Loading...
HomeMy WebLinkAboutBLD2000-00706 • 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 #: BLD00-00706 Received Date: 10/26/2000 SITE ADDRESS: 70 GIBBS LAKE RD Issue Date: 12/19/2000 CHIMACUM, 98325 Expiration Date 12/19/2001 APPLICANT: ROGER GRAFSTEIN LAURICE GRAFSTEIN 3347 S GRANADA AVE SPRING VALLEY CA 91977 SUBDIVISION: Block: Lot: T 7 PARCEL#: 901342013 Section: 34 Township: 29 N Range: 01 W CONTRACTOR/ DEALER INSTALLER: JAIME KOZELISKI WAINS0626 Expires: 7/22/200 1112 JACOB MILLER RD PORT TOWNSED WA 98368 PROJECT DESCRIPTION MOBILE HOME INSTALLATION MAKE: PARAMOUNT YEAR: 1975 SIZE: 55 X 14 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 12/19/2001. REQUIRED INSPECTIONS: [Footing/Set ack (If continous footings are used): [ ] Blocking/Setbac Plu ib : i) ?c-vrosb %c / /ji-o [✓( rliVrting/Ve do es/Step 1)..; —o) 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 4 MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00706 Received Date: 10/26/2000 SITE ADDRESS: 70 GIBBS LAKE RD CHIMACUM, 98325 APPLICANT: ROGER GRAFSTEIN PHONE: (614)668-1188 LAURICE GRAFSTEIN 3347 S GRANADA AVE SPRING VALLEY CA 91977 SUBDIVISION: Block: Lot: T 7 PARCEL NUMBER: 901342013 Section: 34 Township: 29 N Range: 01 W CONTRACTOR/ DEALER: INSTALLER: JAIME KOZELISKI WAINS0626 7/22/2001 (360)385-3215 1112 JACOB MILLER RD PORT TOWNSED WA 98368 PROJECT DESCRIPTION MOBILE HOME INSTALLATION TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: PARAMOUNT SETBACK: VALUATION 4,500.00 YEAR: 1975 LABOR & INDUSTRIES APPROVAL? SIZE: 55 X 14 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: 1 Wetland Erosion Total: 2 Total: 1 Seismic Streams Flood Way Food Plane F&W Landslide Routing Date: 10 icz) Shoreline Aquifer Forest: Commercial Rural Type Approved/Date yp Amount Paid By: Date: Receipt: Manufactured Homes $141.00 MAM 10/26/00 34691 Potable Water Application $30.00 MAM 10/26/00 34691 4 Total: $171.00 DEC 1 9 2000 Jefferson County Planning & Building Department is\F_BLD_App_Mob.rpt 10/29/99 JEFFERSON COUNTY COMMUNITY DEVELOPMENT 62_1 SHEf3IDAN ST. PORT TOWNSEND WA 98368 MANUFACTURED HOME INSTALLATION PERMIT APPLICATION NEW BUILDING 0 REPLACEMENT SIZE 5.�'4f X /4',� r- YEAR /9 75 MAKE RI,rb\->2")0/.1-/111-' COST #'1, 6oO BEDROOMS: BATHROOMS: EXISTING 2- EXISTING PROPOSED 0 PROPOSED 0,/ TOTAL TOTAL / TYPE OF SEWAGE DISPOSAL: WATER SUPPLY: ❑ SEWER ❑ COMMUNITY SYSTEM PRIVATE WELL 0 TWO PARY WELL 0 INDIVIDUAL SYSTEM,Conventional 0 PUBLIC PERMIT # SEP l.4 ()� 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 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 - z DATE fl/ 2.. "-(51O NAME IPLE E INT) FOR OFFICE USE ONLY BASE FEE RECEIPT it ‘5,5ADDITIONAL SECTIONS tltl CASH/CK'# 4 SUBTOTAL /"" °1 a DATE 13 / POTABLE WATER 30 Off. �.. :. 911/ROAD APPROACH TOTAL H:AHOMEIPLNCNTR\F,ORMS\MOBILEAP.10199 / / NNN /Y / Qi3'4*, --C;),,27, 7 -C\O i N , _z . /2:/„) ..„„,.../-- .V „I-G.' / 93/ /ill et �3 tt -. r\-) \ 7K) c, - ' _ lcae f-- ` N -Q,e '' [;11 1\., :le \ 4--z 4 . -‹,-, 4c- .........„. -.. , , T:i ; ' ' ---e' //g .4‘. . 