150 S MAGNOLIA AVE BLDG 1Branco
74054 San Marino Circle
Palm Desert, Ca 92260
Mobile (949) 264-3199
PROJECT NAME Soft -Story Seismic Retrofit
ADDRESS 150 S. Magnolia Ave.
Anaheim, CA 92804 Building #1
ARCHITECT Engtegrity
ENGINEER Micheal O'Brien
CONTRACTOR Concrete West Construction, INC
OTHER Nolasco Welding Services
INSPECTION DATE 3/25/21
PLAN FILE/OTHER City
BLDG. PERMIT/OTHER Bldg 2019-05868
INSPECTION REPORT
INSPECTION
❑
CONCRETE
❑
REINF. STEEL
❑
MASONRY
❑
P.T. CONCRETE
❑
FIELD WELDING
❑
SHOP WELDING
❑
BATCH PLANT
❑
EXP. ANCHOR
✓❑
OTHER Epoxy
PAGE 1 OF 1
JOB NO.
REPORT NO.
MATERIAL IDENTIFICATION
CONC. MIX NO. & Ib/int
GROUT MIX NO. & Ib/int
MORTAR TYPE & Ib/int
REINF. STEEL GR./SIZE
STRUCTURALSTEEL
HIGH-STRENGTH BOLT
MASONRY BLOCK
OTHER
MATERIAL SAMPLING
❑ CONCRETE ❑ MORTAR ❑ GROUT ❑ FIREPROOFING ❑ MASONRY BLOCK
❑ REINFORCING STEEL ❑ STRUCTURAL STEEL ❑ BOLTS ❑ OTHER
INSPECTIONS PERFORMED, MATERIAL IDENTIFICATION, PROGRESS, WORK REJECTED, REMARKS
PLEASE NOTE ANY RE -INSPECTION, TESTING, OR OTHER PROJECT ISSUES.
Arrived on job site on time as requested to perform observation/inspection of :
Epoxy process of of #4 dowel T&B with 6"embedment into existing footing at shear wall footing extension@ A6 AND A7 of building 1.
Holes were wire brushed clean and blown out with compressed air. Hilti Hit-HY epoxy was used.
Work for today is complete and over all work is in progress.
.
41
w
lm
`e
Certification of Compliance: All work, unless otherwise noted, complies with applicable codes and the approved plans and specifications.
PRINTED NAME Antonio Miranda Time Charge 4 hrs
CERTIFICATION NO.
SI R2019-00048
SIGNATURE
Superintendent Cody Wienke �Wia,