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HomeMy WebLinkAboutBLD2000-00390 • , . o a 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 #: BLD00-00390 Received Date: 6/13/2000 SITE ADDRESS: 334 W KINKAID ST Issue Date: 8/29/2000 PORT HADLOCK, 98339 Expiration Date 8/29/2001 APPLICANT: CHRIS ADAMS TRUDY ADAMS 94 ALDER STREET SUBDIVISION: IRONDALE Block: 73 Lot: 29&3 PARCEL#: 961807312 Section: 34 Township: 30 N Range: 01 W CONTRACTOR/ DEALER INSTALLER: KIRK SILVES WAINS0282 Expires: 6/30/200 PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION MAKE: BENDIX YEAR: 1974 SIZE: 24 X 48 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 8/29/2001. REQUIRED INSPECTIONS: [ mg/Setback If continous footings are used): 1 >r /'I�,�/cr 4. [ cking/Setbacks/Plumbing: eJ� f//s/ ___ _..,/....,W (C).-,,r_,A......t_i [ Final/Skirting/Vents/Porches/Steps: ems.. -V cy— 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 ile'r SPECIAL CONDITIONS MAY APPLY - SEE REVERSE HOT-LINE AVAILABLE 24 HOURS A DAY N MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00390 Received Date: 6/13/2000 SITE ADDRESS: W KINKAID ST PORT HADLOCK, 98339 APPLICANT: WILMA Z ZIEGLER PHONE: (206)762-2454 1349 S HUDSON ST SEATTLE WA 981082331 SUBDIVISION: IRONDALE Block: 73 Lot: 29&3 PARCEL NUMBER: 961807312 Section: 34 Township: 30 N Range: 01 W CONTRACTOR/ DEALER: PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: BENDIX SETBACK: VALUATION 5,000.00 YEAR: 1974 LABOR & INDUSTRIES APPROVAL? SIZE: 24 X 48 BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PUBLIC 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 Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: - -A wed/,date , Manufactured Homes $141.00 MAM 06/13/00 31678 PPROrV Potable Water Application $30.00 MAM 06/13/00 31678 p-Q� Total: $171.00 'Jefferson CountyNaming ItePlittiintgafArweiit I:\F_BLD_App_Mob.rpt 10/29/99 f JEFFERSON COUNTY COMMUNITY DEVELOPMENT 62; SHERII,AN ST, PORT TOWNSEND WA 98368 MANUFACTURED HOME INSTALLATION PERMIT APPLICATION Ar NEW BUILDING 0 REPLACEMENT SIZE 'Z"l Y E�y�3'� r`ig YEAR 11-1 MAKE COST 5,00 0 BEDROOMS: BATHROOMS: EXISTING 0 EXISTING U PROPOSED PROPOSED `�- TOTAL 3 2- TOTAL TYPE OF SEWAGE DISPOSAL: WATER SUPPLY: ❑ SEWER ❑ COMMUNITY SYSTEM 0 PRIVATE WELL ❑ TWO PARY WELL X INDIVIDUAL SYSTEM Jai Conventional 0 PUBLIC PERMIT # SEP ^gr 0 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 acces and right of entry to Jefferson County and it's employees, representatives or agents for the purpose of application review and any req ' e later inspections. Access and right of entry to the applicant's property or structure shall be requested and shall occur during regular busi ss ho SIGNATURE 4/t‘ � i C DATE CY iZ1'�, NAME (PLEASE PRINT) CC//�/s A(fig/ s FOR OFFICE USE ONLY BASE FEE iy7.- V RECEIPT# ' ADDITIONAL SECTIONS �- CASH/CK# G G�1 SUBTOTAL Jq/- o0 DATE CO POTABLE WATER 911/ROAD APPROACH < .. 0 TOTAL „e H:AHOMEVPLNCNTR\FORMS\M08lLEAP_10/99 Jefferson County Department 9f Community Development // ON C 621 Sheridan Street,Port Townsend WA 98368 (360) 379-4450 tzT ``\ r3 �So Universal Plot Plan Fill in the following blanks as completely as possible : Project Description: I itia p .ftL 9 Digit Parcel IdentificAkonn (fr y tax ement): Site Address 911#: X,)( tk l rcrr� - , Road Name: Wen t nv.c.Al Zip Code: 3�7 Legal Description rr Subdivision Name: ����t e_ Block: 73 Lot(s):25-33 Section: 3L/ Township: 30 Iv^ l Range: J f,1 Parcel Size (acres or square footage): ifO a l L s. / 7 0 s-C Q scl Property Owner: wr/pin ����i,�r Phonr 6) Mailing Address: L _ Applicant/Occupant: _ ( Phone: (if different from owner) l(J C�'fv'�S � � -v c ?s z/on7 Mailing Address: Authorized Rep: Phone: Mailing Address: General Contractor: Or Manufactured Home Installer: V/` ' Phorc3 ) ?J-7 7S Mailing Address: Contractor's State License Number: Expiration Date: Septic Designer: Phone: Mailing Address: zsa / / Architect:/Engineer: Phone: Mailing Address: Loan Lender/General Phon : Contractor's Bond Holder: ,,Ine• 'f,.l p.,c2s Grf/ t ' c9c0)233-Z3Z8 Mailing Address: �U L1 ci FOR OFFICE USE ONLY Fire District: Planning Area: School District: Zone: 1/00 H:\home\pincntr\forms\universal plot plan 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: Chit Y ►t°'�ico Ad Y The purpose of this questionnaire is to obtain information ADDRESS: 9� `�� regarding either the current location of a mobile home or the Ty �'��/� previous ownership and location of a mobile home. This will --- f ' help our office determine whether the mobile home is already PC),'—/— to SAC in cam- 1 W i 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: 3W /O FC? additional information. 