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HomeMy WebLinkAboutPermit WorksheetsHERMIT N% MBEt
Installer tiro bele+ e- r re
License B rTv
Address of home �_ CPW /U as-( (Lcv
being installed
Manufacturer Length x width CA'4%[-'��
NOTE. If home Is a single wide 1111 out one half of the blocking plan
if home is a triple or quad wide sketch In remalnderbf home
I understand Lateral Arm Systems cannot be used on any home (new u )
where the sidewall ties exceed 5 It 4 in. -
Installer's initials
- -
Typical pior spacinlj -- - - - - - --- - -
2' I WOW
I
PERMIT WORICSHEET
FILE C.O.,
New Home v-a"
Home installed to the Manufacturer's Installation Manual ❑
Home is installed In accordance with Rule 15-C
Single wide ❑ Wind Zone II Wind Zone III []
Double_wide r Installation Docal 11 �9 3 pl 0
TriplelQuad ❑ serial q L( 0G j 019Y/4 01
PIER SPACING TABLE FOR USED HOMES
Load- Footer
bearing - size -18` xi
capacity (sq In) {268)
PIER PA
I-beam pier pad size
Perimeter Piet pad size
Other pier pad sizes
(required by the mfg.)
2' x 18 172' 2V x 2D' 22' x 22' 24" X 24' 26' x 28'
(342) (400) 1 (484)' (676)• (676)
ES7 POP LA PAD SIZES
1; x 1z�
Draw the approximate locations .of marriage
Weill openings 4 foot or greater. Use this
symbol to show the piers,
List all marriage wall openings greater than 4 toot
and their pier pad sizes below,
Opening Pier pad size
TIEDOWN COMPONENTS.
Longitudinal Stab iing Device (LSD)
Manufacturer �'vee
Longitudinal Stab `� l,lzinq Device w1 Lateral Arms
Manufacturer "fit
' ■wlii-m
EM
i[dares�s�.tii► .!lcilll�L/
>®�z�riwxr>ts■�
� e
ANCHOR
4 ft
FRAME TIES
within Vol bnd of home
spaced at 5' 4" oc _>z
OTHER TIES
Sidewali Number
Loniiit w
Marrlane wall
Shearwall
r > �N FL-HMI1 VVURKSHEET I page 2 of 2
PERMIT NUMBER
POCK PENETROMETER TEST
The pocket penetrometer tests are rounded*wn to psi
or chock here to declare 1000 Ib. soil _ .V without testing.
POCKET PENETROMETER TESTING METHOD
1. Test the perimeter o1 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.
here if you are declaring 5' anchors without testi A lest
showing 275 Inch pounds or less will require 5 f n ors.
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 are the mobile home manufacturer may
requires anchors with 0 Iding capacity.
Installer's initials
ALL TESTS MUST E P F RMED BY A LICENSED INSTALLER
Installer Name D e r'f N gyre
Dale Tested 1 ®2 0
Electrical
Ionnect electrical conductors between multi -wide units, but not to the n power
iourco. This includes the bonding wire between mull -wide units. Pg.
Plumbina
:onnect all sewer drains to an existing sewer tap or septic tank. Pg,_
:onnecl all potable water supply piping to an existing water meter, water tap, or other
Idepnndent water supply systems. Pg.
...................Slte Prepavtati6h,.::::
Debris and organic materiaoved _ f
Water drainage: Natural ✓ Swale Pad Other
Fdstening multi wide units
�it
Floor: Type Fastener. L ! Length: Spacing: -
Walls: Type Fastener. Length:'� 7t-- Spacing:
Roof: Type Fastener: i .&J Length: „�Spacing;
For used homes a Min. 30 gauge, © wide, galvanized metal scrip
will be centered over the peak of the roof anti fastened with gaiv,
roofing nails at 2" on center on bofh sides of the centerline.
I understand a property 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, understand a strip
of tape will not serve as a gasket.
,j Installer's initia
Typo gasket a I �T^ �I �� e Installed
� .._... _._... e[waori Floors Yiis V
Between Walls Yes
Bottom of ridgebeam Yes
Weatherproonng
The boitomboard will be repaired and/or taped. Yes l�. Pg.�,_
Siding on units is installed to manufacturer's specifications. Yes
Fireptace.chimney installed so as not to allow,intrtision.ot rain. water...,Y.es.�,/4...
Miscellaneous
Skirting to be installed. Yes I,/ No
Dryer vent installed outside of skirting. Yes N/A ✓
Range downflow vent installed outside of skirting. Yps N/A a✓
Drain lines supported at 4 foot Intervals. Yes ✓
Electrical crossovers protected. Yes
Other;
Installer
verifies all Information given with this permit worksheet
Is accurate and true based on the
Date __/+�lS /D 9