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HomeMy WebLinkAboutBLD2000-00514 MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00514 Received Date: 8/2/2000 SITE ADDRESS: 7TH AVE PORT HADLOCK, 98339 APPLICANT: MAUREEN DUNCAN PHONE: (360)379-3785 281 7TH ST A PORT HADLOCK WA 98339 SUBDIVISION: IRONDALE Block: 52 Lot: 38-48 PARCEL NUMBER: 961805213 Section: 34 Township: 30 N Range: 01 W CONTRACTOR/ 5tu11 ' DEALER: 5 p i) `7 "1 Critical Area 9evw 1! rr. . INSTALLER: JAIME KOZELISKY WAINS0626 7/1/2001 (36-01$8-3215 1112 JACOB MILLER RD PORT TOWNSEND WA 98368 PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: LIBERTY SETBACK: VALUATION 4,500.00 YEAR: 1983 LABOR & INDUSTRIES APPROVAL? SIZE: 14 X 56 BANK HEIGHT: SEWAGE DISPOSAL: CON '1?) WATER SYSTEM: CITY et 1 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 Routing Date: F&W Landslide Shoreline Aquifer Forest: Commercial Rural Type Approved/Date yp Amount Paid By: Date: Receipt: Manufactured Homes $141.00 MAM 08/02/00 33401 Potable Water Application $30.00 MAM 08/02/00 33401 Total: $171.00 is\F_BLD_App_Mob.rpt 10/29/99 Y � 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 #: BLD00-00514 Received Date: 8/2/2000 SITE ADDRESS: 281 7TH AVE Issue Date: 8/22/2000 PORT HADLOCK, 98339 Expiration Date 8/22/2001 APPLICANT: MAUREEN DUNCAN 281 7TH ST A SUBDIVISION: IRONDALE Block: 52 Lot: 38-48 PARCEL#: 961805213 Section: 34 Township: 30 N Range: 01 W CONTRACTOR/ DEALER INSTALLER: JAIME KOZELISKY WAINS0626 Expires: 7/1/2001 1112 JACOB MILLER RD PORT TOWNSEND WA 98368 PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION MAKE: LIBERTY YEAR: 1983 SIZE: 14 X 56 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 8/22/2001. REQUIRED INSPECTIONS: [X.V"—Ecx ng/Set $c (If continous footings are used): d` '4as-- Q/ O,c/ec [ locking/S b s/PI r` d [ ] Final/Skirting/Venter --- 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 #: BLD00-00514 Received Date: 8/2/2000 SITE ADDRESS: 7TH AVE 'VC I PORT HADLOCK, 98339 APPLICANT: MAUREEN DUNCAN PHONE: (360)379-3785 281 7TH ST A PORT HADLOCK WA 98339 SUBDIVISION: IRONDALE Block: 52 Lot: 38-48 PARCEL NUMBER: 961805213 Section: 34 Township: 30 N Range: 01 W CONTRACTOR/ DEALER: INSTALLER: JAIME KOZELISKY WAINS0626 7/1/2001 (360)385-3215 1112 JACOB MILLER RD PORT TOWNSEND WA 98368 PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: LIBERTY SETBACK: VALUATION 4,500.00 YEAR: 1983 LABOR & INDUSTRIES APPROVAL? SIZE: 14 X 56 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: 1 Wetland Erosion Total: 2 Total: 1 Seismic Streams Flood Way Food Plane Routing Date: F&W Landslide Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: p ye /D to_ Manufactured Homes $141.00 MAM 08/02/00 33401 Potable Water Application $30.00 MAM 08/02/00 33401 Total: $171.00 Jefferson County I ionning &Building Department is\F_BLD_App_Mob.rpt 10/29/99 JEFFERSON=COUNTY COMMUNITY DEVELOPMEN 4 621 S4ERIDAN ST, PORT TOWNSEND WA 98368 MANUFACTURED HOME INSTALLATION PERMIT APPLICATION ❑ NEW BUILDING ❑ REPLACEMENT SIZE j X3 r!D YEAR 19$.3 MAKE Abel?{ y COST I-I 50Q BEDROOMS: BATHROOMS: EXISTING EXISTING PROPOSED PROPOSED TOTAL TOTAL TYPE OF SEWAGE DISPOSAL: WATER SUPPLY: ❑ SEWER ❑ COMMUNITY SYSTEM ❑ PRIVATE WELL 0 TWO PARY WELL XNDIVIDUAl_ SYSTEM 0 Conventional PUBLIC PERMIT # SEP 0 Alternative 6e'e Name of water system: L/7 y 0,79 It eR 4tffch es IF WATERFRONT PROPERTY, co 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. ,k 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 4q*cD � DATE / 2606 NAME (PLEASE PRINT) FOR OFFICE USE ONLY BASE FEE RECEIPT# 3g 4-5 0 1 ADDITIONAL SECTIONS CASH/CK# j`)(..) 'J " SUBTOTAL DATE ! " POTABLE WATER 911/ OAD APPROAC TOTAL #2,....(0, H:\HOME\PLN CNTR\FORMS\MOBI LEAP.10/99 A w r Jefferson County Departmentvof Community Development ���, ON C 621 Sheridan Street,Port Townsend WA 98368 (360) 379-4450 1 ,,' 4. ' ;'$ Universal Plot Plan 1SN7Ne° Fill in the following blanks as completely as possible: Project Description: 111 MN( ),a 1 k -- J.