HomeMy WebLinkAboutPermit Worksheet-HERMIT NUMBER,
Installer Uoense # .Zdh> 2 9 /?X
Address of home -?4e
being installed r K± amn, r--G 2y9,q Z
Manufacturer jsa,;Ol — Length x width
AIOT/w' - If home is a single wide fill out one hall of the blocking plan
if horde Ise triple or quad wide sketch in remainder of home
I understand Lateral Arts Systems cannot be used on any home (new or used)
where the sldewall ties exceed 5 It 4 In.
Installer's Initials
Typical pier span ng
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'Show locations of Longitudinal and Lateral Systems
(use dark lines_
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PERMIT WONKSHEET
New Home • Q Used Home Er
page 1 of 2
Home Installed to the Manufacturer's Installation Manual ❑ -
Home Is Installed In accordance with Rule 16-0 •.
Singie wide ❑ Wind Zone II 2__/ Wind Zone III ❑
Double wide [� Installation Decal #
Tdple/0uad ' ❑ Serial # 2'z V? P> 6 sS6A
PIER SPACING TABLE FOR USED HOMES
Lead Fwar
4mring slZe
oepa011Y ,(s91n)
16'X16'
less)
181/99x181/2'
(34
20'X20'
(400)
221x22'
(494)-
24'X24'
(576)-
26'x26'
(676)
1 OD s
9
l t
0
6
000 sf
6
B
2 00 s
iI
B
B
g
SD00 psi
81
abuo
8' •
8
u,.vPwww u,nn mm� lair. Pror spnump Pmla.
PIER PAD SIZES �t
I-beam pier pad size / i Y Z2'P
Perimeter pier pad size I?-eT 2'!.
Other pier pad sizes
(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 marriage wall openings greater than 4 foot
and .their pier pad sizes below.
POPU AR PADS ES
ANCHORS
4It .✓ 5It .
FRAME TIES
within Vol end of horny
spaced at 5' 40 oo,�
OTHER ES
Longitudinal Stablllzln Device (LSD) Sidewall N—
Manufacturer �s9.Arl Mc..•t yd ! r.c Longitudinal
Longitudinal ;11,lz/ngg Devloe w/Lateral Arms Marriage wall
Manwlaclurer�/�iusfG.. hTa,n j.e 71t*iT Sheawall
Opening Pier pad+size
>9x?2
T
,rLp02 -(7/qd
PERMIT NUMBER
POCKET PEN OMETER TES
The bbcket penetrometer tests are rounded jdown to pat
or check hereto declare JOOD lb. soil without testing:
X__ X— . X—
POCKET PENETROMETER TESTING METHOD
f. 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
X__ X— X—
ORO E ROB - S
The results of the torque probe test Is 8 Inch pounds or check
here If you are declaring 5' anchors without testing - A test
showing 275 Inob pounds or less will require 5 foot anchors,
Note: A state approved lateral arm system Is being used and 4 ft.
anchors are allowed at4he sidewall locations. I undarstand 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 400 Ib holding capacity,
Installer's initials
ALL TESTS MUST BE PERFORMEDLICENSED INSTALLER
Installer Name �P�if7.
Date Tested 6 Z • / ®— 7-0 LO.
i
. EleetrIca[
lbrinect electrical conductors between multi -wide units, but not to the main power
ouroe. This•Includes the bonding wire between mult-wide units. Pg.
Plumb nn
onnect all sewer drains to an existing sewer tap or septic tank Pp.
onneot aft potable water supply piping to an existing water meter, water tap, or other
(dependent water supply systems. Pp.
PERiViIT WORKSHEET
Page 2 of 2 I
site Preparation
Debris and organic material removed /
Water drainage: Natural Swale Pad d Other
_ Fasten no multiwide units
Floor. Typa Fastener Length; 8" Spaclnp;
Walls: Type Fastener Length: Spacing: r
Root: Type Fastener. .&* Length: Spacing:
For.used homes a min. 30 gauge, 8" wide, galvanized metal strip
will be centered •over the beak of theroof and fastened With gaiv.
roofing nails at 2" on center on both sides of the centeriine.
Gasket fwmlh"roreollhff w 1n 11
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 of a poorly Installed or no gasket being Installed, I understand a strip
of tape will not serve as a gasket.
Installer's initials /C L
Type gasket Installed:
Pg. Between Floors Yes ✓
Between Walls Yes a."
——
Bottom of ridgebeam Yes
Weatherproorine
The bottomboard will be repaired and/or taped. Yes I,"" Pg.
Siding on units is installed to manufacturer's specifications. Yes
Fireplace chimney Installed so as not to allow intrusion of rain water. Yes
Mlseellaneous '
Skirting to be installed. Yes No .
Dryer vent Installed outside of skirting. Yes WA
Range downflowvent installed'outside of skirting. Yes WA
Drain lines supported at 4 foot Intervals, Yss
Electrical crossoversprotected. Yes zi
Other: _
Installer
Is accurate and true based on the
Date L-!o &a