HomeMy WebLinkAboutApplication for Foundation ReleaseName
Street it
cityStale a:.. ZP +r..�
I
f �
AODULAR NO.
FfLING DATE
ntative: Occupancy
Facility Use
Complete set of plans:
Provided El To follow (Give date)
II "T
fo" Is . Date to be asnt:
checked llowplease
give estimated -�
dale of shipment
OWNER'S CERTIFICATE
Authorized signature(oWnetl__...__. _
I agree to take full responsibility for removing and repiaCln any construction
found by plan examination or by Inspection, to be in violation o1 the building
codes. I further agree not to proceed with above grade construction until the
complete building plans and specifications have been reviewed and released .-- - - -�--f
by the Deppartment of Fire Prevention and Building Safety. NOTE: STATE Authorized name (Type or print) Area code/phone --�
FORM 37318R WITH APPROPRIATE FEES MUST BE FILED WITH THIS FORM.
PROJECT ADDRESS
Name of project
Street address of project r City �/+ County
r - 1 ► l i. _!-\ � '� `__ l_. t ; '! i '_ 1- ii (moi
The release, for site development and foundation work to grade level only, is granted subject to all rules of the Fire Prevention and Building Safety
Commission and any local rules for Issuance of a building permit by the local official. THIS RELEASE IS NOT A PERMIT.
:omments: t
\
Q') Release stamp
Ut
t OUN Tt r RELEASE
sL7 tL a G'� { =� rtl 2 . ^', ,) > �! objet to ; urtgl:an0i with all +;ppdci
L i• > i f i i i - _ , j r Rules and RegUlaV311 of the
t FIRE- PREVENTION AND
BUILDING SAFETY COMMISMI'l
l
STATE BUILDING COMMISSIONER
t of local official, title: street address; city, state anc
[)pp,-. of Colranunity Devalopn7!nt
Mtn: Building Developrent
40 E. Main St.
Camel , 114 116032
e Phone 317
DISTRIBUTION
White copy - Owner/Architect/Engineer
Canary Copy - SBC file
Pink copy - Local office[
Goldenrod copy - SBC district offical