BPAT2016-002778=495 CALLE TAMPICO
14A QUINTA, CALIFORNIA 92253
Application Number: . 8PAT2016-0027
X 4.4 aumt,
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Property_ Address: 54592 SOUTHERN HILLS•
APN: 775120033
Application Description: PGA WEST RESIDENTIAL ASSOC./ 560 SF DURALUM PATIO COVER
Property Zoning:
Application.Valuation: $8,400.00
Applicant:
PGA WEST RESIDENTAL
54320 SOUTHDERN HILLS
__—L-A-QUINTA, CA 92253
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 Professions Code,
and my License is in full force and effect.
License Class: _ License No.:
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 State License Law (Chapter 9 (commencing with Section 7000) of Division
13 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
ermit subjects the applicant to a civil penalty of not more than five hundred dollars
0).:
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
, hin one year of completion, the owner -builder will have the burden of proving that
�(�"she did not build or improve for the purpose of sale.).
(V) 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
tyre Qontractors' State License Law.).
I am exempt under Sec. B. C. for thi f
eason
Dater '" t I 0 w n e�4/X V��
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
VOICE (760) 777-7125
77-7011'.
A INSPE#ON 777=7153
er: I - MAY 1.0'2016
FHEHILLS
E CRAP QQ��UIIYIl1
VGE, CAaff —..__.
Contractor:
PGA WEST RESIDENTAL
54320 SOUTHDERN HILLS
LA QUINTA, CA 92253
LIc. No.:
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: _ Policy Number: _
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that, if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions. .
Date: Applicant:
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 Building Official 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 county ordinances and state laws relating to building
construction, and hereby authorize representy to e r Pon the
above]�;WSignature(App!icam_
y for inspection pu
Date:
FINANCIAL INFORMAT16N
DESCRIPTION 6 a ' ACCOUNT { QTY '. AMOUNT-, x 'PAID IPAID DATE i
F x r F .w._ is r r
BSAS SB1473 FEE
101-0000-20306 0
$1.00. $1.00 5/10/16
na'METHOD ' . ' TRECEIPT# - R CHECK#CLTD BYE"
:.it ,4 r� x
STEVE HERTHELL
CHECK R15356 678 RSE
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00 •
�g : 4y
�DESCRIP.TION '-•
$�'_,r I. - 4 �i.
+` t
"4i
QTY
i ...- . �
G AMOUNT
f , k..i-
PAID >
PAID:DATE.!
s'
ri .ACCOUNT
F
PATIO COVER, STD, ENCLOSED
101-0000-42404
0
$97.17
$97.17
5/10/16
PAID BYr ` �' 3
METHOD
' ��' RECEIPT #
CHECK #Xh
CITp BY
t
STEVE HERTHELL 1
CHECK
R15356
678
RSE
DESCRIPTION,'F
`' ACCOUNT $ ' eG
-s
QTY
_
'' r
AMOUNT
}FPAIDa *'
IPAIDDATEj
,
Yy
t �^
PATIO COVER, STD, ENCLOSED PC
101-0000-42600
0
$131.98
$131.98'
5/10/16
• � 'ai s a -.:, x ^.- .,
PAID.BY�'
, METHOD
'RECEIPT,#,
s
CHECK# �CLTD
BY
STEVE HERTHELL
CHECK
R15356
678
F RSE
Total Paid for PATIO. COVER / COVERED PORCH / LATTICE: $229.15 $229.15
" �• _ DESCRIPTION
ACCOUNT
QTY
19
AMOUNT w
k PAID
PAID -GATE
SMI - RESIDENTIAL
101-0000-20308
•0
$1.09
$1.09
5/10/16
t" "z n'
METHOD `,RECEIPT
#
I ;CHECK #
r rCLTD BY
t xPAID.BY`
STEVE HERTHELL
CHECK
R15356
678
RSE
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $1.09 .$1.09
TOTALS: $231.24 $231.24
�
s ,
Description: PGA WEST RESIDENTIAL ASSOC./ 560 SF DURALUM. PATIO COVER
Type: PATIO COVER Subtype: PRE-ENGINEERED -. Status: APPROVED -CONDITIONS
Applied: 5/2/2016 RSE
ENCLOSED
Approved: 5/9/2016 JFU•
Parcel No: 775'120033 Site Address: 54592 SOUTHERN HILLS LA QUINTA,CA 92253
Subdivision: TR 28776 Block: Lot`. B
Issued`
Lot Sq Ft: 0. w= Building Sq Ft- 0 Zoning: - _ _
Finaled: -
Valuation: $8,400.00 Occupancy Type: Construction.Type:
Expired:..
