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Home My WebLink AboutBLD2000-00432 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 #: BLD00-00432 Received Date: 6/28/2000 SITE ADDRESS: 44 S GARY AVE Issue Date: 8/1/2000 PORT TOWNSEND, 98368 Expiration Date 8/1/2001 APPLICANT: DARYL F HEDMAN 6062 SR20 #23 SUBDIVISION: IRONDALE Block: 127 Lot: 31-33 PARCEL#: 962112708 Section: 34 Township: 30 N Range: 01 W CONTRACTOR/ PRESTIGE PROPERTIES PHONE: (360)385-9033 DEALER 11524 RHODY DRIVE PORT HADLOCK WA 98339 Contractor's License PRESTP1066CM Expires 11/13/2000 PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION MAKE: GOLDENWEST YEAR: 1997 SIZE: 27X44 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 8/1/2001. REQUIRED INSPECTIONS: n ['] Footing/Setback (If continous footings are used): OK cl%A'+I in0/e/2-e ✓e ^/q—eo Blocking/Setbacks/Plumbing: nK, ),e___-- / i-&--O6 nal/Skirtin /V re .ts/PnrrhP. Steps: f]/f / 21f �e , ri ;,..�4_6, _. ) 7 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 r . f f • .. MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00432 Received Date: 6/28/2000 SITE ADDRESS: ii 4 5 GARY AVE PORT TOWNSEND, 98368 APPLICANT: DARYL F HEDMAN PHONE: 6062 SR20 #23 PORT TOWNSEND WA 98368 SUBDIVISION: IRONDALE Block: 127 Lot: 31-33 PARCEL NUMBER: 962112708 Section: 34 Township: 30 N Range: 01 W CONTRACTOR/ PRESTIGE PROPERTIES PHONE: (360)385-9033 DEALER: 11524 RHODY DRIVE PORT HADLOCK WA 98339 Contractor's License PRESTP1066CM Expires 11/13/2000 PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: GOLDENWEST SETBACK: VALUATION 45,000.00 YEAR: 1997 LABOR & INDUSTRIES APPROVAL? SIZE: 27X44 BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PUD BEDROOMS: BATHROOMS: PARCEL TAGS: YES NO STORMWATER: YES NO Exist: Exist: AREA Plat Conditions Prop: 3 Prop: 2 Wetland Erosion Total: 3 Total: 2 Seismic Streams Flood Way Food Plane Routing Date: F&W Landslide Shoreline Aquifer Forest: Commercial Rural Type Approved/Date yp Amount Paid By: Date: Receipt: Manufactured Homes $141.00 MAM 06/28/00 32019P (F 1" 1 Potable Water Application $30.00 MAM 06/28/00 32019 L.J Total: $171.00 u 2000 4-<'-.---1-17 Jefferson County Planning ti Building °apartment is\F_BLD_App_Mob.rpt 10/29/99 T JEFFERSON COUNTY COMMUNITY DEVELOPMENT 621 SHERIDAN ST. PORT TOWNSEND WA 9$368 MANUFACTURED HOME`INSTALLATION PERMIT APPLICATION ` / NEW BUILDING ❑ REPLACEMENT SIZE 2 7/ YEAR , ? MAKE L...s i ` ‘(/' COST �1S r BEDROOMS: BATHROOMS: EXISTING 5 EXISTING P PROPOSED -15*---- PROPOSED 0 TOTAL .5 TOTAL Z...-- TYPE OF SEWAGE DISPOSAL: WATER SUPPLY: 0 SEWER 0 COMMUNITY SYSTEM 0 PRIVATE WELL 0 TWO PARY WELL INDIVIDUAL SYSTEMM2 0 Conventional PUBLIC PERMIT # SEPUO'f 3 0 Alternative Name of water system: fC? i) 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 __.Cs`" c.?— DATE NAME (PLEASE PRINT) FOR OFFICE USE ONLY BASE FEE /v/ G(--) RECEIPT# -"L I �t ADDITIONAL SECTIONS CASH/CK# ).?j :, SUBTOTAL / .f(- 0 DATE �c;_d'.b;.'G POTABLE WATER c _1/' 0 911/ROAD APPROACH 45 J TOTAL � �, �� .0 C> H:\HOME\PLN CNTR\FO RMS\MOBI LEAP.10/99 c.06 Jefferson County Permit Center * Department of Community Development (4-'1_501NT . ' 621 Sheridan Street, Port Townsend WA 88368[3601373-4450 ; ;, - ti 4,P � o -,r-'.