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HomeMy WebLinkAboutPermit Worksheets PERMIT WORKSHEET page 1 of 2 PERMIT NUMBER Installer _ �d License# 1 �G/Z3 /'Y6 New Home ❑ Used Home *� �� �4 installer Mobile Phone# 77?2 Home Installed to the Manufacturer's Installation Manual ❑ Address of home ,//7`" Z4 2 Aa .., .rtl' %eeA?­, Home Is Installed In accordance with Rule 16-C being Installed .�� �•G s'/ Single wide ❑ Wind Zone II 2---*" Wind Zone III ❑ Manufacturer )0,;CAS Length x width Double wide installation Decal# NOTE. !f home Is a single wide fill out one half of the blocking plan TrlplelQuad ❑ Serial# 3'f A_ " ! '3 6 N home Is a triple or quad wide sketch In remainder of home' „ - - ---- --- - - - Roof System: -ypica Hinged I understand Lateral Arm Systems cannot be used on any home(new or used) PIER SPACING TABLE FOR USED HOMES Where the sidewall ties exceed 5 It 4 In. Installer's initials toad Footer 16"x 1611 1811211 x 18 2011 x 2011 22'1 x 2Zi 2411 X 24" 26"x 26" Typical pier spacing bearing size (256) 112"(342) (400) (484)" (576)" (676) 21 �+—� � lalorel capacity (sq In) 1 1 1 1 I Show locations of Longitudinal and.Lateral Systems 16nn naf 41 ^ 1 1 (onglWdlnol (use dark lines to show these locations) I I / so a 71 11. At 18, 1 I I 1 ­131 811 1 I 1 1 * In rpolated from Rule 15C-1 pier spacing table. PIER PAD SIZES �QPUKAR PAD SIZES I-beam pier pad size j�'�aC Z11 ,�a�ze n Perimeter pier pad size 2z�� 16 x 18 .350 .. ...... ....... .. ... .. n. .......m......... ......... ........ ..J. Other pier pad sizes 9 X -4,� X (required by the mfg.) x 1 x 1577 Draw the approximate locations of marriage[D] wall openings 4 foot or greater. Use this 3 6 x 6 nnanlago wall plorowlihin T of and of home par Rulo 160 symbol to show the piers, X 2 x List all marriage wall openings greater than 4 foot 2 x 6 and their pier pad sizes below. ANCHORS Opening Pier pad size U zz Oft 5ft � �x �X Z FRAME TIES ....., within 2'of and of home .I„ spaced at 614"oc !! TIEDOWN COMPONENTS OTHER TIES Number Longitudinal Stabilizing Device(LSD) Sidewall Manufacture rhai�v Q �vj4e g-r Longitudinal - --- - -_..Longgudinal Stabilizin Device w/Lateral Arms Marriage wall .' nP1 - - - r ea Manufacturer �Sh rwall W . � .-1 :I. : �........,.�.� ..._._........................�... .___.... ..._..... ... ......................... ... ... PERMIT WORKSHEET I page 2 of 2 PERMIT NUMBER - site Preparation POCKET PENETROMETER TEST Debris and organic material removed The pocket penetrometer tests are rounded down to psf Water drainage:Natural Swale Pa Other or check here to declare 1000 ib.soil ,tom without testing. asten nn multi wide Site X-^-„ X„�„ X,_, Floor; Type Fastener: � Length: Spacing: Walls:. Type Fastener: (� Length: Spec inn: POCKET PENETROMETER TESTING METHOD Roof: Type Fastener: ( Length: g Spacing: 2- For used homes a min.30 gauge,811 wide,galvanized metal strip 1. Test the perimeter of the home at 6 locations. will be centered over the peak of the roof and fastened with gaiv. - - - ------ - -- roofing nails at 2"on center on both'sides of the centerline. 