HomeMy WebLinkAboutPermit Worsheeta ,
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fnctaller OrnGi. License # `�'kS-(O�SI,��
Address of home jQ-
being Installed ---
Manufacturer Length xwfdth 2, 0 �O Z
N07 M Whom hom s a s1 10 wide MI out One half of the blooWng ppl�an
if hopfo !+s a trlp�e ar quad x►!de sketch !rt tae�alinder of hams
I understand Lateral Aim bysterna cannot be used on any hone (new a u
where the sidewali ties exceed 5 ft 4 In;
Inotaller's Tnitlais
Typical pier spacing..,
lat.td An
Show locations of longftu and Lets stems
{use dark Imes to show these locations)
171
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PERMIT WOFIKSHEET
N499 4 of 2
New Home • Used Home ,
b
Home Installed to the Manufacturer's installation Manual
Home To Installed in aoordanan with Rule 15.0 ❑
Singip wide ❑ Wind zone If 0 Wind Zone Ili '
Double wide ' ❑ Installation Decal #
Trlplenuad ' ❑ serfil #
• PIER SPACING TABLE FOR USED HOMES
9cdtd Ifte Fatter1t8'XUP
Y (at
181J2'xi81J2' 2WX20'
WX221
24'X24'28'X28'
QUO
(nterpoww from
Rule isc-1
nl.r One6a rohr-
jj
PIER PAD SIZES
I-beam pier pad size
Perimeter pier pad size
Other pier pad sizes '
(required W the mfg.)
Draw the approximate locations of nmaniage
WWI openinAis 4 toot or preater. Ua® this
symbol to show the plats,
List ell marriage Walt openings greater then 4 foot
and.their pier pad sizes below.
Opening Pler pad*lze
7IEDOWN cOMPONEM
Longitudinal eta t !� D aSOj
Manufacturer
LorreRudlnal Sta 1JLt! ce w/Lateral Arms
Mamdgourer
. - r W. loll
JWcHaRs '�
Oft /Sry
FRAMts TIES
within V of end of h
spaced at V 4" oo
07'tifSR ES
Stdewall Number
Longitudinal
memoge watt
Sheanva2l
4
PERMIT NUMSI t
f
O
The j boket penetrometerl,; to are rounded down to psf
or cheok here•tb declare low ib..aoll without testing.
X.__ X '
�_ X�.
POCKET PENETROMETteFi 'I ES I NQ METHOD
1. Test the perimeter of the horho %1 a locations.
2. Take the reading at the depth of thgfooter.
Si Why tint) lb, increments, take tho lowest '
reading and round down to that increment
X-- X
OIF
The results of the torque ptabe test is .;a7 � inch pounds or cheek
here n you are declaring b' anchors without test np A test
ftWlhg 275 Inch pounds or less wilt require s toot anchors,
Note. A state approved lateral term system is being used and 4 ft.
nnohore are allowed at4h® sidewall looattotte. 1 uridaratand b tt
anchors are regtlirmd at all he tie point¢ where the torque test
reading Is 276 or lose etrd n le Dome manufacturer may
requires anchors with Copan. infttats
ALL TESTS MUST BE PERFORMED 13Y A LiCENSED iNSTAU.XR
Installer Name
Date Tested
lonngot eleotrfoat oondt dam between multhwide units but not to the main power
ource, Thls•lnoludes the bonding wire between rnult W& UnK Pg:
MIMMMO
:onneot all sewer drains to tm =Wing sewer tap or septic tank, Pg.
cnnect all •potable water supply piping to an odsting water meter, water tap, or other
idepentlent water supply systems. pp.
PERMIT WORKSHEET Page x of 2
Debris and organic material reml
Water drainage; Natural
::, 01her,�;��,
Floor. Type Fastener. •tea' Lemon , `! b'paoing; . W .
Walls: Type Fastener: gpaoing:
Roof; Type Fastener. ion pacing
For.used homwe a min. JO gauge, a a! gaiwanbwd m�al s1
will be aerttared ever the peak of the -roof and fastened W1th gah
roofing halls at 2' on center on both sides of the centedfne. '
1 understand a properly lnsiailed gasket Is a regntrement of new and used
homes and of a that
ynInnstal or noogaasket being irdistaileed un ratad ® and a st
rip
pd Of tape will not serve as a gasket.
Installer's Initials
TTp a gasket Installed:
-- Between Floors Yes
�. Between Wails Yes
Bottom of rldgebeam Yes
The bottomboard will be repaired and/or taped. yes '
Siding on units to Installed to manufaolurees epeolffoatlona Y PRee a
Fireplace chimney installed so as not to allow intrusion of rain water. Y"ss,. '
sou• ,
Skirting to be installed, Yes
Drier vent installed outside of •s ng.NYes.—L WA
Range downflow vent Installed s�utside of sktrihil, Yes ft
Drain lines supported at 4loot irrtw als. Yes -
El
hectrical crossovers protected Yes
itt BCotteiteincl ti'Ite bFed'on the
installer Slgnature a,7 — ( Data
M