--„,..'---:e urtvErst ,p (6\ill' D CO ill Lfe de p lu m c9 algal a4 coesoletelry as*write: Project Description: Installation of Manufactured Home 9 Digit Parcel Identification Number(from your tax statement): 962 112 708 Site Address 911#: Road Name: Gary Avenue Zip Code: 98368 Legal Description Subdivision Name: Irondale 5 Block: 127 Lot(s): 29-36 Section: Township: Range: Parcel Size (acres or square footage): 100 X 200 Property Owner: Ellen C. Bell Phone: 3 7 9-6 9 5 3 Mailing Address: Daryl Hedman Applicant/Occupant: Phone: (if different from owner) Ellen C . Bell 379-6953 Mailing Address: 6062 Hwy. 20, Sp . 23 , Port Townsend, WA 98368 Authorized Rep: Prestige Properties , Inc . ,Lowell Mat thew Phone: 360-385-9033 Mailing Address: 11524 Rhody Drive , Port Hadlock, WA 98339 General Contractor: Prestige Properties, Inc. ' 385-9033 Or Manufactured Home Installer: Jaime Kozelisky Phone: 385-3215 Mailing Address: 11524 Rhody Dr. , Port Hadlock, WA 98339 Contractor's State License Number: PRESTPI065CM I Expiration Date: 11-13-00 Septic Designer: Janet Welch Phone: 385-5910 Mailing Address: P.O. Box 1221, Port Hadlock, WA 98339 Architect:/Engineer: Phone: Mailing Address: Loan Lender/General Phone: Contractor's Bond Holder: Mailing Address: POR'O�r10E RISE ONLY: .. . Fire Distract .. Planiing;Area . : School District: Zone 4/98 H:\home\pincntr\foams\universal plot plan t H • n - - -- - - - - - - - - I I t • 1 •. 1 I 411111.- V ,41 T `^ 1 . N �. v �1 O Jai.'- _ _ _ 7,::..,.1.-- -- --...\ -,-, 7,,,,,d-.....;:f r:-.70-r...7- o > i :ORES 0 .... ...: :::: mies ir ( f 111�:9`D...;a,l ' a l y:'c' --. • I a � e U i iii v- 1 - 4 '.-----\ ..,.... IQ o • >ti� fi I I •.., , • 1 • Il' v) ,..„„ .. . , . cA , il, ‘ ' t i A I • • f` L - - - --I eCLe� 8ecc QRof¢�T -TY a qc z//z7o8 ;4. v Y Avg ?dAl-To,.-vsc.dk40r ' MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00432 Received Date: 6/28/2000 SITE ADDRESS: GARY AVE (3 PORT TOWNSEND, 98368 APPLICANT: DARYL F HEDMAN PHONE: 6062 SR20 #23 PORT TOWNSEND WA 98368 SUBDIVISION: IRONDALE Block: 127 Lot: 31-33 PARCEL NUMBER: 962112708 Section: 34 Township: 30 N Range: 01 W CONTRACTOR/ PRESTIGE PROPERTIES PHONE: (360)385-9033 DEALER: 11524 RHODY DRIVE PORT HADLOCK WA 98339 rri °c• "` Contractor's License PRESTP1066CM Expires 11/13/2000 -- ``j-- PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: GOLDENWEST SETBACK: VALUATION 45,000.00 YEAR: 1997 LABOR & INDUSTRIES APPROVAL? SIZE: 27X44 BANK HEIGHT: SEWAGE DISPOSAL: CON ( ' WATER SYSTEM: PUD J' BEDROOMS: BATHROOMS: PARCEL TAGS: YES NO STORMWATER: YES NO Exist: Exist: AREA Plat Conditions Prop: 3 Prop: 2 Wetland_ Erosion Total: 3 Total: 2 Seismic Streams Flood Way Food Plane Routing Date: F&W Landslide Shoreline Aquifer _ �� s <<< Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Manufactured Homes $141.00 MAM 06/28/00 32019 Potable Water Application $30.00 MAM 06/28/00 32019 Total: $171.00 is\F_BLD_App_Mob.rpt 10/29/99 • STORMWATER CALCULATIONS