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HomeMy WebLinkAboutBLD2000-00803 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 #: BLD00-00803 Received Date: 12/12/2000 SITE ADDRESS: 1091 CHIMACUM RD Issue Date: 1/31/2001 PORT HADLOCK, 98339 Expiration Date 1/31/2002 APPLICANT: JANIE AMDAL PO BOX 758 PORT HADLOCK WA 98339 SUBDIVISION: Block: Lot: T 53 PARCEL#: 901114010 Section: 11 Township: 29 N Range: 01 W CONTRACTOR/ DEALER INSTALLER: JAMES HOESEL WAINS0250 Expires: 7/1/2001 641 PARISH RD SEQUIM WA 98382 PROJECT DESCRIPTION New Manufactured Home MAKE: RIDGEDALE YEAR: 2001 SIZE: 28x60 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 1/31/2002. REQUIRED INSPECTIONS: ] Setbacks: [ ] Footing(If continous footings are used)): Dle-__.?1,1../6/ [ Blocking/Plumbing:0� �/S/o� / FA/ Final/Skirting/Vents/Porches/Steps: ,,!C -' �' . 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. 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 #: BLD00-00803 Received Date: 12/12/2000 SITE ADDRESS: 1091 CHIMACUM RD PORT HADLOCK, 98339 APPLICANT: JANIE AMDAL PHONE: PO BOX 758 PORT HADLOCK WA 98339 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901114010 Section: 11 Township: 29 N Range: 01 W CONTRACTOR/ DEALER: INSTALLER: JAMES HOESEL WAINS0250 7/1/2001 (360)681-0871 641 PARISH RD SEQUIM WA 98382 PROJECT DESCRIPTION New Manufactured Home TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: RIDGEDALE SETBACK: VALUATION 62,680.00 YEAR: 2001 LABOR & INDUSTRIES APPROVAL? SIZE: 28x60 BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: PARCEL TAGS: YES NO STORMWATER: YES NO Exist: Exist: AREA Plat Conditions Prop: 3 Prop: 2 Wetland Erosion Total: 3 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 $137.00 PRB 12/12/00 35584 APPROVED Potable Water Application $27.00 PRB 12/12/00 35584 Total: $164.00 , /001 J R 'N •1 (-.r DEPT.OF CO NITY DEVE NT SIGNATURE: N OP 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 f,Yl REPLACEMENT /ci Z,f/Ze /2eLt> 5'ze SIZE a8X & 7 0� x �O YEAR /o/0a/ MAKE /�idgeda/e 41 4 /403 w ?d/Y)47? h'im s COST , 6 2 6 ?Q BEDROOMS: [ ,,,(,, BATHROOMS: 0 6 EXISTING 3 - / G raked EXISTING a. , de replaced' PROPOSED PROPOSED ea- TOTAL 3 TOTAL TYPE OF SEWAGE DISPOSAL: WATER SUPPLY: ❑ SEWER 0 COMMUNITY SYSTEM ❑ PRIVATE WELL 0 TWO PARY WELL INDIVIDUAL SYSTEM Conventional LR' PUBLIC a PERMIT # SEP 0 Alternative Name of water system: C((�( '� Pa rlit� IF WATERFRONT PROPERTY, J DISTANCE TO BANK OR HIGH WATER LINE OO 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 e• a/y4dai DATE 4/0/66 tl NAME (PLEASE PRINT)cTa1)/e , and David /9 , mda l FOR OFFICE USE ONLY BASE FEE l � coRECEIPT# ADDITIONAL SECTIONS ( CASH/CK# 1 SUBTOTAL DATE Iva-00 POTABLE WATER ;71 91 1/ROAD APPROACH TOTAL tl`JLtt nD H:\HO MEE\PLNCNTR\FO RMS\MOBI 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: .DaV/pr% f Sn/C nmd0/ The purpose of this questionnaire is to obtain information //�� regarding either the current location of a mobile home or the ADDRESS: Jog/ C h,macC!/'LJ /ed. previous ownership and location of a mobile home. This will n //�� ?_ help our office determine whether the mobile home is already ,ee X 7 gr. ,/. Had lock (v19. on the tax rolls in Jefferson County or if it has been moved to Q/ 33 this county from another area. Please see reverse side for TELEPHONE NO:.3(o© — 73a— 974z2 additional information. 