HomeMy WebLinkAboutPermit Worksheet--'0tRM1T- NUMBER
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installer _lrl"y (it'e, 09(h License 101 LtZA
Address of home j Ay; i,) Cy
being installed 7 LJc, _
Lut -
Manufacimer 1 f1lMaS 6 F lhrMt Length x width
"61 M ' 1P home is a single wide fill out one half of the blocking plan
ff home is a triple AP quad wide sketch In i-emalndef of home
1 understand Lateral Arm Systems cannot be used on any home (new or sed)
Where the sidewall ties exceed 5 ft 4 in.
Installer's initials_
Typical pier spacing
.01 • q f . I lateral
I
Sfiow locations of Longifudinal and Lateral Systems
1"ngltudlnel (use dark lines to show these locations)
Lj U Li L-1 L94
13
171
Irm
AM
ardego wall plera
wlthln 2' of end of home pa Rula 150
PERMIT WOFIK-SHEET
I page I of 2 I
New Home . ® Used Home
Home installed to the Manufacturer's Installatlon
Manual [3
Home is installed in accordance with Rule 16-0
Singip wide ® Wind Zone II 2?
Wind Zone ill
Double wide installation Decal 4.
5y O 5
Triple/Quad ® Serial #
PIER SPACING TABU° FOR USED HOMES
Load
beating'
capacity
Footer
size
(sq in)
16" X 16°
t2$6 )
181/2` x 4 S 112`
(842)
20° x 20"
(400)
22' x 22' 24" X 24° •26° x 26°
(484)° (576)° (676)
1000
pst 1
S
D00
s
6
57
2 0D
s
6
8
8
g
'3D00
s
- B
g
3OD
s•
$'
g
11-1puraew rrom nuie icu-i pier spacing [acre,
• PiER PAb SIZES n t�
I-beam pier pad size I- X L Z
Perimeter pier pad size I
Other pier pad sizes
(required by the mfg.)
Draw the approximate locations of mardag
wall openings 4 foot or greater. Use this
symbol to show the piers.
List all marriage wall openings greater than 4 foot
and.their pier pad sizes below.
Opening Pier pad.size
� t ,
T[EDOW 'COMPONENTS
Longltudinaf Stablllz�gDavlce (1. AJ
Manufdcturer �w v4e—nv— (us
Longitudinal stablllzlppg Device / t feral Arms
V Manufacturer Ajea Qj9gjjLA& E •
PORULAR PAD'S1ZES
ANCHORS
4 ft •5 ft
FRaMe Tres
Within 2' of eod of home
spaced at 6 4" oc
5THF-9 TIES
Sidewall
- Number-- - - -
Longitudinal.
Marriage wall
Shearwall
PERMIT NUMBER
..
...,C���tti•".....\:'::i
POCKET PENEiROPAETEA TEST
The pbcket penetrometer tests are round down to psf
or check hereto declare 1000 lb. soil without testing.
X X
POCKET PENETROMETER TESTING METHOD
1. Test the perimeter of the home at 6 locations.
2. Take the reading at the depth of thefooter.
3. Using 600 lb. incremonto, .take the lowest
reading and round down to that inoremenL
X X X
TORQUE PROSE TEST
The results of the torque probe test is-%o & Inch pounds or check
here if you are declaring 5' anchors without testing . 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 at the sidewall locations. i understand 52
anchors are required at all centerline tie points 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 initials
ALL TESTS MUST BE PERFORMED BY A LiCENSED IhiSTALLER
Installer Name
Date Tested
- ' Eleciricai -
lonneot electrical conduotors between multi -wide units, but not to the main power
ource. This -Includes the bonding wire between mutt -wide units. Pg.
- - Plumbing %.+ .vrw rti
- lonneot all sewer drains to an existing sewer tap or septic tank Pg.
onriect all potable water supply piping to an exist' g water meter, water tap, or other
!dependent water supply systems. Pg.
PERMiT WORKSHEET L page 2 of 2 I
site Preparation
Debris and organic materiVdfnoved
Water drainage: Natural Swale Pad Other
Fastening multi wide unitd
Floor. - Typa Fastener LA% Length: (o ci Spacing:
Walls Type Fastener. , Length: = Spacing:
Roof: Type Fastener. 44 Length:. 6 •, Spacing: - z'
For. used homes a min. 30 gauge,;8" wide, galvanized meta!— strip
Will be centered over the beak of the -roof add fastened with gale.
roofing nails at 2n on center on both sides of the centerline.
—_ Gasket (westhervmellnd regulterimnti
t understand a property installed gasket Is a requirement of all new and used
homes and that condensation, mold, meldewarid buckled marriage walls are
a result of'a poorly Installed or no gasket being installed. I nderstand a strip
of tape will not serve as a gasket,
install -eft initials
Type gasket installed: .
Pg. Between Floors Yes
Between Walls Yes Bottom- of ridgebeam Y®
weatherpro6OAnq
The bottomboard will be repaired andlor taped. Yes 4--Pg.
Siding on units is installed to manufacturer's spec'fications. Yes Z;7--
Fireplace chimney Installed so as not to allow ititruslon of rain water. Yes,®
Mtseeiisnaoits
Skirling to be.installed. Yes No
Dryer vent installed outside of skirting. Yes--
.. 'N/A
Range downflow vent installefioutside of skirting. Yes =WA
Drain lines supported at 4 f66t intervals. Yes t/
Electrical crossovers protected. Yes _
Other:
all information given, with thils. p€
is accurate and true based en the
- • ananu�acturer-s In.
Installer Signature_
Date/Y 1 p