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11-0693 (RC)r P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT �%-�Application Number: 11-000006931 Property Address:' 60800"TRILOGY PKWY" APN: 764-270-999-135 -300231- Application description: ,REMODEL - COMMERCIAL Property Zoning: MEDIUM HIGH DENSITY RES' Application valuation: 5000 Applicant' Arc Ili'tect or Englinr. Lryc/TR�z� �6�N c� Vcc6�stc , • x'642/0 ' r LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter,9 (commencing with Section 70001 of Division 3 of7ti ss and Professionals Code, and my License is in full force and effect. r ./ License Class: B icense No.: 693077 _ Date: ontr - ' OW ER -BUILD DECLARATION ' I hereby affirm under penalty of perjury thatI am ex pt from th Contractor's State License Law for the following reason (Sec. 7031 .5, Business and Professi s Code: y city or county that requires a permit to construct, alter, improve, demolish, or repair any structur 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 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 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 _ ) 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. 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 improve for the purpose of sale.). (_) 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 contractors) licensed pursuant .to the Contractors' State License Law.). ( 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owners 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: - Lender's Address: - LQPERMIT Owner: SHEA LA QUINTA ` 60800 TRILOGY PARKWAY` LA QUINTA, CA 92253 Contractor: ORR BUILDERS 39301 BADGER, SUITE #30 PALM DESERT, CA 92211 (760)360-6632, Lic. No.: 693077 ------------------ WORKER'S COMPENSATION DECLARATION Date: 8/29/11 2011 lANTA :P7: .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 STATE FUND Policy Number 1960920-2011 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 Jkae-ii-I-shpu` become subject to the workers' compensation provisions of Section / �• /. 3,700/of the Labor Code, hall for 'th comply with those provisions. , Date: �1�ppficant: WARNING: /FAILURE TO S COMPENSA ION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE ALTIES AND C VIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO T E COST OF CO PENSATION, DAMAGES AS PROVIDED FOR IN, SECTION 3706 OF THE LABOR CODE, INTE ST,.AND ATT RNEY'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 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 ounty ordinances and state laws rela ' o ui in a struction and hereby authorize representatives of ij o to enntearr}pon the above-mentioned property for in ion purpo ' VlaSignature (Applicant or Agent .. Application Number . . . . . 11-00000693 Structure Information Construction Type . . . TYPE V, UNPROTECTED Other struct info .. . . . . CODE EDITION 2010 FIRE SPRINKLERS yes MIXED-USE OCCUPANCY b/A-3 OCCUPANT LOAD 101.00 --------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 1511.00 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 72.00 Plan.Check Fee 46.80 Issue Date . . . . Valuation 5000 Expiration Date'. 2/25/12 Qty Unit Charge Per Extension BASE FEE 45.00 3.00 9.0000 -------------------------- THOU BLDG 2,001-25,000 ---------------------------------- 27.00 ---------------- Permit ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 32.25 Plan Check Fee 8.06 Issue Date Valuation 0 Expiration Date 2/25/12 Qty Unit Charge Per• Extension BASE FEE 15.00 15.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 11•.25 2.00 3.0000 ---------------------------------------------------------------------------- EA ELEC APPLIANCES 6.00 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 59.00 Plan Check Fee 11.50 .Issue Date . . . Valuation . . . . 0 Expiration Date 2/25/12 Qty Unit .Charge Per Extension BASE FEE 15.00. 2.00 4.5000 EA MECH VENT INST/ DUCT ALT 9-.00 1.00 9.0000 EA MECH APPL REP/ALT/ADD 9.00 1.00 6.5000 EA MECH AH <=10K CFM 6.50 1.•00 .6.5000 EA MECH EXHAUST HOOD 6.50 2.00 6.5000 ------------------------------------ EA MECH OTHER MECH EQUIPMENT ------=--------------------------------- 13.00 Permit . . . . . PLUMBING. LQPERIMIT LQPEIM7IT Application Number . . . . . 11-00000693 Permit ... . PLUMBING Additional desc . Permit Fee . . . 36.00 Plan Check Fee 9.00 Issue Date Valuation . . . . 0 Expiration Date 2/25/12 Qty Unit Charge Per Extension . BASE FEE 15.00 2.00 6.0000 EA PLB FIXTURE 12.00 1.00 3.0000 EA PLB.WATER INST/ALT/REP 3.00 2.00 3.0000 EA PLB FIXTURE DRAIN/VENT REP/ALT 6.00. Special Notes and Comments REMODEL OF EXISTING ARTS & CRAFTS ROOM AND PROVIDE KILN ROOM."2010 CODES. Other Fees ACCESSIBILITY PLAN REVIEW 4.68 ENERGY REVIEW FEE 4.68 Fee summary Charged Paid Credited Due ----------------- ------ Permit Fee Total 199.25 .00, .00 199.25 Plan Check Total 75.36 .00 - .00 75.36 Other Fee Total 9:36 .00 .00 9.36 Grand Total 283.97 .00 .00 283.97 C wl City of La Quinta Building $r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # I^ nn �J "l 1 Project Address: , _ eM I'PALO Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: Te le h n P o e. Address: Project Description: P—�' City, ST, Zip: <- Tele Telephone: _. State Lic. # : City Lic. #: (��� tOe Arch., Engr., Designer: u G Address: City., ST, Zip:, Z Telephone: S State Lic. # Z