Loading...
2007-581 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number. P20070581 Date Issued: Tuesday, February 24, 2009 This is to certify that work requested to be done as shown by Permit Number P20070581 has been completed. Location: 4 LUPINE Ln Tax Map Number. 523400-309-005-0001-033-000-0000 Owner. JOAN VAN GARDEREN Applicant: JOAN VAN GARDEREN This structure may be occupied as a: Residential Addition By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the r i property owner of the responsibility for compliance with Site Plan, ij t Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20070581 Application Number. 'A20070581 Tax Map No: 523400-309-005-0001-033-000-0000 Permission is hereby granted to: JOAN VAN GARDEREN For property located at: 4 LUPINE Ln in the Town of Queensbury,to construct or place at the above location in accordance with application together with plot plans and o information hereto filed and approved and in compliance with the NYS Uniform Building Codes and t eensbury Zoning Ordinance. Type of Construction Value Owner Address: JOA AN GARDEREN ' 4 PINE n j siderditlen $19,000.00 UEENS RY,NY 12804-0000 i T t ate $19,000.00 0 Contractor oiZ er's Name,/Addres 4 lectrical Inspection Agency •, f,, f i j Plans &Specifications 2007-581 144 SQ FT RESIDENTIAL ADDITION $75.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday, October 10, 2009 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the Tc, m ee r� zr�� y, October 10, 2007 4 SIGNED$Y for the Town of Queensbury. Director of Building&Code Enforcement TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20070581 Application Number. A20070581 Tax Map No: 523400-309-005-0001-033-000-0000 Permission is hereby granted to: JOAN VAN GARDEREN For property located at: 4 LUPINE Ln in the Town of Queensbury,to construct or place at the above location in accordance with application together with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Type of Construction Value Owner Address: JOAN VAN GARDEREN 4 LUPINE Ln Residential Addition $19,000.00 QUEENSBURY,NY 12804-0000 Total Value $19,000.00 Contractor or Builders Name/Address Electrical Inspection Agency Plans &Specifications 2007-581 144 SQ FT RESIDENTIAL ADDITION $75.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday, October 10,2008 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the To Queens ry; a '!.s4py, October 10,2007 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement own of Queensbury • 742 Bay Road - Queensbury, New York ■12804 ; David Hatin,Director of Building&Codes ; Crwig Brown,Zoning Administrator s. , WINDOW SCHEDULE ' JOB SITE/ADDRESS: DATE: OWNER: APPLICATION NO.: cZ' -7— UNIT OR CLEAR WINDOW WINDOW STOCK ROUGH ROUGH SQ.FT. CLEAR OPENING � NO.OR WINDOW SQ.FT. OPENING SPECIAL HARDWARE OR MANUFACTURER NUMBER OPENING OPENING EGRESS/CLEAR HEIGHT- LETTER MODEL/TYPEVENT WIDTH IN INSTRUCTIONS �\ w ON PLAN NAME CALL WIDTH HEIGHT OPENING INCHES IN uC J SIZE INCHES ^ Ali An do " WDt 2-t,5i W1)H119AII? 0 B 26-LTR 11-05 -- L,ommumty Development Office own of Queensbury • 742 Bay Road • Queensbury, New York •1280410 • David Hatin, Director of Building&Codes 0 0 ..Craig Brown, Zoning Administrator ' BUILDING PERMIT CALCULATION SHEET: Tj NATURAL LIGHT, VENTILATION AND EMERGENCY EGRESS REQUIREMENTS REQUIRED ACTUAL AREA OF ROOM IN LIGHT