HomeMy WebLinkAboutPermit Worksheet;e
b L
�' tRMITNUMBER,
....... �...... .�►...
installer !�� 6� � Gi�4.,i License # h 1,2:�
Address of home -f • . % sT�r'� �.�
being installed
Manufacturer GLt! % T O f L4 X 6 0
Length x width
NOTM ' !f home is a single wide fql out one half of the blocking plan
N home Is a triple or quad wide sketch In remainder of home
i understand Lateral Arm Systems cannot be used on any home (new or used
where the sidewali ties exceed 5 ft 4 in.
Installer's initials '
Typical pier spacing
2, 4�,
locations of Longitudinal and Lateral Systems
Xkdark lines to showthese locations)
PERMIT WdaFCSHEET
New Home • ❑ Used Home [2r"�
page 1 of 2
Home installed to the Manufacturer's installation Manual' ❑
Home is Installed In accordanoe with Rule 16-0 ❑- �'�
Singlp:wlde [L,�Wind Zone 11 ❑ Wind Zone III ❑ _
Double wide -❑ installation Decal # 5- �
Triple/Quad ❑ serial # A L56) 2 4-1- 72 /EL
PIER sPACIN3 TABLE FOR USED HOMES
Load
1. bearing
capacity
Footer
size
(eq in))
is' x i s'
(2se)
i s t/2• x 1 S t/2'
(s42)
20' x 20'
(400
1. 22' x 22+
4a4 •
( )
24• X 24'
(576)
26' X 28'
-(b7b7
1 0ost
3
1500
6
g
000
s
00 s
8
8
B006 s
117
88.
3
nunrpumao Irom rwre Icr--Y pier apaamp umia,
PIER PAD SRES
I-beam pier pad slze !'>
Perlmeter pier pad size l % - yC
1r
Other pier pad sizes /_ 7 X •�:t
(required by the mfg.) S
ID]Draw the approximate locations of marriage
wall opening'; 4 foot or greater. Use this
symbol to sfiow the piers,
List all marriage wall openings greater than 4 font
and.their pier pad sizes below.
Opening Pier pad --size
�R;,;Lz IF
TiEDOWN COMPONENTS
Longltudlnal Stablllming Device (LSD
Manufacturer jW i A4 �w o
Longitudinal StaM ZrJng Device W Laurel Arms
Manufacturer
POPULAR PAD SIZES
1�Sy
1F�1•
3'lf
irirP£i��-Yi1 AE
2 K-'r• '
tiE�L,1
ANCHORS
4 ft
FRAME TIES
within 2' of end of home
spaced at b' O oo
OT09EF71
Number
Sldewaq
Longitudinal
Marriage wall
Shearwall
9
DEC4 0 2019
d' .PERMIT NUMBER ox...' .....
P'PENETRO ETER ES
The pocket penetrometer tests are rounded d�o tn to psi
or check hereto declare t o00 lb. soil without testing.
X X
POCKET PENETROMETER TESTING METHOD
I. Test the perimeter of the home at a locations.
2. Take the reading at the depth of the tooter,
S. Using 500 lb. increments; take the lowest
reading and round down to that increment.
X,__ X X
TORQ PROS ST
The results of the torque probe test ism,_ inch pounds or check
here If you are declaring 5 anchors without testlhA A test
showing 275 Inch pounds or less wilt require 5 foci anchors.
Note: A state approved lateral arm system Is being used and 4 ft.
.anchors are allowed at1he sidewall locations. I tuiderstand 5 It
anchors are required at all centerline tie points where the torque test
reading Is 276 or less and where the rrtoblle home manufacturer may
requires anchors with 4000 lb6ho In capacity.
Installer's Initials
ALL TESTS MUST BE PERFORMED BY A LICENSED INSTALL9R
Installer Name A 4ft^ -•c. 2--• /rq_
Date Tesfed Ai&I j r
!--
Electrical
tbn'nect electrical conductors between multi -wide units, but not to the main power
ouroe. This-inoludes the bonding wire between mult-wide units. . -�_
t. Wrnblna . ' e!iLC.P 0-
nnneot all sewer drains to an existing sewer tap or septic tank: Pg.
onnect all potable water supply piping to an existing water meter, water tap, or other
idependent water supply systems, pg. .
PERMIT WORKSHEET Lpage 2 of 2
• Site Preparation
Debris and organic material ren1wed
Water drainage: Natural L� Swale pad Other
astenin multi wlde un is
Floor. Type Fastener ennth: acing;
Walls: Type Fastener. enAth: Spacing:
Roof; Type Fastener. Length:.._, Spacing: .
For. used homes a min. 30 gauge, a" wide, galvanized metal strip
will be centered over the beak of the -roof and fastened With gale
roofing nails at 2" on center on both sides of the centerline.
Gi1sket (wmthemie,frna ma lreni6no
I understand a property 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. 1 understand a strip
of tape will not serve as a gasket.
Installer's initials tA�! '2
Type gasket Installed-
Pg. Between Floors Yes
Between Walls Yes
Bottom of ridgebeam yes
Weatherproofing
The bottomboard will be repaired andlor taped. Yes— Pg.
Siding on units Is installed to manufacturses speonioatlons. Yes
Fireplace chimney installed so as not to allow intrusion of rain water. es "•-
Mlscelianecus
Skirting to be installed. Yes t/ No
Dryer vent Installed outside of skirting. Yes
Range downflow vent Installed'outside.of skirting. Y NIA
Drain lines supported at 4 foot intervals. Yes
Electrical crossovers protected. Yes
Other;
vau information given with this pE
is accurate and -true based'on the
installer Signature
Date __