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Title Type Number
Air Conditioner / Heat Pump Pre-Inspection Checklist

This checklist is designed to be generic in content and may not include all requirements for your particular installation.

Form F622-014-000
Alteration Fire Safety Pre-Inspection Checklist
Available in: Spanish

Checklist for homeowners on how to upgrade their pre-HUD homes to approach the HUD standards in the area of fire safety.

Form F622-011-000
Alteration Fire Safety Pre-Inspection Checklist -Spanish
Available in: English

Checklist for homeowners on how to upgrade their pre-HUD homes to approach the HUD standards in the area of fire safety.

Form F622-011-999
Alteration Polybutylene Re-Pipe Pre-Inspection Checklist

This checklist is used by the contractor when altering a polybutylene re-pipe. Be sure you can answer YES to all questions before calling L&I for an inspection.

Form F622-053-000
Alteration Re-Roofing for Low Slope Roofing

Checklist used by the contractor when altering a low slope roof.

Form F622-039-000
Application for Insignia Conversion Vendor/Medical Units

Used to apply for an official insignia for conversion vendor or medical unit factory-assembled structures. See sample form for instructions about how to fill out the form correctly.

Form F623-021-000
Application for Insignia for Commercial Coaches

Manufacturer uses this form to apply for an official insignia for commercial coaches that have a plan approval number.

Form F623-019-000
Application for Insignia for Factory Built Structures

Manufacturer uses this form to apply for an official insignia for a manufactured / mobile home that has a plan approval number.

Form F623-014-000
Application for State Plan Insignia for Recreational Vehicles and Recreational Park Trailers

To apply for an insignia for a recreational vehicle.

Form F622-021-000
Application to Establish an Factory Assembled Structure Deposit Account with the Dept. of Labor and Industries

Use to establish a factory assembled structure (FAS) deposit account. FAS deposit accounts are for businesses or other entities that are not currently licensed or registered with L&I as electrical or construction contractors but are legally required to purchase work permits from L&I. (3 pgs)

Form F120-116-000
Copper Tubing Gas Line Pre-Inspection Checklist

This checklist is used by the contractor when installing gas lines with copper tubing. Be sure you can answer YES to all questions before calling L&I for an inspection.

Form F622-046-000
Decertification of Manufactured and Mobile Homes

This document shows the steps to decertify a manufactured or mobile home.

Form F622-063-000
Electric / Gas Conversion Pre-Inspection Checklist

This checklist is generic in content and may not include all requirements for your particular installation. The manufacturer's installation instruction must be adhered to and available to the inspector at the time of the inspection.

Form F622-013-000
Electrical Plan Approval Request - Factory Built Structures & Commercial Coaches

Used by the manufacturer to request approval from L&I on an eletrical plan to build manufactured / mobile home(s) or commercial coaches.

Form F623-016-000
Factory Assembled Structure Alteration Permit Refund Request

A form to request a refund for a factory-assembled structure alteration permit.

Form F623-025-000
Factory Assembled Structures Alteration Application

Used by a homeowner or contactor to request a field inspection for an alteration to a manufactured or mobile home.

Form F622-036-000
Flood Damaged Manufactured Home Checklist

Checklist on how to repair a flood damaged manufactured home. After the contractor has done all that is required by the checklist they call L&I for an inspection.

Form F622-040-000
Gas Piping Test Affidavit

You fill out, print and make a copy of this form on your company's letterhead. This affidavit must be available for the L&I inspector when the inspection is made.

Form F622-048-000
Gas Room Heaters Pre-Inspection Checklist

This checklist is used by the contractor when installing gas room heaters. Be sure you can answer YES to all questions before calling L&I for an inspection.

Form F622-045-000
Homeowners Manufactured / Mobile Home Variance Request

This variance request applies only to the installations performed by a previous owner and does not apply to any home during the warranty period.

Form F622-054-000
Insignia Continuation Sheet Recreational Vehicles and Park Trailers

Continuation sheet to apply for an insignia.

Form F622-021-111
Is it a Manufactured / Mobile Home?

If your home has any of the items in this document, it is a manufactured / mobile home and requires inspections for all alterations by L&I's Factory Assembled Structures Section.

Form F622-043-000
Low Voltage Fire / Intrusion Alarm Checklist

This checklist is designed to be generic in content and may not include all requirements for your particular installation.

Form F622-038-000
Notification to Local Enforcement Agency

L&I sends this form to notify the local agencies when a modular/moblie home is being built within a county or city limits.

Form F623-013-000
Panel Load Calculations

Listing of Connected Loads and the Demand Loads. Used for all appliances that are fastened in place, permanently connected on specific circuit. Single Phase Panel Schedule and Three Phase Panel Scheule inlcude. Sample diagram included.

Form F623-017-000
Plan Approval Request - Factory Built Structures and Commercial Coaches

A manufacturer of factory-built structures and/or commercial coaches uses this form to submit plans to L&I for review.

Form F623-006-000
Plan Approval Request - Conversion Vendor / Medical Units

Used in requesting a plan approval for Conversion Vendor or Medical Unit factory-assembled structures.

Form F622-035-000
Plan Approval Request - Recreational Vehicles and Recreational Park Trailers

Plans to build recreational vehicles or park trailers need approval from L&I. This form is used as part of the approval process.

Form F622-006-000
RCW 43.22.380 Exemptions Fire and Safety Checklist for Vendor/Medical Conversion Units

Generic Checklist to determine if the particular installation includes all requirements prior to calling for an inspection. Must be able to answer YES to all questions prior to calling.

Form F622-073-000
Roof Affidavit

Roof Affidavit

Form F622-076-000
Steel or Wrought-Iron Gas Line Pre-Inspection Checklist

This checklist is used by the contractor when installing steel or wrought-iron gas line. Be sure you can answer YES to all questions before calling L&I for an inspection.

Form F622-044-000
Structural Inspection Request Questionnaire

Structural Inspection Request Questionnaire

Form F622-075-000
Vendor / Medical Conversion Units Pre-Inspection Checklist

Pre-Inspection Checklist to assist vendor owners, manufacturers, and others on what they need to know to get their vendor/medical unit approved by Labor and Industries.

Form F622-072-000
Wood / Pellet Stove / Fireplace Pre-Inspection Checklist

This checklist is designed to be generic in content and may not include all requirements for your particular installation.

Form F622-015-000
Your Manufactured / Mobile Home
Available in: Spanish

Pamphlet/booklet: Covers things you should consider when altering your home. Defines what is meant by alteration, repair and replacement and includes tips for hiring a registered contractor. It also includes contact information for L&I Consumer Assistance Program for owners of new manufactured/mobile homes.

Publication F622-049-000
Your Manufactured/Mobile Home-Spanish (Casas prefabricadas y móviles: Lo que los dueños de casas y contratistas deben saber al modificar una vivienda)
Available in: English

Pamphlet/booklet: Covers things you should consider when altering your home. Defines what is meant by alteration, repair and replacement and includes tips for hiring a registered contractor. It also includes contact information for L&I Consumer Assistance Program for owners of new manufactured/mobile homes.

Publication F622-049-999
Your search for "factory-built" returned 36 documents.



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