--,44-t9ilet.4.4 j 9 Digit Parcel Identification Number (from your tax statement): /Gobi -a Site Address 911#: t ) Road Name: Zip Code: 9733 7 Legal Description Subdivision Name: >J/A Block: ' Lot()s erly ia Section: Township: .iRiv Parcel Size (acres or square footage): Property Owner: Phone: feud Uel. IN- ketx, .38s-ss-e69 Mailing Address: Applicant/Occupant: Phone:(phvue. iveLi (if different from owner) mpuRe,,v DutvC.A& 3'7 g 39Ps- 'Mailing Addr ss: a a' LDeJA1V St. My S) 1 i, #-, ""1'4 )140J LDC-ic' icwt 9g33Y PcRr Towrvse,s.IA- 9cMS Authorized Rep: \ Phone: Mailing Address: General Contractor: 3 `S= 4145%/Ue'ss Or Manufactured Home Installer: .7A in i k✓o 7, e. L j Ski Phone: 3 js Mailing Address: /IMe' 3 j?' qr0 9,-- / T,RcohMiickidr P, 7--L4i Contractor's State License umber. Expiration}Date: X02.Pl—dS awl e 3 / iv-,,706,► Septic Designer: Phone: Mailing Address: Architect:/Engineer: N Phone: Mailing Address: Loan Lender/General Phone: Contractor's Bond Holder: Or/9- Mailing Address: FOR OFFICE USE ONLY Fire District: Planning Area: 0 School District: Zone: 1 i 1/00 H:\home\pincntr\forms\universal plot plan STORM WATER CALCULATIONS Owner/Applicant: )(Antos C DewCm lo ❑ PROPOSED LAND DISTURBING ACTIVITY ti Site Address:4 i � $.* 13 Drainfield area cleared sq.ft. )1 A i L C C,1`', (,(,gyp rJ g 33 q Driveway Length ft. f�J ©`S —0a0 X Width ft. ses6goinc9 Digit Parcel Identification No.: = Total Driveway sq.ft. Permit Number: Clearing and Grading for Site Development PLOT PLAN (Well/Structures/Utilities/etc.) sq.ft. 79 sq.ft. INDICATE the following information. Total Land Disturbance y sq.ft. Draw entire parcel to scale. Indicate scale of plot plan: One inch equals ❑ IMPERVIOUS SURFACE Proposed Structures (all roof area) 73f sq.ft. ❑ 1. North arrow Existing Structures (all roof area) o sq.ft. ❑ 2. All property boundaries and dimensions Sidewalks sq.ft. ❑ 3. Names of adjacent streets Concrete Patios sq.ft. ❑ 4. Driveway/s & parking spaces Proposed: .� ❑ 5. Major features such as ravines, Driveway LengthjS ft. seasonal creeks, bodies of water, etc. X Width 12 ft. ❑ 6. Septic tank, drainfield and reserve area location, = Total Driveway V sq.ft. existing or proposed, and distance to Total Impervious Surface �l 'le() 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 ❑ 12. Setbacks (distances to property thoroughly at the end of the day by shoveling or sweeping. boundaries, structures, banks, Street washing should only be done after the bulk of the 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 • 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: ❑ 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:\HOME\PLN CNTR\FORMS\PLOTPLN.FRM9/97 Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 CRITICAL AREAS QUESTIONNAIRE Applicant Name . ,,u .a / <. ? _ 4 Building Application Land Use Application _ Shoreline Application On site Sewage Application _ Subdivision Application Other: r 1 . Is there any standing or running water on the surface of the _ Yes A 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 \)( No identified as a wetland or swamp? 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 XNo nearby property of rockslides, earthflows, mudflows, or landslides? If YES, please describe: E. Please indicate which line best represents the steepest slope found on your property. (Check appropriate box) C �t / / / / / / /' / / / / / / / / / / / / / / / / / / / / / I-1 / / / / / / / / / / / / / / // / / / / / / / ,- / / / / / / / / / / / / / / / // //4 I / / / / / / / / / / / / / / / // / // / / / / / / / // / /'� • / / / / / / // // / / / /0 / / / / / / // // / /// -- / / / '- ////// /////// /' -- ///////// /_/' i- L (Questionnaire Continues on Back) Page 1 of 2 a 6. Does the site have steep slopes with little to no vegetation? — YES k 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 NC 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 :heir 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. \i/ ignature " q cc ,TJ ,4c,t-.t fir/ Date -f'.0G 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 1.7 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 1/00 . ._ i / - _ / \ , / -1-- . A ,..4 . 1'4 i 0 I C D C / (DT, „,...0 Z 0 Fa . . 4( 0 CD . \ f r/1 / p<Z ri.. 0 -0 m Mt Ilifil i 1 'N. z ..... LI,,.... ?..j Q..$) \ . . • . , i ,Ic........._. I 'L ,....a. -0 9t9N . i,, • ) I I , 1 .t . '."..,. / iv- I . ........... r i E A t4 ,(---i T, ' , .._. . ... ? .„ X , Ci 02 hi 1" t fit'D J 61 I M (rY\ rri ....,.... rwel r171 CP C2.. C2 ...... 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