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DEPARTMENT OF BUSINESS AND INDUSTRY

MANUFACTURED HOUSING DIVISION

1830 E. College Parkway, Suite 120, Carson City, NV 89706

775-684-2940

Fax 775-684-2949

2501 E. Sahara Avenue, Suite 204, Las Vegas, NV 89104

702-486-4135

Fax 702-486-4272

mhd.nv.gov

Permit Application

Please submit the Application to the MHD office closest to the inspection site

Licensee Name: ___________________________________MHD License #:______________________

Phone: _________________ Fax: _________________ Email: _________________________________

Address of Job Site: ___________________________________________________________________

Property Owner’s Name: _______________________________________________________________

Owner/Builder Permit? (Circle)

If Yes, Owner Certification must

be attached.

Are there Approved Plans? (Circle)

If Yes, Plan Review # _________________________

Is this a Re-Inspection for a Failed Inspection? (Circle) Y N If Yes, Corresponding Permit #: ______

Are Utilities present? (Circle)

Are Utilities on? (Circle)

Scope of Work to be done (Brief Description): _______________________________________________

____________________________________________________________________________________

Type

Total

*Single Section Home Installation

$160.00 $

Multi-Section Home Installation

$240.00 $

Commercial Coach Installation (DRY)

$140.00 $

Commercial Coach Installation (WET)

$160.00 $

Re-Inspection (Use Prior/Failed Permit #)

$80.00 $

Pellet/Wood Stove Install

$90.00

Re-Roof, Water Heater, Furnace

$90.00 $

Basic Inspection: Minor Modifications to Electrical, HVAC, Plumbing, or

$90.00 $

Gas Systems

**Structural Remodel/Repair/Alterations (Includes Roofs)

$90.00 $

**Reconstruction of Electrical, Mechanical, or Plumbing System

$90.00 $

**Attached Accessory Structure

$90.00 $

Additional Inspection Time (Per ½ Hour)

$40.00 $

Compliance Label (May require an Inspection)

$50.00 $

*Single Section installations may require an additional inspection if utilities are unavailable

**Requires Plans and/or Multiple inspections

Location: (Multi inspections require multiple travel fees)

Total

Travel Fee

Total Amount Due $____________

I certify that I am the property owner, authorized by the property owner and am licensed with the Division, or an authorized

representative of a licensee who is authorized by the property owner and in that capacity will perform all work associated with this

permit. I have read this application and state that all information contained herein is correct and complete. I agree to comply with all laws

of the state of Nevada related to manufactured housing construction and hereby authorize representatives of the state to enter upon the

above mentioned property for inspection purposes. By signing this application, I acknowledge that it is my responsibility to ensure all

progress and final inspections are performed and failure to do so will result in disciplinary action and/or fines.

_________________________

Signature of applicant

Printed Name of applicant

Date

Note: This Permit will expire in 180 Days, unless an inspection is performed

Permit Number Issued: ____________________________________ Date Issued: ________________________________

Issued by: _____________________________________________ Office Location: _____Carson City _____Las Vegas

Revised 2/2016

Permit Application - Department Of Business And Industry - Manufactured Housing Division Form

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