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0210-241 (RC)LICENSED CONTRACTOR DECLARATION 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 168595 B Ca X31 1 h t Date Signature of Contrb�tnr 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. tY) I have and will maintain workers' compensation insurance, as required by Se tion 3700 tof the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier & policy no. are:. Carrier STATE MIND Policy No. '1603616-02 i (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 Se t on43700 of the Labor Code, I shall forthwith comply with -these provisions. {{// "I Date: v �! Applicant i Warning: Failure to secure Workers Compensatio 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'3 hii 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 representatiyeslof this City to enter upon the above-mentioned prope for inspection put os..... 6 ignature (Owner/An6nt) ate I t* BUILDING PERMIT PERMIT# DATE VALUATION LOT TRACT Plad 30147 JOB SITE ` ADDRESS 73-1ISD VWY A.II APN M^:i^:. '0_(fflA QyVNE.R CONTRACTOR/DESIGNER/ENGINEER Lx&IF, yimysV,yASv,-1mJry{Z Y-yWo ia'eV. RANCH,(,) MRZACM CA. 927,70 3j:AtMINrlA 0,A 142.'253 (15q)? 1-x34.5 CRE'U2180 USE OF PERMIT ,A'.t'.PJSJt+.FOOTINGS W&Y PE `eiAC f Q10'..3 -S O`IZS.r>i."'.o` -em 1"Fra"Or 'C 01ST OFA +a";4J. T.. 175." YSD 7 ODD 1} °XRWr FIM' SITMAOMY r. CONSTRUICT?ON PKIE 101-0004)8-000 0P rArlCO iI °YI;r:tlCTMIXTAIM 1 .rT'C �, Malko DL►=Li � 1;.��:�J �z'';�TJ•', �'!'���w �Ba, �Jgi ��&-J-lYt'r'liA ,'y cr:.it' .NST Y J15.,L�v1'<! a•-.:tT,ildw` OLi+ 2 1102 CITY OF LA QUINTA - FINANCE DEPT. S ' RECEIPT DATES, �� BY DATE FI ,SLED INS 2PEC i l•' /6 v/u, --t INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade _�O Return Air Steel _ 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 Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final .3A POOLS -SPAS BLOCKWALL APPROVALS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Heater Final Waste Lines 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 Appliances,�,�,n Final COMMENTS - 4�" Ca��/�cr- �� z /- /� p ,, / ' O lj ,� �L/�7�Z _ C Final d� 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 .z Utility Notice (Perm) r i JON TANDY 37630 Medjool Ave. ?- Palm Desert, CA 92211 Office (760) 772-7192 SPECIAL' • Fax (760) 772-7193 REGISTERED INSPECTOR'S WEEKLY REPORT Pager (760) 776-3338 EPEREIND ❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY O O POST TENSIONED CONCRETE O ASPHALTTHER ❑ REINFORCED MASONRY O FIRE PROOFING JOB LOCATION (y �' ov p) , / �v (� `PE REPORT SEQUENCE NO. TV i ST^; C E A(/ ,�.w• . 1 V IT 0.� O, -01�� �; ` O DAY OF WEEK MATERIAL DESCRIPTION ARCHITECT IN P . MRS. CHARGED ENGINEER ASSISTANTS NRS. CHARGED INSPECTION GENERALSUB i. DATE _ _CONTRACTOR4)eSe'o(-c_ct- -CONTRACTOR G'�NULJ I ` 1 ��I �� &A, D COPY SENT TO CLIENT O CONTINUED ON NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS, SPECIFICATIONS, AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. % " p ® I&&, - 4 _.' IGN URE OF RE TERED INSPECTOR by v G c DA E O REPORT REGISTER NUMBER SPECIAL INSPECTION SERVICE REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY )(Slpbv ❑ POST TENSIONED CONCRETE ❑ ASPHALT ❑ OTHER ❑ REINFORCED MASONRY ❑ FIRE PROOFING JOB LOCATION S_.7 R i , , r , `p /� (L t , i `®` 1. 1^ REPORT SEOUENCE NO. TYPE OF STRUM T ED� V� PTj �, �� tommMATERIAL PERMIT NO. � 11-E �0� DAV OF WEEK DESCRIPTIO &JO V v *5 ARCHITECT , V- ` , INSPECTOR, HRS. CHARGED ENGINEER S; LO ASSISTANTS MRS. CHARGED INSPECTION GENERAL ����nT GT -Ir Q SUB DATE CONTRACTOR IL �j J CONTRACTOR i (� t -8-o 0b\sEQqe-p PuAoGAAEAfT DF 2$ .�., gE6k WiMSN. '(0 6M o 14To sxi REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY . 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑ POST TENSIONED CONCRETE 99 REINFORCED MASONRY ❑ STRUCT. STEEL ASSEMBLY ❑ ❑ ASPHALT ❑ OTHER ❑ FIRE PROOFING JOB LOCATION 78-7050 ` o vJA 6`® LA Go'^\o' REPORT SEQUENCE N0. TYPE OF S C�RE �� C PERMITN0� 2 DATEit -,1 _ oz DAV OF WEEK Flo n MATERIAL DESCRIPTION ARCHITECT �� �� Co�rENGINEER INSPECTOR HRS. CHARGED 45 1 Afll\ ASSISTANTS NRS. CHARGED INSPECTION DATE GENERALes C, �� CONTRACTOR SUB CONTRACTOR Y" cmv a bICL o,.k A �- ,�c-S b2 ..Jsox, L: A crtA a r 2 L -rrS yr Grp bc—pk a.3 mn r,r. ' I ► 6� � Z �.� S tea. Moc- TSS ow. COPY SENT TO CLIENT ❑ CONTINUED ON NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF M`% KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. 