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HomeMy WebLinkAboutPermit Worksheet:PEFtXu1lFt.Cr r,z• NUMBER, Installer ha `� �� License i1 T 14 11 o i t 3 % Address of home too?) being Installed Manufaciuer E30PJ✓1D% Length xwidth NOTE: 'If home Is a single wide fill out one half of the blocking plan If horde is a triple or quad wide sketch In remalnder'of home I understand lateral Arm Systems cannot be used on any home (new orMseca where the sidewall ties exceed 5 ft 4 In: Installer's initials Typical pier spacing lateral I� Show locations of Longitudinal and Lateral Systems lerelr��t (use dark lines to show these locations) CA i - 0 J-f2C dcu)I. ' 5 - ���a��r�ir111ai���lta�� ■■■■■■■■■■■■■■■� K ■■■■■■■■■■III,■■■■I1 ■■■■■■■■■■■■■■■, u, t. mevinLe wall Planr wlL4n 2' cf end of hcm. PERMIT WORKSHEET Pagel DY2 - -- New Home Z/ ❑ Used Home Home installed to the Manufacturer's Installation Manual [ Home Is Installed In ac ordance with Rule 15-0 ❑ Single wide Wind Zone II ❑ Wind Zone III Double wide ' ❑ Installation Decal k Triple/Quad ❑ Serial n PIER SPACING TABLE FOR USED HOMES Load gearing capacity Foo[er size (sq In) 16'x16' (255) 18 iJ�'Xis 11T (342) 20'X20' (40D) 22'x22' (464)e 24'X24' (576)e 25'x26' (676) ' 100D s 3 DO s 4 6 6 g D00 s 6 8 8 g -20D s 6 a a g 3DD0 Ds 8 8 a g 3 00 QSI I d. I d 8 e uopviu.w uwu num �u�.-i pin[ spac�nA Warne. PPAD SRES I-beam pier pad sizeze f IL CAL Perimeter pier pad size � �1 G Other pier pad sizes W hrr (required by the mfg.) ®Draw the approximate locations of marriage wall openingi 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. POPULAR PAD SIZES ter.-szvau��rr�� fYfIY.iFYbfIY��� ANCHORS 4ft Sft FRAMEMS / within 2' of end of home/ spaced at 5' 4n oc TIEDOWN COMPONENTS OTHER TIES Number Lnng)tudlnal Stt�pb11Wnp —Device ((L�SD) Sidewall Manufacturer 71.P (,l�d✓1 C.f'IgtYl ngitudinal Longltudlna! $gtablllzlrr��gg Device w L rat Arms nlapa wall Manufacturer't t� 01PJt n..!. r a �a wail Opening Pier p d:size (�Jl�e . J M L PERMIT NUMBER :.. x �..•x�"i ?.COa:<e".<,) 'R 'tea tc,•.7�„`.• .POCKET PENETROMETER TEST The pbcket penetrometer tests are rounded down to psi or check here to declare t00D lb, soil without testing. X X X C P NETROMETER TESTING METHOD est the perimeter of the home at 8 locations. 2. Take the reading at the depth of thafooter. S. Using 500 lb. lhorements, 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' anchors without testing A test showln 75 inch pounds or less will require 5 foot anchors, �o�ate approved lateral arm system is being used and 4 ft. Ck/� anchors are allowed at the sidewall locations, I understand 5 ft anchors are required at all hcenterlinetie points where the torque test reading Is 275 or less and er hhe triobile fjomo manufacturer may requires anchors with 40 Idinp capacity. Installer's Initials C 0 ALL TESTS MUSTg PERFO�R DD�Y A LICNS�EDJNSTALLER • a20Nam, rn y� fig �d �wa— � — � ElecVlcal 0 066WAwIrloal conductors between multi -wide units, but not to the main power Outce. is -Includes the bonding wire between mult-wide units. Pg. 0..m' Plumbing. rdnrt�'ta I sewer drains to an existing sewer tap or septic tank Pg. orMot all potable water supply piping to an existing water meter, water tap, or other idepandont water supply systems, Pg. PERMIT WORKSHEET Debris and organic material removed Water drainage: Natural Swa, f Page. 2 of 2 Other Floor. Type Fastener lo? Sp cq Inch.; J1 Q Walls: Type Fastener. Sp c' Roof: Type Fastener. Spa ing' For. used homes a min. 30 "wide, galvanizedmetal 'strip will be centered over the peroof and fastened With paly. roofing nails at 2" on center on both sides of the centerline. Gasket (wmlhm�roeflng regutmmanq I understand a properly installed gasket Is a requirement of all new and used homes and that condensation, mold, meldew and buckled rri pe walls are a result of a poorly installed or no gasket being lnstall_ed� I d st nd a strip of tape will not serve as a gasket. 1IVV�.``'�77 1 1 s " initials Type gasket ` Metalled: Pq. Between Floors Yes Between Walls Yes Bottom of ridgebeam Yes The bDttombDard will be repaired and/or taped. Yes V",, Pg, L Siding on units Is installed to manufacturer's speciflcations. Yes V �( � Fireplace chimney Installed so as not to allow Intrusion of rain water. Yes j_(Ar Skirting to be installed. Yes V No Dryer vent installed outside of skirting. Yes —� WA Range downflow vent installedoutside df skirtlnq. Yes_ WA Drain lines supported at 4 foot intervals. Yes Electrical crossovers protected Yes h� Other: Installer is accurate and true based gp the