Address
• City State/Zip L
i C
i-Th
If moved,was advance tax paid? YES or � If yes, to which County IJAN' Q (rnutJ ,1
i
Does the mobile home replace a previous mobile home at this new location?dP or NO
If this is a replacement, to whom a d where did the previous mobile home go?
•
Thank you for your assistance. If you need help or information about the assessment
of your mobile home call the Assessor's Office at 385-9105. Questions about taxes
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.)
Please send completed form to: JEFFERSON COUNTY ASSESSOR OFFICE
PO Box 1220
PORT TOWNSEND, WA 98368
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