Loading...
9808-019 (SFD)r *„ ,.� LICENSED CONTRACTOR DECLARATION .F I hereby affirm under penalty of perjury that I am licensed under provisions of , -Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date 695405 9 &/31/98 Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) I, as owner of the property,,or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business & Professionals Code). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). ( ) I am exempt under Section B&P.C. for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm ,under penalty of; perjury one of the following declarations: ( ) I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ( ) I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier & policy no. are: Carrierryt Policy No. (This section need not be completed if the permit valuation is for $100.00 or less). ( ) I certify that in the performance of the work for which this permit is issued, I.shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. .,Pate: Applicant Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code -interest and attorney's fees. , IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each.person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City, of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation . I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State lawsrelating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. Signature (Owner/Agent) Date - PERMIT# CONTROL# I # BUILDING PERMIT�, . DATE 0 ' ' t" VALUATION SJ.Q4y+18 4,90 LOT 3 " TRACT* 6701-0 • JOB 51-440�•AVn4 i IDA V�>�,REGO�i ' -APN 773-081-01.4' . ADDRESS OWNER CONTRACTOR / DESIGNER / ENGINEER ,?l,hll:R Y. 111°.E":�!lJk9.;C�� 1224W 252N.0 91REM' 1221 W_ 252ND S'C32EEY HARBOR (,'.n'Y CA 90710 HARBOR C.r%'Y CA 90710 (310)534-3313 CSL€1 3310 USE OF PERMIT SINGLE f• MILY DWE.t..UNG SF0-1';Liil 41[1 DOLS tNoT .i?vt:i.iil'143BLOCK WALL (Al. .l'0011 TRAC T CONS'j iZU(M N 2 ilf3G.UU aF IPIC 11i4IAT10 133.E 3i (.AR.A.0FJC ARP()1' T 420.60 SF 6 177'. WOOF) FUNCE .2t.4i.CND .LF . ES'I'Yft A rr'I) COST OF CONIST ttJC'1°;fON' PERM11* m FEF. SUMMARY CU83SIRUCTKYN FEE 101-M-418-0010 -PLAN CHECK FTE 101 $731.97 Mr-,aiAAtwAL rf r 101-000-421-000 $60,00 &LECTR IC:A:L F EE PLUMBING FEE 101-000-419-000 $169.50 S'I'f+'!. NO RESP) 101.000-241-000 516.81 GRADING FEE !01-000-423-000 INFRA,S-fRUCTURE FEE 225-000-iW3 -3421 �iz.ili3.fi6 PRECISE. PLAN 10-000-4141,345 5`dS.04 AR.T IN PUBIAC PLA('' •a - 12..511" '101 -MO-255_000 gl?0.21 Fes: E10,10SIT 10I. -OW -130-318 425).00 'a SUB -IT) A.1_• CONMMIK 7 ON ANIS PLAN 117.1!ECK. $5,957,05 LESS PRE -PAID FEE S -$250.00PAID 'I'0 117M, PFR1%4I IT VE ES D11F NOV17 SEP 2 91998 1A a RECEIPT DATIF I V.1 BY•., DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings / Ducts Slab Grade Return Air _ Steel Combustion Air Roof Deck TZO Exhaust Fans O.K. to Wrap y9 F.A.U. Framing Compressor Insulation ao Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath (a DrMall - Int. Lath Final Final BLOCKWALL PP OVALS POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Pibg. Test Final I Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final - Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test O _% Appliances C Final Final Utility Notice (Gas) (N rY ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power l c Final Utility Notice (Perm) COMMENTS: yyi�� � 5T ar�7- Li r7 oG �'6r11s7p� �Gc d u/EQ, 7b Bpi ,�no���� , d' D Building Address P.O. BOX 1504 � 78-495 CALLE TAMPICO LA OUINTA, CALIFORNIA 92253 City Zip State 6A hf l + NC.