Owner/Applicant: Ellen C . Bell 0 PROPOSED LAND DISTURBING ACTIVITY /� Site Address: Gary Ave Drainfield area cleared l5?. O sq.ft. Port Townsend, WA 98368 Driveway Length //-1 ft. X Width /3 ft. 9 Digit Parcel Identification No.: 962 112 708 = Total Driveway f sq.ft. Permit Number: Clearing and Grading for Site Development PLOT PLAN (Well/Structures/Utilities/etc.) sq.ft. //� sq.ft. �S INDICATE the following information. Total Land Disturbance —'``7`0—er sq.ft. Draw entire parcel to scale. Indicate scale of plot plan: One inch equals A 0 ❑ IMPERVIOUS SURFACE Proposed Structures (all roof area) /:.Q--e.)sq.ft. 1. North arrow Existing Structures (all roof area) sq.ft. 2. All property boundaries and dimensions Sidewalks -141— sq.ft. 3. Names of adjacent streets Concrete Patios C sq.ft. 4. Driveway/s & parking spaces Proposed: , 5. Major features such as ravines, Driveway Length /6--O ft. Gravel seasonal creeks, bodies of water, etc. X Width t'5.-- ft. - 6. Septic tank, drainfield and reserve area location, = Total Driveway /cJ 0-1e) sq.ft. existing or proposed, and distance to Total Impervious Surface 09,"2C O sq.ft. closest structure 21 7. Sewer lines The Stormwater Manual sets forth the following Small Parcel Minimum Requirements: L 8. Wells and/or water lines • Construction Access Route Stabilization: O 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 u 1 1. Structures, existing and/or proposed sediment onto public roads. If sediment is inadvertently transported onto public roads, roads shall be cleaned 0 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, 2 13. Easements for access or utilities seeding, mulching, plastic covering, application of gravel base D. 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 INDICATE: Management Practices (BMPs). • Maintenance: D 1 5. Ordinary high water mark All erosion and sediment control BMPs shall be regularly inspected and maintained to ensure continued performance of 0 1 6. 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:\HOME\PLNCNTR\FORMS\PLOTPLN.FRM9/97 • • Jefferson County Permit Center Date 621 Sheridan Street Fee • Port Townsend WA 98368 Rec # CRITICAL AREAS QUESTIONNAIRE Ck # Case # Applicant Name V 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 J 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 ENO identified as a wetland or swamp? If YES, please describe: 3. Are any willows, skunk cabbage, alders, or cottonwoods present YES fNO 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 NO nearby 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) C� O 9 Q D y D , i/ r / / / / / / / _____________ (Questionnaire Continues on Back) • • 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 ✓0 surface of the ground? If YES, please describe: The applicant hereby certifies that all of the above statements and the information contained in any other transmittals made herewith are true, and the applicant acknowledges that any action taken by Jefferson County based in whole or in part on this application may be reversed if it develops that any such statement or other information contained herein