HomeMy WebLinkAboutHOME PERMIT WORKSHEETMOBILE HOME PERMIT
WORKSHEET
page 1 of 2
PERMIT NUMBER
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installer b 11"iGYI
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�FQd � License # _ 16�.GG �. �
New HomL Used Home ❑
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Home ins le%to the Manufacturer's installation Manual
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Address of home
being installed
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Home is t. - ac ordance with Rule 15-C
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Manufacturer C 1 M �^ an Length xwidth
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NOTE: if home is a single wide fill out one half of the block/ I O 0
ng P ar o: 'r u, a
off home is a triple or quad wide sketch in remainder of home a U v�i O c
kzza
der�ta d Lateral Arm Systems cannot be used on any home (new or•usolf > Q
t�sidewall ties exceed 5 ft 4 in. r » Yr a
CL c n , In§taIWer initial`s
I pieg%pacin� u�i =
lateral W j C-1 W >
In s
WW-yam
Show locations of Longitudinal and La�t�l 3ysRdi ns
,,,,,r,,,„, 1 (usq dark lines to show these locations/ U
Single W&E 3 Wind Zone 11 ❑ Wind Zone III
Double &Wq Installation Decal #
TripleIAR R❑ Serial #
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Q PIER SPACING TABLE FOR USED HOMES
Load Fsizter
bearin size
16" x 16" 181/2" 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)
s
3
t3
1 0 s
4' 6'
7
g'
20 s
6'
8'
2500 psf
3 00 s
3500 s
A_ ,
PIER PAD SIZWW
I-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
symbol to show the piers. n014
List all marriage wall openings greater than 4 foot
and their oier Dad sizes helnw
Opening Pier pad size
AIN A
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TIEDOWiN COMPONEN
Longitudinal Stabilizing Device (LSD,
ANCHORS
Oft 5ft
FRAME TIES
within 2' of end of home
spaced at 5' 4" oc
OTHER TIES
Nu er
Sidewall
Longitudinal
Marriage wall
Shearwall
MOBiLE -HOME PERMIT WORKSHEET
rpage 2 of 2 �1
PER -MIT NUMBER
POdKET FEN
The pocket penetrometer tests are rounded down to psi
or check here to declare 1000 lb sod without testing.
X LIDO X 11500 X \500
POCKET PENETROMETER TESTING METHOD
1 Test the po:irneter of the home at r locations
2 Take the re d.nq at the depth of the footer
3 Using 500 tt, increments take, the lowest
readrnq and round dovirt to that increment
X Is-
00 X X O�
L TORQUE —PROM TEST
rf Wr torUue Pff,bc ?: F.i a 3 K inch pounds a, chock
tiwe if you aw J-.1annq 5' ciric Fort without testinq A test
5,hovmp ; 27f7 ,t)rii pci nds (;r iris mlt re'-nuire 4 font anchors
Note: A c!n!fr. ap pr;. veil taterri aria Svstern is being used and 4 ft
a+h;t „". #t- :3tSi•�yrji: at th_ sie'ievdall Ior_)tions I understanu 5 tt
a+l'h^r' ?Fi: r,�ijuired at :ill cunierline Ire (Joints where the torqu test
r;r less aril vvhwe the mobile home manufacturer
tr=.t�,u;,, .irutz:,rs .lift= •SOCCi Idinq capaeti�",�v.�;��i:4S5�'.y�s.±;��?`_`-r:..
Yc ;'
li�talie`r"s ,riiti8ls
ALL TESTS MUST BE PERFORMED BY A LICENSED INSTALLER
Insialler ;tame p
Dale ' ested -� O
Electrical
Connect electrical conductors betf,een multi -wide units, but not to the main power
source This includes the bonding wire between mutt -wide units. Pg.
Plumbing
Connect 311 seiner drains to an exisunq sewer tap or septic tank Pg.
Site Preparation
Debris and organic material removed
water drainage Natural Swale Pad Other
Floor Type Fastener Length Spacing
Walls Type Fastener Length Spacing
Roof Type Fastener Length Spacing 1/
For used homes a min 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 both sides of the centerline. .
Gasket tMtatherProutratg regmrctrtpntl w
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 beinc, installed I understand a Strip
of tape will not serve as a gasket
6nstalle:r's truti:ilti ��
Type gaskelk installed
13 :tweeti Floors Yes
Between "Marls Yes
t3uttom 0: ridgebParn Yes
The L'ottorriboarsf-will be repaired andror tape Yes
Siring -
Pq )lI
on units is installed to manufacture's s{,a rLations
Yes
F;replace chimney installed so as not to allow intrusion of rain water Yes
Miscellaneous
Skirting to be installed No
Dryer veal installed outside of sktrhng es N!A
Range downflow vent installed outsides of skirtinq Yes
N/A
Drain lines supported at 4 foot inten+als Ye �l
Electrical crossovers protected Yes
!ether
Installer verifies all information given with this permit worksheet
Is accurate and true based on the
Connect all potable water supply piping to an existing water meter, wafer tap. or other 1�nsta0leySiga�a>tu " C'AJi Ck- Date
w�,�
Jndependent water supply systems Pq