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Mobile Home - TOWN OF SPRING LAKE MOBIL HOME PERMIT APPLICATION

By Anne Bradley,2014-05-06 10:12
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Mobile Home - TOWN OF SPRING LAKE MOBIL HOME PERMIT APPLICATION

    TOWN OF SPRING LAKE MOBILE HOME

    PERMIT APPLICATION

     PERMIT NO: MH-_______________

    Complete address where work will be performed: __________________________________________________

    Mobile Home Park Name: ______________________________ Lot No: ___________ Spring Lake, NC. 28390

    Zoning Class _____________

    Mobile Home Owner’s Name: ________________________________________________________________ Property Owner’s Address: ____________________________________ Phone No: ___________________

    Set Up Contractor’s Name: ___________________________________________________________________ Contractor’s Address: ______________________________________ Phone No: ___________________ NC License No: ___________________________ Spring Lake License No: ___________________

    Signature of Applicant: _____________________________________ Date: ___________________

    Print Name: _____________________________________

Electrical Contractor: ___________________________________________________________________

    Contractor’s Address: ______________________________________ Phone No: ___________________ NC License No: ___________________________ Spring Lake License No: ___________________

    Signature of Applicant: _____________________________________ Date: ___________________

    Print Name: _____________________________________

Mechanical Contractor: ___________________________________________________________________

    Contractor’s Address: ______________________________________ Phone No: ___________________ NC License No: ___________________________ Spring Lake License No: ___________________

    Signature of Applicant: _____________________________________ Date: ___________________

    Print Name: _____________________________________

Plumbing Contractor: ___________________________________________________________________

    Contractor’s Address: ______________________________________ Phone No: ___________________ NC License No: ___________________________ Spring Lake License No: ___________________

    Signature of Applicant: _____________________________________ Date: ___________________

    Print Name: _____________________________________

MOBILE HOME INFORMATION

    Make of Mobile Home: _________________________________________________ New ____ Used ____

    Size of Mobile Home: __________________________ Mobile Home Serial Number: _________________

    Electrical Service Size: __________________________ AMPS

    Year of Manufacture: __________________________

    ? Single Wide ? Double Wide ? Modular ? Construction Trailer Total Permit Fees $ _______________

Comments: ______________________________________________________________________________

     ______________________________________________________________________________

YOU MUST CALL TO SCHEDULE AN INSPECTION AT PROPER STAGE (S) OF WORK.

    CALL INSPECTIONS DEPARTMENT AT (910) 436-0241 TO SCHEDULE AN INSPECTION.

The Manufacturer’s Instruction Manual for setup must be available for all inspections at the mobile home/modular home.

    The undersigned hereby makes application for permit and inspection of work described, and agrees to comply with all

    applicable laws regulating the work performed.

Approved by __________________________________________ Date _________________________

    10/09

Disapproved by ________________________________________ Date_____________________________

10/09

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