HomeMy WebLinkAboutPermit WorksheetPERMIT —I UMBER ���° �� A�a�;� .
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Installer t r 4, 06* <%.,Nj Ce(u License d _t)
Addressofhome (� �(•% (�A
being Installed
PERMIT WC)FIKSHEET / page l of 2
New Home . ® Used Home
Home installed to the Manufacturer's Installation Manual ❑
•Home is installed in accordance with Rule is-O ��••
Single wide ❑ Wind Zone 11 ff� WMd Zone III ❑
Manufaclurer TWIA 9& ten LengthXwldlh DoubleWide
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I understand Lateral Arm s'c
ceedemannotbeuSed on any home (new or used)
wheretttesldewalltlesexceed5R41n. PIER SPACING TABLE FOR USED HOMES
Installer's initials
Load
keadng�
F
size er
16°xi6'
181/2'XIai/2' 20`X20'
22'X22, 24'X24-
p.6-X26'
oapaolly
(sq rn)
(26e) .
(642) .. (400) :
. (4e4)' (676)'
(676)
100
s
9
00
'
s
q.6
•g
8
000
s
6
S g
-2 00
s
8
9000
19,
_ g
9 o
°.Interco algid fmm Ride ur•_r ..re:...._.,r.�._u_ ..
• PIERPAOaRES _ n y
I-beam pier pad size PI X 2'z
Perimeter pier padsiie 11 r• k Z-Zl1
Other pier pad sizes
(required by the mfg.)
®Draw the approximate locations of mardp
wall openings 4 foot or greaten Use this
symbol to show the plers,
Lis( all marriage Wall openings greater than 4 too
and.their pier pad sizes below,
Opening Pier padsize
O- / `/ ' r'7 C,Z7—
TtE4o WN COMPONENTS
Long11ud1na7Stab111a1n Do' Ice(4#D)
Manufdolurer_Jryt o a S sla
Longitudinal stabb117zingDevl ! w/ eleta)A m
Manufacturer—F^'r w..{@^:G.y
♦ j
G� xyr
C
•POPULAR PAO'SI ES
FRAMETIEa
within 2' of end.of home
spaced at 5141 oo
OTHER IE8
sidewall, Number
Longitudinal
marriage wall
sheanyall
I^ OmMI n Via.
POCKET PE 7R6ETERTEST
The
cheek here-tobakel edeclare110016rsoll e mun owdhouttestinq. Psi
X� X_ X_
POCKET PENETROMETER TESTING METHOD
1. Test the perimeter of the horhe at 6 locations.
2. Take the. reading at the depth of the footers
S. Using 600 Ib,.lnorsments,.Iake the lowest
reading and round down to that Increment.
X_
TOROUE ROSETEST
The results of the terWaprobetest is •31crV Inch pounds or check
here If you are declaring 6' anchors Without testing - A test
showing 276 Inch pounds or less Will requke 6 foot anchors.
Note: A slate approved lateral arm system Is being used and 4 ft.
.anchors are allowed allhe sldewall locations. I understand 6 ft
anchors are requked at all centerilne tie points where the torque test
reading Is 276 of lase and where the 'nioblle home manufaolurer may
requires anchors with 4000 lb holding capnolly,
Installer's Inlllals
ALL TESTS MUST BE PERFORMEDBY A -LICENSED INSTALLER
Installer Nam/�e tt'` ytJa p..r pit A% o
Dale Tested _ y 20 Z,J,
r�
--'Eleetrlcsl
lbnneol electrical conductors between multi -wide units, but not to the main power
ouroe. Thls•Ingludesthe bandlnp wire between mutt wide units. Pa.
annoot all sewer drains to an existing sbwar tap or septic tank, pg. f�
cnnW all potable wafer supply plpinp to an ex st - ter meter, water tap, or other
rdependeritwater supply systems. PA.
FiERMI`i WORKSHEET pep®a of a
Site Prep6ratlon
Debris and organic matetlalreyte1
Water drainage, Natural l�Swala_T,Pad,__Other '
- astenino malt Wide anite '
.r
Floor. Type Fastener. L Length: �r Spacing-'Ly r/
Walls Type Fastener. Length:_ Spacing: Zy��
ROOT; Type Fastanok r a b_ Length; Io _ Spool
nyy: _ z
For.useci homes a min. 80 paupe„8" wldo, galvanized m tal strip
will be centeied •over the peak of the roof and fastened Wittt galy.
roofing nails at 2" on center on both sides of the centerline,
Gasket rwnlhetwodlndroaui e
I understand a property Installed pasket Is a requirement of all new and used
homes and that condensation, mold, meldewand buckled marriage walls are
a result of a poorly Installed or no pasket being installed, I un rstand a strip.
Of tape will not serve as a gasket.
/ integer's initials
Type pasket Imo �� Installed:
Pg. Between Floors Yes
Between Walls Yes —V_ `—
Bottom of rldgebeam Y
The bottomboard will be repaired andrer is od. "Yes _ •y . Pg,
Sldinp on antra Is Installed to mahu(aciurePa speoitloatlons. Yes���
Rrep aop chimney Installed so as not.to allow intrusion of rain water, yes_ e�jq
Skirting to be.lnstalied. Yas ✓ No
Dryer vent Installed outside o}skirting: Ya9? WAS
Range downflow vent Installed-cutslde of skirting. Y WA
Drain lines supported at 4 foot intervals !%
Elsotdcal crossovers protected. Yes
Other:
Is accurate and true based on the
Date