No. Buildings: 0 No. Stories: 0 No. Unites: 0
j
Details: DURALUM PATIO COVER SYSTEM - (1).14'X40' (560 SQ FT.) 2012 IBC/IRC, 2013 CBC/CRC AND ASCE/SEI 7-10, ENGINEER OF RECORD:
THOMAS CAMPBELL, NO 37948. THIS PERMIT DOES NOT INCLUDE HELIOCOL THERMAL SOLAR COLLECTORS. PATIO MUST BE
BONDED TO GRID WHERE CLOSER THAN 5' TO WATER'S EDGE AT POOL. ^
ADDITIONALSITES
74t,z
.. .
-
i
�� �"'Sr '''�y yC •
PLAN CHECK SUBMITTAL
T
j
T Applied to Approved
�` . ,•
1
oka
ADDITIONALSITES
.. .
_',.wm� '•"�G'.:4 ""�". ' !'.."?W' .- . -.. :.. _.w -vry;; �ux�:.w�.': .+d .. -fi-Trs ... :': „ r!M ..:.:..aµ: '...:.:.: -. -.'.i :'?`r-� - — - t s �`.a -
:CHRONOLOGY TYPE STAFF NAME :+ ACTION DATE ` COMPLETION DATE> NOTES
PLAN CHECK SUBMITTAL
RAMSES SEVILLA 5/2/2016
5/2/2016
RECEIVED
A _.
PLAN CHECK SUBMITTAL
RAMSES SEVILLA 5/2/2016
5/2/2016
RECEIVED
,
r
CONDITIONS
...*
1 N .ate....
0 A E DATE DATE r
D TSl
x
,..CONDIT ..;:
`g F N
..
STAt,US n:. RE,MARKS": T £ NOTES; a
.;, -TYPE :: , e -Fr
_. :.. . F .. ..�-.. .
ADDED °,,. _REQUIRED 3 :SATISFIED��
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¢"
•-_.. R,rcdan
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..:� �-a. .?aey-.+ :. � :f
READY TO ISSUE
OWNER -BUILDER FORMS MUST' BE SUBMITTED
JAKE FUSON
5/9/2016
PENDING
CHECKLIST'
IN ORDER TO. ISSUE.
ADDITIONALSITES
...r ��.•i.�,�. ..•. ,
INSPECTIONS
u, PARENT PROJECTS,
Printed: Tuesday, May 10, 2016 12:21:26 PM � .2 of 3
. - SYSTEMS
CONTACTS
'NAME _TYPE "<: ; 'NAME>:
:ADDRESS1 : 'CITY
STATE
ZIP
:PHONE
.
FAX
EMAIL
"-
,
A
;
APPLICANT PGA WEST RESIDENTAL
54320 SOUTHDERN
LA QUINTA
CA
92253`
o
HILLS
CONTRACTOR- PGA WEST RESIDENTAL
54320 SOUTHDERN
LA QUINTA
CA
.92253
HILLS
r
OWNER SOUTHERN HILLS
1430 E CHAPMAN AVE ORANGE
CA
92253
STE 100.
FINANCIAL
••
•
,._...
`.QTY
, . ��.�:,
.-� "•M� p » z,
''PAID
�� ," ,� X
""`.:
"RECEIPT,#
r�.°
� .
DESCRIPTION ;' °"ACCOUNT 4 .AMOUNT �` r' PAID,DATE
-CHECK # METHOD
K PAID BY -
�
f
BSAS SB1473 FEE 101-0000-20306 0
$1.00
$1.00
5/10/16
R15356
678
CHECK
STEVE HERTHELL
RSE
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00
$1.00. .
,
BSA
PATIO COVER, STD, ,
101-0000-42404 -
0
$97.17
$97.17
5/10/16
R15356
678.
CHECK
' STEVE HERTHELL
RSE,
ENCLOSED
r
PATIO COVER, STD,
101-0000-42600
0
$131.98
$131.98
5/10/16
R15356
678
CHECK
_ STEVE HERTHELL
RSE
ENCLOSED PC
Total Paid for PATIO COVER / COVERED PORCH / LATTICE:
$229.15
$229.15
SMI - RESIDENTIAL
101-0000-20308 j
0
$1.09
$1.09
5/10/16:
R15356
'678
CHECK
STEVE HERTHELL'
RSE
Total Paid for STRONG MOTION INSTRUMENTATION SMI:
- $1.09
$1.09
TOTALS:
$231.24
$231.24
...r ��.•i.�,�. ..•. ,
INSPECTIONS
u, PARENT PROJECTS,
Printed: Tuesday, May 10, 2016 12:21:26 PM � .2 of 3
. - SYSTEMS
P:O,• Box 1.504
LA QUINTA, CALIFORNIA 92247=1504
78-495 CALLS TAIKPIBUILDING & SAFETY DEPARTMENT
CO
L-A QUINTA, CALIFORNIA 92253 (760) 777-7012
FAX (760) 771-7011
PROPERTY OWNER'S PACKAGE
Disclosures & Forms for Owner -Builders Applying for Construction Pe
rtnits
IMPOR?'AAtl NOTICE TO PROPERTY OWNER
Deai Property Owner:
An application for a buildin ��2 be
impzovements.specified at_, nutted ur name. }fisting yotuseIf as the builder of the properly
We are providing You with.an O er Bulkier Aclamowl
responsibilities and possible risk you may'incta b lin edgment an Information Venficatton Form to.make you aware of your
Y ving this pei t•issued;in your name as.the
Owner=Builds. We will not issue a build` "
signed, and returned this form fo us at our ofCctaivaddrens i dicated �An aaena'of the ownertcarinogefeaate this notice
unless you, the property Darner, obtain the pti approval of the UeII4l ttirio.anrl,...;g,"
U-1.1111. i unaerstand a frequent practice of unlicensed person,,.
d g Permit that erroneously implies that the property owner.
an Owner,Builder, niay be held liable and subject to serious lira
and his or her employees while working o- my property; S
injuries. I am willfully acting as an Owner -Builder and ain aware
aware
MY property. ,
2. I understand building Permits are not required'to be s
ruction and are sof hiring a licensed Contractor 10.85SUn}i j
understand as an "Owner-Builder".I am the irsponabl;
ff from potential financial Halt by hiiinga licensed,Contrac
iroperty owner obtain an "Owner -Builder"
her own'labor and material personally. 1, as
+,injuries sustained by an unbeerised person
Hance may not provide coverage for those
Y insurance coverage for injuries to workers
owners unless they are resPvrisible for the
I undcr'stand that I may protect
in'his or het mine instead of my
I understand Contractors are requ
its and contracts. ired by law to be licensed and bonded in California and to list, their ficense numbers on
it
AV-construction
��. I understend,if 1 employ or otherwise engage anypetsons, other than California licensed Contractors, and the total value
cafe and
ed is at least five hundred dollars ($SOOj, including laboi and materials, I may be on an "employer"
K6.
te and federal law•
understand if I am considered an " to er"_ tnider;state aai7:federal law"! must register .wifh the state and federal
ent, withhold payroll taxes, ::providee orkers' co
mpensahon disability msuiaiice
compensatioq for each "employee:" I also understand ;my failpi a to abide by these` laws :ma bt �oi seri, �finaiic nt
k.
al
I understand under California Contractois' State. License Law, an
etures cannot legally build them with the Qwner Builder who Builds single-famil
subcontractors and tial
the number of stivctxires does no euceed four em for sale, unless all work is single-family
under contract with a licensed genial: buildin ` y Fanned b J
within an calandai year, or;all of the woik is Performed
e g ConTrdctt)T e c r
.F
.8. 1 understand as an Owner-Buildet if I -sell the property for which h s permi for
cial or personal injurfes"suitathi t is issued, I may be held any
ine b a bi dr(s) ibit result from, any latent construction Y 0i su.sequ;aht.oikfi
Ara.,,, nship or materia� c n defects in the
9. 1 understand I may obtain more
information regarding
my obligations an "employer" 66m the, Interiial'Revenue
as
e ce, the United States Small -Business Adn-dnis.traii6n, the bepaff''ment of Beh'efi I t
orma
erstand I May contact theCaliforniaontra -board" `(CSL
Division of Industrial Accidents. I also and the Cald�i6ia
ts understand onta * CA Contractors' State License e
I-CSLB (2752) or Vmmalb.ca. . . �B 1 1.
gov for information about licensed contractors.
10 . I am aware of and consent to an Owner -Builder building permit applied for in my name,
-legally, and financially And understand that I am the
y raponsi le or
propose, construction -acqKlty at the ."following address:
c that, as the party legally and finandiallyyespohmble for this,pro ed construction activity, I will abide
ai;ilt agree
TPs db 0
',c aws And reqdireme'nts that g&ern dwijej4•�j�e� - I . . y
as. as employers.
&
1 2- 1 agree to notify the issuer of this forni immediately of any addid
ons, deletions; any of the information I
rounded -on
this f
5,e vided - on form
or thangetI6.