L O on structi on TY P e: V - Occupancy: A- 3 Project tYPa (circle one): New Add'n Alter Repair air Demo Name of Contact Person: Sq. Ft.: -e- # Stories: # Units: Telephone # of Contact Person: �� ` �-'cj�9 �j Estimated Value of Project: 5 06e) APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections a ( Plan Check Deposit Truss Calcs. Called Contact Person -1111 Plan Check Balance. Tide 24 Cales. a Plans picked up Construction Flood plain plan Plans resubmitted 11 II Mechanical Grading plan 2". Review, ready for correction /issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading t IN HOUSE:- '"' Review, ready for corrections/is a Developer Impact Fee A.I.P.P. • Planning Approval Called Contact Person Pub. Wks. Appr Date of permit issue School Fees Total Perm' Fees 2a �. P.O. BOX 1504 BUILDING & SAFETY DEPARTMENT 78-495 CALLS TAMPICO (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 To: Greg Butler, Building & Safety Directx To PD: August 11, 2011 From: Les Johnson, Planning -Director Due Date: August 17, 2011 Permit #: 11-693 Status: 2"d Building; Plans Approval' (This is an approval to .tissue a Building Permit) The Planning Department has reviewed the Building Plans for the following project: Description: Arts & Craft Room (Trilogy) Address or General Location: 60-80J Trilogy Parkway Applicant Contact: Frank Rodriquez (760)779-5393 The Planning Department finds that: ❑ ...these Building Plans do not require Planning Department approval. V o ...these Building Plans are approved by the Planning Department. ❑ ...these Building Plans require corrections. Please forward a_copy of the attached corrections to the applicant. When the corrections are made please return them to the Planning Department for review. Les Johnson(Di�ector-Planning receive AUG 12 2011 City of La Quinto Planning Department Date PROUDLY SERVING THE UNINCORPORATED AREAS OF RIVERSIDE COUNTY AND THE CITIES OF: BANNING BEAUMONT CALIMESA CANYON LAKE COACHELLA , DESERT HOT SPRINGS EASTVALE INDIAN WELLS INDIO JURUPA VALLEY LAKE ELSINORE LA QUINTA MENIFEE . MORENO VALLEY PALM DESERT PERRIS RANCHO MIRAGE RUBIDOUX CSD SAN JACINTO TEMECULA W I LDOMAR BOARD OF SUPERVISORS: BQB BUSTER DISTRICT 1 JOHN TAVAGLIONE DISTRICT 2 JEFF STONE DISTRICT 3 JOHN BENOIT DISTRICT 4 MARION ASHLEY DISTRICT 5 RIVERSIDE COUNTY FIRE DEPARTMENT IN COOPERATION WITH THE CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION John R. Hawkins - Fire Chief . ' 210 West San Jacinto Avenue -- Perris, CA 92570 (951) 940-6900 - www.rvcfire.org July 14, 2011 RE: TENTAT IMPROVEMENT PLAN CHECK -Non Structural LAQ-1 I -TI -018 Trilogy,=Arts and Crafts,60-800 Trilogy Pakwy La Quinta, CA You have been issued a release for a tenant improvement on an existing building. THIS IS NOT AN OCCUPANCY PERMIT. It is prohibited to use/process or store any materials in this occupancy that would classify it as an "H" occupancy per Sec. 307 of the 2010 CBC. THE FOLLOWING CONDITIONS MUST BE MET PRIOR TO.INSPECTION: Install door hardware and exit signs as ner Chapter 10 of the 2010 CBC. ® All breakers must be labeled and a clearance of 36 inches must ue maintained around the panel at all times. An approved audible interior notification alarm device shall be provided it approved location. An approved manual pull station notification device maybe required at new main entrance door location. Air handling systems supplying air in excess of 2000 cubic feet per minute to enclose(. spaces within buildings shall be equipped with an automatic shutoff. A C-10 licensed contracto- must submit plans, designed in accordance with NFPA 72 to the Fire Department for review anci approval prior to installation A durable sign stating "This door to remain unlocked during business hours" shall be placed on or adjacent to the front exit door. The sign shall be in letters not less than one inch high on.a contrasting background. As may be necessary to maintain proper fire sprinkler protection due to constructions changes, fire sprinkler system plans for the tenant improvement area may be required to be submitted to the.Fire Department for review. - NOTE: Provide illuminated Exit sign at main entrance door. Refer to E.30 for location. Install Kiln per manufacturers specifications. Applicant/installer shall be responsible to contact the Fire Department to schedule inspections. A re -inspection fee will be required if more than one (1) inspection is necessary. Requests for inspections are to be made at least 72 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. Kric rely, By: Jason tubble Fire Safety Specialist Cress Mfg Co. �. , 4736 ConvairDr,Carson -City.. NV,89706";US a ! Phone: 775-884-2777' ! Fax: 775=884-2991 Toll-free: 877-314-1591 }' - Email: cressmfg@earthlink.net Website: hftp://www.crbssmfo.com I} All Categories > Ceramic Kilns > Manual > Digital / Electronic > Item # E2418 . '. Item "# E2418 $11999.00_ s; .4 The Cress E-Series electronic kiln features the most advanced electronic control on the market. It provides 5 (rather than 3) preset easy-to=use firing speeds, plus available custom " I programming capability, for an almost infinitelyflexible range of firing profiles. Most "E" series kilns now"have.3-zone capable•controls, but are initially connected up for one zone This keeps maintenance to a minimum using one thermocouple instead of three. Temperature uniformity is ' superb by design and not brute force. Three-zone temperature controls may be ordered.at additional cost atthe time order is-placed. Cress is now the first to include heat reflective stands" , • ,_.. l mak:.: • ,•, to greatly reduce the floor temperature when firing: t ' ' 4 ` larger Image ! : . Specifications Brick Thickness - �' 2.54 in •Max. No of Cone Max./ Temperature F l� 10 / 2350 °F. ' :FChamber,:Opening 2. Depth" 18 in r ;Volume 3- 4.7 fta--._--� Outside Width �� 29.51 m Outside Depth _ 34 in Height 33 m Limit timer V (:.Electronic Voltage ��p:V t .. - i` d. • .: r • ' • �-� • . - ate .