- Lig. LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am`cl�nsed under Provisions of Chapter 9 (commencing with Section 7000) of Division 13 of the Business and Professions Code, and my license is in full fo ce a�}d' effect. PAI-- I )_Auv_4 -7 7 V Y OWNER -BUILDER DECLARATION' -I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, of repair any structure, prior to 'its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9'(commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for thealleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). L! I, as -owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for -sale. (Sec. 7044, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or tmproves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building Of improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) I l I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) i ] 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION Ihereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company r7 Copy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of the work -for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: d, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Ihereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code:) Lender's Name Lender's Address • �•- This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above- mentioned property for inspection purposes. Signature of applicant —Date— Mailing ateMailing Address City, State, Zip APPLICATION ONLY BUILDING: TYPE'CONST. /OCC. GRP. A.P. Number ✓ I ?S�- 1 legal Description A% . Project Description SFD LEGAc : NeiLa? .i 81.1C 17 61Al1:4 Z r Sq. Ft. No. Size 2 q g 0 Stories New ©+" Add ❑ Alter ❑ r No. Dw. Units Repair ❑ Demolition ❑ PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL " REMARKS ZONE: BY: ` Minimum Setback Distances: Mailing Address Front Setback from Center Line City Rear Setback from Rear Prop. Line Zip Tel _ Contractor 1,A1,AA ' 00 R' ,4 A1 FINAL DATE Address Issued by: City ��i,tr i� Validated by: Zip Tel State Lfic.City / & Classif. b 9 S yo ; f� Lic. III Arch., Engr., Designer f•%NIP A rW 1AA,,fII` Address I Tel. City Zip State 6A hf l + NC.- Lig. LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am`cl�nsed under Provisions of Chapter 9 (commencing with Section 7000) of Division 13 of the Business and Professions Code, and my license is in full fo ce a�}d' effect. PAI-- I )_Auv_4 -7 7 V Y OWNER -BUILDER DECLARATION' -I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, of repair any structure, prior to 'its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9'(commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for thealleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). L! I, as -owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for -sale. (Sec. 7044, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or tmproves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building Of improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) I l I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) i ] 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION Ihereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company r7 Copy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of the work -for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: d, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Ihereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code:) Lender's Name Lender's Address • �•- This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above- mentioned property for inspection purposes. Signature of applicant —Date— Mailing ateMailing Address City, State, Zip APPLICATION ONLY BUILDING: TYPE'CONST. /OCC. GRP. A.P. Number ✓ I ?S�- 1 legal Description A% . Project Description SFD LEGAc : NeiLa? .i 81.1C 17 61Al1:4 Z r Sq. Ft. No. Size 2 q g 0 Stories