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Home My WebLink AboutBLD1989-00118r (3UOING '''ERMIT APPLICATION Jefferson County Building Department*P .O . Box 1220*Port Townsend . WA 98368 " I • LOCATION 1 , Ic-c),A_ SPECIFIC LOCATIONISITE ADDRESS \y// `L POSTAL �1JDISTRICT,((� /SUBDIVISION LEGAL DESCRIPTION LOTJL'-``-1 BL K D I V I S IIO N T A X NUMBER R PLANNING AREA q NUMB �0 TOWNSH1P - C�/ PSAON 7j y1 / A SECTION NORTH RANGE 1/.4 l WM BUILDING INFORMATION BUILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE EINGLE FAMILY 0 NEW BUILDING MAIN FLOOR MOBILE HOME ❑ ADDITION 2ND FLOOR ❑ MODULAR HOME ❑ ALTERATION BASEMENT ❑ DETACHED/ATTACHED ❑ REPAIR CARPORT GARAGE ❑ REPLACEMENT GARAGE ❑ WOODSTOVE ❑ WRECKING/DEMOLITION COMMERCIAL ❑ MULTI - FAMILY ❑ RELOCATION/MOVING INDUSTRIAL NUMBER OF UNITS MOBILE HOMES❑ COMMERCIAL SIZE ��9 /� '' 3 5 ❑ INDUSTRIAL ❑ HOTEL/MOTEL/DORMITORY YEAR ( A .$ 16 NUMBER OF UNITS MAKE /4 @ $g ❑ OTHER - SPECIFY ! ESTIMATED COST OF 0 @ $8 IMPROVEMENTS T TAL FAIR MARKET VALUE UBC OCCUPANCY GROUP $ SELECTED CHARACTERISTICS OF BUILDING PRINCIPLE TYPE OF FRAME PRIN PLE TYPE OF HEATING FUEL ❑ W FRAME ELECTRICITY ❑ COLLECTIVE SOLAR MANUFACTURED ❑ WOODSTOVE ❑ PASSIVE SOLAR ❑ STRUCTURAL STEEL 0 GAS ❑ COAL ❑ REINFORCED CONCRETE ❑ OIL 0 OTHER - SPECIFY ❑ MASONRY ( WALL BEARING )I DIMENSIONS J ❑ OTHER - , NUMBER OF STORIES TOTAL LAND AREA DEPARTMENTAL REVIEW HEAL H D PARTMENT TYPE OF SEWAGE DISPOSAL NUMBER OF PROPOSED BEDROOM `/ ❑ P 1 C OR PR I VATS NUMBER OF EXISTING BEDROOMS IJJ (12P RO q i I ND I V I DUAL ( SEPTIC ) NUMBER OF PROPOSED BATHROOM / ❑ I ND I V 1 DUAL WELL NUMBER OF EXISTING BATHROOM PUD TYPE OF WATER SUPPLY ❑ PUBLIC ( NAME OF WATER SUPPLY) APPROVED DATE ❑ PRIVATE ( NAME OF WATER SUPPLY PLANNING DEPT . WITHIN SHORELINE JURISDICTION ❑ YES NAME OF ADJACENT WATER BODY APPROVED DATE BANK HEIGHT SETBACK PUBLIC WORKS DEPT ROAD RIGHT-OF -WAY WIDTH NAME OF PUBLIC ROAD NAME OF PRIVATE ROAD APPROVED DATE ROAD ACCESS PERMIT REQUIRED ❑ YES ❑ NO IDENTIFICATION a.q,. NAME / t MAILING ADDRESS ZIP TEL NO OWNER r-- Ai r' `L ma.') 3/�- C O N T E�L%� rY' l +1 .- 1 I.i•CEN E GD ,_ — ARCH 4 THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS, i SIGNATURE OF APPL I CANT APPL CA 0 /. NEC I PT N MEBFCR' CFj! KelMBilt,28R C H w. to • -�J 1 / APP-•VED ,. P 'hi I T FiF,5S APRIED 1/�✓ I BASE FEE INSPECTION VI IIII J 9 9'' -. BLDG SURCHARGE PLAN CHECK k. JEFFER ON COI TY i ENERGY SURCHARGE (9"C:5TOTAL PLANNING&BLDG DEPT 10-r-2-- 811 NUMBER REFUND DATE ATE ISSU BUILDING OFFICIAL 94: SF i • OFFICE OF THE ASSESSOR, JEFFERSON COUNTY MOBILE HOME QUESTIONNAIRE RP Account # PP Account # DATE *************.