� $ . .. •-. { y T.. .ice i• "�,. � `fl t* - I Amps . 36 A Kilowatts i 7.9 kW Frequency ` 50/60 Hz7.0 Certification_ ^�J CSA and UL Std 499 Amp Fuse Size 40 Short Wire Size 6 Plug Type 6 50P Shipping Weight _ 210 Pound 1 Options r" ' 3" brick T Sectional kiln (S) + • `t ..- �� .i ti I � a ..' • ` Sr �'.- .+_I . -� � , t S , - i 7 ; V ' ` i - -C, 'i i,.'• � •' _ � a J .� r � ir. _ F , a ti., �4' ,r Electric Heating Appliances 1 Scope 1.1 These requirements cover heating appliances rated at 600 V or less for use in unclassified locations in accordance with the National Electrical Code (NEC), ANSI/NFPA 70. 1.2 These requirements do not cover electric heating equipment or appliances that are covered by individual requirements that are separate from this Standard. 1.3 For the purposes of this Standard, a heating appliance is defined as an electrically energized product that directly or indirectly generates heat to perform its intended function. 1.4 These requirements also cover electrically energized products that generate steam for other than space heating purposes and have an electrical power rating of 15 kW or less per steam generating vessel. 1.5 Steam generating products of the type described in 1.4 having an electrical input power rating of more than 15 kW per steam generating vessel are to be evaluated by the requirements in the Standard for Heating, Water Supply, and Power Boilers - Electric, UL 834. 1.6 Each steam generating vessel in a multi-vessel unit shall comply with these requirements. The unit shall also be provided with the marking in 47.37. UL 499 references these Standards: UL 20 * UL 44 * UL 50 * UL 50E * UL 62 * UL 66 * UL 83 * UL 130 * UL 157 * UL 224 * UL 248-1 * UL 248-5 * UL 310 * UL 353 * UL 355 * UL 486A-4868 * UL 486C * UL 486D * UL 486E * UL 489 * UL 489A * UL 496 * UL 498 * UL 512 * UL 635 * UL 733A UL746B*UL746C*UL 758*UL 796 UL 817*UL834*UL873*UL917*UL935*UL943* UL943B*UL 991 *UL 1004*UL 1012 UL 1029*UL1053*UL1054*UL1059*UL1310*UL 1434 * UL 1441 * UL 1446 * UL 1565 * UL 1581 * UL 1692 * UL 1699 * UL 2459 * UL"4248-1 * UL 4248-9 * UL 5085-1 * UL 5085-3 * UL 8750 * UL 60691 * UL 60730-1 * UL 60730-1 A * UL 60730- 2-7 *.UL 60730-2-9 * UL 61058-1 * . Table of Contents for UL 499. Purchase UL Standards. UL com_-.Standards UL Standards Catalog 9SKLAT Create Your e-mail Profile Enter a -mail here Go • Home • Products • Resources • Tech Support • Architects Specs • Shopping • Contact Us HOTSTART PRO CONTROLLER - A Great Kiln .lust Turned Search O Our Site D F GO - The new HotStart Pro gives you the ability to program and save up to 5 custom programs. Each program can have up to 8 segments. The best part is that you don't have to give up a thing. The HotStart Pro is still the only kiln on the market with the convenient and easy to use GlassFire Mode. Also the HotStart Pro is currently the only kiln of it's size to use high quality Solid State relays for added safety and durability. Just look at what you get! The Same Quality Kih1 • Standard Household Voltage • Reliable Solid State Relay • Top Fired • 15" Firing Chamber Download the HotStart Pro Operating Manual r dyck„ 1 a' fres More Memory Than Any Other 3 Button Controller on The & Market. V Now Has Customizeable Ramp and Hold Programming. * 5 Storable Programs 6r Writes 8 Segment Programs W Adjust Programs On The Fly Im And Yes It Still Has The Incredibly Popular GlassFire Mode Available Only With A Skutt Kiln. HotStart bysKUTr You can easily .32 cm Thick - 46 cm diameter or smaller .64 cm Thick- 10 cm diameter or smaller .% cm Thick - Not recommended upgrade your existing .32 cm Thick - 50 cm diameter or smaller HotStart Kiln with a: .64 con Thick -20 cm diameter or smaller HotStart Pro controller. .96 cm Thick - 13 em duimneter or smaller Contact your Skutt �f Distributor for pricing. AA cm Thick- 46 cm dLrtmeter or smaller The HotStart Pro is available with or without an accessory kit. The kit includes: V 13" Shelf Metric Conversion Chart 6; Three 1" Posts 13.5" x 48" St ThinFire fiber paper 8 oz. Kiln Wash www.skuti.com Terms of Use Privacy Statement Contact skull 0 Copyright 1994-2009 Skutt Ceramics. Inc. All rights reserved. FAST .32 cm Thick - 46 cm diameter or smaller .64 cm Thick- 10 cm diameter or smaller .% cm Thick - Not recommended .32 cm Thick - 50 cm diameter or smaller MMIUM .64 con Thick -20 cm diameter or smaller .96 cm Thick - 13 em duimneter or smaller 32 cm Thick - 60 cm diameter or snal lcr SLOW AA cm Thick- 46 cm dLrtmeter or smaller .96 em Thick - 30 cm diameter or smaller 1.28 an Thick - 20 em diameter or smaller ® L6 id Site Feedback Ho`tStart Pro Studio Kiln HOTSTART PRO STUDIO KILN ■ The perfect starter kiln. and Pyrometer in place of the Large enough to easily fuse a controller. 