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HomeMy WebLinkAboutPermit Worksheets ............ PEF�M[T W(�t�KSHEET pager of n 'PERl1di7 NUMBER f lD� (f _ New Home. U insta!(er sad Home license d. • Home Installed to the Manufacturer's Installation Manual 4 Address of home Home is Installed In accordance with Role'!5-C . being instai<ed Sfngip wide Q 1Nind Zone 11 Wind Zone III ❑ Manufaclurer Length X Width THESEWY A 913ALL FQPOSED'WWon Decal fk m No?- •ff home too stngle wide fill out one half of the blocking plan ARE Sum@NY CQ( ECTI I## r' if harms Iva triple or quad wide sketch In remainder of horns REQUIRED BY FIELD INS9ORS TAT r-n MAY BE NECESSARY IN ORDER TO i understand lateral Arm Systems cannot be used on any home(new or used) COMPLY WITH ALL ARP 4j9R�f3 TABLE FOR US FIOtEs p aT4bCH'e°�tv where the sidewall ties exceed 5 ft 4 In; _ _ lnstaiier's initials �,i t1Ur,�e�n nw.m••-. r taB3r3Rg der 1G X lw 181/2'x 1811V 201�1 .e �'X' �y 4,� G 4'1'26�FX26' '--� Typical pier spacing capacity (Sa W WS) (�� (a°°f�t� 06( ���I��(676) Zv 2' fat.ral 1000 DSt ...t(tCCC Sliow locations of Longitudinal and lateral Systems 4 6 s lorrom�mnal (use dark lines to show these locations) f3 © 0 s 8 8 Z Z • Interpolated from Rv1;15G1 plot spacim table. OF PIER PAD SIZES PO CAR PADS 8 I-beam pier pad size I X�S`�+1' Pad Size so in.1 . v. Perimeter pier pad size ��r e X e `y — Other pier pad sizes N� • x u-+ U �� . (required by the min.) x '- Draw the approximate locations of marriage x 1711 Q 011 wall openings 4 toot or greater. Use this x T rturr40aWaQgl�swmftrolabdat hum WRulal6C symbol to show the piers. it Ilzxzb " . GL X O t7 List all marriage wall openings greater than 4 foot x � m w and.their pier pad sizes below. ANCHORS ca s=a P "nri cg► ^ Opening Pier pad:slze f i2.5'x��,. 4it Sit �• ----- f +x 35 •— 2+a a X 3S FRAME TIES fSi ^. • within 2'of end of home ri spaced at fi 41 oo,�•. n TIEWM COMPONENTS OTHER TIE5 Longitudinal Mablf &v Devloe(LSD) I r cal+ Manufacturer,._ - LcngltudHnal Stalizirirr Dexxice svlLat a Manufacturer i' gnu rJld1► � I r ,` •* z PERMIT WORKSHEET i page 2 of 2 •PERMIT NUM *01 BS ... ... .. . . .. .; 51te Pr aratlon POUM P NETROMEM TES : Debris and organic material removed / The pboket penetrometer tests are rounded down to psf Water drainage Natural Swats Pad ✓ Other; , or check hers-lb declare 1000 lb..soil without testing. X ��U� 10 av Fastening multi wi a un is X 60J� Floor. Type Fastener. Length-. ��-�� — Spacing: •�� • Wails: Type Fastener. length:-- -.---- Spacing: POCKET PENETROMETER TESi'tN©METHOD Roof; Type Fastener. i Length: t6�,Y"• Spacing: Focused homes a min.30 gauge,8°wide,galvanized metal strip i. Test the perlmeter of the home at 6 locations. will be centered'aver the beak of the-roof and fastened with gale roofing nails at 2"on center on both sides of the centerline. 2. Take the reading at the depth of the.footer. Gasket("IheraFyArm ro W—M-2 44 . S. Using 500 lb.increments,take the lowest reading and round down to that Increment. I understand a properly Installed gasket Is a requirement of all new and used • homes and that condensation.mold,meldew and buckled marriage waits are a result of a poorly Installed or no gasket being Installed 1 understand a strip X./coo X ICOC�j� X l d of tape will not serve as a gasket. tnstallees initials rORGUR PROSE TEST Type q ket Installed: • The results of the torque,probe test is_'2,r____•�Inch pounds or check Pg.__ 2,__,_ Between Floors Yes here if you are declaring V anchors without testing — . A test Between Walls Yes showing 275 Inch pounds or less will require 5 foot anchors, Bottom of ridgebeam Yes • Note: A state approved lateral arm system Is being used and 4 ft. .anchors are allowed atlhe sidewail locations: I understand 5 ft Weaftroroolng anchors are required at all centerline tie pointp where the torque test reading Is 275 or lass and where the mobile home manufacturer may The bottombcard will be mpalred and/or taped. Yes � . Pg. v-15, requires anchors with 4000 lb holding capacity. Siding on units Is installed to manufacture'sstmiflcations. Yes, '/ lnstaallleft initials Fireplace chlmnsy Installed so as not to allow Intrusion at rain water. Y ALL TESTS MUST BE PERFORMED BY A UCENSED iNSTALLIER Mim4anecus Installer Name _ �•..r 7.�r�� Skirting to be instaildd Yes _No Dryer vent Installed outside of skirting. Yis WA z Date Tested _ 3113 If z Range downfiow vent Instalted•outside of skirting.}ems WA Drain tines supported at 4 foot intervals. Y ✓ Electrical crossovers protected. Yes Other; eotr • icnnod eleotrlcal conductors between multi-wide units,but not to the Lngin Power outoa This lnrludes the bonding wire between nrult wide utcits. Psi Installer verifies all information given with this permit workshest ,twnbing is accurate and true based'on the aonmot all sewer drains to wi a dsling sewer tap or septio tank Pg. SY manufaaturetr's installation Instructions and or Rule 15Gi &2 onneot all potable water supply piping to aid tine water meter,water tap,or other Installer signature 13I 7 tdepeadent water supply systems. Pg. t