is false. Signature �� C � Date —1 -� _ U • FOR OFFICE USE ONLY ❑ Wetlands ❑ Seismic CRITICAL AREAS ON OR ❑ Aquifer Recharge Area (zone_) 0 Fish & Wildlife Area 1 IMMEDIATELYADJACENTTO SITE: 0 Frequently Flooded Area 0 Fish & Wildlife Area 2 O Erosion O Landslide Zone: Parcel Size: Status: Comprehensive Plan Land Use Designation: Reviewed by: Community Plan: Date: • • • Jefferson County Department of Community Development July 12, 2000 621 Sheridan Street, Port Townsend, WA 98368 (360) 379-4450 CRITICAL AREA STANDARD WAIVER Applicant: DARYL F HEDMAN 6062 SR20 #23 PORT TOWNSEND WA 98368 Critical Area Review Case Number: CAR00-00293 Project Description: manufactured home installation Parcel Number: 962112708 S-T-R: 34-30N-01 W Site Address: 44 S GARY AVE PORT TOWNSEND WA, 98368 FINDING: The development, as proposed and portrayed on the Universal Plot Plan, does not encroach on an identified critical area nor any associated buffers. CONCLUSION: The proposed development meets the waiver requirements established in Jefferson County Ordinance 05-0509-94. CONDITION: The development shall be as proposed and portrayed on the Universal Plot Plan. Deviation, additions or relocation of proposed development activities will require further review pursuant to the Jefferson County Critical Areas Ordinance. 7 IC Department of Comnwxhity Development Staff c: File is\F_CAR_Waiver_Standrd.rpt 12/13/99 • • ,. , PLEASE MAIL TO: JEFFERSON COUNTY ASSESSOR JACK WESTERMAN III JEFFERSON COUNTY COURTHOUSE ASSESSOR PO BOX 1220,PORT TOWNSEND WA 98368 (360) 385-9105 MOBILE HOME INFORMATION FORM OWNER'S NAME / MAILING ADDRESS: THIS IS NOTA TAX STATEMENT NAME: Ellen C. Bell The purpose of this questionnaire is to obtain information regarding either the current location of a mobile home or the ADDRESS: 6062 Hwy. 20 , Space 23 previous ownership and location of a mobile home. This will Port Townsend, WA 98368 help our office determine whether the mobile home is already on the tax rolls in Jefferson County or if it has been moved to this county from another area. Please see reverse side for TELEPHONE NO: 379-6953 additional information. 1) MOBILE HOME DATA: (A) MAKE Golden WEst (B) MODEL Golden Manor (C) YEAR 1997 (D) LENGTH 44 (E) WIDTH 27 (F) SERIAL NUMBER 15030 (G) YOUR PURCHASE PRICE(DO NOT INCLUDE SALES TAX)44, 280 . 00 (H) PURCHASE DATE6/96 2) PREVIOUS OWNER / LOCATION OF MOBILE HOME: (A) FROM WHOM DID YOU PURCHASE MOBILE Prestige Properties , Inc . ADDRESS 11524 Rhody Drive, Port Hadlock, QA 98339 (B) WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR? YES NO (IF NO,WHAT COUNTY? IF YES,WHAT WAS PREVIOUS ADDRESS OF MOBILE? 3) WHERE MOBILE HOME IS TO BE LOCATED: (A) WILL THE MOBILE HOME BE IN A MOBILE HOME PARK? YES NO (B) IF LOCATED IN A MOBILE HOME PARK: NAME at ADDRESS OF PARK SPACE NO. (C) IF NOT LOCATED IN A MOBILE HOME PARK: NAME OF LAND OWNER: LOCATION (ADDRESS) REAL PROPERTY PARCEL NUMBER/DESCRIPTION THANK YOU FOR YOUR HELP! SIGNATURE KELLI LARSON, roperty Technician • THIS FORM CONFORMS TO THE STANDARDS OF THE STATE DEPARTMENT OF REVENUE AND IS SUBJECT TO AUDIT VERIFICATION.