HomeMy WebLinkAboutPERMIT WORKSHEET0
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s : Q NUMBER. ,
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Q Installer V `�'-
License # W 0 w m New Home.
u e �''s q Home Installed
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Address of home a
�-< � being installed -' — E- Home is install
�I w I a Singlp wide `-'
O ` Man utact'urer `1�i1-2�� _� Length xwidth a U
�, Double wide
r NVW E /f home Is a angle wide fill out one half of the blocking plan a ' r u
w TriplelQuad u
o if home Is a triple or quad tylde sketch !n remainder of home W In
w 3 } a.
wYP =¢wa0 4
o H I understand.lateraE Arm Systems cannot be used on any home (new or used I- e Cr
a where the sidewall ties exceed 5 ft 4 in: o
e. P4 Installer's initials v
Typical pier spacing •.�,
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_ !Inu§: <�t
SHEET page's oft
®Used Home
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h�nuiacturer's installation M411i ❑ .
:Urdance with Rule 15.0 11
Wind Zone 11
9d zone ul ❑
Installation Decal # �\
Serial #
SPACING TABLE FOR USED HOMES
6sadng
Footer 16' x 18' 1 a 1/2' X 16 1/2' 20' x 2�' 2::' x 22' 24' X 24' 26' X 26'
lai.wl capacity (sq in) ( (2) (40D) (464)' (Sie)' (676)
f - 1
size
show
of t cnghudinal and Lateral Systems
show these locations)
mnrrLpi wail pbrs wllhln 7.of end at home
7
CPIER PAD SIZES I�
I-beam pier pad size
Perimeter pier pad size
Other pier pad sizes _ '
(required by the mfg.) +
Tse 10Draw the approximate locations of marriage
wall openings 4 loot or greater.- Use this
1 symbol to show the piers.
List all marriage wall openings greater than 4 foot
Lj and.thetr pier pad sizes below.
POPULAR PAD SIZES
Opening Pier pad -size
RS
4it 5 ft
� `I ,
FRahl{ETrES
_^
within 2' of end of non
spaced at 5' 4"
o0
TIEDOWtQ COMPONENTS
07HER ES
Longitudinal Sta !! {ng evice (LSD)
Manufacturer
SIdewall amber
Longitudinal Stabll lrtg evlce w/CateralArn9s
Manufacturer .
Longitudinal
Marriage wall
Shearwall
• v .4
J
' PERMIT NUMBeR
POCKET PENETROMETER TES
Thepboket penetrometer tests are round own to psf
or check here•tb declare 1000 ib.. soil without testing.
X X xr..�
POCKET PENETROMETER TEvnNC3 METHOD
i. Test the perimeter of the home at 6 locations.
2. Take the reading at the depth of the.foctsr.
S. Uping Soo lb• increments, take the lowest
reading and round down to that increment.
X X X
TORQUE PROBE TEST '
The results of the torque prebe 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 anphors,
Note: A state approved lateral arm system is being used and 4 ft.
.anchors are allowed atthe 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 40094iding capacity,
—' Installer's initials
ALL TESTS MUST BE PERFORMMY A LICENSED iNSTAU.irR
Installer Name
Date Tested
Electrica
lbnngot electrical conductors between multi -wide units, but not to the main power
ourca. This•Ineiudes the bonding wire between rnult-wide units. Pg.
Plumbing. B
connect all sewer drains to an existing sewer tap or septic tank Pg.
onneot all potable water supply piping to an existing water meter, water tap, or other
tdependent water supply systems. pg.
PERMIT WORKSHEET page 2 of 2
Site F aration
0
Debris and organic material r oved
Water drainage; Natural Swale —Pad---
Floor Type i=astener. M t—
Walls: Type Fastener. Spacing:
Roof; Type Fastener. Spacing:
Y Length: Spacing: A�
For -used homes a , 80 gauge, 8" de, galvanized met I stop
will be centered 'over the beak of the TO and fastened With gale.
roofing nails at 2" on center on both sides of the centerline,
• Qasket Walh reofin relrient -
1 understand a properly Installed gasket Is a requirement of all new and used
homes
otooa�kidew pinsl�tndatrpaesult f apooynstlled condensation, no gasket bmaled. I andrsasr{
Of tape Will not serve as a gasket.
Type gasket
Pg._
installer's inwaisc--
Installed:
Between Floors Yes
Between Walls Yes,
Siding cotn units Is nstalierepaired
to mnanuuff c urges specifications. es� '
Fireplace chimney installed so as not to allow intrusion of rain water, Yes Yl
Skirting to be Instalied. Yes ,�_ No
Dryer vent installed outside of skirting. YeS�WA
Range downflow vent InstalWoutside of skirting. Yes_-�V--hyA��
Drain tines supported at 4foot Intervals,s_"„
Electrical crossovers protected. yes.
Other;
Is accurate and true based'on the
Installer Signature
Date