HomeMy WebLinkAboutPERMIT WORKSHEET'PERMIT` NUMBER � TIN; `+.: . � �, 's
Installer 10.4 '� /111 c" L G,.r ✓ License
Address of home / 2 / C W-.,' — --t %" _71
ieing Installed Y 4 s4 a
Vtanufacf urer Length x width c� % X 2 y
NOT* ' 11 home Is a single wide 1111 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 or ad)
where the sidewall ties exceed 6 it 41n,
Installer's initials
'yplcel pier spact�A �
.,i1 A,,ice/ 1 taLat
Show locations of Longltudinal and Lateral Systems
,(use dark lines to show these locations),
SCANNED
PERMIT WORKSHEET ' BY page 1 of 2
St. Lucie Cou
New Home . (] Used Home Q ----
Home Installed to the Manufacturer's Installation Manual ❑
Home is Installed In accordance with Rule 16.0
Single wide ❑ Wind Zone II Win one III ❑
Double wide M_ ^ installatlon Decal #
Trlplarpuad ❑ Serial #112
r^ L• 1$'S'p c`�f �t
PIER SPACING TABLE FOR USED HOMES
EFooter16'x76' 1a t/2'xie l/2' 20'x20' 22'x22rsize 24•xZ4' 26'x26.
(sq ttl) (26� (a42) (4oe) (484)' (676)' (676)
I-beam pier pad size
Perimeter pier pad size
Other pier pad sizes
(required by the mfg.)
1> "5C2jy4'
®Draw the approximate locations of marriage
wall openings 4 toot orgreater. Use this
symbol to show the piers,
List all marriage wall openlrigs greater than 4 foot
and.thelr pier pad sizes below.
v
Opening Pier pad:slze
TIE OWN COMPONENTS
Longitudinal Stablgzing Device fLSD)
Manufacturer in .. ✓"'4
Longitudinal Stablltzinyq Device w/Lateral Arms
Manufacturer ""'' . n .•� Y� A"Ylp :.,
PO2 c ce o ii' EI
ANCHCRs
4 it /�5 fl
FRAME TIES
within 2' of end of home
spaced at 6' 4' oo
.OTHER TIES
Sldewal( N bar
Longitudinal
Marriage wall
Shsaiwall
PERMIT NUMBER
•r ,
OC ET O ER ES
The
or check heroket e oedeclare tt p � arerounded d��out testing, pat
X X_ X_
POCKET PENETROMETER TESTING METHOD
I. Test the perimeter of the horns at 5 locations.
2. Take the reading at the depth of the•footer.
S. Using 500 lb, increments, take the Icwest
reading and round down to that increment
X_ XX__
ORQUE PROBE EST .
The results of the torque probe lest is / ` Inch pound or check
here If You are declaring 5' anchors without 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 ft.
.anchors are allowed at1he sldewall locations. I understand 5 ft
anchors are required at all centerline tie points where the torque test
reading Is 275 or less and where the mobile Ijome manufacturer may
requires anchors wARFORMED
0 lb holding capacity.
Installers Initials
ALL TESTS MUST B BY A LICENSED INSTALLER
Installer Name — '% L d l' Z. '/'A'
DaleTWed /J'ec G y e, / f'
Electr os
Ibnnecl electrical conductors between multi -wide units, but not to the main power
ourca Thls•nplude§ the bonding wire between must wide units. Pg.
onneot all sewer drains to an mdsting sewer tap or septic tank Pp.
onnect all potable water supply piping to an existing water meter, water tap, or other
rdependerit water supply systems. Pg.
PERMIT WORKSHEET page 2 of 2
Site Prepersllon
Debris and orpanlo materlal remoyod
Water drainage: Natural ✓S`wale Pad Other
eaten n mu d Wlda un is
Floor. Type Fastener. Length: " Spacing:
Walls: Type Fastener. Length: �r "T.
Roof: Type Fastener. L Length: spacing ��
p r e' Syacfnp: !�
For.used homes a min. S0 gauge, 8' wide, galvanized metal strip
will be centered over the beak of thercof and fastened with gals.
roofing nails at 2° on center on both sides of the centerline.
Basket �Ih. reelin Ir.m.M
I understand a property Installed gasket Is a requirement of all new and used
omes otpoHstonaktbwand buckled wallsare result f aoInstalled o gsete being installedI understand a strip
Of tape will not serve as a gasket
Installer's inftlal
Type gasket Installed:
Pg. Between Floors Yes
Between Walls Yes e--
Bottom o1 rldgebeam Yes _—
Bather roc n
The bottomboard will be repaired and/or taped, Yes Pg,
7
Siding on units Is Installed to manufacturer's specliloatlons. Yes _
Fireplace chimney Installed so as not to allow Intrusion of ran water, Yes -&A
Skirting to be Installed. Yes " No
Dryer vent Installed outside R skirting. Yes WA `!
Rance dowirllow vent installed' outside of skirting Y WA
Drain lines supported at 4 foot intervals, Yes
Electrical crossovers protected. Yss _( i'
Other:
Installer verifies aU information given with this permlt warksheat
Is accurate and true based on the
manufacturer's Insta atl n nstrvc ins and or• Rule ISO•t & 2
Installer Slgnatu Dat —�9
t