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04-6655 (SFD)P.O. BOX 1504. 78-495 CALLE:TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760)17774012 FAX (760) 777-70'1'i INSPECTION REQUESTS. (760).777-71.53 .Application Number . . . . 04-00006655 Date 10/12/04 Property Address 54380 WEST RESIDENCE CLUB DR." APN':.* 775-380-999-2• -31627 - Application description DWELLING.- SINGLE YDETACHED Property. Zoning .. MEDIUM. DENSITY .RES-------� Application -valuation ... 287914 OCT. 18 2 00# Owner Contractor ------------------------ NADADOR, LLC -----------------ATA . JACOBS HOME, IiC�Ec W R"T 781.20.'CALLE,'ESTADO, SUITE: 203. P.O. BOX. 692 LA QUINTA : CA 92.2.53: LA QUINTA CA :92.24.7 (760) . 777:=9921. WCC: EXEMPT . WC: .. EXEMPT CSLB::. 799449 :04•/30/0 CCC: B __----=-.-==-=------ ------ Structure Information. ------ Construction Type TYPE V -NON:RATED. Occupancy Type DWELLG/LODGING/CONG <=10. Flood Zone NON -AO FLOOD ZONE Other struct info CODE EDITION 2001 CBC #. BEDROOMS 3.00 FIRE. -SPRINKLERS. :. :NO. 'GARAGE SQ. FTG 5 31.0 0 PATIO SQ FTG 422..00--. NUMBER OF UNITS.., •1:00 FIRST FLOOR. BQ FTG` .: 3365.:00: Permit . . . . BUILDING PERMIT Additional desc Permit Fee 1.297.50 Plan Check Fee.,. 843:38 Issue Date Valuation 287914, Expiration Date 4/07/05 Qty Unit Charge Per Extension BASE FEE639.50 188.00 3.5000 THOU BLDG 100,001-500,000 658..00 = -------------------------- Permit .ELEC-NEW .------------------------------------------------- RESIDENTIAL. Additional desc Permit*Fee 1.45.6.0' Plan Check Fee... 36.40 Issue Date Valuation 0 Expiration Date.... 4/07/0.5 Tdy ro P.O. Box 1504 .4��Vm VOICE'(:760) 777=7072' '4 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760)' 777-7153' BUILDING & SAFETY DEPARTMENT Application Number: 64 'ip (v $ Je Date: /0./9 • a4' Applicant: --Architect or Engineer: —r Applicant's Mailing Address: Architect or Engineer's Address:I-L, ic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 8 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect ,_-Cicense Class --[)cense j Date r oniractor OWNER -BUILDER DECLARATION 1 hereby affiro under penalty of perjury that 1 am exempt from the Contractors`. State License Law for the following reason (Sea 7031.5, Business and Professions Code: Any city or county that requires a pwnit to construct, atter, improve, demolish, or repair any stnxiure, 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 Contractors' State 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.fhe 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).): U I. as owner of "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 or through his or her own employees, provided that the improvements are not Intended or offered for sale. If, however: the budding 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 imp" Jor the purpose of sale.). - U 1. as owner of the properly, am exclusively contracting with ricensed contractors to constrict the project (Sea 7044, Business and Professions Code: The Contractors' State. License Law does not apply to an owner of property who_bu'dds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. BA P.C. for this reason Date WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations:. I have and will maintain a certificate of consent to selt-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. . _ 1 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 Policy Number I certify -that, In the performance of the work'for which thispermit Is issued, I shag not employ any person In any manner so as to become subject to the workers' compensation laws of California; WA agree that, if I should become subject to the workers'. compensation provisions of Section 3700 of the Labor Code, l shag forthwith comply with those 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 ATTORNEYS FEES. 