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04-5721 (CSCS)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T-iitt °f 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: [0-4-00005721 Property Address: 78995 -HIGHWAY 111 APN: 643-020-999-6 -30903 - Application description: NEW COMML - STORES & CUSTOMER ICE Property Zoning: REGIONAL COMMERCIAL D Application valuation: 669899 d Applicant: Architect or Enginee . MAY 2 5 Z005 CITY0F F�Ngly � ou�n�A -------------------------------------------------- LICENSED CONTRACTOR'S 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 Class: B License No.: 397892 Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he -or she is licensed pursuant to the provisions of the Contractor's Stale License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she 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).: (_) 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 and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or Y improve for the purpose of sale.). 1 AI 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). I—) I am exempt under Sec. , B.&P.C. for this reason Date: s'?.t'O� Owner: - 1���%ro. L/�sL .,�?e.c Al -0 CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued ISec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT Owner: WASHINGTON 111 LTD C/O JACK TARR 30240 RANCHO VIEJO ROAD SUITE SAN JUAN CAPISTRANO, CA 92675 Contractor: MOOREFIELD CONSTRUCTION, INC. 3415 S. SEPULVEDA BLVD LOS ANGELES, CA 90034 (310)390-9400 Lic. No.: 397892 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/25/05 ----------------------------------------------- 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 and policy number are: Carrier 181E FUND Policy Number 1686016-2005 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 forth ith comply with those provisions. /Date: Applicant: '- /��� t>�� �Gf/i1,ai1,� //,1,exp WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this 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 application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomi:s 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 agre6 to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspe i n purposes. ^ Date'fZ%OS ,Signature (Applicant or Agentl:` 4J� �� Gl tr.. A% If/47W Application Number . . 04-00005721 Structure Information "SHELL" FOR RETAIL USE Construction Type . . . . . TYPE V - NON RATED Flood Zone. . . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 - FIRE SPRINKLERS YES MIXED-USE OCCUPANCY SHELL OCCUPANT LOAD .00 PATIO SQ FTG 940.00 ---------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 15049.00 Permit BUILDING PERMIT Additional desc Permit Fee . . . . 2549.50 Plan Check Fee 1657.18 Issue Date . . . . Valuation . . . . 669899 Expiration Date 11/25/05 Qty Unit Charge Per Extension BASE FEE 2039.50 170.00 3.0000 ------------------------------------------- THOU BLDG 500,001-1,000,000 : 510.00 . . . ELEC-NEW COMMERCIAL Additional desc . Permit Fee . . . . 315.98 Plan Check Fee 79.00 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/25/05 Qty Unit Charge Per Extension BASE FEE 15.00 15049.00 .0200 ---------------------------------------------------------------------------- ELEC GARAGE OR NON-RESIDENTIAL 300.98 Permit . . . GRADING PERMIT Additional desc . Permit Fee 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/25/05 Qty Unit Charge Per Extension ---------------------------------------------------------------------------- BASE FEE 15.00 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 235.50 Plan Check Fee 58.88 Issue Date . . . . Valuation . . . . 0 LQPERMIT Application Number . . . . . 04-00005721 Permit . . . . . MECHANICAL Expiration Date 11/25/05 Qty Unit Charge Per Extension BASE FEE 15.00 . 