HomeMy WebLinkAboutPermit Worksheete Y"°'• a ,y WON
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PtRiWIT NUMBER
Installer/��) �' qw frir` e License #
Address of home ZrJi � �4 tJA,, PFi�r( $ftrJ� �Gri �t/SSZ
being Installed
Manufacturer �butteS U�l�(Aab.tf LengthxWidth -&17 �4
NOTE: ' if home Is a single wide fill out one half of the blocking plan
PERMIT WORK -SHEET � paye7ota
New Home . ® Used Home 0—
Home Installed to the Manufacturer's Installation Manual
Home is installed in accordance with Rule 15-0 ®�
single wide
Double wide
If home !s a triple or quad wide sketch In temalnder of home i nplaVduaa
I understand Lateral Ann Systems cannot be used on any home (new or us
where the sldewall ties exceed 5 It 4 in,
Installer's Initials
Typical pier lacing
2, L/ .Ila.emi
I-MuLdnel
Inenlega WeuPlem WINn 2'of end of hmne
®WindZonell ❑ Wind Zone111 ❑
t��Installation Decal _s���1
® serial 0 _p(- in lnf 3 Sp. q,7 3 e r 72 q %
PIER SPACING TABLE FOR USED HOMES
Load
6eadng'
Footar
slze
IVX16°
1a119'X18I12°
20'X20'
22°x22} 24'X24'
.
2s'x26'
eapaoliy
(sq In)
(.259).
(342) .
(400) _
(464)° (576)0
(676)
1000
s
9
00
s
4 6
8
8
' ODD
6
200
s
6
8
8
8
3000
8
8
900.
s8'
8
PIEA PAD SIZES .r ._.
pier pad size
er pier pad size t 2 x'Z,-4-
er pad sizes (7 X2Z
Draw the approximate locations of marrlag
wall openings 4 foot or greater. Use this
tsc symbol to show the piers,
List all marriage well openings greater than 4 foot
and.their pier pad sizes below.
Opening Pierpad:size (4( Sr f -7 XZZ
TIEDOWN CDMPONENTs
Longllrtd[nat Stablflaing Device (LSD)
Manufacturer�ua Jd eM-4r
Longitudinal Stab] laing Device w/Lateral Ardis
'Manufacturer- (Mt.JJ'Fc'-.-�±-..
POPULAR PADsIZEs
4fty3((
FRAMETIEs
Within 2' of end of homi--�
spaced at S' 40 oo _
OTHER TIE6
Sidewall-
Longitudinal
Marriage wall
shearwall
POCKET PENETROMETER TEST
The pocket penstrometertests are rounde5l, rn to psi
orcheck here4odeclare lDOD lb. soil withouttastinq.
X® X® X_
POCKET PENETROMETER TESTING METHOD
i. Test the perimeter of the home at 6 locations.
2. Take the reading at the depth of the footer.
8. uxing 500 lb. increments, take the lowest
reading and round down to that Increment
X X®. X__
TORQUE PROBE TEST -
The results of the torque probe test is inch pounds or check
here if you are declaring 5' anchore 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 at the sidawall locations. I understand S.ft
anefinrs 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 40W'L `�'ng capacity.
e) Installees initials
ALL TESTS MUST BE PERFORMED BY A LICENSED INSTALLER
Installer Name. W: A/it%Q_ 4i C Cry
Date Tested
"Electrical
Ionnect electrical conductors between multi -wide units, but not to the main power
ourae. This•Inctudesthe bonding wire between mult-wide units Pg.
anneot all sewer drains to an Odsting sewar tap or septic tank Pg,
onnect all potable Wafer supply piping to an ex ' g water meter, water tap, or other
!dependent Water supply systems. Pg.
IJERMrr ViWORKSHEET . page 2 of 2 I
site PreoaraUcn
Debris and organic material remoyed
Water drainage: Natural Shale Pad _other '
- Fastening multi Wlde units
Floor. , Type Fastener Length: 6 �i spacing: Zy
Walls Type Fastener. Length: • _ spacing;
Roof: Type Fastener. Length, ( rl spacing: ,v
For -used homes a min. 80 gauge,!8" wide, galvanized metal strip
will be centered'over the peak of the roof and fastened With gals.
roofing nails at 2" on center on both sides of the centerline,
- Gasket(wmth!M:..0nd r"eui 0
i understand a property Installed gasket Is a rquirement of all nowand used
e
homes and that condensation, mold, mellow and buckled ma 'age walls are
a result of a poorly installed or no gasket being installed: I Uri ersland a strip
of tape will not serve as a gasket.
Installsee initials
Type gasket y_ - Installed:
Pg. Between Floors Yes
Between Walls Yes
Bottom of rfdgebsam Y�
Weather aroo}Ino - -
The bottomboard will be repaired andlor taped. yes ✓ Pq,
Siding an units Is installed to manufacturer's specigcatlons. Yes
Fireplace chimney Installed so as not to allow intrusion of min water.' Yes L/
Skirting to be.installed. Yes PNo
Dryer vent installed outside R skirting. Yes ' �WA
Range downflow vent installed•cutsids of skirting. Yes %`—WA
Drain lines supported at 4 foot intervals. Yes
Electrical crossovers protected Yes
Other:
Installer
acqurate. and true based on tfte
!say &
Data � W2. o