Loading...
HomeMy WebLinkAboutPermit WorksheetPERMIT WORKSHEET PERMIT NUMBER Installer License Owner Name & Address of home being installed 2 Ca© Manufacturer Z vim_ Length x width NOTE: if home is.a single wide fill out one half of the blocking plat 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 or used) where the sidewall ties exceed 5 ft 4 in. -Installer's initials Typical pier spacing itaterai jj Ih —'-- < Y Show locations of Longitudinal and Lateral Systems ' (use dark lines to show these locations) langdudmal Li Li Li L-i 4 Li marnagc wall piers wdtun 7 of end of home per ule 15C IL Jr( 'Li�9i f ............. _...... .... . Ipage 1 of 2 New Home ❑ Used Home 02 Year Model Home installed to the Manufacturer's Installation Manual [] Home is installed in accordance with Rule 15-C Single wide ❑ Wind Lone II M/ Wind Zone III ❑ Double wide Installation Decal #{' Triple/Quad [] Serial # y J 7 7,0.,A , 2-y.7JZ,37_,cp I� PIER SPACING TABLE FOR USED HOMES Load bearing capacity Footer size (sq in) 16" x 16" (256) 18 1/2" x 18 112" (342) 20" x 20" (400) 22" x 22" (484)' 24" X 24" (576)' 26" x 26" (676) 1000 psf 3' 4' S' 61 7' 8' 1500 psf 4' 6" 6' 7' 8' 8' 8' 2000 psf 6' 8' 8' 81 8' 2500 psf 7' E= 8' 8' 8' 8' 8' 3000 pst 8' 8' 8' 8' 8' 8' 3500 sf 8' 8' 8' 8' lI IIGIIJU1d1t:0 HUM r;Ule IJI.-1 plef SpaCl[IIr raDti PIER PAD SIZES �1 I-beam pier pad size / Z Perimeter pier pad size L �ii Other pier pad sizes (required by the mfq.) 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 POPULAR PAD SIZES ANCHORS 4f '5ft FRAME TIES within 2' of end of home spaced at 5' 4" oc OTHER TIES Number Longitudinal Stabilizing Device (LSD, Sidewall Manufacturer ���js7 yy�,e e�-j"y.111e •+L,ongitudinal Longitudinal Stabilizinry Device w/ Lateral Arm; Marriage wall ManufacturerS T71epz,_ Shearwall PERMIT WORKSHEET page 2 of 2 PERMIT NUMBER POCKET PENETROMETER TEST The pocket penetrometer tests are rounded down to psi or check here to declare 1000 lb. soil '•L/ without testing. POCKET PENETROMETER TESTING METHOD 1. Test the perimeter of the home at 6 locations. 2. Take the reading at the depth of the footer. 3. Using 500 lb. increments, take the lowest reading and round down to that increment. X TORQUE PROBE TEST 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 400QJb holding capacity. Installer's initials ALL TESTS MUST BE PERFORMED BY A LICENSED INSTALLER Installer Name1-ar; Date Tested Electrical Connect electrical conductors between multi -wide units, but not to the mj power source. This includes the bonding wire between mutt -wide units. Pg. Plumbing Connect all sewer drains to an existing sewer tap or septic tank. Pg.e_,� Connect all potable water supply piping to an ex' ting water meter, water tap, or other independent water supply systems. Pg. Site Preparation Debris and organic material removed Water drainage: Natural Swale Pad Other Fastening multi wide units Floor. Type Fastener: /a �- Length: N Spacing: / 2- Walls: Type Fastener: Length: �" ,� Spacing: / 2- .P, Roof: Type Fastener: /o Length: a? Spacing: 7, For used homes a in. 30 gauge, 8" wide, galvanized metal strip will be centered over the peak of the roof and fastened with galv. roofing nails at 2" on center on both sides of the centerline. Gasket (weatherproofing requiremenq 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. 1 understand a strip of tape will not serve as a gasket. Installer's initials / v ' Type gasket Installed: Pg. Fe:p c"'v Between Floors Yes &1/ Between Walls Yes - Bottom of ridgebeam Yes Weather roofin 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!/ Miscellaneous Skirting to be installed. Yes [// No Dryer vent installed outside of skirting. Yes be"' NIA / Range downflow vent installed outside of skirting. Yes t / N/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 sed on the 11) Installer Signatu Date O W -�21 All information on this w rks et u e filled out completely to be accept( l