Hamilton County Building Department County Court House Room NE First Street Jasper, FL Phone (386) Fax (386)

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1 Hamilton County Building Department County Court House Room NE First Street Jasper, FL Phone (386) Fax (386) APPLICATION FOR MOBILE HOME PERMIT - JENNINGS, FLORIDA Date: The undersigned hereby applies for a Mobile Home Permit and Certificate of Zoning Compliance: Owner of Property: Permission from the owner for the applicant to place a Mobile Home on said property. Witness of Signature of Owner. Name of applicant: 911 Address: Jennings, Florida Signature of 911 Address Director: Roger Ehlert (386) Home Phone: Work Phone: Sub Division Name (if applicable): Lot #: Lot Size: or Number of Acres: Width: Length: of Mobile Home Current Tag Registration or Bill of Sale with Tag Fee proof of being paid. (386) Signature of Tax Collector Office: Date: Legal Description of Property: Property Appraisers Office (386) Section: Township: Range: Parcel #: Page 1 of 6

2 Application Must Be Fully Complete Before Turning In To Building Department Town of Jennings - City Hall (386) Land Classification: Intended Use: The above said property does, does not, lie within the 10 or 100 year flood area, according to to the flood insurance rate map, dated June 4, 1987 Panel # of 285. Approval of Sewage and Water Connection ( Fee Paid ) from City of Jennings (386) Signature of Jennings City Manager: Date: PLOT PLAN Put down size of property you are placing your Mobile Home on. Show existing Buildings that are on the property now. All additions, porches, sheds, Etc. will have to be permitted in addition to your Mobile Home Permit. Set backs should be obtain through the Town of Jennings City Hall. Show which way North, South, East, and West on the property your Mobile Home is placed on. Show where our Well and Septic will be placed on your property. Write the name of the Street, Highway, or Road that runs in Front, Back, and/or Side of Property. YOU MUST HAVE ALL THIS INFORMATION ON THE PLOT PLAN OR YOUR APPLICATION WILL NOT BE COMPLETE!!! Page 2 of 6

3 Signature of Town of Jennings City Hall Official: Date: IMPORTANT NOTICE TO APPLICANT Display of Permit; Building permits shall be issued and on (1) copy shall be kept on the premises affected, prominently displayed and protected from the weather when construction work is being performed thereon. Any Mobile Home MUST have a Florida Licensed Installers Sticker on it. Expiration of Building Permit; Every permit issued shall become invalid unless the work authorized by such permit is commenced in the form of actual construction within six (6) months after its issuance, or if the work authorized by such permit is suspended or abandoned for six (6) month period or more, extensions of time, for periods not exceeding ninety (90) days each, may be allowed, and such extensions shall be in writing by the Land Use Administrator. Statements made by the applicant on the Building Department Permit application shall be deemed official statements. A Building Permit issued in error shall not confer any rights or privileges to the applicant to proceed to construction, and the Hamilton County Building Department shall have the power to revoke such permit if actual construction has not commenced. This application is made subject to all City, County, and State Ordinances and Regulations now in force or may hereafter be passed affecting or relating to this construction. The applicant hereby certifies that the above information and accompanying Plot Plan is true and correct. Signature of Applicant Date OFFICE USE ONLY Page 3 of 6

4 Date Received: Remarks: Owner: Home Phone: 911 Address of owner: City: Jennings Mobile Phone: Work Phone: Mobile Home Installer/Contractor: Work Phone: Mobile Phone: Address: City/ST/Zip: License Number: Expiration Date: Page 4 of 6

5 Detailed directions to the property: This application must be fully completed before returning it to the Building Department. If you bring it in, and the application is not complete, it will not be accepted. If you have any question please feel free to contact our office during regular business hours. Mobile Home set up and Sticker in place INSPECTION CHECK LIST FOR MOBILE HOME Electrical service poll set and wired to Mobile Home Air Conditioning and /or Heating installed and set up Well and Septic Tank installed and hooked up Steps with Handrails on both sides of steps, at each entrance Page 5 of 6

6 911 Address must be properly displayed If applicable, Culvert must be installed for Driveway Inspections will not be made on permitted construction work if the Permit or Notice of Commencement is not posted All of the above must be completed before calling in for a Final Inspection. There will be a $ reinspection fee if the Final Inspection is turned down or denied. Information Needed to Pull a Permit in Hamilton County Mobile Home application must be fully completed Must be a Licensed Installer in Hamilton County Must be State Registered or State Certified in the State of Florida Must have Liability Insurance Must have Worker s Compensation or be Exempted All information on Installer must be current and on file in our office Permits will not be issued without the 911 address, NO EXCEPTIONS!!! NOTE: If a permit is needed for; Set up and Tie Down of Mobile Home: $ Electrical: $ Mechanical/HVAC: $ Reinspection Fee: $ Page 6 of 6

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