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 (Sec. 3097, Civ. C.). Lender's Name Lendees Address 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 shag, defend, indemnify and hold ham -Jess 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 becomes nun and void If work Is not commenced within 180 days from date of Issuance of such pemhit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that do above informatigifis correct I agree to comply with an city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to ent the tioned property for Inspection purposes. Date /y/cif/ ' iSignature (Applicant or Agenl): Application Number. . . . . . 04-00006655 Page 2 Date' 10/12/04 Qty Unit Charge Per Extension BASE FEE .15.00 3365.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 117.78 641.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 12.82 --------------=------------- Permit . : ------------------------------------------------ MECHANICAL Additional desc Permit Fee 171.50 Plan.Check Fee 42.88 Issue Date Valuation . . . . 0 Expiration Date 4/07/05 Qty Unit Charge Per Extension BASE FEE 15.00 4.00 . 9.0000 EA MECH FURNACE <=100K 36.00 4.00 9.0000 EA MECH B/C <=3HP/100K BTU 36.`00 12.00 6.5000 EA MECH VENT FAN 78.00 1.00 6,.5000 EA MECH EXHAUST HOOD 6.50. ---------------------------------- Permit . . . . ----------------------------------------- PLUMBING Additional desc Permit Fee . . . 185.25 Plan Check Fee 46.31 Issue Date . . . . Valuation 0 Expiration Date .4/07/05 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 15.0.0 2.00 7.5000 EA PLB WATER HEATER/VENT 15.00 1.00 3.0000 EA, PLB WATER INST/ALT/REP 3.00 1`.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 7.00 .7500 EA PLB GAS PIPE >=5 5.25 1.00 -------------- 15.0000 EA PLB GAS METER 15.00 - Permit . ------------------------------------------------------------- . . . GRADING PERMIT Additional desc Permit Fee 15.00 Plan Check -Fee .00 Issue Date . . . Valuation . . . . 0 Expiration Date 4/07/05 Qty Unit Charge Per Extension 1 11 Page 3 Application Number . . . . . 04-00'006655 Date 10/12/04. Qty Unit Charge Per Extension BASE FEE 15.00 ------------------------------------ Special Notes and Comments -,--------------------------------------- SFD - LOT 2, PLAN A. PERMIT DOES.NOT .INCLUDE POOL, SPA, BLOCK WALLS, OR DRIVEWAY APPROACH.- ------------------------------- ------------------------------------------ Other Fees . . . . ART IN PUBLIC PLACES -RES 222.74 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 84.34 DIF FIRE PROTECTION -RES 97.00 GRADING PLAN CHECK FEE .00 DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAC - RES• 5.00 DIF PARKS/REC - RES 502.00 STRONG MOTION (SMI) - RES 28.90 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION 7 RES 1098.00 Fee summary ----------------- Charged ---------- Paid Credited --------------------=--------- Due Permit Fee Total 1814.85 .00 .00 1814.85 Plan Check Total 968.97 .00 .00 968.97 Other Fee Total 27.40.98 .00 00 2740.98 Grand Total 5524.80 .00 .00 5524.80 X0.1. �) // r �.r .��+ JOB ADDRESS '�U luuv 1 H Z -UUN i HACT.OR.LIST Sy=.Q,1f CJle4��_RMlT NUMBER OWNER /�I�'Ta�/� BUILDER �C-/Y� cl�e���,• This form shall be posted on the iob with the Building Inspection Card at all times in a c s is o = 'place..Only persons a �L a on this )ob. Any changes to this list must be a appearing will this list or tstop stoppage w are authorized to work approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance a of building permit For each applicable trade, all information requested below 4 must be •-•:...:,,.:;,, .;::..,�.w,,;�t .... .. y File" is not an acceptable response. ' to -applicant. "On comp e y app r '` '`fit `�,,uv State ContracLor''s'license .,."