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Home My WebLink AboutBLD2000-00558r . MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00558 Received Date: 8/25/2000 SITE ADDRESS: 534 COOK AVE EXT PORT TOWNSEND, 98368 APPLICANT: NEIL CAVETTE PHONE: (360)385-3247 BOX 1953 PORT TOWNSEND WA 98368 SUBDIVISION: TIBBALS LAKE PARK Block: 76 Lot: 2-10 PARCEL NUMBER: 999007603 Section: 04 Township: 30 N Range: 01 W CONTRACTOR/ CAVETTE CONSTRUCTION INC PHONE: (360)385-3247 DEALER: P O BOX 1953 PORT TOWNSEND WA 98368 Contractor's License CAVETCI050N5 Expires 07/26/2000 PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: FLEETWOOD SETBACK: VALUATION 22,000.00 YEAR: 1991 LABOR & INDUSTRIES APPROVAL? SIZE: 10 X 30 BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: CITY BEDROOMS: BATHROOMS: PARCEL TAGS: YES NO STORMWATER: YES NO Exist: Exist: AREA Plat Conditions Prop: 1 Prop: 1 Wetland Erosion Total: 1 Total: 1 Seismic Streams Flood Way Food Plane Routing Date: F&W Landslide -G - a _U 0 Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Manufactured Homes $141.00 MAM 08/25/00 34123 Total: $141.00 is\F_BLD_App_Mob.rpt 10/29/99 I` E Jefferson County Department of Community Development /�� oN co�� 621 Sheridan Street,Port Townsend WA 98368 (360) 379-4450 ;17 �SmNG ° Universal Plot Plan Fill in the following blanks as completely as possible : Project Description: � Via'' 2 %ff /` ))% / " !� i''' /"/ 9 Digit Parcel Identification Num rom your tx statement): Site Address / 911#: „3y Road Name: C 41/4 Zip Code: 95d' Legal Description _ n Subdivision Name: / ,149(5 446 ;/�(p/ � / /� Block: / � Lot(s): Section: Township: Range: Parcel Size (acres or square footage): r� 3J/ � M A Gd''cS Property Owner: - ( ,e7f__ 4/. / /1) Phone:5S q9 MailingAddress: ,..&77J 7 �G`2 cy/ Applicant/Occupant: Phone: (if different from owner) S7•-67:rL-9 Mailing Address: Authorized Rep: c ,9 Phone: Mailing Address: General Contractor: I ( /7Or Manufactured Home Installer: 6 Phone: 3 c `f- y ) Mailing Address: �d.....7y. <= Contractor's State License Number: ✓ /�70 C^i)N 5-.— Expiration Date: a _9_ 6 Septic Designer: y�%/ „, - S7-L.4- Q Phone: Mailing Address: SeY /2?/, 4d/-7? (al-- Architect/Engineer: /yew& Phone: Mailing Address: Loan Lender/General Phone: Contractor's Bond Holder: PI/el' ././ 6 Mailing Address: 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: 1(/ 6,6/47/„_ The purpose of this questionnaire is to obtain information regarding either the current location of a mobile home or the ADDRESS: /67,3 previous ownership and location of a mobile home. This will help our office determine whether the mobile home is already QLcr/7_5"E' / �� . n� on the tax rolls in Jefferson County or if it has been moved to 22// 3 this county from another area. Please see reverse side for 3 TELEPHONE NO: ` 3 c �� additional information. 1) MOBILE HOME DATA: (A) MAKE a,.//7�(J,06 (B) MODEL / /J/dQ (C) YEAR ` `/ (D) LENGTH 3i (E) WIDTH ! 6 (F) SERIAL NUMBER (G) YOUR PURCHASE PRICE(DO NOT INCLUDE SALES TAX) 4" 1 C1(J (H) PURCHASE DATE (fr-f -06) 2) PREVIOUS OWNER/ LOCATION OF MOBILE' OME: (A) FROM WHOM DID YOU PURCHASE MOBILE Q//!/7cC:7 ADDRESS "8 �! O (B) WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR? iglIO NO (IF NO,WHAT COUNTY? IF YES,WHAT WAS PREVIOUS ADDRESS OF MOBILE? 