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9702-017 (SFD)LICENSED CONTRACTOR DECLARATION Thereby affirm under penalty of perjury that I am -licensed under provisions of Chapter g (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 69A05 i3 t' 913 i.&zfi a" p s, t ate -2 - IJ- `f I 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: ( ) 1, 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 Colge). ( ) 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 Sects n 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: Carrier - Policy No. YrP:i•E FUND. 108 (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. Date: ADDlicant 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 laws relating to the building construction, and hereby authorize representatives of this City to enter upon theabove-mentionedproperty for inspection purposes. Signature (Owner/Agent) ! J FY3': A Date BUILDING PERMIT PERMIT# °°NTR°`�' 702-017 DATE 'VI )JO VALUATION $11,1853.60 LOT � TRACT 4692 JOB SITE ADDRESS 51-50 AVE+a'V'IDA 0B.}:EGON APN . 773-4'24-004 OWNER CONTRACTOR / DESIGNER / ENGINEER ,,�(11..L11JN11:?C71iM-1 Wrr LI[An4 1,7 IM D011AN 12,24V 252NDM`f EEE 12221 W. 252ND S1REti HA.%CfK)k cn,v (?A 907tO i-1ARBOR CI'T'Y CA. 90710 (310).534-3313 C:33L # 3330 USE OF PERMIT l7lA Sl: f:7 - %kit IT DO139- NOT IN. LURE, ALECK W11J.A.S OR PCNv1 , TRACT CONSTRLY- MIN . 2,004}.00 SF %OiCi:WPA.61.0 152.00 SF GAfdlaGWC:ARPORT 470,06 8 &SnTliti�f�.? CONST 3 ®PI ! ti117' t�J,C�'iR�baL' �'�t:r�$l�i�.'if' FEE StiTil�Q�iti?$Y . CONS FRUC "I'10N FTX 5706.00 MAN CFifx.,C;:t� M. $53344.3: FETE DEQ" ISIT -$250.00 ME'C HANICAL HE S53. O 01A- C"1'1~;ICAL f:lE $141.90 f 1..L.Ihff4f•�ff: i/1� 512"L.75 , S t'siNG.NIO'fi0. 14 FM - RSSLU $3 .W CICeAT)f 130} FSE 520.60 f.NIFRA,NTRI J47TUR E.1:1~ $2,028.72 PREC1317i PLNq $255.0 ART I.N PUBLIC PLACES - RP -31C . 5=17.1 a CUB -TOTAL CON "D'Ett,i(.7110N AND PIAN CHECK LESS PRE-PAMFEES 4250,00 TMA:L P1?,4d)!IIT MRS DUE NOW I S4,091.22, RECEIPT I DATE I BY I DATE FINALED I INSPECTOR — -- ------------- .. — �� _.._ .. .__... .._ .. .. INSPECTION RECORD OPERATION J7 DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air _ Steel I Combustion Air Roof Deck Exhaust Fans O.K to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wali Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath 4 17Final Final +' POOLS - SPAS • BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Pibg. Test Final I 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 Yj Appliances Final COMMENTS: �7 Final Utility Notice (Gas) 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 Final UU14 Notice (Perm) Building Address �J 56o o� Address Owner i n �-1P.O. BOX 1504 APPLICATION ONLY 78-105 CALLE LA QUINTA, CAL FN. ORpIA 92253 Address / zZ V- w ;,*-j z S 7 City Zip Tel. "i't"6W clz�j ?O/o 17,,-t Contractor /A/ AA . /_ . />^ i.