The URL can be used to link to this page

Home My WebLink AboutBLD2002-00376 410 • 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 #: BLD02-00376 Received Date: 7/1/2002 SITE ADDRESS: 107 CEDAR AVE Issue Date: 7/18/2002 PORT HADLOCK, 98339 APPLICANT: GERTRUDE B ADAMS 94 ALDER DR PORT TOWNSEND WA 98368-9460 SUBDIVISION: HARRISBURG Block: 10 Lot: 3,4+ PARCEL#: 956701003 Section: 2 Township: 29 N Range: 01 W CONTRACTOR/ OWNER PHONE: DEALER PROJECT DESCRIPTION MANUFACTURED HOME INSTALLATION MAKE: GOLDEN WES YEAR: 1990 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 7/18/2003. REQUIRED INSPECTIONS: [ J /Footing (CONTINUOUS FOOTING, SLAB r PADS USED . fig a [ ] Blocking/Plumbing: �i� rij/Z [ J Zoning Approval: [ ] Septic System Approval: itordildon [ ] Final/Skirting/Vents/Porches/Steps: -Qcsr &.b 443/U3 gr 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 • • SPECIAL CONDITIONS CASE # BLD02-00376 1.) The application was reviewed by the Jefferson County Department of Community Development for the presence of Environmentally Sensitive Areas (ESAs). The Department conducted a review and has concluded that the property DOES NOT contain Environmentally Sensitive Areas. However, future proposals will be subject to a new ESA review and conditions may be added if new ESAs are found on the property. 2.) The project shall adhere to the Best Management Practices (BMPs) to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 3.) Jefferson County determined that this proposal is categorically exempt from review under the State Environmental Policy Act(SEPA) pursuant to WAC 197-11-800(1)(b)(i). 4.) The site plan as submitted with the manufactured home building permit application on July 1, 2002 has been reviewed for consistency under the UDC, and has been approved by Jefferson County Department of Community Development. Any modifications, changes, and/or additions to the stamped, approved site plan dated July 17, 2002 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 5.) This approval is for a manufactured home only. Any future permits on this site are subject to review for consistency with applicable codes and ordinances and does not preclude review and conditions which may be placed on future permits. 6.) The parcel has been designated as RR 1:5 under the Jefferson County Comprehensive Plan Land Use Map effective August 28, 1998. 7.) An address of 107 Cedar Avenue, Port Hadlock has been assigned to the parcel. 8.) A septic permit(SEP01-0217)was issued on November 19, 2001. 9.) Potable water is provided by PUD#1. 10.) A Boundary Line Adjustment was finaled on November 15, 2001 under AFN 449580. 11.) The building height shall not exceed 35 feet. 12.) Minimum setback from Stevens Steet right-of-way shall be 20 feet. Minimum side and rear setbacks shall be 5 feet. Minimum setback from septic tank to foundation is 5 feet. Minimum setback from drainfield field and reserve drainfield to foundation is 10 feet. 13.) Stevens Street is a county local access road (C643009). • MP MLA02-00358 Review Type:I MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD02-00376 Received Date: 7/1/2002 SITE ADDRESS: 107 CEDAR AVE PORT HADLOCK, 98339 APPLICANT: GERTRUDE B ADAMS PHONE: (360)385-4088 94 ALDER DR PORT TOWNSEND WA 98368-9460 SUBDIVISION: HARRISBURG Block: 10 Lot: 3,4+ PARCEL NUMBER: 956701003 Section: 2 Township: 29 N Range: 01 W CONTRACTOR/ OWNER PHONE: DEALER: REPRESENTATIVE: CHRIS ADAMS 94 ALDER DR PORT TOWNSEND WA 98368 PROJECT DESCRIPTION: MANUFACTURED HOME INSTALLATION TYPE OF WORK MOB MANUFACTURED HOME: r SHORELINE: TYPE OF IMP NEW MAKE: GOLD ES SETBACK: VALUATION 22,000.00 YEAR: a1998 /(:, LABOR & INDUSTRIES APPROVAL? SIZE: 28 X 56 BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: PUD 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: 7(7,102_ rie F&W Landslide Shoreline Aquifer AP r Type Amount Paid By: Date: Receipt: 8 Manufactured Homes $151.00 MAM 07/01/02 47979 JUL 1 Potable Water Application $50.00 MAM 07/01/02 47979 2002 " ' Total: $201.00 Jefferson County Planninrg. rinaePartmer;‘/ �Q JEFFERSON COUNT•OMMUNITY DEVELOPMENT 621 SHERIDAN�PORT TOWNSEND WA 98368 MANUFACTURED HOME INSTALLATION PERMIT APPLICATION NEW BUILDING 0 REPLACEMENT I„, SIZE 22 k 56 JUL .. f 2002 I 4 r 4� YEAR l! � 1U y' I E MAKE C M, . r� _.