0 f1jNfTURE OF REGIST EO INSPECTOR I 60 5077717-8V DA4rE OF REPORT REGISTER NUMBER �. DEC 09 '02 11:20 FR TO 97727193 P.01iO3 MA%. Information eTo Build On En9►ne Long • cans-/lElllq � r®sang REPORT OF MORTAR COMPRESSION TEST TESTED FOR; c��1 ; �,;, Q c C► PROJECT: 7`b - •i vii 'e•-1�;.s•� 11 � DATE' OUR REPORT NO.: O13 - Z01.0-.3 FIELD DATA: LOCATION OF PLACEMENT t; A L t �l a r r = ^ DATE PIACEO 1 \ -• 11 - O SUPPLIER PROPORTIONS TIME 1 U •.4 1 CEMENT AIR CONTENT, % WATER AIR TEMPERATURE. °F SJR FINE AGGREGATE MORTAR TEMPERATURE, OF 7 " o ADMIXTURE DATE RECEIVED IN LAB 11 FIELD DATA SUBMITTED BY MIX DATA SUBMITTED BY COMPRESSION TEST RESULTS ASTM C 109-97 ' SPECIMEN TEST LABORATORv IDENTIF rCATtONI AGE DATE OF TOTAL CUBE LOAD S (IN.) CvGE %COMPRESSIVE) I (SO AREA 1 ' STRENGTH SGTN TYPE OF BREAK I NUMBER OR SET NO. IOAVSI TEST (LOS.) I Ta I SPECIFICATIONS Test results Comply with applicable REMARKS:_ Ctmes made Dy PSI (SOM3e4"uad�e, _ Cubes picked up oy Psi rearesenlaGre. _ toa,ficerions. Cubes made by A2nitel: s or CorZiors reolesontaMe. - Cubes cef trod to PSI 1200et". Test lesats do nbl Comply Wim _ dppl`CeblOspeeifyabons. TNES! TEST Re%VLTS AnaLy OMT TO TNE;PECIAC SI WLES TE V CD AND wI Nor BE a0,GT1VE OF TNG EATICe MATERIAL PLACEMENT. REPOATS MAI NAT 'eE 0PROOLICE0. EXCEPT w FULL. VATNOVT wmTTEI+ PEoMIeSIAN eI PRAFESSWA), SERMC! MICUBTRIls. "IC, Professional Service Industries. Inc. • 42-240 Green Way, Suite C • Palm Desert, CA 92211 • Phone 760/341-$790 • Fax 760/341-S794 PSI ,I-16044 F tries, Inc- REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED O REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY O ❑ POST TENSIONED CONCRETE O ASPHALT O OTHER O<REINFORCED MASONRY O FIRE PROOFING JOB LOCATION REPORT SEQUENCE NO. TYPE OF STRUCTURE \` r� aS P RMIT NO. _ DA'E I� K ao DAY OF WEEK MATERIAL DESCRIPTION ARCHITECT INS CTO HRS. CHARGED ENGINEER cc VI tA [ASSISTANTS HRS. CHARGED INSPECTION DATE GENERAL - CONTRACTOR �-.� SUB e CONTRACTOR A C O N $*"f'emu `S ai Cl. "Jodif L' L -►'n aoL b,.,* l l_ �J m ; n -noA-ko rV o rff\ u, t COPY SENT TO CLIENT O CONTINUED ON NEXT PAGE ❑ PAGE OF CERTIFICATION OF COMPLIANCE I ' HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF M KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. C� S TUR OF REGI RED INSPECTOR t1 12 '77ZIi-eq D TE OF REPORT , REGISTER NUMBER REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED al�� URE OF REGISTEPAD ❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY ❑ POST TENSIONED CONCRETE ❑ ASPHALT .REINFORCED MASONRY ❑ FIRE PROOFING ❑ ❑ OTHER Ii 3 JOB LOCATION F S�,?ZI(-8q REPORT SEQUENCE NO. TYPE OF STRUCTUR PERMIT NO. - 2 DATE �( 1� DAY .OF`EKWE W MATERIAL DESCRIPTION ARCHITECT 1 1111 SF1tCTOF MRS. CHARGED ENGINEER opt A ASSISTANTS HRS. CHARGED INSPECTION DATE GENERAL ti CONTRACTOR SUB CONTRACTORWoM e � t - r r O.r1 �°.. '��'Q. �l S' � r � �l6vi ♦ �O C \C\ 1 COPY SENT TO CLIENT ❑' CONTINUED ON NEXT PAGE ❑ PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS, AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. Cft� SI al�� URE OF REGISTEPAD INSPECTOR Ii 3 2 IM0 S�,?ZI(-8q DA OF REPORT REGISTER NUMBER IfA JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 INSPECTION'SPEC I AL Fax (760) 772-7193 REGISTERED INSPECTOR'S WEEKLY REPORT Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑ POST TENSIONED CONCRETE C<REINFORCED MASONRY ❑ STRUCT. STEEL ASSEMBLY ❑ ASPHALT I ❑ FIRE PROOFING GOPo IC --i ❑ OTHER JOB LOCATION ... L-A \ REPORT SEQUENCE NO. TYPE OF STRUCTURE o ,rn�v�,' PERMIT NO. 2 t — DATE l l l y DAY OF WEEK v MATERIAL DESCRIPTION q r1 �' Jr OC ARCHITEC •� INSPECTOW NRS. CHARGED 9 ENGINEER I ASSISTANTS I HRS. CHARGED INSPECTION DATE GENERAL CONTRACTOR` SUB CONTRACTOR r�. U o r o' (;rL & Lax r VkA 4 e�. oa r kk- 0 e door 6r &-i r. t 1 — Mtn I • � 0 5 Mo•Sonr ' L4 IS b - W C � �G•S '� n 6 � L rM COPY SENT TO CLIENT O CONTINUED ON NEXT PAGE D PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. _ ae el k� I A"* -Cus-� A URE 0 REGISTER D INSPECTOR l l SI D E OF REPORT, REGISTER NUMBER DEC 13 '02 12:01 FR TO 97727193 P.03iO3 (MMInformation Engineering • Consuiung a 1L8t )w REPORT OF MORTAR COMPRESSION TEST r "z, r;_ v r G -k TESTED FOR: `( �.�,�� 3 �., S"M PROJECT: \ � J�•.:.1n C n OIJR REPORT NO.: p 3 OJ DATE: FIELD DATA: S ? C, LOCATION OF PLACEMENT \' ? ':. \ I \_ \ K– 1t DATE PLACED TIME cj ' AIR CONTENT. % AIR TEMPERATURE. eF MORTAR TEMPERATURE. 