> A A/ /il/Su��►,,0 CaN�1�� �•,� BUILDING: TYPE CONST. IOCC: GRP. A.P. Number :22 � J !. " Q �l �r _ Legal Description 50 • f Ur Sit" ;A Cr#(1PA4 L �;A ar v�► }F IA/ 6•c�c�n+t-R Project Description C . )U G c /_ r XX Aaaress l City Zip7 Tel. State Lic. & Classif. �/,A/ V City Lic. #_;�3Q Sq. Ft. No. No. Dw. Size ��d� Stories Units Arch., Engr., )< O&A>T S�AL66NKd W - A A'G Designer / A 9)�,4 r �� ��� New,9 Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address /iA u !l elf Tel. _ City Zip State k, , _ / `T -,L J3,eiNMiiYC�-- C1,27XC) Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business.and Professions Code, and my license is in fullforce and effect. `A _i`-- SIGNATURE ' DATE 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, after, improve, demolish, or 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 thathe is exempt therefrom, and the basis for the alleged 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). 12 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 improves 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 orimprovement 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.) Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. J(a Plan Chk. Bal. Const. Mech. Electrical Plumbing I 11, as owner of the property, am exclusively contracting with licensed contractors to con- strucl 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.) 1"1 1 am exempt under Sec. B. R P.C. for this reason S.M.I. Grading Driveway Enc. Date Owner Infrastructure ` WORKERS' COMPENSATION DECLARATION t I hereby 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 0 Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM�G/I �' ! G I, WORKERS' COMPENSATION INSURANC E (This section need not be completed if the permit is for one hundred dollars ($100) valuation TOTAL f� REMARKA t or less.) I certify that in the performance of thg 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: If, 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. ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Y Side Street Setback from Center Line 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.) Side Setback from Property Line Lender's Name t 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. 1 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 sof this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date_ Mailing Address City, State, Zip — xi - FINAL DATE . INSPECTOR Issued by: Date Permit Validated by: Validation: BUILDING DIVISION SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES— $ UNITS STORAGE TANK ~11, IST FL SO. FT. @ ROUGH WIRING DUCT WORK ROCK STORAGE 2ND FL. SO. F7. @ GAS (ROUGH) YARD SPKLR SYSTEM HEATING (FINAL) POR. SO. FT. @ MOBILEHOME SVC. BAR SINK TEMP. POLE GAR. SO. FT. @ I POWER OUTLET ROOF DRAINS WATER HEATER SERVICE FINAL INSP. DRAINAGE PIPING BOND BEAM CAR P. SO. FT. @ GRADING cu. yd. $ plus x$ _$ WALL SO. FT. @ DRINKING FOUNTAIN FRAMING SO. FT. @ URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER FIREPLACE VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAR. FIREWALL GARBAGE DISPOSAL LATHING FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEM/PERM LAVATORY CERT. OCC. HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER INSPECTOR'S SIGNATURESIINITIALS BOILER B.T.U. SO. FT. @ c BATH TUB GARDEN WALL FINAL SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. S0. FT. RESID @ 1'A c SEWAGE DISPOSAL SO.FT.GAR @ 3/.c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE ni TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP, FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL : Desert Sands Unified School District Notice: 82=879 Highway 111 Document Cannot Be Duplicated Indio, CA.92201 ' 6:19=775-3500; CERTIFICATE:9F COMPLIANCE