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Home My WebLink AboutBLD2000-00484 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 #: BLD00-00484 Received Date: 7/21/2000 SITE ADDRESS: 241 SEATTLE DR Issue Date: 8/2/2000 PORT LUDLOW, 98365 Expiration Date 8/2/2001 APPLICANT: LEO MC NAIR PO BOX 65127 PORT LUDLOW WA 98365 SUBDIVISION: TRAILS END 2ND ADDITION Block: 14 Lot: 18 PARCEL#: 950101414 Section: 16 Township: 27 N Range: 01 E CONTRACTOR/ DEALER INSTALLER: GUY JONES WAINS0254 Expires: 7/1/2001 PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION MAKE: BON PRIX YEAR: 1973 SIZE: 24 X 52 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 8/2/2001. REQUIRED INSPECTIONS: L ,canting/Setback ` ontinous footings are used): e [' lockin /Setbacks/Plums CeVIC /i/ /et'%,'-' C . final/Skirtnq/VVnts/Porche 42K 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 #: BLD00-00484 Received Date: 7/21/2000 SITE ADDRESS: 241 SEATTLE DR PORT LUDLOW, 98365 APPLICANT: DELL MC CANN PHONE: DORIS MC CANN 820 E 16TH ST THE DALLES OR 97058-3049 SUBDIVISION: TRAILS END 2ND ADDITION Block: 14 Lot: 18 PARCEL NUMBER: 950101414 Section: 16 Township: 27 N Range: 01 E CONTRACTOR/ DEALER: wed oat INSTALLER: GUY JONES WAINS0254 Area Raviw [a, 0041 PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: BON PRIX SETBACK: VALUATION 15,500.00 YEAR: 1973 LABOR & INDUSTRIES APPROVAL? SIZE: 24 X 52 BANK HEIGHT: SEWAGE DISPOSAL: CON � ( ), WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: PARCEL TAGS: YES NO STORMWATER: YES NO Exist: Exist: AREA Plat Conditions Prop: 2 Prop: 2 Wetland Erosion Total: 2 Total: 2 Seismic Streams Flood Way Food Plane Routing Date: F&W Landslide 0 Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Manufactured Homes $141.00 MAM 07/21/00 32266 Potable Water Application $30.00 MAM 07/21/00 32266 Total: $171.00 is\F_BLD_App_Mob.rpt 10/29/99 STORMWATER CALCULATIONS Owner/Applicant: � d /21ia c� �� r ❑ PROPOSED LAND DISTURBING ACTIVITY Site Address: c `/� c- H'C� Drainfield area cleared sq.ft. 7 t-T -U.cci tow, LLJ& e?[7365 Driveway Length ft. t X Width ft. 9 Digit Parcel Identification No.: q o oQ I7 /3 = 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 0 IMPERVIOUS SURFACE Proposed Structures (all roof area) - sq.ft. El 1. North arrow Existing Structures (all roof area) 2_2q( sq.ft. 2. All property boundaries and dimensions Sidewalks sq.ft. L 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. 2 6. Septic tank, drainfield and reserve area location, = Total Driveway sq.ft. existing or proposed, and distance to Total Impervious Surface z Z_q((I sq.ft. closest structure 11 • 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 ❑ 1 Paved surfaces (patios) quarry spells or crushed rock to minimize the tracking of ❑ 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, '13. Easements for access or utilities seeding, mulching, plastic covering, application of gravel base 2r14. 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: O 15. Ordinary high water mark All erosion and sediment control BMPs shall be regularly inspected and maintained to ensure continued performance of 0 16. Top of bank, if over 10 feet high their intended function. O 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 I ,.. MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00484 Received Date: 7/21/2000 SITE ADDRESS: 241 SEATTLE DR PORT LUDLOW, 98365 APPLICANT: DELL MC CANN PHONE: DORIS MC CANN 820 E 16TH ST THE DALLES OR 97058-3049 1 SUBDIVISION: TRAILS END 2ND ADDITION Block: 14 Lot: 18 PARCEL NUMBER: 950101414 Section: 16 Township: 27 N Range: 01 E CONTRACTOR/ DEALER: INSTALLER: GUY JONES WAINS0254 7/1/2001 PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: BON PRIX SETBACK: VALUATION 15,500.00 YEAR: 1973 LABOR & INDUSTRIES APPROVAL? SIZE: 24 X 52 BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: PARCEL TAGS: YES NO STORMWATER: YES NO Exist: Exist: AREA Plat Conditions Prop: 2 Prop: 2 Wetland Erosion Total: 2 Total: 2 Seismic Streams Flood