9.00 9.0000 EA MECH FURNACE <=100K 81.00 9.00 9.0000 EA MECH B/C <=3HP/100K BTU 81.00 9.00 6.5000 ----------------------------------------------------------------------------- EA MECH VENT FAN 58.50 Permit PLUMBING Additional desc . Permit Fee . . . . 333.00 Plan Check Fee 83.25' Issue Date Valuation . . . . 0 Expiration Date 11/25/05 Qty Unit Charge Per Extension BASE FEE 15.00 18.00 6.0000 EA PLB FIXTURE 108.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 4.00 6.0000 EA PLB ROOF DRAIN 24.00 9.00 7.5000 EA PLB WATER HEATER/VENT 67.50 1.00 3.0000 EA PLB WATER-INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 9.00 7.5000 EA PLB OTHER BACKFLOW <=2 INCH 67.50 12.00 .7500 EA PLB GAS PIPE >=5 9.00 1.00 15.0000 EA PLB GAS METER 15.00' ------------'---------------------------------------------------------------- Special Notes and Comments COMMERCIAL "SHELL" FOR{RETAIL USE. 15,049 SQ.FT. TYPE VN CONSTRUCTION, 2001 CODES (60 FOOT YARDS AND FIRE SPRINKLERS FOR. ALLOWABLE AREA INCREASE) **PERMIT DOES NOT INCLUDE TEMP POWER, BLOCK WALLS, TRASH ENCLOSURE(S) OR SITE LIGHTING** ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -COM 3329.49 DIF CIVIC CENTER - COMM - 1429.65 DIF FIRE PROTECTION -COMM 481.56 HOURLY PLAN CHECK 87.50 STRONG MOTION (SMI) - COM . 140.67 DIF STREET MATNT FAC -COMM' 346.12 DIF TRANSPORTATION - COMM 25944.47 Fee summary Charged Paid Credited ----------------- Due ---------- Permit.Fee Total ------------------------------ 3448.98 .00 .00 3448.98 LQPERMTT Application Number . . . 04-00005721 Plan Check Total 1878.31 1600.00 Other Fee Total 31759.46 .00 Grand Total 37086.75 1600.00 LQPERMIT .00 278.31 .00 31759.46 .00 35486.75 TWT e2 7 2 P,O. BOX 1504 APPLICATION ONLY Building�e 78-495 CALLE TAMPICO Address LA QUINTA, CALIFORNIA 92253 Owner —47 F,47D BUILDING: TYPE CONST. V- N OCC. GRP. Mailing .693 `002 — /��� G, y Address ?�_ '3'�/ A.P. Number �r C1,y Zip el.Legal Description 7`,'r�� • vi ontractor T Project Description 11A.Si��NC/flrr Ailk Le) ! Address A0 City Zip Tel. State Lic.City Sq. Ft. No. No. Dw. & Classif. Lic. # Size S Stories Units Arch., Engr., New>( Add ❑ Alter ❑ Repair ❑ Demolition ❑ Designer Ez & Address Tel. IZS3 1 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 full force and effect. 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, alter, 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 that he 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). ❑ 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 and Profes- sions 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 or im- provement 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). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sed. 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 am exempt under Sec. B. & P.C. for this reason Date Owner WORKER'S COMPENSATION DECLARATION 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 O Copy is filed with the city. ❑ 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 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. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) 1 _ Lender's Name 1 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 f Mailing Address City, State, Zip WHITE = BUILDING DEPARTMENT Estimated Valuation PERMIT ` AMOUNT Plan Chk. Dep. all Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading e Driveway Enc. Infrastructure JU 0 Luu• CI rY OF LA QUINTA ..