Date 2/10/97 APN # No. 15250 Jurisdiction La:Quinta Owner Name William.E..Doran, Permit # No. 51560. Street Avenida.. bregon Log # City La Quinta zip.: 92253 Study Area Tract # Lot # Square Footage 2000 773-124-004 Type of Development Single Family Residence Comments 121 No. of.Units 1 At the present time, the Desert Sands Unified, School District does not collect fees on garages/carports, covered patios/walkways, residential additioms under 500 square feet, detached accessory -structures or replacement mobilehomes. It has been determined 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 facilityfees imposed pursuant to Government Code 53080 in the amount of 1.84 X 2,000 or $ 3,680.00 the property listed above and that building permits and/or Certificates of Occupancy for this square footaa in this ro osed project iiia 'nW be; issued Fees Paid By oc/Bank of America/William E. Doran Telephone -564-2018 Name on the check _. By Dr. Carol McGrew ' Administrator in Charge Fee collected /exempted by Pauline,Pearson Payment. Received $4;091.22 Check No. 2003315073 SignatureA— JCTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1998) this will serve to'notify.you that the 90 -day approval period in which you may protest the fees or other payment identified tbove will begin to run from the date on which the building.or installation permit for thisproject is.sssued or onwhich they are paid to the District(s) or to another public entity authorized to .,,actthem on the District('s)(s') behalf, whichever is earlier. Collector: Attach a copy of county or.city plan check application form.to district copy for.all waivers. Embossed Original- Building Dept./Applicant Copy= Applicant/Receipt Copy - Accounting �': ".+r k•..r �'A!'n,�,,,,`^`%: .g_ �..a aw, c!�' ks"".' x..._ •'a"'ty� -- . .�"`..'. , ...- _ ,5,- .. �L.a .,.+� ,c•yi r f+ .�. -, .'�` ..,. - COACiIECtJ1,V/�ttEY`Wi4TEADISIAICX CASH=RECEIPT DETAIL "`-'"— Received From: • 08te Accremf Nn(�O �C) /� ��./ . 6 • V � .I.V. -< ®L7? �� —1 ec Tract- �r�' •. L�... Service Address- G:A: Code. : ❑Copy to. Cash Water Service- A Check >• y Money? : .;�; = Cashier Ordet „v` .. r, CMD -438 (11 /88) .r C I ❑ Backflow(s); ❑ House Lateral(s) ❑ Detector Check(s) ❑ Meter Surcharge: *Sanitation Capacity Charge- Q W.S.B.F.C., r '� ❑ Temporary Construction Motor ❑ Tum.on Charge- ❑ Uncollected Account - Name r ❑ InspectlonFee-Tract- •^ Fee- ❑. Plan; Check Fees Water/ Sewer'- Tract- r 'F l ,' ❑ Bond Payment - A.D. - Bond 'r.`` X Assmt. • ❑ Customer Nposlt ..,.e 4" . � : ,'_ r !-�s • "` � � -: � �'�`r ❑' Other' - TOTAL, t .QigQd - Remarks: �rt`4 ❑Copy to. Cash Water Service- A Check >• y Money? : .;�; = Cashier Ordet „v` .. r, CMD -438 (11 /88) .r C I r Jan.:30, J997 1121 -Do'rothy Anna Dr. Banning; Ca. ,~ 92220 . City" of LaQuinta f Building and Safety Dept. ., Subject:r W -....,Duran- Truss Drawings Review , In response -to� your... "request I have-, reviewed"'the truss, drawings as.i furnished;'by .Spate {Fabricators .foci the• subject • residence:, Ast a result1 of this 'review 'I wish to, state that., I find that the -truss drawings are.in substantial conformance -with, the calculations and structural, -drawings. Sincerely, �i �oQROFESS/p� ! Robert .Schoenborn , , R.C.E. ' 28932 : 18 X32 A , ' Project Engineer ofRecord ,o ) No .