� t - r or r 3 r ke s Compensation Insurance Ps' 4 City Business License ` r«xo� s t Company Name I Classification I License'Number Exp. Data Carder Name Policy Number Exp. Data License Number Exp: Date x (e.g. A,.B, C-8) (xxxxxx) (xx/xx/xx) (e. State Fund, CalCom 9 p) (Format Varies) Ixx/xx/xx) (xxcx) (xx/xx/xx) EAg14161- HwoR>� y l/ q QQgq-7 N CONCRETE (C8)� aC"a S/C2 �h�/V/"O `Y�p3Ol050006 qq.2,3' FRAMIJJG(C55), Y 14"D(:%T �%��C� r� a STRUCTtiz$TEEL(C 513k"b `j G 3! 0,5 7_> t y��z Y �I7! os f s� t« _Oodo zo 22 as 'Z6� • 3/0� o a ti ,�� ��� r=veNl� Peng-s G�q �iSb lZB L., /O 3/ Qy S%l9 �1 C /7U4— ry-n /_ /G 0 , % nr F1n n r •`vvr c w I ICC.,I'tftlt/.lLiq-L— G`J�. - -� C/��7.7�� is%Hx PLA�(G"35)R v J'yQ GI Vry 0�t7— 00/�$�0 3 /Z 116 CSS 7 t 108 . /03/ . t� / I�o56 S' 112 as °��s`rlYvRAY�wc�A:,i.c ,L-: sp(�C} 9.,>.W...�»� s`������K� • `D+�o_ vEr,J��fC�Q �e c> C� 634�f 9 DSV0f�1f1� S37DOas000l as ^e - Z11 / 3i o6 /�S�t,��n.r'E G,t=� CcLSO X576 /8� r 0 S ©08�F3 a RooE1NG� 3 } � C&i QOoF1n� / J 3� 06 _51/H �� b If • � H�� qtr!: .. C33 3-77L14/ Jr a3/ SS7_K rc, a� osw:....... 'giRry ese.>, t; o1)as V_ -U/ SivNE�_10 E 1 a t. r., M.r=S??G �:>±...:.< ZfJ./ °Siv N��Gc��1K5 CS 636 T4s' 831 zs'l�i� ` 1-70671V,5_ i CABINETS IC 8)k z. : AT17S io ��vc3G2Sf03� 9,2, 1q q l/Q o FENCING ( , = r . _ � 3/ A5;42873 0 j.� =•o + _ a 2 /5!-7 3o GiS!%1 BELS . oLF1ND'SCAPING'(C27):" 3 sEWgQEp!$xz CL PIG42► •°/g/7 �� b PAINXING�O'3s Y�r :.hr1L h'laQt� _: C33 3-77L14/ Jr a3/ SS7_K rc, ��fb E 1 a t. r., M.r=S??G �:>±...:.< ZfJ./ °Siv N��Gc��1K5 CS 636 T4s' 831 zs'l�i� Doo g1 3 I oS©Oz i CABINETS IC 8)k z. E���h Gb 9,2, 1q q /SOS/S/S� /v / o FENCING ( , = r . _ l 3/ Simi / Q0Cb9X3 / OS _00 /7o . j.� =•o + ,C�93 . oLF1ND'SCAPING'(C27):" 3 -7(V/f� � 6661Z8 POOL, ICS 6 ez 56 12S a6 -COO /(,,Y 14 t 43 '' 0 . CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page 1 of 7) CF4R Project Title Date Sy- 3 k2 Al- _ fes- t Project Address Builder Nam Telephone Rater Teleph Signature Firm: Street Address: 4,r= ?-40,T Copies to: Builder, HERS Provider Plan Number . .. Sample Group Number, Sample House Number HERS Provider: City/State/Zip: HERS RATER COMPLIANCE STATEMENT The house was: WITested ❑ Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verification, I certify that the houses identified on this form comply with the diagnostic tested compliance requirements as checked on this form. The installer has provided a copy of CF -6R (Installation Certificate. Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts) Where cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. IQ MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) Measured Duct Pressurization Test Results (CFM @ 25 Pa) values Test Leakage Flow in CFM_ If fan flow is calculated as 400cfin/ton x number of tons enter calculated value here If fan flow is measured enter measured value here Leakage Percentage (100 x Test Leakage/Fan'-Flow)eheck -Box fbi Pass = Y. 0 orless) Pass Fail. THERMOSTATIC EXPANSION VALVE (TXV) Yes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection ❑ Yes is a pass Pass Fail ❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT 1 ❑ Yes ❑ No ACCA Manual D Design requirements have been met (rater has verified that actual installation matches values in CF -1R and design on plan. 2' ❑ Yes ❑ No TXV is installed or Fan flow has been verified. If no TXV, verified fan flow matches design from CF -1R. Measured Fan Flow = ❑ a Yes for both 1 and 2 is a Pass Pass Fail compliance Forms August 2001 A-16 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page 1 of 7) CF4R z2zls / Project Title Date Project Address led Builder Nam HERS Rater Signature Firm: Telephone Plan Number Street Address: 7J • Q�,���ory;,ti� I)r1 Copies to: Builder, HERS Provider Sample Group Number Sample House Number HERS Provider: City/State/Zip: if � loej; HERS RATER COMPLIANCE STATEMENT The house was: Tested ❑ Approved as part of sample testing, but was not tested As the HERS rater prove ing diagnostic testing and field verification, I certify that the houses identified on this form comply with the diagnostic tested compliance requirements as checked on this form The installer has provided a copy of CF -6R (Installation Certificate. Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts) Where cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) Measured Duct Pressurization Test Results (CFM @ 25 Pa) values Test Leakage Flow in CFM 9r If fan flow is calculated as 400cfm/ton x number of tons enter calculated value here If fan flow is measured enter measured value here Leakage Percentage (100 x Test Leakage/Fanflow) Check Box for Pass or Fail (Pass=6% or less) ❑ Pass Fail tq THERMOSTATIC EXPANSION VALVE (TXV) Yes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection Yes is a pass ❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT l ❑ Yes ❑ No ACCA Manual D Design requirements have been met (rater has .verified that actual installation matches values in CF -1R and design on plan. 2• ❑ Yes ❑ No TXV is installed or Fan flow has been verified. If no TXV, verified fan flow matches design from CF -1R. 1 Measured Fan Flow = Yes for both 1 and 2 is a Pass 0 ❑ Pass Fail ❑ a Pass Fail compoance Forms August 2001 A-16 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page 1 of 7) CF -4R Z—A 7 �� Project Title Date Project Address Builder Nam .S Rater Signature Telephone _ Plan Number Telephone Sample Group/ umber fat Sample House Number HERS Provider: Street Address: 4 ► Qgr3 �� oma► ..ti.�a �� City/State/Zip: 0- / �_ p� C' 9901-16Q Copies to: Builder, HERS Provider HERS RATER COMPLIANCE STATEMENT The house was: � Tested ❑ Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verification? I certify that the houses identified on this form comply with the diagnostic tested compliance requirements as checked on this form. The installer has provided a copy of CF -6R (Installation Certificate. Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts) Where cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT 1 Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) I Duct Pressurization Test Results (CFM @ 25 Pa) Measured Test Leakage Flow in CFM J If fan flow is calculated as 400cfin/ton x number of tons enter calculated value here If fan flow is measured enter measured value here Leakage Percentage (100 x Test Leakage/Fan Flow)eheck -Box fbi Puss 0 or less Pass Fail 3 THERMOSTATIC EXPANSION VALVE Yes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection Yes is a pass ❑ •MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE .CREDIT 1 ❑ Yes ❑ No ACCA Manual D Design requirements have been met (rater has verified that actual installation matches values in CF -1R and design on plan. . 2' ❑ Yes ❑ No TXV is installed or Fan flow has been verified. If no TXV, verified fan flow matches design from CF -IR. Measured Fan Flow = Yes for both 1 and 2 is a Pass go '11 Fail ❑ ❑ Pass Fail Uomphance Forms August 2001A-16 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page 1 of 7 CF4R Project Title Date Sy- 3 ko 4/. s :/dogu 1_ Project Address Builder NamV Firm: �r Contact Telephone Plan Number Rater tTelephone Sample Group Number ying Signature t:� Dat Sample House Number HERS Provider: Street Address: 417= Q J'.d!edor►..., nr, City/State/Zip: i `R� LEre,�L'� MVV ZA Copies to: Builder, HERS Provider HERS RATER COMPLIANCE STATEMENT The house was: A Tested ❑ Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verification? I certify that the houses identified on this form comply with the diagnostic tested compliance requirements as checked on this form. The installer has provided a copy of CF -6R (Installation Certificate. Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts) Where cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in combination with cloth backed, rubber adhesive.duct tape to seal leaks at duct connections. MINIMUM.REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) Measured Duct Pressurization Test Results (CFM @ 25 Pa) values Test Leakage Flow in CFM_ If fan flow is calculated as 400cfrn/ton x number of tons enter calculated value here If fan flow is measured enter measured value here Leakage Percentage (100 x Test Leakage/Fan Flow) _ `-7 • (� o orless) Pass Fail THERMOSTATIC EXPANSION VALVE (TXV) Yes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection ❑ Yes is a pass Pass Fail ❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT 1 ❑ Yes ❑ No ACCA Manual D Design requirements have been met (rater has verified that actual installation matches values in CF -1R and design on plan. 2• ❑ Yes ❑ No TXV is installed or Fan flow has been verified. If no TXV, verified fan flow matches design from CF -IR. c Measured Fan Flow = ❑ a Yes for both.1 and 2 is a Pass Pass Fail Compliance Forms August 2001 A-16 A 'V�T • ter: Copy 1 JCM Inspections Copy 2 Project Superintendent Copy 3 Governing Agency Page —Aof�_, JCM I tions Inspections 39725 Gar' 41 Garanti Lane Suite F —31 I MI �� 1. *1 Palm be"SerV CA 92211 INSF -Phone: 160-345-5554 Fax: 760-772-3895 •E PTION EPDXY INSPECTION REPORT Date: k�" ProjectxName: 4 Project No: 1 71-tp_ ec- w�� - j Project Address: n City: .Title 24 client: Sub -Contractor: C_ < Other' General Contractor: Architect* Structural Engineer: 0±n C_ so C C3 C-VNI") LnlAnchor Bolts F-1 .�6 r WeatxN 4 Epoxy Type: Unresolved lLeMA'. Epoxy Shelf Life: C5V_Non e 'See Hole Cleaning Method(s):%L -,,.o II & '7- C �1� (> C -4P E] Below Description of Work Inspected: k Fs;�. WaTaa4aa �-y V &�'QAk,, t] r Vir, e 1". 1 C, to, t _Vk1n . ex IAI�A_1111\0 Db Q2k El 44 &C, C kA,o p s k: A. Ir kr. C3, - _1% C, e) gr A.0 4- 4N�;� n',-- %Z CA 3AI4 a- _-r_A 0%0 1 V MV 11 % e Og. 1*19!r" Nm r mo c -e* -i c% pdaar\oA d i1a Im±60 v- vMo A_ t 0.%, A', trN v r" Ahl­ tif Work complies with written approval from Structural Engineer and 1CBO Evaluation Report # Sam 11� I hereby certify that I have inspected all of the above 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. Inspector: Jack C. Millin ICC C rt No: 0842216-49 Contractor's Rep esentative: , �Mckilion 01 - Copy 1 JCM Inspections Copy 2 Project Superintendent Copy 3 Governing Agency Page —Aof�_, ••• • _•.tp*Y'� ��Ih SIR FA! F Iwrf +ir Ynyp'w• a+ nt,C i;i } ���: is rr. 1'i Jr X.j`� 1- K'j7�.� t'��`;�'F 43 1. t a i ise} T..L�•`•' ,f. ,.i `. -,^' rk T �. yi' r .tl , .: .1. - _ . �i �.; r, .,. .� ,• ? ` . ST'RUCT.URAL'ENGINEERS. STRUCTURAL JOB SITE OBSERVATION { "• ' v Project Name: 7 C C % , %' �L e- % C C, Project Number. N a "l �'..= Observer: i1?t 7 �� .:l 01 / Date of Observation: � . t ,� , •.'• A visit to the project site was made on the above date to: ;.' .13. Address specific elements of the work. ❑ Assist the field personnel with complying with the intent of the construction documents. " O�Assist the field personnel with complying with the findings from a previous structural job site observation. had Phase: At the time of our visit, work progressed to the point of : 4 _ Address: Bldg. / Lot Number: a Bldg. / Plan Type & Elevation: _ ~. o'%" Foundation Trenched ,❑` 0 ❑ 0 ❑ Foundation Poured �'' 0 ❑ ❑ 0. Roof Sheathing Covered00 0 C10 : �3 ; Roofing Material Stacked and Loaded 01 0 ❑ 0 0ys. Exterior Walls Covered 0 0 . ❑ 0 0 Interior Wall Covered 0 0 0 ❑ 0 �- Insulation Installed 0 ❑ ❑ 0 0 Electrical, Mechanical, Plumbing Complete ❑ 0 ❑ ❑ ❑ Final Framing Pick-ups Completed 0 0 0 ❑ ❑ Building Complete 0 0 0 0 ❑ ` •rte .. ' Based upon our visit: ❑ Refer to the attached field notes to be addressed by the construction personnel. ❑ Additional information will be sent from our office which will need to be addressed by the construction personnel. intent documents 6Y.