Residential Engineered Footing/foundation Form Letter - Town Of Collierville Building Department
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1PPI#02002D
RESIDENTIAL
Permit #________________
Lot #___________________
TOWN OF COLLIERVILLE
BUILDING DEPARTMENT
ENGINEERED FOOTING / FOUNDATION FORM LETTER
Street Address:___________________________________
Subdivision:____________________________
This is to certify that I, _____________________________________, made a pre-pour inspection of the foundation
system at the above location, and that, to the best of my knowledge and belief, said foundation has been built in
substantial conformance with the provisions of the minimum design criteria, including accepted enginering practices,
of the currently adopted code, located in Seismic Design Category D
.
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The following conditions were observed at the time of inspection:
The weather conditions were _______ ºF and
The footing is reinforced with ____ lines of
Clear, Cloudy, Raining, Snowing, or
No. _____ horizontal reinforcing steel.
Other______________________
The concrete slab is to be poured as a monolithic slab
No. ______ rebar is placed vertically on
[with/without] a brickledge or a masonry stem wall
______ inch centers.
supported on a concrete footing.
The footing is supported on undisturbed bearing soil
Termite treatment was performed by:
capable of supporting the intended load.
OR
The footing is supported on properly compacted fill
Grade beams were installed where required.
ground and/or is designed to support the intended load.
Welded reinforcement wire 6 x 6 10/10 was placed in
The slab sub-grade was covered with a vapor
the slab.
barrier.
OR
The Inspection was performed @ ________
Fibermesh concrete is to be used.
AM/PM on _____/_____/20_____.
The footings were inspected for minimum depth, width
Footing & foundations for prefabricated
& thickness as required by the prescriptive codes. The
engineered panels were observed as being
minimum depth, width & thickness observed were
installed in the locations shown on the plans
_____ inches deep _____ inches wide & _____ thick
& in accordance with the manufacturer's
specifications.
Holdown / holdown anchor bolt type(s) and
location(s) per the approved plans.
Engineering Firm Name
Address
Seal
Signature
& Date
City
State
Zip
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