HomeMy WebLinkAboutPERMIT WORKSHEET71
s- = -_ _ PER -MFF WOI3b' .SHE
-Ef1di NUit1;8ER j�_"'
f ,
New Home. Home ,
NA J Home installed to the Manufackwees InsWatton Maivat B -
Address of.homeSli r Home is installed in accordance with flute 15��Wlqdzonsifi
0 , _
befitgiiu�:�led - - fl
Single wide El mdZone if
♦gihxwlehW Dottbfewide 'nstatffionDecat '�����
NOM 'if haws, Is a slr;0a Oda W1 oW one W of Me blocldng plan �' C�t�NN eiQt'
pad o serial � ��l♦I 3kA315O>�
_ Tfilomle l5a fiJpte of cillad vtTitle sketch Irt ierna-Fitdel nfhotrte Y - -
I understand La#eral Aim Systems cannot be used on any home (new or used) Lucie CQU n PI1=^n SPACtt+I6 TAELE FOR uS@HOMES
where the sfdewWI ties exceed 5 ft 4 in: St
Installees i TW1.- -
Tvn,orar nrar
Lozd Fooiar
,.�.I7�iJng S�9
,�^" lbf (sq irk
. 76'x IS'
{
18 Y12'X i81f2` 2D'7C20'
t342� { Ml
22 x\22 24'X24'
{484, t676)`
25X2&'
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t)U
S.
8
8 8
8DOO
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PIM PADS
popUDR P D S12ffS
I-beam pier pad size t��� `�tti
a s _S
Pedmeterpietpadslw M!� �."�t
x
Otherplerpad s¢es l+i� Et
xSO
_
[squired by the mfg.)
x
Draw the approximate locations of rnankge
i•� x
xZU
vuatt operzing9 4 foot or greater Usa Us
x
symbol to show the pm
x d
List all marriage watt opEdui gs greater than 4 foot
2Gx2G
andthefr pier pad it below.
" .
Opeabw Pier paftize
AwcitoRs
t
4ft bft -
FRAME f7'
Within V of end of
�
spaz at �' 4• oo
-nEDOWN COM?ONFNiS
O7H TIES
:nrrgJtrrdJnal Slabflj�ing D�vIcE (LSDj
NMTbar
Sidewaq
t
llanufactwer.
Lonsirtudlnal
�on9ftud7iral StabAL " 1�7p�vJce WlLaletaJ/3r7%s
TJ1�7tage Wall
danrrfacturer. Lh 11VTC�Ynfi?� -
PEi3MIi` NUMSIi
POCK
Q�t1=7RO 1FS
The R"ocket penetrnmetertesis are round 6i,to psf -
ar check hereto osiers 1 i}OD l�.sor7 _=withorit tesFvng.
X X X
POCKET PSeMOME7 ER 7ESMG METHOD -
1. Test the perkneW of the hobos aI 6 locaflom
2_ Take the reading at the depth of the footer - S. Using Sw 1b. increments, take the ►oWesi .
readma and round dower to that increment.
X X X
E PROBE:VEST
Ths results of the torque probe test Is-3 inch pounds or check
here if you are declaring S anchors witliotet tesii"g - - A test
sboWlnll 275 in* pounds or Jess will ragWra S foot amdwrs:
NOW A state approved lateral mm system Is being used and 4 IL
anchors are allowed at -the ddewall ins: I tuidersiand s tt
- zunchoss are t0qu6d at all centedlne go points where the torque test
reading b 275 or lass and Mare the mobPe ljorrre nsatrufacitrrermay
requires anc hors with 40D nA Y-
s�a� `itstallet's:iriftiais
_ At_L TESTS MUST BE PIMFOR ED HY A i-fiCENSED INSTALLS
fnstausr htame �}I� CKD-
tonneot electrical conductors between r all --wide unit% but not to the rnair•t power
ouroa This-kwludes the bonding Kura between mid -wide mots-
_ numD�ra
onned all sewer drains to en exdsting'sewer tap orseptic tank P9:
onnect all potable water suaPty'Ptpirig to'an e0dsfm9'watee miter. wafer tap, or other
rdepshdent w-.�ter supply systems, pg_
PEP.W 1d4ORKSHJ=ET
_ L P83e 2 of 2 --
i 1 Prcparntron
Debris and organic materkd roved
Water drainage: Naiulal �/ Sorrels pad p � .T
Fastenfn mrrrti wlrie aerie '
Floor. Type Fastener. LenjIft �- T Walls. Type Fastener.Alh: Spacing:
Roof; Type Fastener- Lens* �nxy�--
Far -used homes a so gauge. W v�tde, gatnanIWd metal strip
Will be centered bverthe peak of thesoof and fastened Qh gafv. - _
roofing hails at 0 on center or both sides of the centedme,
I understand a property installed gaskBt Is a >aquIrornent of all new afid used
homes and that condensefiora. mold. meidewand bucldednrattlage waft am
a result of a poorly installed or no gasper being lostWIEd I tinderstand a strip
of tape wltl not serve as a gasket
"�is1`aDsf'stttii£ats,�:. •
Type gasket Y00,M }�; '-
P9 Between Floors Yes
Between Wails Yes
13otf6m of ridgebearrr Yes
The botbrnboard will be rmalred andlor taped• Yes „
siding on Units Is fnstatfed to mate facttr Ws spec Hbatform Yes —
Fusplace chimney installed so as not to aftow intrusion of rain water. Yes.
Skirting to be-lnsWI d. Yes ND
CWervent kn&lled outside, of slitting. Y^� W�
Bantle dowrrflow vent lnstalted-ou sjde of zMo g. NfA -
Drain fines supported at 4 fod UQrvals: Y
asobical crossovers proteded. Yes
other;
Installer verifies aU informatfori given with this permit Warkshest
Is acc Uratg and trot: based on the
tnantrfactur Ilat3an i and or: Rule 160-1 2
169tbr Signature