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HomeMy WebLinkAboutBLD2000-00750 --'` MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00750 \...\ 4 i Received Date: 11/20/2000 SITE ADDRESS: 221 DIETZ DR QUILCENE, 98376 APPLICANT: JACK K BINNS PHONE: 221 DIETZ DR QUILCENE WA 983769600 SUBDIVISION: .-- 0 �l, Block: Lot: T 11 PARCEL NUMBER: 501031012 Section: 3 Township: 25 N Range: 01 W CONTRACTOR/ DEALER: INSTALLER: STEVEN BARRON WAINS0465 7/1/2001 (425)775-6433 FLEETWOOD HOMES EDMONDS WA 98026 PROJECT DESCRIPTION MANUFACTURED HOME REPLACEMENT TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: FLEETWOOD SETBACK: VALUATION 74,964.00 YEAR: 2001 LABOR & INDUSTRIES APPROVAL? SIZE: 66 X 27 BANK HEIGHT: SEWAGE DISPOSAL: OSS / 1 WATER SYSTEM: PWELL tZ� / ` BEDROOMS: BATHROOMS: PARCEL TAGS: YES NO STORMWATER: YES NO Exist: Exist: AREA Plat Conditions /' Prop: 2 Prop: 2 Wetland /1/porric, Erosion iv?) Total: 2 Total: 2 Seismic /"� Streams °, Flood Way ✓J Food Plane /�Ng F&W t"; �c Landslide/+ Routing Date: it Z�J0 , /6 &_ Shoreline Aquifer ,+://p Forest: Commercial Al//) Rural 7_ Type Amount Paid By: Date: Receipt: Approved/Date ..�, Manufactured Homes $141.00 MAM 11/20/00 35442 Potable Water Application $30.00 MAM 11/20/00 35442 .i i"', , .,. ' Total: $171.00 OA. . .rC 1;!;,, , 4 44.-(7?, A ir;(z, , 4tice. , it,,9 i:\F BLD_App_Mob.rpt 10/29/99 , K Jefferson County Department of Community Development December 6, 2000 ` 621 Sheridan Street, Port Townsend, WA 98368 (360) 379-4450 CRITICAL AREA STANDARD WAIVER Applicant: JACK K BINNS 221 DIETZ DR QUILCENE WA 983769600 Critical Area Review Case Number: CAR00-00502 Project Description: manufactured home replacement Parcel Number: 501031012 S-T-R: 3-25N-01W Site Address: 221 DIETZ DR QUILCENE WA, 98376 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. Dep rtment of Community evelopment taff g„ c: File I:\F_CAR_Waiver_Standrd.rpt 12/13/99 Dc-12-00 08: 50 P .Oi 12 December 2000 TO: Zoe Niswonger Jefferson County Permit Center FROM: Kari 4 Jack Binns RE: Building permit application Please cancel our recent building permit application and process any refund due, to be mailed to our address as shown on the permit application. Thank you_ MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00750 Received Date: 11/20/2000 SITE ADDRESS: 221 DIETZ DR QUILCENE, 98376 APPLICANT: JACK K BINNS PHONE: 221 DIETZ DR QUILCENE WA 983769600 SUBDIVISION: Block: Lot: T 11 PARCEL NUMBER: 5010310i 2. Section: 3 Township: 25 N Range: 01 W CONTRACTOR/ DEALER: INSTALLER: STEVEN BARRON WAINS0465 7/1/2001 (425)775-6433 FLEETWOOD HOMES EDMONDS WA 98026 PROJECT DESCRIPTION MANUFACTURED HOME REPLACEMENT TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: FLEETWOOD SETBACK: VALUATION 74,964.00 YEAR: 2001 BANK HEIGHT: LABOR & INDUSTRIES APPROVAL? SIZE: 66 X 27 SEWAGE DISPOSAL: OSS WATER SYSTEM: PWELL PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: 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 ��' �� f-ti4--- . Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Manufactured Homes $141.00 MAM 11/20/00 35442 APPROVED Potable Water Application $30.00 MAM 11/20/00 35442 D-,....k„. L3 t,4A Total: $171.00 D E C 1 1 2000 Jefferson County Planning & Building Department is\F_BLD_App_Mob.rpt 10/29/99 (iL. Q/ ? Ift JEFFERSON COUNTY COMMUNITY DEVELOPMENT 621 SHERIDAN ST. PORT TOWNSEND WA 98368 MANUFACTURED HOME INSTALLATION PERMIT APPLICATION 0 NEW BUILDING REPLACEMENT SIZE l`.)X J/ YEAR ).co I MAKE I tit w Oc ) 04A COST 471 q &f BEDROOMS: BATHROOMS: EXISTING EXISTING —Or-- PROPOSED PROPOSED TOTAL t ��, TOTAL TYPE OF SEWAGE DISPOSAL: WATER SUPPLY: ❑ SEWER 0 COMMUNITY SYSTEM PRIVATE WELL 0 TWO PARY WELL 0 INDIVIDUAL SYSTEM 0 Conventional ❑ PUBLIC per/ PERMIT # SEPO D 0 J ❑ 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 !A C., \ ' �- \ ,,ATE V ^ U() NAME (PLEASE PRINT) FOR OFFICE USE ONLY BASE FEE 141 , RECEIPT# 44 ADDITIONAL SECTIONS CASH/CK# 1O SUBTOTAL DATE // 6 0 0 POTABLE WATER �©r 911/ROAD APPROACH TOTAL , H:\HOM EtPLNCNTRIFORMS\MO8I LEAP.10/99 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: J Ae4, K , ).N NIj The purpose of this questionnaire is to obtain information ADDRESS: .,4N I I CT 7- /DK , regarding either the current location of a mobile home or the previous ownership and location of a mobile home. This will A �cr�.lj� ,_ `./, • 9 m 76 help our office determine whether the mobile home is already l� V°Y ly / 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: additional information. 1) MOBILE HOME DATA: r� t�� WOOD (A) MAKE (B) MODEL �� �� (C) YEAR ( 0) (D) LENGTH 66 (E) WIDTH •7 } (F) SERIAL NUMBER (G) YOUR PURCHASE PRICE(DO NOT INCLUDE SALES TAX)` 74 I + (H) PURCHASE DATE 2) PREVIOUS OWNER / LOCATION OF MOBILE HOME: (A) FROM WHOM DID YOU PURCHASE MOBILE ADDRESS (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 a ADDRESS OF PARK / " SPACE NO. (C) IF NOT LOCATED IN A MOBILE HOMEI PARK: NAME OF LAND OWNER: v'i( k k \ gi/V / ,/� LOCATION (ADDRESS) ) -v C.� 1, b k . �'� q I L� , v�� V . �e� r, q REAL PROPERTY PARCEL NUMBER/ DESCRIPTION MALT 6 S ti IRv 1 A� ), I cI�fj pV�V'- dp7w P(`y rJ f PDT 1I oN Off_ ' W /L) or rt,, �C t��' (. Scj-iorJ 3� Ti4'Q/ ° U1.J Pico 6, iC/�il1E 1 W,T"v r, LY r N(' ScA H r /j/ ZeL Pr- R.D. 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. 3357B 4 iE y .$ A 8 &l4 �^ ArminArmin11�riA1 IOIiYYIgStt] �, Els" iiigNiutiiit§l§ et, _ :Or r- 4°. Cn .R gillit45ili ':241‘1,,,, -7 •'"- s ''. - % s131 1 i.� al jam❑ �<���m<„ b v . g $ R $ s 0 •o §§ . . 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