HomeMy WebLinkAboutPERMIT WORKSHEET��RM1iNUMBER •�;: �s..e• ... •
installer /i -i2r tb 7a ice..; _ License # . XY / 0 Z517 b
Address of home 7d-P2—yG��wi�
hetrtg Installed
Manufacturer Length x width 375 X �Y/y Y
Nom. ' If home is a slrtgle ssrlde fill out ~
RECETV—
PER'NIIT WORK -SHEET p ge 1 of 2
SEP 24
I
New Home • f i Used e ,
qu
Ludenty, permitting
Home installed to the Manufacturer's Inst t on
Home Is Installed In accordance with Rule 16-0
13
Sutulp wide
Double wide
!f horffe Is a triple or on® half of the biooldnq plan rL'ripi tQuad
quad wide sketch lrs remainder of home [ �e��
U I understated Lateral Atm Systems cannot be used en arty home {new or used)
where the stdewall ties exceed 5 ft 4 In.:0§ LUCIS Cod ntV
lnstauer% initials %—
TIc pier
Q---3 ShOW locations of Longitudinal
:_and Laterai
(use dark lines to show thlocations)
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❑ Wind Zone II 03" lAthid Zone III []
[" Installation Decal #
❑ serJal #
1,
PIER SPACING TABLE FOR USED HOMES
Load Fester
4earireg size
capacity (sq in)
16 X 1fi
( �
181J2 x 18 t/2'
(
2W X20'
(40)
22' x22-
(484)*
24- X24'
(678)`
2.6, X 26,
(676)
1000
as
139Fs
DSi
8
$
r ht81R0tated from
PO iErm
$'
pie upanlan lel,to
PIER PAD BtZES
I-beam pier pact size / 7xZr
Perimeter pier pad size
Other pier pad sizes
(required by the mf1j.)
Draw the.approXimate locations of marriage
watt openings 4'toot or greater. Use this
sYmbof tc shcwthe.plers•
Lds-t all"marriage..wall op,jntngs greater than 4 foot .
=; _and-lholr pier parl;sjies=beldw
bAenlna '� :I?ler pad•,slze
6000
nEWVM COMF!DNENTS -
Conglfudlnal StebllWng Device (LSD)
Manufacturer-
Longltudlnal Sta- ltlzlr�q_.t7ee!!ce sir/Laiersf Arms`
Manufaoturer' �r
PUPULAR SZ
ANCHORS
4ft.,.;_
PRAMETIES
within 2, of end of home
spaced at 5' 4' oo
oTIiER Es
SIde
Longitudinal GP
Mardogi wall
Shear►rrall
i
.. • ? j• PERMIT NUMBER.. ••. •_-,•.• •r�� PERMIT WORKSHEET 1 page 2 of 2
OMY790YRNO iTE.R
The pbOW penetrornetertests are roundsd�wn to psf
or check hem -to declare 1o0D Ib,.soll without testing.
X X X
POCKET PENETROMETER TI'sS nN(3 M>:7'HOD
1. Test the perimeter of the home at 6 locations.
2 Take the reading at the depth of the footer
S, Usinq 500 lb. Increments, take the lowest
reading and round down to that inorement,
x`..
TOR Q EP O E
The results of the torque probe test is_ �0 Inch pounds or check
here Tf You are declaring V anchors without tesfing . A test
showing 275 inch pounds or less will require 5 foot anchors,
Note: A state approved lateral an system Is being used and 4 ft.
anchors are allowed atthe sidewall locations. I trriderstand 5 ft
anchors are required at all centerline tie points where the torque test
reading Is 275 or less and where the ntoblis Home manufacturer may
requires anchors with 4000 lb holding capacity.
d• 1 installer's initials
ALL TESTS MUST BE PERFORMED BY A LICENSED iNsTALLgR
Installer Name
Date Tested
e
Boa•
ronngd electrical conductors between multi -wide units, but not to them n power
curve. This•Includes the bonding wire between mult-wide units. Pg.
Piumbina
conned all sewer drains to tm =Ming sewer tap or septic tank Pg. 6. 6 d
onnect all potable water supply piping to an 9dPM9 water motor, water tap, or other
,dependent water suupply systems. Pg.
Debris and organic material rpoved P
Water drainage; Natural ✓ _ Swale
Floor Type Fastener �42 _ . L,en�• Spaolnsr
Walls: Type Fastener. LenAft - Sparing;
Roof: Type Fastener, r- Length: « rr
For.used homes a min. So gauge, 6 wide, �dMORI
will be centered -over the beak of the -roof and fastened With galy,
roofing nabs at 24 on center on both sides of the centedln%
Gasket fWeathemiaeIIne rwnuh...,..a- --
I understand a properly installed gasket is a requirement of all new and used
homes and a result of a poorrlyy condensation.
nsttallleeddor noopaske being ins a�ll� I und�ersig anwalls &1p1p
of tape will not serve as a gasket,
Type gasket
Pg.
installer's Iniilals
Installed: .
Between Floors Yes
Between Walls Yes
Bottom of ridgebeam Tes
. Bathe roofln
The bcttomboard will be repaired and/or taped. Yes , pp, 910 •
Siding on units is installed to manufactureft spect8oations. Yes L-:;;- "- ,
Fireplace chimney installed so as not to allow intrusion of rain wale%' esY
M leneous �N
Skirting to be installed Yes No
Oryervent installed outsideaf skirting. Y�WA
Range downflow vent Instatied•outside of skirtjnn, -AYw-= /A��
Drain Ones supported at 4 foot intorvals. Yes
Electrical crossovers protected, Yes
Other;
a all Intortrration given with this pc
iSF accurate and true based on the
Installer Signature _7� ,
Date