HomeMy WebLinkAboutMOBILE HOME PERMIT WORKSHEETE' MOBILE HOME
PERMIT
PERMIT WORKSHEET � page 1 of 2
NUMBER
Installer � f Y r in � �I k � License # � H � 16--u ) -. o
New Home
][ Used Home ❑
y
t" Home installed to the Manufacturer's Installation Manual [
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� Fl �LIgL4 (e
Address of home Lfj�� LI�S- t(�- r1 erCe ,
being installed � `�
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I u Home is installed in ac ordance with Rule 15-C ❑
� W
o
r ,
V
l
o o Single wide
cc
Wind Zone If ❑ Wind Zone III �
1,- _
Manufacturer Cr �(�rn q( (�n Length x width fz
CIO
Q e Double wide
❑ Installation Decal #MR
•
MOTE: if home is a single wide fill out one half of the blocking plan
O° ® Triple/Quad
❑ Serial # FI Z61-ao�- H - $�I a�
if home is a triple or quad wide sketch in remainder of homc
�; z ac
I understand Lafeial Arm -Systems -cannot be -used on any home (new or used)
430
r`j'- % s
where the sidewall ties exceed 5 It in. —
PIER SPACING TABLE FOR USED HOMES
nitfals ff.N' o
LU
, �),ppicai pier spacing tar
L lateral Z Q
i�fEY 2' o
Show locations of Longitudinal and Lateral Systems
long,tuamal (us dark lines to show these locations)
I
LI....
----•
- -
---
---------
---
---------
---
---------
---
------------------- - -
- - -
-
L1
L_j
Li
L_j
L_j
marriage
waft piers
Li
within 2' of end
of home per
Rule 15C
- ..... .... :.... ;.... .>.... .::.... g : rxo';ta�r
;._.; �a
�3_(1: cam: >.._--•-..�...., .._.,...-.-7.r�.•�......
Load
Footer
Baring
size
16" x 16"
18 1/2" x 18 1/2"
20" X 20"
—22"-x-22"
24°' X 24"
-26"_x 26"
capacity
(sq in)
(256}
(342)
(400 )
(484)'
(576)•
(676)
1000 ps
3
4
g
1500 psf
4' 6"
6'
7
g
2000 s
6'
g
2 0 s
7
3000 s
68'
Q8'
8'
s
rnterp
QI
3
W C
a�
oCC
IL C
oOO�
Q F
N
z
a�
W
_ Cr
>_
J from Rule 15C-1 pier spacing tabl(
PIER PAD SIZES
er pad size
pier pad size C� •�
pad sizes `A -
by the mfg.)
raw the approximate locations of marriage
all openings 4 foot or greater. Use this
rmbol to show the piers. AA
arriage wall openings greater than 4 foot
pier pad sizes below.
ADS ZE
POPULAR PS
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iF:�iiciE:1EC�
MENULIi'
K-iff=1
i1'll
lf��'i►�.'�i lf�i
���..��j,���.�.�
ANCHORS
Oft 5ft
FRAME TIES
within 2' of end of home
spaced at 5' 4" oc
OTHER TIES
Number
Longitudinal Stabilizing Device (LSD, Sidewall
Manufacturer Longitudinal
ongrtudinal Stabilizing Device w/ Lateral Arms Marriage wall
M f t
/I
Pier pad size
_1f!4
TIEDOWN.COMPONEN
TS
anu ac urer Shearwall
MOBILE HOME PERMIT WORKSHEET
PER -MIT NUMBER
POCKETPSN ETRUMETSM
T ..Y_
The pocket penetrometer tests are rounded down to psi
or check hereto declare 1000 lb sod without testing.
X-LIIQD X Mil X \500
POCKET PENETROMETER TESTING METHOD
t Test the pe!imetei of the home at r locations
2 Take the rc_ad.nq at the depth of the footer
funnel !)CIO Ib mcreinerts take the lowest
reading and round dovsn to that increment
X.j0(0 X � X.) W -0
TO-9 UE PPRO E TEST
jr••- •,•ctt!i� rt Ifs.. torUut3 �itr:bC i:'St :S J � tl;: f: p�?Un(jS Ctr Cr1:?Ck
fwre if you alto d-Janng 5' ean(,hor� without testtnq A test
f,asnnq 2.7f-) or -it pourids or loss edill re'_nuire 4 Foot an:_hors
Note: It St£}t!;' apv(ove'd lateral tarrn .,'stem is being used and 4 ft
an,;t•, :atiowed at the• sj:iewali locations i undeistafia 5 tt
�iih'IA,lE' :?r(: rt.,ajired at all c-t-rilerime Ile points where the torque test
is 7 ° Jrless and wile=rf; the mchile home manufacturer rnl ay
n �t }I+e , Faiu.hvrs r,=tt= A0+30 {: =aiding cap:aaty
Installr Syii ltia�Sr`
ALL TESTS MUST BE PERFORMEi? BY A LICENSED INSTALLER
Installer Name
Date estec
Electrical
Connect electrical conductors between multi -wide units, but not to the main power
source This includes the bonding urine between mutt -wide units, Pg.
Phrmbing
Connect ,,If sewer drains to an exionq sewer lap or septic tank Pg.
Connect all potable water supply Gipsng to an existing water meter, water tap, or other
independent water supply systems Pg
1� page 2 of 2
site Preparation
Debris and organic maternal removed rW �ti
Water drainage Natural Swale
Floor Type Fastener Length Spacing
Nails Type Fastener Length Spacing
Root Type Fastener Length Spacing
For used homes a turn 30 gauge. 8" wide galvanized metal strip
will be centered over the peak of the roof and fastened with gals
roofing nails at 2" on center on Loth sides of the centerline. .
I :understand a properly installed gasket is a requirement of all new and used
homes and that condensation mold• rneldev, and buckled marriage walls are
a result of a poorly installed Or no gasket be inq installed 1 understand a strip
of tape will not serve as a gasket
r P
instaRc:r's :n,ti.�il;
IVr-C gasketk installµd
Between Floors Yes
Between -Walls Yes
Buttom o! rid.te oearn YES
���_�•�'-�WCSHh4IpfOOtttit� w .�_r._~�-�"�_
The tiottomboafct vadl be repaired andror tape Yes Pg )�
Sio;nq an units is tnstalled to manufacturer's spe ;t ica!iC,,ns yes 1
Fireplace chimney installed so as not to allow intrusion of fain �yate:r Yes Allet
Miscellaneous
Skirting to Ue installe� No
Dryer vent installed outside of skirting es N:A
Range dct+rnfiow vent installed outside -a- kir inq Yes N(A
Drain lines supported at 4 foot mter4ats Ye
Electrical crossovers protected Yes
Other
installer verifies all information given with this permit worksheet
Is accurate and true based on the
ate