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HomeMy WebLinkAboutPermit WorksheetsPERMIT NUMBER Installer License # t`7(� -� Address of home _ /L ZJ to.V being installed Manufacturer ���^ Length x width NOTE: 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 szoo I understand Lateral Arm Systems can?i Qn any home (new or used) Where the sidewall ties exceed 5 ftlpj b1Z odb N� Sbp �r�f Typical pier spacing 401" ;Z1d 03, p� NfO ��� � bl 0o T I lateral ®dobd �; �b Show locatio' &%%.j1H&h§nd Lateral Systems 1=911.dinal (use dark lines, to s kese location ■ i i i i i i i i ■■■■■■■■■■■■■■■■■■■■■■■■■■■■ NOON■■ ■■■■■■■■■■■■■■■■■■■NONE ■■■■■■■NOON■■■ ■NEE■■■■■■■®E.E■NEE■®■N■®0■®®®®® iE■ ■■E EEOE■■®EEE©® E■®E■N Elm ME■min IVEME MEN ■■■■ E ��■■EEE�1N®®E®■®®®■®OE®EELI■■■■E :■■ ...■■■■■■■■■■::N:::C:::■■:::■MEN :::■ No M 0 ME M �E■EEE�■■■■■■p■■EEEEEE■E■E■■NEE■■■ ■ �O■E■ ■■E ■NEE■■■E■■■■NE ■NOO■NEO■E■■■■■■■■■■■■■EEEOE■E■■EN■■■■ENE■■ ■N■ ■ PERMIT WORKSHEET I PL190 1 0. 2 New Home [] Used Home Ql Home installed to the Manufacturer's Installation Manual Home is installed in accordance with Rule 15-C Single wide El Wind Zone II Wind Zone III ©out le wideIR Installation Decal # -7 Triple/Quad El Serial # ;Z 0 PIER SPACING TABLE FOR I ISFn Nnee=c Load Footer bearing size 16' x 16' 18 1/2' x 18 1/2' 20' x 20- 22' x 22' 24' X 24- 26- x 26' capacity (sq in) (256) (342) (400) '(484)' (576)' (676) 1000 s 3 4 5 g 1500 ps 4 6 6 78.8 2000 s 6 8 8 8 2500 psf 7 6 8 8 8 8 8 3000 esf 8 g 8 8 8 3500 s � infarnnlnlcr7 /•.,... 8 O•1„ iGr 8 8 8 PIER PAD SIZES I-beam pier pad size (� Perimeter pier pad size Other pier pad sizes 16 (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. Opening Pier pad size TIEDOWN COMPONENTS Longitudinal Stabilizing Device LSD) Manufacturer OL Longitudinal Stabilizing Device w/Lateral Arms Manufacturer POPULAR PAD SIZES ANCHORS 4 ft ;J 5 It FRAME TIES within 2' of end of horge spaced at 5' 4" oc is OTHER TIES Number Sidewall Longitudinal Marriaqe wall Shearwal l PLHMI l WORKSHEET page 2 0( 2 E<EF;MIT NUMBER POCKET PENETROMETER TEST,z: The pocket penetrometer tests are rounded dpwn to psf or check here to declare 1000 Ib. soil i.! wlthoul 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. X X TORQUE PROBE TEST X 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 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 I capacity. Installer's initials ALL TESTS MUST BE PERFORMED BY A LICENSED INSTALLER Installer Name��(/J • r Date Tested v 1 „/ — connect _electrical conductors between multi -wide units, but not to the mai er ;ource. This includes the bonding wire between mult-wide units. Pg. Plumbina ;onnect all sewer drains to an existing sewer tap or septic tank. Pg. ,onnect all potable water supply piping to an axis •nq water meter, water tap, or other idependent water supply systems. Pg. Site Preparation Debris and organic material rerpoved Water drainage: Natural Swale Pad Other Fastening multi wide units Floor: Type Fastener: 16 r� _ength: ! �� Spacing: _ !� Walls: Type Fastener: Length: Spacing: Roof: Type Fastener: �L Length: � Spacing: For used homes a min. 30 gauge, 8" wide, galvanized metal strip will be centered over the peak of the roof and fastened with galy. roofing nails at 2" on center on both sides of the centerline. Gasket (weatherproofing requirement) 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 being installed. I understand a strip of tape will not serve as a gasket. / Installer's initials Type gasket ,P` v^A"" Installed: / Pg. Between Floors Yes Between Walls Yes Bottom of ridqebeam Yes Weatherproofing / The bottomboard will be repaired and/or taped. Yes woo/ • PC). Siding on units is installed to manufacturer's specifications. Yes — Fireplace chimney installed so as not to allow intrusion of rain water.._Yes. _ Miscellaneous Skirting to be installed. Yes No Dryer vent installed outside of skirting. Yeses N/A Range downf low vent installed outside of skirting. Xes Drain lines supported at 4 foot intervals. Yeses (/ '%l trical crossovers protected. Yes ✓ HMO er Installer verifies all information given with this permit workshee_t is accurate and true based on the Installer Signature s and or Rule 15C- 11