Manufactured Dwelling Placement Permit Application

Manufactured Dwelling/Recreational-Park DEPARTMENT USE ONLY Trailer Placement Permit Application Permit no.: Office: Wallowa County Building Codes By: Issue date: 101 South River St., Room B-1 LOCAL GOVERNMENT APPROVALS Enterprise, Oregon 97828 Zoning approval verified: Yes No Phone: (541) 426-4543 Ex. 170 Fax: (541) 426-6046 Property is within flood plain: Yes No Web: www.co.wallowa.or.us Sanitation approval verified: Yes No Signature: This permit is issued under OARs 918-500-0105 and 918-525-0370. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. JOB SITE INFORMATION AND LOCATION Job site address: City: County: State: ZIP: Project name: FEE SCHEDULE Directions to job site: Description Cost ea. Qty. Total Dept. Use

(1) Manufactured dwelling (a) Placement per side (includes placement, electrical feeder, $210.00 Subdivision: Space/lot no.: water/sewer connection): DESCRIPTON OF WORK (b) Reinspection (per inspection): $100.00 Placement permit to be obtained only by homeowner or Oregon-licensed manufactured dwelling installer.

(2) Recreational-park trailer

(a) Installation (includes stand PROPERTY OWNER INSTALLATION and lot preparation; support blocking; anchoring; $145.00 Name: temporary steps; plumbing, Address: mechanical, and electrical): (b) Reinspection (per inspection): $100.00 City/State/ZIP: Electrical service permit to be obtained only by homeowner performing Phone: ( ) Fax: ( ) work or signing supervisor of Oregon-licensed electrical contractor E-mail: performing work. This installation is being made on residential or farm property owned by (3) Miscellaneous fees me or a member of my immediate family. (a) Surcharge, 12% (.12 x total): Signature: (b) Administrative fee for item (1) only: $30.00 1 $30.00 CONTRACTOR INSTALLATION GRAND TOTAL Business name: Address: City/State/ZIP: Phone: ( ) Fax: ( ) E-mail: CCB no.: MDI no.: Print name:

Signature: