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ICS <br />a <br />P.O. Box 2{N7 . West CoYlo& CA 91793'2047 <br />Phon (62O9254236 <br />icsi$Pectlon@YshooxolE <br />Scn|lag Sot then Calilonia <br />INSPECTION BEPORT <br />Hours <br />REGULAF r.5 x 2X <br />-6--€--€- <br />Mtr..9.: <br />Ett artfer' <br />O n*lorce.rrr* <br />- <br />E cooar. <br />- <br />Cl u."-ry <br />- <br />O Pl..tr.tFtoctTdr-O fmpr"orrB <br />- <br />U-&rrctrnlStrl o <br />D..c.tpdon ot Wotl lEpocr.d <br />@ -l+{-.-ln--T t6.J c' t 3 r g * ?tt o" ya1 1+-<-<- 1-tE3 3 / t a" i--n LLef {^.r.r-Lql <br />Vrr , T--\ { \' Z "Z T1+r?-4 ,A \> dirl AS t!( r s--rt 9,er <br />L>il.r,,ir{ B" €v.Geo *< 1'O.-\? (2-t'I-F-l '-5 <br />L{A z-L lz-<D,<- r:-r rFD oog L <br />rvrE+,',-rj Z Lr n6 \L YL€ B <br />6 I A,3-rk!-a-F a le r-1 of 9ll"r*tz.< 6-sg: g p-o<19 ut,<* B"6 n-t 8E\ 1a',, i-r. <br />€ Fe :r-*4- s'6L rg Aq- lN7-r- l\-r ! lo SDL3o.J <br />fi>".- $,2.r .E r-1 rS ts-<Lt>\E 2- P*'.1 L\ no- € <br />N6r€ ^. &u-\LT LTZlz qt {?-ae F Le \t,=L- CA"^?l€f€ <br />Mix Usod Spodmons <br />Ce ilication of ComPlianee <br />I d6chr€ under penalty ol pedury lhat all ol lh€ above statem€nB <br />aIe truo, and that ot own per3onal knolYledge that lhe work <br />during lhe period covered by this rePorl has bsen Podormod <br />and installsd in €very malerial respoct in compllance wlth tho <br />approved plans, specillcatlons and all aPplicable codes <br />All lnsp€crtion basod on a mlnlmum of 4 hour8 and over 4 <br />hours - I hour rninimum, ln additon, any lnspecdon o)dendirE <br />pasl noon wlll be an I hour minimum. ll lnspeclor b called to <br />a proiacl and no wotk p€rlormed, a 2 hour mlnlmum will be <br />applied. <br />lnspectot t c-**€c 6. oorn <br />- <br />Approved / Authoriz€d by: <br />lnspector Signature (Prclec,l SuFednl.ndent) <br />Pago z or <br />-Z- <br />' lYl ' C.or 't f .7{ t1 'r -t s s <br />Fo t q€<- tLL**@ Lt t c<.( t ez1 &/d ,f r N-!..r, OSA / 6Lrto AB- F- ,ro r49 7s'8 3 L>t tr <br />\oq 4*sr 4* s.ffiffi8r-r{ <br />J 6r?.L/?nqsTb.-1 <br />nEOUIREUEIIIS: LLr{t ol orr lo! nuns.q on rumb.r p.r Eh.tL ld.itt .1, Efi b, tl?. rnd SPEC'FIC lo..lbn. <br />,loGCoi?li.r1t nort must bo sp.dficalty kbrdfird. Co,nttlunlctlho (RFlSlot r,dal lroldrE pl.lrotE nonoqdhnt lt.lEr must bG lblcd. <br />Flscotd com,irlaloars snd codMhath u,Or Boled derhn .t. hJ0&rg .nd penn[ lrrnlino .ulrErily olfdaB. <br />Oeslgn PSI Cublc Yads <br />0 t,rtt <br />Submitted By: <br />Scanned with CamScanner <br />INsppcrroN Consurrtuc SERvIcFS <br />*E-w O0r.t <br />C <br />(lNp.clion Cm.uiing Servlcos) <br />lnspectorlDl /D AYs-'t I-c-c