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P - 83521.� :. Park Name: �'"� %� l O �� . ;� . _ � � . .� �� , �, � City of Fridley :� Manufactured Home/ Accessory Installation Permit Application � �.� � Job Site Address: ! 46s S6 . C t 2c.%..- %V• E Zip .55 y3� Project Valuation: $ (�� (�Q .� c;, Applicant Is: ❑ Owner and Occupant �Contractor must include material and labor costs Pro e Owner Name �';�}( .. ,i¢ J'yj Address_�i�ap °7-,�,Cn�t. ST M�- Unit # City �,Z+pG�y � i�•v State � Zip 55Y Phone Contractor Name �2 i T'�, ��. 1��N � Installer's Name �f � r'fiZ Address�'7�(, f� ��.� � � City � q� T E�ZTe w��.i State �Y1I1� Zip �� Phone ,� �. License # /y1,� �� 'S" Email Pro er Use T e of Structure T e of Work FEES � Residential � Principal Bldg � New Bldg Permit Fee: 100.00 ❑ Commercial ❑ Accessory Bldg ❑ Existing Bldg State Surcharge: 5.00 ❑ Industrial ❑ Repair / Replace ❑ Institutional Other TOTAL DUE: 105.00 ❑ Public T es of Homes s(check all that a ly) Single Wide ❑ Double Wide'�, Additional Yermits Are Required For Electrical, Plumbing (sewer & water), and Mechanical (gas) REQUIRED ITEMS TO BE SUBMITTED WITH APPLICATION: Accurate Site plan: Note Setbacks Soils report: a minimum of 2 engineered soil bearing capacity tests Manufacturer's anchoring specifications Home and Site specific Check if items are included I hereby apply for a manufactured home installation permit and I acknowledge that the information above is complete and accwate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. ��'L'''` ��-�� Permit # (� � Updated 7/1/10 Entered Print Si�nature: � � A! �i'"f 2 For Office Use Only Date _: y �%—/'Z , ��ro A �� n � �� MANUFACTURED HOME: Brand Name: f}DUFNTU7��- Model Name: �iOV ��E. 4s�� Serial Number: 'fi' 6 p Date of Manufacturer: � p 1� Construction Label Numbers: HUD Code 06/14/76 and newer, State Code 7/Ol/72 to 06/14/76, Pre-code prior to 07/Ol/72 Roof Load Zone: ?s p 1 b, Heating/Cooling Zone: ' INSPECTION: Installation• Seals/Certificates# "'�'" 1� {J Anchoring# (Anchoring may be required by Municipal Ordinance park rule for pre code and State Code homes. Anchoring is required for HUD Code homes.) Instructions Used: Manufacturers k State Chapter 1350 (Homes constructed after June 14,1976, requires manufacturer's instructions be used.) Foundation to State Buildin� Cod YES or NO (circle one) (May be required by manufacturer's instructions in a park set or by code adoption or zoning ordinance in a private property set.) Foundation Tvae: Piers below frost depth: �(Q� Crawl space: Full depth basement (treated wood, concrete block, poured concrete or toher) Engineered slab on grade (signed approval by Dapia or MN Engineer) Support Footin�s: Type: C b N G 12 GT E— Size: �� 6 V+v� Soil Conditioas: ��Sb� PSF Pier Material: C D N G 2�T� Pier Snacin�: � Feet _� Inches in center (calculations should be submitted for review prior to inspection.) Shims: Material Used: ,�,¢({ p�Oo� Size: �/ °�(' (� �' (minimum 4" x 6" hardwood) Clothes Dryer vented to outside crawlspace or skirted area ES r NO (circle one) Material Used: Fresh Air intakes to outside crawispace or skirted area: (if required for fireplace or furnace or water heater) YES or NO (circle one) Anchoring Equipment (If applicable): Anchors Used: (manufacturer's model numbers) X( �i S�j S"fc v►h Soil test Probe Torque Value inch uounds Conditions of Issuance ,�'� st�F�� 4� b s-r � e rr s� Se+- v p sk�2fi , 9AS �- �r��f�r�'� Updated 7/Ol/2010 uired Add Delete ❑ ❑ Consultation ❑ ❑ Final ❑ ❑ Plan Review ❑ ❑ Trench tion of Work to be a,"'c- r Pn�`t 9 City of Fridley 6431 University Ave NE * Fridley, MN 55432 Phone 763-572-3604 * Fax 763-502-4977 � � co�c S�feps z 0 H U O � 2 U Z Q J Z C� � H- � Z O DOUBLE-WIDE ANCHORING PLAN (TYPICAL) '- " MAXIMUM END ANCHOR SPACING ALLOWED REQUIRED DIMENSIONS � •-�-�-�-•-•-•-•-�-•-•-•-•---�-�---•-•-�-•-�-•-•-•-•-•-•-•-•-•-•-•-•---�-•-•-•-• •- Z -•-•-•-.