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ELITE SPECIAL INSPECTIONS INC. <br />861"6 Cleta St. Downey, CA,9024L <br />Btsiness CelU Voice/ Text: (562) 413-8159 <br />Eliresll @mail.com <br />SPECIAL INSPECTORS TIME SHEET & REPORT <br />Job #:101019 <br />101100162 permit Dare Bl27l19 Jurisdiction Santa Ana P & B <br />Enlarge lnterior Door Opening Address 23gg W Cape Cod Way, Santa Ana, CA <br />Contractor: Gmeral Jgg6n GOldberg COnStrUCtion <br />LDP: Architect Manuel A. Espino <br />Date: 1Ol1Ol19 <br />Building Permit # <br />Job I dentificarion <br />Sub - <br />Engineer <br />Reinlorced Concrete E ACI Grade l-Tech tr Prestressed Concrete E <br />Other E <br />Masonry El <br />Epoxy Simpson Set-XP <br />NOTE: Contractor assumes responsibilty for any and all work that is performed outside of stam ped/approved plans <br />bearing the seal of the applicable enforcing agency of record. Contractor is informed that any and all work performed <br />prior to Building Department approval is performed at contractors own risk pending proper approval by the Building <br />Official. <br />Provided Visual lnspection for:Plans Date: Bl16lW <br />Placement ol chemical epoxy adhesive lor the anchoring ol: <br />- <br />5/8" alFthread rods into clean 3/4" diameter holes lor an embedment depth ol 10" Ior (2) HDU2'S. <br />All holes blown, brushed and re-blown per code and manufacturer's approved printed installation instruclions <br />(lCC ESR-2508) and set with "Simpson SET-XP" epory adhesive. Exp.612O20, Lot #1000014038. <br />All material cartridges verilied to be lree ol damage and defects. <br />All mixing heads in good working condition providing uniform mixing/color. <br />All material embedments maintained during placement. <br />Workmanship good to excellent. <br />DAILY HOURS WOHKEO Certificate of Compliance <br />Straight Time 4 I hereby certifu that I have observed to the best ofmy knowledge all ofthe above reported work <br />unless otherwise noted. I have fornd this work to be in compliance with the Approved Plans, <br />Specifications, and applicable sections of tbe Governing Building Codes. <br />Check # <br />Invoicc 101019 <br />All inspection is based on a 4 hqrr minimum, over 4 hours is an 8 hours minimum. After 8 is timc and a ha.li rcspectiv€ly. All lab work nec€ssary to <br />complete inspec{iofls will be paid by owner. engineer or contractor. <br />pecial lnspector (Please Print Mauro DelaCruz 166 1.8821400Registered S <br />Registered S <br />Owners Rep: <br />pecial lnspeclor (Please <br />\)r <br />): <br />Company <br />T <br />City #: Registered