HomeMy WebLinkAboutPermit WorksheetMIT NUMBED
Installer ,J,J (tit License �.1 o / j 2
Address of home 6'C--�^O SOU
being installed
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Manufacturer IMQ S 6 G Wier, Length x widthSI-5(� -,I Z ' I�--
NOTE: ' 1f home is a sln9le stride fill out one half of the blockln9 plan
!f honi a Ise triple or quad wide sketch In rernalnder of home
I understand Lateral Arm Systems cannot be used on any home (new c�red)
where the sidewall ties exceed 5 ft 4 in,
Installer's initials_
Typical pier spacing -
lateral
( Sfiow locations of Longitudinal and Lateral Systems
(use dark lines to show these locations) �r
Wall Pier; Wnwri 9 or end of horns ?64nufa ISO
r'i emr
PERMIT WOFIKSHEET L page Y of ti
New Home . ® Used Herne
Home installed to the Manufacturer's Installation Manual []
Hbms is installed in accordance with Rule 15-0 U3
Single wide ® Wind Zone Il 12"" Wind Zone III
Do ble w de Installation Decal 701 Sy a
Triple/Quad ® Serial* f- L t4m a SA C/p 90 Q
Load
bearing*
capaolty
PIER SPACING TA61.E FOR USED HOMES
Footer f6'Xf63 181/21xis
size
(sq In) (2S6) . (342)
20'X20' 22'x22' 24°X24' •26.X26°
(40c) _ (484)a (676)- (676)
• PIER PAb SIZES
I-beam pier pad size
Perimeter pierpadsize l?k22�
Other pier pad sizes ► Irk Z Z
(required by the mfg.)
Draw the approximate locations of marriage
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.
POPUL4R PAD'S1ZES
ANCHORS
4 ft ✓ 5 ft
FRAME TIES
within 2' of end of honi�
spaced at 0 4" 00
7IED.DwN CDMPONENTS OTHER `r1E$
- -- Number
Longltudlnal Stabilizing Device (LSDJ Sidewall .
ManufaotdrerM�a>>�.a,� Longitudinal.
Lon9ltudinal Stsbll! ing �e c ty/"�" ate�ral Arrrls Marriage wall
Manufacturer I�LNQN.Sfe. Sh�twati
Opening Pier padsize
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POCKET PENETROMETER TEST
The pbcket penetrometer tests are roun#�own to psf
or chsok hereto declare 1000 lb. soil v V wiftITt 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 thefooter
3. Using 500 lb. increments, take the lowest
readinn and round down to that increment.
X Jt X
- TOR[3UE PROBE TEST -
The results of the torque probe test is � 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 275•or less and where the mobile tome manufacturer may
requires anchors with 4000 lb holding capacity,
® Installer's Initials
ALL TESTS MUST BE PERFORMED BY A LiCENSED INSTALLER
Installer Name
Date Tested Z .
Electrical
lonnect electrical conductors between multi -wide units, but not to the main power
ounce. This•Ingludes the bonding wire between mult>wlde units. Pg.
Plumnirig -
;onneot all sewer drains to an existing sewer tap or septic lank. Pa.
onnect all potable water supply piping to an exi g water meter, water tap, or other
idependent water supply systems, Pg.
PERMIT WORKSHEET i page 2 of 2
site Preparation
Debris and organic material re
Water drainage: Natural Swale Pad Other_
Fastening muitf wide units
Floor. Type Fastener: Length: Spacing: Zy'r
Walls: Type Fastener, , CAk- Length: ,,,[.L! Spacing: ` zyT---
Roof. Type Fastener. LA &--- Length:. ,i Spacing: _ aYT—
For.used homes a min. 30 gauge,!B" wide, galvanized metal 'strip
will be centered 'over the peak of the•roof and fastened With gain.
roofing nails at 2" on centeron both sides of the centerline.
Gasket (!=1h!MA*e5 j raaulremnnt)
I understand a properly installed gasket Is a requlrement of all new and used
homes and that condensation, mold, meldew and 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 _1::OA-wi installed:
Pg. Between Floors Yes
Between Walls Yes —"
Bottom of ridgebeam Yes
' weatherprobflnv
The bottomboard will be repaired and/or taped, Yes Pg.
SldinA on units Is installed to manufacturer's speoificatione. Yes
Fireplace chimney Installed so as not to allow ititruslon of rain water.
MisaellaneoUs - //
Skirting to be.installed. Yes No
Dryer vent installed outside J skirting• Yes • (-E�_WA�A
Ranqe downflow vent installed -outside of skirting. Y
Drain lines supported at 4 foot intervals, Yes
Electrical crossovers protected, Yes
Other;
I Installer verifies all. information given, With thin permit Workshest
is acnaarate and true. based 'on the
Installer Signature
Date _14W.Z v