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Home My WebLink AboutPermit WorksheetC 'PERMIT NUMBER.-• Installer r� C' License —7-~172101,12 7. Address of home Rks`d being installed lchl- Manufacturer l ` Length x width NOTE: 'If home Is a single wide fill out one half of the blocking plan If home Is a triple or quad wide sketch In remainder bf home�� PERMIT WORKSHEET P� I New Home Used Home ❑ Home installed to the Manufacturer's Installation Manual Home is installed in acc. ance with Rule 15-0 Single wide Wind Zone II ❑ Double wide ❑ Installation Decal n Triple/Quad ❑ Serial x 6=.. ♦ _Z Imo/ I understand Lateral Arm Systems cannot be used on any home (new or ) PIER SPACING TABLE FOR USED HOMES Mare the sidewall ties exceed 5 ft 4 in; L Installer's initials_ ` Typical pier spacing • ' lateral locationsSfiow _ Lateral Systems (use dark ■ 1• ■ ■ ■ ■ ■__ ■ _ _rFt_ _ ■■LlLi l�� i�■I/fi■ IC G ■ t�ii■■■i�i1=�`\I[:f =1■■■■■ I 'y4 � ala p Footer S C) 16' x i 6' 18 1/2' x 18 112' 20' x 20' 22' x 22' 24' X 24' 26' x 26' gBar�,ll size ity (sq In) (256) (342) (40D) (484)(576)' .(676) p OOO s 3 1 00s 4 6 6'1.8 000 Pst 6' 81 8 2 0O pst 6 8 8 8 nnnn Ds' 8 8 8 3 00 psi 8— interpolated from Hula 15C-1 pier spacing ladle. PIER PAD SIZES I-beam pier pad size /7;rz X2 Perimeter pier pad size Other pier pad sizes (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 TIEDOWN COMPONENTS Longitudinal Stabilizing Device (LSD) Manufacturer LongltudJn zI Stabilizing Device w/Lateral Arms Manufacturer POPULAR PAD SIZES �y 11t3IE1• MEWME SEMI ■ W,YjI ANCHORS 4 ft -5 ft FRAME TIES within 2' of end of home spaced at 5' 4" oc OTHER TIES Number Sidewall Longitudinal Marriage wall Shearwall ink interpolated from Hula 15C-1 pier spacing ladle. PIER PAD SIZES I-beam pier pad size /7;rz X2 Perimeter pier pad size Other pier pad sizes (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 TIEDOWN COMPONENTS Longitudinal Stabilizing Device (LSD) Manufacturer LongltudJn zI Stabilizing Device w/Lateral Arms Manufacturer POPULAR PAD SIZES �y 11t3IE1• MEWME SEMI ■ W,YjI ANCHORS 4 ft -5 ft FRAME TIES within 2' of end of home spaced at 5' 4" oc OTHER TIES Number Sidewall Longitudinal Marriage wall Shearwall ink ANCHORS 4 ft -5 ft FRAME TIES within 2' of end of home spaced at 5' 4" oc OTHER TIES Number Sidewall Longitudinal Marriage wall Shearwall ink PERMIT WORKSHEET r PERMIT NUMBER POCKET PENETROMETER TEST The pocket penetrometer tests are rounded down to psf or check hereto declare 1000 lb, soil 600ll without testing. 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. S. Using 500 lb. increments, take the lowest P reading and round down to that increment X X X TORQUE PROBE TEST - The results of the torque probe test is 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 at1he sidewall 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 4 b Idfng capacity. Installers initials ALL TESTS MUST BE PERFORMED BY A LICENSED INSTALLER InstallerName Date Tested Electrical ibinect electrical conductors between multi -wide units, but not to the main power ource. This -Includes the bonding wire between mult-wide units. Pg. Plumbing flnneot all sewer drains to an existing sewer tap or septic tank. Pg. onnect all potable water supply piping to an existing water meter, water tap, or other idependent water supply systems. Pg. V ® c I page 2 of 2 I Debris and organic material removed Water drainage: Natural Swale Pad Other Fastening multi wide units Floor Type Fastener Length: Spacing: Walls: Type Fastener, Length: Spacing: Roof: Type Fastener Length: Spacing: For.used homes a min. 30 gauge, 8" wide, galvanized rt�eral �" rip� will be centered over the peak of the roof and fastened W13 s roofing nails at 2" on center on both sides of the centerline. -,'I understand a properly installed gasket is a requirement of all new and used Jo homes and that condensation, mold, meldew and buckled marriage wails are v 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 Typegasket Pg. Installed: Between Floors Yes Between Walls Yes Bottom of ridgebeam Yes 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 Skirting to be installed. Yes `-- No Dryer vent installed outside of skirting. Yes "✓ WA Range downflow vent installed' outside of skirting,JGss =WA Drain lines supported at 4 foot intervals, Yes Electrical crossovers protected, Yes Other: Installer verifies all information given with this permit worksheet is accurate and true based on the manufacturer's insta ion instructions and or Rule 150-1 & 2 Installer Signature Date a