- O our opinion that this building is being constructed in general conformance with the of the construction prepared y.'our ouroffice. ❑ Site Observation ceased, framing was not at a stage of completion in which site observation could be performed. = ❑ Concerns brought to the attention of field personnel based on previous site observation made on have yet to be addressed. ' Comments: •it i'�1. �'tn�. ,� /Vd Please note e c 'I r ✓ 1-e • S ' Our findings and recommendations may have other than structural ramifications which we have not addressed. Be advised that changes to the construction documents need approval of the building official. Our firm is not authorized to act as the Owner's agent. Our findings shall not be construed as authorizing the expenditure of additional funds. Site Observation was made only to determine general conformance with the intent of the construction documents. Observation was made of those portions of the work which would best represent the intent of the construction documents, not each and every element of the work. Site observation did not include review, approval or observation of, among other items: 1. The contractors safety precautions, procedures, designs, methods or techniques. 2. Any shoring, scaffolding, underpinning, temporary retaining of excavations, or any other erection methods or temporary bracing. 3. Any soils at the site, their adequacy to support the building, expansiveness, or any other soil related conditions. 4. Any drainage courses or devises of a temporary nature or. as a permanent part of the structure, including roof and floor slopes, drains and pipes. `k The findings of this observation are understood to be an expression of professional opinion by the engineer based on his or her best knowledge, information and belief. As such, it consists of neither a gu/aarantee nor a warrantee expressed or implied. Field Superintendent (third copy) ,-/�_�'� i'/ Date: 1/2 Client (second copy via mail) � Field Engineer (first copy) / �/r j�-� ri Date: If you have any questions please contactouroffice COSTA MESA, CALIFORNIA �' Phone: 714-513-7500 Fax: 714-513-7555 ROSEVILLE, CALIFORNIA Phone: 916-774-7597 Fax: 916-774-7599 PLEASANTON, CALIFORNIA Phone: 925-474-1180 Fax: 925-467-1780 LAS VEGAS, NEVADA Phone: 702-740-5427 Fax: 702-740-5431 PHOENIX, ARIZONA Phone: 623-869-0607 Fax: 623-869-0609 B0 RM ASSOCIATES; INC. Structural Engineers STRUCTURAL JOB SITE OBSERVATION, ` , `tIV, Project Name: ti--, ,y .r r 7, / l'% s - Project Number. r Observer. Date of Observation:- - p r A visit to the project site was made on the above date to:- ❑ Address specific elements of the works , J /O/ -Assist the field•peisonriel with complying with the intent of the construction documents. ' O Assist the field personnel with complying with the findings from a previous structural job site observation. - At the time of our visit, work had progressed to the point of : Phase: f wv , T Address: -Bldg./ Lot Number. -� Bldg. / Plan Type & Elevation: n Foundation Trenched ❑ 0 0 ❑ Foundation Poured Or 0- 0 0 0 Roof Sheathing Covered 0/ ❑ 0 0 0 Roofing Material Stacked and Loaded 0/ 0 ❑ ❑ ❑ , Exterior Walls Covered o ❑ 0 0 0 Interior Wall Covered 0 ❑ 0 0 0 Insulation Installed 0 ❑ 0 0 0 Electrical, Mechanical, Plumbing Complete 0 ❑ i 0 0 0 Final