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Mobile Home Permit Worksheet 10-12-2021
Mobile Home Permit Worksheet t Installer: EDDIE GRUNDEL 1 I License # IH1118467 �} Address of home 7868 CARLTON RD PSL being installed Manufacturer JACOBSEN Length x widths NOTE. if home is a single wide rill out one half of the bloc if home is a triple or quad wide sketch in remainder of home I understand Lateral Arm Systems cannot be used on any home (new or used) " where the sidewall ties exceed 5 ft 4 in. "" Installer's initials EG Typical pier spacing 7 9, 61 / ' lateral Show locations of Longitudinal and Lateral Systems longitudinal (use dark lines to show these locations) I ---•....=----- -------------- -------------------------------- f3----------- ----------,..---- marriage wall piers within Z of end of home per Rule 15C 11 Application. Number: i } New Home []✓ Used Home Ej Home installed to the Manufacturer's Installation Manual Home is installed in accordance with Rule 15-C Single wide El Double wide E✓ Triple/Quad ❑ Date: Wind Zone II Wind Zone III Installation Decal # TBD Serial # TBD PIER SPACING TABLE FOR USED HOMES H a Load bearing Footer size size 16" x 16" 18 1/2" x 18 20" x 20" 22" x 22" 24" X 24" 26" x 26" capacity (sq in) (256 ) 1/2"342 ( ) 400 ( ) (484)* (576)* (676) 1000 Dsf3' 4' 5' 6 8 500 Ds ' 6" 6' 8. 2000 s 6' 8 81 2500 s 7 6" ET g 8' 300 s 8' g 8• 3500 s 8' g --8--- PIER PAD SIZES I-beam pier pad size 17X22.5 Perimeter pier pad size 16X16 Other pier pad sizes (required by the mfg.) Draw the approximate locations of marriage wall openings 4 foot or greater. Use this symbol to show the piers. List all marriage wall openings greater than 4 foot and their pier pad sizes below. Opening Pier pad size 1-4 17X22.5 2-3, 23X31 TIEDOWN COMPONENTS C kongitudinal Stabilizing Device (LSD) ryManufacturer OLIVER Longitudinal Stabilizing Device w/ Lateral Arms Manufacturer POPULAR PADS ES Pad Size q n 16 x 16 256 6 x 18 288 18.5 x I 8. 3 16x22.5 6 7x 7 314x 26 1/4 348 x 17 6 T-2-5-3-TW 441 7 112x25124T6- 24 x —5-79- 26 x 26 76 ANCHORS 4ft ✓ 5ft FRAME TIES within 2' of end of hr-- spaced at 5' 4" oc ✓ OTHER TIES Number Sidewall Longitudinal Marriage wall Shearwall OFM i] L � SI•��1 - Mobile Home Permit Worksheet Application Number: Date: POCKET PENETROMETER TEST Site Preparation The pocket penetrometer tests are rounded down to 1500 psf Debris and organic material removed X Water drainage: Natural Swale Pad X Other or check here to declare 1000 lb. soil without testing. 1500 , X X 1,500 X 1,50�: Fasteningmulti wide units Floor: Type Fastener: LAG Length: 6" Spacing: 24" POCKET PENETROMETER TESTING METHOD -�' Walls: Type Fastener: LAG Length: 6" Spacing: 24" Roof: Type Fastener: GALV Length: CONT Spacing: 24" 1. Test the perimeter of the home at 6 locations. c®� For used homes a min. 30 gauge, 8" wide, galvanized metal strip will be centered over the peak of the roof and fastened with galy. 2. Take the reading at the depth of the footer. 11 roofing nails at 2" on center on both sides of the centerline. 3. Using 500 lb. increments, take the lowest , _ C Gasket (weatherproofing mqulremeng (� reading and round down to that increment. (:--- ® I understand a properly installed gasket is a requirement of all new and used homes and that condensation, mold, meldew and buckled marriage walls are X 1,500 X 1,500 X1,500 ,_._.,�j.' ��� Lr:-• a result of a poorly installed or no gasket being installed. I understand a strip of tape will not serve as a gasket. F 'l Installer's initials �� TORQUE PROBE TEST qq Type gasket FACTORY FOAM Installed: The results of the torque probe test is 290 inch pounds or check Pg. Between Floors Yes X here if you are declaring 5' anchors without testing A test Between Walls Yes X . showing 275 inch pounds or less will require 5 foot anchors. Bottom of ridgebeam Yes X Note: A state approved lateral arm system is being used and 4 ft. anchors are allowed at the sidewall locations. I understand 5 ft anchors are required at all centerline tie points where the torque test reading is 275 or less and where the mobile home manufacturer may requires anchors with 4000Iding capacity. Installer's initials ALL TESTS MUST BE PERFORMED BY A LICENSED INSTALLER Installer Name EDDIE GRUNDEL Date Tested Electrical Connect electrical conductors between multi -wide units, but not to the main power source. This includes the bonding wire between mult-wide units. Pg. Plumbina Connect all sewer drains to an existing sewer tap or septic tank. Pg. Connect all potable water supply piping to an existing water meter, water tap, or other independent water supply systems. Pg. Weatherproofing The bottomboard will be repaired and/or taped. Yes X Pg. Siding on units is installed to manufacturer's specifications. Yes X Fireplace chimney installed so as not to allow intrusion of rain water. Yes X Miscellaneous Skirting to be installed. Yes X No Dryer vent installed outside of skirting. Yes X N/A Range downflow vent installed outside of skirting. Yes X N/A Drain lines supported at 4 foot intervals. Yes X Electrical crossovers protected. Yes X Other: Installer verifies all information given with this permit worksheet is accurate and true based on the manufacturer's installation instructions and or Rule 15C-1 & 2 Installer Signature Date Page 2 of 2 IN The Imperial i i i i i i 1 i i i L----------------- `L �v ,'may 4 OCT 12 2021 t i i i i i i I i i i ---------------------- --- ---� ❑ ❑❑ sm ❑❑■❑ mmanam r m nmisawaac ❑„❑ ❑�❑❑ 600 Packard Court ■ Safety Harbor, Florida 34695 ■ Telephone (727) 726-113B o JAMBSIN www.jachomes.com/Floor—Plans 32, Z 521 1,595 SQUARE FEET Model IMP-45214W-309 2020 (ALL SIZES ARE APPROX.) DESIGNED FOR ZONES 11 & 111 © 10-12-12