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FertnitAppikation Manufactured Home Installatlon
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Permit # �p
�6f�-�va� Name of Licensed Installer '
A leant �✓VI LLB jyl . ./ /l:�s s
pp..,. License # / S
Address Imo— - Installation Decal
�t.r.� �� Wind Zone a2 New
home _ Used home
Manufacturer's Name Length y� Serial
Number of Sections �� W idth_
Installa
tion standard used: (check one) manufacturer's installation manual Rule is
SITE PREPARATION: p �6 _ or -
Site Graded and fill"dirt c�mpaetec to 90%
Drain tile and sump pump to be installed _L2—.. - or. -
Describe any other site prep method to be used
Organic; material removed
Site graded or prepared for -:adequate- drainage
A vapor barrier is required for new homes
I understand that a poorly prepares site can cause doo and windows to bind, mold
and mildew to form in the home. Installer's initials
FOUNDAT74N: — - or assumed 1000 psf ter.
Load bearing s plastic
capacity (psf) } }6 �nerc footer , poured footer _
Footittgrtype: plastic pads-' Foundation pad size
I-beam piers: O/C spacings
Perimeter piers:.locatio as
Centerline pier locations Footer saes
Centerline piers: Number �f
blocking: fireplace, bay windows, tubs, shear walls, etc, Yes
No
Page
page
page
Page
Page
Page
Page
Page._
Page
Page
Page
TIE DOWNS: Page
Torque probe reading 2� B Declared 5 ft. anchors
I understand a torque ro test can only be performed by a licensed installer.
Installer's initials _ 71`� Page
Anchor type: 4 ft. E c5 tL Angle of strap dew Page_:._______._
Number of frame ties:r Spacing �_ page
Number of vertical ties:_
Number of centerline anchors,---,, Page
Longitudinal straps/anchors �_or longitudinal stabilizing devices tom. Page
Manufacturer of longitudinal stabilizing devices Page
Manufacturer of lateral arm systems (if used) n�
State approved lateral arm system is being used and the installer will follow both the
A pp
lateral arm manufacturer's installation instruct
home's installation manual and the or
51 anchors are required at all centerline tie points where the totest re
rque ading
less and where the mobile home manufacturer may require anchors with 400011) holding
capacity. Installer's initials • %'�a
`W�
J
L
Permit Application Manufactured Home 10swIlatiolt -
CLDSE UP:
Page 2
Gasket• t is a requirement of all new and used homes and
I understand a properly install gaske
condensation, mold, mildew and buckl4tiar iage walls can -be, a result of a poorly installed
or no gasket being mi lied. I understand a strip of tape will not serve'as a gasket. Page
Installer's initials - /2 Type gasket
Fasteners are required to secure multi -sections of homes together (roof, sidewalls, floor)
Fasteners: Roofs Type and size Spacing /� " `' , Page --
Endwalls Type and size ` Spacing z2 ,, - par ---------
Floors Type and size ig I, Oy Spacing 4.4 Page
Electrical: 1 ��
Connect electrical conductors between. sections of the home this includes the bonding Page
wire. Installers are not allowed to connect electrical power to the home. Access panels
are to be installed.
Plumbing:
Using the manufacturer supplied drain line drawing connect all sewer drains to an ` 5 e-
existing sewer°tap or septic.tank. Page --
Connect the potable water supply to an existing water meter, water tap or other .157 &
independent water system. Access panels are to be installed. Page ---
Weatherproofing:
Rule.15C-2 requires the complete weather sealing of the home. page Ae 4—
Bottom board repair
Vinyl siding Page
Soffit and facia Page
Roof dose up: Check the one that applies
Manufacturer's insgation manual •_______ -Page
Rule 15C-1 tL' ,,_ 30 gauge, 8'' wide, galvanized metal strip catered over the
peak and fasten with gals. roofing nails at 2 , on center on both sides of the centerline:
Chimney:
Install extra length flue pipe, install and seal storm collar, chimney cap Page
Home skirted Yes r-�No Page
if skirted ventilation is required: (cheek one) Page
1 square foot for every 150 square feet of home (with no vapor barrier)
1 square foot for every 300 sq. f. of home. (suggested with vapor barrier)
Ventilated skirting