12" platter. ■ Both kilns operate on . ■ The Hot Start Pro has standard household voltage. programming features for the Its compact size makes it beginner and the advanced perfect for the fuser on the artist. move. ■ An even more economical ■ Order with the HotStart version of this model, the accessory kit and you are GP706, is available with ready to go. Includes 13" shelf manual controls which with posts, kiln wash and includes an Infinite switch fiber paper. FEATURES ■ G1assMaster LT Controller ■ 8" stand ■ Element in lid ■ Porcelain peep plug ■ Works on standard ■ Low Mass Type K household current Thermocopule The GlassMaster LT . .7 ■ The HotStart now comes s.' standard with the most versatile 3 button controller on the market. The GlassMasteLT now has r; p? nearly all the features of the standard 11 GlassMaster m -a compact 3 -button '.' controller. 3. ■ •,To learn more, go to 19 e, www.glasskilns.com / hotstert GlassFire Mode Preset programs For fusing " q, slumping; and tac fusing help begiriners start Firing the kiln right owoy �. Ramp and Hold Mode . j up to 8 segment programming Room to store 5 Custom programs wp° - Add Time, Add Temp, Skip Segment .a ■ Infinite switch (Model GP706) ■ Pyrometer (Model GP706) Temp I Wire Breaker NEMA Ship Model Phase Volts Amps Watts 'F Cubic Feet Opening Depth Size Size Receptacle Weight I II 1 II I GP706 1 115 15 1725 1650 I 66 CI- 6� F-cc4F( KQLR.E29997 Heaters, Industrial and Laboratory Page Bottom Heaters, Industrial and Laboratory See General Information for Heaters, Industrial and Laboratory SKUTT CERAMIC PRODUCTS INC E29997 6441 SE JOHNSON CREEK BLVD PORTLAND, OR 97206 USA Electric,kilns, Models 10F, 12F, 714*c*d+, 818*a*c+, 818P*a*c+, 818-30*a, 1018*a*c+, 1027*a*b*c+, 1218*a*b*c+, 1227*a*b*c+, 1227PK*a*b*c+, 1231PK*a*b*c+, 1627*a*b*c, 1627PK-LF*a*b*c with or without prefix letters GM, KM or KS; Models FSX-1627, KM-822abc, KM-1022abc, KM-1222abc. Glass Electric Kilns,_Models-GM followed by -814, -1014, -1414, followed by 208 or 240, maybe followed by 3, maybe followed by ph. GM -10F, GM -706, GP -706 and HotStart� followed by 115. Models 10F*d, 814*a, 1014*a, 1414*a*c, 22CS*a*c, 706*d with or without prefix letter GM or GP. KS Extension ring, Model 714WR; Models 818WR, 818-30AWR , with suffix -208 or -240, with or without suffix -3. KS Retrofit kit, Cat. Nos. KM -1, KM -1/3 phase. AccessoriesModels EnviroVentSEI, EnviroVent2. *a With suffix 208 or -240. *b with or without ZC suffix *c with or without suffix -3 (3 in brick) or -3ph (3-phase) *d with suffix -115 or 120/208;or -240 V Last Updated on 2011-06-10 Ouestions? Print this page Notice of Disclaimer Page Too Copyright n 2011 Underwriters Laboratories Inc.@ The appearance of a company's name or product in this database does not in itself assure that products so identified have been manufactured under UL's Follow -Up Service. Only those products bearing the UL Mark should be considered to be Listed and covered under UL's Follow -Up Service. Always look for the Mark on the product. UL permits the reproduction of the material contained in the Online Certification Directory subject to the following conditions: 1. The Guide Information, Designs and/or Listings (files) must be presented in their entirety and in a non -misleading manner, without any manipulation of the data (or drawings). 2. The statement "Reprinted from the Online Certifications Directory with permission from Underwriters Laboratories Inc." must appear adjacent to the extracted material. In addition, the reprinted material must- include a copyright notice in the following format: "Copyright 2011 Underwriters Laboratories Inc.@" An independent organization working for a safer world with integrity. precision and knowledge. i BUILDING ENERGY ANALYSIS REPORT PROJECT: Trilogy Golf Club -Arts ' 60800 Trilogy Parkway La Quinta, CA 92253 Project Designer: Prest Vuksic Architects 44-530 San Pablo Ave. Suite200 Palm Desert, Ca 92260.... (760) 779-5393 CITY OF LA QUI NTA BUILDING & SAFETY DEPT. 7a µ Report Prepared by APPROVED FOR CONSTRUCTION Tim Scott r Scott Design and Title 241 DAIE o11By 77-085 Michigan Drive -Palm Desert, Ca 92211 (760) 200-4780 r Job Number: AUG 1 1 2011 Date: 7/28/2011 By The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is authorized by the California Energy Commission for use with both the Residential and Nonresidential 2008 Building Energy Efficiency Standards. This program developed by EnergySoft, LLC—www.energysoft.com. EnergyPro 5.1 by EnergySoft User Number: 6712 RunCode: 2011-07-28T14:58:12 ID: 1 � Y - 4 PERFORMANCE CERTIFICATE OF COMPLIANCE (Part 1 of 3) PERF -1 C Project Name Date n.gy Golf Club -Arts 7/28/2011 Project Address Climate Zone Floor Area Addition Floor Area 60800 Trilogy Parkway La Quinta CA Climate Zone52,028 TTotalCond. n/a GENERAL INFORMATION Building Type: m Nonresidential ❑ High -Rise Residential ❑ Hotel/Motel Guest Room ❑ Relocatable - indicate ❑ specific climate zone ❑ all climates Phase of Construction: ❑ New Construction ❑ Addition ❑ Alteration STATEMENT OF COMPLIANCE This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 and 6 of the California Code of Regulations. This certificate applies