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HomeMy WebLinkAboutBLD2000-00399 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 #: BLD00-00399 Received Date: 6/19/2000 SITE ADDRESS: 170 HAYDEN ST Issue Date: 6/26/2000 PORT HADLOCK, 98339 Expiration Date 6/26/2001 APPLICANT: MICHAEL GRAVES SUSIE GRAVES PO BOX 283 SUBDIVISION: PHILLIPS ADDN TO IRONDALE Block: 2 Lot: 3-4 PARCEL#: 986400207 Section: 02 Township: 29 N Range: 01 W CONTRACTOR/ DEALER INSTALLER: C JON LUGAR WAINS0260 Expires: 5/29/200 PROJECT DESCRIPTION MANUFACTURED HOME REPLACEMENT MAKE: REDMAN YEAR: 2000 SIZE: 28 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 6/26/2001. REQUIRED INSPECTIONS: [ ] Footing/Setback (If continous footings are used): [ ] Blocking/Setbacks/Plumbing: [ ] 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 rw MANUFACTURED/ MOBILE HOPE INSTALLATION APPLICATION Jefferson County Depaiment of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00399 Received Date: 6/19/2000 SITE ADDRESS: 170 HAYDEN ST PORT HADLOCK, 98339 APPLICANT: MICHAEL GRAVES PHONE: (360)437-5136 SUSIE GRAVES PO BOX 283 PORT HADLOCK WA 98339 SUBDIVISION: PHILLIPS ADDN TO IRONDALE Block: 2 Lot: 3-4 PARCEL NUMBER: 986400207 Section: 02 Township: 29 N Range: 01 W CONTRACTOR/ DEALER: INSTALLER: C JON LUGAR WAINS0260 5/29/2001 (360)479-8312 PROJECT DESCRIPTION MANUFACTURED HOME REPLACEMENT TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: REDMAN SETBACK: VALUATION 56,000.00 YEAR: 2000 LABOR & INDUSTRIES APPROVAL? SIZE: 28 X 52 BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: CITY 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 Approved/Date Type Amount Paid By: Date: Receipt: pp Manufactured Homes $141.00 MAM 06/19/00 31761 Potable Water Application $30.00 MAM 06/19/00 31761 . PR (2L,' ED Total: $171.00 J 3 2000 y F/ Jefferson County Planning & Building Oeper inert I:\F_BLD_App_Mob.rpt 10/29/99 JEFFERSON COUNTY COMMUNITY DEVELOPMENT 621 SHERIDAN STr PORT TOWNSEN4 WA 98368 MANUFACTURED HOME INSTALLATION PERMIT APPLICATION ❑ NEW BUILDING REPLACEMENT SIZE 'Z <Z YEAR 0CD MAKE r►'f f•1'-zi ttA I COST 5-6 o-ee BEDROOMS: BATHROOMS: EXISTING EXISTING 2- PROPOSED Z PROPOSED TOTAL TOTAL TYPE OF SEWAGE DISPOSAL: WATER SUPPLY: 0 SEWER 0 COMMUNITY SYSTEM 0 PRIVATE WELL 0 TWO PARY WELL INDIVIDUAL SYSTEM id-Conventional 54c-tS t--"c p. PUBLIC PERMIT # SEP 0 Alternative Name of water system: 0/-r-i cc POsu �c1 S tray J IF WATERFRONT PROPERTY, g ic�uo(Z�� sr, v(`' 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. (.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 dyring regular b iness hours. SIGNATURE DATE 7 �- � NAME (PLEASE PRINT) P0,46 e (A., E E D FOR OFFICE USE ONLY BASE FEE 4( l RECEIPT# + t ADDITIONAL SECTIONS CASH/CK# �` • SUBTOTAL (14 I :Oa DATE / J' u' POTABLE WATER 3C). Co 911/ROAD APPROACH y TOTAL - . .y��pp H:IHOME\PLNCNTRIFORMS\MOBILEAP.10/99 • d Jefferson County Department of Community Development 5°N /c 44 1 , �oG� 621 Sheridan Street,Port Townsend WA 98368 (360) 379-4450 ik. '= Universal Plot Plan YS, 7N4 Fill in the following blanks as completely as possible: Project Description: P-EPC4C- iffy T O - i slei AiG, S0.v 6�-L zv r1.��/go,3,4c •.t ' C i Zyt ) cve 7/4 .4 lU i;-r tv 71_e4- &JL IAc•i ()IL _f g V 5 Z ° J 2 0 D,fl. -" „f._:.,NG A 4,,,L/,er4,?cJ(ZLD !4c>�r.0 19 Digit Parcel Identification Number(from your tax statement): I t0? (-.1' iur,,.. . i - ,',is % 4 Ai C. 3s t-i i j` 62.,i c•,,�,t<<<j "Go e Z ICI Site Address —. -_if.r._ _a, 9I i#: i C,,� Road Name• � • __ r� `DA/ ; 7 jZipCode: C'y�'- Legal Description 6 ,j .Zc�3o/off-IZ<9 c-2!/ I Subdivision Name: 7.i.h C. c_-1 pS A z D N 'T^d 06 ti 9 4, Block: on Lot() 3 44 Section: I Township: Rane s Parcel Size (acres or square footage): g 11''`J PAY �„_ Pro Owner: _ ,�..,,.l ` .1 ,4 4 c,E- ct) E D Phone: p Mailing Address: -' 7�'- l 3 _ /q Y L S i dP o c2-7 14 14-0 -o C,c, 1,0 �� ci 8 3 3 _ Applicant/Occupant: (if different from owner) Phone: Mailing Address: Authorized Rep: Mailing Address: PnrC� 29 - D 7 9.