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PERMIT WORKSHEEI page
PERMIT NUMBER
Installer , "THOMAS GRUNDEL License# IH1025148,
.__ _... :..' ew Home e
N
Home installed to ttie Mariufactur`er's Installation Mandal
Address of home TT
,481 NELES BLVD '•Home'is Installed m accordance with;Rule 15=C
being installed .. _...JENSEN.BCH.., .---- _ d W Z II d it SIn le wi a Ind one iWn Zone 1 , ❑
9
Manufacturer" "JACOBSEN Len"th xwidth 20X39/40` "Doublewlde Installation Decal#` TBD
NOTE: ifhome is a single wide fill out one tielfofthe blocking plan Tnple/Quad Serial# TBD
_.
rf home is a triple or quad wide sketch in remalnder of home
understand lateral Arm Systems cannot 66 used on anylibme(new or used)
wfiere the s'idewallties exceed 5 ft4 in. - PIER SPACING TABLE FOR USED HOMES
Installer'sinitials 1' `TG -
_._ 6"x 1 8 1/2"x 1 0"x 2 22"x 22 24"X 24 6"x 2 _\
!Typical peer spacing ' . 1 (256)6 11/2"`(342)8 2(400) 1, (484)- (576)* 2(676)6
Load (rooter
z
Jateral ,
_61: . . .. .._..
• s
bearing size
capacity ( q in) �
Show Locations of Longitudinal and Lateral Systems 1500 ps:
I . _
to ng d ud i.rd
(use dark lines to show these locations) ps81
. ps
3500 ps:
Q interpolated from Rule 150 pier spacing table.
- . -._ . -- PIER PAD SIZES -� POPULAR PAD SIZES
m7
..,-,-earn pier pad size: p 17k� a Size q n
� o16X16
_ ,
rm�
Perimeter pier paden-. 16) ' o x18
i N'wn v :. 16- - - ------ --- -- - - --------- ---- -- v x
� 4
Other pier ad;s it`s
n..
(required by o.n v22.5
x 4
- r 20 x20 e I c rriar ta 441 hisw all o eni r re � 0 x
� iers bo o s b hhoofend• sym 446.
marriagewalLpierswithin2 In_
• .. - - - - -
List all marriage w�, i cgs gr o�f�t�-foolx
._. . _.._ _. _.. - OR
and their pier pad sew _�,
Opening` r pad§Ize
-r rr--r-i-'S-�-7'*^r-i -i'�-7--r-T-r'r-I--i '1'7,^i, f.-.r-,-.�_-1-.T-T-r- .. - .:.. . . . ......�.
ANCHORS
1 1 1 1 , 1 I 1 1 1 I'. 1 _I_ 1 1 1 �)1 1 1 , , , i 1 4 ft X
r-r r'I-l-Ti1i TAT r r i-1 •i- 1-1 T i-I 1 -i- 1-T: 'y9f yrTi -i'i 1'i' I 1.-r-1 1-5 I7XZ
i_1 1..-�- - ' --� - -1 �'_.LJ 1 _J_ _ J_4J, Y 1 L_.�_� -
�. rzjl,j �T175��'► �� ' I 1 FRAMETIES
J_ _,1_.L.iL_ J J. �t L._L. .. ...__ - - __.
P 1 1 i. I- Y y I I 1 I. I• 1 T(� .,1 Y _,. 1. r. i 1 . 1 i- r 1 -
L_L L`
1 1 i, 1 „ i_ 1I i 1 1 I r 1. , -r 1 1• 1 ,1 1:-�1 -i. I 1. 1, 1 ,. :within2'of�end of home X..
9-.ti 7-r-r r 1-'l �. t.-,i' �.- r �r - - •r-r r-r 1 ._ __ .. _ 11
� .� r , 1 -1.. 1 1 ; 1. i 1 1 1 1 1 , spaced at 5'4 6&�(
r-r r 1 1 r rr-1 1 i-7 r -IATy1- 1-"r-r - -- - T- r-r
I�
1 ,I �}mm�,}}��,** ,
- {-17 i ?-T:-, r_i___- GA F "1f t1� �`,ij -i L- ,�lt`i�l�� -r 1
J_ _I__ �__IFN - `--= TIEQOWNCOMPONENTS
1. 1, 1 I 1 r u I 1 1, 1 �y��y,Tt��+�p C l it V 4tr LL)-Y3 �r 1 1 11 1
1_,J,_,J._. t._ J _-i:_,L._i-_i�i1Y WJJLQi_ _�__ ��J��_,.._L 1L_I_ 1._J._ _.�_.c._,t 1„ ,.;, -. _:__. ... , _ OT TI Num.ber..
