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. �ar� _` _�._.� CITX OF DIAMOND BAR
. � DEPARTMENTdFCOMMUN[TY&pEVEIApMCNTSERVICES
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BUILDING PERMITAPPLICATION
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CITY OF DIAMOND BAR �-,.,a ,
INSPECTION RECORD - �
• � � • - • � • • -
SEf&4CK/LEfTFA N - TRACT AND LEDGER
FOOTINGS FORMS k /�F SWRCH GEAR
SLAB COMMERCIAL HOOD
UG PLUMBING ' T-BAR
UG ELECTRICAL INTERCEPTER
UFER GROUND HOT MOP/SHOWFAPAN
SEWER LATERAL SEPTIGCESSPOOL
MAIN WAlER LINE HEHS REPORT RECENED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF�RAINS
FLOORSHEATHING ROUGH CONDUR
SHEAR WALLS FJC�ERIOR � POOUSPA
SHEAR WALLS INTERIOR t � ROUGH PLUM8ING
FRAMINGNENTING RQUGH ELECTRICAL
ROUGH MECHANICAL P - ROl1GH MECHANICAL
ROUGH ELECTRICAL W( )CO ' GAS TEST
ROUGH PLUMBING PRE GUN(fE
INSULATION WALL " POOL PRE DECK BONDING
INSULATION CEILING P-TRAP
DRYWALL k � � FENCE/GATE/ALARM
LATH(PR� FINAL POOL
LATH EXfERIOfl WALLS
LATH INTERIOR WALL FDOTING/$TEEL
GAS TEST WALL STEEL 1"( )2ND( )LIFf
SCRATCH COAT 0 WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIW SEAL
GAS METER RELEASE WALL FlNAL
SPECIAL INSPECTION RO FNNNNGPINlt�RNGAPPRWAL
FINAL BIIILOING HOUGH FIRE APPRDVAL
FINAL MECHANICAL 1 � FINAL FIRE DEPARTMENT
FINAL ELECTHICAL FINAL PLANNING
FINAL PLUMBING FINAL ENGINEERING!PW
T C af OCCIIPANCY FINAL COMMIINITY SERYICES
CERL ol OCCUPANCT FINAL HEALTH DEPT.
FINAL INDUSTHIAL WASTE
COMMENTS
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, . CITY OF DIAM4ND BAR [ ;
Daperhnent of @ullding and 8afety
- REQUEST FOR APPROYAL OF SAECIAL INSPECTOR �,,, .,,
- � '�
SpeciallnspectorsName ^��'�^��r�Js.ti-�-�� �'haneKo ?� �� �'/�$"
Addf88S r�7�(} �}F �yA- ,,Qt� G�ty �/t lLtl d zip q,�,.���
Type of Inapect��an ❑ Gant�nuous � Penod�c
JobSateAddress �*�-g4 �` �'x.� $ �+G �� _
Job Nams ,�Q�At11t�6 L ,�'O(�, [.7t^
Type of Project .11,�J� �t
Attach wark expenence and educationai qualMf�cations ko ih�s application
The abave named person wtlf be�mployed ta�nspect andior kestandw�ll be reapons�ble tor the toNawmg mspectioas
(Ptease circle number and provid8 deaCnpHo� of xrorkj,
1 ConCrete Piacement
2 Re�nforcingandlorpreatressedsteei
3 StructuralWelding �� "
4 H�gh-Strength BolUng
. 5 StructuraiMasonry
s E�tt,�.�AlC'��tS �(- 4)e���L�.c1t�
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Outies and responsibdit�es of the Speclal inspector
1 The apeaal �nspeCtor shall obaerve the wark ass�gned for Canformance w�th the apProved das�gn
dr8wtngs and sp9C�fiCat�ons
2 Theapec�aimspeatorehatltumishinspecttonreportskothebudd�ngofiia�al,theengineerorarchrtectof
record,andotherdear�naRedpersons Alldiecrepanc�esshaUbebroughttotheimmed�ateattenbonof
the contractor far correc#Mon,then, �f uncorr8�t�ed, to the proper des�gn authorrty a�d to the butiiding
O}}ICi81 � *i, .�
3. The speciai mspectpr shal! submrt a finel signed repoM stat�ng whether the work requinng spec�al
�nspecbon was, ta the best of his knowiedge, �n conformance wfth the approved plans and
