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w � .:� �, C . <br /> i '* ' <br /> � PERMIT WOIZKSHEET ,page�z of z � <br /> PERMIT NUMBER .� <br /> - - , <br /> POG P ER T S Slto Preparntlon <br /> The pocket penetrometer.tests are rounded down toa�� sf Debrts and organlc material removed;�� - <br /> or check her�to declare 1000 lb.soll without e'stt ing. p Wat�r drainage:Natural Savale Pad„�,_Other • <br /> X�� X� • X� FasEanln mul v�de un ts: • <br /> �-" �loor. TypeF.astenar, � S Length; • `J� Spacing; '� <br /> POCKET PENEfROMETER TEST(NO METHOD w���s� 7Ype Fastener. Length:" Spacing: � <br /> Roof. Typa Fastener. � . Length:_ r' Spacin�: 1 �� <br /> 1, Test the perimeter of the home at e locations. For used ttomea a m 30 gauge,8" de;g�iyanlzed'metal strip 4 <br /> wllf 6e cenfered over the peak aP fhe roof and fasfaned=wlth galv, <br /> 2. 7ake the readfltg at the depth of the foofer. <br /> roofing na11a at 2"on cenfer on both sides of the centerllne, <br /> � ' 3. Ustng 6001b.Inorements,take the loWest Q�*k�t tw.atherprootrna rvdulr.mmtl • <br /> readtng and round down to thaf increment � I underetand a properiy fnetalled gaekeE fs a requlrem�nt of all new and used • <br /> � - -- homes and thaE cohdensatton,tr�id,meldew and buckled matiiage walls are <br /> a result oi a poody Ihstalled•or no gesket bethg inst�lled. I undetstahd_a strlp <br /> X,�� X„� X� of tepe wIA not sery�e as a gasket. ��5 <br /> ��; Installer's Initlats '�&. � <br /> • O P OB S •s �� <br /> The results of the torque probe test Is,�(�Inch pounds or check p�e gasket_ Installed: • � ' <br /> here tf you at�deciaring 6'anchore Wlthout testlhg . A test Between Floors Yes �C' � <br /> showing 278 Ihch pounds or less wlll reqttin�'foot an� ors. � •Batween.Walfs Yes_ X <br /> Bottom of rldgebeam es <br /> Note: A state approVed later�l erm sysEem fs being uaed and 4 ft. ' :,� ���-, ;�� <br /> anahors are allowed at the sldewall IocaHohs. I understand 6 ft � p � WOatho rootin ,_: r <br /> anchors are reqUlred at all centetilne tle potnts where the torque test -. - ' <br /> reading Is 278 or less and where the mobile home mahufacturer may The bottomboard v�;be repa(red and/or t�ped:�Yes � �� � ° <br /> re'uires anchors with 4000 tn ca acl,�, �'-� ` . P g, ' <br /> a 9 p �Y S l d i►ig.o n u n i t s i s I n s t a l(e d to mah u fsc fure r's spectflca ions. ' es,,,�_ - <br /> , ---�_, Installer's tnit(ala Firep lace oh(mney Installed so as not to allow in6us(on of raln water. Yes <br /> ALL 7ESTS MUS7 BE PERFOltM�D BY A LICENSED INSTALL�R Mlscel nn�oua <br /> Installer Name • Sklrting to be.Installed. Ye$�No <br /> D�te Tesfed � . Dryervent Instal(ed outslde of s in�. Ye`s���(/A <br /> . Range ilownflow vent insfailed outatde of ek rtlT ng;Yes_�"N/q <br /> Draln Ildes supporEed at°4 fioot littervals, Ye§ <br /> c� aEleidtrlcal ct�ossovers protected. Yes,,�_�' �` <br /> leafrlcal �t�' , � <br /> . �-: <br /> , Connect electrlcal conducfors be�ween muiti-wide uqit�,but not to the main power � " <br /> source. Thls includes the bonding w1re between mult-wide unffs. pg. "` , <br /> �� . InsEaller�verltles a[!tnformatton.glven�wtth this permtt worksheet • � <br /> _ . _ umb ng , Is accvrate and true b�sed on the I' <br /> � connect all sewer draina to an existing sewer tap orseptic.tank. Pg. manufacturer's installation fnstructlons and or i�ule 15C�1'&2 ', <br /> Connect all potable water supply piping to an exisfing water mater,water tap,or other Installer Signatu Rate��17 , I <br /> . Independent water supply e�ystems. pg. <br />