HomeMy WebLinkAboutPERMIT WORKSHEETERMYr NUMBER
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;nstaller Jos :;P: l F; l�ffl i3cr i °1`1: '� 2Q,
Address
iU�aR41•ac�[ttsi'y`� � �1 •�9IISX•lN�I1 „�!��7� ��.�1
NOM 'If home Is a area wide fill aut one half of the 67ocAdng plan
lfhaWe lsa 1n1pJe or quad wide sketch b2 J ewander of home
I understand LgteW Arm Systems carurot be used on any home (new or used)
Where the sidewall ties eDzeed 5 ft 4 Brit
lnstailer's�rnr'tiais_ _
:imera► rilnr charinn
SCANNED
BY_ - - ----` --
- PERIVIrr WORKSHEISt Lucie Cou Y page l fl1z
New Home- ❑ Usedl;otrre _
Home installed to the M mutactm-ses InsWatlon Manual M
Home Iskmtaffed in aoc=l=ce wfth FhAe 15-0
Smuts wide El ind tons l l Wlnd Zone tl l -El _
Double mide nstalfztion Decal �19��'��
TriplerQuad p Serials Zy� ? �3� S
PIT'r'i SPACING ?"ABLE FOR USED HomEs
Load Fbotw
siFe 161X1ti
i2)
181/zX18 tl2 2W;c2D"
(342) (400)
22'XW'
(484)'
24'X24'
(576)`
' X26'
(670
1 ps
as 4 6
g
so005 Ers
u..o.Nwo..w �nta awns a.�va {»w o}s,u¢pr wuui
PIER PAD s[7FC
I-beam pier pact size t12\
Perimetsrpisrpadstm t"t��� 3, �•
Merplerpad sizes
framed by the mfs2-)
®Draw the apprwamale locations o1 manias
wall openings.4loot orgrmter_ U) aUm
symbol to show the pler3
List all rpan*%ge Wall opanurgs grmlerttran 4foot
anri:their pier pad saes below.
Open1~�q Pier pad:_ z
-nE OWN COMPONafM
-nffJfLkUnal Stabllk�ny A�w3ce [LSAT
hanurachnw t ti1 a aVti11�
ongtttrdJrlal SiablJlzrrgD� vice sv/LaferatRrir`is
hariFs(aclWer_ 1il l.'�v`tt�'1tis±� '
P LAR PAD S
ANCHORS
4ft ft
FRAME-n
virgin 2' o1 end of hm
spansd at � 4' o0
Nmnber
orsEa TrEs
Loner
SlrBar,P -
PERMITNUMBMI -- --- ......
:4
POMEMNETROMETM TEST
The pocket paneff0matertests are round 6ito psf
or check here-tb declare 10M lix.soli vafta tesillrr .
x x • x
POCKET Pa-ErRDMETM I F-S I ND MEMD
I. Ted the perimeter of the horhe at 6 locaffom
2- Take the twang at the depih of the fcoter.
3, Vag Soo lb, ri=mecgs, takethe
reaang and round down to that Increment.
x X—. X
B F= T rW
Tim rnsulls, of the torque probe test inch pomis or check -
here It YOU are declaring & anchors wail WA •testing — Atast
show1n.9 275 inch potuls or hm will require s foot anchors:
Note: A state, approved lateral ann Wftm Is being used and 4 It.
anchors are allowed at1he aldewall joc;f m I =Wmsiand s g
imchors are mulred at all CmWdhe 68 Points where the torque test
readho J9276or less and where the mobile home manufacturer may
requires anchors with
ALL TESTS MUST 13E PERFOR EDBYALJCENSr=DItMTALLgR
:brOWd elOcWGW condt'r-1015 between 1WHA%ids unit% but not to the main power
0=186 7111-Wud— the bonding me between mLd-wide wdt,-. Pa_
i-N \N
10YVI
;Dnned all sewer drabs to tin oftling sewer tap orzepth tank. Pg:_
Bnnect all potable water supply piping to an existing water meter, water tap, or other
dependent 'water supply syeems, pg.
PERMTWORKSHEEr-
Page 2- of 2
M-Pr-P&I.R..
Debris and organic lovsd
M
Waterdrainage: UW—SWalf3—pad _OUW
Fast InnitUAIII wtde traits
Floor. Typo Fastener. Length. &PWITIP: —44— , '1AV
Walls: Type Fastener Len9ft S 6
Roof* Type Fastener. Lenuft
For_used homes a SD gauge, a" 1� galvanized M-871@ strip —
will be cent the ttealt Of the -roof and fastened w6 gaiv.
rooting nails at V on center an both sides of the centerline.
I understand a properly installed gasket Is a raqulretnent of aB newand used
homes and that condensation, mold, meldew and buckled marriage wmft are
a result of a poorly installed or no gasket being installed I understand a strip
of taP6 WRI not serve as a gasket
Typegasket Y03m - installed:
Pa BEtwem Floors Yes_--V/l
Between Waft yes
Bottom of fidgebeam yes
The bottom6MH will be repalredzWorteped. Yes \/
Ing 00 unft Is bstalled to fnanmcacftmn�s sp9almHorr, yes
Fireplace chirrmay
bstaged-sO as; not to ago* kdn;dOn of rain
Doug
Skirling tpbabstallid. yes No
DrierVentinstalled outside of.sMrfirig. Ym WA
Flanile domadlow vent bstalledOEdside, ofski di!3g. NIA
DMInlines moolledat4fodIrdmals. Y
Electrical crossovers protected. yes
InstaHer verffles aU informations given with this pun nit Vk; . arksheet
Is; accurate and e '0.-1 the
manufactttr itatia sfru and &
Installer Signature. 9s. :,�._ Ck L. tic,