. , Licensed contractors are regulated by laws designed to protect the public. If you contract with
someone who does not have' licen.,te dt(� 6 , �,, , t
ve a License Boird4i"iuiable -
assis you with any financial
You may sustain. as a result of a complaint. Your only remedy against unlicensed;contrActo,ts may be mcivil
i " court. Itis . also
important for you tdAinderstirfif that if , an i6�e,41,Contractorori working
or Earn 1�,m whi
oil your property� you may be hild liable for datnag: w jq.!;d . e
y?u,? in a permit as Owner _��&Msft'toh6 " '
Contia
'ble for v6fi'hfit�gwheiihdr.'�j' t thoge Contractors i
Y will -be resp*'onsi' no Contractors,
!�s aTq properly hcen�e� and
compensation insurance coverage.
of their. workers'
coverage.
13'efore a.bfidding permit can be issued, this form fifilst be completed and signed- - by the pr*-9perty
the agency responsible:.�. ..." :, ', ,, - .1; �. I I 0�yh6r.4nd.returned to
f6r issuing., p�rnu - A d''
0
pW.ofthepr�peny�,- O?Wf s. !Tver'sfice, 4, or
other verification acceptable
-ag is a -h
owner's'signature. e '.to j .'is Issued
�w when
to Oirifji'lhe prop,eny
Signature of property pwne
Date:
Note: .7hejbl1owing.4u1jh0rL,,ation Form is required 10 be completed by the. property own
an agent of the property owner to apply for a CO P owner oply when designating
for
.the Builder
Excluding
-
permit the,.
A TMnYTd*%�
ExcluC69 the Nofice.to Property ,0
, wnerj*the execution
the fpl]6w4ng person(j):
to act as my agents) toapply fon
project
Permit for my p
Scope Of Construction Pr6ject (.or Description of Work):
Project Location otAddress:
It winch 'I'Unde'
rstAnd is
my Persona re I sponsi ility, I heicby'a'jthotiz6
and -file'the do o t, -o 6iri an Ow-
Name of Authorized Agent:.
7
Address of Authorized Agent
I declare under penalty -Ofperjury that amthe prOPefty owner -for.,the address listed above and'I per
information. and certify its sofiallY Med out the above
acc . owner
h
acceptable lo,theqgen On " Or other on
aP .-en
verifythe permit is isstredao the pro
P.&Yy owner s:signature:
Property Owner's Signatur
Date. 1n J
Bin #V
Cit of La Quinta
Building uSafery Division - " - , APR2 9 2016
P.O. Box 1504, 78-495 Calle Tampico CITY OF LA
La Quinta, CA 92253 - (760) 777-701COAlM Q61IV7A
Building Permit Application and Tracking SXN eRy DEVELOPma
Permit #
OAT-2-616.
Project Address:
Owner's Name: WES) Aff),V— '&Ser,
A. P. Number:
Address: 6T-3,;16 56 u-7hy--4N
Legal Description:
City, ST, Zip: (!,A 9A;Z�13
U, 1AJ T,
Contractor: J'9A
Telephone:
Address: x`732 Q U V-A 67Y)us
Project Description:
City, ST, Zip: Z-1d)ZAWFA 0-A 9,7.26-3
W1 05 x 40 *'lowv
Telephone:Z D- %7
A1L)V"WxeJ cemew-'i *LbILW—
State Lie.
City Lie. M.
Arch., En gr., Designer: F6 M )'WX y
Address:
City., ST, Zip"'/I��- No-kiy1mi(m,
Telephone:
- - - - - - - - - - - -
.... .........
................... . .. ... .
. . . ......
ons uc ton Type: Occupancy:
State Lie. .#:
Project type (circle one 10 Add'n Alter Repair. Dem 0
Name of Contact Person: STE UE- P- 79FL#
Sq. Ft.:!'��o
# Stories:
Units:
Telephone # of Contact Person: q S:Amo
Estimated Value of Project:
APPLICANT: DO NOT. WRITE BELOW THIS LINE
N
Submittal
Req'd
Ree'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready forcorrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans
ans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'd Review, ready for'corrections/issueElec
trical
Subcontactr List.
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
"Milt I
I
FAIMErik An
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• S . i - _ •�, • .. ' �^ • A • - - ' �+'�' _ , - •' 2 GUTTER .: ,. . .
CORBEL T RAFTER Q PIECES COME- t
' TOGETHER OVER SPLICE:.
