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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