specifiCatlons and the appl�cahie warkmanshlp pr�tvision of the codes
��l��� ��d� ti�
Dete Owner's 5tgnatu» Conttaatcte 5tgnature
fee S �l, cs i. APPtored'_ r��c�—
e�+�winp orr�crer
Rece�pt No �`� a� Data � f t4
• � OtBtRlauT�oN wnrre—Frte
Ganmg—lnapectpt
14Dt 2 80 Pink—$p9cl6t lnapeefOr
. � � •
'` ` � County c�f L.os Angefes
�'.� ` i� pEPARTMENT OF PU$LiC Wt?RKS BUI�DING $ SAFE7Y DIVlSIQN
PVBUC 9RKS'
�os Angetes Regianai Uniform Code Program
J STRUCTURAL C)BSERVA7fON REPORT FORM
STRUCTURAL 08SERVATtON means the visua!observa!ron o7lhe structurai system, tor genera!conformanee to the
epproved ptans a�d specrficahons, a[s�gnr;rcant constr�ct+on stages arad a!completzon ot the structu�al system
Structurat o6senrabon doss not inctude or w�+vs the responsib+lrty for the+nspectror�s requrred by Sectron t08, 9704 or
other sscUoas af the tos Angetes County 8u+tding Coda (Sectrons t 06 4 5, 1709j
- - Repori No j `
This report indudes aA cortstrucUon work ihtough day of ,20 P Page No __�,_of.,_�
Pro�ect Addressi T..l �` � 4Skructurai C7bserv r of ReconrtlU,(S4R) 54R Phone No
't 4�4 in' o ViA �`^YI a P+. �..MA.�+ -Z b
Bw4ding Permit No / Structurai Observauo.ne �.1 Observr Pr fess/�onal �wc 1Reg No Qk�server Phone No
3 -�0 �,U Perfarmed tlY tF^-�/�''' �' �o
4BSERYED STR CTURAI ELEMENTS AND THEIR CONNEGTIONS
FOUNDATtON WALL FRAP.9cS FLQOR �LEMEN7S?CONNEC7ION
OBSERVATIQN L�CATfON
❑rooung,Stem Walis ❑ Cor�crete ❑ Steel Moment Frame � Concrete
❑Mat�oundat�on CI Masonry � Steel Braced Frame ❑ Steei Deck
❑Ca�sson,P,ies, ❑ Wood O Concrete Moment ❑ Wood
Grede Beams Frame
C]Retammg Faundaqon fl Others ❑ Masonry Wall O Others
Htllside Spaciai Anchors Frame 1
❑Qlhers I ❑ Others
NOTEO dEFICfENG1ES wlth the proposed correspondmg correchve act�ons with respect to general
conformance wnh the approved Qlans or in the load path (A rinai repoR hy the strUcturat observer which states that
aIl observed derycienaes have been resofved�s required before acceptance of the work by the bui4d�ng aNicals )
5.�re„r t,J�t� Y�r�: �� i ol�aco�� 9:►'� c?• K, - — —
_._1��S;�.S c.3 a' '
iz. I. '�'Ydt YN�3�-k 1 S (^�� —
I DECLRRE THAT THE FOLLOWtNG STATEMENTS ARE TRUE TO TNE BEST OF MY KN4WlEQGE
t f AM THE ENGINEER OR ARCHITEGT RETA�NED BV THE OWNER Td BE iN RESPflNSIBLE
CHARGE FflR THE STRUGTURAI 49SERVATIflH IN ACCORDANCE WITH THE
REAUIREMENTS Qf THE COUNN OF LOS ANGEL£5
2 I, OR ANOTHER£NGINEER OR ARCHiTECT WHO I HAVE DESfGNATEO A80VE AND tS ����"�'(t�
UNDER MY RESPONSfBtE GHARGE, HAS PERfQRM£D THE R£QUIRE4 S{TE ViSiT& AT ���
EACH SIGNVfICANT CONSTRUCTI4N STAGE TO VEPoTY VF THE STRUGTURE i5 iN
GENERAL CONFpRMANCE W(TH APPROVED PLANS AND SPECIPICAT14M5, NO,C 8E8�$
i �'�A�
3 ALL NOTED pEFtCiENGES WHiCH R£MAfN TQ 8H CORftECTE6 HAYE BEEN INpICATEp ��y,
A60YE, �jy, C
A 1 R£C4MMEH0 TNAT ACCEPTANCE 06 THE STRUCTUftAt SYST£MS 9Y THE COUNTY
C��
OF L9S ANGELES 8E WITHH£Lp UNTIL A�.L OBSERYEO DEPICIENCIES ARE
CflRRECTEO ���� `
�>��-�=Q��-- iSIAMP4f'STRUC.IURALOBSERVER}
SIGNATURF OF STAJ.TtlRAI U3SERVFR �' ��fll�
versian t�{2008 LACBCI ^ .�a.^ 70 2068