HomeMy WebLinkAboutPermit WorksheetPERMIT NUMBER
Installer 1614 License 6 d000 9'7 q
Address of home oZ% iy � � wy (Lbt q)
being installed Pt, Aeylce, f 3 !Yu
Manufacturer E W Length x width J
MOTE: 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 haute
- I understand Lateral Arm Systems cannot be used on any home (new or used)
where the sidewall ties exceed 5 it 4 in.
Installer's initials
Typical pier spacing
7' I latent
. Y... Show locations of Lonqitudinal and Lateral
--Lj(use dark lines to show these locations)
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ONE
PERPAIT WORKSHEIET
New home ID Used Home 12F
i
page 1 or 2
Home installed to the Manufacturer's Installation Manual
Home is installed in accordance with Rule 15-C,
Single wide Wind Zone 11 Wind
Zone III
Double wide E] Installation Deoal 4
Triple<rQuad ® Serial it - a?
®o if(5y
PIER SPACING TABLE FOR USED HOMES
Load
bearing
capacity
Footer
size
(sq in)
16' x W
(256)
111112 ' x 18 112'
(342)
20'-x 20'
(400)
--22' x 22'
(484)'
24" X-24=
(576)'
25' x c6'
(676)
1000 s
3'
B
1500 s
4 6
6
T
8
fi
C00fl s
6
8
B
6
2500 pst
7 6
8
II
8
B
3000 PSI
a-
I Ii
a
t3
B
3 00 s
8
&
8
mterpolatee morn mute ion:-t pier spacing tame.
PIER PAD SIZES
I-beam pier pad size
Perimeter pier pad size
Other pier pad sizes
(required by the mfq.)
I- Draw the approximate locations of marriage
Lwall openings 4 toot or greater. Use this
�.-, symbol to show the piers.
List all marriage wail openings greater than 4 foot
and their pier pad sizes below.
Openinq Pier pad size
TIEDOWN COMPONENTS
Longitudinal Siabillging Device (LSD)
Manufacturer 01; rr a-1-
Longitudinal Stabrlr ing Device wtLa.teral Firms
Manufacturer
POPULAR M SIZES
Pad Size
In
16 x 19
296
19 x 18
W. x 18.5
.342
bx22.
17 x
x26
348
20 x 20
x2
X
x 26
ANcitoRs
Oft sit_
FRAME TIES-�
within 2' of 8nt1 of home/
spaced at 5' 4" oc r/
OWER TIES
Number
a il
Lonttituriinatrria
Marriage :va[I
Shearwall
Y
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PERIP&T NUMBER
170CKET PENETROMETER TEST
The pocket penetrometer tests are roundedAwn to _____ psi
or check here to declare 1000 11)- soil &" without testing.
X X X
POCKET PENETROMETER TESTING METHOD
t .- 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.
TgfiQUE PRt]t3E TEST
E The results of the torque probe test is � - inch -pounds or check
here if you are declaring 5' anchors without testing V ✓9' . A test
showing 275 inch pounds or less will require 5 toot anchors.
Note: A slate approved lateral arm system is being us4. i and 4 it.
anchors are allowed at the sidewall locations, I understand 5 it
anchors are required at all centerline tie points where the torque test
reading is 275 or less and where the mobile Borne manufacturer may
requires anchors with 4000 1 capacity.Installer's initials
ALL TESTS MUST BE PERFORMED BY A LICENSE} INSTALLER
Installer Name
Date Tested
Electrical
connect electrical conductors between multi -wide units, but not to the mat er
oource. This includes the bonding wire between mull -wide units. Pg.
Plumbing —_
:onnect all sewer drains to an existing sewer tap or septic tank. Pq.�
;onnect all potable water supply piOnn to an existing water meter, water tap, or other
tdependenl water supply systems. PI __. e� _
tjLKMt t Vtd:.JRKSHF-ET
pacje 2 of 2 6
Rite Preparation
Debris and organic material repoved �E=5
Water drainage: Natural ✓ Swale Pad Other
Fastening niulti wlde units
Floor: Type Fastener: Length: Spa p:
Walls: Type Fastener: i enc ' . _ Spa tnq:
Root: Type Fastener: nth: Spacing:
For used homes a min. 3( auge, 8" wide, galvanized metal strip
will be centered aver th eak of the root and fastenLd with gain.
roofing nails at 2" or . nier on both sides of the centerline.
I understand a property installed gasket is a requirement of all new used
homes and that condensation, mold, meldew and buckled m qe wails are
a result of a poorly installed or no gasket being Installer + understand a strip
of tape will not serve as a gasket.
�j�A Insta is initials
Type aasket Installed:
Pg. Between Floors Yes
` Between Walis Yes
Bottom of ridgebeam Yes
The bottomboard will be repaired and/or taped. Ye . Pg.. L _ L'
Siding on units is installed to manufacturer `s ttications. Yes
Fireplace chimnet, installed so as not to w intrusion of rain water. Yes _
Skirting to be installed. Yes ti - No
Omer vent installed outside of skirting. Yes N/A
Range downf low vent installed ouiside of skirtinq. YesDrain lines lines supported at 4 foot Intervals. Ye��
Ciectrioal crossovers protected. Yes
Other:
[_'in-stailer verifies all information given with this permit worksheet
is accurate and true based on the
o-e,�n,rt��e„ror�c inettntint-inn instructions and or Rule 15C
installer Signature
Date �� `