7 3 Lcs‘,/27/2.4 66, 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 a ADDRESS OF PARK SPACE NO. (C) IF NOT LOCATED IN A MOBILE HOME PARK: NAME OF LAND OWNER: A/,-Q/( 6a6 // E: LOCATION (ADDRESS) Y C oc REAL PROPERTY PARCEL NUMBER/DESCRIPTION �%�/x 99 9 ^`''d2 -CCo3 3/0'ck 7 7Fó 4/, .,,c/a;: ) THANK YOU FOR YOUR HELP! SIGNAT RE KELLI LARSON, roperty Technician THIS FORM CONFORMS TO THE STANDARDS OF THE STATE DEPARTMENT OF REVENUE AND IS SUBJECT TO AUDIT VERIFICATION. r JEFFERSON COUNTY COMMUNITY DEVELOPMENT 621 SHERIDAN ST, PORT TOWNSEND WA 98368 MANUFACTURED HOME INSTALLATION PERMIT APPLICATION ❑ NEW BUILDING ❑ REPLACEMENT SIZE 30 / .' ( 0 YEAR �Ql MAKE f-L / C)C/ COST 7 (� BEDROOMS: BATHROOMS: EXISTING 4— EXISTING4_ PROPOSED PROPOSED TOTAL 4— TOTALAL TYPE OF SEWAGE DISPOSAL: WATER SUPPLY: ❑ SEWER - 0 COMMUNITY SYSTEM 0 PRIVAT WELL 0 TWO PARY WELL ❑ INDIVIDUAL SYSTEM 0 Conventional UBLIC PERMIT # SE y Mit6Y RiAlternative Name of water system: C iti,,,,r /,i celd 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. Ac right of entry to the applicant's property or structure shall be requested and shall occur dur g regular bu ' ess hours. SIGNATURE .4_._ DATE �� 5.2 NAME (PLEASE PRINT) FOR OFFICE USE ONLY BASE FEE /V •"C0 RECEIPT# `, "y " ADDITIONAL SECTIONS CASH/CK# S 6/ + SUBTOTAL /�t-0 DATE 01 POTABLE WATER 911/ROAD APPROACH TOTAL t,U , H:\HOME\PLN CNTR\FO RMS\M O BI LEAP.10/99 6- =lIWO - 42623 MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION ...-------.. Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00558 Received Date: 8/25/2000 w SITE ADDRESS: 534 COOK AVE EXT PORT TOWNSEND, 98368 APPLICANT: NEIL CAVETTE PHONE: (360)385-3247 BOX 1953 PORT TOWNSEND WA 98368 SUBDIVISION: TIBBALS LAKE PARK Block: 76 Lot: 2-10 PARCEL NUMBER: 999007603 Section: 04 Township: 30 N Range: 01 W CONTRACTOR/ CAVETTE CONSTRUCTION INC PHONE: (360)385-3247 DEALER: P O BOX 1953 PORT TOWNSEND WA 98368 Stormw B Contractors License CAVETCI05ON5 Expires 07/26/2000 Required 5 .i ',` Crtica Wea1 ;' i`-- Revievu , ` '' PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: FLEETWOOD SETBACK: VALUATION 22,000.00 YEAR: 1991 BANK HEIGHT: LABOR & INDUSTRIES APPROVAL? SIZE: 10 X 30 SEWAGE DISPOSAL: ALT ) R : 2-- 0 WATER SYSTEM: CITY PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO Exist: Exist: AREA Plat Conditions Prop: 1 Prop: 1 Wetland Erosion Total: 1 Total: 1 Seismic Streams Flood Way Food Plane F&W Landslide Routing Date: -16 - 1 - _,0 Shoreline Aquifer•3 eh f, j./1 Forest: Commercial Rural / Type Amount Paid By: Date: Receipt: Approved/Date Manufactured Homes $141.00 MAM 08/25/00 34123 Total: $141.00 i:\F_BLD_App_Mob.rpt 10/29/99 Jefferson County Department of Community Development August 29, 2000 621 Sheridan Street, Port Townsend, WA 98368 (360) 379-4450 CRITICAL AREA STANDARD WAIVER Applicant: NEIL CAVETTE BOX 1953 PORT TOWNSEND WA 98368 Critical Area Review Case Number: CAR00-00384 Project Description: manufactured home installation Parcel Number: 999007603 S-T-R: 04-30N-01W Site Address: 534 COOK AVE EXT PORT TOWNSEND WA, 98368 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. Department of Community Development Staff c: File is\F_CAR_Waiver_Standrd.rpt 12/13/99 G 11 LI 9 • iip 0.