15365 15364 15363 AV- CITY OF
CUPERTINO - SPECIAL INSPECTIONS RECORD
Job Address /b5,go Building Permit No.
/ 5365Type of/lsdo3rO /5363
fl. Concrete. Reinforcing Gypsum Concrete
ElDuctile Moment-Reslsting Concrete Frame Insulating Concrete Fill
❑ Reinforcing Steel and Prestressing Steel ❑ Spray-on Fireproofing
❑ Welding ❑ Piling, Drilled Piers and Cassions
❑ High Strength Bolting Q Grading - Excavation - Filling
Structural Masonry Special Cases
Type Type
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ate Location Ins ecto Fe Location Insper_to
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nOTE: Post this card adjacent to Bu d ng Perm t Inspection Record Card.
Weekly reports to be submitted to the Inspection Division.
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