New ©+" Add ❑ Alter ❑ r No. Dw. Units Repair ❑ Demolition ❑ PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL " REMARKS ZONE: BY: ` Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date e Validated by: Validation: AL 2 8 1998 WHITE = FINANCE YELLOW = APPLICANT JiTY OF LA QUITITA PINK = BUILDING DIVISION Desert Sands Unified: School District 47-950 DuneTklms Road Notice: La'Qumta; CA 9225.1 Document Cannot Be Duplicated `160-7718515 CERTIFICATE"'O COMPLIANCE Date 8/1:9/98 APN # 773-081-.014 No. 17557 Jurisdiction La Quinta Owner NameWilliam Elmer Doran Permit # No. 51-440 Street Avenida Obregon City La Quinta zip .922:53 Tract # Lot # Square Footage Type of Development Single. Family Residence Comments Log # Study Area 2,880 No. of Units 1 At the present time, the Desert Sands Unified Schoof District does not - collect fees on *rages/carports, covered patios/walkways, residential additions under 500 square feet;, detached accessory structures or'ieplacement, mobilehomes. It has been determiried the' above-named owner is exempt from paying school fees at this .time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Governmentcode 53080 in thetamount of 1.93 X 2,88.0 or $ 5,558.40 the property listed above an hat°liuilding N , permits and/or Certificates of Occupancy for this square footage in this proposed projr;Ct-nisy now'- be issued - Fees Paid By. Cash - William Elmer Doran T'phone 31&J34-33 `i 3 Name oh'the check By Dr. Doris Wilson " Superintendent Fee collected /exempted by Juanita Green Payment Received ,$5,558.40 Check No. N/A Signature NOTICE: Pursuant of A s bly Bill 3081 (CHAP 549, STATS: 1996) this will serve to notify you that lfie 90 day approval period in which you may,protest the fees or other payment identified above will begin to run•f the date on which the building or installation permit for this project is'sssued or on which they are paid to the District(s) or to another public entity authorized to collect them on the Dis�ct('s)(s') behalf, whichever is earlier. Collector: Attach a copy of county or city plan check application form to district10' py for.all.waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt •Copy - Accounting COMMONWEALTH LP.WDatTLE iA. AND 1A1MaF1 R®WIIaRO IrAIL fM�. O[fO;A1fO.;.yMLdj30 (tRllttrtllltaa aatOSMM•at1.01 .'MAIL TAA OTATSIAaM O,m Millair0 E.. t Varna'° Doran 1 :o/o Pla®tio Ptlroonaltlo®, ®^ 1214 [root 2S2 2nd .`ot. ��W s wsL;;Eartsor City;CA.,,4?T10 J TkI@ Order Nw_-_, tares, Na.,.10• 16476' Y'AR' TERSH` P GRAN,' co ' fII a tQ to ler AeverA:a a W _ 3 THS UNDERSIGNED G. AM011_6) DECLAR1(i) 20.90 — --- GOCUMENTAIY TRANSpF7t _TjtX 11 O. 'noxporatrd irea City of pu - computed on full •due of property tamed, or Q computed on fell •value leaf value of lien or encvmbrancea "Minlas at New of yell. and FOR A'VALUABLE CONSIDERATION, receipt of whichli Iiere6r scknowledg„d, JUAREZ "4” LIMITED PARTNERSHIP; a Maryland Partnership hereby GRANT(S) to WILLIAM E. DORAN and'VERNA H. DORAN, Trustees for the Doran Family Trust Dated 9/10/81 the following, described real property in the City of La Quints county of Riverside , state of Californias The North half of Lot 3 in Block 19 of. Santa Carmalita at Vale La Quinta Unit 2 as per map recorded in'Book 18, pages 55 and 56 of Maps, Reccrde of Riverside County, California. Dated June - 12, 1991 STATE OF C*MP00MM04Cq"Np COUNTY OF �Q .n ff,1Cr SS. On sT /99i befog e, the undenlaned, a Nou Public In and for .►d County an so State, perna appes.. r-4 iL / known to nta to.baAt th.:.partners of tht:partnenhlp C/ that tseeuted the Within Inrtrutnent, and, icknowledaed to nit that* such partnership executed the s m i_ illEnata Notary Public in and MAIL TAX 6TAT1M2NT11_,TO PAI JUARE:. `4" LIMITED PAi1TNE P, e Ma yllind Partners � S BYt ,• ,,"�ptUnuur.q•, .