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Home My WebLink AboutPERMIT WORKSHEET' .: .: PERMIT NUMBER ... ...... .. / �• �- Installer /�� s� pFi S/I/�C.�i� license # L /r o 0o 0 V_Lr Address of home 7 O O A-C- C C'4_- (fZ c••-` v 7' being installed yr� Manufacturer Length xwidth lux6b NOTE. If 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 Arts Systems cannot be used on any home (new or used) where the sidawall ties exceed 5 it 4 in, Q t� Installer's initials Typical pier spacing/ n 'r -f :: I lalerd 6, i n d ke W t dl'P Sfiow locatio�s of Longitudinal and Lateral Systems (use dark line s to show these locations) ■ ■ ■ ■ ■ ■ ■ ■ L7. ■ ti ■ I ti fi _ �■■■i■■i■■■■i■i■ii■■■■iii■■■■■■■■■■■■■ ■■■i■■ii■■■■iiii■■■■■■■■■i■i■i■i■■■■i �■■■i■■■■i■i■■■■■■■■ii■■i■■i■i■iiii■■ r■iiii■■■■■■■■i■■i■■■i■■■■■■■■■■■■■■■ r■iiiii■■■■■■■■i■■ii■ii■ii■■■■■i■iii■ r■■■■■iiiii■■■ii■■■■■■■i■■ ■■■■■■■ii■ rii■■ii■■■■■■iiiii■iiiiiiiii■■■■■■■n■ p PERMIT WORKSHEET I page 1'of 2 New Home ❑ Used Home SCANNED Home installed to the Manufacturer's Installation Manual 03Y Home Is installed in accord nce with Rule 15-0 St. ,1� le/C''oUnf Single wide Wind Zone II ❑ Wind Zone III LS' Double wide ❑ Installation Decal # 0 3 33 C( Triple/Quad ❑ Serial # G f4 F4l(3VII 27s�I';1TAW PIER SPACING TABLE FOR USED HOMES Load beadng capaci Footer size In) 16' x 16' (266) 18 112' X 18 1/2' (342) 20' x 20" (400) 22' x 22 (464)' 24' X 24' (676)' 26' x 26' (676) 0 s 2000 vsf 2500 psf8 3 00 s 8 s 8 mlerpoia[ec rrom nine ibui pier spacing mole. PIER PAD SRES � I-beam pier pad size Perimeter pier pad size !7 `r 22. v Other pier pad sizes l7fix ;X e' (required by the mip.) ®Draw the approximate locations of marriage wall openings 4 foot or greater. Use this symbol to show the piers. List all marriage wall openings greater than 4 foot and.their pier pad sizes below. Opening Pier pad size Longitudinal Stabilizing Device (LSD) Manufacturer in Longitudinal Stabilizing Device w/Lateral Arms Manufacturer POPULAR PAD SIZES ANCHORS 4 it 5 it _JC FRAM E TIES within Vol end of home spaced at 5' 4" oo OTHER TIES u bar Sldewall Longitudinal Marriage wall Shearwall N Fly, \ L A[ r I i� �UcsS,l PERMIT WORKSHEET page 2 of 2 PERMIT NUMBER'. POCKET PEN TRO ETEfl S The pocket penetrometer tests are rounded n to psf or check here to declare 1000 lb. soil � without testing. X_ X_ X_ POCKET PENETROMETER TESTING METHOD 1. Test the perimeter of the home at 6 locations. 2. Take the reading at the depth of the tooter. 3. Using 500 lb. increments, take the lowest reading and round down to that increment. TORQUE PROS ES The results of the torque probe test Is a!2,0 Inch pounds 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 at the sidewall locations. I understand 5 ft anchors are required at all centerline tie polntp where the torque test reading is 275 or less and whe the mobile home manufacturer may requires anchors with 4 OD (ding capacity. Installers initials ALL TESTS MUS BE PERFORMED BY A LICENSE D INSTALLER Installer Name `SA A�J h AFC--N/ Date Tested 9�- Electrical :bnnect electrical conductors between multi -wide units, but not to the main power ource. This Includes the bonding wire between mull -wide nits. p41. Debris and organic material PT Water drainage: Natural bT Swa Other Fastening multi wide Units Floor. Type Fastener. Length: Spacing: Walls: Type Fastener. Length: Spacing: Roof; Type Fastener. Length: Spacing: For used homes a min. 30 gauge, a"Wide, galvanized m al strip will be centered ver the peak of the roof and fastened with galv. roofing nails at 2" on center on both sides of the centerline. Gasket (w""iheryro"Iing rwuir"mme I understand a properly Installed gasket Is a requirement of all new and used homes and that condensation, mold, meldew and buckled marriage walls are a result of a poorly installed or no gasket being installed. I under nd a strip of tape will not serve as a gasket. r Installer's initials L� Type gasket Installed: Pg, Between Floors Yes Between Walls Yes Bottom of ridgsbsam Yes � Weather rooan The bottomb card will be repaired and/or taped. Yes Pg. Siding on units is installed to manufacturer's specifications. Yes Fireplace chimney installed so as not to allow intrusion of rain water. Yes Miscellaneous Skirting to be installed. Yes v No Dryer vent installed outside df skirting. Yes WA Range downflow vent installed'outside of skirting. Yes, WA _{G Drain lines supported at 4 foot Intervals. Yes L- ' Electrical crossovers protected. Yes �- Other; all information given with this pc Is accurate and true based on the onnect all sewer drains to an existing sewer tap or septic tank. Pg. I manufacturer's Installation Instrucl onnect all potable water supply piping to an water meter, water lap, or other Installer Signature (dependent water supply systems. Pg. SO Sam VV I L %tzvopy Date C��/