HomeMy WebLinkAboutPermit Worksheet'4
PERMIT NUMBER
Installer J
Address of home
being installed
Manufacturer
-oo
C
N •C
N tx O
WORKSHEET � o 0
a_ C�License #' '114 _ 11011 151
NOTE: ff home is a single wide ffll out one half of the blocking plan
ff home is a triple or quad wide sketch In remainder of home
I understand Lateral Arm Systems cannot be used on any home (new o ed
where the sidewall ties exceed 5 ft 4 in.
Installer's Initials
Typical pier spacing
9' I lateral
Show locations of Longitudinal and Lateral Systems
(use dark lines to show these locations)
longltudlnal
-------------------------------------------------
-----=---------------------
---
...�--
marriage
wall
piers
within 2' of
end of home per
Rule
15C
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W
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New Home ElUek9
Home (�
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
page 1 of 2
Double wide ❑ Installation Decal #
Triple/Quad ❑ Serial #
PIER SPACING TABLE FOR USED HOMES.
Load
bearing
capacity
Footer
size
(sq In)
1 6" x 16"
(256)
181/2" x 18 1/2"
(342)
20" x 20"
(400)
,. 22" x 22"
(484)`
24" X 24"
(576)'"
26" x 26"
(676)
0 vsf
os
6
a
000 sf
I8
8
00psf
8T8
818
3000 Pst8
8
3boo pst8
interpolatea from Rule t ou-1 pier spacing tame,
PIER PAD SIZES �j
I-beam pier pad size C iU
Perimeter pier pad size
'
Qther pier pad sizes - 1 2 X
(required by the mfg. )
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
POPUCAR PAD S ZE5
x
M x ;&0 1 a L �
ANCHORS
Oft 5ft LU
FRAME TIES Guam
within 2' of end of h m
spaced at 5' 4" oc
TIEDOWN COMPONENTS OTHER TIES
Number
Longitudinal abitW vice (LSD) �� �,�4 Sidewall
Manufacturer 1 I T'�.] ti�,(��Yl�rrrr ( ongill.Idinai _
Longitudinal Stabilizing Device wl Lat al Arms - arrIage wall
PERMIT WORKBHEET
10
PERMIT NUMBER ofalta. o05A
POCKET PgNETROMETEWTIEST
The pocket penetrometer tests are roun down to' psf
or check hereto declare 1000 lb. soil without testing,
X
X
X_
+m
POCKET PENETROMETER TESTING METHOD
1. -Test the perimeter of the home at 6 locations.
2. Take the reading at the depth of the fboter.
3. Using 500 lb. increments, take the lowest
reading and round down to that increment.
X
X
TORQUE -PROBE TEST
The results of the torque probe test Is ch pounds or check
here if you are declaring 5' anchors wnhou testing A test.
showing 275 Inch pounds or less will require 4 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 p k; where the torque test
reading is 275 or less and w or the lie hpme manufacturer may
requires anchors with 4000 1 capacity.
Installer's initials
ALL TESTS MUST B PERFORME BY A LICENSED INSTALLER
Installer Name
Date Tested -
Electrical
Connect electrical conductors between multi -wide units, but not to the ma, iryiwer
source, This includes the bonding wire between mult-wide units. Pg. V
page 2 of 2
Debris and organic material removed
Water drainage: Natural Swale Pad �lher
Fastening muld wide units
Floor: Type Fastener. Length: Spacing:
Walls: Type Fastener: — Length: Spacin
Roof: Type Fa r. Length: Spacin
For used wid;Othe
ot
e st p
will be ce ed r k the roof ga v.
roofing n atI
Mn sides centerline.
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 iniI
Type ga Inst II d:
Pg. B
s
7
Between Walls Yes
Bottom of ridgebeam Yes
Weatherprooflnd
The bottomboard will be repaired and/or taped. Yes Pg.
Siding on units is Installed to manufacturers specifications. Yes'
Fireplace chimney installed so as not to allow intrusion of rain water. Yes
Skirting to be Installed. Yes -- No
Dryer vent installed outside of skirting. Yes N/A
Range downflow vent Installed outside LlyskirU N/A
Drain lines supported at 4 foot intervals.e
Electrical crossovers protected. Yes
Other:
Installer verifies all information given with this permit wo
Is accurate and true based on the
or
Connect all sewer drains to an existing sewer tap or septic tank. Pg.
. 11 .,,,r kl, w nit r of innh, nininn to nn existina water meter, water tap, or other
Installer Signature
ME