HomeMy WebLinkAboutX2021-1418 - Misc (3)DON CARD
Deputy Inspection Services
218 W. Ave. Cordoba
San Clemente, Calif. 92672
Phone (949) 413-6248 Fax (949) 361-2118
Project Name & Address
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Report of Special Inspection
Permit Number
Inspection Type(s)—_-_-__-- --
Inspection Date(s) ---- --- — --- [ ] Periodic ( ] Continuous
Describe Inspection Made, including Locations:
List Tests Made:
Total Inspection Time Each Day:
Date —
Hours
List Items Requiring Correction, include uncorrected items previously listed
Comments:
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. All
inspections based on four hour minimum. Inspections exceeding four hours will be billed at eight hours. Any
inspections beginning before 12:00 noon and end after 12:00 noon will be billed as eight hours
Signed: _.__-_ Date
Print Full Name: _ __
Registration No.
FOAM SI-02,01