HomeMy WebLinkAboutPERMIT WORKSHEETPERMIT WORKSHEET
PERMIT NUMBER �r305__L3_5-1
Installer UC,t h0.! ^1— License#
Address of home
being Installed
Manufacturer _ -�, Lengthxwidth��
NOTE., if home is a single wide fill out one half of the blocking plan
If home is a triple or quad wide sketch In remainder of home
I understand Lateral Arm Systems cannot be used on any home (new r used)
where Me sidewall ties exceed 5 R 4 in.
Installer's initials
Typical plea spacing
��—
Show locations of Longitudinal and Lateral Systems
rolsuumnul (use dark Tines to -show These locations)
r-----------------
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New Home
Used Home V
Home installed to the Manufacturer's Installation Manual
page 'I of 2
Home Is installed me
Single wide
Wiind{<Z—on(e llll —2gwto�/W__nd Zone III
Double wide [f
Installation Decall#(U3l I
Triple/Quad ❑
& Serial # I 0 `f 4
_
PIER SPACING TABLE FOR USED HOMES
Load
bearing
capacity
rooter
size
(sq in)
16" x 16'
(256)
18 1/2" x 18
12'(342)
20" x 20"
(400)
22" x 22"
(484)'
24" X 24"
(576)T
26" x 28"
(676)
1500 s
2000 ps
S
s
_
JDUU PST
o
interpolated from Hine l bG t pier spacing table.
PIER PAD SIIlS
I-beam pier pad size CIO Xao
Perimeter pier pad size -
Oherpierpadsizes tl� dmvLt
(required by the mfg.)
Draw the approximate locations of marriag
! wall openings 4 foot or greater. Use this
'-' symbol to show the pitrrs,
List atl marriage wall openings greater than 4 foe
and their pier pad sizes below.
Opening Pier pad size
�:Ir77[IIr7]'e\iTrlF.i3."i
tiitLcfi lLY3'a.Ycff [ctl�i%'�
tlrrirrsrt.
MUM
Ittttttt!'Lli'Yl�
ANCHORS
Oft 5R_
FRAM E TI
within 2' ofend of home
spacedat5'4"oc_ r;11"
OTI•IER TIES
Number
Longitudinal Stabil' i/rg Device (LSD) Sidewall
Manufacturer (VIVO Longitudinal
Longitudinal Stabilizing Device w/ Lateral Arms Marriage wall
Manufacturer„ Shearwall
TIEDOWN COMPONENTS
PERMIT NUMBER
PERMIT WORKSHEET
v iu CY( ZEST
The pocket pen etrometertests are round down to or check here to declare 10oo Ib. soil — psf
without testing,
X— X— X
POCKET PENETROMETER TESTING METHOD
1. Test the perimeter afthehome at6locations,
2. 'rake the reading at the depth of the looter.
3, Using 500 Ib, increments, take the lowest
reading and round down to that Increment.
X— X—
The results of the torque Probe test is
here if you are declaring 5'anohors withouttesHng inch pounds o check
showing 275 inch pounds or less will require 5 foot anchors,
Note: Astate approved lateral arm system is being used and 4 f!.
anchors are allowed at the sidewall locations. I understand 5 it
anchors are required at all centerline tie points where the torque test
reading is 275 or less and where the mobile home manufacturer may
requires anchors with 4 b holding capacity.
Installer's initials
ALL TESTS MUST BE PERFORMED BYA LICENSED INSTALLER
Installer Name
DaisTested
Connect electrical conductors between multi -wide units, but Otto the main Power
source. This Includes the bonding wire between muit-wide units, Pg,
— —
connect all sewer drains to an existing sewer tap or septic tank. Pg,
Connect all potable water supply piping to an e>asking water meter. Water tap, or other
_.
Page 2 of 2
Debris and organic material removed �.
Water drainage; Natural Swale pad Other
as en ng mu r wide units--
----.—._._.__
Floor. Type Fastener:
� Length: ___ Spacing: Length: Spacing:
Watts; Type Fastener: _
Roof: Type FastenLength: spacing;
For used homes a min 30 gauge, 8"wide, galvanized me-- to p will be centered over the peak of the roof and fastened with galv.
roofing nails at2" on center on both sides ofthe centerline.
Gasket woat horproating roqutreinemj
I understand a properly instailed gasketis a requirementofall newand used
homes and that condensation, mold, meldew and buckled marriage walls are
a resultofe poorly installed or no gasket being installed. I understand a strip
of tape will not serve as a gasket.
Installer's initials
Type gasket _ Installed:
Pg. Between Floors Yes _
Between Walls Yes
Bottom ofridgebeam—Yes "--'-
---mat erproo mp �"-'
The bottomboard will be repaired and/or taped, Yes _,.,_! pg, --
Siding ce units is installed to manufacturer's specifications Yes' Fireplace chimney installed so as notto allow intrusion of rain water. Yes.
--' rice aneous ---
Skirting to be Installed. Yes
Dryer vent installed outsideofskirting. Yes —y N/A �p�t Range downflow vent Installed outside ofskint ng. Yes — ,%-' N/A ■ Drain Imes supported at 4 foot intervals. Ye --�
Electrical crossovers protected. Yes Other:
!r verifies all information given with this permit work Z
is accurate and true based on the
Installer Signature
or Ku Is ISC-1 &
Date