-.: -•- � - U . °' � � � �: � � �•�"� �'n N y� � •-•-�-�---�-�-�--- �-�-�-�-�-•-�-�-�-�-�-�-•-�-�-�-•-•-•-�-�-�-�-�-•---�---� -- W -�-�-�-•-•-�-�- MATE LINE ANCHOR LOCATIONS m REQUIRED DIMENSIONS I� > _ >, �I� �� ' "- MAXIMUM END ANCHOR SPACING ALLOWED REQUIRED DIMENSION ORIENTATION MAXIMUM INTERMEDIATE ANCHOR SPACING ALLOWED REQUIRED DIMENSION � "- MAXIMUM END ANCHOR SPACING ALLOWED REQUIRED DIMENSION MANUFACTURER INFORMATION Name ��V��`'«. �!�.....- Home Size � `� � +L� Maximum I-Beam Spacing � :� Maximum Anchor Spacing ��t SOIL INFORMATION Classification No. .�.�� -r �n�� Soil Bearing Capacity �7�"� (�� ANCHORING INFORMATION Ext. Wall Height � + Roof Pitch � � � Z�. Height From Ground to Frame Connection ��s5 ''%'�'�- �� `� � ► z 0 � U O � _ Z Q � Z G � H C9 Z O J ANCHORING INFORMATION Cont. Anchor Manufacturer `i�+� r�� r.�� Lateral Anchors Req'd ��I�r NO Anchor P.N. � �� a �'"7 Connector P.N. �" �c� � � Lonctitudinal Anchors Req'd �r NO Anchor P.N. �' � � l �r Connector P.N. S� � � � �+ No. Per End Mate Line Lateral Anchors Req'd Anchor P.N. Connector P.N. YES or(�' * P.N. = Part or Product Number G:/BCS/WORD/ms/CCLD Installation Permit Application PackeUSupport-Anchoring Plans 04-02-09 DOUBLE-WIDE SUPPORT PIER PLAN (TYPICA�) i$ ' � s�.� « � � PERIMETER PIER SUPPORT @ OPENINGS REQUIRED DIMENSIONS � ._._._._._ ._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._. ._Z_._._._._ I��—� - �� ,�. _� ° C� f- � a � I-BEAM PIER LOCATIONS � g REQUIRED DIMENSIONS Q �- -�-•-�---�-�-�-�-�-•-�-�-�-�-�-�-�-�-�-�-•-•-�-�-�-•-�-�-�-�-•-�-�-•-�-�-•-�-� �- W -�-�-•-�- �' �_" - MAXIMUM END PIER SPACING ALLOWED m REQUIRED DIMENSION — �---f� ' � ' _I_ _I�_ � ORIENTATION MATE LINE PIER LOCATIONS REQUIRED DIMENSIONS �- ' O "- MAXIMUM END PIER SPACiNG ALLOWED REQUIRED DIMENSION MANUFACTURER INFORMATION Name � uvf�'�°fi��tQ � Home Size ,� Y � �� ' Maximum I-Beam Spacing $ � Door Openings �te 5 I-Beam Loading PLF (� �a f�, Maximum End Support (I-Beam) 2' Ground Moisture Control y� Yes No Mate Line Loads � $�� ti Grading to Slope AWAY From Home �� S � �` . �zw �O=iC� J W 0 � I �' � w W � 0 J J Q Q ¢ a ¢ �� X X X Q Q Q � � � SOIL INFORMATION Classification No. �""'e � ��Pr"�` Soil Bearing Capacity �S�c�. � I� FOOTING INFORMATION I-Beam � g '` � � x �� Mate Line �� x Q6�,,,SZ.- x�{a " G:/BCS/WORD/ms/CCLD Installation Perrnit Application PackeUSupport-Anchoring Plans 04-02-09 FROST DEPTH PIER SECTION VIEW ^"';DBOARD FORMINr �"�� DEPTH "BELOW" GRADE SOIL CLASSIFICATION Nd� G�� SOIL BEARING CAPACITY �.��a_ PSF FOOTING AREA �`�3'� SQ. IN. SOILS TOTAL LOAD CAPACITY �Sd� �b. PSI CONCRETE �s�' ALTERNATE "BELLED" FOOTING �I „ G:/BCS/WORD/ms/CCLD Installation Permit Application PackeUBelow Frost and Frame Pier Sedion Drawings 04-02-09 :� FRAME PIER SECTION VIEW TOTAL HEIGHT �� 0 » �� /� �� _ FRAME HEIGHT U� � f--�' HARDWOOD SHIM 'IER HEIGHT FOUNDATION TYPE « �'� -��pWut9lp (TwL�lc�� CAP MATE IAL C� N � �2 eT�.- �— BLOCK TYPE �-- - _ _ �_ _ G:/BCS/WORD/ms/CCLD Installation Permit Application Packe�elow Frost and Frame Pier Section Drawings 04-02-09 � � � h'� wi �''>.'r,� s R'�`�'#.r �+ 'h �,�' .� `�(, 1 f�i�j i � «1'i{ f � �� +_ 4 ( , . j' i' �Ji� .T K�A,+�� *' x� iC�4 1�A � � f N A^�'�Ga��a��l k1,� ��i� �� °{� n , �. t �L 4` �4 h�f rViFr �:� r ,. , ' ' n t � f,�F' , , �„ 1 � �, �s � �ik�La,: e � � �"`��.�� . x'�'� � � �f tf � I ,� .. y - �i� � rx�} i' . . , � �{, y � �, t—�" t rn� ,' . , 4 7 �' � - .. i O . 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