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-PkRAVNUMBER.
Installer
Address of hone
being Installed
. Llcaltse# ,��� 1. 2
ManutaolDrer `1Y\�C`.� Lang%xWldfh Lo`OxV k
HOT.•Jfhome1saslrlglewideMIWAonehaffafthe bloaNngplan
Jf horde fsa triple rrt r,*Ifadwlde sketch to remainder of home
understand Lateral gem Sys of 6e used on any home (stew or used}
where iFfe sldewall tlets excaja4 I D, ^ n�
InstatLet'stnlHals
PER(OIIT WOVASHEEP
Now Home j f] Used Fl me B
Home installed to the Menu{actutafs Inelallatla Manual
Lucfe
Home is Installed to a anon wllh Rule 15.0
Single wide Wind Tone II �Wlnd Zone Ill
Double We ' Q Installation Decal 0 S Co\kA
TripletQuad j] Serial 0L Iylk 21n2n
PIER SPAdNa TABLE FOR USED HOMES
1012
Load I Footer
capul ' (sy In).
fe'x16'
(mot
181f2'xl'8M'
(442t
2e'x2V
(aoo)
22'x221
(<sa}'
WX24'
(c+e)
2_,,;J
(sre)
e uD
4
S
8
20DO
B
'
300 EST
trZftluu
B
PST
B-'
InIWPdaIW TrOM He19 ibG1 Pier sPWLM tents.
PIERPADSLZES ,t
I-beam pier pad site
Perimeter pier pad size 4iXSla
Other pier pad sizes tit )(A.1
(reaulred by the mtg.)
[0]Draw the appraftate locations of matdage
wall openinnc 4 tooter greater. Use this
symbol to show the plem.
11st all marriage wall aperttnps greater than 4 foot
andthelr pier pad sizes below.
OpenlnA Pier pad:size
11i,x ��
4 ft
�• to
%Vmin Z of enq ai hom
1 X
spaced atW41 oo�
TIEDOWN COMPONWM
OTHEAITIESt
tlmbar
Lertglrrrdlnal Sla WnaWevJee (LSD)
SYdewall l,�
Manufacturer \ eAn
Longlolinal
L.onyltudlnefStehffldviceWLatereIAMI
Marriage wall
Manufacturer A\' aiTi�'
Shearwall
•V .I L
PERMITNUMBER
POCKET PENETMUFME_�
The pboket penetrometer tests are rounds own to par
or check hereto declare I OOD lb. Soli "Mou! testing,
)t_ X� X_�
POCKET PENETROMETER TESTING MEMOD
t. Test the por[meler of the horhe at 6 locations
2. Take the reading at the depth of the fboter.
& Uaina SDti lb. IneremaMa, teke the lowest
reading and round down to that Increment
rD E Ito TEST
The results of the torque probe lest Is Inch pounds or check
here If You are declaring 5 anchors w ilhoul testlnR - - A test
showing 275 ID* porstds ar less WE! requlra 6 fool anchors,
Note: A state approved lateral arm system rs boing used and 4 &
.Unchors are allowed atlhe sidewali locations. 1 understand 5 ff
anchors are required at all cerderilne Ile poinip where the torque test
readEna Is 275or lass and where tha nrtoblle home manufacturer may
requlras anchors with 40 �I �+ qIdkrg aapacilY.
- Installer's Initials
ALL TESTS MUS BE PERFo aY A LICENSED INSTALLER
Installer Name
Dale Tested
. � Fiecit cat
obhnQct electrical conductors beiwom mulll-wide units, bul not to the main power
auroe This Ncludes the bonding wire between mullrwfdo units, Pa.
onneot alf sawar drains to an edsting sewer tap orsepffo tank Pg.
onnecl all potable walersupply piping to an EDUUng water meter, water tap, or other
rdepandogt vvaler supply systems. pg.
PERMIT WORKSHEET
Debris and organlc material
Water drainage: Natural ._4
Page 2
Floor. Type Fastener. 94 Leng01' Sp g
Walls TYFa Fastener �_ Latpth Sp Tno: a
Hoof: Type Fastener: &— Langlb: tang: _`a "
Forused homes amin. 30 Aeolis e^ Hdde, r,,Iva�ked mQtal3
VAIi be centered 'over the peak of thetcof and fastened V— - r
roofing nails at Zn on center on both of of the da 1 1
1 Understand a propedy Installed gasket Is a requirement of
homes and that condensation, mold, meldew and buckled p
a result of a poorly Installed or no gasket being Installed 1 i
of laps will not serve as a gasket.
Installe'a inftrals _)6-
Tvsaasket UMV►' Installed:
Pg. Between Scors Yes
Between Walls Yes
Bottom of ridgabeam
The boitombcard will be repalred andror tapes
Sldlnn on units Is Installed to mamdacturv?s e
Fireplace chimney Installed so as not to allow
Sklding to be Installed. Yes �_ No
Dryerverlt Installed oots]de of striding. Y
Ramie downllowverl Instailed'outslde of
Drdln lines supported at 4lobt intervals,
Electrical crossovers protected Yes L
Other:
Installer
Is accurate and true Based on