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#0318-RE1102-01
Supplemental Questionnaire

Last Name
First Name
1.

Did you graduate from an accredited college or university with a degree in civil or structural engineering or architecture?
Yes No
2.

If you answered "yes" to question 1, list the school, major and type of degree completed:
3.

Describe at least two years of professional work designing buildings or examining building plans and ensuring their conformance with applicable codes and ordinances.  Include employer name, job title, dates of employment and hours worked per week.
4.

Are you currently registered as a civil or structural engineer or architect in the State of California?
Yes No
5.

Do you possess a valid California driver's license?
Yes No