only to a Building using the performance compliance approach. The documentation author hereby certifies that the documentation is accurate and co tete. Documentation Author Name Tim Scott Signature Company Scott Design and Title 24, Inc, Date 728/2011 Address 77-085 Michigan Drive Phone (760) 200-4780 City/State/Zip palm Desert Ca 92211 A% (2.c> 13 '©q - -5 70 The Principal Designer hereby certifies that the proposed building design represented in this set of construction documents is consistent with the other compliance forms and worksheets, with the specifications, and with any other calculations submitted with this permit application. The proposed building has been designed to meet the energy efficiency requirements contained in sections 110, 116 through 118, and 140 through 149 of Title 24, Part 6. Please check one: ENV. LTG. MECH. I hereby affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code to ❑ ❑ ❑ sign this document as the person responsible for its preparation; and that I am licensed in the State of California as a civil engineer, mechanical engineer, electrical engineer, or I am a licensed architect. I affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code by section ❑ ❑ ❑ 5537.2 or 6737.3 to sign this document as the person responsible for its preparation; and that I am a licensed contractor performing this work. I affirm that I am eligible under Division 3 of the Business and Professions Code to sign this document ❑ ❑ ❑ because it pertains to a structure or type of work described as exempt pursuant to Business and Professions Code Sections 5537, 5538 and 6737.1. Principal Envelope Designer [Signature Name Prost Vuksic Architects Company Prost Vuksic Architects Date Address 44-530 San Pablo Ave. Suite200 License # City/State/Zip Palm Desert, Ca 92260 Phone (760) 779-5393 Principal Mechanical Designer Name Signature Company Mechanical Compliance Not In the Scope Of This Submittal Date Address License # City/State/Zip Phone Principal Lighting Designer Name Signature Company Lighting Compliance Not /n The Scope Of This Submittal Date Address License # City/State/Zip Phone INSTRUCTIONS TO APPLICANT COMPLIANCE & WORKSHEETS (check box if worksheets are included) m ENV -1C Certificate of Compliance. Required on plans. ❑ MECH-1C Certificate of Compliance. Required on plans. ❑ LTG -1 C Certificate of Compliance. Required on plans. ❑ MECH-2C Air/Water Side/Service Hot Water & Pool Requirements. ❑ LTG -2C Lighting Controls Credit Worksheet. ❑ MECH-3C Mechanical Ventilation and Reheat. ❑ LTG -3C Indoor Lighting Power Allowance. ❑ MECH-5C Mechanical Equipment Details. EnergyPro 5.1 by Energ Soft User Number: 6712 RunCode: 2011-07-28T14:58:12 - ID: Page 3 of 10 PERFORMANCE CERTIFICATE OF COMPLIANCE (Part 2 of 3) PERF -1 C Project Name Date Trilo Golf Club -Arts 7/28/2011 ANNUAL TDV ENERGY USE SUMMARY kBtu/s ft- r Standard Proposed Compliance Energy Component Design Design Margin Space Heating Space Cooling Indoor Fans Heat Rejection Pumps & Misc. Domestic Hot Water Lighting Receptacle. Process ' Process Lighting TOTALS 0.94 0.94 0.00 420.37 414.70 5.66 81.59 81.45 0.14 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 76.96 76.96. • 0.00 64.10 64.10 0.00 0.00 0.00 0.00 0.00 0.00 0.00 643.96 638.15 5.81 Heating Cooling' °^^ Fans Heat Ref Pumps :. .,, DHW r �r Lighting s` . X� a Receptacle Process Process Lt4� Percent better than Standard 0.9 Y. 0.9 % excluding process) BUILDING COMPLIES GENERAL INFORMATION Building Orientation (E) 90 deg -Conditioned Floor Area 2,028 sqft. Number of. Stories 1 Unconditioned Floor Area 0 sqft. , Number of Systems 1 Conditioned -Footprint Area 2,028 sqft. Number of Zones 1 Natural Gas Available On Site Yes Orientation Gross Area Glazing Area Glazing Ratio Front Elevation Left Elevation Rear Elevation Right Elevation Total Roof (E) 376 (S) ` 396 (vv) 0 (N) 531 1,303 2,0281 sqft. sqft. sqft. sqft. sqft. sqft. 53 190 0 32 ' 274 0 sgft. sqft. sqft. sqft. sqft. sqft. 14.0% 47.9% 0.0% 6.0% 21.0% 0.0% Standard Proposed Prescriptive Values for Prescriptive Lighting Power Density 1.100 W/sqft. 1.100 W/sgft- Comparison only. See Prescriptive Envelope TDV Energy 82,040 148,404 LTG -1 C for allowed LPD. Remarks: - 1 1 Ene Pro 5.1 b Ene Soft User Number: 6712 Run Code: 2011-07-28714:58:12 ID: Page 4 of 10 4 4 RFORMANCE CERTIFICATE OF COMPLIANCE (Part 3 of 3) PERF -1 C ct Name gy Golf Club -Arts rTn Date 7/28/2011 E INFORMATION System Name Zone Name Floor Inst. Ctrl. Allowed LPD Proc. Area LPD Credits Area Tailored Loads Occupancy Type s ft. W/sf' W/sf z W/sf 3 W/sf 4 W/sf HVAC - Exist Arts & Crafts Lounge, Recreation 2,028 '1.100 1 Notes: 1. See LTG -1C 2. See LTG -2C 3. See LTG -3C 4. See LTG -4C Items above require special documentation items marked with asterisk, see LTG -1-C by others) (by others EXCEPTIONAL CONDITIONS COMPLIANCE CHECKLIST The local enforcement agency should pay special attention to the items specified in this checklist. These items require special written justification and documentation, and special verification to be used with the performance approach. The local enforcement agency determines the adequacy of the justifications, and may reject a building or design that otherwise complies based on the adequacy of the special justification and documentation submitted. The