Framing Pick-ups Completed 0 ❑ vi,❑ ❑ 0 Building Complete ❑ D 0 0 0 1 Based upon our visit: O%Refer to the attached field notes to be addressed by the construction personnel. ' O Additional information will be sent from our office which will need to be addressed by the construction personnel. = O It is our opinion that this building is being constructed in general conformance with the intent of the construction documents prepared by our office. - O Site Observation ceased, framing was not at a stage of completion in which site observation could be performed. ❑ Concerns brought to the attention of field personnel based on previous site observation made on have yet to be addressed. Comments: q— Please note: Our findings and recommendations may have other than structural ramifications which we have not addressed. Be advised that changes to the construction documents need approval of the building official. ' ffcial.. Our firm is not authorized to act as the Owner's agent. Our findings shall not be construed as authorizing the expenditure of additional funds. Site Observation was made only to determine general conformance with the intent of the construction documents. Observation was made of those portions of the work which would best represent the intent of the construction documents, not each and every element of the work Site observation did not include review, approval or observation of, among other items: 1. The contractors safety precautions, procedures, designs, methods ortechniques. 2. Any shoring, scaffolding,`underpinning, temporary retaining of excavations, or any other erection methods' or temporary bracing. 3. Any soils at the site, their adequacy to support the building, expansiveness, or any other soil related conditions. 4. Any drainage courses or devises of a temporary nature or as a permanent part of the structure, including roof and floor slopes, drains and pipes. The findings of this observation are understood to be an expression of professional opinion by the engineer based on his or her best knowledge, information and belief. As such, it consists of neither a guarantee nor a warrantee expressed or implied. Field Superintendent (third copy) l Date: Client (second copy via mail) Field Engineer (first copy) • �% �+• . 1 / �` Date: If you have any questions please contact our office. COSTA MESA, CALffORNIA Phone: 714-513-7500 Fax: 714-513-7555 ROSEVILL.E, CALIFORNIA Phone: 916-774-7597 Fax: 916-774-7599 SAN RAMON, CALIFORNIA Phone: 925-242-2577 Fax: 925-242-2961 LAS VEGAS, NEVADA Phone: 702-740-5427 Fax: 702-740-5431 PHOENM ARIZONA Phone: 623-869-0607 Fax: 623-869-0609 • i JCM Inspections ry, 39725 Garand Lane Suite F f S' Palm Desert, CA 92211. �. { �• -. . itiSPCCTi(3:�5 ; `� Phone:760-345-5554 f=ax: 760-772-3895 INSPECTIONS,. ' r EPDXY INSPECTION REPORT Date: x_13_ Project Name_: .4 „ . Project No: 2_" S i fJ�Q r� CQ.. �' C \U��• �/ \ lT' � �S� a t Project Address: n 2.' Q ',' City: � r 'J r,�%. _ �t� ° I �G �-•O� c/ c�CJ I i � 0�::, Title 24 Client: Sub -Contractor: ; , a n L..Lc- Other:. General Contractor: Architect: Structural Engineer: "�n Q o c abS rro c ' ®Anchor Bolts _ ❑Rebar Weather; Epoxy Unresolved Items: Type Epoxy Shelf. Life: ^ 7:Sy\y\1'..200(. p None, Hole Cleaning Method(s): na _ h ' `, a _ o p ❑ See'Below, Description of Work Inspected: �` o '3-'� ,, y' p �PJr A _ cllGyrapaQ�� �d GJC.�- �J \I:� 114\1a:2 1L Q Iva t f f r A' \Nall K.oOr � �\ D "�A• . c-:. PO n)( 14 PA Lh,7 i ns D r 1 11P.e�•• M� Q A a iii O 4 D � e Work complies with written approval from Structural Engineer and ICBO Evaluation Report # Sa I hereby certify that I have inspected all of the above 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. Inspector: Jck C. Millin ICC Ce ific In No: 0842216-49 1 Contr tog's' m sentati,�e`_�) C\.. . v, Copy 1 JCM Inspections Copy 2 Project Superintendent / v Copy 3 Governing Agency Page of r STRUCTURAL JOB SITE OBSERVATION FINDINGS �-,B'RM STRUCTURAL ENGINEERS''' Project Name: /z k ?