Way Food Plane Routing Date: F&W Landslide � �4 -6-0 Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Manufactured Homes $141.00 MAM 07/21/00 32266 Potable Water Application $30.00 MAM 07/21/00 32266 - PR ' , Total: $171.00 J 0 Jefferson County Planning & Building Department is\F_BLD_App_Mob.rpt 10/29/99 7 • 4 r JEFFERSON COUNTY COMMUNITY DEVELOPMENT 621 SHERIDAN ST, PORT TOWNSEND WA 98368 MANUFACTURED HOME INSTALLATION PERMIT APPLICATION NEW BUILDINGN ❑ REPLACEMENT SIZE t) X �" ( cQ q X 5 ) w t \ 4-0 ►•?e YEAR 'ICJ r73 MAKE &Ai Ph'X' COST 4 I5,5 L0 BEDROOMS: BATHROOMS: EXISTING e EXISTING �' PROPOSED PROPOSED TOTAL TOTAL TYPE OF SEWAGE DISPOSAL: WATER SUPPLY: ❑ SEWER 0 COMMUNITY SYSTEM PRIVATE WELL 0 TWO PARY WELL 11, INDIVIDUAL SYSTEM lit Conventional 0 PUBLIC PERMIT # SEP5Z) /6 ❑ Alternative Name of water system: 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. 4 SIGNATURE 1. , J�T_ icy .x. v DATE NAME (PLEASE PRINT) Lo i \ AI FOR OFFICE USE ONLY BASE FEE /Y7 Ci�C RECEIPT# -V ADDITIONAL SECTIONS CASH/CK# k + SUBTOTAL +; U DATE _// 1/ ,( :: POTABLE WATER ''9• •C`' 911/ROAD APPROACH _'r. TOTAL / —7 f,. C C H:AHOMEIPLNCNTR1FORMS\MOBILEAP.10/99 „ " _x 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: A / " I c luf /< The purpose of this questionnaire is to obtain information ` y� regarding either the current location of a mobile home or the P ADDRESS: 0 L �'1c. .5" " I previous ownership and location of a mobile home. This will T �� help our office determine whether the mobile home is already O 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: ho ` � — additional information. 1) MOBILE HOME DATA: �" (A) MAKE EQlj fir (B) MODEL (C) YEAR /�f 3 (D) LENGTH '' (E) WIDTH �. (F) SERIAL NUMBER 3UJ38 7/ (G) YOUR PURCHASE PRICE(DO NOT INCLUDE SALES TAX) /5.J,on. °a (H) PURCHASE DATE /" 'O ' 00 2) PREVIOUS OWNER / LOCATION OF MOBILE HOME I: Pool(A) FROM WHOM DID YOU PURCHASE MOBILE�y V 0 Ida) i- �' s ADDRESS l `7 `*6 '7 6 c R 'PcU (0 WC (B) WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR? NO YES (IF NO, WHAT COUNTY?r/ �,I St�.-� p ✓1)_ IF YES,WHAT WAS PREVIOUS ADDRESS OF MOBILE? £oO) .4;^.iCde 1✓�d, 7 !O (4I ha W14 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 0 lA SPACE NO. (C) IF NOT LOCATED IN A MOBILE HOME PARK: NAME OF LAND OWNER: LEO /71 a c( 1 r LOCATION (ADDRESS) L ' cAeci tt (Dr. REALPROPERTY PARCEL NUMBER!DESCRIPTION c1501 3 1 `C 13 etoc I 1 4.' ° s 44 631.4.4), i;t%! L -f / ,i4-4 / T 7 /mo d *Ate,_ 1p 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. Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 CRITICAL AREAS QUESTIONNAIRE Applicant Name L( CIA l ram, Building Application _ Land Use Application _ Shoreline Application" On-site Sewage Application _ Subdivision Application , Other:yin N. 71tfs //4h c4) '4 o' 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? If YES, please describe: 2. Has any portion of the property or any nearby property ever been _ Yes 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: /)_'r 4. Are there any indications on any portion of the property or on any _ YES Z--�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) 4 4 4 �p , / / / / / / i ,' ,' -.�'� l / / / l i i �� i / / / r i i11.1116 , l///ri i , / - ///// /, . -� (Questionnaire Continues on Back) Page 1 of 2 • 6. Does the site have steep slopes with little to no vegetation? YES Xo If YES, please describe: Does the site contain high percentages of silt and/or veryfine YES 4.0 7. 9 P 9 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 Date FOR OFFICE USE ONLY ❑ Wetlands ❑ Seismic CRITICAL AREAS ON OR ❑ Aquifer Recharge Area (zone ) E Fish & Wildlife Area 1 IMMEDIATELY ADJACENT TO SITE: ❑ Frequently Flooded Area ❑ Fish & Wildlife Area 2 D 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.docl/00 ..- 2, r 1 1 ,‘--- i cs i ...3 6. --2) :...., , ..,,r.„..„ „...... .. ti- 14.) , . ,,J. „.. ...„ ..„,.. . ....,. . . , v { r sssis-, S , ; Cr) ; r. , . ., , _...... 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