'F ) A' ()ATE RECEIVED IN LAS FIELD DATA SUOMITTE0 By MIX OATA SUBMIT'TEO 8Y C epi SUPPLIER J p C� "` \,{ PROPORTIONS CEIMENT WATER FINE AGGREGATE ADMIXTURE COMPRESSION TEST RESULTS ASTM C 109-93 SO�C:MEN TEST TOTnL CUBE SIZE u.BORATORY ' 10ENTIFICATION1 AGEOTEST F l aS.1 pH.t NUMBER ORSET.,IO. I (OAYS) Z 2 °J 2 sir -t2 730 I . SPECIFICATIONS REMARKS • —Cubes made by PSI reorese"lat'" _ Cuoos Picked vo by PSI rearesanmlf e. Cubes made by Aiuwea-f w l( CuOes det,�gted 10 PSI I800ra10h. Conlractae s re0'e,,A181W e. _ CUBE (CCMPRESSIuE; AREA 1 STRENGTH : f$Q. 1N.1 (PSII TYPE OF BREAK Test resuei caimlY with e001iw01e �oe,�(catiOM. Test resul0 d0 not comoly •'.m aP06cabte s0eClftCAI: C"' ndustries, Inc MEitt'Et"E... r TO i>,C SOEW►1C S.ssV1.E5 TE9yE0 Iwo w1v HOT eE OMICA"A OF Me &14 Mfl wttJit•1. at.ct>+EtaT. aaea sslewa. sEavttE INOUi*atEs. IMG. �POaTs.,.. r ' §ronaF eiv Ce InCIUSTries. Incl a 42-240 Green My. Suite C e Palm Desert, CA 92211 a Phone 760/341-5790 a Fax 7601341.5794 ** TOTAL PAGE.03 ** f SPECIAL INSPECTION SERVICE REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY ❑POST TENSIONED CONCRETE ❑ASPHALT REINFORCED MASONRY O FIRE PROOFING �� OX O OTHER INS E R JOB LOCATION 8 R,%aL `nr REPORT REPORT SEQUENCE N0. TYPE OF STRUCTUREPERMIT Comm. : 2 -2 OAT 16 02 DAV OF WEEK MATERIAL DESCRIPTION iMc► o K. , ARCHITE /1 /W_ INSPE MRS. CHARGED S -L ENGINEER ASSISTANTS NRS. CHARGED INSPECTION DATE GENERALSUB CONTRACTOR .0 CONTRACTOR A r M ♦ L G1 r. kk .Z #jo( O IF resv- jo , C. i' i n S q re 6 �' �' h a q r LA -4 � Co r n -V . Q r A 7v h S ooh C. J COPY SENT TO CLIENT ❑ CONTINUED ON NEXT PAGE ❑ PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. V SI TURE R-EGISAERED INS E R oz le/r36 S-07??r?�8�¢ DATE/OF REPORT REGISTER NUMBER REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE O STRUCT. STEEL ASSEMBLY ❑ POST TENSIONED CONCRETE ❑ ASPHALT EINFORCED MASONRY O FIRE PROOFING ❑ ❑ OTHER JOB LOCATION 7 $ - ", REPORT SEQUENCE N0. TYPE OF STRUCTURE p M M DSS FPERMIT NO. QS - 7 Q DATE 1 QSZ DAV WEEK JG MATERIAL DESCRIPTION ARCHITECT �a INSPE TO MRS. CHARGED ENGINEER^�� a QArA ASSISTANTS HRS. CHARGED INSPECTION GATE GENERAL CONTRACTOR SUB /L CONTRACTOR A4 N 4 0 - i0, QPAk4ZAf Co sk J18 PU b -F 9. S P (sr o Ll t 1 it ltq Q 3 Telma S i COPY SENT TO CLIENT O CONTINUED ON NEXT PAGE OPAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. 1 HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS, SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS.' 4 cem:!:� �)" A,.&A — I SI URE OF REGISTERRE INSPECTOR— ` ' 1 D E OF REPORT i me) -7 -72i7—eq q REGISTER NUMBER DEC 17 '02 12:4? FR TO 9 -?727193 P.02i02 ARM d& Information r .To Build On 3 Engbeer ft • Constrlfing a Testing REPORT OF GROUT COMPRESSION TEST TESTED FOR: PROJECT; 'i ��o��s ���s(?�C�'�4�,5 7� - �0 OXV o I L a OUR REPORT NO.: Q_M e �u 0 DATE: FIELD DATA: tL LOCATION OF PLACEMENT`. LLJ l NG UJ O•LL- DATE PLACED TIME SUPPLIER - PROPORTIONS CEMENT WATER AIR CONTENT. % b FINE AGGREGATE AIR TEMPERATURE, /F ADMIXTURE GROUT TEMPERATURE, IF 7 A."' DATE RECEIVED IN LAB \L - ZZ U Z. FIELD DATA SUBMITTED By MIX DATA SUBMITTED 6Y COMPRESSION TEST RESULTS ASTU Cto1s3 I t SPECIMEN I TEST I I M A TOTAL i OATS OF LOAD LA80RATORv I tOOR SE NUMBER OR S� y NO. ' (OArS1 � NO. TEST LBS.1 i 'z� 5 -7i \\ 3 3 k3 x 6 I Zb LZ -n - 0.2.. i I �i?00 I I I t 1 I SPECtrICAnONS Cs CUBE COMPRESSIVE to REA S� vsnTM I i (so, . 3 k3 x 6 I U i 1`�Jv I I I �i?00 I I I t 1 I REMARKS: _ CUbe$ _00, by PSI Iear3eAtati�e. — Gabee viCkad UP by PSI reWe3enuiive. CUbe$ mid$ by A--*1'1e7s 0' 1L Cube3 aefref9A to PSI �aboiftory. V COnbaC•ers $6pm,4AI2I"0. _ TYPe OF BREAK rest,esuits coe5" -iU1 appt10awe specifica40ns, Ye$t M.'O $ 0o eot comoty "11,epvtiO3ele Spet;bpatibn3. itIESE TEST RESULTS M0.'v a,y TO ME SeEUM ----3 rEtTtLA AMO - NOT SE IMpG MI15 00 TME rJJnRE NAIEA W. P"CEM&ff' aEPOR$31N$r ,,,az op ncoeObUGlD. EXCEPT IN AJ. VNT"`*JT WRITTEN elAwa:,10N ev cRO.E9at0$uL SEIMCE IPQLteTR1Ei. OC - IE Professional Service Industrie8, Inc. • 42-240 Green Way, Suite Co Palm Desert, CA 92211 -.Phone 76Q'341-5790 a Fax 7601341.5794 Industries, Inc ** TOTAL PAGE.02 ** a REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY ❑ ❑ POST TENSIONED CONCRETE ❑ ASPHALT ❑ OTHER o<BEINFORCED MASONRY ❑ FIRE PROOFING JOB LOCATION 78 - -1 w A ��� REPORT SEQUENCE N0. TYPE OF STRUCTURE Corr, M- S PERMIT N0. 