HomeMy WebLinkAboutPermit Worksheety
p &Rk? NUMBER
lnstallar Xi�C-�•,� .
Address of home
betnp lnstalled
Manufacturer CO ac,►���t L�Bngth xwtdth 5a• xj
OOM, ' if home /s a 8! Ja'wlde fllf out one half of the blocldn ,tan
11hoWa is a WO, a or quad wide skatch !r1 J emalnder olhorne
I understand Lateral Atm 5y►stams cannot be used on any home (new or
where Ibe sidawall flag exceed 6 ft 4 In
!n erb
Typical plat ofng • r
TIGWWN DDMPONWTS
Langltudlnd Si lVoe LSD)
Manufacturer
Loraltudlrral no Kr stem! s
Man ufpoturerPe
PERMIT won mim
.i.
page 1 of 2
Now Home • ❑ Used Homy
Home Installed to the Manufacturer's lnsieliation Meru '
Hoene is Installed In accordance with Rule I"
b`ingip wide �,], Wind Zone II ❑ W1)d Zone III t, ,
Double wide
' ❑ inetalletlon Dana! #
Triple(Quad ❑ Serial # '
PIER 9PAC1Na TABLE FOR USED HOMER
t.oaed Feeler tg. x 16' t8 4/2' x 181/2' 20' xE0' 28' x22' 24' X 24' 26' x 26'
terns s> r (250 (3) (aoo) (4U)* (srs)� (era)
tv (sa IN
I-beam pier pact size
Perimeter pier pad size I ✓�L�
Other pier pad sizes �—
(required W the Mfg.)
Draw the epproxirteate locations of rnwdags
wall
opening' 4 toot or greater. Use this
Im symbo(to show the plere,
List all marriage wall openings Wetter than 4 foot
and.their Pler Pad sizes below,
Opening plc, pad:slze aNCNaRs
t: E
Within 2' of end of home
Spaced at 8' 4" co
o11 es
Sidewal! umber
Longitudinal
Marriage wall
Shearwall ,
PERMIT WORKSHEET
PERMIT NUMBER page 2 of 2
Tho pocket penetrometer tests are rounded down to psf
or check nets tb dealers 10at? Ib,,acil wlthow testing,
x_ X� x�,
POCKET PENETROMETER TESTING METHOD
1. Test the Retfnseter of the home at 6 location
2. Take the reading at the depth of the tooter. '
S. Using Soo lb, l'norernents, take the lowest
reading and round down to that inorament.
x._.�
The results of the torct ue probe test Is to ands or chuck
here O you am decletfng 5' anchoro OFout tes
showing 275 Inch pounds or less wiO require 5 foot . A test
Note: A state approved lateral arm system is being used and 4 ft,
anchors are atlowQd at the cidewall locations. I urderstand a ft
anchors are required at all centerilne tin poir� where the torque test
reading is 276 or teas and where the moblis home manufacturer may
ramgraa anchors with 4000 lb holding ma y.
f staller's tnhtats
ALL TESTS MUST BE PERFORMED BY A LICENSED iNSTALLER
Installer Name L 1� k.0 PA 0- yQ
.Date Tested '
;onn®ot electrical conductors between mull wide units but not to the main power
ouroe. This•In¢ludoi the bonding wire between rnulizde resits. Pg. , �,
onmeot all sawar drabs to Sit erdsttn s
Debds and organlo material removed �
Water drainagw: Natural Swale Pad - u \
---•�
eeLua mu a u ..,
Floor, Type FOAM=. __... • I-engfh: spacing: .
Walls: Type Fastener; r.�� Lenaft Spacing:
Roof: Type Fastener: Length: Spacing:
For used homes n m' nni .'go gauge, s wide, ge,lvantzed melt +et
will be centered 'over the beak of themof and fastened tVith ga!
roofing halls at 2" on cshter an both sides of the centerline.
1 understand a property installed gasket !s a requirement of all now and used
homes and that condensation, mold, meldew and buckied mw tap® wells ere
a result of a poorly installed or no gasket being installed. I understand a st
Of, tape will not oorva as a gasket,
instauses initials
Type packet
metalled:
Between Floore Yes
Between Walls Yes
Bottom of ridgeboam yes
wain roc no
The
onmunits Is IImtall repaired
to anufaccturses sp Y aatton . es .
Fireplace chimney installed so as..., to aliaw intrusion of er as
Skirting to be lnstall®d, Yes
Dryer vent installed outside a aWn'g.Sail
ge downflow vent Installed'outsideirting. ss
Drain Ones supported at 4 fo6t kdSwal Yes
Elect W Crossovers protect es
Other:
1; accurate and true bmwd'on the
g e+wer tap or SOW tank. rg.
cnneot all potable water supply piping to an existing water motor, water tap, or other .t . nature
edependent water supply ryatema, Pp. �+
L p S
Date