2. Take the reading at the depth of the footer. - Gasket Iwoothomrooflna Moulmmnntl 3. Using 500 lb.Increments,take the lowest. reading and round down to that Increment. I understand a propbdy.installed gasket Is a requirement of all new and used homes and that condensation,mold,meidew and buckled marriage walla are a result of a poorly Installed or no gasket being installed. I understand a strip X X X of tape Will not serve-as a gasket. ,., . Installer's initials P EJ TORQUE PROBE TEST Type asket cam, Installed: The results of the torque probe test Is t 8 Inch pounds or check .Pg. 0 Between Floors Yes A,-'- here if you are declaring 5'anchors without testing . A test Between Walls Yes showing 275 Inch pounds or less will require 5 foot anchors. Bottom of ridgebeem Yes zz!:�— Note: A state approved lateral arm system is being used and 4 ft. anchors are allowed at the sidewall locations. I understand 5 ft Weatherproofing anchors are required at all centerline tie points where the torque test reading Is 275 or less and where the mobile home manufacturer may• The bottomboard will be repaired and/or taped. Yes , Pg. requires anchors with 4000 lb holding capacity. Siding on units is installed to manufacturer's specifications. Yes z Installer's initials Fireplace chimney installed so as not to allow Intrusion of rain water. Yes ALL TESTS MUST BE PERFORMED BY A LICENSED INSTALLER Miscellaneous Installer Name Ze,1_� Skirting to be installed. Yes ✓ No Dryer vent Installed outside of skirting.. Yes N/A Date Tested l��"CG!� Range downflow vent installed outside of skirting. 'Yes ✓ N/A Drain lines supported at 4 foot Intervals, Yes Electrical crossovers protected. Yes Other: Electrical Connect electrical conductors between multi-wide units,but not to the main ower source. This Includes the bonding wire between mull-wide units. Pg. tZInstaller verifies all information given with this permit worksheet n is accurate and true based on the Connect all sewer drains to an existing sewer tap or septic tank. Pg. manufacturer's installation i)stru Ions and or Rule 16C-1 &2 Connect all potable water supply piping to an exl tang water meter,water tap,or other Installer Signa r�- Date��„C 9 Z f independent water supply systems. Pg, PERMIT WORKSHEET page 1 of 2 PERMIT NUMBER— d S 9/-- - - - Installerzf_ cz.5�_ 1 _ License# -� �L/Z3 �3� New Home ❑ Used Home Installer Mobile Phone# 7,1 .5I Home Installed to the Manufacturer's Installation Manual ❑ Address of home �,�1 o Home Is Installed In accordance with Rule 15-C I� being Installed 3-2 9,,.6-0I Single wide ❑ Wind Zone II Wind Zone III ❑ Manufacturer /r es- Length x width 56 Double wide ( Installation Decal# 81183 NOTE., if home Is a single wide rill out one half of the blocking plan Triple/Quad ❑ Serial# 6 A - -4 % '91 6 6 If home Is a triple or quad wide sketch In remainder of home Roof System: Typical Hinged I understand Lateral Arm Systems cannot be used on any home(new or used) PIER SPACING TABLE FOR USED HOMES where the sidewall ties exceed 5 ft 4 in. Installer's initials ' z Load Footer u u " n n n n n Typical pie pacing bearing (sq e (256 1 n 8 182/2n 6 ZO x 2 x - 2a X 24 26 x 26" ) (342) (400) (464) (576) (676) lelateralca i 1 I Show locations of Longitudinal and Lateral Systems " ' longltudine[ (use dark lines to show these locations) $ ' L i 8 ;Ono nqf - tA."EE 1 , nqf E..Q, - - ' 8 8 ' * In rp IM-i from Rule 15C-1 pier spacing table, PIER PAD SIZES I-beam pier pad size 7 3"k XZ'' adze SQ In x16 Perimeter pier pad size _1 X 2 Z x its 18.5 .. 18.5 [E] ...... -- -Ea....... . ....n........... E3......... :.------.. ...... .,�- Other pier pad sizes o �7'� x (required by the mfg.) x 13 x 26 1 348 Draw the approximate locations of marriage 20 x wall Openings 4 foot or greater. Use this 6 x 25 marriage wall piers within 2'of and of home par Rule 16C symbol to show the piers. 