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GIty of S^4+ /a-4- <br />tos Angeles Uniform eode program <br />Uniform Proeedure I-7: Special Inspeltions <br />Special Ins pection Report <br />Alldisci'eparcr'es shall b€hought to th6 iavnodiate atefitbo of li wo.* con <br />RMANCE <br />Forms and code rsquirg J'rEnb, s utn ;.1 <br />t16 Confactoi for ca.r Ection. ll canectiom are not mad€ in a his repod h Euil d copies to Cosf&-br , Eoginger.itjmely maiia, t\is re po( shdl be used 6 a d rsueparcy no0ce.,drfiitect of record and O'{ner nO larer than lle busines d ay folloirir€Submil thr a rigind to Buildiog Depa-rnent a nd copbs b &e conclusion ol $e special lns pection, For inspectons 9 realer th31 5 <br />ConFaclor ;'te of record and O*rei.d duration a conform anc€ resubmit orl d ieast 0nce eve l'?€ 9ii <br />Thisisa: .,p recs Re Final Re rtR rt No.+3Ptqe$ AJdress;Pa e No.1of <br />.DiSCREPAN CY <br />2441 tu. HFs FZ.*l / 4ttr* B Descdp tuod <br />Full Name of Spa.ial In5p€ction: <br />l'luan Van Bui <br />Type of Int Pe<{Jonro Reinforced Concrete. Prestressed/post-tenslone.d <br />r ShotcretVGunlte <br />CONFO <br />/yar%,/z-e <br />-Applled FIre proofino+a "o/ V*+- <br />I <br />Catl <br />Company;Pnc n! liumber;VanBui Inspection 71+345-8266 <br />c Structural M asonry o Piling, picrs & Gissons 3 Smoke Controlo Eolts in Concrete/Har:nry o Exca\rdton and Filis r Energy Compliancea Structurdl Wedh o o Spny! I nsuiatirE Concret{Gypcr€te o HIgh Strength BolUng 9 OthaTlmeTimeDate <br />7/-/rg 8 ;a / o.'w g'e:2? //'4)1/ 4 <br />Arrlvd Departed Doscrrp,Uon.ndL6;1;z on/., 3 , 2a=ol Work Inspeated <br />2$)27r*41 (2a),Z /$ -///7Vz-r42a7o .2X.Ez- .@..=-,*Z <br />i Testing ReporE <br />Z <br />/tuez-=%,O z<t eA l:-C" r.z7z* Tkna$.fui. G //n44 c)?€cayatA P-e,"{/@-? *,O <br />Remarksl /.4k ch:pp .27 %.fk-4 --h>zzaz-<-a z->:> €V\2 _sv7<,2,./c.<<3-A 2<4a <br />1 HEREBY DECLAiE fiAT IHE FOLLOHHG IS TRUE TO THE EESI OF IIfY KNOWLEDGE: <br />lil <br />: AM, OR MY COMPAI{Y I s,REIA]HED BY IHE OIVX ER OR THE ARCHIIECIIEX GINEER OF RECORD TO PROV]OE SPECIALSPECT]OI{ FOR ]HE w0Rx COVERED IH THIS RE PORT,i. I HAVE PERFORT'EO IHE REQUIRED II{SPECNO Ii OURJTIG IHE T][!E P ER]OO AS STAIED ABOYE,3, }HE IYORJ( COVEREO It{I}IIS REPORT IS IH COt{FORflAtiCE M THE APPROVED PI-ANS, SPECIFICANr!0Rx AltsHtP PROVtStON I0F IltE CooE ETcEPTAS u{otctrEo o T}'ERTIISE, <br />{vz=-_-z <br />3zPerinit Numaer: <br />Archit!.VE n*fngi <br />isfd doc?tv Re9 Nuol <br />1 3 049 C-/a-Z1- <br />SiEnature: <br />iliran Van Bui, oepL.iy Insp€ctor <br />Da <br />0H5 Afi 0 APPLTCA it.}r