` �i ;-OPMFNr COST -2/COD BEDROOMS: BATHROOMS: EXISTING EXISTING 0 PROPOSED 3 PROPOSED TOTAL TOTAL TYPE OF SEWAGE DISPOSAL: WATER SUPPLY: 0 SEWER 0 COMMUNITY SYSTEM ❑ PRIVATE WELL 0 TWO PARY WELL Ill INDIVIDUAL SYSTEM 0 Conventional Iii PUBLIC PERMIT#SEP p Alternative Name of water system: i- 1,) 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; WI. r t[ J SIGNATURE DATE / a z/0 NAME(PLEASE PRINT) FOR OFFICE USE ONLY CONSISTENCY REVIEW FEE 47.00 RECEIPT# 4 l c_I ct BASE FEE 15( r eD C.� //�� ADDITIONAL SECTIONS // `� CO CASH/CK# `4O SUBTOTAL l`t U• DATE 7 / 1 I 67-. POTABLE WATER 'V . 0 911/ROAD APPROACH 0 TOTAL 2141 .03 H:W OME\PLNCNTR\INFOBLD\FORMS\MOBILEAP.11/26/01 --APPLICATION FOR PERMI. ,\ . Jefferson County � r(�'� \ 0 r� Department of Commu �velopment z 621 Sheridan Street i , ; dt)L �/ a:C:-------\----------1 Port Townsend,WA 98368 "� e,,,f.,_ :,,,%,,,,,,,,,,,i0-:__,,i,:::t..„:..',..-„,,'„,,ai,,...:.,itij e 1= ` -rdP0 (360) 379-4450 or 1-800-:31-2678 ;,:*,' r7t 1' r APPLICA'.• EASE PRINT OR TYPE ALL INFORMATION - CHECK BOXES THAT APPLY laRoad Approach ❑ Road Approach Permit&Address ❑ General Permit Fee: $141.00 Fee: $141.00 Fee: $141.00 ❑ Utility Class A ❑ Utility Class B ❑ Yearly Class A Fee: 20%of Class B Fee: $141.00 jay ( ( 1-lQ F-e: 141.00 County Road Name: PI V"�- �5112-1 �� C)`r _� " i � r 6 Intended use of County Right-of-Way is to construct,operate and maintain a: qI arress 1-5 r .BOA / Gras a "✓ta ,5 ki'n Shur lea I hereby designate5 Applicant (Owner, Utility, or Authorized Represents 1 e. to ac^tAs my agent In matters related to this c_± .`t( �Q2.5' . d forpg ,Its) ��2- rA/� 1�J 7/ O� C20�Qf� v'f r I��Gi t 6 G`)ld Mailing Address Applicant Signs re Date OKl 7Uwn 3- CC/)- 94' ' 9 s6 7G/ co 3 ity-State-Zip Code Parcel Number 36a -3ts rde-7Y6o 77Y--7560 rh K 4//•r� 7 / oZ Telephone No.Tele P FI grog Co r&Date ACKNOWLEDGEMENTS By signing the application form,the applicant attests that the information provided herein Is true and correct to the best of their knowledge and agrees to al conditions on the permit. I also certify that this application is being made with the full knowledge and consent of all owners of the affected property. Any material falsehood or any omission of 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 Iiablities,judgment,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 Its employees,representatives or agents for the sole purpose of application review and any required later Inspection. This right of entry shall expire when the County concludes the application has complied with all applicable laws and regulations. Access and right of entry to applicant's property shall be requested and shall occur only during regular business hours. The action or actions Applicant will undertake as a result of this permit may negatively Impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the"Endangered Species Act"or"ESA." Jefferson County makes no assurances to the appicant that the actions that will be undertaken because this permit has been Issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your actiort(s)even if you are in compliance with the Jefferson County Development Code The Applicant acknowledges that he,she or it holds individual and non-transferable responsiblit for adhering to and complying with the ESA. The Appicant has rea this dis laimer and signs and dates it below. /0 Z--- (APPL CANT OR AUT IZED REPRESENTATIVE SIGNATURE) (DATE MAKE CHECK PAYABLE TO JEFFERSON COUNTY Updated 12/19/01 IF 46° l RETURN ADDRESS odY. 70 C4\5 LJSTATE OF WASHINGTON MANUFACTURED HOME � � F��d°1 x�'';'�`�� L/l De=artmentof TITLE ELIMINATION icEnsInc APPLICATION TRANSFER IN LOCATION Anyone who knowingly makes a false statement of a material fact is guilty ❑REMOVAL FROM REAL PROPERTY of a felony, and upon conviction may be punished by a fine,imprisonment,or both.(RCW 46.12.210) D MANUFACTURED HOME TPO/PLATE NUMBER R MAKE , LENGTH/WIDTH(FEET) VEHICLE IDENTIFICATION NUMBER(VI �' tiv fm x ?�� L;9S92cl7 ti° .. ® LAND LEGAL DESCRIPTION ON PAGE REA OP�TY A E N MB R MANUFACTURED HOME WILL BE al AFFIXED ❑ REMOVED �� LOT f BLOCK • PLAT NAME �w , SEECTION/TOWNSHIP/RANGEy ® GRANTOR(S)REGISTERED/LEGAL OWNER(S) ADDITICI NAMES ON PAGE COUNTY NUMBER NUMBER OF REGISTERED OWNAcw NUMBER OF LEGAL OWNERS Chti s sTy NAME OF RF,GISTERED OWNt- NAME OF ADDITIONAL REGISTERED OWNE ADDRESS CITY STATE ZIP CODE 9 LI Al Aar- R Wit . nS \. .i7 NAME OF LEGAL OWNER (Tr5 tt Tv--,-)A-1c; ,5 NAME OF ADDITIONAL LEGAL OWNER ADDRESS "i ` ey..,..k ITY 9 �6 1STATE IPCo.E GRANTEE NAME I DO SOLEMNLY ATTEST UNDER PENALTY OF PERJURY THAT I/WE A / E TH ISTERED OWNER(S)OF THIS VEHICLE AND THIS INFORMATION IS ACCURATE: ". /�' Signature of Registered Owner and Title,IF APPLICABLE a /6,, Signature of Additional Registered Owner and Title,IF APPLICABLE NOTARY SEAL OR STAMP NOTARIZATION/CERTIFICATION FOR REGISTERED OWNER(S)SIGNATURE State of Washington Signed or attested County of before me on by Signature PRINT NAME OF REGISTERED OWNER NOTARY OR AGENT by PRINT NAME OF REGISTERED OWNER PRINTED NAME OF NOTARY County/Office No.OR Title AND: Dealer No.OR DEALERSHIP POSITION/AGENT/NOTARY Notary Expiration Date 4 TITLE COMPANY CERTIFICATION I certify that the legal description of the land and ownership is true and correct per the real property records. NAME(TYPED OR PRINTED) TITLE COMPANY/PHONE NUMBER SIGNATURE/POSITION DATE Finalize this application with a Licensing Agent within 10 calendar days of the date Title Company Representative signs. ® BUILDING PERMITOFFICE CERTIFICATION I certify that: ❑ the manufactured home has been affixed to the real property as described. ❑ a building permit has been issued for this purpose and the attachment will be inspected upon completion. NAME(TYPED OR PRINTED) BLDG PERMIT OFFICE/PHONE# BLDG PERMIT# SIGNATURE/POSITION DATE TD-420-729 MANUF HOME APPL(R/8/98)OR Page 1 of 2 ,_r----------.)) , I I II': ri ji,r. 1),.,(.1.'3 1 i - 1 ACJCVNAS . . I 1 .' . - . trq : 1." r 10: Ave . u." L............___ ,_.._: R)ri ci It:x.1N,, ,„...- ._. , - ,--------- a. (ID r+k wc, u.: 1,...-:_:..... ; 0 Lo+ c_ sck ---.' i 0 Pe,e4- c't SG 7C, 1 0 0 TC\`'..' i • 1 Re-s tt„.1 c3(gki401-' Dr ---rcuv\cwa:-t , 83'• ..-.645 - I CirciNis. Aawis .,...,\c ..b.. . Li a t , . . . 51 . . : .. . 55 / P.se serve ArQ.ck .,c.E. ite 00' )... i . 12 i r5c14 \k. ,.. ..........,....______,..., ._...,,,,,,__ . (...i lir 1 71„..-v 1--- / _ „,........, A ) / stonnwater Bmp,„ Requi iv 4v .) . .., , k...,;, , 1 Il "4 , , L ,., . . , , . ____________,..____________._......„.__._ ,..._ :_,...,. i. 1 • ----- 56" APPROVED SITE PLAN 1 / \c), (:) ) \ , , c--) : n / skiAl , ..----- - 2.---1 I 0\330---\,, , .. i ,', JUL 1 7 2002 1 V I i JEFFER N CO S?OrATUR.°I? 0 . VELOP ENT IN . k li \\_3°1 1 Pckirk u rt ----- ' v es. .....j/ \\/\ .#4., _________ &____ (70 --....._____> v , verNS. S+Ceiir (..., V ' ‘IP 0 N, .. . St * c..'t . (k. Li Wok-6r Li-xra Na ())