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HomeMy WebLinkAboutPERMIT WORKSHEETr r cn m 70 n rp c rM M :� 3 co �3 _30,Y L �.•. " • Y .1 ............. .... -PaRMIT NUMBER .... . . Installer License #k (+? Z_5 1,7 & Address of home 366.6 '7,—f , 11,ft,14 being installed � ,_ �" �. �. � �i •c , Manufacturer Lsngth x width .30Vl< • NOM- ' If home is a single"wide fill out one harf of the blocking plan if home Is a triple or quad wide sketch In temalnder or hams I understand Lateral Ann Systems cannot be used an any home (new or used) where tbs sldewalt ties exceed 5 ft 4 In: lnstaller"s initials Typlcal pier spacing •� f show_10oations of Longltudinal and Lateral Systems i„sg„�„t (use dark lines to show these locations) v New Home . Used Home ❑ Home Installed to the Manufacturer's Installation Manual page 7 of 2 Home is Installed in aoaprdance with Rule 15-0 C' ❑ Single wide ❑ Wind Zone II Gr Wind Zonellf ❑ Double wide ' M'� Installation Decal t# TrIpldQuad © Serial # PIER SPACING TABLE FOR Uagn uruxua Load tang FooW Size 1e' x 1 r 18112' x 181/2' 20' x2W �22' x22' 24' X24' W x 2a• eapaWy (S9 in) (2" (S42) (400) (494)' {b98)• (sts) 100-0 g D 0D s a a 8 00 $ 8 BD s g ' Int fPolaled ffom Ru1®15Gi Oar wade_ &&a. B PIER PAD SIZES POPt! g I-beam Pier pad size _ ' / % �C___,��f �aa ze n Perimeter pier pad size l� �` K eL " • x x Other pier pad sizes • x (required by the mfg.)--.--.--�.__ x Draw the _ roxi hate locations of marriage x i wall op niit -Ad 0,3 . Q�Oa3� �O �Oi��1N05 Pi AO u11191SNOdSU Ri 39 S1NN OdLLb 80 SHOW 03VON43 Ol Uacuo NI Ansam 30 An lm sumousm amd AS asminom MOM MUM 11V ONY SNb1d 383M1 3atlW 3fl "IIIM NOLLOUSNl ON d0 sor NO 1d3)13e ianw 11lN 3d aNm SN d 31tl0 Afl a3M31/13F� Il 00 MOd M31A3d IAIa e)Nlalina kLNnoo mom is r n rt�PERMIT WORKSHEET 177 C ROMEfER TE5 The pboket penstrometertests are rounded down to psf or check hereto declare i ot3o Ib..soii ,.. j,without testing. X.._ X X..._. POOKET PENETROMETER TF.S'i tNe METHOD 1. Test the perimeter of the horhe at 6 locatlons. 2- Take the reading at the depth of the,footsr. S. UAng 500 lb, ibcrements, take the lowast reading and round down to that increment. T • Q E OBE TEST ' . The results of the torque proba test is � % _ , Inch pounds or check here if you are declaring V anchors wiilrout testing _ A test showing 275 Inch pounds or less will require 5 foot anchors,, Note: A state approved lateral arm system Is being used and 4 t. .anchors are allowed at4he sidewall locations. I understand 5 S anchors are required at all centerline tie points where the torque test reading Is 276 or lass and where the mobile Ejome manuraoturer may requires anchors with QOOQ Ib holding capacit�yy — •�••'�;�•, tnstallet's Inftiats ALL TESTS MUST BE PERFORMED BY A UCENSED INSTALLF-R Installer Name _ _7Z ..+,•, • . Date Tesfed 9 — / y MeWlaw 1onneot electrical conductors between multi -wide units. but not to the main power ouram This•lnpludes the bonding wire between must wide units. PM X& PlUmbina anneot all sewer drains to sot existing sewer tap or septic tank. Pg. 6 onnect all potable water supply piping to an sting wafer mefor, water taps or other rdependent water supply systems. pa. - Slte Preaur� att_ on Debris and organic material removed Waterdrainage: Natural `&e,*-_ Swale pad ✓ Other ' Floor. Type Fastener. L.enpth; S Walls: Type Fastener. ?[�� length; Spacing: �7 Roof. Type Fastener. Length.: Spadng: "'- Forused homes a min. 30 gauge, a' wide, galvanized metal strip will be centered over the peak of themof and fastened With gaiv. ? 1 roofing hails at 2° on center on both sides of the centerine. Gaske,� t (w�ee�feonng i understand a property installed gasket is a requirement of all new and used homes and that condensation, mold, meldew 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. T-- Installer's inittals Type gasket /`®/�� Installed: Between Floors Yes Between Walls Yes P - Bottom of ridgebeatn Yes The bottornboard will be repalred and/or taped, Yes t/ pg. Siding on units Is Installed to manufacturees,specifiaatlons. Yes Fireplace chimney installed so as not to allow intrusion of rain water. yas Mr tanaous - - Sidtting to be installed. Yes i/ No Dryer vent installed outside of skirting. Yes~ WA Range downflow vent Installed•outside of skirting, Yes _�NIA"_,_ Drain litres supported at 4 foot IntQrvals. Yes '� Electrical crossovers protected. Yes Other; installer verifies all information given with this partnit mlarksheet iv accurate and true based on the manufacturer's Installation Instructions and or. Rule 150.1 & 2 Installer signature Gate l f8