2. k — Z y DATE DAY OF WEEK 20 MATERIAL DESCRIPTION ARCHITECT w O /ow- coy, v IN P TOR NRS. CHARGED ENGINEER ASSISTANTS HRS. CHARGED INSPECTION GENERAL�� 1. SUB DATE CONTRACTOR '1` CONTRACTOR 2c bs,t [ r `7 Gni` < S/ PCM 0'^ I rD "AJG . 3 n "i My «21 Orr. Gr' Noy /-,61r f , an rnkf ka1.. - ar O LC. W CxoJ O row V COPY SENT TO CLIENT O CONTINUED ON NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS, SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. S ATURE OF REGIS ERED INSPECTOR D E OF REPORT REGISTER NUMBER DEC 17 '02 12:40 FR Information f • ` Ll'"i'� To B uald On Engiineenny Conarrftin9 - Testft TO 97727193 P.02i02 REPORT OF GROUT COMPRESSION TEST (� PROJEC ESTED FOR: .e N O S tJ JY C-7\ 4�-f S C. O• 1 SATE: FIELO DATA: LOCATION OF PIACCMENT OATS PLACED \\ 2 0 0 2 AIR CONT—ENT. AIR TEMPERATURE. eF 1 GROUTTEMPERATURE. •F 7 v OATE RECEIVED IN LAS O Z. FIELD OAT,', SUBMITTED BY MIX OATA SUBMIT i EO 8Y G(. . OUR REPORT NO.: l l ��ul>•1S�QF I a G cr.� C3�:�O�N�� Wo•L� SUPPLIER C� PROPORTIONS CEMENT WAiCCR FINE AGGREGATE AOMIXTURE COMPRESSION TEST RESULTS ASTM C too -93 i 1 SPEC:NEN I TEST Abe I OAYE OF yT BE TQTAI. S SIZE �QAO I IZE 1196.1 ueORAtORf I1OENnFtCATfON NuMeER OR 1.2 ro. (oAvSI 17 ' \\- Z. %I) 3 x3 k 6 2+A- 1 I I 1 ' I - i SPSC:FICATION$ REMARKS: C..ova made by PSvee^sentau•e. ' Cubes made OY'1rt7atoo' Os . a� CentlaC•of a room#9erat"'. ` Crfbes pidted tfo VY F SI rope senuv-e. X G�Oes 4a�ivtvao to rsf lJoorato'y, (5Q, IN,1 , •...(PSII-.. I rypa OF BREAK P i � •U � �a`i0 I 1 I 21 i I Tear restits WAICN �� aootk. ae f PeC��r,�o^f rest maolu do nef catioW wW% aopttYdOta sverahc qws. ndustries. Inc Mrp uwv'gf SE'Mot4nvE W TM! FNr7AC fsnYEAlfl7V.CEJEMY, a• e-e&11eV T. Y"p SPEC fVtl. ,,TMCUr w41rMM PEJfMaE't>M 9r' P1tOa1•serW+1V• ifAt'tGt: rfpytlTilF.a. arC. 1M0lE RfY f1EslllTl .VPIY OK'f 10 YY'E sPECVrC s.u'P1r3 TESY'FD pr AEPQMS wY 0 pfAY Professional Service Industries, Inc. • 42.240 Green Way Suite C • Palm Desert, CA 92211 -.Phone 760/3415790 • Fax 760/$41-5794 ** TOTAL PAGE.02 ** REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY ❑ POST TENSIONED CONCRETE ❑ ASPHALT ❑ REINFORCED MASONRY ❑ FIRE PROOFING SPO JGy ❑ OTHER JOB LOCATION , REPORT SEQUENCE N0. TYPE OF STRUCTURE o S PERMIT N0. -2 DATE DAY OF WEEK n. MATERIAL DESCRIPTION sa a 'C . AR ITECT Cir INS CTO °' C HRS. CHARGED 12 2 ENGINEER NLO ASSISTANTS MRS. CHARGED IN PECTION DATE GENERALSUB CONTRACTOR �', CONTRACTOR A ZS a.5 - : S COPY SENT TO CLIENT ❑ CONTINUED ON NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. G ATURE OF OE GISTERED INSPECTOR DATI OF REPORT REGISTER NUMBER REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED GISTERED INSPECTO 12-02 yZACP GNATURE OF ASU 12 ❑ REINFORCED CONCRETE O STRUCT. STEEL ASSEMBLY ❑ POST TENSIONED CONCRETE ❑ ASPHALT 6<REINFORCED MASONRY O FIRE PROOFING ❑ O OTHER JOB LOCATION w REPORT SEQUENCE NO. TYPE OF STRUCTURE Comm'. I�Qss PER I2T NO. 16 - �� DATE_ 11 - �� DAY OF WEEK MATERIAL DESCRIPTION ARCHITECT Cor INSPECTOR HRS. CHARGED . ENGINEER ASSISTANTS HRS. CHARGED INSPECTION DATE GENERAL CONTRACTOR eCANTRACTOR •-� - \ _� Y• "crl I 1 vz � i ivs o. g mac- ' �a 11 C Iry�4 a b)\6 - m (\&- -Sjr&Zi kkr Ge, IV e r c7 O 'ar t u C. oQe- G " CnIk L4 cojCwLs 'St S. l r COPY SENT TO CLIENT O CONTINUED ON NEXT PAGE ❑ PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. 0&'-t n 52"� GISTERED INSPECTO 12-02 yZACP GNATURE OF ASU 12 DATE OF REPORT REGISTER NUMBER ,SOZ77 6 7-��} JAN 08 '03 13:12 FR TO 97727193 P.01i01 9 rs i Infonwtion °To Build On Lrngm 13 01 w,g • reSatv N REPORT OF MORTAR COMPRESSION TEST =STED FOR: a �� ,@E L `( \'J1.1 PROJECT: R u5 5 �1 q°"� `�� � '�' C >tIc V>J� 11 � avast %t5 i. r. �v\rJ1t Ga OUR REPORT NO.: -ATE: 0 3 Z tJJ IELDDATA: \�\�(1) �JuR�N aG\iJr VJc�t.'" OCATION OF PLACEMENT 2 t�JG \a �\ oZ SUPPLIER )ATE PLACED SPEClcccarlONS PROPORTIONS 'IME 1 Z'• AZ Cvaea Ma69 ey 951 rceresoMaGve. CEMENT Cu as mace by ATanilecfS or WATER 11R CONTENT, % FINE AGGREGATE >IR TEMPERATURE. PF ADMIXTURE AORTAR TEMPERATURE. OF DATE RECEIVED IN LAB ►� =IELD DATA SUBMITTED 9Y Ots S MIX DATA SUBMITTED BY COMPRESSION TEST RESULTS ASTMC109-93 ' SPECIMEN TEST TOTAL ' IDENTIOICATIONi AGE OTES,0f CUBE CUBE ICOMPRESSIVEI I size AREA sTRENC'rN I (50. IN.) (PSI) TYPE OF BREAK LABORATORY .; NUMBER • OR SET NO. c (OAYSI) (LBS.) 3 7— Z k4 `I Cuoos 9'4406 up by PSI rapresanmfive. It Cubs 6ervero6 I. PSI laboraepry. 