1) MOBILE HOME DATA: �/ (A) MAKE et *IX (B) MODEL (C) YEAR 19 714 (D) LENGTH 22-1 (E) WIDTH I ' (F) SERIAL NUMBER Z`-/1 &{S 5i3l! U (G) YOUR PURCHASE PRICE(DO NOT INCLUDE SALES TAX) 3 ©0 (H) PURCHASE DATE Sin II lK 2) PREVIOUS OWNER/ LOCATION OF MOBILE HOME: (A) FROM WHOM DID YOU PURCHASE MOBILE R i'`6r-- C)1( ` Ci ADDRESS "1 7/© -Ti J (t~'yP,� PCDCACA (B) WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR? YES NO` (IF NO,WHAT COUNTY? k 1 +SCA f ) 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 el ADDRESS OF PARK SPACE NO. (C) IF NOT LOCATED IN A MOBILE HOME PARK: jle! r�� � ,� r' -to 5 � o � Acir ;her\lS NAME OF LAND OWNER: X , //� �(" I ?? LOCATION (ADDRESS) X VVe cT l✓1 C 1,. ((� _.Llr�7�d I J J47 REAL PROPERTY PARCEL NUMBER/DESCRIPTION /6 J S-07 312,, If I( 2 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. MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00390 Received Date: 6/13/2000 SITE ADDRESS: 59A W KINKAID ST PORT HADLOCK, 98339 APPLICANT: WILMA Z ZIEGLER PHONE: (206)762-2454 1349 S HUDSON ST SEATTLE WA 981082331 SUBDIVISION: IRONDALE Block: 73 Lot: 29&3 PARCEL NUMBER: 961807312 Section: 34 Township: 30 N Range: 01 W CONTRACTOR/ DEALER: PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: BENDIX SETBACK: VALUATION 5,000.00 YEAR: 1974 LABOR & INDUSTRIES APPROVAL? SIZE: 24 X 48 BANK HEIGHT: SEWAGE DISPOSAL: CON (2J? E3WATER SYSTEM: PUBLIC BEDROOMS: BATHROOMS: PARCEL TAGS: YES NO Exist: Exist: STORMWATER: YES N AREA Plat Conditions ti Prop: 2 Prop: 2 Wetland Erosion it --ITotal: 2 Total: 2 Seismic �y-o ., Streams Flood Way be _Food Plane Routing Date: F&W NO, Landslide liO Shoreline NX.1 Aquifer !`4) Forest: Commercial n Rural Type Amount Paid By: Date: Receipt: Approved/Date Manufactured Homes $141.00 MAM 06/13/00 31678 . .,,: .. Potable Water Application $30.00 MAM 06/13/00 31678 rt,' .'".1-14,-'0,,itY (e, /__ C/0 ()VW Total: $171.00 -e>m,P� %Mar Plot s I:\F_BLD_App_Mob.rpt 10/29/99 STORMWATER CALCULATIONS Owner./Applicant: Iris Adq X PROPOSED LAND DISTURBING, ACTIVITY Site Address: S L.25-� /1'm CC\ [ Drainfield area cleaicl , sq.ft. Driveway L� �Ic /cD ft. X Width 9 Digit Parcel Identification No.: 9-6/ / 3/ = Total Driveway 11/0 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 ki IMPERVIOUS SURFACE Proposed Structures (all roof area) 11s2„,,.sq.ft. ❑ 1. North arrow Existing Structures (all roof area) sq.ft. ❑ 2. All property boundaries and dimensions Sidewalks t sq.ft. ❑ 3. Names of adjacent streets Concrete Patios 0 sq.ft. ❑ 4. Driveway/s & parking spaces Proposed: ❑ 5. Major features such as ravines, Driveway Length 7C:7 ft. seasonal creeks, bodies of water, etc. X Width 2.0 ft. • 6. Septic tank, drainfield and reserve area location, = Total Driveway ! L0 sq.ft. .r existing or proposed, and distance to Total Impervious Surface / 2_, 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 l 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, ❑ 1 3. 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:1H O ME\PLN CNTR\FOR MS\PLOTPLN.FRM9/97 ,. J Sewage Disposal Design ' __ _ ,_ Appr v d for Construction AFR 2 7 2000 Date � � - -._._, V'^C,mF.2.0i _ Li+be I Lot 31 ! L4 0--A I I. - ' O I c . 1'rababk, � g 4-2 it e. a �� / v) A4'.� w"�. - 1 ,A .' ' `- � ' � I •- J � -_ i � s I t r r I / CA m w I <A I `pv.rk� t tT x �r-r� bl�ba \ b W , K I kMS' s'E . 4' N—DVM,, N — N Ct p' , ' Lor .ov1 d .o-Pe.Q, �ov�i.o��n o- u1. IS`' '' • Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 • CRITICAL AREAS QUESTIONNAIRE Applicant Name Ar.�r}I S X 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 X 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 X No identified as a wetland or swamp? P If YES, please describe: 3. Are any willows, skunk cabbage, alders, or cottonwoods present _ Yes X 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 X 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) a a Q ❑ ❑ ❑ r , , , / / , / / / . , r / , / / / . , ,/ / ,' / ,.� :./ / '' .Ca I , , , , , , / . , 0 / / / / r i,,,,, ,�. - - _-tom (Questionnaire Continues on Back) Page 1 of 2 6. Does the site have steep slopes with little to no vegetation? _ YES X 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 require ater inspections. Access and right of entry to the applicant's property or structure shall be requested and shall occur during regular busine h ur Signature ' �( Date 647--hk 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 t/00