HomeMy WebLinkAboutPermit Worksheets 1-27-22PERMIT 11 O RKSHEET
page 1 of 2
PERMIT NUMBER 1 I l -- 0450
Installer alf.Z/agft ge License ##
Installer Mobile Phone .772
Address of home ri' C3�, f , sez, ZO�/
being Installed
Manufacturer W Length x width
NOTE. If home Is a single wide till out one half of the blocking plan
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
21
d1F o laforol
Show locations of Longitudinal and Lateral Systems
lonpitudfnel (use dark lines to show these locations)
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of homo po ulo 16C• ,
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91
New Home ❑
Used Home
Home Installed to the Manufacturer's Installation Manuel
Home Is Installed In accordance with Rule 15-C ❑
Single wide ❑ Wind Zone II ❑ Wind Zone III i
Double wide ga" Installation Decal #
Triple/Quad ❑ . Serial #ice' ---
Roof System:. Typlca! Hinged
PIER SPACING TABLE FOR USED HOMES
Load
bearing
capafti
Footer
(sq siza
16" x 16"
(266)
18 1/2" x IS
1/2" (342)
20" x 20"
(400)
22" x 22"
(484)*
24" X 24"
(576)*
26" x 26"
(676)
,
41611
71
1
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g1
t
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trz;
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fig
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8
Interpolated from Rule 15C-1 pier spacing table.
PIER PAD Sf�ES
I-beam pier pad size / 3',�� Z'�
Perimeter pier pad size 7-2,&Z'�
Other pier pad sizesP
(required by the mfq.)
Draw the approximate locations of marriage
wail 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 paid size
�e
Pad ze
n
it x
lb x 16
ZO
18.5 x
x
13 114 x 26 114
348
20 x
I)
17 3116 x 253
17 2x2 1446
2 x 24
26 x 2
676
ANCHORS
4 ft 5 ft '
FRAME TIES
within 2' of end of home
spaced at 5' 4" oc
TIEDOWN COMPONENTS OTHER TIES
/
Longitudinal Stabilizing Device (LSD) Number Sidewall
Manufacturer f2'r',c rh�� - nn�.�,� S -T 71Longitudlnal
Longitudinal Stabilizing, evioe w/LafePalArms Marriage wall
Manufacturer a i,�� —s�,5-, 1, �Shearwall
12
PERMIT WORKSHEET
Pao 2of2
PERMIT NUMBER
POCKET PENETROMETER TEST
The pocket penetrometer tests are rounded own to psf
or check here to declare 1000 lb, soil without testing,
X X X
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 X I X
TORQUE PROBE TEST
The results of the torque probe test Is. Z87 ' 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 sidewali 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 I �olding capacity.
4
Installer's initials
ALL TESTS MUST E PERFORMED BYA LICENSED INSTALLER
Installer Name c�;,a2�i �% ��/ca✓
Date Tested /G — Z
Electrical
Connect electrical conductors between multi -wide units, but not to the maingower
source. This Includes the bonding wire between must -wide units. Pg. •/
• u
Connect all sewer drains to an existing sewer tap or septic tank, Pg. .
site- Preperatlon
Debris and organic material removed
Water drainage: Natural Swale Pad Other
Fastening multi wide units
Floor: Type Fastener: Length-,9 ;, Spacing: �
Walls: Type Fastener: Length: „ Spacing: iZ ,
Roof: Type, Fastener: Length: SrSpacing: / 2
For used homes a , 30 gauge, t -' wide, galvanized metal strip
will be centered over the peak of the roof and fastened with galy.
roofing nails at 2" on center on both sides of the centerline,
G9PROt (Wgnthnmrooflnn roaulrowntl
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 Initials _, .
Type gasket Installed:
pg. Between Floors Yes �
Between Walls Yes _ ?Z
Bottom of ridgebeam Yea_
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 ,✓ N/A
Drain lines supported at 4 foot Intervals. Yes.1
Electrical crossovers protected. Yes
Other:
Installer verifies all information given with this permit worksheet
Is accurate and true baseo on the
manufacturer's Installation InstrmetimWand or Rule 1SC-1 & 2
Connect all potable water supply piping to an existing water meter, water tap, or other Installer Signatures � �—� pate zo -�77'
independent water supply systems. Pg. ��