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HomeMy WebLinkAboutPERMIT WORKSHEET-PEHMIT NUMBER .
installer , :� �`+ F ^c_r��1Q Llcc�se41 ? '✓ t`
Addrass'cfhome' L'�i!_i1�0
&elite fis'tailed ' ,r j -
5
M�Ttrtfacttttei' i..etigih xwFdth°�. �� ��
NOTE W home is a single wide fllk out one half of the blocking plan
kf home is a hWv or quad w1de sketch In temafnder of borne
I understand Lateral Attu Systems cannot be used on any home {now or
Mere the ddewafl ties exceed 5 ft 4 in:
Instailer's�ih%alfs'
Tarnir�r nicr c�T»ninn _�
® 1 Co
A
PERMIT WO f KSKEET
page 1 of 2
New Home . I] Used biome
Home installed to the Manufacturaes Installation Manual
[]
Home Is installed in accordance with Reis 15-0
5ingie wideZone Ii WidZ�
ill] [}
Doublewide Decal 4?
Tdple!Quad [j >;SeFial'�.
PIER SPACING TABLE FOR USED HOMES
�P�tY (sR
16' x 1B'
(250
181W x'i8112'
(342)
2W;C20'
(400)
?2 x22'
(4134)•
24' X24'
R6)`
2W '
(fi,,r_�
low n
s
DU
6
g
'
6
$
ti
8
w6d) s
.-8
- - --
i u Npomuu3 uwn rsu" Zo i pw upaqwQ can+m
PtEii PAD SIZ
I-beam pier pad size x��
Perimeter pier pad.size N-7 -,4
r-
Other pier pad sites l-?`
(required by the rnfg.)
Draw the approximate locatlorry of rnarrI4
wall openings 4 toot or primer_ Usa tits
symbol to show the piers.
List all marriage Wall openings greater than 4 foot
andiheir pier pad sizes below.
Open);v Pier pad -size
4 ft 5 ft
I FRAME Ties
atin 2' of end of horl
spat
OTHER TIES
-nEDOWN COMPOtJFNTS
Longltudlnal Ma61U7I, Device (LSo)
Sidswan --
Manufactwer 119'\`t•ti'�tT%eAxMN
Longitudinal
z
Longlfudlndl Stablllz, g vice w/Lateral Arms
Marriage wall
Vanufacturer V i z Jtt�VW i N
r
PERMIT NUME3M
. . . . . . . . . . . . . . . . . . . . N!
O PENETROMETEk TES _
The pocket penetrbmetertests are round wn to psf
or check here lb declare 1 OM lb. soli !! without tes+inp.
X X X
Pacl¢f PENEMOME1 IEZIZNO IVEMOD
i. Test the peritnater of the home at 6 locations.
2. Take the reading at the depth of the tooter.
S. Using 500 lb, kjcremerris, take the lowest
readmg and round down to that increment
X X _X
- {2 E MOBE TEST
The results of the torque probe test Is �15 _ inch pounds or check -
hem if You are declaring 5 anchors wijh6tA- testing A test -
dmWing 275 inch pounds or low will require 5 foot anchor
Note: A state approved Wetaf arm syslern Is being used and 4 IL'
anchors era allowed atl)a sidewall locaflum F understand 5:
_ anchors are t•equlrsd at ail centetllne tie points ubere tho torque test
reacting is 275 or less and where the mobile Florae manufacturer may
requires andrors with -0OQO.t„ dung capacity .
.tnsiallet's:iiiitiais
ALL TESTS MUST BE PERFORMED BY A LICENSED INSTALLER
Installer Name LLB]
mate:Tas�et
Electi
cal -
tonnect electrical conductors between mdti-wide unNs: but not to the maul power
ou nxx This-Wudes the bond na wire behveen mutt -wide unl s. Pg_
CN
Ir[abinc�
brined all sewer drams to tui a dsling sewer tap orseptic tank Pg:
cmact all potable water supply piping to an e4sUng water meter, water tap, or other
idependent water supply systems. Pg.
PERMIT WORKSHEET page 2 of a
site PrepiiratIon
Debris and organic rnaterlal r WUved
Water drainage. Nafvial V SWafs Pad Meer j
Fasta�tna mutts write craft, -
Floor, Type Fastener: L tax-
KIWIL Spachr 1.14Walls: Type Fastener:Length:Roof: Type Fastener.LenQlIr bpa6hg:Fnr_used homee gauge, 8' wide; gAd m'Strip
``—
will be centered bverthe Reakof the-mof and fastened with galy.
rooting nails at V on center on both sides of the renier�e:
• 6nsket (��. ,
I understand a property Installed gasket is a Mqulretrtent of all new and used
homes and that condeasenon. mold, meldew and budded marriage walls are
a result of a poorly installed or no gasket being hastened 1 understand a strip
of taps wRl not serve as a gasket
C indauees iraials .
Type gasket 1 � tJ OPf n. Installed:
Pg. Between Floors Yes
Between Yes-=�
- Bo#tom of ridg ridgebeam
The bottomboard will be repaired andfor taped, Yes- E�Z�
Sid ng on units Is Eistalled to manufacttA"speciUlvatlor YFreptsce chirmay installed so as not to ailovi► urtrtrslon of rain
Skirting to be installed Yes_ No
Dryervent installed outside of sklttirig. Yes
AU
Flange downflow vent installed'otdside of ski � � WA
Drain Goes supported at 4 foot intervals. Y
©ectrtcal crossovers proteded, Yes _ 2
Other:
au inforrnation given with this permit
Is accurate and true based on the
Da , MAI-A