Manufactured Home/mobile Home Building Permit Application Form printable pdf download

CANYON COUNTY DEVELOPMENT SERVICES DEPARTMENT

Avenue, #140  Caldwell, Idaho  83605

111 North 11

Phone (208) 454-7458 Fax: (208) 454-6633 

MANUFACTURED HOME/MOBILE HOME BUILDING PERMIT APPLICATION

Date: ____________________________ BP Number: ______________________________________________

Name Company Name

Name

Mailing Address / Business Address

Mailing Address

City, State, Zip

Phone Fax email address

Contractor Registration # Expiration Date

Property Owner Signature Date

Site Information

Site Address City, Zip

Parcel #

# of acres

Flood Zone

Yes / No

Subdivision Name if applicable

Lot

Block

Section

Township

Range

Quarter

Manufacturer Home Information

Home Manufacturer

Year Built

# of Transportable Sections

Width

Length

Sq Ft. of Living Space

Value

Please check only those that apply:

New

Move‐On

Used/Year_______________

Rehabilitation Complete

Standard Set (with skirting)

Air Conditioner

Heat Pump

Permanent Foundation

Attached Garage/Carport

Ad‐Valorem

Home to be declared as Real Property

Additions/Type __________________

Covered Porch/Patio

Declare as Real Property

Basement (furnish construction drawings)

**NOTE: MOBILE HOMES CONSTRUCTED PRIOR TO JUNE 15, 1976 REQUIRE MOBILE HOME REHABILITATION

In lieu of the Property Owner Signature, the Applicant/Builder affirms that he/she is an appointed representative of the property

owner for the sole intent of filing an application for this permit. Applicant/Builder agrees to indemnify, defend, and hold harmless

Canyon County, its elected officials, offices, departments, employees and agents against all liability related to signing this form.

Signature: ________________________________________________________ Date: ________________________________

All information provided within this application is correct to the best of my knowledge. I understand that the acceptance of this

application does not guarantee that a Building Permit or Zoning Compliance Certificate will be issued and that this application will be

used to help determine if the project complies with the Canyon County Zoning Ordinance and adopted Building Code.



All required documents must be turned in at the same time as this application. DSD will not accept/hold incomplete

applications. Building Permits do not start the approval process without all required documentation.



You will receive a call from our office when your permit is ready for pick‐up. You may do so between 8 a.m. and 4:30

p.m., Monday through Friday, excluding all legal holidays.

Applicant/Builder Signature: _________________________________________ Date: ________________________________

o:\admin\diana\forms\xxx.new form updates\building dept forms\612.manufactured.mobile bp.app.doc

Manufactured Home/mobile Home Building Permit Application Form

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