Fillable Manufactured Home Installation Information (Brevard County Board of Commissioners)

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Manufactured Home Installation Information (Brevard County Board of Commissioners)

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Brevard County Building Code
2725 Judge Fran Jamieson Way, A114
Viera, FL 32940
Phone (321) 633-2072 | Fax (321) 633-2087
Manufactured Home Installation Information
Date _____________________ Building Permit Number ________________________________________
Site Address _____________________________________ _________________ _______ _________________
Street City State Zip Code
Manufacturer’s Name: ______________________________________ Date Manufactured ________________
Model _____________________________ Year __________ Serial Number ____________________________
Wind Zone __________ Number of Sections __________ Width __________ Length __________
Site Preparation Mfg. Manual
Debris and organic material removal compacted fill pg. # __________
Water Drainage: natural swale pad other pg. # __________
Foundation
Load bearing soil capacity ______________________ or assumed 1000 psf pg. # __________
Footing type: poured in place portable pg. # __________
Footing size and thickness ______________________
I-beam or main rail piers: single tiered double interlocked pg. # __________
Size of piers ______________________________ placement o/c _________________ pg. # __________
Perimeter pier blocking: size _________________ placement o/c _________________ pg. # __________
Ridge beam/center line support blocking: size __________ number _______________ pg. # __________
Ridge beam support footer: size _______________ number_________________ pg. # __________
Special pier blocking required: (fireplace, bay window, etc) yes no pg. # __________
Brevard County Building Code
2725 Judge Fran Jamieson Way, A114
Viera, FL 32940
Phone (321) 633-2072 | Fax (321) 633-2087
Mating of multiple units: mating gasket type used pg. # __________
Fasteners: roofs, type and size ___________________ spacing __________ o/c pg. # __________
end walls, type and size ___________________ spacing __________ o/c pg. # __________
floors, type and size ___________________ spacing __________ o/c pg. # __________
Anchors: type 4725 ultimate load 6000 ultimate load pg. # __________
Test probe torque value ___________________ (275 in. lbs. or less = 5 ft. anchor) pg. # __________
Height of unit: (top of foundation or footer to bottom of frame) _______________ pg. # __________
Number of frame ties: _______ spacing: _______ o/c angle of strap _______ degrees pg. # __________
Number of over the roof ties: (if required) ______________ pg. # __________
Number of sidewall anchors: _________ Zone II _________ Zone III _________ pg. # __________
Number of centerline anchors _________ number of stabilizer devices __________ pg. # __________
Number of end wall anchors __________ pg. # __________
Vents required for underpinning (1 sqft per 150 sqft of floor area) number _________ pg. # __________
The information provided above meets the requirements of 15C-1
___________________________________________________ License # ___________________________
Licensed Installer or Dealer Name
Form Date 2/8/2021 Form: MHINSTL
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Manufactured Home Installation Information (Brevard County Board of Commissioners)

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Completed 1 April 2021

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