HomeMy WebLinkAboutPermit WorksheetOtRMIT NUMBER
installer l-A,4JL License # 1('I rb I (o r Zg
Address of home C- o s�v
being installed
mq
S-I-- Ly c r 6 . r% 3 y5S
Manufacturer hateC Qc k aL, LengthXWidth
N07*F-- ' if home is a single Wide fill out one half of the blooking plan
if hotri a is a trip[® Pr quad wide sketch In pemalndet' of home
I understand Lateral Ann Silsems cannot be used an any home (new or used)
wherd the sidewall ties exceed 5 ft 4 in.
installer's initials '
PER -MIT WOFIKSHEET
I page i of P.
New Home
Used Home
Q�
. [3
Home installed fb the Manufacturer's Installation
Manual (�
O
Home Is installed in accordance with Rule 15-0
Single wide tj
o(• seer
D6uble
Wind Zone ll
Wind Zone IIi
wide
installation Decal x
TriplelQuad 0
Serial # t" e
�� ��►��J�� , �j
PIER SP_ACiNC TABLE FOR USED HOMES
Load FooteC , °
ypfcal par spaolnq •
L, /
[. beating'
size416
X f 6
(2ss)
IS f/2°X.S 1/2°
(342)
20°X2W
22°X22° 24°X24° -26° x 26°
Ialara► ..
capacity
(sq in
-
(4oD)
(484)* (576)' (676)
Show locations of Longitudinal and Lateral Systems
1000
s
a
loi allwnal (use dark lines to show these locations)
oo
o0o
s
4 s
s
8
176
2 00
s .
s
s
fi
e .
8
8
8/71
6
t3
3000
s
g
U r PiER PAD S1ZE5 — -
I-beam pier pact size
Perimeter pier pad size t.7
__�. Other pier pad sizes (•% )G22
�-� ILI F_
(required by the mfq.)
13 Draw the approximate locations of marriag
wall openings 4 foot or greater, Use this
arrlagowallplamwilhln2'ofandafha'ap RuaYSc symbol to show the piers.
13 List all marriage wall openings greater than 4 foot
and.their pier pad sizes below
ANCHORS
Opening Pier pad -size
1%•S� — 9j0 17 )c Z Z rf 4 it 5 ft
• FRAhAEY(E5
within-2' of end of hoT�
spaced at 6141160
• 7IED.DwN CDMPONENTS - b7l�Eii `rlEs
Longliudlnal.Sfablll bw Devl ( ) - -- Sidewall Number
idlanufaotcirer Longitudinal.
Longttudnna! S b11 zl �evlc !b feral rRis Marriage wall
-Manufacturer _ fV�+ t,iS Sh magi t
w
Z Q
a�
L
F� H
oWoU)
—p z
ro a O
LU
0
02, a�
00
Ljj
ULUw Q�
Jwwfn0
LIJ
»t—zu.f
U)W�agU)
J"
PERMIT NOMBE
•:.y+hi. �'� 5S..��. :.fir \�.5�� x'y,h��.,.f 2�1-�� .....
• i.. i�ii �\ C�tiC'..'.i�h• �hy�LYL ••V:'.��.�'Y ��i.
POCKET PENETROMETER TEST
The pocket penelrometertests are rounded to psf
or check hereto declare $000 lb. soil without testing.
x X x
POCKET PENETROMETER TESTING METHOD
I. Test the perimeter of the home at 6 locations.
2. Take the reading at the depth of the,footer.
S. Using Soo lb. increments, take the. lowest
reading and round clown to that increment.
X�
' TORCaLIE .PROBE TEST '
The results of the torque probe test is 0 inch pounds or check
here if you are deolarinq V 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 5.ft
anchors are required at all centerline tie points where the torque test
reading Is 275. or less and where the mobile home manufacturer may
requires anchors with 4000 lb holding capaoity.
Installer's initials
ALL TESTS MUST BE PERFORMED BY A L.ICEidSED INSTALLER
IrisiallerlVame
Date TWed 'z ( 'Zp
EleafrlDal
IArinect electrical conductors between multi -wide units, but not to the main power
ource. This•inoludes the bonding wire between molt -wide units. Pg.
_ onneot all sewer drains to an existing s®war tap or septio tank. Pg.
onriect all Potable water supply piping to an exi.s ' water meter, water tap, or other
idependent water supply systems, Pg.
PERMIT WORKSHEET L - page 2 of 2 I
site Preparation
Debris and organic material r ved
Water drainage: Natural �oSwalo . Pad Others_,
Fastening multf wide Unite
Floor. Type Fastener: - Length: k {, Spacing: .
Walls: Type Fastener, —S Length: ,�_ Spacing: _ •Z
Roof: Type Fastener: Length:. /_ to Spacing: 6.
For.used homes a min. 30 gauge,'8' ,wide, —galvanized metal strip
Will be centei'ed'over the peak of the roof and fastened With galy.
roofing hails at 2° on center on both sides of the centerline.
GaSiGet(wedhetp&Tffr: regal }y
1 understand a property 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 a strip
of tape will not serve as a gasket.
installer's initials -
Type gasket - E&A Installed,
Pg. Between Floors Yes
Between Walls Yes Bottom -of ridgebeam Yes
' weafherprootlna
The bottomboard will be repaired and/or taped. Yes ��Pq,
Siding on units Is installed.to manufacturer's speciflcations. Yes,—_
Fireplace chimney Installed so as not to allow iritruslon of rain water. Yes
Mlseelfaneous
Skirting to be.installed. Yes C--__ No
Dryer vent installed outside of skirting. Yes.,,�(!A
Range downflow vent installed -outside of skiittng. Y.es=WA -
Draln lines supported at 4 fobt intelvals,.� t==—
Electiloal grossovers protected. Yes
Other:
I in,smiter verlttes aLt. information given. with thin permit Workshest
is acuura$e and true )based on the
----
installer slgnaturs
Date Z�- •)- Z o
0
0
Uj
U.