ACTUAL LIGHT REQUIRED ° VENTILATION SQUARE FOOT HT HABITABLE ROOM SQUARE FEET 8"% GROOM SQUARE VENTILATION-4/° SQUARE OPENING FOR REMARKS AREA FOOTAGE OF ROOM AREA FOOTAGE EGRESS 1 eii,, e QUESTIONS 4 CALL 761-8256 OR EMAIL co.des0hqueensbury.net u�.net VISIT OUR WEBSITE FOR MORE INFORMATION wwwguensbu�-net-net B 10-LTR 11-20 OFFICE USE ONLY 11 0-33 TAX NO. / PERMIT NO. —(2[ sLE FEES: PERMIT. FECREATION ENGINEERING (If applicable) �� 11 2007' PRINCIPAL STRUCTURE: T "WNBUILDING`'&CODES APPLICATION FOR ZONING APPROVAL & BUILDING PERMIT A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID �/PERMIT FOR CONSTRUCTION. NP—n TISI iii DER: ' ��=WA �! 1- ��C � ` s�uNEI✓' �1��ti1 �11.�1 lti�Zl l __ — ------- -ta iuvi� c�c. t ADDRESS: 4 L u Q l (z, L -�i�- ADDRESS:4 L� Q'-1 Q Q, L ao(z, PHONE NOS. q q,�- PHONE NOS. I, �- 2.21242 RRr CONTACT PERSON FOR BUILDING &CODES COMPLIANCE: WRALEIA PHONE: r743-,5-2-q)+ LOCATION OF PROPERTY: �,IA 1156 tit ob ��ILA G1 L>- SUBDIVISION NAME: PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW: CHECK ALL THAT APPLY TO YOUR z 0 L o O d w U-- PROJECT 0 h 0 l 0 = i Q (DU d o � Zz ¢ Q a OL LL (L 0 SINGLE FAMILY TWO-FAMILY MULTI-FAMILY (NO.of UNITS ) TOWNHOUSE BUSINESS OFFICE RETAIL- MERCANTILE FACTORY OR INDUSTRIAL ATTACHED GARAGE(1,2,3) OTHER IF COMMERCIAL OR INDUSTRIAL-NAME OF BUSINESS: ESTIMATED CONSTRU TION COST: I% ()DC) FUEL TYPE: HEAT TYPE: t o� Cti V HOW MANY FIREPLACE(S): U AND/OR WOODSTOVES(S): ZONING CATEGORY: ARE THERE WETLANDS ON THIS SITE? V-1 0 IS THIS A HISTORIC SITE? 4't C PROPOSED USE OF BUILDING OR ADDITION: L %V i VICA Q-V'CA �CAV-Ccvvl. *Please complete a separate Application for"Fuel Burning Appliances&Chimneys"available in our office B 3-LGL I 1-OS It 4, Town of Queensbury - Community Development Office - 742 Bay Road, Queensbury, NY 12804 ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? 0 ARE THERE EASEMENTS ON PROPERTY? i✓ I acknowledge no construction activities shall be commenced prior to issuance of a valid permit. I certify that the application, plans, and supporting materials are a true and complete statement,'description of the work proposed,that all work will be performed in = accordance with the NY State Building Codes, local building laws and ordinances, and in conformance with local zoning regulations. I acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a certificate of occupancy. I also understand that I/we are required to provide an as-built survey by a licensed land surveyor of all newly constructed facilities prior to issuance of a certificate of occupancy. I have read and agree to the above. Signed X 11�,. .j G` y� ��L>> ^w 21 Director of Building & Codes: 761-8256 (for questions regarding Building Permits, construction codes or septic systems) Zoning Administrator: 761-8218 (for questions regarding required permits, the permit process, application requirements or to schedule an appointment) ...................... Permission is hereby granted to the above This application / proposed action described Applicant to erect or alter the building herein is found to be in accordance with the described herein in accordance with said zoning Laws of the Town of Queensbury. Application: 0 ' , 01 , , BUILDING & CODES APPROVAL 0, ZONING APPROVAL 01 01 / / 0 , , DATE DATE 11 , , :........................_-.._........_........_..; :......