HomeMy WebLinkAboutPermit WorksheetFERMIT-NUMBER
Installer _/yfyf HVii/fc--f— License 4
Address of home d,L, 3,7 A/ 05 f rR Aralaf;
being installed
Manufacturer �� %t✓`l� Length x widthX900 `
NOTE: It home Is a single wide fill out one half of the blocking plan
/f home Is a triple or quad wide sketch In remainder"of home
l understand Lateral Arm Syste4&rp4�used on any home (new or used)
where the sidewall ties exceed %Rg ' . S AN
R5QU/ $JxrQ04il�47a YCOI?RECSE
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PERMIT WORKSHEET
I pugo 1 of 2
New Home ❑ Used Home R
Home installed to the Manufacturer's Installation Manual ❑
Home Is installed in accordance with Rule 15-C
Single wider Q> Wind Zone II S Wind Zone III ❑
Double wide ❑ Installation Decal 11
Triple/Quad ❑ Serial k /0,7 3
PIER SPACING TABLE FOR USED HOMES
Load
- Bearing
capacity
I Footer
size
(sq In)
16` x f 6'
(}
18 i/2' x-18 -1/2'
(342)
20' x 20'
(400)
22' x 22'
(484)'
24`X 24`
(576)'
26' x 26'
(676)
1000 pst
3
4
5
-
a
1 00 psf
4 6
6
a
200o ps
6
8
a
$
2500 s
7 6
ll
a
a
e
3000 s
8
8
8
8
8
3 s
8
8
a
p
J umpulareu uum nuie w%.- r pier spacins] lame.
PIER PAD SIZES
I-beam pier pad size
Perimeter pier pad size
Other pier pad sizes
(required by the mip.)
Draw the approximate locations of marriage
wall openings 4 toot or greater. Use this
symbol to show the piers.
List all marriage wall openings greater than 4 fool
and their pier pad sizes below.
Opening Pier pad size
TIEDOWN COMPONENTS
Longitudinal Stabilizing Device ILSDI
Manufacturer
Longitudinal Stabilizing Device w/Lateral Arms
Manufacturer
POPULAR PAD St2ES
Pad 19ize9
1n
15 A
x
X 18.5
x
x
x
20 x
x
x
x
x
ANCHORS
O ft _'Z it
FRAME TIES
within 2' of End of home
spaced at 5' 4" oc
OTHER TIES
Number
Sidewall
Longitudinal
Marriage wall
Shearwall
K
PE,RPJftT NUMBER
POCKET PENETROMETER TEST
The pocket penetrometer tests are round own to V//t psf
or chock here to declare 1000 Ib. soil without testing.
x
POCKET PENETROMETER TESTING METHOD
1. Test the perimoter of the home at 6 locations.
2. Take the reading at the depth of the looter.
3, Using 500 lb. increments, take the lowest
reading and round down to that increment.
x x x
TORQUE PROBE TEST
The results of the torque probe test Is 3;Lq_inch ounds or check'
here if you are declaring 5' anchors without testing A test
showing 275 inch pounds or less will require 5 fool anchors.
Note: A slate approved lateral arm system is being used and 4 ft.
anchors are allowed at the sidewall locations. 1 understand 5 it
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 ilbAholding capacity.
Installer's initials
ALL TESTS MUST BE PERFORMED BY A LICENSED INSTALLER
l'
Installer Name
Date Tested
Electrical
IJUHMI 1 YVURK5HEET I Palle 2 of 2 1
Site Preparation
Debris and organic material remjed
Waler drainage: Natural t/ wale Pad Other
Fastening mum wide units
Floor: Type Fastener. Le . h: Spacing:
Walls: Type Fastener. Spacing: _
Roof: Type Fastener: gth: _ Spacing:
For used homes a mi gauge, 8" wide, galvanized metal strip
will be centered oy a peak of the root and fastened with galy.
rooling nails.at on center on both sides of the centerline.
Gasket (weatherproofing re ulrenx t -
I understand a properly installed gasket is a require of all new and used
homes and that condensation, mold, meldew uckled marriage walls are
a result of a poorly installed or no gasket b ' installmi. l understand a strip
of tape will not serve as a gasket.
nslaller's initials _
Type gasket v Installed:
Pa. Between Floors Yes _-
Between Walls Yes
Bottom of ridgebeam Yes
Weather roofin
The bottomboard will be repaired and/or taped. Yes . P.
Siding on units is installed to manufacturer's specifications. Yes
k�
Fireplace chimney installed so as not to allow intrusion of rain or. Yes —
Miscellaneous
Skirting to be installed. Yes ✓ No ���
Dryer vent installed outside of skirling. Yes t� NIA
Range downflow vent installed outside of skirting. �s �N/A
Drain lines supported at 4 foot intervals. Yes t/
Electrical crossovers protected. Yes 4LI-A
Other:
,onnecl electrical conductors between multi -wide units, but not to the mna/in� wer
source. This includes the bonding wire between mull -wide units. Pg..— Installer verifies all information given with this permit worksheet
Plumbing Is accurate and true based on the
manufacturer's installation instructions and or Rule 15C-1 & 2
;onnect all sewer drains to an existing sewer tap or septic lank. Pg. ��
t, In ,t41 er;Slgraatur Date
,onnoct all potable water supply pipinq to an oxistinq w .j mdte-,wator'tap, or olh,e
idepandont water supply systems. Pg.
¢ y .
�sr �M "o,