� CIV ` OF , N r Ell -Ar A, -.c Of b C.nLq t 2TTJCGf.nT%. c�n�.�.r_iu�Jzrc..�, M� � �? f J{a �'�; :�r�; src•rra:,� .:rrJ-J ��.: rrc�-n*�J gx�•r,TT�d^ . f7 j -'-Z. cyI 7fArl,d•: :,'t:H TTT rr, ; qugTej E+?.rq bid (:z,r.� j r U t l (,pl 1 Mra!I, f,0 gr,gmioaa sa EnxuTapUc? p3 rE��rFt� F,spr.TL�f JAS: �Ot 0,1•r - rrplcc.i. ru k'sc�bOL(�f, � U 71CIOL t b(1�"- .� 1 P^►i _; 9 GATGt%,.;.' r }'fes � J. (1'':i; �(iV1�iC�': tl' ^f9t;(ij �i.�Y2% jjT`YN77JC+3 «�6AT�':, F:nTj'��].��, •.,� ;�,,�e.�}, �,=,fid. CSF}► Ct llt,(,FT'Ip7 ,1_►• ic' aaa 9 a� •ICB0 'Evaluation Service, In 'c. yn ., •lase• 1M A s_cibsidiary corpora•(ion of the Intern'ationa-I 'Conference of Building Gtfficia, A EVALUATION � 13eprtNo y Copyright © 1991 ICBG Evaluation Service, Inc. AuguU Filing Category: DESIGN -!—'Concrete; (038) CONCRETE CONSTRUCTION FOAM exterior plaster. Wire lath isyinstalled with staples in accoi dance w PLASTI-PERSONALITIES; fNCORPORATED tion 4706 of the code, except staples are spaced 3 inches on cente 1214 WEST 252 STREET mu_,rn: Pairs of staples may be spaced 6 inches on center maximum HARBOR CITY; CALIFORNIA 90710 or plaster, must''comply wltti'$ection 4708., of the code. See Figui I: Subject: Concrete Construction Form. for additional -details. 8. If. Description: A: General: The concrete construction forms are for re- C. Design: Concrete walls,must be designed in accordance with I inforced concrete walls in one- and two -story buildings Each form con- '26 of the code with calculahons and plans submitted to th,, building sists of two identical facings attached with? wire' dwiders.to form units 48 for approval. 3' inches long and 16 inches high with Various widths Each lacing has• ; ,,D 1990 Accurnulahve Supplement to the 11.B.C.: Ths report ,1.-jncji offset edges at the top,.boltom and ends to allow•interlocking with fected by, the Supplement.', adjacent forms. Facings airs expanded from Huntsman Chemical Corpora-, E: Identification: Each concrete construction form b,,,z.rs a label tion,- Type. 3486A,,`4486B.or 47868 polystyrene: beads (NER-384) to a - Yx. .maximum density of" 2.0 °pcf ` The expanded beads have;,a Class 1 lhe'manutacturer's name andaddcess,.evaluation report number, flame spread rating aind smoke-densityrating of less than 450... spread rating smoke -developed ratingand the name of the quality 3 "'agency ('Smith Emery Company. AA -554). Wire dividers are manufactured from No. 12 gauge galyaniied wire. No. : 2 Ponderosa pine wood'l alts tiave'a net.thickness and width of?/^ and t'/Z developed Evidence Sub aility s' Mrol mlaost anual and installorts of s is aiinstruc inches, respectively, and are located in molded grooves spaced 16 inches - `do: on center. They are attached to the'form by the wire dividers which are tun' i through the batt, bent over and stapled to the batt Concrete construction ' Findings forms are available with different wire dividers that provide for concrelc IV. Findings: Thatthe,Concrete Construction Form frr, walls co thicknesses of 4 or 6 inches and facing thicknesses of 2, 3 or 4 inches. Set; with the 1908 Uniform Building Code, subject to the following t' Table No. Ian Figure No.1 for additional details. Additional .wiredfviders tions and wood bolts are furnished to assemble forms al corners. Redwood 1 Specjal inspection, isprovided