HomeMy WebLinkAboutMOBILE HOME PERMIT WORKSHEETMOBILE HOME PERMIT WORKSHEET L,
PERMIT NUMBER � "I
*. Installery r �Vense # H
t � Q W f� /� � i=--
Address of home "_ I Lj,,S— 1 5or+ t P / '�—I 6iq �pa +�
being installed l.0 c w I.-,0
Manufacturer cloa M (311 Lei
NOTE: if home is a single wide all out one l
if home is a triple or quad wide sketi
I understand Lateral Arm Systems cannot be use
where the sidewall ties exceed 5 ft 4 in.
c ��:•�=-Iris
pical pier spacing '-'
W 2 lateral
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Show locations of Longitudinal and Lateral Systems
long+tuamal (us dark lines to show these locations)
---------------------------------------------------------------------------------
,...�
marriage
wall piers
w:thn 2' of end
of home per
Rule
15C
.................
page 1 of 2
New Home
Used Home ❑
Home installed to the Manufacturers Installation Manual
Home is installed in ac ordance with Rule 15-C
Single
WTI*'
wide
Wind Zone II ❑ Wind Zone
III
Double wide ❑
Installation Decal #
Triple/Quad ❑
Serial # F1 261-ooe— H _
14
F>QQf Sr, 6
PIER SPACING TABLE FOR USED HOMES
Load
bearing
capacity
Footer
size
(sq in)
16" x 16"
(256)
18 1/2" x 18 1/T
(342)
20" x 20"
(400 )
22" x 22"
( 484)-
24" X 24"
(576 )'
26" x 26"
(676)
10000 s
15000 s
4' 6"
g
0 s
8
g� i
3000 ss
3500 pst
....,,.r,.......................c .w-. Fnc. aNawry rerun
PIER PAD SIZES POPULAR PAD S Z S
1-beam pier pad size
x��
Perimeter pier pad size
✓
(0
Other pier pad sizes
)C�
(required by the mfg.)
Draw the approximate locations of marriage
wall openings 4 foot or greater. Use this
- symbol to show the piers. /Vl/#
List all marriage wall openings greater than 4 foot
and their pier pad sizes below.
ANCHORS
Opening Pier pad size
)� � n�,j� Oft 5ft
�I�✓ FRAME T105
within 2' of end of home
�1 spaced at 5' 4" oc
TIEDOW N C00P0NEBITS OTHER TIES
Nu er
Longitudinal Stabilizing Device (LSD Sidewall
Manufact r Longitudinal �—
o g udinal Stabilizing Device w/ Lateral Arm: Marriage wall
Manufacturer Shearwall
i[:yci►�.�.�
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MOBILE HOME PERMIT WORKSHEET 't'
page 2 of 2 1
PERMIT NUMBER
P CKTPW R
The pocket penetrometer tests are rounded down to psi
or check here to declare 4t3W lb soil without testing.
X150D X ISOd X \500
POCKET PENETROMETER TESTING METHOD
t Test the ptn+rtteiet of the home at S locations
L Take the readvq at the depth of the footer
3 Usinq 500 ttJ increments take the lowest
readinq and round down to that increment
X1�Qt7 XN%0 X)O-0
TORQUE PI2O fr T��
it-••-ue;ftt� to +r..- torque oio't c t?at a n:ch pounds nr check
hurr: if v.Ju aita ,i:>Jartnq 5' an:,hor� without testing A test
.!,cwmn•; 27f, orn pounds or lr:ss .nit rrr}ure 4 foot anchors
Note: A shalt:•'apvfcved lateral aim 5yslern is being used and 4 N
an,a • : art- :allowed at thin s� :ev�ellloC�at+ons f understand 5 fi
at all .'tonterline tie points, where the torque test
ru-cO ':q is l `: r r less and where the mobile home rnanufaCturer may
rq ju%.-5 tinchurs -.fath 400tr rrtdi capacity
Installeitial
ALL TESTS MUST BE PERFORMED BY A LICENSED INSTALLER
Installer fame
Date t ested 2—g3- I
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.
Plumbing
Connect all sewer drains to an existrnq 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
site Preparation
Debris and organic material removed
Water drainage, Natural Swale
Floor- Type Fastener Length Spacing
Wails Type Fastener Length Spacing d, f
Roof Type Fastener Length Spacing
For used homes a min 30 ga'.Jge. 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 Moth sides of the centerline.
Gasket (axainerprournw rtaguirement)
1 understand a properly installed gasket is a requirement of all new and used
homes and that condensation mold, meidew 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 initlaf;
Type grlsket Installed
Between Floors Yes
Between Waft Yes
Brittom of rid:let:eana Yr;s
Weatherproofing
The i:ottomboarcf will he reparEd andror tripe Yes
Sia,nq
Pq %
".,Iq
on units is installed to manufacturer's spec+ nations
Yes
Fireplace chimney installed so as not to allow intrusion of rain water Yes lf/�,,Q�
r
Miscellaneous
Skirtinq to be +nstailed(5y� No
Dryer vent installed outside of skirting es N:A
Range downflow vent installed outside o irtinq Yes
N!A
Drain tines supported at 4 foot intervals Ye.
Electrical crossovers protected Yes �1
Other
Installer verifies all information given with this permit worksheet
Is accurate and true based on the
C Date y_z &
Page 1 of 1
cm i.1FlMi1 ■
S
is
3
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File COPY
https://factoryhomesale.com/wp-content/uploads/2016/06/Jennings-wpcf 880x527.png 4/10/2018
PROPERTY LOCATION:
❑ Assumed 1,000 P.S.F. soil bearing (If not assumed enter results in box below.)
T9st Location #1
sf
X
PENETROMETER TEST RESULTS
Test Location #2
o sf
�X
• Test the perimeter of the home at xix (6) location
• Take the reading at the depth of the footer
Test Location #3
MOO sf
X
• Using 500 LB increment, take the lowest reading and round down to that increment.
Test Location #1 Test Location #2 Test Location #3
S0—<�) psf , 5 0 (D psf ISo0 psf
x x x
Soil bearing capacity used to determine pier layout: 1 S0 U psf. Date Test Taken: 3 -/q- /
ANCHORING SYSTEM TO BE USED
15C (Anchored in accordance with Chapter, 15C of Mobile/Manufacture Home Installations Standards)
Bracing System (Installation Standards for Model Required)
I 51a�--w c &e hereby certify that the above is true and accurate.
Installer Name Printed
Installer Signature
Subscribed and sworn to before me this day of 20 lg (4Is ( ) Is not
personally know to me. Identified by:
LIZ, M commission expires:
Y P
NOTARY PUBLI
1 of 1 NOE]
�'{ t��orida
s 3�n GG 197151/2022