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HomeMy WebLinkAboutPermit WorksheetO a PERMIT =ABER Ins1a11er We -Jell 14. r License # ma y /o i S-1 8 3 � MY � L ' M 4YNAfidr-s of horrc 1'7? 4' S* >.4.k , E c 62 - �� O OV.q H � L�•l F� installed vn` r04D12 f • a for r Pteke @�wianufacturer 3ctc o la S c r� Lenpth x width y 6'6 4 ND?-E. ' If home is a single wide fill out one half of the blocking lan ll home is a triple or quad wide sketch In temalnder o�l�orre p, 1 understand Laieral Arm Systems cannot be used on any home (new or used) cO where the s!devmll tins exceed 5 it 4 in. ® r Instaliu-'s initials /T of Lengiludinal and Lateral Systems lines to show these lo�aticns) P-ERNIlT WORKSHEET � � Ls go 1 01 2 OL New Home- Used Home Tome insW!ed to the Na nufac;urer's :nsfaliailon Mlanua! (� � / Herne is ine-;Ica in zccardance with Atr!e 15-: Sinpie wide ❑ Wind Zone II Wind] Double •,vide Installation C�zl f# Tripl&Quad (_] Serial # .) !I 1p % PIERSPACING TABLE FOR USED HOLES PIER PAD SIZES POPULAR PAD B;ZES I-beam pier pad size 21 • t 3 X J. t 3 r y %� EX.b an Pe'i^eter pier i�SC� illcck Pi,,% , P Pa sizeCthor Pier pad sizesfrL-!lLIreC �JY t:iG Ti:ip. ;-r ; Dra•.v Lho a�prexima:s iceL:!cns c1 marr!aao !I rl 11 v I openings" 4 foot or pr Cr.iUse this /mbcl to show the piers. List aU marriago wall 0PCI:n!;s prea.er :`an 4 foof and.:heir Pier pad sizes beiovr. Oac-nine Fler pad size T1EDC'.YNCD7;EGIJE?TS Lonc�ituclnal Slabhl; lnp Device (LSD) tti;anutacturer _OO_) r,v c .- Lon_rftuolna! S«bjlL Jnq Device sti/Lsterzl Airs ANCHORS 4fl �51t -d 7FRGJ.IETIE5 ! within 2' of c,7d of hn re spacsa at 5' 4" cc OTHER T]ES tvutT byr Lonq•ttudina! MZ!. iepe 1;all Snwn'rull L; PERMIT NUMBER POCKET PENS, ROfdETER TES The pocket peno:romo:or tes!s are rourdcd deem to pc or c; ,xk he, to declaro 1000 lb. soil ✓v:itnoui testin . 1'1 X POCKET PENETROMETER TESTING METHOD 1. Test thne perimeter of the horr,o at 6 lo:;atlons. Take the reading at the depin of the tooter. 3, Usir:q 500 lb, increments, ta?s the lowest reeding and round down to that inorement- 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 shpwinp 275 ihcn Pounds or less will require 5 foot anchors, 4 Note: A state approvod lateral arm system is being usc,? and 4 ft. anchors are allowed at :he sidewall locations. I uriders:and 5 it anchors are rcquirrd at all centerline tie points wh>_ra the torque test rsadinq is 275 o,- ;ass and where the mobile i-tome ma,utacturer rrzy requires anchors with 4000 lb,no1'inp, capacity. tt�� installers initials ALL TESTS MUST BE PERFORMED BY AjLICENSED INSTALLER installer Name We"at« Date Tested El ectri ca l :bnnaot electrical conductors between multi-vride units, but not to the maip power oureo. This Includes the bonding wire between mult-wide units. P„. cnnoct all sower drains to an existing sower tap or septic tank. Pp. H LD onnect all potable waters ?pIY piping to an g water meter, water ;ap, or o: er :dcpendont water supp!y sys:o ns. r q. PERMIT WORKSHEET Pe9e 200 Slit PfeUaratlon a Cabris ar.d organic malarial rE,i3OVad ✓ �. `'� Wa ter d,ainags:Natural Swaio Pad rarWril, ) :multi WiCfb unl;s n ,t Floor. Type Fastener, yLS� long be,grh. �. v s " i pacin Wa!Is: Tyre Fastener. to Sor&A ength: Y„ Spaci Roof: Type Fastons ! ongth: t " Spacih?�° For h ad omes a mi . 30 gauge, o" v,ido, galvaniz I slap ',gill be cania d'over the peak of the roof and fasten alv. roofing „ails at 2" on center on Lett: sides of tho cei t,. _ Gnsket{ ath -a' ^ng req�lrcrnentl .. I und�rsland a property installed gasket Is a requirement of all new and used homes and that condensatlon, mold, moidew and buckle: marriage wal!s are. a result of a poorly installed or no gaskat being lnsta)jed. I understand a step of tape -,:ill not sowa as a gasket. installer's initials A/ W Typegaskt Fps�p..a rRfjq.�l4b tallc�: Between Floors Yes Between Walls Yes �— Bottom of ridgebeam Yes- W es th crpro o (in The bottom; boar d will be, opa:rsd andror teprn:i, Yes Siding on units Is installed to manufacturer's saocificatlons. Yes r:replace chimney Installed so as not to allow in:ruslon of rain water. Yes �%{ISCF311IIh CO US Skirting to be installed. Yes No Dryer vend installed outside of sldrtinq. Yes I VA Range downflow vent instatl©d:outside of skininq. Yes !yrA Drain lines supported at 4 foot intervals. Yes ✓ Electrica! crossovers protected. Yes M, or ; Installer verifies all information given with this permit worksheet is accurate and true based 'on the manufacturer's installation instructions and or Rule 15c-1 & 2 Installer Signature 41 Date O