HomeMy WebLinkAboutPermit Worksheet-PtRMIT NUMBER
Installer g,� •er•P- -z r✓ASoirJ lJcense#
Address of home _ 3)L t) S; i
being Installed
Manufacturer ! w t 0 1
Length x width
NOTE 'it home Is a single wide fill out one half of the blocking plan
!f home [as triple or quad wide sketch In remainder of home
I understand lateral Arts Systems cannot be used on any home (new or used)
where the sidewall ties exceed 5 ft 41n. L .
Installer's initials
Typical plar�pyacing 7
o I locations of
linesl and Lateral Systems
(use dark these
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PERMIT W08K-SHEET I page 1 of P
New Home Used Home ®/
Home installed to the Manufacturer's Installation Manual ❑
Home is Installed In accordance with Rule 16-0 Single wide ❑ Wind Zone II i2'- Wind Zone III ❑
Double wide Gg-�-Instailatlon Dacal # E' 7 943
TripletQuad ' ❑ Serial* r2 !;'? f & .SSG /414%
PIER SPACING TABLE FOR USED HOMES
Imdg
4eadn
capaolty
Foosizerer
I (sq in)
16'X18'
(26s)
181/2'081/2'
(342)
Wx20'
(40D)
22'x22'
(484)•
24'X24'
(676)'
26'X26'
(676)
1000
at
9
1600 Psi
4
6
DOD
s
a2
00 s
6
8
6-
i
3000 s
B
3 0
8' '
.u.o.Mvaua. uuw r,um wv, y,e, nyeuniH ,_,.,e.
PIER PAD SIZES
I-beam pier pad size
Perimeter pier pad size
Other pier pad sizes
/7" X 2--?
(required by the mfg.)
®Draw the approximate locations of marrial;
wall openings 4 toot 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 padsize
!/�rx i1
Longitudinal Stabilizing Devlce ((LSD1'�r_
Manufacturer t^+:F. �7�<c� fi
Longitudinal Stabllhdn evlce w/t�. 1era/Ani7s
Manufacturer Ar�-• r7 O+'
POPULAR PAD SIZES
ANCHORS
4it fl
FRAME TIES .
within 2'.of end o1 home
spaced at 5140 co
-OTHER ES
Nu ber
Sidewall
Longitudinal
Marriage wall
Shsarwall
° +PERMIT NUMBER ems• '" ... 4 m,. •,ate
.......
POCKET PE ETRO ETER TES
The pbckst penetrometer tests are rounded do to pat
or check hereto declare I OOD lb. soil rounded
testing.
X X— X_
POCKET PENETROMETER TESTING METHOD
t, Test the perimeter of the home at 6 locations.
2. Take the reading at the depth of the .footer;
S. Using 500 lb. increments, take the lowest
reading and round down to that increment
TORQUE PROBE TEST .
The results of the torque probe test ism inch pounds or check
here if you are declaring 5' 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 ft.
anchors are allowed atQhe sldewall locations. I understand 5 ft
anchors are required at all centerilne tie point,; where the torque test
reading is 275 or less and where the mobile home manufacturer may
requires anchors with 400• t ding capacity,
G Installer's initials
ALL TESTS MUSS BE PERFORMED BY A LICENSED INSTALLER
Installer Name �h - 2-.,-
Dale Tested _ /�/ T���y/ Jn
FJeetrlcal
Veen multi -wide units, but not to the main power
wire between mult-wide units. Pg.
w, Gal sewer urams io an existing sewer tap or septic tank. Pg.
�� CIE iai�� IAI'1'N
PERMIT WORKSHEET
Page 2 of 2 I
site Preohracon
Debris and organic mate rlaf reraomed
Water drainage: Natural le Pad Other1,
_ Fastening mulc wide units
Floor. Type Fastener. � Length: r Spacing: 0 a
Walls: Type Fastener. ? Length: Spacing: �—
Roof Type Fastener. Length: �' Spacing: Z • �—
For.used homes a in. 30 gauge, 8' wide, galvanized metal strip
will be centered'over the peak of the roof and fastened With paiv.
roofing nails at 2" on center on both sides of the centerllne.
Gasket (wmthe,oreennn rwvinYnent
I understand a properly installed gasket Is a requirement of all new and used
homes and that condensation, mold, meldew and buckled marriage walls are
a result of a poorly Installed or no gasket being installed. I understand a strip
of tape will not serve as a gasket y�
Installer's initials— X_ 2,
Type gasket �"" Installed:
Pg. Between Floors Yes
Between Walis Yes
Bottom of ridgebeam Yes
Weatherproogng
The bottomboard will be repaired and/or taped. Yes Ci' pg.
Siding on units Is Installed to manufacturer's specifications. Yes
Fireplace chimney Installed so as not to allow intrusion of rain water. Yes%
Mlsceilaneous '
Skirting to be installed. (as No -
Dryer vent installed outside of skirting. Y;� ----' WA
Range downflow vent installed'outside of skirting. Yes WA
Drain lines supported at 4 foot intervals,. Y
Electrical crossovers protected. Yes
Other:
is accurate and true based on the
Piping to an existing water mstar, water tap, or other Installer Signature /�/ Date�O�Z