HomeMy WebLinkAboutPermit WorksheetsFILE (;UFY
PERMIT NUrqBER
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Installer to p-,* d — re Licenso # _Two 000 J' 7 7
_c Address of home
being Installed
Manufacturer
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Length x width
(VOTE. if home Is a single wide fill out one half of the blocking plan
If home Is a triple or quad wide sketch In remainder'of home
I understand Lateral Arm Systems cannot be used on any home (new s
where the sidewall ties exceed 5 It 4 in,
Installer's initials
Typical plor spacing
71 1 latarnl
Show locations of Longitudinal and Lateral Systems
(use dark lines to show these locations)
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PERMIT WORKSHEET t
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New Home
__Home.installed-lo-theManufaclurdeslnstailation_Manual
Home is installed In accordance with Rule 15-
Single wide Q Wind Zone II Wind Zone III ❑
EDiiu6le:wiiie V= Installation Decal N o� 9 3 ��U✓
Trlplat0uad Q Serial a aO(O Qo ga /f Al ,26&_2�j�
PIER SPACING TABLE FOR USED HOMES
Load F(266
) ' .1, 16'x16' 8/2' bearing te 7X24'26' x 26'
(00) (484)' In) )capaalty (sq
PIER PAD SIZES
I-beam pier pad size's
Perimeter pier pad size 01 X'Ay
Other pier pad sizes I r K W
(required by the mfg,)
7 Draw theapproximate.local(ons-cf_marriage..
wait openings 4 foot or greater. Use this
symbol to show -the piers.
List all marriage wall openings groater than 4 loot
and their pier pad sizes below.
Opening Pier pad size
a2A! xXI
TIEDOWN COMPONENTS
Longitudinal Stabilizing DeV1cejLSD)
Manufacturer � — L i — r
Lon"gltudlnal Stab lzinng iNce�v/Lateral Arms
Manufacturer O l e i9 Gr _
POP LAR Ab Sl2ES�i
a . ize
x
x
n
288
x .�
x
x374
1/4 x
7=
x
- x MT
x
26_x
AA�NCHf�ORS ...
4 it t./5 it
FRAME TIES
within Vol end of.Itom�
spaced at 5' 4" oc
OTHER TIES
Sidowall Number
Marriatle wall
Shearwall
•
PERMIT NUMBER
.
....... — POCRET PENETROMETER TEST
The pocket penetrometer tests are roundeAown to psf
or check here to declare 1000 11). soil[ - without testing.
X� X
X---
POCKET PENETROMETER TESTING METHOD
1. Test the perimeter of the home at 6 locations.
2. Take the reading at the depth of the tooter.
3. Using 500 lb. increments, take the lowest
reading and round down to that increment.
•XX X_
TORQUE PROBE TEST
The results'of the torque probe test is ""�S� f s or check
here it you are declaring 5' anchors without testing A test
showing 275 Inch pounds or less will require 5 toot anchors.
Note: A state approved lateral arm system is being used and 4 ft.
anchors are allowedat the sidewall locations. I understand 5 fl
anchors are required at all centerline tie points where the torque test
reading Is 275 or less d ere the mobile home manufacturer may
requires anchors with 4 0 t Iding capacity.
Installer's initials
ALL TESTS MUST BE P RFORMED BY A LICENSED INSTALLER
InstallerName'
erf n r r^e'W-
Date Tested
Electrical
:onnect electrical conductors between multi -wide units, but not to the main power
source. This includes the bonding wire between mull -wide units. Pp. _ V___
Plumbino
NEHMt 1 WURKSHEET I page 2 of _2 1
Debris and organic material re oved
Water drainage: Natural Swale % Pad Other
i
Fastening multi wide units
Floor: Type Fastener. L� rr
.._.� Length: � Spacing:
Walls: Type Fastener. Length: (P Spacing:
Roof: Type Fastener: L.6 5 Length: _�_ Spacing: _
For used homes a min. 30 gauge, 8" Wide, galvanizes metal strip
will be centered over the peak of the roof and fastened with gaiv,
roof ing nails at 2" on center on' both sides of the centerline.
Gasket (waatharprootlnq raquircmrnt)
I understand a properly installed gasket Is a requirement 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 boin(i installed. I understand a strip
of tape will not serve as a gasket.
i
Installer's Initials
Type gasket a f4c a-✓!e Installed;
Pg: Between Floors
Between Walls
Bottom of ridgebeam o§
The bottomboard will be repaired and/or taped. Yes ✓ Pg,
Siding on units is Installed to manufacturer's specifications. Yas! � /
Fireplace chimney installed so as not to allow.tntrusion.ol.rain water. Yes.. J /_.,
Miscellaneous --
Skirting to be Installed. Yes No
Dryer vent installed outside of skirting. Yes NIA r
Range downflow vent installed outside of skirting. Yes NIA
Drain lines supported at 4 toot intervals. Yes _sue -�
Electrical crossovers protected. Yes _
Other:
Installer verifies all information given with this permit worksheet
Is accurate and true based on the
:onnect all sewer drains to an existing sewer tap or septic lank, Pg. 4— manufacturer's InSJafta11AP_n1r6dANctIdnAnd or Rule 15C-1 P. 2
3onnecl all potable water supply piping to an oxisting water motor, wator tap, or other Installer Slgnalur4m� date lee
ldependont water supply systems. Pp.