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HomeMy WebLinkAboutBLD2002-00287 • i M LA02-00279 Review Type:I MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD02-00287 Received Date: 5/15/2002 SITE ADDRESS: 211 SMITH LANE QUILCENE, 98376 APPLICANT: MARIBETH T DUFFY PHONE: (360)280-9903 JEFFREY W NEJEDLY 1318 25TH AVE LONGVIEW WA 98632-3647 SUBDIVISION: Block: Lot: PARCEL NUMBER: 501032023 Section: 3 Township: 25 N Range: 01 W CONTRACTOR/ OWNER PHONE: DEALER: REPRESENTATIVE: PROJECT DESCRIPTION: MANUFACTURED HOME INSTALLATION TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: REDMAN SETBACK: VALUATION YEAR: 2000 LABOR& INDUSTRIES APPROVAL? SIZE: 28 X 56 BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: PARCEL TAGS: YES NO Exist: Exist: STORMWATER: YES NO Prop: 3 Prop: 2 AREA Plat Conditions Total: 3 Total: 2 Wetland Erosion Seismic Streams Flood Way Floodplain Routing Date: r'' F&W Landslide `, �(5-/o _ `2_ Shoreline Aquifer Type Amount Paid By: Date: Receipt: AFtrinceivED Manufactured Homes $151.00 MAM 05/15/02 47637 Potable Water Application $50.00 MAM 05/15/02 47637 SEP _ 4 2002 Total: $201.00 Jefferson Co- ;t PIP, ,, & Bt9 l?cid I+vi, • .. 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 PERMIT#: BLD02-00287 Received Date: SITE ADDRESS: 292 SMITH LN 5/1 QUILCENE, 98376 ((e $'L "ru.A Issue Date: 9/4/2002/2002 APPLICANT: MARIBETH T DUFFY -`42-1/4 103 JEFFREY W NEJEDLY ' Lo. o,c 1318 25T • a ) L IEW WA 98632-3647 SUBDIVISION: Block: Lot: PARCEL* 501032023 Section: 3 Township: 25 N Range: 01 W CONTRACTOR/ OWNER DEALER PHONE: PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION MAKE: REDMAN YEAR: 2000 SIZE: 28 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 9/4/2003. REQUIRED INSPECTIONS: [ ] /Footing (CONTINUOUS FOOTING, SLAB or PADS USED): [ ] Blocking/Plumbing: [ ] Zoning Approval: [ ] Septic System Approval: [ ] Final/Skirting/Vents/Porches/Steps: 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. SPECIAL CONDITIONS APPLY - SEE REVERSE HOT-LINE AVAILABLE 24 HOURS A DAY 1 e" • • I. i: _ i JEFFERSON COUNTY COMMUNITY DEVELOPMENT 621 SHERIDAN ST. PORT TOWNSEND WA rk..-1 ' i "' MANUFACTURED HOME INSTALLATION PERMIT APPLICATION gi 4 : NEW BUILDING 0 REPLACEMENT 02? Y 5( a r SIZE .� r,7 11_ YEAR ,;'fM(O C � ��C - a MAKE Ceci,rita rt L\' (1 i� c Io0 1'S{o 3 COST BEDROOMS: BATHROOMS: EXISTING ✓ EXISTING PROPOSED � PROPOSED o? TOTAL 3 TOTAL TYPE OF SEWAGE DISPOSAL: WATER SUPPLY: 0 SEWER 0 COMMUNITY SYSTEM PRIVATE WELL 0 TWO PARY WELL &NDIVIDUAL SYSTEM ti Conventional ❑ PUBLIC PERMIT#SEP 01"0-0R2,.o Alternative Name of water system: IF WATERFRONT PROPERTY, fJ/A. 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.. / _ -75V-‘4,...../2' ��-� j DATE I Z'��l NAME (PLEASE PRINT) /"/ 7 a k //'j Acf O-tc /Li, © . JP 1 Q Q A\")\ Cv rme rvl S FOR OFFICE USE ONLY CONSISTENCY REVIEW FEE 1 /8 39.00 RECEIPT# , BASE FEEI T'� A ADDITIONAL SECTIONS /f ll CASH/CK# /Dc3 /SUBTOTAL ; 1�L�( l ' "© DATE f45 Q POTABLE WATER v /' r ` 911/ROAD-APPPRROACH OP . . � a, .)a`�� , ,". TOTAL '�` V o tr _ cf H:WOME PLNCNTRVNFOBLDFORMSIMOBILEAP.11/26/01 Eli" RPf{j(,IL�p` ..C8Z . OO+ -I. t----; F•CEK�4/"�!'KL¢,�` VT------- ! '1 / 'N1cu11 w ac"4--4-4.re cr 1-1- -►,... , / 1=00� � �,ti{ - L� xS(O • / , f&63B 0 �, APPROVED' gi mi SITE PLAN • I , 4. �� JUL 2 2002 'o,, Su` Set Lack 4 _ y i0 OP- ,,�►oP fSON COUNTY - scr ru°E," , ' ri z v lit, ' li ,o,,,,, ./. . . e r' ,Y„ _.,_e ''' ev z -1.4 o li 9 s J \3%.,t, .1-. _ _ , I / rr p �mil. P\ 0' / \ ' \ _, / \ `\ . ‘,. �� \\\S:si ' \ 1 \ V t \\I \'\''N we LL -4 I k \\--7-<X�4 / a' . EL E t: I od �743 i Kl �, • IP .\ . . ,.„, �6r� `�� L T IZ (��rA ?0) Jvv-iit �1 L . I C 0 t,J�A - Cv T-,k -_ zr 5-0/ o, z C>2 oI'��'P 1/J�, 5? 2-- L / b0 ' =' N (360) 570-- Sk4 3y ..\ � 50 PP __,,,,`' ' /5.,11zy / 5 /Z•n-/ 5:0 CZ L'! `, s�C 00 C , "1 MAY 1 5 2002 V t_ .J .,1 L'.1 i'r' DEPT Or COMMUNIIYDEVELOPMENT 7.( / LGUiQR-LUCL_ `g12..3040 - trcfista.aO Crk propCitLO Q..eiv\) -us'asz.,0L:v -22- -(?,"1