HomeMy WebLinkAboutPermit WorksheetPERMIT NUMBER;::zE.:.:.
Installer W 44 "�-- 910 d'A Lfcanse ii _DZ u I(DI bi ze
Address of home (ft(—IJAGC)
being Installed
Manufaciurer r - Length xWidth i!x--Z
NOTE: • If home Is a single wide fill out one half of the blocking plan
It honie Is a triple or quad wide sketch in remainder of home
I understand lateral Ann systems cannot be used on any home (new or Seri)
where the sidewali ties exceed 5 It 4 in,
Installers initials
Tvninal Hier cr,� 7....-_
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PERMIT WOFIKSHEET I page 1 of 2
New Home . ❑ Used Home Vl
Home installed to the Manufacturer's Installation Manual ❑
Home is Installed in accordance with Rule 15-0 �.
Singie wide ❑ nd Zone II Wind Zone III ❑
Double wide ' Installatlon Decal l Sy\(1(0
Triple/Quad ❑ Serial f- A 9g
PiER SPACING TABLE FOR USED HOMES
Lead Footer
bearing size
capaciy (sq In)
161X16'
(ems)
181/2'X 181/2'
(342) ,
201x20'
(dD0)
221X22'
(484)•
24'X34'26'x26'
(576)'
(676)
1000
Dst
1 3
ODD
4 6
6
g
D00
s
6
8
8
200
Ds
6.
8
8
g
3000
8
a
o s
a
a
PIER PAD SIZES .
I-beam pier pad size Irk }6 Z 2
Perimeter pier pad size
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.thelr pier pad sizes below.
POPULAR PAD -SIZES
ANCHORS
4ft it
FRAMEMS
within 2' of end of home
spaced at 5' 4a oo
OTHER ES
Longitudinal Stabilizzing Device (LSD) Sidewall Number
Manufacturer Mwulc V s L. f Longitudinal
Longitudinal StablilzIng Device w/Lateral Anus Marriage wall
ManufacturerJtN +fof-L 5ryr -i Shearwall
Opening Pier pad:size
5W,yLe
PERMIT NUMBER a An 1 _
' POCKET PENETROMETER TEST
The pbcket penetrometer tests are rounded wn to psi
or check hereto declare 10oo lb. soil without testing.
X X_ X__
POCKET PENETROMETER TESTING METHOD
1. Test the perimeter of the home at 6 locations.
2. Take the reading at the depth of the.fc oter;
S. Using 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 testis O Inch pounds or check
here if you are declaring S 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 tt.
anchors are allowed at the sidawall locations. I un arstand 5 tt
anchors are required al all centerline tie points where the torque test
rea6IngIs25
or less and where t mobile home manufacturer may
requires anchors with 40D0 Ib h pacity,�
Installer's initials
ALL TESTS MUST BE PERFORMED BY A LICENSED 119STALLFR
Installer Name L k&Le. RJd--,cerr
!Tate Tesfed _ ql,?
• f
' I?lectrleal
Ibnneot electrical conductors between multi -wide units, but not to the main power
ouroe. This•In9ludes the bonding wire between mult-wide units. Pg.
Plumbing -
onneot all sewer drains to an existing sewer tap or septic tank. Pg.
onnect all potable wafer supply piping to an i p water meter, water tap, or other
idepandent water supply systems. Pp,
PERMIT WORKSHEET Page 2012
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Site Preparation
Debris and organic materlal removed
Water drainage: Natural t/ Swala Pad Other
Fastening mule wide units
[/
Floor. Typo Fastener. Length: Spacing: Zyd,
Walls. -Type Fastener. L Length: rp__ Spacing: 2Y
Roof: Type Fastener. t Length: -a ,/ Spacing:
Forused homes a min. 30 gauge,!8" wide, galvanized metal strip
will be centered'over the peak of the -roof and fastened with galv.
roofing nails at 2" on center on both sides of the centerline.
Gasket (wmu,w II emwi n
I understand a properly Installed gasket Is a requirement of all new and used
homes and that condensation, mold, meldew and buckled meorlage walls are
a result of a poorly installed or no gasket being installed. 1 derstand a strip
of tape will not serve as a gasket.
Installer's initials
Type gasket Installed:
Pg. Between Floors Yes L_�
Between Walls Yes ___7;;'
Bottom of ridgebsam Yas ___��
Weatherproofing
The bottomb card will be repaired andror taped. Yes Pg.
Siding on units is Installed to manufacturees apeciflcat ons. Yes _LG
Fireplace chimney Installed so as not to allow intrusion of rain Water. Yes
Skirting to be Installed. Yes v No
Dryer vent installed outside of skirting. Y WA
Range downflow vent installed'outside of skirting. Y =WA
Drain lines supported at 4 foot Intervals.
Electrical crossovers protected. Yes
Other:
is accurate and true based on the
Installer Signature
Date