HomeMy WebLinkAboutPermit Worksheet{HERMIT NUMBER .��.. .
..............
Installer!g do License
Address of home
belnp Installed �tfce at
Manufacturer - Length x width
NOTIw 'It home Is a single wide fill out one half of the blocking plan
If horde to a triple or quad wide sketch in remainder of home
I understand lateral Ann Systems cannot be used on any home in
More the sidewall ties exceed 5 ft 4 In.
Installer's Initials
Typical pier spacing • I
1�/ ILLerd
9'
PERMIT WdRK-SHEET
New Home . Q Used Home
page 1 of 2
Home Installed to the Manufacturer's Installation Manual
❑ '
Home Is Installed In accordance with Rule i6-O
Single wide ❑ Wlnd Zone II 23 wind Zone III
❑
Double wide ' Installation Decal #
Tdple/Quad ❑ Serlal #
PIER SPACING TABLE FOR USED HOMES
Load
tleadng
capacity
I Footer
SIZE
(sq in)
16' X 16'
(266)
181/2' % 9 6 1/2'
(342)
20' x 20'
(400)
22' x 22'
(484)'
24' X 24'
(676)'
26' x 26'
(575)
1000 st
3
1500 ost6
6
DO Pat
6'6
2 00 s
6
8
6
8
8000 s
8
B
Interpolated from Rule 16C-1 pier spaolnp table.
PIER PAD SIZES
I-beam pier pad size "%%-
Perimeter pier pad size`2
Otherpierpad,sizes
(required by the mfg.)
®Draw the approximate looatlons 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.
Opening Pier pad:size
TIEDOWN COMPONENTS If
Longitudinal Stablllzing Device (LSD)
Manufacturer
Longitudinal Stablltzing Devoe wl Lateral Arms
Manufacturer
POPULAR PAD SIZES
ANCHORS
4 ft it
within 2' of end of home
spaced at 5' 4' o0
OTHER IES
Number
Sidewall
Longitudinal
Marriage wall
Sheaiwall
• •' PERMIT NUMBER , ;�> •:: �;� �.•, r, ,� . t'
POC PUNETROM9iTR TES
Thepbcket penetrometer tests are rounded down to psf
or check hereto declare 1000 lb. soli without testing,
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.
S. Using 600 lb. increments, take the lowest
reading and round down to that InommenL
X— X_. X—
ORO E PROB
The results of the torque probe test is Inch pounds or check
here If you are declaring 61 anchors w out testing . A test
showing 2751nob pounds or less will require 5 foot anchors,
Note: A state approved lateral arm system Is being used and 4 it.
anchors are allowed at4he eldewall locations. I understand 5 it
anchors are required at all centerline tie pointg where the torque test
reading Is 276 or less and the mobile home manufacturer may
requires anchors with 40 ding capacity,
Installers Initials
ALL TESTS MUSPE PERFOR BY A LICENSED INSTALLER
Installer Name 8
Dale Tested
ectrleel
:bnnect electrical conductors between multi -wide units, but not to the main power
ouroe. Thls•include3 the bonding wire between mult-wide units. Pp.
Plgmb n
onneot all sewer drains to an existing sewer tap or septic tank Pg,
onnect all potable water supply piping to an existing water meter, water tap, or other
Idependent water supply systems, Pp.
PERMIT WORcKSHEET I page 2012
Site Preparation
Debris and orpenlc material removed
Water drainage: Natural Swale Pad,
Other —
Fastening multi wide un is
Floor. Type Fastener Length: .42_ Spaolnp: It,
Walls: Type Fastener. Length: Spaolnp:._
Roof: Type Fastener. Length: � Spacing:
For. used homes a min. 30 gauge, 8" wide, galvanized metal 'skip
will be can the peak of the roof and fastened with gaiv.
roofing nalls at 2" on center on both sides of the centerline.
Oesket (wmlhwieelln ne I 11
I understand a properly Installed gasket Is a requirement of all new and used
homes and that condensation, mold, meldew and buckled marrlape walls are
a result of a poorly Installed or no gasket being Installed. I un rot d a strip
Of tape will not serve as a gasket.
Installers initials
Type gasket .-U tc Installed:
Pg. Between Floors Yes
Between Walls Yes l--'
Bottom of ridgebeam Yes
Weatherprcopno
The bottomboard will be repaired andrortaped. Yes_ . pp,
Sldino on units Is Installed to manufacturers specilloations. Yes
Fireplace chimney Installed so as not to allow intrusion of rainwater. yes_
Mlsoellaneous
Skirting to be Installed. Yes No
Dryer vent installed outside of sklrting. Yes . WA
Range downflow vent installed'outside of skirtlnp. Yss WA
Drain lines supported at 4 foot Intervals, Yes
Electrical crossovers protected. Yes
other: _
Is accurate and true based on
Installer Signature