From: Clark Public Utilities

To: House Move Customer

From: Clark Public Utilities

Date: May 5, 2005

Subject: Additional house/structure move provisions

Dear Sir or Madam:

Due to increased requests and the complexities of moving a house/structure, Clark Public Utilities has included additional requirements to the house/structure move guidelines. The additional requirements are immediately in effect, as follows:

1)Assessment by a Clark Public Utilities planner is mandatory prior to anyhouse/structure move.

2) A utility watchman is now required at the time of the house/structure

move, and it is the customer’s responsibility to inform Clark Public

Utilities of the time frames for the requirement.

Clark Public Utilities will continue to work with state, county, cities, and other utilities to make this process as safe and easy as possible. If you have any questions, or for more information on these guidelines, please contact me at (360) 992-8802.

Sincerely,

Bonnie J. Sant

Construction Services Manager

BJS/drk

Required Documentation for House Moves

The following documentation is required and must be submitted at the time of application. Applications that do not include this documentation will be returned and the hauler will need to reapply.

Copy of WashingtonState Contractor’s License

Location map showing proposed route

Written route

Certificate of Insurance

Approved building or storage permit

Copy of WashingtonState Escort Certifications

Proof that arrangements with the utilities or other facilities have been

made.

Current Equipment Inspection Certification Form showing decal

issuance

This information is required beforeClarkCounty will begin the review process. Applications that do not include this information will not be processed and will be returned to the hauler for completion.

Application for House/Structure Move

It shall be the mover’s sole responsibility to provide the required information listed below. A permit will not be issued if this application and the required items are not included. Any application missing information or required items will be considered an incomplete application and will be denied.

Once an application is denied, the mover will need to reapply. All re-applications will require an additional application fee and permit request.

Additional information or conditions not listed in this checklist may be required to determine application acceptance. (ClarkCountyCode 10.06)

Date of Application:
House Moving Company:
Address:
Copy of valid Contractor’s License / Date of Expiration:
Business Phone: / Owner of Company:
Agent’s Name: / Agent’s Phone:
Item being moved:

Building dimensions when loaded including eaves, porches, chimney, and other protrusions:

Length: / Width: / Height:

Acknowledgement of Representative Capacity from the owner of the company.

(Notarized statement to be attached)

Proposed date of move:
Start time: / End time:

I understand under penalty of perjury that the information given is true to the best of my knowledge.

Applicant Signature: / Date:
Company:

Office Use Only: Permit Approved Denied

Approval Signature

Applicant Checklist

Copies of the route approvals from all utility companies, including, but not

limited tothe following:

Clark Public Utilities (360) 992-1234

Qwest (360) 699-3635

Comcast (360) 518-1535

AT&T Corp.

Verizon

Other:

Notification to all other affected agencies, school districts, C-Tran, Sheriff’s

Office(Notification and verification is the responsibility of the mover):

C-Tran (360) 696-4494 / Date:
BattleGroundSchool District (360) 687-1479 / Date:
EvergreenSchool District (360) 604-4950 / Date:
VancouverSchool District (360) 696-7237 / Date:
Other School District: / Date:
Clark County Sheriff’s Office / Date:
West Precinct (360) 737-6079 / Date:
East Precinct (360) 253-2047 / Date:
Central Precinct (360) 737-6095 / Date:
911 Emergency Dispatch / Date:

Type of building to be moved (i.e. one story home, office building, etc):

Present Address:

Proposed route Written Map – showing directions

Copy of approved building permit(s): Check all that apply

City of Vancouver Permit / Permit No.
ClarkCountyPermit / Permit No.
Other: / Permit No.

Applicant Checklist (Continued)

Tow vehicle description

License number or trip permit number:

Copy of valid vehicle insurance (required)

Copy of approved inspection of all equipment for power unit, dollies, etc.

(required)

Surety bond of $100,000

WashingtonState licensed pilot cars required. License numbers of pilot cars:

1) / 2) / 3)

Permit fee paid (Required at time of application request)

Proof of Liability Insurance naming ClarkCounty as additional insured.

Insured amounts are as stated in Clark County Code 10.06.020 Section A.

Copy of WashingtonState Transport permit (if route is on or across a state road)

Copy of City of Vancouver Transport permit (if route is on or across a city road)

Move notification to area residents and/or businesses. House mover will

arrange to have a registered tow company available to move and replace

vehicles as needed. Notifications to include date and time of move:

City of Vancouver
ClarkCounty
Other:

Written House Move Worksheet

Written route must be submitted to all state, county, city, and utility agencies for approval.

Present address of structure:
New address where structure is being moved:
Date of move: / Time of move:

Building Dimensions:

Loaded Height:
Loaded Width:
Loaded Length:

Movement will be by the following route: (Hauler must attach a map that indicates the route.)

On / To / On / To
On / To / On / To
On / To / On / To
On / To / On / To
On / To / On / To
On / To / On / To
On / To / On / To
On / To / On / To
On / To / On / To
On / To / On / To
On / To / On / To
On / To / On / To
On / To / On / To
On / To / On / To
On / To / On / To

SignatureDate

House Movers Checklist

Please contact the utilities to obtain the following information.

This information must be obtained before any county permits will be issued.

CLARK PUBLIC UTILITIES
Conditions/Restrictions
Fee Paid / Date:
Route Approved / Date:
Crew Assistance / Date:
Approved by: / Date:
CABLE COMPANY
Conditions/Restrictions
Fee Paid / Date:
Route Approved / Date:
Crew Assistance / Date:
Approved by: / Date:
PHONE COMPANY
Conditions/Restrictions
Fee Paid / Date:
Route Approved / Date:
Crew Assistance / Date:
Approved by: / Date:
OTHER
Conditions/Restrictions
Fee Paid / Date:
Route Approved / Date:
Crew Assistance / Date:
Approved by: / Date: