HomeMy WebLinkAboutPermit Worksheet' a _
41tRMi�' NUMBER
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Installer t<> ��'.e �„� L �r�.-n License # / ev %l,2-1 C
.4Address of home a
being Installed
Manufacturer e! ` 1 e, Lend x wldth l ,
MOTE:• 'It home Is a single wide flit out one half of the blocking plan
11home Ise triple orr quad aide sketch In remainder of home
'I understand Lateral Arm Systems cannot be used on any home (new or used)
where the sidawall ties exceed 5 ft 4 in:.
rnstaner� rntnat� �_
PERMIT WORKSHEET L pag131 of 2
New Home • C] Used Home In ,
Home installed to the Manufacturer's Installation Manual ❑
Home Is installed In accordance with Rule 15-0 ,
Sirigle wid® ❑ Wind Zone II Cj Wind Zone Iil
Double wide [ Installation Decal # U/
TriplelOuad ❑ Serial # B P,4ce
PIER SPACING TABLE FOR USED 14omce
Load
4sadrt
capaally
r
size
(sq in)
181/2' x 1 B t/2' 20' x 20'
(342) (4001
22' x 221
(404)1
248 X 24' 26' X 26'
(676)• (676)
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PIER PAD SIZES
I-beam pier pad size%•�-
Perimeter pier pad size t' 7
Other pier pad sizes . 2e ` )( 2 i�
(required by the mig.)
®Draw the approximate locations of marriage
wall openings 4 toot or greater. Use this
symbol to show, the piers,
Ust all marriage'wall openings greater than 4 foot
and -their pier pad sizes below.
Opening, yPier pad -size
TIEDOWN COMPONENTS
Longitudinal Stabilizing Devke (LSD)
Manufacturer' -fig' a- --- 7" r v*z
Lorrgltudlnal Stab111#ng Device w/Lateral Arms
POP LAM PAD Si ES I
limit=�rt��rrci
War LA
ME3811
airirs-rs-->irra
•I:
ANCHORS -
Oft
FRAME TIE6
within 2' of end of home
spaced at 6140 o0
r OTHER IES
Sldewall Nu_ t ar
Longitudinal 'T
Marriage wall
Shearwall
~ d', PERMIT NUMB513 ............
POCKET PRENETROMOER TES
The pbcket penetrometer tests are rounded down to psf
or checkhere•to declare 1000 lb. soli without testing.
XX X
POCKET PENETROMETER TESTING METHOD
1. Test the perimeter of the horhe at 6 locations.
2. Take the reading at the depth of the•fcotsr.
3. Using 500 lb. Increments,. take the lowest
reading and round down to that increment.
X X X
ORQ E PROBE-TEST��y
The results of the torque probe test is *� /E- Inch pounds or check.
here If you are declaring & anchors without testing _ , A test
showing 275 Intl pounds or less will require 5 foot anchors,
Note: A state approved lateral arm system is being used and 4 ft.
-.anchors are allowed atlhe sidewall locations. I understand 5 ft
anchors are required at all benterline tie points where the torque test
reading is 276 or less and where the mobile home manufacturer may
requires anchors with 400 b h (ding capacity.
�• Installer's initials
ALL TESTS MUST BE PERFO MED BY A LICENSED INSTALLi=R
Installer Name %�'c �4r • C� i' 00,
Date Tesfed 0
Electrlca
IbrinW electrical conductors between multi -wide units, but not to the main power
ounce. This•inludes the bonding wire between mult-wide'units. Pg.
__ t?IUn1b nq
connect all sewer drains to tin existing sewer tap or septic tank Pg.
onnect all potable water supply piping to an existing water meter, water tap, or other
►dependent water supply systems. Pg;
PERMIT WORKSHEET page 2 of 2
site Preparation
Debris and organic material rem o ed
Water drainage: Natural Swale Pad Other
asten np InUltl wide Units
Floor. Type Fastener Length: pacing:
Walls: Type Fastener, ennth: Spacing:
Roof: Type Fastener. Length: Spacing,•
For. used horn min. 30 gauge, 8" de, galvanized metal strip
will be centered'over the peak of the -roof and fastened With gale.
roofing nails at 2" on center on both sides of the centerline.
Gasket twnthero:eotina 1mr,enH
i understand a properly installed gasket 1s a requirement of all new and used
homes and that condensation, mold, meidew, and buckled marriage walls are
a result of a poorly installed or no gasket being, installed. 1 understand a strip
of tape will not serve as a gasket
Installer's Iniiiats —�
Type gasket Installed:
Pg. Between Floors Yes
Between Walls Yes
Bottom of ridgebeam Y
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 raln water, Yss/'//9
Miscellaneous
Skirting to be.instaEfed. Yes No
Dryer vent Installed outside of skirting. Yes WA
Range downflow vent Instalied•outside.of skirting. Yes WA
Drain tines supported at 4 foot intervals. Yes
Electrical crossovers protected. Yes
Other:
aU information given with this permit
is accurate and truejjased-.gn the
installer Signature y Date