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PERMIT WORKSHEET page 2 of 2 i
PERMIT NUMBMI _
- _ _ site Prepzeratinn -
POCKETENeVRJG •IES _
Debris and organic material reftvr d -
Ti a packe£penefrometertests are round wn to psf Water dialnaga.A� V Swale Pad Other—
or check here-to declare 1 OW lb.soil wifhocit reefing.
Fastening inutti wide antis
X X X 11 ht
Floor Type fastener: I.eM*- Spaoing
Waller Type Fastener: Len&-daa Sni� �
POCKET PaNETRoMETai'IESI7Ne l�MIMD Hook Type Fastener: ' Lon gfFr Span.T `
Fbr_used homes a SO gauge;i3" des�m.
i. Ted the perimeter of the home at 6 locations. - WlH be centered avertha beakof the•roof and fastened With
roofing nails ed 2'on center on both sides of the centeri'mm
2. Taloa the l'ead'ing at the depth of fhet footer.
_ .. _ , _ - - - fi7sssket(vrostticzp�a�inyeacznhrme+it _
S. Using 5D01b•fitctamerit take the lowest
raae�ris7 and found down fio that increment. 1 undeust�nd a properly Installed gasket Is a rsquIrement of art new errd used
homes and that conxionsatiom mold.meldow,and budded marriage walls are
- a result of a poorly Installed or no gaslwt being Installed I understand a strip
X X X of taps Witt not serve as a gasket.
Installer`s infttals
TORQUE
Typegasket �00l� lnstalted: =
The results of the tmwe probe test inch pounds or check Pg. Between Floors Yes
here$you are dectaring&anchors without testing _ A test - Between Walls Yes V
duywW ng 275 incli potsids or less vW11 rujuke 5 foot anchors: Bottom of ridgebeam Yes
Nous: A state approved Woral arm system Is being used aW 4 it..
anthers are aflowed at'the sidewall foto= I midersland 5 ft LYeath
anairoxs ars required at all centeriine tie points where$he torque test -
reading Ie 275 or law and where the mobile home manufacturer may -Ihe bottonrboard wail be repaired andlor t apesd. Yes Pg.
requkW anchors withA Y a chug on units Is installed to manukmftr aft spoo ficattans. Yes r
��� Installer's Initials Fireplace chimney fistalied so as not to allow b&usbn of tall water: Yes P�' .
ALL7FST^ MUST Iii=PE IFOR ID BY A LIC D INSTAtLER sous -
Installer tame - ` 1t9 to be hhstalied: Yes Na
D yervent insfalled outside of skirting. Yes
Rate Teslac Mange downflow vent Irnstatted'outside of ski -
Drain Gees wippoi ted at 4 foot Intervale Y
Electrical crossovers protected. Yes
•
mai -
ronnod electrical condudom bethveen rnu1 -wida unit%but not to the main pDwer
ourae. Mgs Inoudes the bonding vvira between mLd-wide unAm Psi Installer verities all information given with this pertrdt Warksheet
v P jznD is accu-ale and true based on the
tinned all sewer drakes to tui odsling sewer tap orseptic tank. P9• rrrantifactu traria In 'csrhs and of Rule 150t &
,onnoct all potable water supply ptpina to an e�dsting water meter,water tap,or other Installer signature Date
sdepenttegt water swPly sys7ar= Pg-