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D!pt. ol Btd. & Saloty <br />Clly ol <br />TYPE OF <br />INSPECTION <br />REOUIFED <br />O Boinlorced Concrele <br />o Posl Tensioned Concrete <br />O Beinlorcod Masonry <br />q Structural Sleel Assembly <br />O Fire Prooling <br />O Ouality Control <br />O Other <br />REGISTEBED INSPECTOR'S OA]LY REPOHT <br />Job Name Permil No lssued By <br />Type ol Structure & Size Architect <br />Mat8rial Description (type, grade, source)Engineer <br />Conlractor <br />lnspector(s) Name Subcontraclor <br />WELDEF WELOEF <br />INSPECTION SUMMAFY _LOCATIONS OF WOHK INSPECTED. TEST SAMPLES TAKEN, WORK REJECTEO, JOB PHOBLEMS, <br />PBOGBESS, REMABKS, ETC. INCLUDES INFORMATION ABOUT: AMOUNTS OF MATERIAL PLACEo OR <br />WORX PEFFORMED, NUMBEH, ryPE & IDENI. NO'S OF TEST SAMPLES TAKEN, STRUCI CONNECTIONS <br />(WELD MADE H,T, BOLTS TOROUED) CHECKED. ETC. <br />CONTIITUED ON TIEXT PAGE O PAGE <br />- <br />OF <br />- <br />sr GNATUqE OF REGISTERED INSPECTOR <br />All tnspecllons ba56d on a lnlnimum ol a hour6 3nd over a iours - g hotla <br />manimum. ln 6ddlllon. 6ny lospeclioo exlending pasl noon hour wlll b€ an I <br />FEG.IiOUFS TEST STIIIE IN TI[IE OUT <br />SPECIALTY <br />firh.rtorn\1/ll/201{ <br />NO AGENCY <br />Apptovod By-- <br />Pror€ct Superlrllandant <br />FISHER INSPECTION SEHVICES <br />CONST R UCTION IN S PE CTI ON AND TESTIN G <br />19360 Rinaldi Street, #350 Northridge CA 91326 <br />Office: 818-349-1806 Fax: 8'18-349-2340 <br />Cell:818-618-1052 <br />CEFTIFICATIOT,I OF CO"PLIANCE <br />I HEBEBY CERTIFY THAT I HAVE INSPECTEO TO THE EEST OF MY KNOWLEOGE <br />ALL OF THE AEOVE BEPOBTEO WORX UNLESS OTHEBWISE NOTED. I HAVE <br />FOUND THIS WOBK TO COMPLY WITH THE APPROVEO PLANS. SPECIFICATIONS. <br />AND APPLICAELE SECTIONS OF THE GOVEBNING BUILOING LAWS. <br />o.l HouRs <br />m <br />Job Address City <br />LICENSE #LICENSE #