Purchase a Manufactured/Mobile Home Permit


New Fields are available to record Contact name and phone number. If contact MUST be made to arrange access this is to be entered. Remember only when we must make contact for access to perform the inspection When requesting an inspection, please make sure you provide information as to what is to be inspected.

Job Site Information - * Indicates required fields
Applicant
Site owned by *
Mailing Address
Address *
City *   State *   Zip *  
Phone * - -   Ext.   999 999 9999 Ext. 99999
Fax - -   999 999 9999
E-Mail *   xxx@xxx.xxx
Enter Site Information - Accurate information below will aid the L&I Inspector in conducting the inspection
Site Address   Check if job site address is the same as the mailing address above.
SiteAddress *
Site Zip Code * Zip *     City *     State
Site Phone * - -    Ext.    999 999 9999 Ext. 99999
County (L&I Office) *
Work Description *
Driving Directions(from nearest main crossroad) *