HomeMy WebLinkAboutPERMIT WORKSHEET: S
a'-
'° " PERMIT N
Installer
W A§ jress of home _� D� /" 69-1) 0
V nt7 installed 3
OC Per3- SA,A4- w �, - r=L '/9 r2 . .
O Q t§ufacfurer S� Length x width
LL.
J ®D -if home is a single wide fill out one hall of the blocking plan
Q. L) V irhonie Ise triple or quad wide sketch in !remainder of home
0 Ian�t and Laleral Arm Systems bannot be used on any home (new or u ed)
® vehe;Ahe sidewall ties exceed 5 ft 4 in,
V�qq Installer's tnitfals
SCANNED
PERMIT WORKSHEET St�UC @ ,' Page 1 of 2
New Home . ❑ Used Home
Home installed to the Manufacturer's Installation Manual ❑
Home is Installed in accordance with Rule 15-C ❑ ,
Single wide /n find Zone II )j�7 Wind Zone III ❑
Double wide ' Installation Decal # 3l0 \L B
Triple(Quad ' ❑ Serial # r-Z 4 X11 5 P'31 Z —3 07 ,b % A A
PiER SPACING TABLE FOR USED HOMES
Load Faze
a a city size
capaolty (aq In)
16'x16' 16112'x 1a 1123 201x20'
(266 342 )
) ( ) (400
22x22' 24'X24'
(4e4)• (676)'
26'x26-
(676)
100DDst
3
00 PST
4 6 6
g
OOD
s
6 B 8
25
One
6 8 6
B
3000
s
8 B
3
0
8' B
.0 =.y..�a.w u u nwv iav � piw apacu�p wum.
PIER PAD SIZES �
I-beam pier pad size 17r c Z- -
Perimeter pier pad size ZZ
Other pier pad sizes
(required by the mfg.)
®Draw the approximate locations of marriage
wall openings 4 foot or greater. Use this
symbol to show the piers,
Ust all marriage wall epenirigs greater than 4 foot
and.thelr pier pad sizes below.
Opening Pier pad:size
k
POPULAR PADSIZES
ANC ORS
4 it 5 it
FRAME TIES
Within 2' of end of hona e
spaced at 54" oo,�
TIEDOWN COMPO—NE—N—TS—1 I OTHERT1Es
Number
Longlrudlnal Stabilizing Device &SD) Sidewall
Manufacturer S$ Longitudinal
Longitudinal Stabl, Devles was/ !era! Arms Marrlage wall '
Manufacturer_h�ttA7+ Shearwall
° :PERMIT NUMBER
' POCKET'PENETROMETERIES
•
The pocket penetrometertests are round n to psi
or hereto declare
V
check 1 DOD lb, soil without testing.
X__ X_. X_®
Q
U.
J
NETROMETER TESTING METHOD
a
imeter of the home at 5 locations,
FTakethe
LLI
ding at the depth of thefooter;
Ul
• increments, take the lowest
LLB
round down to that Increment.
Q
X_ X_-' X_
V
TORO E PROBE TEST
The results of the torque probe test Is CD 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 It.
.anchors are allowed at the sidewall locations. I understand 5 ft
anchors are required at all centerline tie points where the torque test
reading Is 276 or less and where the mobile home manufacturer may
requires anchors with 4000 Ib holding capacity,
Installer's Initials
ALL TESTS MUST BE PERFORMED BY A/L�ICENSED INSTALLER
Installer Name
Dale Tested _��� f S 1
Electr cal
:bnnect elecldoal conductors between multi -wide units, but not to the main power
Durce. This•includes the bonding wire between mult-wide units. Pg,
Plembinc iw//, 0 ..7
onneot all sewer drains to an existing sewer tap or septic tank Pg, l�
onnect all potable water supply piping to an axis np water meter, water tap, or other
(dependent water supply systems, pp,
PERMIT WORKSHEET page 2012
Site Preparallon
Debris and organic) material� reeed
Water drainage: Natural_�_Swale Pad Other_,
Fastenlng multi wide units
Floor. Type Fastener: Length: rr Spacing: 7y it -
Walls Type Fastener. Length: Spacing:
Roof: Type Fastener. _gam Length: Spacing: v r4 i
For.used hornes a min. 80 gauge, 8.1 wi e, galvanized metal strip
will be centered over the peak of the roof and fastened With paly.
roofing nails at 2a on canter on both sides of the centerline.
GesKet fwmrhemieefrarop Iremantl
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 ofa poorly installed or eL gasket being Installed. I nderstand a strip
of tape will
r l not see as a gasket,
Installer's Initials
Type gasket — Installed:
Pg. Between Floors Yes
Between Walls Yes �—
Bottom of ridpebeam
The bottomboard will be repalred and/or taped. Yes C/ pg,
Siding on units Is Installed to manufacturer's specifloallons. Yes Fireplace �—
chimney Installed so as not to allow intrusion of rain water, Yes �lriJ
Mlscalianeous
Skirting to be Installed. Yes C__ No _
Dryer vent Installed outside of skirting• Yes ✓ WA
Range downflow vent installed'outslde of skirting• Y WA
Drain lines supported at 4 foot intervals. Yes t�s '
Electrical crossovers protected. Yes
Other:
Is accurate and true based on the
Installer Signature
Data �'Z� ).di9