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Home My WebLink AboutBLD2000-00107 t 4 •1 MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00107 Received Date: 2/14/2000 SITE ADDRESS: 277 Hog2TQJJ PORT HADLOCK, 98339 APPLICANT: JAMES OSMER PHONE: (360)437-2675 321 WERNER RD PORT LUDLOW WA 98365 SUBDIVISION: IRONDALE ADD Block: 52 Lot: PARCEL NUMBER: 961805212 Section: 34 Township: 30 N Range: 01 W CONTRACTOR/ OWNER PHONE: DEALER: PROJECT DESCRIPTION MANUFACTURED HOME REPLACEMENT TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: BILTMORE SETBACK: VALUATION 1.00 YEAR: 1968 LABOR & INDUSTRIES APPROVAL? SIZE: 12X60 BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PUBLIC BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Wetland Erosion Exist: Exist: Seismic Streams Prop: 1 Prop: 3 Flooding Landslide Total: 1 Total: 3 F&W Plat Conditions Shoreline Aquifer Routing Date: Forest: Commercial Rural Proximity Type Amount Paid By: Date: Receipt: n �� .J tV E D Permit $141.00 MAM 02/14/00 24194 �f"E �/ Total: $141.00 MAR 3 2000 Jefferson County Planning & Building Department I:\F_BLD_App_Mob.rpt 10/29/99 r 4110 . i JEFFERSON i:OUNTY COMMUNITY DEVELOPMENT 621 SHERIDAN ST, PORT TOWNSEA 98368 MANUFACTURED HOME INSTALLATION PERMIT APPLICATION ❑ NEW BUILDING REPLACEMENT ' i) O4:1-1 SIZE 1 YEAR ( 6 c - y MAKE 9, 1 f ,-,,, o r COST jw BEDROOMS: BATHROOMS: EXISTING R EXISTING I PROPOSED V PROPOSED I TOTAL ZY TOTAL L. TYPE OF SEWAGE DISPOSAL: WATER SUPPLY: A SEWER 0 COMMUNITY SYSTEM 0 PRIVATE WELL 0 TWO PARY WELL 0 INDIVIDUAL SYSTEM 4P Conventional W PUBLIC PERMIT # SEP 0 Alternative Name of water system: C \ i**/ IF WATERFRONT PROPERTY, j d /� DISTANCE TO BANK OR HIGH WATER LINE / (- 64 ft BANK HEIGHT 17\a ( ft By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner 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 it's employees, representatives or agents for the purpose of application review and any required later inspections. Access and right of entry to the applicant's property or structure shall be requested and shall occur during regular business hours. "' SIGNATURE. �`YyyS�� DATE h/ �lC. .ti) NAME (PLE E PRINT) CA W'. e,s C4 Y' s •'w r— FF F OFFICE USE ONLY BASE FEE a ,G I ' ° RECEIPT# T ADDITIONAL SECTIONS CASH/CK# (. SUBTOTAL r 9-if I. 0 DATE POTABLE WATER ---- 911/ROAD APPROACH n4V I - TOTAL # ' . . H:\HOME\PLNCNTR\FORMS\MOBI LEAP,10/99 • • MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00107 Received Date: 2/14/2000 SITE ADDRESS: 277 i-4ogrOJ PORT HADLOCK, 98339 APPLICANT: JAMES OSMER PHONE: (360)437-2675 321 WERNER RD PORT LUDLOW WA 98365 SUBDIVISION: IRONDALE ADD Block: 52 Lot: I`S,Iq, 31 3ti PARCEL.NUMBER: 961805212 Section: 34 Township: 30 N Range: 01 W CONTRACTOR/ OWNER PHONE: DEALER: Cx t Area l w,„ - . ,5/00 7 11--- ..�_ *W OO zits- o Al I PROJECT DESCRIPTION MANUFACTURED HOME REPLACEMENT TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: BILTMORE SETBACK: VALUATION 1.00 YEAR: 1968 LABOR & INDUSTRIES APPROVAL? SIZE: 12X60 BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PUBLIC BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Wetland Erosion /o Exist: Exist: Seismic Streams o Prop: 1 Prop: 3 Flooding Landslide Total: 1 Total: 3 F&W Plat Conditions Shoreline (v Aquifer 6 Routing Date: Forest: Commercial CO v Rural 1 0 Proximity Type Amount Paid By: Date: Receipt: Approved/Date Permit $141.00 MAM 02/14/00 24194 Total: $141.00 I:\F_BLD_App_Mob.rpt 10/29/99 • STORMWATER CALCULATIONS Owner/Applicant: TC VY1'�-�'S C.1 Yk ❑ PROPOSED LAND DISTURBING ACTIVITY Site Address: Drainfield area cleared sq.ft. Driveway Length ft. q Q( `� �� X Width ft. 9 Digit Parcel Identification No.: ! b r' ""•' = Total Driveway sq.ft. Permit Number: Clearing and Grading for Site Development PLOT PLAN (Well/Structures/Utilities/etc.) sq.ft. sq.ft. INDICATE the following information. Total Land Disturbance sq.ft. Draw entire parcel to scale. Indicate scale of plot plan: One inch equals ❑ IMPERVIOUS SURFACE Proposed Structures (all roof area) 6 7 R sq.ft. IN ft ❑ 1. North arrow Existing Structures (all roof area) "t'' sq.ft. ❑ 2. All property boundaries and dimensions Sidewalks sq.ft. ❑ 3. Names of adjacent streets Concrete Patios sq.ft. ❑ 4. Driveway/s & parking spaces Proposed: ❑ 5. Major features such as ravines, Driveway Length ft. seasonal creeks, bodies of water, etc. X Width ft. ❑ 6. Septic tank, drainfield and reserve area location, = Total Driveway sq.ft. existing or proposed, and distance to Total Impervious Surface 4 sq.ft. closest structure • 7. Sewer lines The Stormwater Manual sets forth the following Small Parcel Minimum Requirements: 8. Wells and/or water lines • Construction Access Route Stabilization: 9. Neighboring wells within 150 feet Construction vehicle access shall be, whenever feasible, limited to one route. Access points shall be stabilized with ❑ 10. Paved