exceptional features listed In this performance approach application have specifically been reviewed. Adequate written justification and documentation for their use have been provided by the applicant. Authorized Signature or Stamp EnergyPro 5.1 by Energ Soft User Number: 6712 Run Code: 2011-07-28714:58:12 ID: Page 5 of 10 0 C n CERTIFICATE OF COMPLIANCE (Part 1 of 3) ENV -1 C AND FIELD INSPECTION ENERGY CHECKLIST Project Name Trilogy Golf Club -Arts Date 1 7/28/2011 Project Address 60800 Trilogy Parkway La Quinta Climate Zone 15 Total Cond. Floor Area 2,028 Addition Floor Area n/a GENERAL INFORMATION Building Type: m Nonresidential ❑ High -Rise Residential ❑ Hotel/Motel Guest Room ❑ Schools (Public School) ❑ Blellocatable Public School m Conditioned Spaces [3 Unconditioned Spaces ❑ Skylight Area for Large Enclosed Space >_ 8000 ft (If checked include the ENV -4C with submittal) Phase of Construction: ❑ New Construction ❑ Addition ❑ Alteration Approach of Compliance: ❑ Component m Overall Envelope ❑ Unconditioned (file affidavit) Front Orientation: N, E, S, W or in Degrees: 90 deg FIELD INSPECTION ENERGY CHECKLIST OPAQUE SURFACE DETAILS INSULATION Ta /ID Assembly Type y Q c 0 3 ;a t N N W O Z 0 li M °' 3 m U of oC c d 7 V �a W> c o� O N W U. � C O y 7 m > � of O C y '` c U- e x v aci C n o a -� Q c 'a n C« O O N y m a iii LL 1 Roof 2,028 (N) 0.031 R-30 4.2.1-A20 Existing ❑ ❑ 2 Wall 499 (N) 0.074 R-19 4.3.1-A5 Existing ❑ ❑ 3 Wall 324 (E) 0:074 R-19 4.3.1-A5 Existing ❑ ❑ 4 Wall 206 (S) 0.074 R-19 4.3.1-A5 Existing ❑ ❑ 5 Slab 2,028 (N) 0.730 None 4.4.7-A1 Existing ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 1. See Instructions in the Nonresidential Compliance Manual, page 3-96. 2. If Fail, then describe on Page 2 of the Inspection Checklist Form and take appropriate action to correct. A fail does not meet compliance. FENESTRATION SURFACE DETAILS Tag/ID Fenestration Type a C Y cN yW O 2 v '� M> O O :5 (n U = U u N W c t O N o v 0 <n N L a LL 1 Window 32 (N) 0.790 NFRC 0.6901 NFRC ❑ Existing ❑ ❑ 2 Window 28 (E) 0.790 NFRC 0.690 NFRC ❑ Existing ❑ ❑ 3 Window 25 (E) 0.510 NFRC 0.460 NFRC ❑ New ❑ ❑ 4 Window 190 (S) 0.790 NFRC 0.690 NFRC ❑ Existing ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 1. See Instructions in the Nonresidential Compliance Manual, page 3-96. 2. If Fail then describe on Page 2 of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary. EnergyPro 5.1 by EnergySoft User Number: 6712 Run Code: 2011-07-28714:58:12 ID: Page 6 of 10 a CERTIFICATE OF COMPLIANCE (Part 2 of 3) AND FIELD INSPECTION ENERGY CHECKLIST ENV -1 C Project Name Trilogy Golf Club -Arts Date 7/28/2011 ROOFING PRODUCT COOL ROOFS (Note if the roofing product is not CRRC certified, this compliance approach cannot be used). Go to Overall Envelope Approach or Performance Approach. CHECK APPLICABLE BOX BELOW IF EXEMPT FROM THE ROOFING PRODUCT "COOL ROOF" REQUIREMENTS: Pass Fail' N/A ❑ Roofing compliance not required in Climate Zones 1 andl6 with a Low -Sloped. 2:12 pitch or less. ❑ ❑ ❑ ❑ Roofing compliance not required in Climate Zone 1 with a Steep -Sloped with less than 5 Ib/ft2. Greater than 2:12 pitch. ❑ ❑ ❑ Low -sloped Wood framed roofs in Climate Zones 3 and 5 are exempted, solar reflectance and thermal emittance or 11 SRI that have a LI -factor of 0.039 or lower. See Opaque Surface Details roof assembly, Column H of ENV -2C. 13 13 11 ❑ Low -sloped Metal building roofs in Climate Zone 3 and 5 are exempted, solar relectance and thermal emittance or SRI that have a U -factor of 0.048 or lower. See Opaque Surface Details roof assembly below, Column H of ENV -2C. ❑ ❑ ❑ roof area covered by building integrated photovoltaic panels and building integrated solar thermal panels are [3 exempted. exem ted. Solar reflectance and thermal emittance or SRI, seespreadsheet calculator at www.ener .ca. ov/title24/ [3 13 13 constructions that have thermal mass over the roof membrane with a weight of at least 25 Ib/ft are exempt from 13 the the Cool Roof criteria below. 13 ❑ ❑ ❑ High-rise residential buildings and hotels and motels with low -sloped roofs in Climate Zones 1 through 9, 12 and 16 are exempted from the low -sloped roofing criteria. ❑ ❑ ❑ 1. If Fail then describe on this page of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary. CRRC Product ID Number' Roof Slope s 2:12 > 2:12 Product Weight < 5lb/fe a 5lb/ft2 Product Type 2 Aged Solar Reflectance Thermal Emmitance SR 15 Pass Fail6 ❑ ❑ ❑ ❑ ❑ ° ❑ ❑ ❑ ❑ ❑ ❑ ❑ ° ❑ ❑ ❑ ❑ ❑ ❑ ❑° 1 ❑ 1 ❑ ❑ ❑ ❑ ❑ ❑ 4 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ° ❑ ❑ ❑ 1 ❑ 1 ❑ ❑ ❑ ° ❑ ❑ 1. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coolroots.orq/products/search-php 2. Indicate the type of product is being used for the roof top, i.e. single -ply roof, asphalt roof, metal roof, etc. 3. If the Aged Reflectance is not available in the Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the same directory and use the equation (0.2+0.7(p;�1,1a1 — 0.2) to obtain a calculated aged value. Where p is the Initial Solar Reflectance from the Cool Roof Rating Council's Rated Product Directory. 4. Check box if the Aged Reflectance is a calculated value using the equation above. 