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14110009-Spec InspFILE` STATEMENT OF SPECIAL INSPECTION DATE: 11/26/14 TO: Community Development Department—Building Division City of Cupertino 10300 Torre Avenue Cupertino, CA 95014 Phone: 408.777-3228 Fax: 408.777.3333 FROM: Dan Pineda, P.E. Phone: 925.984-0682 159 Paddington Ct. San Ramon CA 94582 SUBJECT: Special Inspection for wedge anchor installation Project Name: Water Heater Replacement Project Address: 22590 Voss Ave. Cupertino Contractor: Legacy Mechanical & Energy Svcs. Inc. Permit #: 14110009 INSPECTION REPORT: The wedge anchor installation for (4) 1/z" KB -TZ SS304 concrete expansion anchors was inspected and was in compliance with the approved plans and specifications. Hole depth, hole size, hole cleanliness, bolt size & length and tightening torque were verified. Sincerely, Dan Pineda, P.E. Eq IC OF