HomeMy WebLinkAboutBLD2000-00541 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 #: BLD00-00541 Received Date: 8/17/2000
SITE ADDRESS: 694 HIDDEN TRAILS RD Issue Date: 8/25/2000
PORT TOWNSEND, 98368 Expiration Date 8/25/2001
APPLICANT: JAMES REYNOLDS JR
84 BOURBON LN
PORT TOWNSEND WA 98368
SUBDIVISION: Block: Lot: T 21
PARCEL#: 001082012 Section: 08 Township: 30 N Range: 01 W
CONTRACTOR/ OWNER PHONE:
DEALER
PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION
MAKE: LIBERTY
YEAR: 1987
SIZE: 14 X 66
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 8/25/2001.
REQUIRED INSPECTIONS:
[ ] Footing/Setback (If continous footings are used):
[ ] Blocking/Setbacks/Plumbing:
[kr Final/Skirting/Vents/Porches/Steps:
r /D -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
•
MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00541 Received Date: 8/17/2000
SITE ADDRESS: 694 HIDDEN TRAILS RD
PORT TOWNSEND, 98368
APPLICANT: JAMES REYNOLDS JR PHONE: (360)379-8308
84 BOURBON LN
PORT TOWNSEND WA 98368
SUBDIVISION: Block: Lot: T 21
PARCEL NUMBER: 001082012 Section: 08 Township: 30 N Range: 01 W
CONTRACTOR/ OWNER PHONE:
DEALER:
PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION — RALp
Q f �.
TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE:
TYPE OF IMP NEW MAKE: LIBERTY SETBACK:
VALUATION 5,000.00 YEAR: 1987
LABOR & INDUSTRIES APPROVAL?
SIZE: 14 X 66 BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: PUD
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
( � c- Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: Approved/Date
Manufactured Homes $141.00 MAM 08/16/00 33464AP
Potable Water Application $30.00 MAM 08/16/00 33464
Total: $171.00 AU 2000
7
Jefferson County Planning
is\F_BLD_App_Mob.rpt 10/29/99
•
•
JEFFERSON COUNTY COMMUNITY DEVELOPMENT 621 SHERIDAN ST, PORT TOWNSEND WA 98368
MANUFACTURED HOME INSTALLATION PERMIT APPLICATION
❑ NEW BUILDING REPLACEMENT
SIZE t q x 61
YEAR -+g7
MAKE 1 lakk>_>i
COST c3 SOOO
BEDROOMS: BATHROOMS:
EXISTING EXISTING
PROPOSED PROPOSED
TOTAL TOTAL
TYPE OF SEWAGE DISPOSAL: WATER SUPPLY:
SEWER ❑ COMMUNITY SYSTEM ❑ PRIVATE WELL 0 TWO PARY WELL
0 INDIVIDUAL SYSTEM 0 Conventional A PUBLIC
PERMIT # SEP 0 Alternative Name of water system: P a
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 Callto DATE F'`
NAME (PLEAS INT) Ir}M E /'Re✓ )c/Ds ,�„2
FOR OFFICE USE ONLY
BASE FEE , RECEIPT# `'?3LA1">"
ADDITIONAL SECTIONS CASH/CK#
L�
SUBTOTAL "`I DATE
POTABLE WATER •
911/ROAD APPROACH
TOTAL I ,
H:\HOME\PLN CNTR\FORMS\MO BI LEAP.10/99
MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION
• 7, Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00541 Received Date: 8/17/2000
SITE ADDRESS: 694 HIDDEN TRAILS RD
PORT TOWNSEND, 98368
APPLICANT: JAMES REYNOLDS JR PHONE: (360)379-8308
84 BOURBON LN
PORT TOWNSEND WA 98368
SUBDIVISION: Block: Lot: T 21
PARCEL NUMBER: 001082012 Section: 08 Township: 30 N Range: 01 W
CONTRACTOR/ OWNER PHONE:
DEALER: -
/ri-
CrrnCa Ar
r Review 5A // m//1
PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION — RI illc..0Ji . ±("
TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE:
TYPE OF IMP NEW MAKE: LIBERTY SETBACK:
VALUATION 5,000.00 YEAR: 1987
LABOR & INDUSTRIES APPROVAL?