•� ;r,�1ill�n ��•• •L Q2 V oy ti b1,O t 1� y and State - fEgee abtTa be ON'FOLLOWINO LINtt t17 o PAllT>t W 1RO 'tNiMal) ' 7M,Dn ft' 2D ABOY1 • Sept. 23 1998- City 6 f 998_City'of LaQuinta f .Dept-. of i Bui`l ding: '&. Saf ety' , t rJ ,RE: Residence at '51440�:'Obregon Owner: Bill Doran ,► Y .`Thee undersigned Engineer of Record,- (EOR); has,.reviewed ,the truss design--criteria • for conformance' with..the =project requirements: The-EOR'was 'not 'in ,`responsible charge for the truss- design;j but-does approve l the - design 'cr_ teria to `which these,components were.designed:�, �OQROFESS/p��l • � . - ,Sienc -rely,. - � - XTFm W�' �4`�,�H F �� t✓ rna +' p� No.. 18,932, Robert'-Schoenborn; R.0 E 18932„ OF CQl1F0� { ;h ;A — s t Cod. �. ICBO Evaluation Service, ..Inc. o� � _ 9.. A subsidiar Cor oration of the International Conference of Buildin Officials -.ti 1M . _,. . EVALUATION REPORT w Report No. 4345 Copyright © 1991 IC[3o Evaluation Service,' Inc. AuguSt, 1991 Filing Category: DESIGN—Concrete (038) Evaluation reports of 1010 li valuatiori Service, Inc., arc issued solely to provide information to Class A members of 1CBO, utilizing tlhecbdC upon which the report is based. Evaluation reports arc not to be construed as representing aesilhclics or any other altribihtes not specifically addressed nor as an endarsemenf orrecommen- dation for use of the subject report. This report is based upon independent tests or other technical data submitted by the applicant. The ICtO Evaluation Scrvicc, inc., technical staff has reviewed the test results and/or other data, but docs not possess test facilities to make an independent verification. There is no warranty by IC110'Evaluation Service, Inc., express or implied, as to an), "Finding "or other natter in the report or as to any product covered by the report. This disclaimer includes, but is not limited to, merchantability. Pagel of 5 CONCRETE CONSTRUCTION FORM exterior plaster. Wire lath is installed with staples in accordance with Sec- PLASTI-PERSONALITIES, INCORPORATED tion 4706 of the code, except staples are spaced 3 inches on center, maxi - 1214 WEST 252 STREET HARBOR CITY, CALIFORNIA 90710 mum. Pairs of staples may be spaced 6 inches on center maximum. Exteri- I. Subject: Concrete Construction Form. or plaster must comply with Section 4708 of the code. See Figure No. 4 for additional details. II. Description: A. General: The concrete construction forms are for re- C. Design: Concrete walls must be designed in accordance with Chapter inforced concrete walls in one- and two-story buildings. Each form con- 26 of the code with calculations and plans submitted to the building official sists of two identical facings attached with wire dividers to form units 48 for approval. inches long and 16 inches high with various widths. Each facing has 1-inch offset edges at the top, bottom and ends to allow interlocking with D.1990 Accumulative Supplement to the U.B.C.: This report is unaf- adjacent forms. Facings are expanded from Huntsman Chemical Corpora Corpora- fected by the Supplement. tion, Type 3486A, 4486B or 47866 polystyrene beads (NER-384) to a maximum density of 2.0 pcf. The expanded 'beads have a Class 1 E. Identification: ��eh concrete construction form bears a label Wolin g the manufacturer's name and address, evaluation report number, flame - flame -spread rating and smoke-density.rating of less than 450. spread rating, smoke -developed rating and the name of the quality control Wire dividers are manufactured from No. gauge galvanized wire. No. agency (Smith Emery Company AA 554). - .12 .2 