_...._..__.._.. QUESTIONS? CALL 761-8256 OR EMAIL codesft-queensbury.net Office Use Only VISIT OUR WEBSITE FOR MORE INFORMATION www.gueensbury.net Operating Permit Issued: Yes No Occupancy Type: Construction Classification: Assembly Occupancy Limit: Special Conditions: QTOWn of Queensbury- Community Development Office - 742 Bay Road, Queensbury, NY 12804 r Plmt- Pia q � R -©mot s T. -. -- ----- r 7, aa U!� r W �iS4 0 B" J/ IM�, , { /A �� -.�..... { }ram," ._.-�-: � •.� Poo Pe SLA F Based on our �.�mIc �s�,n _. ... :i compliance w'b ou �,r,ts Ali 0 { N t 0 n not be con `rued as ,il l a",1 he I Mans and s ecifi of cn a re 11 full - ry compliance w'th the&ildir;Go es of New York State. i ` TOWN OF QUEENSBURYFOAM ! B OV E BUILDING & CODES EPT, BY i �.. _ ����� � , r�� r Reviewe y: A 15 rs Date: F P -� sw -a Lr, �. L t , t UP x � 1 PN .� X {� O4 1 (`a �4 1 � R Os— C` i�✓ t4*; i J U�- 1, l 1 I Id^ 1 S 1� a Lug ire I-janQ- 0 7 cat Q- , i 1 ► I Vah GaV-CA(2,VeV1 Queensbury Building & Code Enforcement - Reside nti l Final Inspection i Office No. (518) 761-8256 Arrive�ore-sZlnitials: am/pt'n Depart: am/pm Date Inspection request received: Ins NAME: PERMIT#: LOCATION: DATE: '7 TYPE OF STRUCTURE: Comments: Yes No NJA 4' Building Number Address visible from road Chimney Height/'B'Vent/Direct Vent Location Fresh Air Intake 3 inch Plumbing Vent through roof minimum 6 inches Roof Complete/Exterior Finish Complete Platform at all exterior doors Handrail 4 or more risers Guards at stairs decks patios more than 30 inches above grade Guard at stairwell at 34 inches or more Guard at deck,porches 36 inches or more Handrail Termination at Newell Post or Wall interior/Exterior Railings 34 inches to 38 inches Deck Bracing/Handicapped Ramp Compliant Grade away from foundation 6 inches with 10 feet 6 inch clearance to sill plate Gas Valve shut-off exposed!regulator 18 inches above grade Interior privacy/trim/doors/main entrance 36 inches Bathroom/Kitchen watertight Safety glazing/Window in stairwells safety glazing Interior Smoke Detectors/Carbon Monoxide Detectors Every level: Every Bedroom: Outside every bedroom area: Inter Connected: Battey backup: Attic access 30 inches x 22 inches x 30 inches(height)in accessible area Crawl Spaces 18 inch x 24 inch access 1 sq.ft.-150 sq.ft.vents ,Bathroom Fans,if no window Plumbing fixtures Foundation insulation/Insulation Certification t r?, Floor truss,draft stopping finished basement 1,000 s .ft. Emergency ress below grade Gas Furnace shut-off within 30 feet or within line of site Oil Furnace shut-off at entrance to fumace area Furnace/Hat Water Heater operating Low water shut-off boiler Relief Valves installed/Heat Trap/Water Temp 110 Enclosed Stairs Sheetrock Underside minimum'A"Gypsum Basement stairs closed rise>4 inches Garage Floor Pitched Garage fireproofing/%hour fire door/door closer Duct work Sealed properly Gas Loge in Sealed or Glass Enclosure Final Electrical Final Survey Plot Plan Arc Fault Breaker in Bedrooms Flex Gas Pipe Bonding As Built Septic System/Sewer Dept. Inspection Sticker Site Plan /Variance required Flood Plain Certification,if re uired Okay to issue C/C or C 10 1 Temporary/Permanent L:\Building&Codes Forms\Building&Codes\inspection FormslResidential Final Inspection Forrn_revised_100405.doc;Revised January 7,2008;Revised 6/26/08 Queensbu Building & Code Enforcement - Resi tial Final Inspection ` rY 9 _ Office No. (518) 761-8256 Arrive: am/p 12 rt: am/pm Date Inspection request r ived: Inspector's Initials: NAME: � jf� � li`rde' 4 PERMIT#: LOCATION: ? DATE: TYPE OF STRUCTURE: +Comments• _ Yes No NIA 4' Building Number Address visible from road Chimney Height/"B"Vent/Direct Vent Location Fresh Air Intake 3 inch Plumbing Vent through roof minimum 6 inches Roof Complete/Exterior Finish Complete Platform at all exterior doors Handrail 4 or more risers Guards at stairs decks,patios more than 30 inches above grade Guard at stairwell at 34 inches or more Guard at deck,porches 36 inches or more Handrail Termination at Newell Post or Wall Interior/Exterior Railings 34 inches to 38 inches Deck Bracing/Handicapped Ramp Compliant Grade away from foundation 6 inches with 10 feet 6 inch clearance to sill plate Gas Valve shut-off exposed/regulator 18 inches above grade Interior privacy/trim/doors/main entrance 36 inches Bathroom/Kitchen watertight _ Safety glazing/Window in stairwells safety glazin Interior Smoke Detectors/Carron Monoxide Detectors Every level: Every Bedroom: Outside every bedroom area: Inter Connected: Battery backup: Attic aocess 30 inches x 22 inches x 30 inches (height) in accessible area Crawl Spaces 18 inch x 24 inch access i scl.ft.-150 sq.ft.vents Bathroom Fans,if no window Plumbing fixtures fj 5 t A u— Foundation insulation/Insulation Certification l�'ln,�v L/& D/2 Floor truss,draft stopping finished basement 1,000 s .ft. Emergency ress below grade i2,�k I � ,U E IQ,Gas Furnace shut-off within 30 feet or within line of site / Oil Furnace shut-off at entrance to furnace area �-- Furnace/Hot Water Heater operating Low water shut-off boiler Relief Valves installed/Heat Trap/Water Temp 110 Enclosed Stairs Sheetrock Underside minimum"A"Gypsum Basement stairs dosed rise>4 inches Garage Floor Pitched Garage fireproofing/'/.hour fire door/door closer Duct work Sealed propedy Gas Loos in Sealed or Glass Enclosure o Final Electrical ' V�� 1�r,�� Final Survey Plot Plan Arc Fault Breaker in Bedrooms Flex Gas Pipe Bonding As Built Septic System/Sewer Dept. Inspection Sticker Site Plan /Variance required Flood Plain Certification,if required Okay to issue C/C or C 10 1 Temporary/Permanent LABuilding&Codes Forms\Building&Codes\lnspecbon Forms\Residential Final Inspection Form_revised_100405.doc;Revised January 7,2008; Revised 6/26108 � . /rnn'�- Rough Plumbing / Insulation In ection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building & Code Enforcement Arrive: am/pm Depart: am/pm 742 Bay Road, Queensbury, NY 12804 Inspector's Initials' I ILjn NAME: PERMIT #: ` `� J LOCATION: INSPECT ON: -+�- TYPE OF STRUCTURE: Y N N/A Rough Plumbing /Nail Plates Plumbing Vent/Vents in Place 1 %inch minimum Drain Size Washing Machine Drain 2 inch minimum Cleanout every 100 feet/change of direction Pressure Test Drain /Vent Air/Head 5 P.S.I. or 10 ft. above highest connection for 15 minutes Pressure Test Water Supply Piping `50 .S.I fo 15 minutes i -,,f _ Insulation!Oesidential Check/Commercial Check T ek or 6idnilar Exterior Sealant ent, Attic Vent Door/Window Sealed No Insulation Duct/Hot Water Piping Insulation If required unheated spaces Combustion Air Supply for Furnace Duct work sealed properly/No duct tape COMMENTS: f-orL, � e ►���- C Nb Rough Plumbing Insulation Report.revised Nov 17 2003, revised February 15,2005, revised January 7,2008 Rough Plumbing / Insulation Inspection Report l� Office No. (518) 761-8256 Date Inspection request received: Queensbury Building & Code Enforcement Arrive:12, m/prrt? !!Part: am/pm 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: �,� NAME: ,9�I C1A� 2 CJ/V PERMIT #: 7' S LOCATION: L�jQ(.