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7 <br /> 4 <br /> 6� LINN COUNTY PLANNING AND BUILDING DEPARTMENT <br /> ti Steve Wills—Director <br /> £' ' Rick Goff—Building Official <br /> 71:0- <br /> 4tzc9Th' Room 114,Linn County Courthouse <br /> PO Box 100,Albany,Oregon 97321 <br /> Phone 541-967-3816,Fax 541-926-2060 <br /> Linn County Planning and Building Department Ckecktist for <br /> Manufactured Homes <br /> Year Made 2O 2J 1 Make l alb, <br /> Size '2-1?t 6 Z Serial or X Number 1130 <br /> In an effort to have all the permits issued in one visit,please answer the following; <br /> Will the manufactured home be placed on concrete footings (runners)or a lab? <br /> If yes, who will be doing the work? Ch1A-lr/,LH (,{?/li IMA1o�/l. <br /> Check one of the following: <br /> El Single Wide [ Double Wide ❑ Triple Wide <br /> y' Will you be installing a new electrical service? - <br /> If yes,who will be doing the installation? I C Y1L <br /> OD Is your manufactured home equipped with gas.appliances? <br /> If yes,who will be installing the gas line? <br /> 111.0 Will you be installing a wood burning,pellet stove,or gas room heater? <br /> If yes,who will be doing the work? <br /> lVl) Will your manufactured home be equipped with a heat pump or air conditioner? <br /> If yes,who will be installing the electrical circuit(s)? <br /> ___ Will you or an electrical contractor be installing either a septic or well pump? <br /> If yes,who will be installing the electrical circuit(s)? <br /> ‘))1AARAt 9-41 1 ao-if <br /> Owner/Contractor Signature Date <br />