HomeMy WebLinkAboutPermit Worksheets PERivilT WOFIKSHEET page 1 of 2
�s � �'�EFtA�It NUMBER7a3Pb"tt
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�tom°'a; �tn - New Home• Used Home []
S Installer `3 rJ ;tNr1n\ License#
p v, �� •' Home Installed to the Manufacturer's lnslsllatlon Manual
rn r ��C t: dress of horse . I�ICC��.. - Home is Installed in accordance with Rule 15-0 ❑
"o o intt Installed
n Sing{p wide ❑ Wind Zone ll Wind Zone III
p , n�ufaciurer Length x wkitft I Double wide [ Instal{ation Decal fk
/Q
NO?- 'If hone is a single wide fill out one halt of the bToaklrtg plan TrlplelOuad ❑ ,Soda]+
It home Is s triple or quad wide sketch In remainder of home
!understand Calera!Aim Systems cannot be used on any home(new or used) PIER SPACING TABLE FOR USED HOMES
r�r M l?y where the s{dswall ties exceed 5 ft 4 in:
tZI Installer's initials ..._ l.aad I Footer jW x ts. 181W x S8 t/2' 2W x2W 22'xW. 24'X W 2W X26'
teems .size (256) (342) (400) (484)* (876)* (875}"-
d b Typical pier spacing• mw (sq In)
O ' g jC t
Show locations of Longitudinal and Lateral Systems Q 4 s s e
'n (use dark lines to show these locations) s s
00 g 8
00 s 8
Interpolated imm Rule i5Gi pier spaclnp table a1°-3
PIER PM SIZES PQ R P D S Z
I-beam pier pad size 17' X ,'z a e n.
• Perimeter pier pad size 13 ®x.1��� x
o ' Other pier pad sizes A x
• x
(required by the min.) x
4 x
Draw the approximate locations of marriage x
wall openings 4 foot or greater. Use this x
rt •a• -crv.rRw.iac symbol to show the piers, x
Q c u, List all marriage watt openings greater than 4 foot x
a --, - and.iheir pier pad sizes below. ANCHORS
Z ` irrv�
h'- -- -+ M. --- - s Opening Pler pad:size
LU �,y s m 4 ft -5 it
10`
r b' as"x 3s" FRAMETIES
within Z of end of horrie
0 spaced at 8'4°oo, „
` -
,,r 77EpOtIVN COMPONENTS OTHER TIES
Longitudinal Stabliizingr Device(LSD) Sldewall s
;.a ia- Manufacturer Longitudinal
a Longitudinal Stabl/{� De �wl Lateral Arms Marrlage wall Al
Manufacturer i � cuy Shearwall
PERMIT WORKSHEET page
+IaERM17 NUM��h .. .... ... .... . . .. . .. �.`.._.?of a
NUMB EA -
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sl Miratron
POCK-U-PENETR2METER TEST .
Debris and organic material removed
The pbcket penetrometer tests are rounded down to pst Water drainage:Natural Swale Other ,
or check hereto dedam 1000 Ib..soll ✓ without tesllnM
Fasten no multi wide u is
x�a ' x/ x m e i..
Floor Type Fastener. 5 �.� LenAfh: Spacing:_,7
Waits: Type Fastener Spacing:
POCKET PENETROMETER TESTING METHOD Roof; Type Fastener. i ra, Length:Length: Sparing:
For used homes a min.S0 gauge,6"wide,gaivantzed metal strip
i. Test the perimeter of the holies at 6 locations. will be centered'aver the peak of the-root and fastened with gate.
roofing nails at 2°on center,on both sides of the centedine.
2. Take the reading at the depth of thejcooter.
a _ Gasket(w.atheraienfln9nc+>tre�nenl;
S. Using 500 lb,fivrements,take the lowest
reading and round down to that Increment i understand a property installed gasket is a requirement of all new and used
• homes and that condensatfon,mold,meldew and buckled marriage waits are
X, � K X i'C a result of a poorly installed or no gasket being Installed. I understand a strip
of.tape will riot serve as a gasket.
oidt� E OB TEST Installer's iniilats Z",
Type gasket Installed:
The results of the torque probe test is inch pounds or check ' Pg.__V&- Between Floors Yes'here if you are declaring 5'anchors without testing A test Between Walls Yes .00" �
showing 275 Inca pounds or lass will require 5 foot anchors, Bottom of ridgebeam Yesr
Note: A state approved lateral arm system Is being used and 4 ft.
anchors are allowed at the sidewall locaflons I understand 5 ft eatheraroofing
; anchors are requited at all oenterlrne tie.polntp where the torque test
reading is 276or less and where the ntobils Itome manufacturer may The bottomboard will be repaired and/or taped. Yes_ �®�/
requires anchors with 40Co�b hot ng capacity, siding on units is installed to manufacturer's specifloations. Yes
installer's Initials Fireplace chimney Installed so as not to allow Intrusion of rain water. Yes,11
r
ALL TESTS MUST BE PERFORJAFED BY A LICENSED INSTALLi+R Mi raneous
Installer Name Skirting to be Install ed Yes No
Dryer vent Installed outside t f skirting. Y WA
Date Tested i3I'7 Lange downfiow vent instaiied•outside of sktrttnq• >es WA
Drain lines supported at 4 foot Intervals. �/
Electrical crossovers protected Yes
Other:
anngd elecUfcal conductors between multi-wide units,but not to the ia p�o er
ouroe. ThIs Irt4ludes the bonding wire between nrult wide units. Fg. w Installer verifies all information given with this permit workshest
CPPlumbina _ .�_ Is accurate and true based'on the
nneot.all sewer drains to bn exWInq sewer tap or septic tank Pg. '' manufacturer's Installation Instructions and or Rule 150-1 &2
onnect all potable water supply piping to an g water meter.water tap,or other installer 5lgnature
rdependent water supply systems, Po.