+/C— l '� INSPECT ON: I L-2 TYPE OF STRUCTURE: Y N N/A Rough Plumbing Nail Plates Plumbing Vent Vents in Place 1 1/2 inch minimum Drain Size Washing Machine Drain 2 inch minimum Cleanout every 100 feet change of direction Pressure Test Drain / Vent Air/ Head 5 P.S.I. or 10 ft. above highest connection for 15 minutes Pressure Test Water Supply Piping Air/ Head _ 50 P.S.I for 15 minutes Insulation Residential Check Commercial Check Proper Vent 41 Attic Vent �' F, G�t �+ Duct/ Hot Water Piping Insulation If required unheated spaces �- �,� C qe:o Combustion Air Supply for Furnace Duct work sealed properly / No duct tape COMMENTS: LAPam Whiting\Building&CodesUnspection FormsURough Plumbing Insulation Report.revised Nov 17 2003.doc Revised February 15,2005 Rough Plumbing / Insulation Inspection Report Office No. (518) 761-8256 Date Inspection quest received: ?Queensbury Building & Code Enforcement Arrive: am/ Depart: am/pm 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: D& NAME: 4� 6W-A&kC4, PERMIT #: 0�7- 5� LOCATION: L Jarnl& C,Al INSPECT ON: t 2 dE El d TYPE OF STRUCTURE: Y N N/A Rough Plumbing Nail Plates Plumbing Vent Vents in Place 1 1/2 inch minimum Drain Size Washing Machine Drain 2 inch minimum Cleanout every 100 feet change of direction Pressure Test Drain / Vent Air/ Head 5 P.S.I. or 10 ft. above highest connection for 15 minutes Pressure Test Water Supply Piping r/ Head 50 P.S.I for 15 minutes Insulation Residential Check Commercial Check Proper Vent Attic Vent Duct/ Hot Water Piping Insulation If required unheated spaces Combustion Air Supply for Furnace Duct work sealed properly / No duct tape COMMENTS: LAPam Whiting%uilding&Codes\Inspection Forms\Rough Plumbing Insulation Report.revised Nov 17 2003.doc Revised February 15,2005 Rough Plumbing / Insulation Inspection Report Office No. (518) 761-8256 Date Inspe 'on relest received: Queensbury Building & Code Enforcement Arrive: 05m/p Depart: am/pm 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: NAME: / A) PERMIT #: (17' 5r / LOCATION: LokA C— �AJ INSPECT ON: OS TYPE OF STRUCTURE: Y N N/A Rough Plumbing Nail Plates Plumbing Vent Vents in Place 1 1/2 inch minimum Drain Size Washing Machine Drain 2 inch minimum Cleanout every 100 feet change of direction Pressure Test Drain / Vent Air/ Head 5 P.S.I. or 10 ft. above highest connection for 15 minutes Pressure Test Water Supply Piping Air/ Head PAP, (4,L— P.S.I for 15 minutes %nsulation Residential Check Commercial Check _..