` BEF =1 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 Permit Validated by: Validation: YELLOW = APPLICANT PINK = FINANCE Tom Tisdale Fire Chief Proudly serving the unincorporated areas of Riverside County and the Cities of: Banning Beaumont Calimesa Canyon Lake r. Coachella Desert Hot Springs Indian Wells Indio Lake Elsinore La Quinta Moreno Valley Palm Desert 4. Perris Rancho Mirage San Jacinto 4. Temecula Board of Supervisors Bob Buster, District 1 John Tavaglione, District 2 Jim Venable, District 3 Roy Wilson, District 4 Marion Ashley District 5 RIVERSIDE COUNTY FIRE DEPARTMENT In cooperation with the California Department of Forestry and Fire Protection 82-675 Highway 111, 2nd Fl., Indio, CA 92201 . (760) 863-8886 • Fax (760) 863-7072 August 18, 2004 KKE Architects, Inc. 20321 SW Birch Street, Ste. 201 Newport Beach, CA 92660 Re: Non -Structural Building, Plan, Review_ LAQ-04-BP-105_/ 78-995,Hwy 111 Fire Department personnel have reviewed and approved the plans you submitted for the above referenced project. Please be advised the following conditions apply as a part of the conditions for the issuance of a building permit. 1) The Fire Department is required to set a minimum fire flow for the remodel or construction of all commercial buildings using the procedure established in the 2001 CFC. A fire flow of 1500 gpm for a 2 -hour duration at 20 psi residual operating pressure must be available before any combustible material is placed on the job site. 2) The required fire flow shall be available from a Super hydrant(s) (6" x 4" x 21/2' x 21/2") located not less than 25' or more than 165' from any portion of the building(s) as measured along approved vehicular travel ways. 3) ` Prior to the issuance of a building permit; applicant/developer shall furnish one blueline copy of the ,,water system plans to the Fire Department for review. Plans shall conform to the fire hydrant type's, location -and spacing, and the system shall meet the fire flow requirements. Plans must be signed by a registered Civil Engineer and/or the local water company with the following certification: "I certify that the design of the water system is in accordance with the requirements prescribed by the Riverside County Fire Department". 4) Install a complete fire sprinkler system per NFPA 13. The post indicator valve and fire department connection shall be located to the front within 25' to 50' of a hydrant, and a minimum of 25' from the building. System plans must be submitted to the Fire Department for review, along with a plan/inspection fee. The approved plans, with Fire Department Job card must be at the job site for all inspections. 5) Install a monitoring system designed in accordance with NFPA 72, which must include a water flow monitor, control valve tamper and continuous monitoring service. System plans must be submitted to the Fire Department for review, along with a plan check/inspection fee. 6) Install Knox Key Lock box, Model 3200, mounted per recommended standard of the Knox Company. If the building/facility is protected with a fire alarm system or burglar alarm system, the lock boxes will require "tamper" monitoring. Special forms are available from this office for the ordering of the Key Switch. This form must be authorized and signed by this office for the correctly coded system to be purchased. 7) All egress doors shall comply with CBC Sec. 1003.3.1.8 for proper door hardware. 8) Install portable fire extinguishers per Title 19, but not less than 2A10BC in rating. Contact certified extinguisher company for proper placement of equipment. EMERGENCY SERVICES DIVISION • PLANNING SECTION • INDIO OFFICE 82-675 Highway 111, 2nd FI., Indio, CA 92201 • (760) 863-8886 • Fax (760) 863-7072 9) Approved building address shall be placed in such a position as to be plainly visible and legible from the street and rear access if applicable. Building address numbers shall be a minimum of 12" for building(s) up to 25' in height, and 24" in height for building(s) exceeding 25' in `height. In multi -tenant buildings, businesses shall post the business name and suite number on back doors as well as the front. Suite numbers or letters must be a minimum of 6" in height. All addressing must be legible and of a contrasting color with the background. 