HomeMy WebLinkAboutPERMIT WORKSHEETInstaller Glcense
'e
Address of home '
being installed
Manufacturer y�C\,Qf�� �w Length .xwidth
NOTE; ' ff home (s a single wide fill out one half of the blocking plan
If home Is a triple or quad wide sketch In remainder of home
1 understand Lateral Atrn Systems cannot be used on any home (new or used)
where the sidewall ties exceed 5 ft 4 in:
lnstaller's initials
TYolcal tlar nhar_inn .
PERMIT WOFIK-SHEET `CANNEL)
AV
New Home • (3 Used Home ,
Home Installed to the Manufacturer's Installation Manual ❑
Home Is installed In accordance with Rule ;��Wlnd
Single wide ❑ Wind Zone II Zone 111 ❑
Double wide ' • [Installation Decal f# l�j S
TriplefQuad ❑ Serial*
PIER SPACING TABLE FOR USED HOMES
+..oaa
hearing
rooter
size
g• x 16`
18 t/2' X i 8 1i2`
20' X 20'
22' x 22' 24' X 24'
26` X 26' J
aapaally
(sq in)
(250
(842)
(400)
(464)1 (576)�
(676)
100D
s
g.
00
s
.a
f3
6
2 00oats
$
WOO
Day-
a0vu
Dal8'
8
t leferpolated from Rule ISC-1 rater seacinn tahtA
PIER PAD SIZES
POPU ARP D SIZES
I-beam pier pad size
a Up In,
Perimeter pier pad size \1
x
x
Other pier pad sizes
X
(required by the mfg.)
x
-
10
Draw the approximate locations Of marriage
WWI openings 4 toot or greater. Use this
X
symbol to show the piers.
x
x
List all marriage wall openings greater than 4 foot
�24x
and -their pier pad sizes below.
X 29—
Opening `Pier pad -size
ANe ors
4 ft 5 it
TIES
within 2' of end of hony�
spaced at B 4" — ) ,
TIEDOWN C0MP0NEN
11 OTHER TIES
Lon9ltudlnal Stab1{(iing evlce (L5D)
Manufacturer C
Sidewall bor
Longitudinal Stablllzlrrg vice rrd Lateral Arms
Manufacture
Longitudinal
Marriage wa.. —"-"
Shearwall
POCKET PENETROMETER TEST
The pboket penetrometertests are roun own to psi
or cheok here•tc declare 1000 lb,.soil without testing.
POOKET PENETROMETER TESTING METHOD
1. Test the perimeter of the home at 6 locations
2. Take the reading at the depth of the looter.
S. Usinq 500 lb, increments, take the lowest
reading and round down to that increment.
X— X X
--TO E PROBE TEST
The results of the torque probe test Is inch pounds or check
here if you are declaring V anchors without esting _ . A test
showing 275 inch pounds or lass will require 5 foot anchors,
Note: A state approved lateral arm system Is being used and 4 ft.
anchors are allowed atihs sidewall locations. I understand 5 ft
anchors are required at all centerline Us points where the torque test
reading is 275. or less and where the mobile home manufacturer may
requires anchors with
f otding capacity,
Installer's initials
ALL TESTS MUST BE PERFORMED BY A UOENSED INSTALLFER
Installer Name 1
.Date Teded
Elea trlca
Ibnngct electrical conductors between multi -wide units, but not to the main power
ource. This•lntludes the bonding wire between mull -wide units. Pg.
onnect all sewer drains to an existing sewer tap or septic tank. Pg.
onnect all potable water supply piping to an existing water meter, water tap, or other
idependent water supply systems, Pg.
PERMIT WORKSHEET page 2 of 2
Site Preparation
Debris and organic material removed
Water drainage: Natural Swats Pad Other
Floor Type Fastener: `Ag . Length: Spacing: h
Walls: Type Fastener. Length: Spading:
Roof: Type Fastener Length: Spacing:
For. used homes a n. 30 gauge, 6' wide, galvanized metal stripy
Will be centered 'aver the beak of the -roof and fastened With gaiv, r
roofing nails at 2" on center = both sides of the centerline
Gasket (W-thirpA=ffm Mbwftt)-
I understand a properly Installed gasket Is a requirement of all new and used
homes and that condensation, mold, meidew and buckled marriage wails are
a result of a poorly Installed or no gasket being Installed. I understand a strip
of tape will not serve as a gasket.
lnstaliees Initials
Type gasket '�f.1Q m Installed:
pg• Between Floors Yes
Between Walls Yes
Bottom of ridgebeam Yes
The bottomboard will be repaired andlor taped, Yes p
Siding on units is Installed to manufacturees•speotfloatlons. Yes,g '
Fireplace chimney installed so as not to allow intrusion of rain water. Yes'�.'�
oomi-smianeous
Skirting to be lnstalied. Yes No
Dryer vent installed outside of skirting. Yes A
Range downflow vent instalisd•outside of ski g,
Drain tines supported at 4 foot Intgrval_s. SFr
Electrical crossovers protected Yes V
Other;
Installer verifies all utforrnation given with this permit vtrarksheet
Is accurate and true based -on the
Installer signature
Date` ��