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HomeMy WebLinkAboutPermit WorksheetPER IT'�;NUMBER - ';r: r� •a., ! �`�- Installer A9 de License # f 0©0 D g77 Address of horns S r✓ a �,S — Ld� p�� being installed Manufacturer LOW Length x width C_-Ay NOTE. If home Is a single wide Jill 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 where the sidewall ties exceed 5 fl 4 in, Installer's initials Typical pier spacing 7 2 / I lateral PERMIT WORKSHEET page ; 2 -F1 PN New Home ❑ Us�ed�Horno�— Home installed to the Manufacturer's Installation Manual ❑ Home is installed in accordance with Rule 15-C Single wide ❑ Wind Zone II Eg/-- Wind Zone III ❑ IDou`E9ie_tyido Installation Decal # TriplelQuad ❑ Serial # %3 lot 3a9�%�,3y�3 g PIER SPACING TABLE FOR USED HOMes Load I bearing capacity Footer izze - size (aq In) 16' x 16' (256) 18 112' x t8 1/2' (342) 20'.x 20' (400) 22' x 22' (484)' 24" x 24' (576)' 26' x-26' (676) 1000 st 3 4 5 g 1 00 s 4 6" Tg 2000 nsf 6 8 8 g 2500 s 6 8 a 8 a 3000 s 8 81 8 g a 3500 s 8 8 8 a ....... p....w.. .. i ..w_ wv-, V aF will laula. PIER PAD SIZES I-beam pier pad size 2, y Xa q Perimeter pier pad size Other pier pad sizes 1 x l (required by the mfq.) ❑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 loot and their pier pad sizes below. Opening Pier pad size AH 6 ;i,�_ TIEDOWN COMPONENTS Longitudinal 5tabilizi g Device (LSD) Manufacturer _p(i V e DV Longitudinal Stablllz(ng Device w/ Lateral Arms Manufacturerr� POPULAR PAD SIZES Pad Size S In ie x 16 18 x x 18.5 16 x 22.5 17 x 22 13 1/4 x 20 x x x 24 x 26 x ANCHORS 4ft V 5ft_ FRAME TIES within 2' of end of tlom spaced at 5' 4" oc OTHER TIES Number Sidewall LormMagri uriinal Marriage iage wall Shearwall PERI;JI[T NUMBER �)(� %/j/y�� •w. �=i NEHMI.I WORKSHEET I Paue 2of 2 POCKET PENETROMETER TEST The pocket penetrometer tests are roundeVown to psf or chock here to declare 1000 Ib, soil ��C_ 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, lake the lowest reading and round down to that increment. X X — X TORQUE PROBE TEST The results of the torque probe testis 1H ® - -- i nds or check' here if you are declaring 5' anchors without testing A test showing 275 inch pounds or less will require 5 foe rs. 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 d ere the mobile home manufacturer may requires anchors with Iding capacity. Installer's initials ALL TESTS MUST BE RFOR ED BY A LICENSED INSTALLER Installer Name Q6✓`&(4 Date Tested /o/ ail to Electrical 'onnecl electrical conductors between multi -wide units, but not to the maill power iourco. This includes the bonding wire between mull -wide units. Pg. e S Plumbing ;onnect all sewer drains to an existing sewer lap or septic tank. Pg. - f-- :onnect all potable water supply piping to an existing water meter, water tap, or other -idependent water supply systems. Pg. �Ye� Site Preparation Debris and organic material rgpabved )(e s Water drainage: Natural V Swale Pad Other fr f Floor: Type Fastener. D Length: Spacing: Walls: Type Fastener: r Length: �� Spacing: I ' Roof: Type Fastener: _I �4_9 _ _ Length: -_(a____ Spacing: I For used homes a min. 30 gauga, 8 wide, galvanized metal strip will be centered over the peak of the roof anti fastened with gaiv. roofing nails at 2" on center on both sides of the centerline. GaSket'(w—therprnoling regUlrement) 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 initi _ Type gasket �� Installed: 4�l�S Pg. Between Floors Yes Between Walls Yes ve 37— Boltom of ridgebeam Yes �v. eS — Weatherproofing The bottomboard will be repaired and/or taped. Yes Pg, Siding on units is installed to manufacturer's specifications. Yes Fireplace chimney installed so as not to allow intrusion of rain water. Yes _PIA Skirting to be installed. Yes ✓ No Dryer vent installed outside of skirling. Yes N/A Range downflow vent installed outside of skirling. N/A _� Drain lines supported at 4 fool intervals. Yes Electrical crossovers protected. Yes LZ_ Other: Installer verifies all information given with this permit worksheet is accurate and true based on the manufacturer's I Ila on i and or Rule 15C-1 � 2 Installer Slgnat e Date A S�0 d