HomeMy WebLinkAboutHOME PERMIT WORKSHEETMOBILE HOME PERMIT
d PERMIT NUMBER
2 a� — o90
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Installer VC}Yl m l 6 License # X 14 hb kci
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Address of home
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being installed
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Manufacturer Cy, jrY,.(�(- (3o Length x width ��
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NOTE_ if home is a single wide Fill out one half of the blocking plat
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if home is a triple or quad w
wide sketch in remainder of home
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I understand Lateral Arm Systems cannot be used on any home (new or -used) a LU c w }
where the sidewall ties exceed 5 ft 4 in.
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Installer`sYin,tials _s�Zm W Q o
� )�ypical pier spacin`
L.gal"winal
I Show locations of Longitudinal and Lateral Systems
` ( (usy dark lines to show these locations)
LI-.. ----------•-- -- --- ------------ -- - --- ---• - --
marriage wall
.........i.. :................._...........'.........i....'........'............................
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per Rue 15C
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IKSHEET ?�
page 1 of 2
l
](Q` fUsed Home ❑
19alled to the Manufacturers installation Manual
sa`rilstalled in ac ordance with Rule 15-C
❑
Lrde Wind Zone II ❑ Wind Zone
111
ride ❑ Installation Decal #
uad ❑ Serial # F! Z61-ooe-- N -
$2QI %Q
PIER SPACING TABLE FOR USED HOMES
Load
F er
bearing
size
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 s
3
8,
1500 ps
4'
6'
7
g
2 bsf
6'
8,
2500 psf8
,.8
3000 s
3500 pst
PIER PAD SIZES
I-beam pier pad size !! ✓��%� %���/`a
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
-= symbol to show the piers. 1n14
List all marriage wall openings greater than 4 foot
and their pier pad sizes below.
AIOCHORS
:..........: ....I
Opening Pier pad size
1�
I /1 /"j,
4ft 5ft
-=ES
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'1
FRAME TI
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within 2' of end of home
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-
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spaced at 5' 4" oc
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TIEDOW N COMPONENTS
OTHER TIES
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Longitudinal Stabilizing Device (LSD
Manufacturer
Number
Sidewall 1,13
`t.�....,.
o t udinal Stabilizin a
g g Device w/Laiera/ Arms
Manufacturer
Longitudinal
Marriage wall
_;
Shearwall
MOBILE HOME PERMIT WORKSHEET
page 2 of 2
PERMIT NUMBER
POCKET PENETRONETIR-f9gy, —I
The pocket penetrometer tests are rounded down to psi
or check here to declare 1000 lb soil wthout testing.
x-[' �00i x �a X �o
POCKET PENETROMETER TESTING METHOD
t Test the pefrrneter of the home at 6 locations
2 Take the re<3d:nq at the, depth Of Itie footet
3 Using 00 lu increments take the lowest
reading and round down to that increment
X j!,c c-, X %%0 X )a'o -0
TORQUE PROB TES --
:orrat.ite prrjb- t,r;: is 3 K inch pounds o' choca
t;RtrF, if viii ate r3.:1arinq S' a(1%;Yiors Withptit testuric; A test
;;hu•rr)nq 27f) orii rounds of ir;ss .wilt rroutre 4 #oat aricnors
Note: is ti}•,f;• apinfr-ved lateral irrr 5yStern is being used . -and k tt
aitcwed at tthv s) aevralt locations I understand 5 ti
at all , nteriirae he points where the tt�rqur: test
r-: 2-*` r.r less and where the mobile hornemanufacturer relay
4000 l trig capacity _
I r: st i311iar==�;iE� tt ra l�}•kr�+"
ALL TESTS MUST BE PERFORMED BY A LICENSED INSTALLER
Installer game
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Eloctrical
Connect electrical conductors between multi -wide units, but not to the main power
sourc w This includes the bonding wire between mull -wide units. Pg.
Plumbing
Connect ail sewer drains to an existfnq sever tap or septic tank Pg.
Connect all potable water supply piping'•o an existing water meter, water tap, or other
independent v:ater supply systems Pg
Site Preparation
Debris and organic material removed 'iW
water drainage- Natural Swale Pad Other
Floor Type Fastener Length Spacing
Waits Type Fastener Length 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 root and fastened with galy
roofing nails at 2" on center on both sides of the centerline. .
Gasket ("oherproatruq raqutrc m"ti
I understand a properly installed gasket is a requirement of all new and used
homes and that condensation mold, nieldew and buckled marriage walls are
a result of a poorly installed or no gasket beinq installed I understand a strip
of tape will not serve as a gasket
irisIaIle."s {, uta rl;
T yifc gasket Installed /
Between F= [oafs Yes
Eietween 'Nails Yes
Britton 0 rid woeam Yes
The t ottomboaiq will be repai!ed andror !al;e Yes Pq-
Srdtnq on units is insiailed to manufacturer's sp-GUI iCations Yes
Fireplace chimney installed so as not to allow intrusion of rain wat(;r Yes
Miscellaneous
Skirting to be installedYe No .
Dryer vent installed outside of skirting es N!A
Range downfiow vent installed outside o kirtrn!q Yes Nl.4
Drain lines supported at 4 foot intervals Ye
Electrical crossovers protected Yes /fj1
Other
Installer verifies all information given with this permit worksheet
is accurate and true based an the
Date fr—er ro