- '`' >7 Al C f t"! Project #: Observer: J LotBldg. # Plan Type: Elevation: 'Foundation '/t.Floor`Framingw%-Roo`f Framing / AIG Foundation / Alt Framing /Foundation Option /Framing.Option Foundation s. Provide AB per detail per plan. �B Provide nut & washer tightened connection '@ sill plate connection to foundation. 1, HD and HD anchorage to foundation have not been installed as indicated on foundation plans., Refer to repair p ocedures from ' BAI. ti D. Provide concrete patching or repair procedures at damaged concrete for completion of slab or foundation application per plans. E. Framing `F Provide shim, post or solid blocking for bearing condition @. framing member. G. Provide sole plate connection to framing below as called for in shear wall schedule. H Provide beam, floor joist, roof truss or header as indicated on plans. QProvide (verify, complete) nailing and length of strap as indicated on plan. J. Provide A-35 connection (or H1 connector at roof level) with spacing per plan. Unable to see, contactor to verify. L.',. Provide blocking and/or straps per details 18/SD3 or 19/SD3. 1 Provide top plate splice at breaks in uppermost top plate with nails or strap per detail per plan.' N. O. Provide additional studs at trusses per detail and/or verify the stud grade. P. Provide minimum 3X per shear wall schedule. Provide connection or shear transfer per detail per plan. a � R. Provide (verify, nail) connector hardware/hanger. S .Provide completion of nailing of shear material to framing at boundaries and at adjacent panel edges as called for in shear wall schedule. T. Provide shear material (at ceiling lid) per plan as construction sequence allows. �f Install diagonal brace to top plate per plan detail 2/SD3 & 14/SD3. ; V. Provide bracing blocks with bouddary,nailing at the floor sheathing at 48" o.c. for parallel framed floor joists per detail 2/SD4. ,' _ 1 C.Provide blocked diaphram per plan. C X. Providettruss hangers at truss to girder truss or at beam to truss connection as 060' an<tifecturer'gspeeccificat ons. Y. Provide full depth blocking with boundary nailing per detailat drag line Z. Provide edge nailing at post with holdo"i strapdown or at the edge of shear wall. Field Superintendent (third copy): Framing Foreman (second copy): Field Engineer (first. copy): _ - _ Date: Date:. / 1 Date: Time: Time: Time: PAGE _ OF A �rY O. Provide additional studs at trusses per detail and/or verify the stud grade. P. Provide minimum 3X per shear wall schedule. Provide connection or shear transfer per detail per plan. a � R. Provide (verify, nail) connector hardware/hanger. S .Provide completion of nailing of shear material to framing at boundaries and at adjacent panel edges as called for in shear wall schedule. T. Provide shear material (at ceiling lid) per plan as construction sequence allows. �f Install diagonal brace to top plate per plan detail 2/SD3 & 14/SD3. ; V. Provide bracing blocks with bouddary,nailing at the floor sheathing at 48" o.c. for parallel framed floor joists per detail 2/SD4. ,' _ 1 C.Provide blocked diaphram per plan. C X. Providettruss hangers at truss to girder truss or at beam to truss connection as 060' an<tifecturer'gspeeccificat ons. Y. Provide full depth blocking with boundary nailing per detailat drag line Z. Provide edge nailing at post with holdo"i strapdown or at the edge of shear wall. Field Superintendent (third copy): Framing Foreman (second copy): Field Engineer (first. copy): _ - _ Date: Date:. / 1 Date: Time: Time: Time: PAGE _ OF A