Ponderosa pine wood balls have a net thickness and width of 1/, and 1'/' Evidence ence Submitted: bmited oof Test reports offlame-spread me-spread and msmoke- inches, respectively, and are located in molded_ grooves spaced .16 inches . _ dcIlll. manual and on center. They arc attached to the- form by the wire dividers which are run through the batt, bent over and 'stapled to the batt. Concrete constructionFindings - — - -'----forms are available with different wire dividers that provide for 66ncrcte '-IV. Findings: That thi;•ConCretc Construction Form for walls complies thicknesses of 4 or -6 inches and facing thicknesses of 2, 3 or4 inches. See Table No. I and Figure No.1 for -additional details. Additional wire dividers with the 1988 Unilorm Building Code, subject to the following condi- tions: MM and wood balls are furnished to assemble forms at corners. Redwood balls are also furnished for the wall base. 1. Special•inspection is provided in accordance with Section 306 - pnstruction for -B. -Installation: -The coms are concrete -fou oda-- ��• -•°-�-•:wspection of the code: When approved by the building official, special in- is�not�necessary-lor installation -of-single- maxi-' -- tions with wood baits aligned vertically. Redwood baits are installed with g y mum 8 -foot -high -walls housing Group R-3 or M-1 Occupancies, wire dividers at the wall base as noted in Figure No. 3. All vertical wood . provided the. following conditions are met: balls must bear (firmly on the redwood:base.See Figures:Nos..2 and 3 for installation at -corners' -and -openi ngsVertical andhorizontal steel -rein .: -- �=Maximum height of individual concrete_pours, is:48 inches.._. - _--- "- - - - - -�- forcement is placed in the wall cavity prior to initial placement ofconcrete b: `Installation is'by trained installers approved by the manufac-- . after laying the.second course of forms. Concrete is'placed to mid height turer. of the upper course prior to vibrating or. tamping. Successive courses•of c. Half the allowable design stresses are used for the design of forms are laid and concrete placed in the same manner. Anchor bolts as the walls. required, are located in the uncured concrete at the top of the wall and ver- . tically as necessary prior to concrete placement. To determine that 2. The walls.are constructed in accordance with this report and the con- crete has been completely and properly placed, a sharp instrument such as an ice pick is used to penetrate the foam to the concrete. Probe the form manufacturer's instructions. 3. Installation is limited to areas subject to a maximum basic wind at 32 inches on center horizontally to verify complete ,and solid,nlacement speed of 80 miles per hour with Exposure C with a maximum heiy5t of i; t' of concrete. 1901 Electrical conduit and outlet boxes are located in the wall by cutting 4. Structural calculations on the wall and attachments must be sub - channels in the foam plastic facing with a sharp knife, hot-wire cutter or mitted to the building official for approval. grinding wheel on an electric drill: The voids must be filled with plaster of.. 5. Walls are considered combustible construction. paris or equivalent: Plumbing:and vent pipes are installed in interiorwalls:.. 