1 %S /s s arinC7Mici 1 k \ re,,,a,\,,,>>.../, *444,81811,6, i 04 \ /(94, ' E411,, ,-z, 74-1"eism'd .. i. dual , �ur fix?",' N ,, Jefferson County Department of Community Development / G�oN . co 621 Sheridan Street,Port Townsend WA 98368 (360) 379-4450 4,4 Aso Universal Plot Plan HING Fill in the following blanks as completely as possible: Project Description: ' zn5-fr sfich)14;1 4, mobile, %® 07)42, , 96' 0,,cre A)I A +G� r&/1i r G. actin lsc�a 9 Digit Parcel Identification Number (from your tax statement): r�9 7 1 r .- J J .i „a', _. Site Address _ ' t 478 52'.5 911#: f Road Name: i L% s: -, Zip Code: Legal Description Subdivision Name: Block: Lot(s): Section: Township: Range: 1 Parcel Size (acres or square footage): 4/�, 5 tiz Property Owner: Ph ne: Q �©0g_,r- �-- �.r/tee, L L-1, <0e)Y) a(08 —//88 Mailing,Address: 4, d,U ive, o 9.j ,/ ./;7X Wq 77 Applicant/Occupant: /. / Phone: (if different from owner) C e,D amcz Z. /� -, ;' ''/ 377 Mailing Address 7 .K�/.�G�� r' ,C''Y �'�� ,S°/ 7147 Fg1 S Authorized Rep: Phone: Mailing Address: General Contractor: Or Manufactured Home Installer: ;; glj e Q Phone '..? • 3a6 M ddress g - ) , i7j r Rid- '7 7-0- ail� /ld 4 9g3 3 Contractor's State License Number: 6c I -7-6 Expiration Date: i2pi Q d : Septic Designer: Phone: p g e Mailing Address: Architect:/Engineer: Phone: Mailing Address: Loan Lender/General Phone: Contractor's Bond Holder: Mailing Address: FOR OFFICE USE ONLY Fire District: Planning Area: School District: Zone: 1/00 H:\home\pincntr\forms\universal plot plan T. 6Arl °r0 00 .. fit / MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION 1 Jefferson County Department of Community Development t4 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00706 Received Date: 10/26/2000 SITE ADDRESS: 70 GIBBS LAKE RD CHIMACUM, 98325 APPLICANT: ROGER GRAFSTEIN PHONE: (614)668-1188 LAURICE GRAFSTEIN I 3347 S GRANADA AVE SPRING VALLEY CA 91977 ) SUBDIVISION: Block: Lot: T 7 PARCEL NUMBER: 901342013 Section: 34 Township: 29 N Range: 01 W CONTRACTOR/ DEALER: INSTALLER: JAIME KOZELISKI WAINS0626 7/22/2001 (360)385-3215 1112 JACOB MILLER RD PORT TOWNSED WA 98368 PROJECT DESCRIPTION MOBILE HOME INSTALLATION TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: PARAMOUNT SETBACK: VALUATION 4,500.00 YEAR: 1975 LABOR & INDUSTRIES APPROVAL? SIZE: 55 X 14 BANK HEIGHT: SEWAGE DISPOSAL: CON Ile_ / i �� WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: STORPARCEL TAGS: - `_ NO Exist: Exist: AREA •TE- , NO �j lat Conditio 1\f0 Prop: 2 Prop: 1 Wetland it" Erosion Total: 2 Total: 1 Seismic 17 Streams ryY_ Flood Way_ t) Food Plane OM Routing Date: F&W N(f , Landslide :0 1 (�_ g '(� ic:: (0 ix Shoreline 1\ f) Aquifer r' F �„ Forest: Commercial�Rural \_, . Type Amount Paid By: Date: Receipt: �►_qii loaf a tpk ,' s Manufactured Homes $141.00 MAM 10/26/00 34691 3:--gAReW Potable Water Application $30.00 MAM 10/26/00 34691 , art' ....., Total: $171.00 ...ter C/ • n a , i:\F_BLD App_Mob.rpt 10/29/99 Jefferson County Department of Community Development November 3, 2000 621 Sheridan Street, Port Townsend, WA 98368 (360) 379-4450 CRITICAL AREA STANDARD WAIVER Applicant: ROGER GRAFSTEIN LAURICE GRAFSTEIN 3347 S GRANADA AVE SPRING VALLEY CA 91977 Critical Area Review Case Number: CAR00-00466 Project Description: mobile home installation Parcel Number: 901342013 S-T-R: 34-29N-01W Site Address: 70 GIBBS LAKE RD CHIMACUM WA, 98325 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 Count "tical Areas Ordinance. Department of Community Development Staff c: File I:\F_CAR_Waiver Standrd.rpt 12/13/99