HomeMy WebLinkAboutPermit Worksheetsit,.: a .,r : ,' •'. '. :. .. _ _..
-IERMIT NUMBER
Installer •e h K K 04-p
Address of home 2,fr�
being installed
Manufacturer��>`T Lenpthx:width
NOT& ' If home to a single wide fill out one half ' the blocking plan
if hord a Is a triple or quad wide sketch In temalnder of home
I understand Lateral Ann Systems cannot be used on. any home (new or
where the sidewall ties exceed 5 It 4 in,
Installer's:�initiais ��;.•
PERMIT WC7FIKSHEET page 1 of z
1
New Home Used Home _ ®�
Home installed to -the Manufacturer's Ins tallatlon Manual ❑
Homexis Installed I aocgrdanoe with `Rule 16-C []�•
Single :wide �!' Wind Zone Il ' _ ,❑ Wind Zone III [�
Dcuble.Wide ❑ Installation Decal.#
Trlpla/Quad ❑ Serial#3740'r�Tly..
PIER SPACING TABLE FOR USED HOMES
Load:
tg
oapealapaolty
Footer
.s1T
• (sg In)
16' x 16'
(266)
18112' x 18 i/2'
(842)
20' x 20'
'(40b)
22' x 22T
(4a4)-
24' X 24'
(a76)•
26' X '26.
(676)
1 DOD st
a
00 Dst
4 6
6
:.8..
8
00
6
B
8.
0 s
26006
6
a600 s
8
8
abuu
8'
8
interpoiatea;rom time '►sc:-i pier spaomp uwie.
PiER PAD SIZES
I-beam pler.'pad size r rk 2 2 • ''
Perimeter pier pad size l i
Other pier pad sizes % rr X ?2 r�
(required by the mfg.)
®'Drawthe approximate locations of marriage
wall openings 4 foot or greater. Use this
symbol to -show the piers,
List sill marriage wall openings greater than 4 foot
and.thelr' pier pad sizes below,
Opening Pier padtsize
o2
2y,�
TIEDOWN COMPONENTS
Longitudinal Sfab11lz/n� Devlce (LSD)
Manufacturer l�41 K K rzc 7,",W L'
Longitudinal StablikingDevlce w/Lateral Arrils
Manufacturer- ✓h�`y •�r.� ��
POPULAR PAD S ZES
re�X-�7b;c�
iftiE�'L:1
(—ANCHORS
4 it _ ft r
FRAME TIES
within 21 of end of home
spaced at 5140 oo
OTHER IE5—I
Nu bar
Sidewall
Longitudinal
Marrlags wall
Shearwall
4 " " PERMIT WORKSHEET page 2 of 2
+ •PERMIT NUMBER :.fflu
POCKET ETROME I ER TES
The pbcket penetrometer tests are rounded down to psi
or check hereto declare 1000 lb. soil --S,--vdt?I5ut testing.
X X X
POCKET PENETROMETER. TESTING METHOD
I. Test the perimeter of the hothe at 6 locations..
2. Take the reading at the depth of the•footer;
S. Using 600 lb. lhorements, 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 51 anchors without t ing _ : 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 at4he sldewall locations. i understand 5.ft
anchors are,. required at all centerline tie pointp where the torque test
reading Is 276 or less and where the mobile home manufacturer may.
requires anchors with 4000 lb holding capacity.
Installer's inittalW.2,
ALL TESTS MUST BE PERFORMED BY A LICENSED INSTALL -R
Installer Name --r 2, /-,r4 04
Date Tested l / r/ /:za I it
Electrical
lbrineot electrical conductors between multi -wide units, but not to the main power
ource. This•Ingludes the bonding wire between must-wlde'units. Pg.
Phimbinq
bnneot all sewer drains to an existing sewer tap or septic tank Pg.
onneot all potable water supply piping to an existing water meter, water tap, or other
rdependerlt water supply sydiems. Pg..__
site Preparation
Debris and organic material remov
Water drainage: Natural aie Pad Other
Fasten ng multi wide un to
Floor. Type Fastener. enAth: Spacing:
Walls: Type Fastener. Len Spacing:
Roof: Type Fastener. Length: Spacing:
Fcr.used homes min. 30 gauge, & ida, galvanized m tal strip
will be centered'over the peak of the -root and fastened With gale.
roofing nails at 2" on center on both sides of the centerllne.
Gasket rwntherpro"Una r auin:enentf
I understand a property installed gasket is a requirement of all new and used
homes and that condensation, mold, meldew and buckled marrlape'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.
Installer's initials' �•
Type gasket Installed:
Pg. Between Floors Yes
Between Walls Yes
Bottom of ridgebeam Yes ci
Weatherproofing
The bottomboard will be repaired and/or taped. Yes Pp.
Siding on units Is installed to manufacturer's speoKloatlons. Yes
Fireplace chimney installed so as not to allow intrusion of rain water. Yes
Nflsee raneous
Skirting to be Instatidd. Yes t!--:�—No . .
Dryer vent installed outside of skirting. Yes
Range downflow vent instailed'outslde.of skirting. Yes WA -
Drain lines supported at 4 foot intervals. Yes
Electrical crossovers protected. Yes
Other.:
aU information given with thl
is accurate and true based on
Installer Signature
Date /• ,