SIZE: 14 X 66 BANK HEIGHT:
SEWAGE DISPOSAL: CON n T c
WATER SYSTEM: PUD I
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: Approved/Date
Manufactured Homes $141.00 MAM 08/16/00 33464
Potable Water Application $30.00 MAM 08/16/00 33464
Total: $171.00
is\F_BLD_App_Mob.rpt 10/29/99
STORMWATER CALCULATIONS
Owner/Applicant: �ilyY\C k'S-eife '
El PROPOSED LAND DISTURBING ACTIVITY
C ++
Site Address: 67 9 q Pi00e. `j,-"/} iS Drainfield area cleared sq.ft.
Driveway Length ft.
X Width ft.
9 Digit Parcel Identification No.: Q 0 I 0 S„' C) /. .. = 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 v sq.ft.
Draw entire parcel to scale. Indicate scale of plot plan:
One inch equals AN cox`,mj,e S r=-7- IMPERVIOUS SURFACE
Proposed Structures (all roof area) i ? sq.ft.
'5/1. North arrow Existing Structures (all roof area) i `)L, - sq.ft.
-2. All property boundaries and dimensions Sidewalks sq.ft.
(i . Names of adjacent streets Concrete Patios sq.ft.
. Driveway/s & parking spaces Proposed:
5.
Major features such as ravines, Driveway Length ft.
seasonal creeks, bodies of water, etc. X Width ft.
27
6. Septic tank, drainfield and reserve area location, = Total Driveway k sq.ft.
1. 'LI
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:
Wells and/or water lines • Construction Access Route Stabilization:
Neighboring wells within 1 50 feet Construction vehicle access shall be, whenever feasible,
limited to one route. Access points shall be stabilized with
" Paved surfaces (patios) quarry spalls or crushed rock to minimize the tracking of
i. Structures, existing and/or proposed sediment onto public roads. If sediment is inadvertently
Al
transported onto public roads, roads shall be cleaned
_ 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 . 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
G 16. Top of bank, if over 10 feet high their intended function.
LE 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
• 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: NIA ".-Retih M I .) J The purpose of this questionnaire is to obtain information
regarding either the current location of a mobile home or the
ADDRESS: �c;w.�ic � /-�`� previous ownership and location of a mobile home. This will
help our office determine whether the mobile home is already
Pt-c; "--Th a V--eiv*<.D Li« 9?'&E 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: 3((C '37'1 '8-301 additional information.
1) MOBILE HOME DATA:) p ^�
(A) MAKE ,,C.) 6414 (B) MODEL (C)U YEAR PJ /
L C
(D) LENGTH (. (E) WIDTH I (I (F)SERIAL NUMBER 0 ✓i-- D. ) 67 7/�
(G) YOUR PURCHASE PRICE(DO NOT INCLUDE SALES TAX) ✓' S (H) PURCHASE DATE 7f 4,av
2) PREVIOUS OWNER/ LOCATION OF MOBILE HOME:'
(A) FROM WHOM DID YOU PURCHASE MOBILE ill r,-p.;-eA
ADDRESS 'G- / 3 Rf}1I Ro e N
Paulsb,, Wri , y�.3 �c (�
(B) WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR? YES 6O /IF NO,WHAT COUNTY? 1 Pec...Lb. )
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 ONO
(B) IF LOCATED IN A MOBILE HOME PARK:
NAME az ADDRESS OF PARK SPACE NO.
(C) IF NOT LOCATED IN A MOBILE HOME PARK:
NAME OF LAND OWNER: ` me5 �etAl c,It�s J1
LOCATION (ADDRESS) / (I !-I ►nD�tir�, TgI /�S
REAL PROPERTY PARCEL NUMBER/DESCRIPTION 00 I — U 01
THANK YOU FOR YOUR HELP! G,
URE
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 °4-- ►1'l � 6� cs
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 _�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 • V Yes _ No
on your property or adjacent properties?
If YES, please describe:
4. Are there anyindications on anyproperty
portion of theor on any _ YES 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)
J J
/ / /
/ / / / / / / /
/ / / / / / / /
/ / / / / / //
/ / / / / / /
/ / / / / / /
/ / / / /I / / /////// //// / // / / / / -i/''-/ •
///// / /
///////
////////,//.
/////////
-----
(Questionnaire Continues on Back)
Page 1 of 2
6. Does the site have steep slopes with little to no vegetation? YES "--"/ 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 or
application review and any required later inspections. Access and right of entry to the applicant's property or structure shall be requested anc
shall occur during regular business hours.
Signature Date - - err()
.
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
7. Erosion ❑ Landslide
CSeismic ❑ Commercial Forest
Section Township North Range
Parcel Number: Parcel Size: .
Comprehensive Plan Land Use Designation: Reviewed by:
•
Community Plan: Date:
Page 2 of 2
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