3-•\4- , z�\O i i I I I I i I j Teel results comply wiln aPolic"le TpeoficatiIA9. Test Ieaulb 60 Act comply won apopeeOlo s0sodcatiana. \ mgsE TEST 0.E4ULr0 APPLY ONL,, ro rME SPCVFIC SAMPLES T931ED ANO Auy NOT of INOICUTNE Co THE ENn9B HATEAwA PLACEMENT REPORTS WAV Aor of REPROOVCEo. "cEyT w iuLL.`/ArAcof w0.1rTEN vERM'saro" eY vepfE9WONAl 4fi0.1nCE INOUei0.1E3, TNG. Professional Service Industries, Inc. • 42-240 Green way, Suite C - Palm Desert, CA 92211 • Phone 760/347.5790 • Fax 760/341.5794 ndusrries, Inc. ** TOTAL PAGE.01 ** e_ SPEClcccarlONS REMARKS: _ Cvaea Ma69 ey 951 rceresoMaGve. .� Cu as mace by ATanilecfS or Comeaclors NtPreaeAlmive. Z k4 `I Cuoos 9'4406 up by PSI rapresanmfive. It Cubs 6ervero6 I. PSI laboraepry. 3-•\4- , z�\O i i I I I I i I j Teel results comply wiln aPolic"le TpeoficatiIA9. Test Ieaulb 60 Act comply won apopeeOlo s0sodcatiana. \ mgsE TEST 0.E4ULr0 APPLY ONL,, ro rME SPCVFIC SAMPLES T931ED ANO Auy NOT of INOICUTNE Co THE ENn9B HATEAwA PLACEMENT REPORTS WAV Aor of REPROOVCEo. "cEyT w iuLL.`/ArAcof w0.1rTEN vERM'saro" eY vepfE9WONAl 4fi0.1nCE INOUei0.1E3, TNG. Professional Service Industries, Inc. • 42-240 Green way, Suite C - Palm Desert, CA 92211 • Phone 760/347.5790 • Fax 760/341.5794 ndusrries, Inc. ** TOTAL PAGE.01 ** SPECIAL INSPECTION SERVICE REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED O REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY ❑ POST TENSIONED CONCRETE O ASPHALT GVZEINFORCED MASONRY O FIRE PROOFING O ❑ OTHER JOB LOCATION _ LA REPORT SEQUENCE NO. TYPE OF STRUCTURE PERMIT NO. 2 DATE DAY OF WEEK MATERIAL DESCRIPTION ARCHITECT INSPECTOR HRS. CHARGED ENGINEEcRR�\ GJ 1� ASSISTANTS HRS. CHARGED INSPECTION DATE GENERAL CONTRACTOR SUB NTRACTOR r .• G,•-nporse cv 1, c-sk 3 _ 2< « Gcsel� COPY SENT TO CLIENT p CONTINUED ON NEXT PAGE ❑ PAGE 0: CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS, SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. SI ATURE OF REGISXERED INSPECTOR DATE OF REPORT REGISTER NUMBER r 'A SPECIAL INSPECTION SERVICE REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED O REINFORCED CONCRETE RUCT. STEEL ASSEMBLY ❑POST TENSIONED CONCRETE O ASPHALT ❑ REINFORCED MASONRY ❑ FIRE PROOFING ❑ �THER ` JOB LOCATION n REPORT SEQUENCE N0. Tv�F STRUCTURgE PERMIT N0. D DAY OF WEEK MATERIAL DESCRIPTION v v J V V , V_ ARE(�T f r v C, C�o`/�r_ IN$PFLTpN HRS.CHARGED E-:-? �� Is ENGINEE:rR r.I A , I ASSISTANTS MRS. CHARGED INSPEDATE CTION CONTRAGENECTOR �I e SUB C V CONTRACTOR W S 1 "-� ••� I 1 kkA e �4�E.thlrc0 c,cJ w D �, � L bl �,0 G•Qe�' Ws L.-ae.< COPY SENT TO CLIENT ❑ CONTINUED ON NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF M? KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS, SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. SIGN TURE OF REGIS ED INSPECTOR A*TE bF REPORT REGISTER NUMBER f .41 J-� Ll I d WcICT:t?O aW 9T m L-Ld t4-- L; 77 8-qLB86S 606: IIN xii-A E943 L4FJL)-II5: WCJdJ f 1 JON TANDY r 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 SPEVAL • Fax (760) 772-7193 REGISTERED INSPECTOR'S WEEKLY REPORT Pager (760) 776-3338 TYPE OF INSPECTIONOTHER PERFORMED 0 REI NFORCED CONCRETE 0 STRUCT. STEEL ASSEMBLY-. NREINFORCED MASONRY 0 FIRE PROOFING JOB L. ARCHITECT '91 • - MEN m.e ENGINEER ENERAL .. PONTRACTOR nm HIM w • 1 14 ARE EEEEErjM WL r1 u S' '� •� .� .� r' I ME l .. •_ Z COPY SENT TO CLIENT 0 CONTINUED. CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF Md SIG URE OF REGISTEPAD INSPECTOR KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE 1 I �� � 7,� 717 , 7 -9� NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED ` U L/ 1� PLANS, SPECIFICATIONS, AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. DATE OF REPORT REGISTER NUMBER I i` SPECIAL INSPECTION SERVICE REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED O REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY (z ?,' mo �❑POST TENSIONED CONCRETE ❑ ASPHALT ❑ OTHER C5116REINFORCED MASONRY ❑ FIRE PROOFING (1C JOB LOCATION— - a REPORT SEOUENCE NO. TYPE OF STRUCTURE Ca PERMIT NO. - zqToes DATE DAY OF WEEK MATERIAL DESCRIPTION ARCHITECT INSPECTOR HRS. CHARGED ENGINEERASSISTANTS S HRS. CHARGED INSPECTION DATE GENERAL CONTRACTOR SUB CONTRACTOR r- e c- J �L'Yn Cof c1. << IVo i 6�`n 0 0� mI , rr L ,. - 14 nrPn-s Lm r W din4 a COPY SENT TO CLIENT O CONTINUED ON NEXT PAGE ❑ PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF M`% KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. SI TURE OF REGI RED INSPECTOR 2 - - lO.717 84 DATE OF REPORT REGISTER NUMBER v 4' • �ii JAN 20 '03 10:51 FR �W771 Infomw ion M%' eTo 17 ild On l;jH o►•C. TO 97727193 P.03i05 REPORT OF MORTAR COMPRESSION TEST TESTED FOR:PROJECT: R v SS CJt Q -C i3 • > U>J �-ivJ`. \ll 17iS>rR� C \i t�� 117. a. i GATE: OUR REPORT NO.: FIELD DATA: LOCATION OF PLACEMENT ; ? oa (J L �t Z C n1 V ' lr� o.