in accordance >ti ith Secti batts are also furnished for the wall base: of 11166de: When approved b the building official, s e �.y 9 p / B: Installation: The constructionforms are placed_on concrete founda- spection is not necessary,lor.ipstallation'of single -story Y' 9' itions With yvood balls aligned vertically: Redwood baits ale installed with mum 8 -toot -high walls housing•Group fl -I or M•;1 Occup/ wire dividers at,the wall_base as noted in Figure No. 3. All vertical wood `" g provided the following conditions are mel: 4; bads must bear'firmly on the redwood base. See Figures Nos. 2 and 3 for a. Maximum helghtol individual concrete pons is 48 h 'installation at corners and openings. Vertical and horiiontal`steel rein lP,,; forcemeat is placed in the wall cavity prigs to initial placement of concrete b. Installation is by trained installers approved by the ma later. after -laying the second course of forms. Concrete,is placed,to mid height' of.the upper course prior to vibrating or tamping. Successive courses of c. Half the allowable design stresses are used lou the de forms are laid and concrete placed in the same manner. Anchor bolts as the walls... '. required,'are located in uncured concrete al_the topoflhe wall and ver- 2'. The ,walls are constricted in accordance with this report a tically as necessary prior to concrete ptacement,,To determine'that con-' manufacturer's instructions. crete has been completely and properly placed; a_sharp instrument such 3. Installation is limlle'dto areas subject to a maximum bast as an ice pick is used to penetrate the foam to the concrete. Probe the form speed ol'80 miles per, hour with. Exposure 'C with a ma; at 32 inches on center horizontall,and solidplaceeneetegio f of concrete. '4 4; Structural talculatloftonthewallandattachmentsmust t Electrical conduit and outlet boxes .are located inthe will'by cutting . ngf - milted to.the binlding�'oflicial torapproval ,. channels in the foam plastic facing with a sharp knife, hot-wire cutter'or. 'grinding wheel on an electric drill; The voids must befilled wi-th'plaster of 5 Walls are cons idetedLcombuslible construction. 'paris or equivalent. Plumbing and vent pipes are installed in,interiorwalls. 6. The building mlerio is separated. from.thd,foam plastic. The interior wall surface's; covered with'/2 inch thick gypsum waII7 - %Jnch thick.gypsum.Jwa11board`,installed<an V -i: interii surface in accordandd4ilh'Sedion IIB of this r :port. board placed vertically and at{ache�.tothe wood balls and,top andbotlom. , . plates with Ty,pc W drywall screws at 7 inches; on centerrhaving sufficient'' 7' The concrete<construchon 4orms are fabricate„ it the ma length to provide a minimum 5/i inch wood penetration. Gypsum wail-- turer's•faclilily at lli,, R,INest 252 Street,'Narbor"11ty, Calll board panel edges must bear on,wood batts or wood plates. wittil(illow-up inspections conducted by Smith -Emery A weather -resistive barrier instalied overthe'extenorrwall surface in ac - pony. cordance. with Section 170,7 (a) of the code is covered with wire lath and This -report is subject toy e9examinaI" in two year,:. Evaluation re sorts o ICUU Evahtation Service Inc. are issued solei to rovidc iii orsnalion to.ClassA inembers o %Clio utilizin the"code u ou which list j y n j I r,. s n