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Report of Special Inspection
Richard Roth
1077 E. Pacific Coast
Hwy. #118 Seal Bch%
Ca. 90740
PC
Project Name & Address - - Linda Perry
1 �.nF CanrlractlP f)Y NPgort Bch
Permit Number X2019-2358
Inspection Type(s) .-Epnxy hniting
Inspection Date(s) _ 2-14-20 [ ] Periodic [ X ] Continuous
Describe Inspection Made, including Locations: I observed the installation of (1) 5/8"
List Tests Made: --- Vii ial nnty
Total Inspection Time Each Day:
List Items Requiring Correction, include uncorrected items previously listed
nue
Comments: Per plans
To the best of my knowledge, the work inspected was in accordance with the Building Department
approved design drawings, specifications and applicable workmanship provisions of the U.B.C.
except as noted above.
Signed: -"WV
Print Full Name: Richard James Roth
2k-,
Date 2-14-20
Registration No, NR -09.q5
FORM S142,90