Do I need a notary for the One-Time Mobile Home/Modular Permit Extension?

No. The form has a signature line but no notary block or notarized attachment. The signer just signs and dates the form.

How long is the extension, and is there a fee?

The form allows a one-time extension of 180 days and states that a $150 fee must be paid before an extension can be granted.

What information does the extension form request?

It asks for the permit number, project address, reason for the request, preferred notification method, contact information, and the applicant’s signature.

Pinal County, AZ · Pinal County

No notary required

One-Time Mobile Home/Modular Permit Extension

Pinal County permit holders use this form to request a one-time 180-day extension for an active mobile home or modular installation permit.

At a glance

Issued by: City of Pinal County · Pinal County, Pinal County, Arizona
Notarization: Not required: file this form without a notary.
Official source: pinal.gov
Blank form: Download the PDF
Catalogued: Oct 5, 2026
Machine-readable: JSON record · about the forms index

What this form is

This form lets a permit holder ask Pinal County Community Development Building Safety Division for a one-time extension of an active mobile home or modular installation permit. It requests the permit number, project address, reason for the extension, contact information, preferred notification method, and signature. The form states that a $150 extension fee must be paid before an extension can be granted; an expired permit may be extended at the Building Official’s discretion.

Who needs it

A holder of an active mobile home or modular installation permit who needs up to 180 additional days may use this form to request an extension.

How to submit it

Mail the form to Pinal County Community Development Building Safety Division, Attn: Plan Examiner Trainees, PO Box 2973, Florence, AZ 85132, or email it to [email protected]. The form states that a $150 fee must be paid before an extension can be granted.

About notarization

This document is signed without a notary; the signer just signs and dates the form, and it identifies no notarized attachment or related step.

How to submit this form

1
Download the Form
Download the One-Time Mobile Home/Modular Permit Extension form.
2
Complete the Request
Enter the date, permit number, project address, reason for the extension, preferred notification method, contact details, and signature.
3
Gather Any Extra Information
Attach a separate page if you need more space to explain the circumstances for your request.
4
Submit to Pinal County
Mail the form to the Building Safety Division in Florence or email it to [email protected]. The form states a $150 fee must be paid before an extension can be granted.

Frequently asked questions

Do I need a notary for the One-Time Mobile Home/Modular Permit Extension?: No. The form has a signature line but no notary block or notarized attachment. The signer just signs and dates the form.
How do I submit the permit extension request?: Mail it to Pinal County Community Development Building Safety Division, Attn: Plan Examiner Trainees, PO Box 2973, Florence, AZ 85132, or email [email protected].
How long is the extension, and is there a fee?: The form allows a one-time extension of 180 days and states that a $150 fee must be paid before an extension can be granted.
What information does the extension form request?: It asks for the permit number, project address, reason for the request, preferred notification method, contact information, and the applicant’s signature.

Need something notarized?

This One-Time Mobile Home/Modular Permit Extension doesn’t need a notary, but if you have another Pinal County form that does, a commissioned online notary can help.