17 1 T2 x 6 24 x246 List all marriage wall openings greater than 4 foot 2 x 26 676 and their pier pad sizes below. ANCHORS .).. Opening Pier pad size ... ...... .7.... Z 4 ft 5 ft .... ( / X 7....... �x ✓ I— FRAME TIES :I: Z _ .. within 2'of end of home j i n ..d....� .I...... spaced at 5 4 oc ...... ..1..... ij .. .. ..I.. �. 'TIE—DOWNCOMPONENTS OTHER TIES 1­1Number j.­ ....... ..1.. ! Longitudinal Stabilizing Device(LSD) Sidewall �.. Manufa turer=;y' tea.. S r Longitudinal ..�:.; Longitudinal Stabilizin Device wl Cateral Arms Marriage wall Manufacturer :�._. .. .:� rv � pyr7C.�,�- Shearwall- ��._....I.... . } }. l 4. j PERMIT WORKSHEET I page 2—"'2 of 2�-�"1 PERMIT NUMBER____-- e"-- _--- _- -- " -- SitePre�ara Pon— -- - ---- POCKET PENETROMETER TEST Debris and organic material removed The pocket penetrometer tests are rounded down to psf Water drainage:Natural Swale P-1-Ay Other or check hereto declare 1000 lb.soil ,t/ without testing,' astening multi wide units X X _, X,^,,,, Floor. Type Fastener: !"S' Length: g` Spacing: / Walls: Type Fastener: P�8 Length: Ff'„ Spacing: i 2_,''' ,, POCKET PENETROMETER TESTING METHOD Roof:. Type Fastener: (� Length: Spacing: i 2— For used homes a min.30 gauge,8"wide,galvanized metal strip 1. Test the perimeter of the home at 6 locations, will be centered over the peak of the roof and fastened with gaiv, roofing nails at 2"on center on both'sides of the centerline. 2. Take the reading at the depth of the looter. GROket fwonthomraogng magamontl 3. Using 500 lb.Increments,take the lowest. reading and round down to that Increment. 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 X X X of tape will not serve-as a gasket. Installer's Initials e , TORQUE PROBE TEST � Tvpe tasicet �f. Installed: The results of the torque probe testis Inch pounds or check .Pg, Between Floors Yes here If you are declaring 5'anchors without testing . A test Between Walls Yea showing 275 Inch pounds or less will require 5 foot anchors, Bottom of rldgebeem Yes_ Note: A state approved lateral arm system is being used and 4 ft, anchors are allowed at the sidewall locations. I understand 5 ft Weatherproofing anchors are required at all centerline tie points where the torque test reading Is 275 or less and where the mobile home manufacturer may The bottomboard will be repaired and/or taped. Yes,��. Pg. requires anchors with 4000 lb holding capacity. Siding on units is Installed to manufacturer's specifications. Yes 12 Z Installer's Initials Fireplace chimney Installed so as not to allow Intrusion of rain water. Yes :/— ALL TESTS MUST BE PERFORMED BY A LICENSED INSTALLER Miscellaneous Installer Name e� Ze-A �� Skirting to be Installed. Yes ✓ No - Dryer vent-installed outslde-of-skirting.-.-Yes_p N/A- Date Tested Range downflow,vent installed outside of skirting, Yes N/A Drain lines supported at 4 foot Intervals. Yes Electrical crossovers protected, Yes Other: Electrical Connect electrical conductors between multi-wide units,but not to the main.power source, This Includes the bonding wire between mult-wide units. Pg. Installer verifies all Information given with this permit worksheet Is accurate and true based on the Connect all sewer drains to an existing sewer tap or septic tank, pg. manufacturer's Installation 1)),strptlons and or Rule 15C-1 &2 Connect all potable water supply piping to an exi tang water meter,water tap,or other t-0 --. independent water supply Installer Signs Da systems. Pg, ��