HomeMy WebLinkAboutPERMIT WORKSHEETMOBILE HOME PERMIT WORKSHEET
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PERMIT NUMBER �Z
Installer 6f iaffjn m�2ak 6 License # X N /[6 2f Cj 15 0
Address of home (_ L1S— Q( Ili Bice Fl S'-f61VI
being installed
Manufacturer _0-a M a) Length x width x width �f���
NOTE_ if home is a single wide rill out one half of the blocking plat
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.1 =;
� �� n , Installer"s:iriitials''' ��%
)�ypical pier spacing
�Lklatoral
li Show locations of Longitudinal and Lateral Systems
I ow (usya dark lines to show these locations)
... .. ........' ..
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w4hm 2' of end of home per Rule 15C
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New Home Used Home ❑
Home installed to the Manufacturer's Installation Manual [nz
Home is installed in ac ordance with Rule 15-C ❑
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Single wide � Wind Zone II ❑ Wind Zone III
le Double wide
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❑ Mtbl%iion Decal # 17a
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❑ FI Q r ' 61-00ra-- H - 8201$
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PIE ABLE FOR USED HOMES
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PIER PAD SIZES
1-beam pier pad size
Perimeter pier pad size
Other pier pad sizes
(required by the mfg.)
Draw the approximate locations of marriage
wall openings 4 foot or greater. Use this
i symbol to show the piers. Ml
List all marriage wall openings greater than 4 foot
and their pier pad sizes below.
ANCHORS
Opening Pier pad size
Oft 5ft
FRAME TIES
At
within 2' of end of home
F�...•...•.- •. ��'� spaced at 5' 4" oc
h.J....7.. ' TIEDOVR/M COMPOR1EtdTS OTHER -HE S
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Nu er
Longitudinal Stabilizing Device (LSD, sidewalla Manuf ct r Longitudinal
Itudfna I
Of at udinal Stabilizing Device w/Lateral Arm: Marriage wall T
..... Manufacturer Shearwall
POPULAR PAD SIZES7
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MOBILE HOME PERMIT WORKSHEET
page z of 2
PERMIT NUMBER
POCKET PENEYROMEM
The pocket penetrometer tests are rounded down to pst
or check here to declare 1000 lb soil tnnthout testing.
X15—M XLI:zd X\50v
POCKET PENETROMETER TESTING METHOD
t Test the peffinetei of the borne at 6 locations
2 Take the read!nq at the, depth of the footer
:3 Using 500 tll increments take, the lowest
reading and round down to that increment
It 00 X
_.TORQUEPROBE TEST Y�
ir..' •„erf;t� f•i tr.• tofctuc prr�t?< tee.t is J � rr.Ct'f r>C:undS nr ch•�ra
here if Vail ait? S.k-e'lartng .rl° anC;iiQrS 'd'ttf)f,)e)! testing /A test
'Iwr.onq 27f> :nri) rrourids cr inss .vita rtmuire 4 foot anchors
Nate: A Sta!f- iapo(cve:t laterci atrn systern is being used and 4 It
an'j; "Y•. rrrf, :iilowed al the; si-Sewall locations l understatia v ft
:#.,a fired at all c :nterhra itp points wt ere the torque test
rt;SS'.t":() it ! `, or less and where the mobile homernanufacturer may
anctx;cs .with 40 t q gfrtg c8!tra y -
4rist`allstaiE als
ALL TESTS 161UST BE PERFORMED BY A LICENSED iNSTALLER
Installer Name; Date t estec �z3- l9
Electrical
Connect electrical conductors betWe;erl multi -wide units, but not to the main power
source This includes the bonding ware between mutt -wide units. Pg.
Plumbing
Connect all sewer drains to an existfnq server 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
Site Preparation
Debris and organic material removed
water drainage- Natural Swale Pad Other
Floor Type Fastener Length Spacing
Walls Type Fastener Lenqth Spacing
Roof Type Fastener Length Spacing
For used homes a min 30 gauge, 8" wide galvanized metal strip
will be centered over the peak of the roof and fastened with gaiv
roofing nails at 2" on center on moth sides of the eenteriine. . a
Gasket 1weaRserprowina requirement)
I understand a properly installed gasket is a requirement of all new and used
homes and that condensation mold, metdew and buckled marriage walls are
a result of a poorly installed or no gasket beinq installed 1 understand a strip
of tape will not Serve as a gasket %
installer's enitialy,
Tyke rletsket Installed
A Between Floors Yes
Between :Nails Yes
Buttom r)) rid:.tYbeanp Yes
W eatherprooti�_
'me i;ottomboatcl will be repay d andror tare Yes Pq (ca%
Suing on units is installed to manufacturer's spr'U tions Yes "mil
F+replaces chimney installed so as not to allow intrusion of rain water Yes��
Miscellaneous
Skirting to be +n5talled� No
Dryer vent installed outside of skirting 6 es ht:A
Range downflow vent Installed outside o kirting Yes N!A
Drain tines supported at 4 foot tnlervals Ye. �l
Electrical crossovers protected Yes
Other
Installer verifies all information given with this permit worksheet
Is accurate and true based on the
Date t__Z_ 7