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PERMIT WCj F!1CSHEaT Page 101 2
- ER 1 1Vt1N�BER
Installer
New Home -
Used iiarne
7
home �
®
Home installed to the manufacturees Insiellatlon Manua! -
Addrass of _ 1, �{�i1�►
beirigIi§tzi(ed - - - -
Home is inst-aIIed
_
in aocordance with Rule is-C _
Single wide
[] lnd Zone If Wind Zons l l [}
1
iv}antsiacitite^ ��' � i;sngth Xyrli3fh _ L'} � ii �1
Doubts wide
- •Irsstall;�on Decal 1}
D
_
NOM W1`tome Isa an -do w1de 1111 out one half of the blocM_gp?an
TrIptaram'd
Serial.2 V—%-MM -gSPLI O-;Z ns-s
11haMe Is a triple or quad ruins sketch in remainder of horror
I understand Lateral Azm Systems cannot be used on any home (newor used)
where the sidewall ties exceed b ft 4IIi:
Installer's inials
PIER, SPACING TABLE FOR U5Q3 HOMES
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PIER PAn SfZES
I-beam pier pad size 41i"' `in."
Perimeter pier pad size N 1'�
Ofherplerpad sores
Uegvired by the mfg.)
101 Draw the appro)dmaie locetlom of mardas
wall openings 4loot or greater_ Uss this
symbol to show the piers,
List, aU_rizarria_qe Wali openings.greater than 4 toot
ancHheir pier pad sizes below.
P LA13 F ITS S
ANCHORS
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PERMIT NUMBM
POCKETENETR0 TES
The Docket penetronretertests are Fotm Wrt to psf -
or check here-16 declare t tiW lb. sot? tit toe Tng-
X X X
POCKET PENETRDMEj 7A I NG METHOD
1. Test the perimeter of the home st 6 locations.
2- Take the reading at the depth of the footsr.
S. UpIng sw lb. increments, take the lowest
reading and round down to that increment.
X X - -x
T6RQ1J-E-P-JT0-BE TEST
The results of the torque probe test Fs_ hch pormds or check
here If You are declaring 3 anchors without testing - . A test .
stmwing 275 incp pounds or less will require S foot anchors°
Nottc A state approved lateral arm system Is bring used and 4 ft.
anchors are allowed at'lhe sidewatl locailons. I understand 5 It
anchors are required at all ceaterllne 60 poiru its where the torque test
reading Is 275. or less and where the m_ob7e Florae manufacturer may
requkres anchors with otding capacity.
Itrstallet's:iriftiais
ALL TESTS MUST BE PaIFOR ED BY A i.FOENSED INSTALLER
PERMIT ltlFORKSHEEJ' PHse 2 of 2
site Pr-- �p
Debris and organic material moved
Water drainage: Natuml V Swate Par} Meer
Fastenrn multi wideun}Ls
Floor. Type fastener:4a-
LerajdL Spzoing:
Walls: Type. Fastener:Least 4acln� -- --
Root; Type Fastener.LenQlFt:nsl:y---
F br_used homeo gauge, 6` WHGa sla�ranixed m�---
wlll be centered -aver the peak of Me -roof and fastened Qh s>�
rooting nails at V on center an both sides of the centerTme:
---------------
GnskeY (wry . ia�+np rogutrus e,�j
I underst4nd a properly Installed gasket is a MgUIr"Mml of all newand used
homes and that condensallor;, mold, meidewand budded martla-go wags a!a
a result of a poorly installed or no gasket bdrng fnstWied I tinderstand a strip
of taps will not serve as a gasket.
Type gasket Vt9am - Instattect
PM Between Floors Yes ✓
Between Walls Yes
Bottom of ridgebsam Yes
The bottomboan3 will be repairedarrcior#eped. Yes
Sidufg on units is installed to mantfacftueft =qdffi,,ffons Y�
F lreplace ciri=ey installed so as not to allow WMSIon of rain water. Yes .
.instaer-Name - -- - - - - - _ ..
- - ll...-Sldtiing to Ile FiisEail'ed:.les Nv
i?ate7'as€sc3' Dryer vent FnstaffedVOL ideofskirting. Yeses AV1
Range downflow vent Instalked•outside of ski NIA -
Dmin fines supported at 4 fobt intervals Y
E lectriart crossovers protectecL Yes
'Becuimr
014er:
tbnneot electaGalconductors batmen M-W-ti-widetrni3s,_bt*na3.to_ihs_maut_pnaacai .- ----- ----------- ------ -- -----. -
o�oa�trrs`uftwss�a7xunYme berweenin g - - — - - - -- - --
manned all sewer drains to tut Odsting sewer tap or septic tank. Pet:
onned all potable water supPFy DFPInSl to an Tdoj ng water meter. wafer tap, t
lnstatker
n art rnrornatnon given with 'this pe
is accurate and true based on the
rdependerjtwater UPPFy sysleT s g_