5. The SRI value needs to be calculated from a spreadsheet calculator at httr)://www.eneray.ca.00v/title24/ 6. If Fail then describe on this page of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary. To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage recommended by the coatings manufacturer and meet minimum performance requirements listed in §118(i)4. Select the applicable coating: ❑ Aluminum -Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating ❑ Other Discrepancies: I �EnemPro 5.1 6 Ene Soft User Number: 6712 RunCode: 2011-07-28714:58:12 ID: Pae 7 of 10 0 C F— L_A CERTIFICATE OF COMPLIANCE (Part 3 of 3) ENV -1 C AND FIELD INSPECTION ENERGY CHECKLIST Project Name Trilogy Golf Club -Arts Date 7/28/2011 Required Acceptance Tests Designer: This form is to be used by the designer and attached to the plans. Listed below is the acceptance test for Envelope Fenestrations system. The designer is required to check the acceptance tests and list all the fenestration products that require an acceptance test. If all the site -built fenestration of a certain type requires a test, list the different fenestration products and the number of systems. The NA7 Section in the Appendix of the Nonresidential Reference Appendices Manual describes the test. Since this form will be part of the plans, completion of this section will allow the responsible party to budget for the scope of work appropriately. Enforcement Agency: Systems Acceptance. Before Occupancy Permit is granted for a newly constructed building or space or whenever new fenestration is installed in the building or space shall be certified as meeting the Acceptance Requirements. The ENV -2A form is not considered a complete form and is not to be accepted by the enforcement agency unless the boxes are checked and/or filled and signed. In addition, a Certificate of Acceptance forms shall be submitted to the enforcement agency that certifies plans, specifications, installation certificates, and operating and maintenance information meet the requirements of §10-103(b) of Title 24 Part 6. The field inspector must receive the properly filled out and signed forms before the building can receive final occupancy. A copy of the ENV -2A for each different fenestration product line must be provided to the owner of the building for their records. Test Description ENV -2A Test Performed By: Fenestration Products Name or ID Area of like Building Envelope Requiring Testing or Verification Products Acceptance Test Double Metal Tinted 25 13 13 13 13 13 13 11 11 11 13 13 EnergyPro 5. 1 by EnergySoft User Number: 6712 Run Code: 2011-07-28T14:58:12 ID: Page 8 of 10 • ENVELOPE MANDATORY MEASURES: NONRESIDENTIAL ENV -MM Project Name Date Trilogy Golf Club -Arts 7/28/2011 DESCRIPTION Building Envelope Measures: §118(a): Installed insulating material shall have been certified by the manufacturer to comply with the California Quality Standards for insulating material, Title 20 Chapter 4, Article 3. §118(c): All Insulating Materials shall be installed in compliance with the flame spread rating and smoke density requirements of Sections 2602 and 707 of Title 24, Part 2. §118(f): The opaque portions of framed demising walls in nonresidential buildings shall have insulation with an installed R -value of no less than R-13 between framing members. 17 a All Exterior Joints and openings in the building that are observable sources of air leakage shall be caulked, gasketed, §1 ()' weatherstripped or otherwise sealed. Manufactured fenestration products and exterior doors shall have air infiltration rates not exceeding 0.3 cfm/ft.2 of §116(a) 1: window area, 0.3 cfm/ft.2 of door area for residential doors, 0.3.cfm/ft.2 of door area for nonresidential single doors (swingingand sliding), and 1.0 cfm/ft.2 for nonresidential double doors (swinging). §116(a) 2: Fenestration U -factor shall be rated in accordance with NFRC 100, or the applicable default U -factor. Fenestration SHGC shall be rated in accordance with NFRC 200, or NFRC 100 for site -built fenestration, or the §116(a) 3: applicable default SHGC. Site Constructed Doors, Windows and Skylights shall be caulked between the unit and the building, and shall be §116(b): weatherstripped (except for unframed glass doors and fire doors). EnemvPro 5.1 by EnemySoft User Number. 6712 RunCode: 2011-07-28714:58:12 ID: Pa e 9 of 10 • • MECHANICAL MANDATORY MEASURES: NONRESIDENTIAL MECH-MM Project Name Date Trilogy Golf Club -Arts 7/28/2011 Equipment and System Efficiencies §111: Any appliance for which there is a California standard established in the Appliance Efficiency Regulations will comply with the applicable standard. §115(a): Fan type central furnaces shall not have a pilot light. §123: Piping, except that conveying fluids at temperatures between 60 and 105 degrees Fahrenheit, or within HVAC equipment, shall be insulated in accordance with Standards Section 123. §124: Air handling duct systems shall be installed and insulated in compliance with Sections 601, 602, 603, 604, and 605 of the CMC Standards. Controls §122(e): Each space conditioning system shall be installed with one of the following: 1A. Each space conditioning system serving building types such as offices and manufacturing facilities (and all others not explicitly exempt from the requirements of Section 112 (d)) shall be installed with an automatic time switch with an accessible manual override that allows operation of the system during off -hours for up to 4 hours. The time switch shall be capable of programming different schedules for weekdays and weekends and have program backup capabilities that prevent the loss of the device's program and time setting for at least 10 hours if power is interrupted; or 1 B. An occupancy sensor to control the operating period of the system; or 1 C. A 4 -hour timer that can be manually operated to control the operating period of the system. 