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DEPUTY 1 INSPECTION SERVICE INC. DEPT OF BLDG.&SAFETY
25121 DE SALLE ST, LAGUNA HILLS, CA 92(1 CITY _
1-800-DEPUTYI=1-800-337-8891 COUNTY OF_.
SPECIAL INSPECTION REPORT
Building Permit No. RS ffi06 Job. No. Date__._
Job lndernmantion lAtld d 1 v v9
General Contractor/Address 61 . L. '
Sub- Contractor/Address LOAA
Structural Engineer l Address R b 9 rlccpgbl 4ri' Arch_
REINFORCED CONCRETE_ MASONRY HI -TENSILE BOLTING_ CHEMICAL ANCHORS_
PRESTRESSED CONCRETE WELDING GYPSUM CONCRETE_ OTHER I ...
WELDER
RECEIPTNUMBER
WELDER
RECEIPT NUMBER
DATE OF INSPECTION
DESCRIPTION OF WORK INSPECTED
HOURS
SAMPLES
DATE
Reg.
OT
Time In
Time ON
Grout
Morten
Concrete
Block
Prisms
Density
t.
m at mours ir arer 4 hourly hours
nzpMlo.NnEing paetrMmmlheurvnll Oe Eille0as8
tuurday Immanency wOb NN aaur
ATTORNEY'S FEES- If any action at law orm Egity is brought to enforce or neempt the terms of this Contract, me prevailing paM
shall be entsed to reasonable atlomal s fees, ral and necessary dlabursaments in Andrew to any other relief to which such parry maybe
entitled.
i SPECIAL INSPECTION REPORT pr
Inspectors Nam: �.—Tn (�1 .t. Inagina 's ingratiate:ii��ln /�u mr
I.D. No. 1311 has been filed and it states that the above Acidto the best of llor knowledge complies with the
previsions of the Uniform Building Code and meets approved plans and specifications
Respectfully Submitted,
Approved by. _