' TAILS '2 O:C. -2 FASTENERS PER FOOT ti COSMETIC ONLY — WILL NOT r
' FRONT FASCIA MINIMUM (#14 SMS) PER AFFECT STRUCTURE'S RIGIDITY
TABLE #2 Pg. '4 of 49 OR. INTEGRITY
RAIN GUTTER
2.5" TALL -X-14' LONG X 6.,
2
WIDE INTERLOCKING PANS
t 3"x8" DOUBLE
DRILL %" ACCESS HOLE HEADERS
FOR SMS TO ATTACH
HEADER TO POST• - 3"x3" STEEL POST '
8" COLUMNS - SCREW AT UPPER
RIDGE PREVENTS t
SLIDING AFTER_, INSTALL'
CAULKING B
ET"' WEEN GUTTER; • `� �
<r AND`SPLICE WILL PREVENT
ALUMINUM -SPLICE PIECE
HEADER/GUTTER, '
.LEAKS AT SPLICE LOCATION ' ` SLIDES INSIDE GUTTER, TO
'
JOIN 2 PIECES TOGETHER
DETAIL • Y ': j - Gl1TTFR cpI ire
TECHNICAL INFORMATION AND SPECIFICATIONS �t
The Heliocol
Advantage
THE FEATURE THE ADVANTAGE
Patented individual tube design Allows expansion and contraction, eliminating cracks and leaks.
Lets roof breathe, keeping it clean and dry.
Patented mounting hardware Eliminates hoses, clamps and straps. No gaps between panels for
smoother look; less than half the number of roof penetrations.
One-piece overmolded construction Eliminates welds and weld leaks.
Hurricane resistant Can withstand hurricane -force winds; Heliocol panels are approved
by most property and casualty insurance carriers.
Low collector -head loss rate Reduces pump requirements.
Using the power of the
sun to heat your pool
A. Using your existing pool
pump, pool water is directed
through a series of valves to
your solar collectors.
B. Pool water enters the
solar collectors at the bottom
and rises to the top through
the individual tubes of the
collector. C. As the water
rises through the collector it
is heated by the sun's radiant
energy D. The water is then
returned to the pool to repeat
the cycle until your pool has
been wormed.by the sun.
c Certification Data
• ISO 9001:2008 and ISO 14001:2004
• Ortech International Laboratories
• Solar Rating & Certification Corporation (SRCC)
• Solar Energy Analysis Laboratory (SEAL)
• DSET Laboratories, Inc.
• HRS, Florida (Required for commercial use)
• Florida Solar Energy Center (FSEC)
• City of Los Angeles #RR -4508
• British National Water Council (for potability)
• German Federal Health Board
• NSF 50 for Recreational Water Facilities
Enjoy Year -Round Leisure Living.
HC -204 10/201 1
Mix Design Report
Superior Ready Miz Concrete, L.P. 4
• ; A + 1508 W Mission Rd
+` Escondido, CA 92029 x•' �'"
760-745-0556
« , }Mix ID# D837P— '4500 PSI 1" [O]
This design is being submitted for approval. Conformance with specification should be reviewed.
- t ,
Contractor;' PGA West
Project: PGA0est�4
Compressive Strength :
4500 psi at 28 days
Aggregate `size ': • .
"1" ` 25 mm .
Air: ' ._ a
1.2 ± 1.0 %Ii
Water/Cement ratio:
0.45
Slump
4.00 ± 1.00 in
Source of Concrete SUPERIOR READY MIX CONCRETE
Construction4ype
Placement: TRUCK PLACE / 4' PUMP ,
Unit Weight: 147.89 pcf
Design,Date : 01/14/2015 "r
Constituents :. '
Quantity
Density
Volume
ASTM C150 TYPE IIN CEMENT °"
�, : 559 Ib
• 3:150
2.84
ASTM C618.CLASS,'F".. FLYASH
99 Ib
-2.200
"10.72
Water,,'
29616
1.000
4.74
ASTM C33 #57'ROCK,
1418 Ib
2.670
18.51
ASTM C33 #8 ROCK :
` ' s : 350 Ib
2.640
ASTM C33 FINE AGG i '
1269 Ib
2.640
x;2.13
`17.70'
ASTM C494 TYPE A WATER REDUCER,' . _ 3
: ,26.32 floz (US)/yd3
1.000
•''1;0.03
Air ,}. i
��� 1.2 %.
'•;'0.32
4.
Total
3993:
27.00
Remarks
Reported by Superior Ready Mix L.P. it -
Approval by : 4!
Date : 01/01/2015 , . r
Date
4.
SIGNATURE tKED" r P4
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'RO t log N0.
000 SUB ECT 4 �,.,.e, SHEET. OF SHEETS
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