6.. The building interior is separated from the foam plastic by the. t The inferior v/alrsurface•is covered with /Z -inch -thick gypsum wall- '/Z -inch thick gypsum' wallboard installed on the interior wall board placed vertically and attached to the wood bails and top and bottom surface in accordance with Section 11 B of this report. plates with Type W drywall screws at 7 inches on center having sufficient 7. The concrete construction forms are fabricated at the manulac- length to provide a minimum 5/8 -inch wood penetration. Gypsum wall- turer's tactility at 1225 West 252 Street, Harbor City, California, board panel edges must bear on wood baits or. wood plates. with follow-up inspections conducted by Smith -Emery Com - A weather -resistive barrier installed over the exterior wall surface in ac- pany. cordance with Section 1707 (a) of the code is covered with wire lath and This report is subject to re-examination in two years. Evaluation reports of 1010 li valuatiori Service, Inc., arc issued solely to provide information to Class A members of 1CBO, utilizing tlhecbdC upon which the report is based. Evaluation reports arc not to be construed as representing aesilhclics or any other altribihtes not specifically addressed nor as an endarsemenf orrecommen- dation for use of the subject report. This report is based upon independent tests or other technical data submitted by the applicant. The ICtO Evaluation Scrvicc, inc., technical staff has reviewed the test results and/or other data, but docs not possess test facilities to make an independent verification. There is no warranty by IC110'Evaluation Service, Inc., express or implied, as to an), "Finding "or other natter in the report or as to any product covered by the report. This disclaimer includes, but is not limited to, merchantability. Pagel of 5 ions Kona: -16 0 41 3�vla% Gaeoftk FAix•. Qr : '7 (a -3129 -Sw TE:ST:;SPECIM.E-.N DATA SHEET Client:O.c.a Job No.. Contractor Report No.; .Material TYPO: Concrete0 ..Grout � •. Gunile 0 .iMorl.ar 0 , Core 0 Other. Project: lestLI Dbfe p .Sample Location: S.(� °� �1.70� •- I o o � •. Made 8 : S,G.r,'C, Mix.Desi h: ��So . ,Date Cast: S ecrf�ed Siren tli: s a, Date Received:--` : Adm'* izlura: Suc tier: Inches: Ticket No.: po Air l:ontent:- Unit Wt: �— Time InN.ixer: a Q Tem of>'San les, OF: Water Added on Jobsite: g . Air Tern�, F: San !e The: l oTruck -N • . !7 Field I.D. IJ2tRin :.� b A e •to 9reak Sarn fes: MOM?- � Lill.. •.TZ%1• al. ��.a�i.:K.••.�°r,�J .a.� ^': t: ..i. �.. ,�`t�..� :�`� i:•:�:� 1.2bor_,ory ,\'o.: I I Ace Days: g 3::_ cl .rlCi.:.E:1• .1.: I,. I I I Area. Square Irc`es: Total Load. 'ou:Ids: Sirer•Sth. PS1: .410: ��� D Ftc;cr: JCM Inspections 39725 Gaiarid Lane. Suite. G. Palm' Desert,_CA`92211 , Phone:. 760-345-55,54, • Fax: •760=772-3895 Project Name: Project No*,Date: a - Project Address: s l LA o C� UBC --.—.—.Title 24 Other: Client: va e .� ,� ; . ` Sub=Contractor: Weather: General Contractor: Architect: Structural Engineer: Location of Samples: o a r', •W Y p' . Welding Process / Electrodes: Slump inches): Time Sampled: �'�o ���� Time in Mixer: `�a>'.,t Water Added @ Jobsite: I (f -4n . Concrete Temperature: '7 Ambient Air Temperature: ;6% F. Supplier. Mlz Design: • Q U, Specified Strength-_iP.S1 Admixture: Q oZZ Truck # "FieldlD'M"ar6-„ to' ` Welders:. Description of Work Inspected: 1 nno o Doc cas u T cy' s S.f 16 S ,J a is aC b 3 e' r Q' « t ..J u: 1 �u n Page of I Spector.-& C., \,;y� - ,�Q Contfactor a esenfative:. co1 JCM Inspections Copy 2, Projeot Superintendent Copy 3 Governing Agency - SUPERIOR READY MIX CONCRETE, L.P. ",..-MAIN OFFICE -5680- MISSION ROAD -ESCONDIDO, CA 92029 X PHONE: (760) 745-0556 e h d I ig e �a 72270 Varn 227 er Ro -Thousand ,Palmls, A 92276 , (760)343-34.18 DELIVERY TICKET .048790 WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity was weighed, measured, or counted bya weighmaster, whose signature is on this certificate, who is a recognized authority of accuracy, as prescribed by Chapter 7 (commencing with section 12700) of.i'.*.