HomeMy WebLinkAboutPERMIT WORKSHEETPERMIT NUMBER
(i�!✓1 i / 1 /a %d1 LlCense r'ur ..�lT �( �! .J' Z
Address of home �%l /�cr�C��i�' /� � l G�i�'/ i r-c
Installer
.66
............... W'
being Installed
Manufacturer �`-c-�n /� ��n%^ Length x width
NOTE, 'it home Is a single wide fill out one half of the blocking plan
If horde Is a triple or quad wide sketch In temalnder'of home
I understand Lateral Arm Systems cannot be used on any home (new, or
Mare the sidewall ties exceed 5 ft 4 in;
Installer's Initials
Typical pier spacing
2• lateral
PERMIT WORKSHEET
CD
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Amy o 0
New Home ❑ Used Home .2
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Home installed to the Manufacturer's Installation Manual
Home is installed in accordance with Rule 15-0
page 1 of 2
I�
Single wide ❑ Wind Zone II ❑ Wind Zone III ® --
Double wide Installation Decal F
TriplarQuad ® Serial
PIER SPACING TABLE FOR USED HOMES
Load
bearing
capacity
Footer
size
(sq In)
i 6' x Is,
(256)
is 112, x is 1l2'
(342)
20' x 20'
(40D)
22' x 22°
(484)°
24' X 24'
(576)`
26' x 26,
(676)
10D0 s
3
4
1 00 IDs
4 6
6
8
DO s
6'
8
8
8
2 00 s
6
8
8
8
'3000 C)ST
8
81
8
8
3 00 Dst 1
8.a,-
8
Interpolatea rrom hule'Ibu-1 pier spacing lade,
PIER PAD SIZES
I-beam pier pad size �.
Perimeter pier pad size
Other pier pad sizes / :12Z Y,
(required by the mfq.)
MIDraw the approximate locations of marriage
I 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,
POPULAR PAD SIZES
�.T�s'i�.ie�
• � �
ANCHORS
Opening Pier pad: -size
ft 5 ft
/
4
-
FRAMETIEs
within 2' of end of home
! jFr/ X /L
spaced at 5' 4" oc �/
TIEDOWN COMPONENTS
OTHER 71E5
Number
Longliudlnal Stabillzln Device (LSD)
Sidewall
Manufacturer min dLl ee�
Longitudinal
Longitudinal Stabll•Izing Device wl Lateral Arms
Marriage wall.
Manufacturer- d12 m
Shearwall
POCKET PENETROMETER TEST
The pbcket penetrometer tests are rounded down to psf
or check hereto declare f DOD lb, soil without testing.
X X 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.
3. Using 500 lb, increments, take the lowest
readinq'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 inoh pounds or less will require 5 foot anchors,
Note: A state approved lateral arm system is being used and 4 ft,
.anchors are allowed at•the 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 400 inq capacity.
Installer's initials
ALL TESTS MU_5TPERFORMED BYAJUCENSED INSTALLER
Installer Name
Date Tested
1
Electrical
lonnect electrical conductors between multi -wide units, but not to the main power
ource. This•ingludes the bonding wire between mutt -wide units. Pg.
Plumbinq .
bnnect all sewer drains to an existing sewer tap or septic tank. Pq.
onnect all potable water supply piping to an existing water ete aier tap, or other
tdependegt water supply systems, Pg.���
PERMIT WORKSHEET
1 page 2 of 2 I
Debris and organic material remo_f�Iq_<_
Water drainage: Natural Swale Pad Other
Fastening multi wide units
Floor: Type Fastener `_— Length: ! Spacing: r� X�
Walls: Type Fastener Length: Spacing: 68' CJ G
Roof: Type Fastener: Length. K " Spacing: /&- C> For. used homes' a twin. so gauge, 8" wide, galvanized metal strip
will be centered over the peak of the -roof and fastened with gaiv. -
roofinq nails at 2" on center on both sides of the centerline,
Gasket(we therproofingr&gulremant)
-i understand a properly installed gasket is a requirement of all new and used
homes and that condensation, mold, meldew and buckled marriage walls are
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 /
Type gasket �r✓«%`1�' Installed:
Pg. Between Floors Yes
Between Walls -Yes
Bottom of ridgebeam Yes
Weatherprooflng
The bottomboard will be repaired and/or taped. Yes Pg.
Siding on units is installed to manutacturer`s specifications.' Yes
Fireplace chimney Installed so as not to allow intrusion of rain water, Yes
Skirting to be installed. Yes ' No
Dryervent installed outside of skirting. Yes N/A
Range downflow vent installed, outside of skirting. Y WA
Drain lines supported at 4 foot intgrvals.
Electrical crossovers protected. Yes
Other:
installer verifies al.l information given with this permit Worksheet
is accurate and. true based on the
manufacturer's insta.11e ion lnstrucf=s and or Rule 150-1 & 2
installer Signature
r
Date