HomeMy WebLinkAboutPERMIT WORKSHEETRECEIVE
PERMIT NUMBER
installer
License
DEC 19 2021
ity, Permitting;
Address of home ! %l. 6) 4�a to
being Installed
Manufacfurer L r► -J a� -�,?�/ Length x width �' X
NOTE ' M home Is a single wide fill out one half of the blocking plan
if home Iva triple or quad wide sketch In remalnder'of home
i understand Lateral Arm Svstams cannot be used on any home (new or used)
where the sidewall ties exceed 5 ft 4 in.
Installer's initials
typical pl�u spa1�?
'i .....55 J®IWarel
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PERMIT WOF K-SHEET
page T of 2
New Home ❑ Used Home
Home installed to the Manufacturer's Installation Manual 13
Home is Installed In accordance with Rule 15-0
Singip wide ❑ Wind Zone II El Wlnd Zone III ❑
Double wide ' installation Decal l-ur
Triple/Quad ' ❑ Serial
PIER SPACING TABLE FOR USED HOME'S
Load
��n8
capacity
Fooler
SlzIXe
(sq Ir>)
16' X 16'
(26 s)
181/2' X 181/2'
(342)
2D' X 20'
(40D)
22' X 2Z•
(484)'
24' X 24'
(576r
26' X 26'
(676)
00
8
00Dst
5,
8
8
2500 s
6
8
8
g
3000 0
8
8
abuo Ps
8'
8
- =Tpoiarea rmm Kure ids.:-i pier spacira mie.
PIER PAD SIZES
I-beam pier pad size
Perimeter pier pad size
Other pier pad sizes
(requlred by the mfg.)
®Dmwthe approximate locations of marriage
wall openings 4 foot or greater. Use this
symbol to show the piers,
Ust all marriage wall openirigs greater than 4 foot
POP LAR PAD SIZES
- - -
tttt-Y1Ili
ON
EI1
itifYF4;-sir#W!;
�Pzfi'ZII■i•�
!■i��:s
�'[■
andaneir plerpad sizes below.
Opening Pier pad.size
ANCHORS
„ X
4 ft 5 it
X, 1r
FRAMETIES
X 2a r
paceedzat5 4doohome
TIEDOWN COMPONENTS
L OTHER ES
LflngltudlnaiStablllzing Device (LSD
Mbar
Sldewal(
Manufacturer- . PILL EZ4 �
longitudinal
Longltudlnal Stabilizing Device wlLateral Am7s
Mardage wall
Manufacturer_ +'n = a K T- "-so m-
Shearwall
Ir
PERMIT NUMBER
oc P Ro a Es :
The pbcket panetrometerteste are round d oM to pat
or check hereto
�deecllaare 1060 lb. soil L! without testing.
10 ' Xxc; - x2 X��l�
POCKET PENETROMETER TESTING METHOD
1. Ted the perimeter of the horbe at 6 locations..
2 ' Take the reading at the depth of the,looter,
S. Using600 lb. Ins oremento, take the lowest '
madp and round down to that increment.
X�?S x o-2 7-7-
TORQUE PON
The results of the torque probe test (s Inch pounds or check
here If you are declaring 61anchom without t no _ • A test
showing 276 Inch pounds or loss will require 6 foot anchors
Note: A state approved lateral arm system is being used and 4 ft.
.anchors are allowed olthe sidewaii locations. I uriderstand 6 ft
anchors are required at all centerline tie pot* where the torque test.
reading Is 27%or less and More the ntobtle ('tome manufacturer may
requires anchors with 40 o ding capacity.
installer's Initials
ALL TESTS MUST BE PERFORMED BY A LICENSED iNSTALLrER
Installer NameDate Tested
Ionngot electrical conductors between muktl•wide units, but not to the maln,power
ounce. `I'hIs•inOudas the bonding wire between mutt -wide unitm . Pa;
um na
bnneot all sewer drains to tern odsting sewer tap or septic tank ft.
' onnect all potable water supply piping to an existing water meter, water tap, or other
idependent water supply systems, Pp.
PERMIT WORKSHEET page 2 of 2 1
Debris'and organic matelot ved
Water dralnapa NaturalSwale Pad �� Other
Faideraffil—R-1—ifflos units
Floor, 'type Fastener. �� Length: Spacing:
Walls: Type Fastener. �I14� Lengh, —� BPaoing: C
Hoot. Type Fastener. " mil i en she. Bpaoing:
For•used homaq a n, 80 gauge, 81 de, galvanized m_qtal strip
will be asntered over thepeak of the—f and fastened with gaiv.
rooflnp nabs at 2" on center an both sides of the centaft -
Oa hv.sth.rofedino e.milRe+e+tf • .
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 paskel being installed. I understand a strip
of tape will not serve as a gasket.
Installer's Initials_:•
Type gasket �fa�l�' Installed:
Pg, Between Floors Yes
Between Wane Yes
Bottom of tidgebearn Yes
_W"therproo ng
The bottombbard wig be repaired andlor taped. Yes
Siding on unite Is Installed to manufacturer' {loot o"� p�. �fas
Fireploop chimney installed so as not to -allow Intrusion of rain water. Yes
aneous
SWIng to be Installed. Yes �^No,r,..,_•
Dryer vent Installed outslde of skirling. Yea NIA
Range downflow, vent instelled'outside of silrtin Y
Drain lines supporlsd at 4 tobt intervals, Yes �'es WA
/"�'+"r
Eisctrical crossovers protected, Yes
Other;
is accurate and true based 'an the
installer signature (LI
Date