is based. Evaluation reports arc not lti tic i onslrucd as rcprescsiling acs/hclics unity titl�crallribulcs-sof spccificnllyaddresscd noras an endorsement orrcco ti 's+ dation for use of!he subject rellbrt. %, s < This report is based upon independent tests or other technical data subnsitted by the applicant. The X110 Evatualmn Service, Inc., technical sta�Q has revie► test results and/or other data, but does not possess test jacitilieslo make an Inde jtcntlenl verification. There is no wtirranly by ICUO'Evatuation Service, Inc., E or implied, as to any 'Finding"or utherruattcrin the Apart oras to airy product covered by the, 'ori Thisdisdmnsci tcMes, but is'not limited to; merchant �tx . F Page a 'age 2 of 5 . - Report Nd'.- 4345 14, "TABLEA0. 1—CONCRETE C`DNSTRUCTION t .FORM DIMENSKAS`. T' OVERALL,6 FOAM FORM . �' . '. '-WIDTH •;, ' ,(Inches) ..�. ..:,.� CONCRETE 7 •' =WALL }.. THICKNESS I •(Incliea) • .. , ,FOAM FORM - SIDEWALL ;' THCKNESS +.(Inchae) ' 10 (1 2 IOr q- ; 1.2 6 i 12 q . q q z I i13 r 1"11; LCCAf IIS tl�z 5WOOD t' + HOLES r`1 + SATTEN5.. + ,. u 4 I 15 , - x. + T i t 3 ,¢ 3 :, •"lW:' gra r Aft CTYP.) - 4 w1Rc MIN, 12 Z OR 3 4i W1KE SE1'ARATORo�TI,E3i BATTk'N FdRlvl . yVI, '� 13ENI7`OV�R 04 -rt. Vq. . /// i{ f• AND /`` �}TA Pl-C:►h17o...: I TN/CI�IVC55 y� L"C) VIEW FIGURE NO. 1 CONSTRUCTION FORM 5f ( Y ` L z I i13 r 1"11; LCCAf IIS tl�z 5WOOD t' + HOLES r`1 + SATTEN5.. + ,. u 4 I 15 , - x. + T i t 3 ,¢ 3 :, •"lW:' gra r Aft CTYP.) - 4 w1Rc MIN, 12 Z OR 3 4i W1KE SE1'ARATORo�TI,E3i BATTk'N FdRlvl . yVI, '� 13ENI7`OV�R 04 -rt. Vq. . /// i{ f• AND /`` �}TA Pl-C:►h17o...: I TN/CI�IVC55 y� L"C) VIEW FIGURE NO. 1 CONSTRUCTION FORM , � `� �r SSE E � � I • � i F ige 4 of 5-54 Report No. 4345 11I A. r. es.c A r E—IL-tr. Cx 11' P- o y tv/Y 1 GoNSTR �� �Ir 12 NIR E T16 C' ATG r'R \ ' APPROVED ,5T qPLM* �oR:WIRE LATH OR G DFLYVVAL:L SR'cWS ,�� • 8 II y rOR 6101 N6 . � i, • __.'1111-L .:, •� .. � t' EONCRETE FOOTIhIG` a 1l�=.1111 VIII E 9 • ' • 1111. ,: - .. •. � , I • _. is : �,• o -A� f --�I k.0TrFIlT 5 fta o,. ME .•` �nRSLI 2 h4 A © IL Oz. of v - FIGURE NO. 3—TYPICAL INSTALLATION, DETAILS Wig.. Page 3 of 5 RepdI t No. 43' S., w fir. i. '�TYR MOLQEOFOAM'- ., .. �t• .. SEDT1cw.5, EA. 5/OE i Y� `r0�/2 iY/RE H�/Tf/iS%lL� TAL � � C € / 2 W/i¢E'. W'/ A W:gS/YER � F��CH S%DE METAL lYA9HER'QN ONE v/OE Ai:/O T/EO PYC P/PE OR EL E',CTR/CALc� Tb THE oTNER IYiRE MICA;-- OCC!/d¢5 � As Z,✓/o/N/V • RF/NFORCEAP. ' { v � \ `{ •:.GORE- zc�,� !� .4n p{ • � TYF' %x.2. LATH /Y/>�/2 iV/RE ✓.� -NOTE.: '�• IVO .vOTE:.he/Z FOR'6O/MEN�/OiVS NOT v'NOs ✓N SCE `' . !Y/RE: SPACED a 6lrox.Nocr, o/VOC4:;R'O.0 YE/ZT. ,; TYP.) S -.� ' , CORNER PLAN I ,irlYP. /2 t �4 PP {,• p• y TM METAL �W iN6R .4 t cr 4: TA/ -L E I %6 GA W/RE r�TrR) - y j / x 2 'ZAT//` @CORNER CORNERISOMETRICTitt' '.e ` FIGURE NO.2-CORNER DETAIL'= . a ue �T • s2 i, yy 13 Page 5.of 5 a: Repin:rt No. 4345 p i '"IFti1aTH W G�; 1.