HomeMy WebLinkAboutRS042141_DEPUTY REPORTrDEPUTY 1 INSPECTION SERVICE INC.
25121 DE SAI1E ST, LAGUNA HILLS, CA 92653
1 - 800 - DEPUTY 1 =1 - 800 - 337 - 8891
SPECIAL INSPECTION REPORT
Building Permit No. Job. No.
Job lndenYrfication/Address I Gr( C ent�_
General Contractor / Address t
Sub - Contractor / Address lr,a S .P jam_
Structural Engineer /Address�sr t
Arch.
DEPT. OF BLDG. & SAFETY
CITY OF jJar [aci'
COUNTY OF Cjrio,yS
Data
REINFORCED CONCRETE MASONRY_ HI -TENSILE BOLTING CHEMICAL ANCHORS —7]
PRESTRESSED CONCRETE__ WELDING_ GYPSUM CONCRETE OTHER
WELDER
RECEIPT NUMBER
WELDER
RECEIPT NUMBER
DESCRIPTION OF WORK INSPECTED
77�7777 7 L V p
a
h r
L
(7
LAI
DATE
Reg.
OT
rim In
Time Out
Grout
Mortar V Concrete
Block
Prisms
Density
omr4 hours-ahours
minimum. Ansbasedin extending main, ae 6
minimum. Arry. M inkaonemn0'ns Pert n i dent hour will n 8 hour
inspection tme and Past. a hour pa
hour minimum. rn e,fdnion, will
clod, or Selurtley Irupeceon well be 6116etl et time entl a haft.
ATTORNEY'S FEES - If any action at law or in equity is brought is enforce or interupt the terms of this Contract, the prevailing parry
shall be entitled to reasonable attorney's fees, costs and necessary disbursements in addition to any other relief to which such party maybe
entitled.
SPECIAL INSPECTION REPORT
Ins etor's ms: ' 6rN't`✓t" ( Inspector's Signature: 1>e `—�� Ins ctor's Si //{
I.D. No. 4 has been filed and It states that the above work to the best R Wher knowledge complies with the
provisions of the Uniform Building Code and meets approved plans and specifications.
Respectfully Submitted,
Approved by: By.
Propel superintendentlartY argr