HomeMy WebLinkAboutPermit WorksheetPERMIT NUMBER E
Installer License # .7E(X'113 / ?6
Address of home 3Z IXi s, fir'(' 7ly� f
being Installed
. d � G � 8z •3y
Manufacturer i u/ii7 Length x width
NOTE: 'it home is a single wide till out one half of the blocking plan
It home Iva triple or quad wide sketch in remainder of home
I understand Lateral Arm Systems cannot be used on any home (now or used)
where the sldewall ties exceed 5 ft 4 In.
Installer's initials
Typical pier span ng
2' S// -0 I minnl
26?72 —o jr, (
PERMIT WORKSHEET
New Home . ❑ Used Home [�
page 1 o12
Home Installed to the Manufacturer's Installation Manual ❑
Home Is Installed In accordance with Rule 1s-C •,
Sinpie wide ❑ Wind Zone II Wlnd Zona III ❑
Double wide ICr'!/ Installation Decal #
TriplelQuad ' ❑ Serial 0 72 t9 p/% o'; OA
PIER SPACING TABLE FOR I rcRn unl,v.
Load
Footar
6earing
size
16'X16'
781/2'%te fl2'
20'x20'
22'x221
24'X24' 26'x26'
capaolty
.(s9 ln)
(256)
(S42)
(40D)
(494)'
(576)' (676)
1000
s
9
0
00
s
6
g
g
g
8
2 00
s
6
8
g
8
80002-51
g
g
3 0
s
8'
8
Inlwmnlo 1M Im...
e..!
PIER PAD SIZES
I-beam pier pad size
r,
Perimeter pier pad size
Other pier pad sizes / ,r77'' '
(required by the mfg.)
®Draw the approximate locations of marriage
wall openings 4 foot or greater. Use this
symbol to show the piers,
List all marriapo wall openings greater than 4 foot
and.their pier pad sizes below,
Openlnp Pier pad:slze
InEDOWN COMPONENTS
Longltudlna/ Stabilizing Device (LSD)
Manufacturer _.�i:.i1 iL.re S2 +s^
Longltudlna/StablltziniDevlcew/ eterelArr�s'
Manufacturer
POP LAR PAD SIZES
iL•'i3L•'�S'�4:�
�Il�r:lrs'�'.ai��c
.Lyre
�rsyv.>t�i�
�Irry.7r�
. r r
flKri[:lFY.r.7crif•9��
irilhss4.�►yat!�
ANCHORS
4 it L/ 5 it
FRAME TIES
within 2' of end of hom
spaced at 5' 4" oo �%
DTHER IES
sldewall Number
Longitudinal
Marriage wall
Sheanvan
1. PERMIT NUMBER
W"VW4 PA
N
POC ET PE ETROMETER TES
The pboket penetrometer teals are rounded down to pat
or check hereto declare 1 WD lb. soil 4/ without testing.
X— X__ X
POCKET PENETROMETER TESTING METHOD
1. Test the perimeter of the horns at 6 locations,
2. Take the reading at the depth of the.fcotar.
S. Using 500 lb. increments, take the lowest
reading and round down to that Increment.
ORQUE PROS TEST
The results of the torque probe lest Is .� Inch pounds or check
here If you are declaring 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 4 ft.
.anchors are allowed etlhe sldewall locations. I understand 5 ft
anchors are required at all centerline tie points where the torque test
reading Is 27sor less and where the mobile f)ome manufacturer may
requires anchors with 4DD holding capacity.
2 Installer's Initials
ALL TESTS MUST BE PERFORMED BY A 116ENSED INSTALLER
Installer Name /<<�+-P� Z, 4
Date Tested CJ 2= !0 20 Zo
Eleetrleal
:bnnecl electrical conductors between multi -wide units, but not to the main power
ouroe. Thls•Ingludss the bonding wire between mull -wide units. Pp.
Plumbin
onnect all sewer drains to an existing sewer tap or septic tank. Pg.
onnect all potable water supply piping to an existing water meter, water tap, or other
ldependent water supply systems, Pp,
,Lco2—CatF
PERMIT WORKSHEET page 2 of 2
site Pre eretlon ,
Debris and organic mateirlal removed
Water drainage: Natural Swale Pad � Others,
Floor. Type Fastener
Walls: Type Fastener.
Roof: TVDs Fastanar
will be centered •over the peak of the roof and fa:
roofing nails at 2° on center on both sides of the
aesket wealhe revlln r Irement
I understand a properly Installed gasket 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 pasket being Installed, I understand a strip
Of tape will not serve as a gasket
Installer's InillalSZ!E:3_
Type gasket —Iera4alkl� Installed:
Pp. Between Floors Yes il
Between Walls Yes
Bottom of rldpebeam Yas—�
mther roonn
The bottomboard will be repalred and/or taped. Yes_ Pg.
Sldlnp on units Is Installed to manufacturer's specifications, Yes
Fireplace chimney Installed so as not to allow Intrusion of rain water. Yes
Mlseolinnoous
Skirting to be Installed. Yes No
Dryer vent Installed outside of skirting. Yes • WA _
Range downflow vent installed, outside of skirting. Yes WA
Drain lines supported at 4 fo6t intervals, Yes a.
Electrical crossovers protected. Yes
Other:
Installer
Is accurate and true based on the
Date C> /G "WIC,