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Date:6-1.lq <br />ELITE SPECIAL INSPECTIONS INC. <br />9545 Firestone Blvd. #5, Downey, CA,90241, <br />Office: [562] 413-8t59 | FAX: (5621 867-8470 <br />Elite.Safe@mail.com <br />SPECIAL INSPECTORS TIME SHEET & REPORT <br />Job # <br />ld\ 1 ( 160 Permit Date 7lvt1 Jurisdiction <br />6-l-fi4 <br />Building Permit # <br />Job Identification <br />Contractor: General <br />t 4 &u I Address <br />Sub - <br />Engineer <br />(,loto Pqi^lq\,n Avc <br />LDP: Architect AlqrPrq,fl^s {- ,l')es,on <br />Reinforced Concrete D ACI G rade I -Tech tr <br />Dswr\1, \n"\ors t [.,\\ t^"rvu <br />Prestressed Concrete E <br />Other tr <br />Masonry E <br />NOTE: Conlractor assumes responsibilty lor any and all work that is performed outside of stamped/approved plans <br />bearing the seal ol the applicable enlorcing agency ol record. Contractor is informed that any and all work performed <br />prior to Building Department approval is pertormed at contractors own risk pending proper approval by the Building <br />Oflicial. <br />Provided Visual lnspection for:Plans Date: <br />0 <br />-\ <br />(\$ <br />Ir <br />D U <br />I oN <br />S v\'tL e - 2-o <br />Certif icate of ComplianceHours Billed # <br />Paid Check # <br />BAL,d\CE <br />All inspection is based on a 4 hour minimum, over 4 hours is an 8 hours minimum. After 8 is tjme and a half, respectively. In addition, any inspection <br />extending past noon hour will be an 8 hour minimum. Al) lab work necessary to complete inspections will be paid by owner, engineer or contractor. <br />Certilied Special lnspector (Please Print)Jared Brekenfeld rcc +. 8024.186 <br />Certilied Speci <br />qpproved By: <br />lease Sign ): <br />) <br />Lqah4r' <br />I hereby certify that I have observed to the best of my knowledge all of the above reported work <br />unless otherwise noted. I have found rhis work to be in compliance with the Approved plans, <br />Specifications, and applicable sections of the Governing Building Codes. <br />/^, t Company: <br />hn+ t hq <br />I <br />Epoxy <br />INVOICE # <br />City #:_