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-VtflkT NUMBER
tnstalter _„_,_,!
Address of home
being kwtailed n .
Manufacturer Length xwi th
NOM* Whom a sirtgle'wlde MI out Ong W of the blo p!en
if hOJ" a triple or qt�d -Fide sketch y t lrtd home
I understand Lateral Attu Systems.cannot be used on any home (new or
whore the stdowali ties exceed 5 ft 4 In:
lnstallet'e initials
Typical pier spacing •.�
•x �
Show locations of Longkodlnal and Lateral Systems
{use dark lines to show these locations)
i s ■
■ t ti ■ Mi ! .. ■ - -- 1SEll
ins
MUMMMEMON an SillQtis■■i■■■i/■i■/■ii■■■/■>G■S■■■■■■MMI
4iifs��tJii�i■!■ir■■af�ard��re,�:..��.....--------
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PERMIT WC)FIKSHEET page 7 of 2
New Home. Used Home [j
Home Installed to the Mwwfacturees insteliation Manual
Horne Is Installed In aocordanca wfth Rule 15-0
MOP wld® ❑ Wind Zone Ii ❑ Wind Zane iIi
Double wide ' Installation Decal #t
TriplelQuad ❑ Serial -7An
PIER SPACING TABLE FOR USED HOMEB
PIER PAD SIZES
S S
_
I-beam pier pact size x aa7, S
.
-Perimeter Pier pad size N"11 1
e
ni
OtherplerpadsPres
x
f equlred W the Mfg.)
x
10
Omw the appn»dmats locations of marriage
WWI opeutIn s 4 toot or ovater. Use this
symbol to show the piers,
x
List all mar iape well openkips greater then 4 foot
x
x
and.their pier pad slzes below,
x
Opening Pler pad -size
ANCHORS
ft 6 ft
' �4
FFtaME Es
-------�_
wMin 2' of end of home
Spaced at s 4' co home
spaced
. TIEDOwN CDMPONEM
IMe ES
Lowltudlrral stab..v es ( D)
Manufacturer tl-M
Sidewall Number
Manurpeurrer Sta D®vlce tv/Lateral Arms
i onphudinal
gge wish
Shearwall
fr
PERMIT NUM139A
FOCRIPEN
O
The gbolaet penstrometertestaaie rounded down to J pat
or check hereto declare 1000 Ib..solt wft LA testing.
xl xl xL�
POCKET PENETROMETER TESTING METHOD
1. Test the perimeter of the hothe at 6 tocattons.
2 Take the reading at the depth of the•foatsr, '
S. Using SW lb. Iihcrements, lake the lowest .
reading and round down to that tnorement.
1 (775
O
The results of the torque probe test Is a inch pounds or check .
hery iI you are declaring V anchors wttFrout tomes, ling _ A test .
siJowing 275 Inc b pounds or less will require S toot anchors.
Note: A state approved lateral arm system to being used and 4 ft.
anchors are allowed atilhe sldewall loca3fo= I widemtand 5 ft
anchors are required at all o arllne tie pol tp where the torque test
reading is 276 or lass and a rr{obile ome manufacturer may
raaulres anchors with
Acap
let's Initials
ALL TESTS MUST BE P MED BY A i NSED INSTALLER
installer Name
Date Tested ap « � ° '
lbmgd electrical conductors betty i alF�i=ride .� but not to the main power
outoa 'this-hrJudes the bonding wife bet"en rnutt �fde Unite. Pa..,_„�_
-FlumbIna .
nrneot all sewer drains to tin =Wing sewer tap or septic tank Pg.
onned all potable water supply piping to an existing water meter water tap, or other
idepandent water supply r yateme. Pp.
PERMIT WORKSHEET
{ • V
l page 2 of 2
Debris and organic material removed Y '
Water drainage: Natural Swale .._,_,• Pad , — Other
Floor. Type Fastener. _ � Ath' Spacing:
Watts; Type Fastener Length: Spacing:
Roof; Type Fastener. Length: Spacing:
Forused hom a min. SO gaugee,, a° wile, galvaMzed nngtal
WAll be centered 'over the beak of %e• oof and fastened Witthh or
roofing halls at r on center on both sides of the centerline
i understand a properly installed gasket Is a requirwnent of all newand used
homes and that condensationu moil meldew and budded marriage walls are
a result of a poorly installed or no gasket being installed. I d a strip
Of. tape will not serve as a l laskst.
Installers Inittals
Type gasket Installed
PM Between Floors Yes _ r1z
Bo�ttft of rridgebearrn Y �T
-- eatrtiart�roofle�t
The bottomboard wlil be repaired and/or taped. Yes .. Pg.�-
Sfding on units Is installed to manufacturersspecifics
Flrepiac o chimney installed so as not to allow intrusion of talk wets
Skirting to be installed. Yes �,� No
Dryer vent installed outside of skirting. Yes Ott --WA
.z.= WA
Range downflow vent Installed outside of set Yes
Drain lines supported at 4 fobt Werrvals. Yes
Eladdeal crossovers protected. Yes
Other;
Ise
Installer signature
true bavgd'on the
Date _ Z /S