HomeMy WebLinkAboutBLD2000-00139 •
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 #: BLD00-00139 Received Date: 2/29/2000
SITE ADDRESS: 412 ARCADIA RD W Issue Date: 3/10/2000
PORT TOWNSEND, 98368 Expiration Date 3/10/2001
APPLICANT: DAVID DIPRETE
DIANE DIPRETE
915 M STREET
SUBDIVISION: ROBINSON SHORT PLAT Block: Lot: 2
PARCEL#: 001171027 Section: 17 Township: 30 N Range: 01 W
CONTRACTOR/
DEALER
INSTALLER: JAIME KOZELISKI WAINS0626 Expires: 7/20/200
1112 JACOB MILLER RD PORT TOWNSED WA 98368
PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION
MAKE: RIDGW
YEAR: 76
SIZE: 14X66
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 3/10/2001.
REQUIRED INSPECTIONS:
[ ] Footing/Setback (If continous footings are used):
[ ] Blocking/Setbacks/Plumbing:
[ ]' Final/Skirting/Vents/Porches/Steps: 0 06
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
•
MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #:
BLD00-00139 Received Date: 2/29/2000
SITE ADDRESS: ARCADIA RD W
PORT TOWNSEND, 98368
DIPRETE PHONE: (360)385-6521
APPLICANT: DIANDAVIE DIPRETE
915 M STREET
PORT TOWNSEND WA 98368
SUBDIVISION: ROBINSON SHORT PLAT
Block: Lot: 2
PARCEL NUMBER: 001171027 Section: 17 Township: 30 N Range: 01 W
CONTRACTOR/
DEALER:
INSTALLER: JAIME KOZELISKI WAINS0626 7/20/2000 (360)385-3215
1112 JACOB MILLER RD PORT TOWNSED WA 98368
PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION
TYPE OF WORK MOB
MANUFACTURED HOME: SHORELINE:
TYPE OF IMP NEW MAKE: RIDGW SETBACK:
VALUATION 20,000.00 YEAR: 76 BANK HEIGHT:
SIZE: 14X66
LABOR & INDUSTRIES APPROVAL?
SEWAGE DISPOSAL: CON
WATER SYSTEM: 2WELL
STORMWATER: YES NO AREA
BEDROOMS: BATHROOMS: Wetland Erosion
Exist: Exist: Seismic Streams
Prop: 2 Prop: 1 Flooding Landslide
Total: 2 Total: 1 F&W Plat Conditions
Shoreline Aquifer
Forest: Commercial Rural
Routing Date: Proximity
,
Type Amount Paid By: Date: Receipt: /rP p Pf `!llddd/ D
Permit $141.00 MAM 02/29/00 25292 J�►`" t.•�
Potable Water Application $30.00 MAM 02/29/00 25292 , ® i
Total: $171.00 1/4 1e
10/29/99
I:\F_BLD_App_Mob.rpt
JEFFERSON COUNTY COMMUNITY DEVELOPMEN`f 621 SHERIDAN ST, PORT TOWNSEND WA 98368,
MANUFACTURED HOME INSTALLATION PERMIT APPLICATION
❑ NEW BUILDING 0 REPLACEMENT
SIZE
YEAR 1/74
MAKE IQGt.c3
COST Y a 0(000
BEDROOMS: BATHROOMS:
EXISTING EXISTING r
PROPOSED PROPOSED >
TOTAL ,yZ. TOTAL
TYPE OF SEWAGE DISPOSAL: WATER SUPPLY:
❑ SEWER 0 COMMUNITY SYSTEM 0 PRIVATE WELL .K TWO PARY WELL
0 INDIVIDUAL SYSTEM 0 Conventional 0 PUBLIC • \
PERMIT # SEP 0 Alternative Name of water system: AD131.15,Y, ., CJeJZI' 175
IF WATERFRONT PROPERTY,
DISTANCE TO BANK OR HIGH WATER LINE ft BANK HEIGHT 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 :i0 4 DATE >1,�_ ; #`
NAME (PLEASE PRINT)
FOR OFFICE USE ONLY
BASE FEE RECEIPT#
ADDITIONAL SECTIONS :F CASH/CK #
SUBTOTAL „ ', DATE / /
POTABLE WATER
911/ROAD APPROACH
TOTAL
H:\HOME\PLNCNTR\FORMS\MOBILEAP,10/99
4
MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00139 Received Date: 2/29/2000
SITE ADDRESS: `yi"' ARCADIA RD W
-3oi0 PORT TOWNSEND, 98368
APPLICANT: DAVID DIPRETE PHONE: (360)385-6521
DIANE DIPRETE
915 M STREET
PORT TOWNSEND WA 98368
SUBDIVISION: ROBINSON SHORT PLAT Block: Lot: 2
PARCEL NUMBER: 001171027 Section: 17 Township: 30 N Range: 01 W
CONTRACTOR/
DEALER:
INSTALLER: JAIME KOZELISKI WAINS0626 7/20/2000 (360)385-3215
1112 JACOB MILLER RD PORT TOWNSED WA 98368
PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION
TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE:
TYPE OF IMP NEW MAKE: RIDGW SETBACK:
VALUATION 20,000.00 YEAR: 76
LABOR & INDUSTRIES APPROVAL?
