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SCANNED
PERMIT NUMBER
Installer EDWARD GRUNDEL
License'# IH1118467
Address ofhome 1936 BLUEFIELD RD '
being installed °
Manufacturer -JACOBSONe
ACOBSON ngth xwidth 26'8"X68'
NOTE: if home is a single wide rill out one half of the blocking plan
if home is a triple of quad wide sketch in refnaihder of home
I understand Lateral Arm Systems cannot be use_ d on any home (new or used)
'where the sidewall ties exceed 5 ft 4 in.
- `Installer's initials y 1EG '-
Typical pierspacing
2'
6' ✓ I IIDvel
'Show locations of Longitudinal and Lateral Systems
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BY
New Home OSt. Lug&i 86
'Home installed to the Manufacturers -Installation Manual
;Home is installed In accordance with Rule 15-C
Single wide Wirid Zone ll ," Wind Zone III
Double wide 0 Installation Decal # TBD
TriplelQuad Serial # TBD
PIER SPACING TABLE FORUSED HOMES
Interpolated trom Rule tact pier spacing iaole.
- PIER PAD SIZE
I-beam piw pad sim; 17X22.5
Perimeter pier pad size 16X16
Other pier pad sizes
(required bythe mfg.)'
Draw the approximate locations
wall openings 4 footorgreater.
1- . - s"ymb to show the piers.
List all marriage wall openings greater
and their pier pad sizes below.
'OpeningPier pad size
1-& 4 17X22.5
2 &'3 2r3 X39
POPULAR PAD
ANCHORS ,
4ft X 5ft
FRAMETIES
within 2' of end of home X
spaced at 5' 4" oc X —
TIEDOWN COMPONENTS OTHE2 TIES
Number
Longitudinal Stabilizing bevice (LSD) Sidewall
Manufacturer OLIVER Longitudinal
Longitudinal Stabilizing_ Device w/Late_ral Arms' Marriage wall
'Manufacturer 8hearwall
i - - , ' -- PERMIT WORKSHEET - I page zorz
PERMIT NUMBER
FOCKEI ET OM ES
. .
The pocket penetrometer tests' -are round1500
_ founded down to psf
or check here to declare 1000 lb. soil without testing.
X 150C X 150C- X'150C
POCKET PENETROMETER TESTING METHOD
1. Test the perimeter of the-homeaf6locations.
2. Take the reading at the depth ofhe footer.
3. Using 500 lb. increm_ exits, take the lowest
reading and round down to that increment.
X 150C - X-150C
TORQUEPROBETEST
X 150C
The results of the torque probe'testis 285 inch pounds or check
here if you are declaring 5' anchors without testing . Atest
showing 275 inch pounds oriess will require 5 foot anchors.
Note: A state approved lateral arm system is tieing used and 4 ft.
anchors ar`e allowed atthe sidewall locations. -I understand 5 ft
anchors are required atall centerline tie points where the torque test
reading is 275 or less and where the mobile home manufacturer may
requires anchors with 4000 lb holding capacity.,
EG Installer'sinitials
ALL TESTS MUST BE PERFORMED BY A LICENSED INSTALLER
Installer Name EDWARD GRUNDLL
Date Tested
Electrical
Site Preparation
Debris and organic material removed YES"
Waterdrainage: Natural Swale Pad X Other
Fastening multi wide units
Floor: Type Fastener: LAG Length: 6" Spacing: 24"
Walls; Type Fastener: LAG ;Length: 6� Spacing: 94"
Roof: Type Fastener: GALV 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 galv.
roofing nails at 2" on center on both sides of the centerline.
Gasket(woathorp roofing roquiromont)
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 ofa poorly installed or no gasket being installed. I understand a strip
of tape will not serve as a gasket.
Installer's initials EG
Type gasket FOAM Installed:
Pg. Between Floors Yes X
Between Walls Yes X
Bottom ofridgebeam Yes X
Weatherproofing
The bottom board will be repaired and/or taped. Yes X Pg.
Siding on units is installed to manufacturer's specifications. Yes X
Fireplace chimney installed so as not to allow intrusion of rain water. Yes X
Miscellaneous
Skirting to be installed. Yes_ X 11 No
Dryer vent installed outside of skirting. Yes X NIA
Range downflow vent installed outside of skirting. Yes X NIA
,Drain lines supported at4 footintervals. Yes X
Electrical crossovers protected. Yes X
Other
onnect electrical conductors between multi -wide units,'but notto the -main power
mroe. This includes the bonding wire between mutt=wide units. Pg.-
Install r verifies all information given with this permit worksheet
Plumbing is accurate and true based on the
manufacturer's iriptaVation i uctio a or Rule 15C-1 8r 2
onnect all sewer drains to an eAsting sewer tap or septic tank. Pg:
onnect all potable water supply piping to an ebsting water meter, water tap, or other Installer SignaturetdhDate
.A----rlonlurolcrwmnly c,_F temc Pr, - _ .i