10) Electrical room door shall be posted "ELECTRICAL ROOM" on the outside of door. 11) Room capacity shall be posted in a conspicuous place on an approved sign near the main exit from the room. Please contact the Fire Department Planning & Engineering staff for final inspection prior to occupancy. Applicantrnstaller shall be responsible to contact the Fire Department to schedule inspections. Requests for inspections are to be made at least 24 hours in advance and may be arranged by calling (760) 863- 8886. All questions regarding the meaning of these conditions should be referred to the Fire Department Planning & Engineering staff at (760) 863-8886. Sincerely, FRANK KAWASAKI Chief Fire Department Planner, By Walter Brandes Fire Safety Specialist Cc:—City of La 05inta — BuildingDept. K-%PE2%WP oata%a aLir"wROJECIZUk V PCLLAG-04-SP-105.due f City Of La Quinta Plan Check # 04-6420 P.O. Box 1504 Verizon Wireless 78-495 Calle Tampico 78-995 Highway 111 -La Quinta, Cafifornia 92253 Attn Bert Hanada Dear Mr. Hanada, As per comments dated June 6`h 2005 the following letter will address the outstanding open issues. Item 3 section,C:,Drawings _will,be,revised ,to indicate door -3, -previously. door -2;-W'11-11 tfhave a passage,lockset. The door will, not -be .able to.be..lockedFfrom-either.direction. (The card reader will`be install d and will only disable the chime function when the door is opened without a card. The door will not require a key or card to operate. The card reader is for the -monitoring of personal using the door. I have attached the card reader device cut sheet for your records: Item 6 Section Q.Toilet-rooms will-hav mless sheet vinyl: With`a'minimum•5"•sel_fj cove base. Optional for vinyl tile has been deleted. I hope this will address the open issues and allow the issuance of a building permit. Architect In AUG ? 6 Z� I� N ter" �i TANDY'S INSPECTION SERVICES, INC. PO BOX 13766 - PALM DESERT, CA 92255-3766 OFFICE / FAX - 951.769.9717 PAGER 760.776.3339 SPECIAL INSPECTION DAILY / WEEKLY REPORT TYPE-OEIN.S N PERFORMED Poxes PERMIT NUMBER 1 Oy- s�--I�-1 TYPE OF STRUCTURE DATE t0- o5 P OJECT ADDRESS (INCLUDE STREET ADDRESS AND CRY OR COUNTY) Sufic�� PROJECT NAME (INCLUDE COUNTRY CLUWBUSINESS PARIUCORPORATE CENTER ECT. NMIE) RCHITECT '�ZNT-rC�TS ENGINEER v -E 113 ny-A GENERAL CONTRACTOR moo 2� S>-� c t� ►a S -r t2��T' SUB CONTRACTOR DESCRIPTION OF WORK INSPECTED ©e,SEP en C x� Zit- S/�" I( �-t~��C�� lf� � �� �� .�,Tc Cc •J, �YZ.q 3/0 S S a--" CxkxkPSC;Q 1-- 7 PoYc" , l x -7 /bi . I t - �C,L-rs �u� � ��. 2F(n•�L��2 oti= �,� 6 . !o r' �.w�B�.1J WELDING INFORMATION WELDERS NAME' CERTIFYING AGENCY NAME AND NUMBER PROCESS AND ELECTRODE j SAMPLE INFORMATION TIME SUPPLIER TICKET NUMBER MIX NUMBER AIRTEMP. SAMPLE SLUMP WATER TEMP ADDED TIME IN MIXER " LOCATION TAKEN: �.. LOCATION TAKEN: I HEREBY CERTIFY IT AT I HAVE;INSPECTED ALL/OF THE ABOVE REPORTED -WORK, UNLESS OTHERWISE NOTED,."TO THE PEST OPMY ABILITY I HAVE FOUND THIS WORK TO COMPLY WITH ' THE APND PROVED PLANS. SPECIFICATIONS 8 APPLICABLE BUILDING LAWS. INSPECTORS �e--' G ��I -A5A NATURE INSPECTORS CERTIFICATION AGENCY AND NUMBER KE �"�.,.ea.-'+r�'•�w •.•.-_ ..�^<f`..-�+-�-..-+-Pry �,-s,,rf ;.� ,.r..k : �;a.,•,y,:.v; {•:.-,.-,�_�� aL `� rrL. �- ..•rrr., v i a : � t.:1T TANDY'S INSPECTION SERVICES, INC. PO BOR 13766 - PALM DESERT, CA 922553766 a- OFFICE / FAX - 951.769.9717 PAGER 760.776.3339 SPECIAL INSPECTION DAILY I WEEKLY REPORT TYPE OF INSPECTION D 1 PERMIT NUMBER o TYPE OF STRUCTURE DATE PROJECT RESSS ((IINCLUDEE sTREer AAD�DR AND CRY OR COUNTY) PROJECT NAME QNcLuDE couwwcLunusiNEss PARIVWMRATE cWmk ECT. NOE) ARCHITEC ENGINEER C _ ✓ '/�r� c_ /y� lJly GENERAL CONTRACTOR SUB CONTRACTOR ` f �✓ ` / DESCRIPTION OF WORK INSPECTED rrJ 11 � � � 1/ � Yi L✓ � G � / / t/ �� ,// ,� / � ��� 7'� IV 2 Z .7 lz l.