Fillable Planning & Development Department Building Code 2725 Judge (Brevard County Board of Commissioners)

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Planning & Development Department Building Code 2725 Judge (Brevard County Board of Commissioners)

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Page 1 of 2
Planning & Development Department
Building Code
2725 Judge Fran Jamieson Way
Building A, R
oom 114
Viera, Florida 32940
Email: InspectMail@brevardfl.gov
(321) 633-2187 Phone
AFFIDAVIT OF SAFE OCCUPANCY FOR USED MOBILE HOME
____________________
Building Permit Number
Site Address
___________________________ ______________________ ________ ____________
Street City State Zip Code
I hereby certify that the manufactured home to be installed at the above referenced address is safe
for occupancy.
_____________________________________________________
Home Manufacturer
_________________
Year Built
_______________________________________________
I-Beam Spread (if width of mobile home is 12 feet for more)
Federal Wind Zones from Mobile Home Data Plate: III (South Florida) II (South)
In the event the manufactured home is determined to be unfit for human occupancy when inspected
by the Brevard County Building Code Inspector, the manufactured home must be removed from the
property within five days. Failure to remove the home will result in appropriate Code Enforcement or
other legal action by the County against the property owner, mobile home park, and/or the mobile
home installer.
___________________________________________ ______________________
Printed name of Manufactured Home Installer License Number
___________________________________________ ______________________
Signature of Manufactured Home Installer Date
Page 2 of 2
Planning & Development Department
2725 Judge Fran Jamieson Way
Building A, Room 114
Viera, Florida 32940
Email: InspectMail@brevardfl.gov
(321) 633-2187 Phone
Subscribed and sworn to before me this _____ day of _______________, 20 ______, personally
appeared _____________________________________ who is personally known to me or produced
_________________________________________ as identification, and who did/did not take an
oath.
_______________________________
Notary Public Signature Seal
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Planning & Development Department Building Code 2725 Judge (Brevard County Board of Commissioners)

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Completed 5 August 2020

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