HomeMy WebLinkAboutMobile Home Permit WorksheetMobile Home Permit Worksheet Application Number: Date:
Installer: EDDIE GRUNDEL License # IH1118467
Address of home
being installed
i PAD Ca�,.T�N �d
Manufacturer JACOBSEN Length x width &
NOTE. if home is a single wide rill out one half of the blockinq plan
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 p6' spacingI
lateral
Show locations of Longitudinal and Lateral Systems
longltudlnal (use dark lines to show these locations)
;...
---i
I----------------------
-------------------------------
--- --------------------
--...
i----
marriage
wall
piers
within T of
end
of home pe
Rule 15C
New Home
Q
Used Home
Home installed
to the Manufacturer's Installation Manual
Home is installed in accordance with Rule 15-C
Single wide
R
Wind Zone II Wind Zone III
Double wide
r_71
Installation Decal # TBD
Triple/Quad
Serial # TBD
PIER SPACING TABLE FOR USED HOMES
Load
bearing
capacity
Footer
size
(sq in)
16" x 16"
(256)
18 1/2" x 18
1/2" (342)
20" x 20"
(400)
22" x 22"
(484)'
24" X 24"
(576)'
26" x 26"
(676)
1000 psf
3'
4
5'
6
8'
1500 pst
4' 6"
6'
7'
8'
8'
8'
2000 psf
6'
8'
8
2500 psf
T 6"
8'
8'
8'
8.
8'
3000 pst
8'
8'
8'
8
8'
8'
3500 pst
1 8'
8'
8'
8'
1 8'
8'
Interpolatea from KUIe 1 bG- I pier spacing IaDle.
PIER PAD SIZES
I-beam pier pad size 17X22.5
Perimeter pier pad size 16X16
Other pier pad sizes
(required by the mfq.)
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,
POPULAR PAD SIZES
Pad Size
Sq In
16x16
256
16 x 18
288
18.5 x 18.5
342
16 x 22.5
360
17 x 22
374
13 1 x 26
348
20 x 20
400
17 316x25316
441
17 1/2 x 25 1 2
446
24 x 24
576
26 x 26
676
ANCHORS
4ft —1/_5ft— —
FRAME TIES
within 2' of end of hc---
spaced at 5' 4" oc _ —
TIEDOWN COMPONENTS OTHER TIES
Number
23X31
Longitudinal Stabilizinq Device (LSD) Sidewall
Manufacturer OLIVER Longitudinal
Longitudinal Stabilizinq Device w/Lateral Arms Marriage wall
Manufacturer Shearwall
Page 1 of 2
Mobile Home Permit Worksheet Application Number: Date:
POCKET PENETROMETER TEST
The pocket penetrometer tests are rounded down to 1500 psf
or check here to declare 1000 lb. soil without testing.
X 1,500 X 1,500 X 1,500
POCKET PENETROMETER TESTING METHOD
1. Test the perimeter of the home at 6 locations.
2. Take the reading at the depth of the footer.
3. Usinq 500 lb. increments, take the lowest
reading and round down to that increment.
X 1,500 X 1,500 X 1,500
TORQUE PROBE TEST
The results of the torque probe test is 290 inch pounds or check
here if you are declaring 5' anchors without testing . A test
showing 275 inch pounds or less will require 5 foot anchors.
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 4000 lb holding 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 mutt -wide units. Pg.
Plumbing
Connect all sewer drains to an existing sewer tap or septic tank. Pg.
Site Preparation
Debris and organic material removed X
Water drainage: Natural Swale Pad X Other
Fastening multi wide units
Floor: Type Fastener: LAG Length: 6" Spacing: 24"
Walls: Type Fastener: LAG Length: 6" Spacing: 24"
Roof: Type Fastener: GALV Length: CONT Spacing: 24,,
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.
roofing nails at 2" on center on both sides of the centerline.
Gasket (weatherproofing requirement)
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
a result of a poorly installed or no gasket being installed. I understand a strip
of tape will not serve as a gasket.
Installer's initials
Type gasket FACTORY FOAM Installed:
Pg. Between Floors Yes X
Between Walls Yes X
Bottom of ridgebeam Yes X
Weatherproofing
The bottomboard will be repaired and/or taped. Yes X . Pg.
Sidinq 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
Connect all potable water supply piping to an existing water meter, water tap, or other Installer Signature
independent water supply systems. Pg.
Paqe 2 of 2
Date