1) MOBILE HOME DATA: (A) MAKE,geebnd y) //Y1e_S (B) MODEL/f 4ea'4/c y605 W (C) YEAR o?QQ/ (D) LENGTH 6 to (E) WIDTH pig. (F)SERIAL NUMBER (G) YOUR PURCHASE PRICE(DO NOT INCLUDE SALES TAX) 6/? tp 8'O (H) PURCHASE DATE 42/0O 2) PREVIOUS OWNER / LOCATION OF MOBILE HOME: / (A) FROM WHOM DID YOU PURCHASE MOBILE Bay717e /ljro`'j'1 cS ADDRESS 25+9 V43 /14u/y /0/ 69.Li/M GUAI. �O 38 2 (B) WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR? YES 0 (IF NO,WHAT COUNTY? A/O ✓6 IF YES,WHAT WAS PREVIOUS ADDRESS OF MOBILE? /Y h2�i met a irk 12r4i/ /2'/&O 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 et ADDRESS OF PARK SPACE NO. (C) IF NOT LOCATED IN A MOBILE HOME PARK: NAME OF LAND OWNER: .1//c, f-h n/e 4i' ,da LOCATION (ADDRESS) PO 30 X 7 -go /6.9/ LArngazav ied . QQ'/© �i- REAL PROPERTY PARCEL NUMBER/ DESCRIPTION G rce,l 3 o- Ere ect,J ,S /i �G729 ,e / w Tax 5'3 1DJ /l `f o/O J THANK YOU FOR YOUR HELP! (1 j 4 o/a-e SI ATURE KELLI LARSON, roperty Technician THIS FORM CONFORMS TO THE STANDARDS OF THE STATE DEPARTMENT OF REVENUE AND IS SUBJECT TO AUDIT VERIFICATION. OOil FACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00803 Received Date: 12/12/2000 SITE ADDRESS: 1091 CHIMACUM RD PORT HADLOCK, 98339 APPLICANT: JANIE AMDAL PHONE: PO BOX 758 PORT HADLOCK WA 98339 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901114010 Section: 11 Township: 29 N Range: 01 W CONTRACTOR/ DEALER: INSTALLER: JAMES HOESEL WAINS0250 7/1/2001 (360)681-0871 641 PARISH RD SEQUIM WA 98382 PROJECT DESCRIPTION New Manufactured Home TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: RIDGEDALE SETBACK: VALUATION 62,680.00 YEAR: 2001 LABOR & INDUSTRIES APPROVAL? SIZE: 28x60 BANK HEIGHT: SEWAGE DISPOSAL: p� WATER SYSTEM: 1` �41 BEDROOMS: BATHROOMS: PARCEL TAGS: E NOp< STORMWATE Y S NO Exist: Exist: AREA lat Condi .+ns OD Prop: 3 Prop: 2 Wetland ,� Erosion Total: 3 Total: 2 Seismic '? Streams / Flood Wa ir0 Food Plane ' Routing Date: F&W f () Landslide '1 Shoreline ID Aquifer , L Forest: Commercial k _;ural -,vi Type Amount Paid By: Date: Receipt: ,` ved/Date Manufactured Homes $137.00 PRB 12/12/00 35584 ,, b Potable Water Application $27.00 PRB 12/12/00 35584 0��f-‘-� Total: $164.00 ip,6 • .,,,,i;e.‘4N . ft) . is al 6. is\F_BLD_App Mob.rpt 10/29/99 —_� • Jefferson County Department of Community Development January 31, 2001 621 Sheridan Street, Port Townsend, WA 98368 (360) 379-4450 CRITICAL AREA STANDARD WAIVER Applicant: JANIE AMDAL PO BOX 758 PORT HADLOCK WA 98339 Critical Area Review Case Number: CAR00-00542 Project Description: Manufactured Dwelling Parcel Number: 901114010 S-T-R: 11-29N-01 W Site Address: 1091 CHIMACUM RD PORT HADLOCK WA, 98339 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 o proposed development activities will require further review pursuant to the Jefferson County Cr ti al Areas Ordinance. D partment of Community Development toff c: File is\F_CAR_Waiver Standrd.rpt 12/13/99 . . . ---------------„,_ - ......-I -........„ - --- % D - / I /..---- 1 „---- . . , . , . , ^I it' \44-117Th" 144) -t-n ( b0 1 _c r / 1 i . , , oz , 4 k i ' 1. • ........„ A2‘4 voil, ,.. r.4 , , 05f/ . /g -\"' . Pi. i 1-i-g-s-grP. \ ''' '' .,5 glii 14 11 -r/fs444.4fr'w \ Pv-4j1* ,Oh -',/I -f',fAc .,... , I . 2 a r 2.. . ( ____._._._.__________T>- , ,. i 011 ., , 0 - iii1 irt- 77,9 ., __tY rlicr; -P-r‘/a ' -4 .4,4t,titAgii \ , w g'ay c _--14.1,702 , ..-t , , , (-1— 1----- /cir?'141A 1A-4 ____ —— 1,)1 , - - - - - - ,-_,---- -, (1 i 'r1c161 . 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