HomeMy WebLinkAboutPermit Worksheets2C01 _ p 2-0-7
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•-PERMIT NUMBER
Installer 7e%� !I
Address of home J iZ Od S. 3%A- .34V Aej
being Installed
cif Pit-G` P/ _?v9F32 _#
Manufacturer 7'W,i P Length x width _?y k p q
NOT!~• •!f home Is a single wide fill out one half of the blocking plan
If home is a triple or quad wide sketch In remainder of home
I understand Laieral Arts Systems cannot be used on any home (new or used)
where the sidewall ties exceed 5 it 41n.
Installeez Initials
Typical pier spac p
,1 U ie�-%J I W"
Show locations of Longitudinal and Lateral Systems
(use dark lines to show these locations)
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PERMIT WdFZKSHEET gape l of 2
New Home . ❑ Used Home
Home Installed to the Manufacturer's Installation Manual ❑
Home Is Installed In accordance with Rule 16-0 �•.
Singie wide ❑ Wind Zone II e Wind Zone III ❑
Double wide 9� Installation Decal #
Triple/Quad • ❑ Serial # TX T9 / / / V 9 A
PIER SPACING TABLE FOR USED HOMes
lmd
Footar2'%181/2'
¢caring
size
20x20'
22%22'
24'XZ4'
26'X26'
capacity
(sq In)(942)
(400)
(484)'
(876)'
(firs)
100D s
941
- 7
00 s
6
8
000 s
B 8
2 00 s
8 6
8
3055 s
g
3 0 s8'
8
PIER PAD SIZES
I-beam pier pad size
Perimeter pier pad size
w ,
Other pier pad sizes
(required by the mip.)
®Draw the approximate locatlons of marriage
wall openings 4 toot or greater. Use this
symbol to show the piers.
List all marriage wall openings greater than 4 foot
and.thelr pier pad sizes below.
Openlnp Pier pad:size
POPULAR PAD SIZES
arm
■ -1-2
�L�-
y3�l�SY'■
�rsyya�t�v
ANCHORS
4If 1�51t
FRAME TIES
within Vol end of home
spaced at 5144 oc
TIEDOWN COMPONENTS OTHER TIES
Longitudinal Stabilizing Device (LSD) Sldewall Number
Manufacture
r_rY/i:iriP �rirr,n s.�eJynonpitudinal
LongitudlnaI Stab/thin Device w/Carer ms Marrlepe Wall
Manufacturer_AY/:A�t /!'to+.� r� s ti Shearwell
._ I
2coz - C;>20r1
PERMITNUMBER ay:F:•t v�� t,
POCKET PE ETROMETER TES
The pbcket penetrometer tests are rounded down to psi
or check hereto declare 1000 lb. soil �_ without tesiing.
X__ X—_ X_
POCKET PENETROMETER TESTING METHOD
1. Test the perimeter of the horde at 6 locations.
2. Take the reading at the depth of the.footsr;
S. Using 600 lb. lhorements,•take the lowest
reading and round down to that Increment.
X— XX__
ORO E PROBE TEST
The results of the torque probe lest Is Zg'j 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 it.
anchors are allowed et -the sldewall locations, 1 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 40D Ib t�yoldlnp capacity.
C. Installers Initials
ALL TESTS MUST BE PERFORMED B.Y A LICENSED INSTALLER
Installer Name -zee-�17 ej
Date Tasted
Electrical
Ibnnoct electrical conductors between multi -wide units, but not to the main power
ouroe. This•InPludes the bonding wire between mult-wide unlis. Pg.
Plembinp
cnnect all sewer drains to an exlsling sewer tap or septic tank Pg.
onnect all potable water supply piping to an existing water meter, water tap, or other
idependent water supply syslems. Pg.
PERMIT WORKSHEET
Page 2 of 2
Site Preparation
Debris and organic material removed
Water drainage: Natural Swale Pad Other
Floor. Type Fastener. Length: Spacing: /6'.
Walls: Type Fastener, o.. Length: Spacing:
Roof; Type Fastener. ___/dam Length: Spacing: /6
For. used homes a m'tb 30 gauge, 8' de, galvanized metal strip
will be centered •over the peak of theroof and fastened With gals.
roofing nails at 2"on center on both sides o1 the centerline.
—_ Gasket fwmlhemfeeltnar.eul t1
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
Installers initials 1-z
Type gasket OOGw .rti Installed:
Pg. Between Floors Yes
Between Walls Yes --Z7—
Bottom of rfdgebeam Y�
Weather roorin
The bottombcard will be repaired and/or taped. Yes pg
Siding on units Is Installed to manufacturers specifications. Yes
Fireplace chimney Installed so as not to allow. Intrusion of rain water. Yes
Mlseelleneous
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 foot Intervals. Yes
Electrical crossovers protected. Yes
Other:
all information given with this lot
is accurate and true based on the
Installer Signature
Date a • r0