2 Each space conditioning system shall be installed with controls that temporarily restart and temporarily operate the system as required to maintain a setback heating and/or a setup cooling thermostat setpoint. Each space conditioning system serving multiple zones with a combined conditioned floor area more than 25,000 §122(8)' square feet shall be provided with isolation zones. Each zone: shall not exceed 25,000 square feet; shall be provided with isolation devices, such as valves or dampers that allow the supply of heating or cooling to be setback or shut off independently of other isolation areas; and shall be controlled by a time control device as described above. §122(c): Thermostats shall have numeric setpoints in degrees Fahrenheit (F) and adjustable setpoint stops accessible only to authorized personnel. §122(b): Heat pumps shall be installed with controls to prevent electric resistance supplementary heater operation when the heating load can be met by the heat pump alone Each space conditioning system shall be controlled by an individual thermostat that responds to temperature within the zone. Where used to control heating, the control shall be adjustable down to 55 degrees F or lower. For cooling, the §122(a&b): control shall be adjustable up to 85 degrees F or higher. Where used for both heating and cooling, the control shall be capable of providing a deadband of at least 5 degrees F. within which the supply of heating and cooling is shut off or reduced to a minimum. Ventilation §121(e): Controls shall be provided to allow outside air dampers or devices to be operated at the ventilation rates as specified on these plans. 22 f §1 ()' All gravity ventilating systems shall be provided with automatic or readily accessible manually operated dampers in all openings to the outside, except for combustion air openings. Ventilation System Acceptance. Before an occupancy permit is granted for a newly constructed building or space, or a §121(f): new ventilating system serving a building or space is operated for normal use, all ventilation systems serving the building ors ace shall be certified as meeting the Acceptance Requirements for Code Compliance Service Water Heating Systems §113(c) Installation 3. Temperature controls for public lavatories. The controls shall limit the outlet Temperature to 110° F. Circulating service water -heating systems shall have a control capable of automatically turning off the circulating pump 2 when hot water is not required. EnergyPfo 5.1 Fy EnergjtSoft User Number: 6712 RunCode: 2011-07-28T14:58:12 ID: Pae 10 of 10 L INSPECTIONS JCM Inspections : 39725 Garand Lane -Suite F Palm Desert, CA 92211 Phone: 760-345-5554 - Fax: 760-772-3895 i I N S P E C T I O N S PRESTRESSED CONCRETE INSPECTION REPORT Date: Project Name: b Project No: Trilogy @ La Quinta - Shea Homes 02-1109 Project Address: 60-800 Triolgy Parkway City: La Quinta; CA Client: Shea La Quinta, LLC Sub -Contractor: Sun Coast Tensioning General Contractor: Shea Homes for Active Adults Architect: Structural Engineer: Bassenian Lagoni Borm & Associates, Inc./ Suncoast Post Tensi Size and Type of Tendons: Jack Machine Calibration: SL(ob Calibration Date: Phas J-7MLot# -1 pc1 a 1/2" Diameter Seven Strand Stress -Relieved Tendons Received Sheet from Sun Coast -Gage Pressure in psi to Machine Load in kips psi to 33.04 kips/33,000 lbs Machine # 3� (� �' 4� Product Plan LASSO �� _03"7-'>Qte , �,,,D,-L, ❑✓ IBC ❑ Title 24 Other: Unresolved Items: ❑ None ❑ See Below Description.of Work Inspected: Lot # Location Actual Elongation (in) Specified Complies within 7% +/- of specified elongation. . Tendons Elongation (in) Reference 11 h/SN2. Yes No [�Z ❑ o L� ❑ El 3 I ❑. 0 1 3 ❑ .41 El ❑ e :❑ ❑ ❑ El, El ❑ ❑ 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 Certi'fic tion No: 0842216-89 Contractor's Representative: Copy 1 JCM Inspections Copy 2 Project Superintendent Copy 3 Governing Agency Page 1 of _T C -..cjwj:lletc Gerjerxd orad S1}e,cL&I Inspectioo -1972.S.Gnrand L.,4xie, Suite F, Palm Mese t'l:looc: 760 - 345 - 555E Fax: 760 - 772 - Sf rviC. rt., Cal Cornl-�i Via??! i 3595 ESQ, SPECIAIEN DATA 4 ' CP a., 'E -SZ + -0 SHE ET jCc[; t p '�,� �-1�c� l�`� u,. � �'� Com. �, � V�:�c; '�"� 4,r� ti.�.c-• ��� QS =' L/0 -CATION LN STRUCTURE: 44 4 S� e(r Rc.P"JRT OF STRENGTH TESTS; Morar () Grout() Concr-CL,4(ithcr,, 1 Sri' �s Date Cast_ Date Received.- gut By: Titme. Siimpled_ IvfkDesiga:— Supplier;_P k 0 LA JpecL�e�l nst:Q7�C, Ticket Number: \ t Ages to be. Tested Gl+_ Sl i1 Ql Dkte: �-' Q�-o -7 ?7 ii Slump (in): C Ad.mix-twe: =ZZz Ai_r Temp (F): l / — Cooc Temp(F): ( J Unit Wt (PCO:- " A.irConimt(%): —} `Tat( -x Added (Sal): _ Time Lin Atixer (mita): 0 b a_ Field M Markings: 4 FOR LABORATORY USE ONLY 9 3Q%o ea ([n): 3100 sod 13 "---- -S' n e.�s—_ ed ela _ --- .-- -- 9 3Q%o