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Projed Narne <br />Address: <br />Owner Name <br />Address: <br />Phone & Fax <br />Contraclor: <br />Address: <br />Phone & Fax: <br />I HEREBY CERTIFY THAT THE FOLLOWNG PORTION OF THE WORK ATABOVE ADDRESS VV}IICH REQUIRED SPECIAUDEPUTY <br />INSPECTION AND FOR WHICH I WAS EMPLOYED TO INSPECT BY MEANO COMPLY WTH THEAPPLICABLE PROVISIONS OF THE <br />BUILDING CODESAND THE APPROVED DRAWNGS: <br />Engineer: <br />Address: <br />Phone & Faxi <br />TYPE OF INSPECTION <br />Reinforced Concrete Shotcrete Gunite Rebar \4,/elding E <br />Structural Masonry Prestress Anchors Bolts Dowels a Fireoroofno E <br />Post - Tension Framino Nailing lnsp Grading Others <br />Quality Control <br />Cylinders Samples Core Panels Mortar Grout <br />JTS INSPECTION SERVICES <br />OFFICE/CELL| (323) 53G9436 146 SOUTH BONNIE BEACH PLACE <br />FAX: (323)269-5671 LOS ANGELES, CA 90063 <br />E-rnail: JTsinsp@gmail.com INSPECTION DATE 06t221't8 <br />REGISTERED SPECIAUDEPUTY INSPECTOR - CERTIFICATE OF COMPLIANCE <br />Permit # <br />NAME- <br />DANIEL SIGALA <br />SIGNATURE OF REGISTEREO <br />ICC: 8'144858 LA: p033469 <br />'tD195673 1C195674 1U95672 10195671 10195670 <br />1932 1940 1936 1920 1924 DeereAve SantaAna Ca92705 <br />Alton Deere LP <br />1932 1 940 1936 1920 1924 Deere Ave Santa Ana Ca 92705 <br />INSPECTION DESCHPNON: <br />Simpson epoxy set XP RR#:257M EXP: 9-19 <br />TIME IN <br />8AM <br />IIME OUI <br />11 <br />REG HOURS O T HOURS SAMPLES <br />ALI INSPECIIONS ARE BASEOON MINIMUM OF 4I]OURS,AIIY INSPECTION OVER 4 <br />HOURS WLLBE CHARGEO AS 8 HOURS ANY INSPECIION EXTENOING PAST NOON <br />WILL BE CIIARGED AS 8 HOURS SATUROAY ARE AILIED AS TIME AND A HAIF <br />SUNOEY ARE BIILED AS OOUBLE TIME <br />SITE CONTACT: <br />TYPE LICENSE NUMBER <br />0 <br />Farhad Foroutannami <br />E E E D <br />E E EtlEE E E <br />E