� S V v1\A F e� r;,� n,!o IvES1 OT Gh11Re. � r GATE PLACED 12- li UZ SUPPORT PROPORTIONS TIME ' �'• X14 CEMENT AIR CONTENT. % WATER AIR TEMPERATURE. OF FINE AGGREGATE MORTAR TEMPERATURE. OF (Izl " ADMIXTURE DATE RECEIVED IN LAB 12 , 7114 FIELD DATA SUBMITTED BY MIX DATA SUBMITTED BY G-3 F- (' Q 0vGL a.6 Test reautls tom -ply wild aOPiicable toeclticatloAt. Teti rasulla 00 rot CJBMPly wkt. e0plicable s0", call T-' TYPE OF BREAK Repo TESIT wi vlBULTs sPPty ONLsn� ael;15TUE "P.ceULL p"TMOVT VVMTTE� E IABStpN pY PRO06 ,d+�y MOT 99 INOICAYNE ()F Al selwteE wowSTF IES�NC.M *. RlPORTS uay IfOi 9E�titIRrlOt'� Professional Service Industries, Inc. • 42.240 Grean Way, Suite C • Palm Desert, CA 92211 • Phone 760/:141.5780 - Fax 760/3411-5794 • 7 • ndustries, lnC COMPRESSION TEST RESULTS ARE (SO.IN.1 iCSMcEETH TRNG I PSt) ASTM C 109.93 SPECIMEN i TEST LABORATORY ' IOENTIFICATIONI ACE •Y OiESTOF ' TOTAL CUBE LO (LOS.) SNE NUMBER OR SET NO. t (OAYS) 2�\iU 21� A ItZ: z1.►2 5z5� 2 k i • � ze C SPECIFICATIONS , REMARKS _ Cubet maae by PSI .eere:enlalive. _ Cubes Picked u0 by PSI gpresMleU"c. �L Cubes maae by AI'CRIleCrs or Cantrecwes •erNesenLau.e. \` )c . Cubea oeorereo I. PSI taoaalary. Test reautls tom -ply wild aOPiicable toeclticatloAt. Teti rasulla 00 rot CJBMPly wkt. e0plicable s0", call T-' TYPE OF BREAK Repo TESIT wi vlBULTs sPPty ONLsn� ael;15TUE "P.ceULL p"TMOVT VVMTTE� E IABStpN pY PRO06 ,d+�y MOT 99 INOICAYNE ()F Al selwteE wowSTF IES�NC.M *. RlPORTS uay IfOi 9E�titIRrlOt'� Professional Service Industries, Inc. • 42.240 Grean Way, Suite C • Palm Desert, CA 92211 • Phone 760/:141.5780 - Fax 760/3411-5794 • 7 • ndustries, lnC EIA ARE (SO.IN.1 iCSMcEETH TRNG I PSt) 3.1gr lt;�� • c.1�U 2�\iU 1 Roo Test reautls tom -ply wild aOPiicable toeclticatloAt. Teti rasulla 00 rot CJBMPly wkt. e0plicable s0", call T-' TYPE OF BREAK Repo TESIT wi vlBULTs sPPty ONLsn� ael;15TUE "P.ceULL p"TMOVT VVMTTE� E IABStpN pY PRO06 ,d+�y MOT 99 INOICAYNE ()F Al selwteE wowSTF IES�NC.M *. RlPORTS uay IfOi 9E�titIRrlOt'� Professional Service Industries, Inc. • 42.240 Grean Way, Suite C • Palm Desert, CA 92211 • Phone 760/:141.5780 - Fax 760/3411-5794 • 7 • ndustries, lnC JAN 16 '03 10:55 FR 7pj. InformationI �rr-Build On �Fixjineering • Com" • 7f�sting TO 97727193 P.06i06 t��rL�r•Z� 02\0 -- 241 REPORT OF PRISM COMPRESSION TEST ESTEO FOR: 0 o.l� )E S E 9.Y C,J�JS7QvC,�Wty PROJECT: RuSS 1% OUR REPORT NO.: DATE: FIELD DATA: LOCATION OF PLACEMENT \Z , .t� SUPPLIER - OATH PLACED Pi DELIVERY TICKET NO./TRUCK NO. Z `; TIME 1,Z 5 1 MIX NUMBER AND PROPORTIONS (00 SvZG P CEMENT AIR CONTENT. % WATER AIR TEMPERATURE. OF 1 FINE AGGREGATE MIX TEMPERATURE. '5 , ie COARSE AGGREGATE DATE RECEIVED IN LAB 2 ' 2^ ADMIXTURE FIELD DATA SUBMITTED BY (Z J U C, L c, 5 MIX DATA SUBMITTED BY COMPRESSION TEST RESULTS ASTM E467 SPECIMEN i -EST AGE DATE Of LAgu BELAY :IDORTSETNO IFICATIONIl0 YS)' TEST �3 Z, a It" 2� 1-1h •u3 SPECIFICATIONS REMARKS: Soectmenf made 07 PSS rePreacvuab�e Sea Imens maga ay ArVI•Iou c It, Conuecto/Srapreseruaa•e. TOTAL LOAD SPECIMEN DIMENSIONS (LOS.) STR (Psi) TYPE OF :BEAK (Psi) OJU 2510 5� o Spac:mem o,cke0 vo oy PSI v,+eereaanwti�e. Soae.mens dak,,cred to PSI Iabolatey. SPECIMEN i COMPRESSIVE rREA STR (Psi) TYPE OF :BEAK (Psi) 2510 5� o Tesl reau4: cOr*OIY -r,tn e0ottcaOla soecif;eotiona. Test results co not cemolY with aoplcaote soocdeaoons. TErl EFORTS W^y NO of AE a0OutED CX EPYENIF�`AMTNWTEwR1TTEN E WIISIO 8v T BE PROF SSOONm 4ETM10E mOU61-4169, u+G.MfM. Professional Service Industries. Inc. - 42.240 Green Way. Suite C • Palm Desert CA 82211 a Pnone 76or.341-5790 • Fax 7601341-5794 indusvies, if'( )at a-aoO It F ** TOTAL PAGE.06 ** REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE O STRUCT. STEEL ASSEMBLY d2e(bJ ❑ POST TENSIONED CONCRETE O ASPHALT ❑ OTHER REINFORCED MASONRY ❑ FIRE PROOFING JOB LOCATION 7 - Il Lc& Qv; REPORT SEOUENCE NO. TYPE OF STRUCTURE .