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' pERIfiT NUMBER
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Installer _UyAJOe, lu► l ., ts:i,, GU License # �1 H — 10 i (at Zia
Address of home.
being installed
Manufacturer 686 6k- WeJ-.t' ' Lengthxwidth 51 7
NOTI«• ' If home Is a single Wlde fill out one half of the blocking plan
If honfe is a triple or quad Wide sketch In remainder of home
�ERMIT WORK -SHEET
page 1 0
w Home . ❑ Used Home
me installed fo the Manufacturer's installation Manual
Cow,
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Home is installed in accordance with Rule 16.0
jam.
Singip wide ❑ Wind Zone II 0 Wind Zone 111
r-•
Double wide installation Deca�ll# �V1�
'frlple/Quad ❑ serial # Cr S GS-- 3
i I4
I understand Lateral Arm Systems'cannot be used on any home (new or •) _ PIER SPACihIG TABLE FOR USED HoMEs
where the sidewali ties exceed 5 ft 4 in.
installer's initials /
Typical pier spacing
2' IL,/ ' lateral
Load
beattng
capaolly
Footer
size
(sq ln)
16' x 16'
(25e)
181/�' x 1 S 1/2' 20' x 20'
(342) (400)
22' x 22s
(484)'
24' X 24'
(576)•
2(
100D
361
0.0 s
4 6
6
DDO s
6
8 8
2,500 s
6
8 8
30s
00
8
8
3 0
$• g
PIER PAD SIZES
I-beam pier pad size iG22
Perimeter pier pad size %cZ 7—
Other pier pad sizes
(required by the mfq:)
®'Draw the approximate locations of marrial
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.
POPULAR AD'S1
Ann,
4 ft L---' 5 It
FRAM E T1E5
within 2' of end.of horr
spaced at Cl 4" oo _
TIEDOWN COMPONENTS OTHER TIES
Nurr,
L.0119ltudinal Stablllzing Device (LSD) Sidswall
Manufacturer. wr,A)vt ^v.. 5v_s4e r.J Longitudinal
Longitudinal S ablllz! Devlcg w/ ateral Ardrs Marriage wall
Manufacturer�r� JSrS J Shearwall
Opening Pier pad -.size
ZS�7f/ (7 k2Z
f ,� j .. f :.• ': PERMIT WORKSHEET ( page 2 of 2
PERMIT NUMBER
POCKET PENETROMETER TEST
The pocket penetrometer tests are round d to
psf
or check hereto declare 1000 lb, soil Le without testing.
X
POCKET PENETROMETER TESTING METHOD
i. Test the perimeter of the home at 6 locations,
2. Take the reading at the depth of the•fcoter
S. UAIng 600 lb, increments, take the lowest
readiniq and round down to that increment.
X
TORQUE PROSE TEST
The results of the torque probe test is 3 C/o inch pounds or check
here if you are declaring 5' anchors without testing . A test
ds
showing 275 inob pounor less will require 5 foot'
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 torqus test
reading Is 275-or less and where the mobile i ome manufacturer may
requires anchors with 4000 lb holding capacity.
Installer's initials
ALL VESTS DUST BE PERFORMED BY A LICENSED INSTALLER
Installer Name (iU Y A) N e
Date Tesfed
- - • Electrioaa -
'bnnW electrical conductors between multi -wide units, but not to the main power
ource. This•Ingludes the bonding wire between molt -wide units. Pg.
— Plumbirig ",
Site Pre aratlon
Debris and organic material removed
Wafer drainage; NaturalSwale
>°
Pad Other_
irk°
Z
Fastenin multiwldeunit�
Q
Floor. Type Fastener lA% - Length; ��� Spacing: Zy
Walls. Type Fastener. _ A�. Length: !_ Spacing: ?,V ��
Roof: Type Fastener: t,+4•�_ Length;.'! Spacing: Zy��
For. used homes a min. 30 gauge,;8" wide, galvanized metal strip
be
will centered over the peak of the •roof and fastened with gaiv.
O
roofing nails at 2" on center on both sides of the centerline,
LU
(.)
C)
Gasket worth reolln' ulrm&.t
1 understand a properly installed gasket Is a requirement of all new and used
homes and that condensation, mold, meldsw grid buckled marriage walls are
a result of a poorly Installed or no gasket being installed. I understand trip
of tape will not serve as a gasket,
installer's initialsZ.
Type gasket ?C'-W installed:
Pg. Between Floors Yes _ 4!
Between Walls Yes -
Bottom of ridgebeam Y`
weatherprooftnt7
The bottomboard will be repaired and/or taped, Yes ---�Pq,
Siding on units is installed to manufacturer's specifications, as
Fireplace chimney Installed so as not to allow intrusion of rain water. Yes
MisaelianeoUs
Skirting to be.installed. Yes No
Dryer vent installed outside of skiiiing. Yeses N A
Range downflow vent installed'outside of skirting. _Yes - `-WA
Drain lines supported at 4 foot intervals, Yes
Electrical crossovers protected, Yes
Other:
nnneot all sewer drains to an existing sewer tap or septic tank. Pg, �� L
verifies all. inform- anon given. with thfa� permit Workshest
is sopurate and true based'on the
onnect all potable water supply piping to an axis ' g water meter, water tap, or other Installer signature �r.���� Date SL511�11 idependent water supply systems, Pg,