HomeMy WebLinkAboutPermit Worksheets•' i"• C - • •u• ...j : . r. • , • • • `' !'EF iVI IT ih(O R�CSF`1EE'T P 9e Y ®f 2
• ski+ .
NUMBER
Installer _aW wj e. - R ...r-M
tom? License # _Dl 4 -to I / Z �( New Home . ® Used Home
Home installed to the Manufacturer's Installation Manual [�
Address cf home e I S � � 1"'
being installed
Q
Home is installed to accordance with Rule i5-C13
ILL
Manufacturer Length x width ? y X ? �®n
Singie wide
fjuble wide '
®
RPLU
Wind Zone I Wind Zone Ili
Installation Deca'i�-d�."
_
NOTE; W home Is a,single wide fill out one half of the blocking plan
li home is a triple or quad wide sketch In remainder of home
®
plelQuad
W Q-
Serial # f aD }
I understand Lateral Arm Systems cannot be used on any home (new or ed) LU
where the sidewall ties exceed 5 ft 4 in, ,. �-�
"
_
PIER SPACING TABLE FORUSED HOMES
Installer's initials_ <'�
Typical pier s dCinq
if �� lateral
®
t cad Poorer
bearing' size181/�'
capacity (sq ir1)
tE56 )
X 181/2' 20' X 20'
342
( ) (400)
22' X 221 24' X Z4' ae• X Z6'
(48 (576)• (576)
PIER PAD SIZES
I-beam pier pad size t Y Z Z
Perimeter pier pad size l _/ X Z Z
Other pier pad sizes
(required by the mfg.)
MIDraw the approximate locations of marriag
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
- !S- 351 r`_k zZ-
POPULAR PAD SIZES
ANCHORS
Oft
FRAME TiES
within 2' of end.of home
spaced at 5' 4" oc
TIEDOWN OOMPONENTs
OTHER TIES
L.ongltudlnal sfablllxing Device (L-SD)
Number - -- - -
Sidewail
Manufacturer W W
.
Longitudinal
Longltudlnal Stabblllaing Device W a ral ArMs
�4
Marriage wall
Manufacturer 1/4l N ur" �� +t'
Shearwall
At
PERMIT NUMBERk; s�; ;� > r: ; , \yr 2 4Y
POCKET PENETROMETER TEST ;
The pocket penetrometer tests are rou ded wn to psf
or check hereto declare 1000 lb. soil without testing.
X X X
POCKET PENETROMETER TESTING METHOD
1. Test the perimeter of the horde 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.
X
TORQUE PROBE TEST
The results of the torque probe test is inch pounds or check
here if you are declaring V anchors without testing . A test
showing 275 inob pounds or less will require 5 foot anchors.
Note: -A state approved lateral arm system is being used and 4 ft.
.anchors are allowed at -the sidewall locations. i understand 51
anchors are required at all centerline tie points where the torque test
reading Is 275•or less and where the Mobile home manufacturer may
requires anchors with 4000 lb holding capacity.
Installer's initials
ALL TESTS MUST BE PERFORMED BY A LICENSED 11gSTALLER
Installer Name W � NAIR_ 6.11d, A,—d- co-ce
Date Tesfed
Electrical
Ibnneot electrical conductors between multi -wide units, but not to the main power
ource. This•includes the bonding wire between molt -wide units. Pg.
onneot ail sewer drains to an existing sewer tap or septic tank Pg.
onnect all potable wafer supply piping to arws i i g water meter, water tap, or other
idepandent water supply systems, Pq.
PERMIT WORKSHEET page 2 of 2
Site Preparation
Debris and organic material reMoved
Water drainam Naturaly Swale Pad Other__T,
Fastening multf wide units Al
Floor. - Type Fastener. Lam_ Length: 0 Spacing:
Walls: Type Fastener. Length: 0/_ Spacing: �</ — Q�
Roof: Type Fastener. - c Length Spacing:
For.used homes a min. 30 gauge,;8" wide, galvanized metai strip
will be centered'over the peak of the -roof and fastened With gals.
roofing nails at 2" on center on both sides of the centerline,
1 understand a properly installed gasket is a requirement of all new and used
homes and that condensation, mold, meldew Arid buckled marriage walls are
a result of a poorly installed or no gasket being installer], .I un, erstand a strip
of tape will not serve as a gasket.
Installer's initials
Type gasket / `~ installed:
Pg. Between Floors Yes
Between Walls Yes c/
Bottom of ridgebeam Yes
Weatherproofing
The bottomboard will be repaired and/or taped. Yes Pg._
Siding on units is installed to manufacturer's specifications. Yes
Fireplace chimney Installed so as not to allow intrusion of rain water, Yes /�i9
MlsaeltaneoUs
Skirting to be.installed. Yes I.",- No
Dryer vent installed outside of skirting. Yes ✓N/A
Range downflow vent installed -outside of skirting. Yes N/A
Drain lines supported at 4 foot intervals, Y�
Electrical crossovers protected. Yes
Other: -
verifies all information given, with this pe
is accurate and true based -an the
Installer Signature
Datelt/