SIZE: 14X66 BANK HEIGHT:
SEWAGE DISPOSAL: CON ,ram
-`
WATER SYSTEM: 2WELL =? N
BEDROOMS: BATHROOMS: STORMWATE : YES NO AREA
Wetland AA),
Erosion Oa
Exist: Exist: Seismic NU Streams LI
Prop: 2 Prop: 1 Flooding Nam! Landslide 10(0
Total: 2 Total: 1 F&W Ni Cr) Plat Conditiops Jf?<
Shoreline Iv 0 Aquifer 730
Routing Date: Forest: Commercial 1,,,.,_ Rural Oc}
Z Proximity
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $141.00 MAM 02/29/00 25292 �,�� �
Potable Water Application $30.00 MAM 02/29/00 25292 r � f
Total: $171.00 G
ReVle y
StaTMVateT W.,
S\.<1 `,
I:\F_BLD_App_Mob.rpt 10/29/99
STORM WATER CALCULATIONS
Owner/Applicant:
0 PROPOSED LAND DISTURBING ACTIVITY
Site Address: .3 qD -,Jy�1, „� t�� ( �.��" Drainfield area cleared sq.ft.
Driveway Length ft.
X Width ft.
9 Digit Parcel Identification No.: (90 ( t 71 0?_7 = Total Driveway sq.ft.
Permit Number: Clearing and Grading for Site Development
PLOT PLAN (Well/Structures/Utilities/etc.) sq.ft.
/2 J sq.ft.
INDICATE the following information. Total Land Disturbance sq.ft.
Draw entire parcel to scale. Indicate scale of plot plan:
One inch equals C' - ❑ IMPERVIOUS SURFACE
Proposed Structures (all roof area) qvz? sq.ft.
❑ 1. North arrow Existing Structures (all roof area) sq.ft.
• 2. All property boundaries and dimensions Sidewalks sq.ft.
• 3. Names of adjacent streets Concrete Patios sq.ft.
0,7 4. Driveway/s & parking spaces Proposed:
7-7 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 / c.) sq.ft.
existing or proposed, and distance to Total Impervious Surface ( 9,;2 j 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:
2. 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,
0 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:
0 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.
0 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:\HOME\PLN CN TR\FORMS\PLOTPLN.FRM9/97
J
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
CRITICAL AREAS QUESTIONNAIRE
Applicant Name \ _ emit& -c- .,}tom r ��) 5 t--,�_IV:._.
Building Application _ Land Use Application _ Shoreline Application
On-site Sewage Application _ Subdivision Application Other:
1 . Is there any standing or running water on the surface of the _ Yes �` No
property or on any nearby property at any time during the year? 1�
If YES, please describe:
2. Has any portion of the property or any nearby property ever been _ Yes /X,, No
identified as a wetland or swamp?
If YES, please describe:
3. Are any willows, skunk cabbage, alders,or cottonwoods present 7, Yes _ No
on your property or adjacent properties? //
If YES, please describe: 5‘,�,,e ,,i {'9, F,e', Gedar, mac ("cai ia-
4. Are there any indications on any portion of the property or on any _ YES No
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)
s Q a a
r / / / / / /,
/ / / / / /
/ / / / . / / ,c
r / / / / / / i'
iiii / / / / .'�
/ / / / i i i / .
iiii ii i' 'i /
r / / i / / / ii ,' . ."
/ / / / / / / / - -
I / / / / i ice',.' -...
-TO / / / / / / / /
r // iiiii �- ,fl
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(Questionnaire Continues on Back)
Page 1 of 2
,
6. Does the site have 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 �i % � , Date -,7" �
FOR OFFICE USE ONLY
E Wetlands ❑ Seismic
CRITICAL AREAS ON OR ❑ Aquifer Recharge Area (zone ) ❑ Fish & Wildlife Area 1
IMMEDIATELY ADJACENT TO SITE: E Frequently Flooded Area ❑ Fish & Wildlife Area 2
E 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
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