*.: Division 5 of the California Business ands Professions Code, of I administered by the Division of Measurement Standards he California Department of Food and Agriculture. L Mk CUSTOMER:NO' ]iORDEWNO. LIXER . Y_TI!CXE7rAW Q .9 1.) 9 1P 9. 97 _CU.5T.9ME AME4a#&��tM�� - - - - - - - - - - - - - - - - - >SP N$.TFkQC U'N F 17�1 t-,' tiLli'l :!J LAPRR LE. � ,LBS.SAND ;QSACK.;. _WATMz­''Z ADD:MIk(LBS.)%L&�4A--_,k 1;&�LBS.;CEMEt9TAX-Z-1 - - - - - - - - - - DEPUTY OYA 0R6D6C.CODE N ITORIC TAX J, ch •6, tj quo "ps 1 i 'I C� E.,11 1]*7 1.- 6 h 4 lykos%;rddbs� In 1he event of -delivery beyond -curb, line, this,6ompiny will n6fassurne liability for damage to'sidewalki driveway,, utility lines, - TOTAL THIS ORDER meters,, septic :systems, or, any, other property t;-.,Miierial6'-tieiie6i';sold become property of purchaser at point of. origin: The _ "not STAND-BY TIME TH'IS;TICK purchaser- shall in,no-6vent-apopt deliveries 'Of7materials �,i-6'iiccord withtheagreement of the parties, but such, materials- .,"shall, b6;refui6ed,15y the purchaser and returnedAct 'th6jselioir;,W'1-6°-a- written.stateriient:of the reason for the refusal thereof- No TAND- ('P�EYIOU ,S 'I§Y';­,,%, ati d' It 'cancellation accepted after concrete has been, aded.,6�6rrieiktrucks at our Customer is to for and assume ' resoonsibility.,for area or containerv. for. clean',+oq't�"of�'c-oncre.te':. truck * chute. Any discharge street gutters or ge to watercourses stbrmdrains; is.a violation of,law: Concrete i6a;structural building *,material warnantebcl only to -meet ASTM standards. Sortie:; for responsible. 'r Imperfections and p6pouts may.qcc;ur which'sboolieris not NT OUT 7 UNUSUAL INCIDENT' _0F N0TEbN`JTHIS DELIVERY ' MAXIMUM RECEIVED INGOOD 'Cd NDITIONB�-�,,tl, , 'J4 SLUMP 0 0 C., 2"., x, ­ IN WATER ADDED AT CUSTOMER'S CUSTOMER SIGNATURE c. CAUTIONICement or freshly mixed concrete r,may injury. Avoid ON powder ,.grout•orrrtorla . cause skin contact,with skin and wash exposed skin areas promptly with .water. If any cement powder or mixture 1 .1 . I gets into ttieeyie's�,' rinse immediately and repeatedly with water and medical REQUESTGALLONS - ESTIMATED SLUMP AT UNLOADING JOB DEPART UNLOADING START got prompt attention. Keep children away from cement powder and all freshly mixed cement products. ANY WATER ADDED TO MIX ON THE JOB WILL BEAT THE PURCHASER'S RISK 1 . . I % NY INGREDIENTS ARE ADDED NOT RESPONSIBLE FOR ULTIMATE QUALITY OFCONCRETE IF ANY INCHES W AITING AND/OR UNLOADING ARRIVAL FINISH AFTER LEAVING PLANT. READY Stand-by and/or dumping time in excess of 4 minutes per yaramij . I be cnargeo+ TIME HOUR, TO UNLOAD INLAND FOUNDATION ENGINEERING, INC. ConsultingGeotechnicalEngineering liff South Santa Fe Avenue San Jacinto, California 92583 (909) 654-1555 FAX (909) 654-0551 Client: SLADDEN ENGINEERING Date: November 16, 1998 39-725 Garand Lane, Ste. "G" Project No: S435-003 Palm Desert, California 92211 Your Project No: REPORT OF STRENGTH TESTS: Mortar () Grout () Concrete ( x ) Project: Residence Contractor: Boettcher Concrete Location of Sample: Swimming Pool Footing east End Source Of Concrete: Superior Mix No.: D352P Ticket No: 7123857 (1) Batch Size (d : 9.5 (2) Sacks/yd3: 5.2 (3) Water Added @ Job (gals): 15 (4) Water Added @ Plant (gals): --- Slump (in): 4.25 Air Temp.: 93 Concrete Temp. 84 SET A Project Location: 51440 Obregan Ave. La Quinta, CA Arch/Engr.: ------ Date Molded Design Strength(psi): 3000 Max. Size Aggregate (in): % Admixture: POZZ Percent Air: ----- No. Cylinders Molded: 3 Specimen Size: 6" x 12" Water/Cement Ratio: --------- Time of Sampling: 2:1OPM Sampled By: JCMillin-Inspector Submitted By: SladdenEngineering 4035 I.F.E Your Lab. No. No. Date Molded Date Received Date Tested Load lbs. Age Das Compressive Strength(psi) 2952 --- 10-19-98 10-26-98 10-27-98 70,000 8 2475 2953 --- 10-19-98 10-26-98 11-16-98 114,000 28 4035 2954 --- 10-19-98 10-26-98 11-16-98 1 111,000 28 3925 This laboratory data indicates.conformance to the approved specifications YES,( x ) NO( ) Et446 Rv Doi+: jm) �orzo The service of I.F.f. includes furnishing compressive test results only. All other information may have been furnished to us by our client. }i�.