>N�� ilAlllrJ(n iia? 1whi 'w jef1-->rS r SNS `Coi'Jr�I,GToFS ' CONCZE-LE CORE. REIN c ...S:,'E�� II II FO/ZGEMEN7 `' r hjll F- AKv.r.C,v ` REI N I=•ORC.'E M i,. STEEL- .REIN -F0,KCEMr-/q; • A o W t 4 S x., GOt±T1�110�5. LoA 6 rorIHG� �ry� r it fit`:, I J�KEt�(EHIMP 1 � µ •, k �FIGURE N0.4 , ev�r� i 79-811 B Country Club Drive nift Earth Systems Consultants Bermuda Dunes, CA 92201 Southern California (619) 345-1588 • (800) 924-7015 1r �. DAILY REPORT OF INSPECTION OF CONCRETE t SB/R.S CO. GOV. UBC TITLE 21/24 OTHER Building'Permit No.: OSA Application No.: y �� 7 Date of Inspection:, Project Name: S l - S(oQ p 6/&Q. o ✓v 6 Job No.: Z1—PZ Project Address: Architect: Structural Engineer: ' General.Contractor: -Bill Sub Contractor: TYPE OF INSPECTION: Reinforcing lacement Other Description of Work Inspected: Av:ye-d no S i e-, 7: /Sa,u� - V&64A Nl1,x - /')asfi Sn_wl)lT ✓e &f A16P'M 1A1,,J/ vine%" L/,a M&k41' 10116'J S14.)L44ID C4- Coh 501&idintn mef od _5 p SEllnnnP ' _#6A , ce vPv�/fitC s Unresolved Items: - Descriptive Location of Samples: IA& - UD Pe✓ L Slump: / Cone Temp: 7l F Time in Mixer- Supplier: Admixture: r Water Added`. :w. Air Temp: 8 Z �� ` Specified Strength: zs% fb Mix Design: Truck #: Air Content, %: Unit Wt.: Sample Time: B ; 1$6V -c # of Samples: Field'I.D. Marking: I hereby certify 'that I have inspected all of the above reported work, -unless otherwise noted, and to the best of my ability I have found this work to comply with the approved plans, specifications & applicable building laws. Final report issued at project completion. Name/No. %� \ o'� 7710 6 Inspector's Signature— Inspector's Time in Time out Lunch Straight Time O.T. D.T. All inspections based,on a -minimum of 4 hours; over 4 hours will be an 8 hour minimum. . In addition, any inspection extending past 12 pm will bean 8 hour minimum. Contractor's Representative/L :� ' ���� -� .�! Copy 1 ESC Lab Copy 2 Project Superintendent Copy 3 Governing Agency �i'aet�ci7eayr�i'RL"A#�S'�"iirei'�y�r�---.rH..yy1-'s'-�r`�'�H•-e+�gr�a;+-sr���4d'"Y�i�u,t; .,y :°t°x"Z d�i�e.R_''iki+1G�-�.t'''F�����`-.'-�i:S;�'1�.'�":5'"J?R.i:A;+aw�j�,�y+�py�c?w^.;.:�:.�.. EarthSystems Consultants 79-811B Country Club Drive Y Bermuda Dunes, CA 92201 w..a (619) 345-1588 - (800) 924-7015 Southern California DAILY REPOR' S13113.5 CO. GOV. OF CONCRETE TITLE 21/24 OTHER Building Permit No.: L OSA Application No.: Date of Inspection: I LI -9 _t Project Name: SG,cO RtVe, t ��c� C7b C2cspyX Job No.: ST- GPM- ?.1 Project Address: Architect: K)MA� _-_A, D_ICa nd\i:no _Cr__ Structural Engineer: �� Scar►�,� �, r� General Contractor: ?-A Sub Contractor: TYPE OF INSPECTION: - elnforcinlacement Description of Work Inspected:. 6 ara�ca. C,1-7�_ + Unresolved Items: Descriptive Location of Samples: Hou- Slump: t-{ - 0 o i;, I) QS- Cone -Temp: �F Time in Mixer: C7 - A • Supplier: + ,)< Admixture: .2 a N Water Added: 2cl0 Air Temp: Specified Strength o ,'S Mix Design. DSO LA' Truck #: Air Content, %: — Unit Wt.: Sample Time: # of Samples:Uc�r^=� v Field I.D. Marking: I hereby certify that I have inspected all of the above reported work, unless otherwise noted, and to the best of my ability I have found this work `to comply with the approved plans, specifications & applicable building laws. Final report issued at project completion. \N�B_ Inspector's Name/N0.___ L �1,��1,� -07 S� Inspector's Signature R c— Time in g ' 1)00%M Time out '•o r— Lunch Straight Time D.T. All insoctions based on a minimum of 4 hours; over 4 hours will be an 8 hour minimum. In addition, any inspection extending past 12 pm will be an 8 hour minimum. Contractor's Representative Copy 1`.ESC"';Lab Copy 2 Project Superintendent Copy 3 Governing Agency 2 "