Gasket (weatherproong requirement)
I understand a properly installed gasket is a requirement on all new and used homes and
that condensation, mold, mildew, and buckled marriage walls are a result of a poorly in-
stalled or no gasket being installed. I understand a strip of tape will not serve as a gasket.
Installer’s Initials
Type gasket Installed:
Pg. Between Floors Yes
Between Walls Yes
Bottom of ridgebeam Yes
Weatherproong
The bottomboard will be repaired and/or taped. Yes Pg.
Siding on units is installed to manufacturer’s specications. Yes
Fireplace chimney installed so as not to allow intrusion of rain water. Yes
Miscellaneous
Skirting to be installed. Yes No
Dryer Vent installed outside skirting. Yes
Drain lines supported at 4 foot intervals. Yes
Electrical crossovers protected. Yes
Other:
Installer’s Signature Date
PERMIT WORKSHEET
POCKET PENETROMETER TEST
The pocket penetrometer tests are rounded down to
psf (or)
Check here to declare 1000 lb. soil bearing capacity without testing.
X X X
POCKET PENETROMETER TESTING METHOD
1. Test the perimeter of the home at 6 locations
2. Take the reading at the depth of the footer.
3. Using 500lb. increments, take the lowest reading
and round down to that increment.
X X X
TORQUE PROBE TEST
The result of the torque probe test is
inch pounds (or)
Check here to declare 5’ anchors without testing.
.
A test showing 275 inch pounds or less will require 5 foot anchors.
Note: A state approved lateral arm system is being used and 4ft. anchors are allowed
at the sidewall locations. I understand 5 ft. anchors are required at all centerline
tie points where the torque test reading is 275 or less and where the mobile home
manufacturer may requires anchors with 4000lb holding capacity.
Installer’s initials
Installer Name
Date Tested
ALL TESTS MUST BE PERFORMED BY A LICENSED INSTALLER
Electrical Information
A licensed mobile home installer can connect electrical conductors including the bonding
wire between multi-wide units. An electrical contractor's license is required to build the
service and connect the home to the main power source.
Plumbing Information
A licensed mobile home installer or a plumbing contractor can connect all sewer drains to
an existing sewer tap or septic tank. In addition the installer can connect potable water
supply piping to an existing water meter, water tap, or other water supply system.
Site Preparation
Debris and organic material will be removed and site prepared for adequate drainage?
Water drainage: Natural
Swale
Pad
Other
Fastening multi wide units
Floor: Type Fastener: Length: Spacing:
Walls: 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 roof and fastened with galv. roong nails at 2"
on center on both sides of centerline.
Gasket (weatherproong requirement)
I understand a properly installed gasket is a requirement of all new and used homes and
that condensation, mold, mildew, and buckled marriage walls are a result of a poorly
installed or no gasket being installed. I understand a strip of tape will not serve as a
gasket.
Installer’s Initials
Type gasket
To Be Installed:
Between Floors
Between Walls
alls
Bottom of ridgebeam
Weatherproong
The bottomboard will be repaired and/or taped? Yes
Siding on units will be installed to manufacturer’s specications? Yes
Fireplace chimney will be installed so as not to allow intrusion of rain water? Yes N/A
Miscellaneous
Skirting to be installed? Yes No
Dryer Vent to be installed outside of skirting? Yes N/A
Downdraft Range vent will be installed outside of skirting? Yes N/A
Drain lines will be supported at 4 foot intervals? Yes
Electrical crossovers will be protected? Yes
Other:
Installer veries all information given with this permit worksheet is accurate and
true based on the manufacturer’s installation instructions and/or Rule 15C-1&2
Installer Signature Date
