HomeMy WebLinkAboutPermit Worksheets-.PERMIT NUMBER•t,:1r.>a z.
Installer 2�1 t /f�1li,'� �w .. License# sf/�//L3/3es
Address of home .?EOC7
being Installed
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Manufacturer //on+e, 6F 2_ddd •?' Length x width 4.9, "X
NOTE: • it home Is a single wide fill out one halfal the blocking plan
If horde is a triple or quad wide sketch in remainder of home
I understand lateral Ann Systems Cannot be used on any home (now or used)
where the sidewall ties exceed 5 ft 4 In. p
Installers initials /, Z
Typical pler spacing
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Sfiow locations of Longitudinal and Lateral Systems
717."na I (use dark lines to show these locations)
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PERMIT WORKSHEET
New Home . ❑ Used Home 2(
Zczf�>Z — olg�
Pepe 1 of 2
Home Installed to the Manufacturer's Installation Manual ❑
Home is Installed In accordance with Rule 16-0
Single wlde ❑ Wind Zone II ff� Wlnd Zone III ❑
Double wide Installation Decal #
Triple/Quad '❑ Serial 0 %-A.°I9 P 2/ 3 2 LA
PIER SPACING TABLE FOR USED HOMEs
Lnad
kafin
slier
Wx16'
1e1f2109112'
201x20'
22x22+
24'X24'
26•x2G.
eepeolly
(eq In)
(26e)
(342)
(400)
(484)•
(576)•
(676)
1000
s
3
1 1
00 s
46
6
6
00 s
6
6
6
2
00 s
6
8
6
6
3000
s
6
6
3
0 s 1
8'
3
Inln.n..lele.l
1....�
. - . � PIER PAD SIZES n �•-•
77
I-beam pier pad size /'7X22"
Perimeter pier pad size /'9/ Z_`
Other pier pad sizes
(required by the mfg.)
_ Draw the approximate locations o1 marriage
®
wall openings 4 foot or greater. Use this
symbol to showthe piers,
List all marriage wall openings greater than 4 foot
and their pier pad sizes below.
POPULAR PAD SIZES
Rug
WDA
i[[11111*949
i[
Yle)r.�jW-10
■�rsyr��Elgv
iv�avc�rK':Sl
■�3nrr�.>o
..
•'�Ya.Ycr .
KUM
Illm
JJJJ.M=SLU■
4It 5 ft
FRAME TIES
within 2' of end of home
spaced at 5' 4" oo
OTHER IES
Longifudinal Stabilizing Device (LSD J Sidewall Number
Manufacturer /yfi c i1�2a.a onpaudinal
Longitudinal Stabl/lxing evice w/ ateral Arm Marriage wall
Manufacturer .�'lnJc• h2� ;,,,,�, Shear g If
Opening Plerpad:size
TIEDOWN COMPONENTS
°' PERMIT NUMBER
POC ET PENETROMETER TEST
The pbckel penetrometer tests are rounV down to pat
or check hereto declare 1000 lb. soli without testing.
POCKET PENETROMETER TESTING METHOD
1. Test the perimeter of the home at a locations.
2. Take the reading at the depth of the,focter.
S. Using 500 lb. increments, take the lowest
reading and round down to that increment.
X_
TOROUE PROBE TEST
The results of the torque probe test Is 2-0 � Inch pounds or check
here If you are declaring 5 anchors Without tasting . A test
showing 275 Inch pounds or less will require 5 foot anchors,
Note: A state approved lateral arm system Is being used and 4 ft.
-anchors are allowed et4he sidewali locations. I. understand 5 ft
anchors are required at all centerline tie pointp where the torque test
reading Is 275 or less and where the mobile home manufacturer may
requires anchors with 4oD b holding capacity.
Z Installer's Initials
ALL TESTS MUST BE PERFORMED BY A�LICENSED INSTALLER
Installer Name /�� e- �/or
Date Tested O Z- /0 • Zp Zc,
Elextrleal
Ibnnect electrical conductors between multi -wide units, but not to the main power
DUMB. Thls•Inoludss the bonding wire between mull -wide units. Pg.
Pigmbino _
my.
onnect all sewer drains to ah existing sewer tap or septic tank. Pg,
onnect all potable water supply piping to an existing water meter, water tap, or other
idepehdent water supply systems, Pq,
Zcoz-Ot03
PERMIT WORKSHEET I page 2 of 2
site Preparation
Debris and organic material removed
Water drainage: Natural Swale Pad Other
Fastenln multi wide units '
Floor Type Fastener lei✓ Length: $ Spacing: rI
Walls: Type Fastener, Length: �qcr�� Spacing: —
Roof: Type Fastener. Length: FI spacing: —
-
For -used homers' a m metal —Strip
. So pauge, 8" wide, galvanized
will be centered over the peak of the roof and fastened with palv,
roofing halls at 2" on center an both sides of the centerline.
Gesket mIhe rneM . IremeM
1 understand a properly Installed pasket Is a requirement of all hew and used
homes and that condensation, mold, meldew 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 Fd o s+ Installed:
Pg. Between Floors Yes •ram
Between Walls Yes
Bottom of ridgebeam Yes
weatherproonne
The bottomboard will be repaired andror taped, Yes Z�/ _ Pg.
Siding on units Is Installed to manufacturer's specifications, Yss
Flreplace chimney Installed so as not to allow intrusion of rain water. Yes _
Miscellaneous
Skirting to be Installed. Yes No
Dryervent Installed outside df sit ding. Yes WA_ .
Range downflcw vent installed- outside of skirting. yes WA
Drain lines supported at 4 foot Intervals. �
Electrical crossovers protected. Yes
Other:
Installer
Is accurate and true based on the
Date QL- tb-24ZC