__.. _ Proper Vent Attic Vent (�( l 5 Duct/ Hot Water Piping Insulation If required unheated spaces Combustion Air Supply for Furnace Duct work sealed properly / No duct tape COMMENTS: LAPam Whiting\Building&CodesUnspection FormslRough Plumbing Insulation Report.revised Nov 17 2003.doc Revised February 1 S,200$ l✓ 1 I 1 Rough Plumbing 1 Insulation/Inspection Report Office No. (518) 761-8256 Date Inspectign request received: Queensbury Building &Cate Enforcement Arrive: & am/prrt Depairt: amlpm 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: --� Cam'' NAME: 1w 661'r-Are," PERMIT#: -� -- ` LOCATION: INSPECT ON: � .' TYPE OF STRUCTURE: Y N NIA Rough Plumbing /Nail Plates Plumbing Vent/Vents in Place 1 Y2 inch minimum Drain Size Washing Machine Drain 2 inch minimum Cleanout every 100 feet/change of direction Pressure Test- Drain/Vent Air/Head 5 P.S.I. or 10 ft. above highest connection for 15 minutes Pressure Test , Water Supply Piping �� ,���'► p G� ����� �31 5 minutes Insulation/ sidential Check/Commercial Check Tyvek or_SAilar Exterior Sealant r ent, Attic Vent Door/Window Sealed No Insulation Duct/Hot Water Piping Insulation If required unheated spaces Combustion Air Supply for Furnace Duct work sealed properly/No duct tape ve COMMENTS: Rough Plumbing Insulation Report.revised Nov 17 2003, revised February 15,2005, revised January 7,2008 -Z/ , © Framing / Firestopping Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Depart: t am/pm 742 Bay Road, Queensbury,NY 12804 Inspector's Initials: NAME: Va i., 2 r PERMIT#: LOCATION: INSPECT ON: TYPE OF STRUCTURE: Y N N/A COMMENTS Framing ccess 22"x 30"minimum Jack Studs/Headers Bracing/Bridging Joist hangers Jack Posts/Main Beams Exterior sheeting nailed properly 12"O.C. Headroom 6 ft. 8 in. Stairwells 36 in. or more Headroom 6 ft. 8 in. Notches/Holes/Bearing Walls Metal Strapping for Notches Top Plate i '/z w 16 gauge 8 16D nails each side Draft stopping 1,000 sq. ft.floor trusses Anchor Bolts 6 ft. or less on center Ice and water shield 24 inches from wall Fire separation 1,2, 3 hour Fire wall 2, 3,4 hour Firestopping Penetration sealed 16 inch insulation in cavity min. Garage Fire Separation House side '/2 inch or 5/8 inch Type X Garage side 5/8 inch Type X Ceiling/wall Windows Habitable Space/Bedrooms 24 in. (H) 20 in. (W) 5.7 sf above/below grade 5.0 sf grade Foundation Inspection Report a Office No.(518)761-8256 Date I V re st received: Z �Queensbury Building&Code Enforcement Arrive:� 5am/pizi�, pepart: am/pm 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials. c�.� `� _,, NAME: V A✓,Y C ey DVZ-e-vt PERMIT#: o7-�a- LOCATION: V-P C L INSPECT ON: TYPE OF STRUCTURE: Comments Y N N/A Footings Piers Monolithic Slab Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose on site. oundation/Wallpour Reinforcement in Place Footing Dowels or Keyway in place Foundation Dampproofing Foundation Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing /r 6 mil poly for wet areas under slab Backfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Building&Codes Forms\Building&Codes\lnspection Forms\Foundation Inspection Report.doc Last printed 12/20/2005 9:24:00 AM )--q /� ars Foundation Inspection Report Office No.(518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Depart: L7-1pm 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: NAME: PERMIT 4: LOCATION: INSPECT ON: TYPE OF STRUCTURE: Comments Y N N/A rFoZtiing�s�S) Piers Monolithic Slab Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose on site. Foundation/Wallpour Reinforcement in Place 2--`e��'�i Footing Dowels or Keyway in place u Foundation Dampproofmg Foundation Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing 6 mil poly for wet areas under slab Backfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc Last printed 12/20/2005 9:24:00 AM