✓l 2 i�' A av ,D A / 47 /V X (,2 , `/a / n� F /—A AI—L f WELDING INFORMATION WELDERS NAME CERTIFYING AGENCY NAME AND NUMBER PROCESS AND ELECTRODE H /I I-/-- /v /L p/r SAMPLE INFORMATION TIME SUPPLIER TICKET NUMBER MIX NUMBER AIRTEMP SAMPLE SLUMP WATER TIME IN TEMP ADDED MIXER LOCATION TAKEN: LOCATION TAKEN: I HEREBY CERTIFY THAT 1 HAVE INSPECTED ALL OF THE ABOVE REPORTED WORK. UNLESS OTHERWISE NOTED. AND TO THE BEST OF MY ABILITY I WAVE FOUND, THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS`&APPLICABLE BUILDING LAWS. INSPECTORS SIGNATURE INSPECTORS CERTIFICATION AGENCY AND NUMBER EE KEN OKAMOTO & ASSOCIATES, INC. STRUCTURAL ENGINEERS DATE: TO: CITY OF _ L'Q- U ( A%A BUILDING DEPARTMENT RE: LV4S(fl,U-6;-res -i GENTLEMEN: AS REQUIRED BY THE BUILDING DEPARTMENT, OUR OFFICE MADE'A STRUCTURAL OBSERVATION AT THE ABOVE-MENTIONED PROJECT. THE PURPOSE OF THIS VISIT WAS TO OBSERVE THE ITEM(S) OF CONSTRUCTION AS NOTED BELOW. THE OBJECTIVE OF THIS SITE VISIT IS TO HAVE AN ADDITIONAL REVIEW OF THE STRUCTURAL SYSTEMS BY A KNOWLEDGEABLE OBSERVER DURING THIS SIGNIFICANT CONSTRUCTION STAGE IN ORDER TO ASSIST THE CONTRACTOR WITH CONFORMANCE WITH THE PLANS. THESE OBSERVATIONS ARE LIMITED TO THE STRUCTURAL ASPECTS OF THE BUILDING. /n� ITEM O.,,F,,,��CONSTRUCTION BLDG. NO. DATE wit(/ t 1 4- rF�N1Gu� �' � � � (2�1 BASED ON VISUAL OBSERVATION, THE ABOVE ITEM(S) APPEARED TO BE !Ni GENERAL CONFORMANCE WITH THE DESIGN INT NT. EXCE T AS FOLLOWS: vl & Nyt-xGe, K '0 S' S� i�i��c9 ` A7 HSL S� P XT e,61VI�- , 4u S'/Z--r OUR OBSERVATIONS OF THIS STRUCTURE WERE MADE ON A VISUAL BASIS, AND IT IS NEITHER EXPRESSED NOR IMPLIED THAT ALL POSSIBLE DEFICIENCIES HAVE BEEN ADDRESSED. STRUCTURAL OBSERVATION DOES NOT CERTIFY, GUARANTEE OR ENSURE CONFORMANCE WITH THE APPROVED PLANS. IT DOES NOT PROVIDE THE QUALITY ASSURANCE OF CONTINUOUS INSPECTION. IT DOES NOT WAIVE OR LIMIT ANY OF THE RESPONSIBILITY OF THE CODE REQUIRED INSPECTIONS BY THE BUILDING INSPECTOR OR DEPUTY INSPECTOR. IT IS, OF COURSE, THE CONTRACTORS IBILITY TO CONFORM WITH STRUCTURAL PLANS AND THE U.B.C.R OFESS/p LY SINCERE <C KEN OKAMOTO, S.E. Q H pEy p.12-31-05 �TFpf CAO / 3186-F AIRWAY AVE. • COSTA MESA, CA 92626 • (714) 444-2422 - FAX (714) 444-2122. �w_ .-.-n'+.�n+-�-�.,.--. ; .-..r..r •.- -.�. ,. w-.+.,-w+.r....�,.o.i,�.+iw.:r`t'�},���liic•C1i(►�'�yF`�� 4�Y�(^..�.wt:�''� "�+f'%'t�9 iF-/+�vY- 'iii TANDYTS INSPECTION SERVICES, INC. PO BOX 13766 - PALM DESERT, CA 92255.3766 a- OFFICE / FAX- 951.769.9717 PAGER 760.776.3339 SPECIAL IN-gPFCTION DAILY I WEEKLY REPORT r 1 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 THHErkP`PROVED PLANS, SPECIFICATIONS & APPLICABLE BUILDING LAWS. INSPECTORS SIGNATURE INSPECTORS CERTIFICATION AGENCY AND NUMBER is NUMBER - TYPE OF STRUCTURE � (�uE�� L-]DATE 9 - I1 - b's TYPE OF INSPECTION PERFORMEDPERMIT (;—:- pt-)x� PROJECT ADDRESS (urcLuoE STREET ADDRESS AND Cary OR COUNTY) �V qci S 4"J `A • 111 PROJECT NAME pNmuDE comm cLunuslNEss PARKmomRATEcwn3t ECT. NAME) �J a�-,.� � ►.) ��. ARCHITECT 1 %-1� �-l�c'!•f�r•'TlZ'`t`S ENGINEER ��-�►*� �1�.,IR 1ua �kla� ���T��� . GENERAL CONTRACTOR SUB CONTRACTOR DESCRIPTION OF WORK INSPECTED Vku-71A k.Ci h koC T -S, -AtjU C:71.E-sito r 1 f 1 y i 9 ( WELDING INFORMATION WELDERS NAME CERTIFYING AGENCY NAME AND NUMBER PROCESS AND ELECTRODE Y SAMPLE INFORMATION' TIME SUPPLIER T7CKETNUMBER MIX NUMBER AIRTEMP SAMPLE SLUMP WATER TIME IN TEMP ADDED MIXER r. LOCATION TAKEN: LOCATION TAKEN: 1 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 THHErkP`PROVED PLANS, SPECIFICATIONS & APPLICABLE BUILDING LAWS. INSPECTORS SIGNATURE INSPECTORS CERTIFICATION AGENCY AND NUMBER is -� 0`; ?,/loo' :ICON 22:59 Ft.T X002/Ooh •moi 07:25i2(165 1F: cl 7144442322 i►r,,sY41JUJ &Uq :;:3� KF: UrAMTo SE EM PAGE ®2 1602/002 To: L9 916 P. Vl n liffih !!Z! 40REFlRL9 ONS RUCnON.INC la 1 S 9. 1-l"ri2DA 51W., 5wh SSo Crc7:lQ:+ REQUEST c� 4 tQ) 9 -"do WL FOR ATION0- LIC. 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