surfaces (patios) quarry spalls or crushed rock to minimize the tracking of ❑ 11. Structures, existing and/or proposed sediment onto public roads. If sediment is inadvertently transported onto public roads, roads shall be cleaned ❑ 12. Setbacks (distances to property thoroughly at the end of the day by shoveling or sweeping. Street washing should only be done after the bulk of the boundaries, structures, banks, sediment has been removed by sweeping. and shorelines) • Stabilization of Exposed Soil: All exposed and unworried soil shall be stabilized by sodding, • 13. Easements for access or utilities seeding, mulching, plastic covering, application of gravel base ❑ 14. Arrows showing direction of slope on roads and driveways, or other appropriate means within seven days during the period from May 1 to September 30 assume an elevation of 100 feet at one and within two days during the period from October 1 to April lot corner and indicate the other lot 30. Mulch shall be applied to a minimum depth of two inches. • Protection of Adjacent Properties: corner elevations in relation to it Adjacent properties shall be protected from sediment deposition by appropriate use of vegetative buffer strips, sediment barriers or filters, dikes, mulching, or by a FOR APPLICATIONS ADJOINING SHORELINES, combination of these measures and other appropriate Best Management Practices (BMPs). INDICATE: • Maintenance: ❑ 15. Ordinary high water mark All erosion and sediment control BMPs shall be regularly inspected and maintained to ensure continued performance of ❑ 16. Top of bank, if over 10 feet high their intended function. ❑ 17. Slope of bank in degrees • Other Appropriate BMPs as required by Jefferson County to mitigate the effects of increased runoff shall be applied. H:\H O ME1 PLN CN TR\FORMS\PL OTPLN.FR M 9/97 f Y 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 (800) 831-2678 PERMIT #: BLD00-00107 Received Date: 2/14/2000 SITE ADDRESS: 277 7TH AVE Issue Date: PORT HADLOCK, 98339 3/3/2000 Expiration Date 3/3/2001 APPLICANT: JAMES OSMER 321 WERNER RD PORT LUDLOW WA 98365 SUBDIVISION: IRONDALE ADD Block: 52 Lot: 31-34 PARCEL#: 961805212 Section: 34 Township: 30 N Range: 01 W CONTRACTOR/ OWNER PHONE: DEALER PROJECT DESCRIPTION MANUFACTURED HOME REPLACEMENT MAKE: BILTMORE YEAR: 1968 SIZE: 12X60 THIS PERMIT IS VALID FOR ONE YEAR AND IS NOT RENEWABLE. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 3/3/2001. REQUIRED INSPECTIONS: [ ] Footing/Setback (If continous footings are used): [ ] Blocking/Setbacks/Plumbing: (3 7tc ._- arg-O7 [ ) Final/Skirting/Vents/porches/Steps: HEALTH DEPARTMENT APPROVAL REQUIRED PRIOR TO FINAL INSPECTION BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. Inspector's Phone Hours 8:00 a.m. - 9:00 a.m. SPECIAL CONDITIONS MAY APPLY - SEE REVERSE HOT-LINE AVAILABLE 24 HOURS A DAY Illefferson County Department of Community Development• lk 621 Sheridan Street, Port Townsend, WA 98368 CRITICAL AREAS QUESTIONNAIRE Applicant Name ` c-1 n� S -- °1 r-� CS in Building Application Land Use Application Shoreline Application On-site Sewage Application Subdivision Application Other: O 1 . Is there any standing or running water on the surface of the Yes 7 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 1.,4(lo identified as a wetland or swamp? If YES, please describe: 3. Are any willows, skunk cabbage, alders, or cottonwoods present Yes NO on your property or adjacent properties? If YES, please describe: 4. Are there any indications on any portion of the property or on any YES 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) ❑ ❑ 4 Q ❑ ❑ ❑ i i i / / /�,' .' �,.�❑ �f� C✓ `== ------__________� fi s II_3 `( r t 41 (Questionnaire Continues on Back) Page 1 of 2 6. Does the sitetve 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: By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner 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 it's employees, representatives or agents for the purpose of application review and any required later inspections. Access and right of entry to the applicant's property or structure shall be requested and shall occur during regular business hours. Signature ak-yrisk, Date adirk I /"K°6g 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 :Seismic ❑ Commercial Forest Section Township North Range Parcel Number: Parcel Size: Comprehensive Plan Land Use Designation: Reviewed by: Community Plan: Date: Page 2 of 2 h:\home\pincntr\forms\car.doc 1/00 ,.......___., , K , s+ ' /N u 6k-k \ _________ _ 56 R T e'ckt e I /', '/ ,ic , ---7 P'../ t 411F- i k n iq , ....... oai) k( u I ' . / I i m I , i E 1 1 p I -'s 1 ) (\ ) 1 * 1°Til . O 1 0 11 i 1 , ill v' , i ! 1 a 1,3 1 • ,-' \\\\ pli i k i*Jrc, "..) ell 13" 14 t'im5 \ \ c 5 Pi- t ri P ctit f‘ k we le 9k ., \ 4 t -3 • 56 FT 1:Aes -rtAk n ' - to- 9 74,„. 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