+%fe:{;2jc'i":`..'!'�j�'"Y*'.P"�r'x"F°"'^T"+sF'a�''"`'.,ndr';,%.'£1�+',.3';7'',v'43i/1.'t,r,�Ks4�'%'r",.t,^";';;..:,;}sa,;;Dr':iirsk`;n;he:';"."�}.�:•;Qir+e�rJ"r"i *¢ - JCM Inspections ;-I.. 39725 Garand Lane Suite G Palm Desert, CA 92211 y Phone: 760=345-5554 " Fax: 760-772-3895 f Project Name: "" Project No: Date: - $ Project Address: 5 N LAo Lo Quin c, (7, UBC Title 24 Other: Client: - "y Sub-Contractor:Weather: �<< u r) n General Contractor: ^` Architect: Structural Engineer: Ora , Location of Samples: Welding Process / Electrodes: a" — \ Pf n0 .-C�S� 6Y� Slump (inches) r� •� I Supplier: �TimeSampled ��1`O't�rr- --MizDesign... �•�� .°.� � .. - ---•.- - , .__ _- _.. , -_ >.. _ Welders. Time in Mixer: Specified Strength: Q1_1 Water Added @ Jobsite: f n A Concrete Temperature: Admixture: Q �2 Truck #: a RS� Ambient Air Temperature: Field I.D. Marking: S .Description of Work Inspected: p e)n— rr v" r tin �CAAA 1, cc. P - 1 R(I�in,%s et ! A,,r L .: C rnorrr 6r"c,^C--� 1 v 11 •P r'1('10 1 �t�rLP1' . C 'NeAe i n D^ L Page f of 1 Inspector:-' rr Contractor's Repr— sentative: Cop` t JCM Inspections Copy 2 Project Superintendent Copy 3 Governing Agency •.,,,�.^'�.7.r`-+.e'vsf7},'W�?�*.::"4.�,K+f`'.hn+ifx'rs�,(TrrytY..SS-r....�i:.iM1yY':'.Yr'i.6'�::i.. �,.N:'ti-7.i7::...{'�i;N�..-•r7,:Tr1r`nvw.gnxri."t-+,rwr`1^•r.-�,r;."��',..r. :.;rd�; y,....�''`ir. .".moi' . .'wh �.....7r^-.� 0 Earth Systems Consultants Irl/ Southwest 79-811B Country Club Drive Bermuda Dunes, CA 92201.- (760) 345-1588 f C. Client Name Client Address Client Phone DATE f / r �G•.t n.F 0-17 G JOB NO. 6-7 - PROJECT FIELD TESTING REFERENCE CURVE LOCATION Z -4 -- DRY DENSITY lbs/cu. fl. MAXIMUM DRY DENSITY .CONTRACTOR , I OPTIMUM MOISTURE CONTENT OWNER WEATHER TEMP oat AM Oat PM PRESENT AT $I.TE TEST NUMBER f / r �G•.t n.F 0-17 G LOT NUMBER ELEVATION FIELD TESTING REFERENCE CURVE MOISTURE CONTENT %' DRY DENSITY lbs/cu. fl. MAXIMUM DRY DENSITY MAXIMUM DRY DENSITY lbs/cu. ff. OPTIMUM MOISTURE CONTENT f7 3 { 77 - 7, q 111, 2-1 74 v 1C)rf 7 r%' �J REMARKS: 7/ _ "`/ /ri -n� i h GYn��' —Le k'p -f .. I�o� fir, r c C CLIENT REPRESENTATIVE SIGNATURE BD -FS -001 (10/98) FIELD REPORT TECHNICIANS SIGNATURE N2 0370 'r..,♦hrty. � A �� �,y �F .: , � y. � 1 ♦. �..-.`-...�Y\•-.ir�.+.�r'^��'rl�r'1,(-.yam � ._�.�-� ^�.1•'�'r 1AV.f+w.tlyr.Iryri>�WY'9,Yh•�r�✓"'4i.:�r�"^Y+t^'+I�lih+'*Y+r'+r��pw.r.1.^M"�^�i�+i.r'M"M"A.. �r-.��..!'�"'�.r•fw7..v�J ���.. .. JCM . Inspections 39725 Garand Lane Suite G Palm Desert, CA 92211 Phone: 760-345-5554 • Fax: 760-772-3895 Project Name: Project No: Date: Project Address: i-1 O v e C-0 Q IzirAn d UBC Title 24 Other: Client: Sub -Contractor: ...... — Weather: r a KI General Contractor: RZIAN n 6 Architect: Structural Engineer: Location o'Samples: Welding Process / Electrodes. ------ Slump (inches): Time Sampled: O yS C;LVV1\ Time in Mixer: CR 0 Water Added @ Jobsite: Concreie Temperature: 1_1 ° Ambient Air Temperature: -144a F- Supplier: a ' Mix Design: - Specified Strength: 3000 pc2t Admixture: Q ZZ Truck #: Ll 19 Tic 7 IJ Oji Field I.D. Marking: Welders: Description of Work Inspected: A / r r 1 n r^ W C J 4 as w e. Pte! r1 1 LTcrs ' a o , Page of a' Inspector:`C T�` 1� G �... J l � � Contractor's Representative: Q r- GCopy 1 JCM Inspections Copy 2 Project Superintendent Copy 3 Governing Agency 9