No preview available
HomeMy WebLinkAboutPermit WorksheetNUMBER PERMIT WORKSHEET PERMIT 16t2 0601 Installer '/?__ License 1rC Owner Name & Address of home lam! (_©y/� being installed -1Z0O -3. In �° 4 y Manufacturer %'z fl Length x width 94X ,4 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 Ilateral E— > 010M I Show locations of Longitudinal and Lateral Systems tonJiludinal (use dark lines to show these locations) emElS l marnogr. wall prers within2' of end of home per Rule 15C New Home ❑ page 1 of 2 Used Home Year Model 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 Installation Decal # Triple/Quad ❑ Serial #k 7 2,C / 5 -5 0 a,& 7-Z.6315750 gf3 PIER SPACING TABLE FOR USED HOMES Load bearing capacity Footer size (sq in) 16" x 16" (256) 18 1/2" x 18 1/2" (342.) 20" x 20" (400) 22" x 22" (484)' 24" X 24" (576)' 26" x 26" (676) 1000 sf 3' 4' 5' 6' 7' 8' 1500 psf 4' 6" S. 7' 8' 8' 8' 2.000 psf 6 8' 8' 8' 8' 8' 2500 psf 7' G' 8' 8' 8' 8' 8' 3000 psf 8' 8' 8' 8' 8' 8' 3500 psf 8' 8' 8' 8' 8' 8' un-puiareu uuui mini- izn. i pier spacing taim PIER PAD SIZES I-beam pier pad size Perimeter pier pad size / } X 22 Other pier pad sizes 4 _2 (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 marrage wall openings greater than 4 foot and their pier pad sizes below. Opening Pier pad size Z,�rZ_ 7-» TIEaOWN COMPONENTS Longitudinal Stabiliz' Device (LSD, Manufacturer Old gX �,,,� i Longitudinal Stabilizing Device w/ Lateral AFm; Manufacturer /�/4/j��wf rfey,,•f PERMIT WORKSHEET POPULAR PAD SIZES ANCNORS� 4 ft 5 ft FRAME TIES within 2' of end of home spaced at 5' 4" oc OTHER TIES Number Sidewali Longitudinal Marriage wall Shearwall page o' s PERMIT NUMBER 14' POCKET PENETROMETER TEST The pocket penetrometer tests are rounded down to psl or check here to declare 1000 lb. soil f% without testing. x x POCKET PENETROMETER TESTING METHOD 1. Test the perimeter of the home at B 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. X X TORQUE PR06E EST The results of the torque probe test is Z(3 47 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 4000 lb holding capacity. /a � Installer's initials ALL TESTS MUST BE PERFORMED BY A LICENSED INSTALLER Installer Name Date Tested V Electrical Connect electrical conductors between multi -wide units, but not to the main power source. This includes the bonding wire between mutt -wide units. Pg. Plumbinq ri Connect all sewer drains to an existing sewer tap or septic tank. Pg. ,r/ Connect all potable water supply piping to an existing water meter, water tap, or other independent water supply systems. Pg. l� Site Preparation Debris and organic material removed Water drainage: Natural Swale CPad Other Floor: Type Fastener: t -9 Length: Spacing: / 2' Walls: 'Type Fastener: (09 Length: g�' �, Spacing: Roof: Type Fastener: /, � Length: Spacing: i L For used homes a r6in. 30 gauge, &' 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 (weauiemroorinu requirement) 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. l understand a strip of tape will not serve as a gasket. Installer's initials Z Type gasket Installed: Pg. Between Floors Yes ✓� Between Walls Yes Bottom of ridgebeam Yes f 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 Miscellaneous Skirting to be installed_ Yes &,-' No Dryer vent installed outside of skirting. Yes :,/ N/A Range downflow vent installed outside of skirting. Yes NIA Drain lines supported at 4 foot intervals. Yes t-- Electrical crossovers protected. Yes Other : Installer verifies all information given with this permit worksheet is accurate and true based on the Installer Signature .� All information on this Date Je- 7— � out completely to be accepts