L_t. 1 i f i r i 1 1 1 1 1 i 1' 7 1 i- 1 i t r
4_.,. J_.J J_:1_ti_1..:_i_.J„ _`LongltudinalStabrhzrngDeyice(LSD) -.,_: Sidewall
1 I 1. i 1 1 ( 1 :Manufacturer OLIVER_ _ .� - Longitudinal
. -I-.a...a-.i--r.-r_1-� - _
1 1 , i 1- 1 1 1 r I 1 r 1 i 1 , 1 1 , �. 1 1 �. i 1. 1 1 1 l i LongitudinalStabilizingDeyicew/Lateral Arms-Marriagewall'
r-r-r'-r.-1_.�._.+-^r, �.-r-1^-i:-'+ T-r-r•-r-i-�-�-?-r-!--�-^i-� �^*--r._,r-r-i -1-�-T-r-�-1 _ ..._..__, ,.._.. ..,__..... .._. _
i I, 1 ,, 1 .':.Manufacturer- �:Shearwall , .
i--r-i--1- T-r-i' i-'l-•"1-T^r-r"-r-i-4-l-T-r-r-i-i-�^�-.4 r-1`-r 1 -...,; .. .. ..-.. ... . .. _. .. _
r L
PERMITORKSHEET I page o
PERMIT NUMBER
r -
POC ET PENETROMETER TEST
Site reparation
: .. iDebr nd o genic maf ved Y
1500 .. ..:
.... .
The pocket penetromete_r tests'are rounded down to psf Water drainage Naturalen emSwale E Pad Other
al r
or check here to declare 1000 Ib.soil without testing. _
astening multi wide units
15ef �. X 1.5� X:151d
r 1-AG Length: pacing.
Was ?4
or Type'Fas ene
Ils .Type Fastener:-LAG 'Length. ;Spacing:
POCKET PENETROMETER TESTING METHOD Roof: Type Fastener: GALV Length: Spacing:
_ ._.._. . . 8"'w
>... ..
For used homes a min. 30 gau e, ide, alvanized metal strip
. 1. Test the perimeter ofthe-home at 6 locations. ; � " will be.centered over the eak of the roof and fastened with galv.'
ro• - _ ofing nails �_ �center on both sides of the centerline. ;
2. Takethe-reading"at the depth of the footer.
Gasket(wenthorproofing roquiromenti,
3. Using 500 Ib increments,take.the''lowest
reading and round-down to-that increment I understand a properly installed gasket is a requirement of all new and useC
:homes and'thatcondensation,,mold, meldew and buckled marriage walls are
a re of a poorly Installed or no g
r asket being Installed. I unders nd a strip
X 15Q�`! X 15�' :X: 15 oftapewlll notserve as a gasket::
Installer's in'itials;TG
TORQUE PROBE TEST
Tyl5The results of the torque probe testis 285 inch pounds or check Pg e g 'Between Floors Yes_ X
asket FOAM
here if-you are declarin 5'anchors withouttesting Atest Between VVaIIs Yes. X
showing 27.5 inch you ds o�less'wili require 5 foot anchors. : `Bottom of ridgebeam' Yes'X
Note: Astate approved lateral arm system-is'being-used and 4 ft.;
anchors a•re allowed atthe sidewall locations. I understand 5•ft. Weatherproofing
,anchors are required at all cent@rune be points Where'the torque test.
reading is 275 or less and where the mobile home manufacturer may The bot#omboard will be repaired and7or taped'. Yes X Pg.
- requires anchors with 4000 Ib holding cipacity. ding on rer's specifi es _
Si units is Installed to manufactu cations Y
TG Installer's initials Fireplace chimney.ins.talled so as notto allow intrusion:of rainwater. Yes X
ALL TESTS MUST BE PERFORMED BY A LICENSED INSTALLER
Miscellaneous
`Installer Name THOMAS-GRUNDEL Skirting_t{bestalled. Yes X
_. .
Dryervedn in lled"outside of skirting Yes
Date Tested ange rti�ng. Yes X NIA
D.
own vent installed outside of ski
' - :rain Ines supported at4 foot intervals. Yes X
Electrical crossovers protected. Yes X
Other
ectrica
onnectye1 ctrical conductors between multi-wide units"butnotao the main power _- „-
Ource"Thi'' nc es the bonding-wire between multwide units. Pg.
- Installer verifies all info nation given with this permit worksheet
Plum mg is acc ate and true baseA on the
_- manufacturers i -
onnectall sewer rains to an eAsfing sewer tap or septic tank
manufactu n 'on instructio and or Rule '15C 1 8�2
onnect'aII potable water su" I i in to an ewsting water meter water tap or other Installer Signature Date
.rler�cnrlenFro4or-ci innito%Mf-mc Pn - -