� General Contractor: Or Manufacttued Home Installer. (3 ,� ,� ,� Phone Mailing Address 3`(�- — f Z Contractor's State License Number: Li �, Expiration Date: l Septic Designer: _ Phone: ,f15"Ti N Mailing Address: Architect:/Engineer � — - 1 a/14 ->�./ «t ,c �L'7rCle. Phone Mailing Address: faD r ?�ZG- 7 ge 1 E'204l f1 / c. L 5 S/.4. v iZz,,,,- OGZ 9 739/ Loan Lender/General A-SNiA4raZi' in(4 !'r/4-4 Phone: ,,,, Contractor's Bond Holder: Mailing Address: ' Z FOR OFFICE USE ONLY I Fire District: I Planning Area: J. School District: Zone: 1/00 H:\home\pincnrr\foam \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 /S NOT A TAX STATEMENT NAME: f-'o G Eca (Ai + The purpose of this questionnaire is to obtain information regarding either the current location of a mobile home or the ADDRESS: /7 Ca /4 4 y previous ownership and location of a mobile home. This will help our office determine whether the mobile home is already P c(Z-7 (N 11 9)3�( 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: 36 b 379 - ` .2M additional information. 1) MOBILE HOME DATA: (A) MAKE E)4-1/>!A.i J-ten i°t 7,/ C,(B) MODEL 4 S Zz - (C) YEAR (D) LENGTH .c..` (E) WIDTH .2 0 (F) SERIAL NUMBER // (G) YOUR PURCHASE PRICE(DO NOT INCLUDE SALES TAX) 5'(, Oat, (H) PURCHASE DATE 2) PREVIOUS OWNER / LOCATION OF MOBILE HOME: (A) FROM WHOM DID YOU PURCHASE MOBILE 2—MOBILE NiL�-1 /14 F. C' �A t�t4 , c ..�AJC. / , ADDRESS Ze, niIL - S , S�LVeRTQ�`- b (2- 973 & f (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 ez ADDRESS OF PARK SPACE NO. (C) IF NOT LOCATED IN A MOBILE HOM ARK:, 4 sr 12.06 tit NAME OF LAND OWNER: l.V - C) l ?J LOCATION (ADDRESS) i 763 l-I-i4�0 fi-/V % P o R (— j-A-D l'/C_ 9 a 3 q REAL PROPERTY PARCEL NUMBER/DESCRIPTION 0004i 9 ©O, -f07 , P d2 'PS AD_I Al 7-17 ; ; { a c-o e K Z -07'1' 3.1 4 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. ° 12--OO-- d07-&- ` :°' MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00399 Received Date: 6/19/2000 SITE ADDRESS: 170 HAYDEN ST PORT HADLOCK, 98339 APPLICANT: MICHAEL GRAVES PHONE: (360)437-5136 SUSIE GRAVES PO BOX 283 PORT HADLOCK WA 98339 SUBDIVISION: PHILLIPS ADDN TO IRONDALE Block: 2 Lot: 3-4 PARCEL NUMBER: 986400207 Section: 02 Township: 29 N Range: 01 W CONTRACTOR/ DEALER: INSTALLER: C JON LUGAR WAINS0260 5/29/2001 (360)479-8312 PROJECT DESCRIPTION MANUFACTURED HOME REPLACEMENT TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: REDMAN SETBACK: VALUATION 56,000.00 YEAR: 2000 LABOR & INDUSTRIES APPROVAL? SIZE: 28 X 52 BANK HEIGHT: SEWAGE DISPOSAL: CON --,��+ � WATER SYSTEM: CITY BEDROOMS: BATHROOMS: PARCEL TAGS: YES NO � STORMWATER: YES NO Exist: Exist: --it . REA elat Conditions Prop: 2 Prop: 2 > p,iy►nL Wetland te5 -0,e/42(1. rosion ND Total: 2 Total: 2 IN Seismic TO Streams /4/0 Flood Way /k1P Food Plane r/0 Routing Date: F&W r0 Landslide 0 Shoreline /I/0 Aquifers Forest: Commercial ni Rural Type Amount Paid By: Date: Receipt: Ai ° 11. .a•, Manufactured Homes $141.00 MAM 06/19/00 31761 (117 Potable Water Application $30.00 MAM 06/19/00 31761 tie p tie 1 4/1171' Total: $171.00 ittalifiter; k, At,i) ?equ / 1 i:\F_BLD_App_Mob.rpt 10/29/99 � a yafferson County Department of Community Development June 22, 2000 621 Sheridan Street, Port Townsend, WA 98368 (360) 379-4450 CRITICAL AREA STANDARD WAIVER Applicant: MICHAEL GRAVES SUSIE GRAVES PO BOX 283 PORT HADLOCK WA 98339 Critical Area Review Case Number: CAR00-00262 Project Description: manufactured home replacement Parcel Number. 986400207 S-T-R: 02-29N-01 W Site Address: 170 HAYDEN ST PORT HADLOCK WA, 98339 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. 74,v Department of Community Development Staf c: File I:\F_CAR_Waiver_Standrd.rpt 12/13/99 ? . > / . . ) , . / | � . . ! « „ y { 4 f