�. s PERMIT NO. 2 - 2� DATE 12- l8 -Q5 DAY OF WE C� MATERIAL DESCRIPTION ARCHITECT Cwt INSPECTOR D HRS. CHARGED ENGINEER f\ 1 f\ ASSISTANTS MRS. CHARGED INSPECTION DATE GENERAL . CONTRACTOR SUB CONTRACTOR O l�� \rA L4 cg- CIS Co�K 3 ID. t��. Ccc65 GP �A rr CN` 6r: w c.: c S ` " a 1 n cb J r lv 3 - nILU , L�As� 6 le r u ncL L, l tr Q. COPY SENT TO CLIENT O CONTINUED ON NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS, SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. N GDL� Ino��� GNATURE OF RSTERED INSPECTOR 12-- M - trio =71717-8{ DATE OF REPORT REGISTER NUMBER JAN 20 '03 10:51 FR ' TO 97727193 P.01i05 ff �; Infonnadon .ToBuildOn EgWnewft a "nwnft a 1lsNnp REPORT OF GROUT COMPRESSION TEST TESTED FOR:PROJECT: C2 5S u �� �\v3QcC�i�'p;5 \tI \311E c��\e6 sa OUR REPORT NO.: 073 - Ou G DATE: FIELD DATA: LOCATION OF PLACEMENT J� G til kr�iG�, OATE PLACED Z. 1 p- 62 TIME � Y. AIR CONTENT, AIR TEMPERATURE" eF 4, GROUT TEMPERATURE. 'f �7 GATE RECEIVED IN LAB \Z _ \ V 2— FIELD DATA SUBMITTED B`1 MIX OATA SUBMITTED BY C, 0 f—% 9— ,WORATOAV I IGEN NUMBER OR I ` ' I SPECIFICATIONS SUPPLIERr�i - I PROPORTIONS CEMENT WATER FINE AGGREGATE AOMIXTURE ^� T COMPRESSION TEST RESULTS ASTM C 109-97 EN TEST AftoNi AGE I OATS OF TOTAL CUBE t. 10A0 SIZE I CUBE COMPRESSWE I AREA STRENGTH ISO. IN.) (PSI) tYPE Of 80.fAK MotoTEST 0I t0Ar5) (183.) ItN.1 I 7 kZ �;5 �Z. V. 850 13 x 3 x I •03 I Z4(�.Q � '• 1 15 u 3 � 23 3vU 2590 I i Z0 REMARKS: _ Cueee made W PSIreoro7snlen•e. , C."s OwKee up by PSI re0rotenu11we. m `/ Cueee made 0r AIt7"I051 0' 7C Cuba, eedvemd to PSI 185" N. X COntmcor a reOrraentO-me. _ � r.• v v v Teat results MT%PN vttP 6096da01e sOe6Ocadi - Test ranks 00 MOI dom01T'-iN a001i2ele r0ezd1�liwj. AEPOWS UAV NOT of aepaOMAM, EXCEPT EN IS IkL vwriCtlTw.itTTEN PPEPI..SdrON 4ywpRpO�ylll7V�1, SERVICE rrOuitld!! � JfT. ProfeS3t0n8e Service Indusaies, Inc. • 42.240 Green Way, Suite C • Palm Desert. CA 92211 - phone 76DI341-5790 • fax 760/341-5794 om Iylebal F ndu$Vies, !nc SPECIAL INSPECTION SERVICE REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office .(760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑ POST TENSIONED CONCRETE REINFORCED MASONRY ❑ STRUCT. STEEL ASSEMBLY ❑ ASPHALT ❑ FIRE PROOFING ❑ ❑ OTHER JOB LOCATION REPORT SEOUENCE NO. TYPE OF STRUCTURE PERMI N0. DATE 7_ - DAY OF WEEK rS. MATERIAL DESCRIPTION ARCHI T ��CUL INSPECTOR ' HRS. CHARGED ENGINEER ASSISTANTS HRS. CHARGED INSPECTION GENERAL DATE CONTRACTOR SUB NTRACTOR 2- `r GAO's t u.1 or ', ,y% c v Ro\\- v oac' ' JrT • ` v oor" — a o or �Gr t r VSO i" o 8' . c-\ rQ Cdrk ;- Gr, - �J �- roof' ti d COPY SENT TO CLIENT O CONTINUED ON NEXT PAGE ❑ PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS, AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. _PVNATO-RE OF RE ISTERED INSPECTOR Z� 2 )C9Q SQ(71717- 8� DATE OF REPORT REGISTER NUMBER SPECIAL INSPECTION SERVICE REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑ POST TENSIONED CONCRETE REINFORCED MASONRY ❑ STRUCT. STEEL ASSEMBLY ❑ ❑ ASPHALT ❑ OTHER ❑ FIRE PROOFING JOB LOCATION i W REPORT SEQUENCE NO. TYPE OF STRUCTURE l o �S PERMIT NO. -2 DATE _ DAY OF WEEK MATERIAL DESCRIPTION ARCHI I ECT INSPECTOR HRS. CHARGED ENGIN R ASSISTANTS HRS. CHARGED INSPECTION DATE GENERAL CONTRACTOR SUB CONTRACTOR z'3 -4 0& L >• iN o. L T U Uk'C\90 dv)f tl c. : n�-fE 4Qo, d c tf e ei Q / l - f o 0 C O� 0 c o P G, A 4 4neQ, COPY SENT TO CLIENT ❑ CONTINUED ON NEXT PAGE ❑ PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF M? KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. r) l ('" 064'km - I NATURE OF RE STERED INSPECCTTORR �r 2 DATE OF REPORT REGISTER w72 A4 r= i SPECIAL INSPECTION SERVICE REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑ POST TENSIONED CONCRETE REINFORCED MASONRY ❑ STRUCT. STEEL ASSEMBLY as( i0PO kU ❑ ASPHALT ❑ OTHER ❑ FIRE PROOFING JOB LOCATION E�- 100 L\C\ REPORT SEOUENCE NO. TYPE OF STRUCTURE • PERMIT NO. - 2 DATE -2-4-o-,- DAY OF WEEK MATERIAL DESCRIPTION " C� o� ARCHITECT C.r � (�,o INSPECTOR NRS. CHARGED 'X0, I2 ENGINEER 5� v ASSISTANTS HRS. CHARGED INSPECTION DATE GENERAL CONTRACTOR tA t -.S SUB CONTRACTOR 12-Z \a o OA 1k\ (^� tra.Q twf `V p lS ky- e o,c i ZA ' C\\ -o 6c, Gk inA st, i fi=� -inV nor r.Qr- _Z9 - AS o r CSS d ,h i, �# 5 e o t-- . qr 2- o IV -1 0,u- , -12-Ly 12.