******************************************************************** • 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 Building Moving by deputy affidavit, permit permit Dealer report Application e nquent State transfer by sale for title taxes report ******************************* MOBILE HOME OWNERSHIP/OCCUPANT DATA ('''‘c, Oin 4 1�1 o cep_ YVi t 4) Name(s) ,.� Street or Box 0 ( k) . Troy City L.--0 rn Yam/ GUI C) State/Zip cy Home phone ✓'� - Li c S `Cork phone --- Best time to call (specify home or work) NOTE: If you rent the mo ile home give name, address, and telephone number of owner here �. ***************** MOBILE HOME DATA: Length (exclude hitch) (6514Width Model Year 89 Make , ,9t _oincycQModel ,( Irkk SerialPumber 9 ?' ***************** MOBILE HOME LO�(CAT,I N - IN PARK Park name l� Space # Date placed in park (PLEASE COMPLETE REVERSE SIDE) MOBILE HOME LOCATION - NOT IN A PARK Do you own (or are buying) land on which mobile home is located or do you rent the land? (CIRCLE) OWN BUYING RENT Assessor's Real Property account (parcel) number (The 9 digit number on the tax statement or valuation notice) . 9(10( 807 o"7 What is the street address of this land? ' (--Coecik Street �. City —(C If you rent the la d what is the name and mailing address of the land owner? Name A) 4.--- Street or Box City State/Zip Telephone number *********** MOBILE HOME HISTORY Date you purchased rn()\--) Purchase price U ///Vi, 1.3k 1)40 How did this mobile home get to its present location: Moved into Jefferson County from Lta AO' (County or tate) Delivered by dealer (name) Moved from another Jefferson County location. •sr NO. If yes, please give previous address/location. I alCikilLQ. '°)11\ Didn't move - purchased in place. .Yes oD( - Name of previous owner A..)/4) Address City State/Zip If moved, was advance tax paid? YES or NO. If yes, to which County Does the mobile home replace a previous mobile home at this new location? YES r NO If this is a replacement, to whom a d where did the previous mobile home go? , /t) zir— . 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 JEFFERSON COUNTY MOBILE HOME PERMIT Jefferson County Permit Center Castle Hill Mall 621 Sheridan St. Port Townsend, WA 98368 206-379-4450 PERMIT # 'BLD89-0118 DATE ISSUED. : 06/19/89 SITE ADDRESS: 280 W KINKAID :PORT HADLOCK, WA 98339 APPLICANT. . . :MONIKA SATHER PHONE: 385-4492 MAILING ADDR:280 W KINKAID :PORT HADLOCK WA 98339 PROPERTY OWNER: PHONE: MAILING ADDR. . : CONTRACTOR. . : PHONE: MAILING ADDR: • CONTR. LIC #: EXPIRATION DATE: / / PARCEL NO. . . : 961807307 LEGAL DESC. . : STR 34-30-01 WWM, TAX # LOT , BLOCK DESCRIPTION OF IMPROVEMENT: reactivate case for title elimination 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 03/08/95 ( ) toting/Setback (If continuous footings are used) : & -9--? [ / ( ) locking/Setbacks/Plumbing: — y ( ) Sewage Disposal System Final: ( ) Final/Skirting/Vents/Porches/Steps: q— qy 21%c „( CALL 379-4455 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9 a.m. to 4 : 30 p.m. Inspector's Hours 8 - 10 a.m. 24 Hour Recorder for Inspections • s JEFFERSON COUNTY INSTALLATION APPLICATION Jefferson County Permit Center Castle Hill Mall 621 Sheridan St. Port Townsend, WA 98368 206-379-4450 PERMIT # •BLD89-0118 DATE RECEIVED. : 06/19/89 SITE ADDRESS: 280 W KINKAID :PORT HADLOCK, WA 98339 APPLICANT. . . :MONIKA SATHER PHONE: 385-4492 MAILING ADDR: 280 W KINKAID :PORT HADLOCK WA 98339 PROPERTY OWNER: PHONE: MAILING ADDR. . : CONTRACTOR. . : PHONE: MAILING ADDR: CONTR. LIC #: EXPIRATION DATE: / / PARCEL NO. . . : 961807307 SEPTIC: DATE: LEGAL DESC. . :STR 34-30-01 WWM, TAX # WATER : DATE: LOT , BLOCK , SHORELINES: BY: DATE: DESCRIPTION OF IMPROVEMENT: reactivate case for title elimination BUILDING TYPE 'MOB BEDROOMS--- BATHROOMS-- MAIN FL. . . : 0 sf TYPE OF IMPROVEMENT:NEW EXIST. : 0 EXIST. : 0 ADD'L FL. . : 0 sf GARAGE/CARPORT PROP. . : 4 PROP. . : 1 HTED BSMT. : 0 sf WOODSTOVE TOTAL. : 4 TOTAL. : 1 UNHT BSMT. : 0 sf UBC OCCUPANCY GROUP: SEWAGE DISP. . :CON CARPORT. . . : 0 sf TYPE OF CONST • WATER SUPPLY. :CITY GARAGE 0 sf UNITS. : 1 STORIES: 1 HEAT TYPES. : DECKS 0 sf DIMENSIONS: MOBILE HOME COMMERCIAL: 0 sf FRAME TYPE: MAKE:FLEETWOOD YR: 89 INDUSTRIAL: 0 sf EST COST. $: 0 SIZE: 28X66 BANK HT. . . : 0 ft PROJ GRP. . : 5372 SH SETBACK: 0 ft Owner/agent FEES Signature: type amount by date recpt INSP $ 30. 00 DE 03/08/94 89586 Date: Issued By: Date: $ 30. 00 TOTAL ** JEFFERSON COUNTY INSTALLATION PERMIT APPLICATION APPLICANT NAME vv I (A S i 3 1 7i V . , P ( �� MAILING ADDRESS 9,,{) a) K .1 n KA i tr il-cci (_ 0 c c U3 ZIP C„_. P3 J 9 PROPERTY OWNER NAME J 71.Z..)/1 1eAf) c --- TN F k PHONE .-36 J L 7 472, MAILING ADDRESS 5'- in-771. ZIP CONTRACTOR A MAILING ADDRESS ' PHONE i STATE LICENSE NUMBER EXPIRATION DATE FEDERAL I.D. NUMBER SITE AD911f/RDDRRESNS`: _ & W kf i / ) ! ri Wlt ZIP CODE 9 .J LEGAL DESCRIPTION: / SUBDIVISION NAME /_LOT �Q p�BLOCK DIVISION TAX NUMBER 9 DIGIT PARCEL NUMBER 9 6 / ( \l C /), 36 7 SECTIONS 9' TOWNSHIP ;_ F NORTH RANGEy 1 w ,W/M DESCRIPTION OF IMPROVEMENT: F L_ ,/✓1/� " /a/L/ SIGNATURE ))14 _ DATE /5 4,1 77- FOR OFFICE USE ONLY Planning Area Fire District School District BUILDING TYPE IMPROVEMENT TYPE UBC OCCUPANCY ❑ NON ❑ WOO ❑ NEW GROUP FRAME TYPE 0 WOOD ❑ MANUFACTURED ❑ STEEL 0 MASONRY OTHER BASE FEE PLAN CHECK RECEIPT # STATE SURCHARGE TOTAL CASH/CHECK # -)dO h:\HOME\PLNCNTR\FORMS\INSTALL.FRM • g• ti9 Z I w a fir MAY25'89 HEALTH DEPT. G