-2 q 'C _a . or4✓` S COPY SENT TO CLIENT ❑ CONTINUED ON NEXT PAGE ❑ PAGE OF CERTIFICATION OF COMPLIANCE 'HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF M1? KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. (.41NOLIFFE OF REGI RED INSPECTOR v (o1+7q DATE OF REPORT REGISTER NUMBER 1 JAN 21 '03 17:13 FR TO 97727193 P.01iO3 � 4 I Ifo nation __.._ .. ` .To Build 4n EngMeet" *Wing REPORT OF MORTAR COMPRESSION TEST TESTED FOR: a��� c� sQ� (-'I \'W PROJECT: uiV 7a •'ioU 1av�iy \\\ I PATE: OUR REPORT NO.: O73 ZOL) 0 i FIELD DATA: LOCATION OF PLACEMENT *k liJ au— DATE PLACED Rl GAr - o Z TIME AIR CONTENT, % AIR TEMPERATURE. °a A) MORTAR TEMPERATURE. OF DATE RECEIVED IN LAB FIELD DATA SUBMITTED BY Mex DATA SUBMITTED BY rO V., `Q 5Ur.�—oN a SUPPLIER _ PROPORTIONS O rR \x CEMENT WATER FINE AGGREGATE ADMIXTURE CUBE ICOMPRESSIVEI AREA STRENCTM i ISO, IN.1 , (PSI) • �3��0 I i SPECIFICATIONS i Test result5 cemeH with ■polieeole REMARKS: _ Cubes Teen by PSI mWesentalive. _ CuOu viCkaOUPby PSI'eorelentalwo. _ :bae+fleadona, Cubes Tedd by Atcn11cCr9 of \/ Teel 1-116,0411 GO nm comply.eltll •�_ contractors representative. It _ Cubes delivded to PSI laberalmy. _ apolicSNe specifications. r TYPE OF BREAK IV&Sfi PEST RESULTS APPLY ONLY TO TPP, SPEGPIC 4MPLEe TESTED ANO WY NOT eE INOW-ATIVZ OP T1E ENTIPC N TEAIAL Pt AGEMEMT. REPORTS suy NOT of AGPRCOV41W. EXCEPT IN CULL, VAT%00 WRITTEN pEllNeescm ev PAOPEWONAL SGRVCE WOUSTAIES. wG. Professional Service Industries, Inc. - 42.240 Green Way. Suite 0 • Palm Desert, CA 92211 • Phone 760/341-5790 - Fax 7SM41-5794 41 industries, Inc. COMPRESSION TEST RESULTS ASTM C 10943 ' LABORATORY ; SPECIMEN j TEST 10ENTIFICATIONi AGE DATE OF TEST TOTAL LOAD ! (LBS.) CUBE SIZE PN•) NUMBER OR SET NO, (OAYSI . Z��- � ' 7 �2-3�•Oz. � X100 i Z I k �} • � ' BOG ` C CUBE ICOMPRESSIVEI AREA STRENCTM i ISO, IN.1 , (PSI) • �3��0 I i SPECIFICATIONS i Test result5 cemeH with ■polieeole REMARKS: _ Cubes Teen by PSI mWesentalive. _ CuOu viCkaOUPby PSI'eorelentalwo. _ :bae+fleadona, Cubes Tedd by Atcn11cCr9 of \/ Teel 1-116,0411 GO nm comply.eltll •�_ contractors representative. It _ Cubes delivded to PSI laberalmy. _ apolicSNe specifications. r TYPE OF BREAK IV&Sfi PEST RESULTS APPLY ONLY TO TPP, SPEGPIC 4MPLEe TESTED ANO WY NOT eE INOW-ATIVZ OP T1E ENTIPC N TEAIAL Pt AGEMEMT. REPORTS suy NOT of AGPRCOV41W. EXCEPT IN CULL, VAT%00 WRITTEN pEllNeescm ev PAOPEWONAL SGRVCE WOUSTAIES. wG. Professional Service Industries, Inc. - 42.240 Green Way. Suite 0 • Palm Desert, CA 92211 • Phone 760/341-5790 - Fax 7SM41-5794 41 industries, Inc. [SPECIAL-INSP-ECTION SERVICE REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION — PERFORMED ❑ REINFORCED CONCRETE TRUCT. STEEL ASSEMBLY ❑ � .Q,(1D ❑ POST TENSIONED CONCRETE O ASPHALTQTHER ( qQ`4 `- . ❑ REINFORCED MASONRY ❑ FIRE PROOFING / " l/�� JOB 7,90p t4(toop. 6 REPORT SEOUENCE NO. TVP •OF STRUCTURE PERMIT 0. D?N.? DAV OF WEEK MATERIAL DESCRIPTIO� /J ARCHITECT ILTOp MRS. CHARGED ENGIN , t IDA [ASSISTANTS HRS. CHARGED INSPECTION GENERAL SUB DATE CONTRACTOR C jf CONTRACTOR 101, o cY1 c -c 0(6A Wu -Sow --p U)XtC LivAe 'A' D ot V, 0 Ye.o Gv��s • GSR d S csv� A.lo G• l( COPY SENT TO CLIENT O CONTINUED N NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I .HAVE INSPECTED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. 1 t IGR OF RGISTERED IR�6�� 6 XV6 // DKTE OF FtEPORT REGISTER NUMBER RG43,q1Q,- F'uc. L �✓•4'�2A-7Zo� aQ, t3.4�2 c 1VIV, + 40` D t t —Hll 5 i r?ut l ur;H - tpp-1 8{ r Hx NU. -M" zx70U roc SILOAM TIS' t Structural Engineering Consultant, 3333 Brea Canyon Rd. 0 116 1-4 Diamond Bar. CA 91765 . Number: fEL:(909)598-8218 ' Amt: Date: I MOM- RG43,q1Q,- F'uc. L �✓•4'�2A-7Zo� aQ, t3.4�2 c 1VIV, r REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE Of O INSPECTION PERFORMED REINFORCED CONCRETE STRUCT. STEEL ASSEMBLY O POST TENSIONED CONCRETE SPHALT O REINFORCED MASONRY O FIRE PROOFING O O OTHER JOB LOCATIONWUM©® p f LA REPORT "GUENCE NO. TYPE OF STRUCTURE PERMIT NO. OAT DAY OF WEEK MATERIAL DESCRIPTIONa ' _ ` II/VI LC+I, a yv`, .\J ARCHITECT � �1.� � / L:. INS ! NRS. CHARGED T•��� i / ENGINE �� pk� ASSISTANTS MRS. CHARGED GATE INSPECTION CONTRACTOR ` CONTRACTOR I?j co - S�- COPY SENT TO CLIENT O CONTINUED ON NEAT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE10 " < I HEREBY CERTIFY THAT 1 HAVE INSPECTED TO THE BEST OF M1i SIGNATURE OF REGISTE E INSPECTOR KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE �. y 0 3".wl 4 '� �' NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. DATE OF REPORT t REGISTER NUMBER