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11825 (SFD)A Building Address 52-700 Vallejo Owner R� Kan M. Doran. Mailing Address •CityZip 71— ) `-Contractoll d, Owner / iui l der ,Address-. '• City Zip Tela State Lic:City & Classif.` - Lic. # r- Arch., Engr.,• Dga£tech .Designer. Address 30'-E. 'Bays Tel. _ ynnZi�2220 State. Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Diyisio 3 1 tthe,Business and Professions Code, and my license is in full force and w effect. tO. f . + SIGNATURES DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reeson: (Sec. 7031.5,Business and Professions Code: Any city orjcounty which requires a permit to construct,. alter, Improve, demolish, or repair any structure, I prior to its issuance also .requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he Is exempt therefrom, and the basis for the alleged exemption. Any-ylolation 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). ' O 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, Buisness and .Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon and who does such work himself or through his own employees, _provided that such improvements are not Intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the ,project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) • ❑ 1 am exempt under Sec. ti yB. & P.C. for this reason Date Owner+ WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company i ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. ' .r CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thg 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. Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption youshould become subject to the Workers' Compensation provisions or the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. -1 agree to comply with all city and county ordinances and state laws relating'td building ;t4 construction, and hereby authorize representatives -of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip P:O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 No. 118.25 It BUILDING: TYPE CONST. OCC: GRP A.P. Number 773-293-010 Legal Description Lot -.14 Block 152 r Project Description SFO Sq. Ft. 2305 No. N:q_;Dw. Size Stories Units New E? Add ❑ Alter ❑ Repair ❑ Demolition's Permit dries not in -elude blocs stall's or pool. Estimated Valuation $130t249.50 134F249.50 PERMIT, �. AMOUNT' Plan Chk ,Dep. 250.00 Plan Chk. Bal. 365.27 Const. 748..00 ' Mech. 49.00.._.. Electrical 152.78 Plumbing 144.00 S.M.I. 13.10 Grading 20.00 Driveway Enc. _ Infrastructure 2o,'892.36y6t Arts in y,l7 �y} PUbr PlaCeS 5.6 TOTAL 4,710.13 4,464.13' REMARKS .Yq ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS ' l HEATING (ROUGH) STORAGE TANK YARD SPKLR SYSTEM 2ND FL. SQ. FT. DUCT WORK ROCK STORAGE FOUND. REINF. MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® REINF. STEEL GAS (FINAL) TEMP. POLE—((—q'3 L� POWER OUTLET ROOF DRAINS GAR. SO. FT. ® FINAL INSP. BOND BEAM WATER SYSTEM DRAINAGE PIPING CARP. SQ. FT. ® LUMBER GR. FINAL INSP. 2 WALL SQ. FT. FINAL/ INSP. (Z—�� j` DRINKING FOUNTAIN. // f[ oQ G /'/S h URINAL SQ. FT. ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE,TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. @ c BATH TUB FINAL INSPECTION , 2�6—G13 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER INSPECTOR'S SIGNATURE&INITIALS GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR 1 SETBACK I n1 GROUND PLUM BIN UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMSO WER �K—�_ O UGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE—((—q'3 L� GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. 2 FRAMINGS� G� FINAL/ INSP. (Z—�� j` ROOFING // f[ oQ G /'/S h REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL? _2(—C LATHING �'Yg MESH INSULATIONISOUND 7—Zo -13 FINISH GRADING FINAL INSPECTION , 2�6—G13 CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURE&INITIALS GARDEN WALL FINAL Building Address malting Address T4ht Q"' P.O. Box 1504 APPLICATION ONLY 78.105 CALLE ESTADO /,d i L ,r r LA QUINTA, CALIFORNIA 92253 City I Izip ITel. Contractor 40 City Zi Tel. 7. O— State Lic. City & Classif. Lic. # Arch., Engr., Designer _ /- L Address Tela a = City Zip State r� ... P. / _ . — I QJ s -Y Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Win full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5.Business and Professions Code: Any city or county which requires a permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractors License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. or thatheis 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 ' 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, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however. -the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) I, as owner of the property, am exclusively contracting with licensed contractors to con• str cI the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -' I am exempt u�nder Sec. B. & P.C. for this reason -: Dale )Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to sell -insure, Or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company S^ 1 `'L-1 4r . b7 g Copy is filed with the city. C Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if _the permit is for one hundred -dollars (5100) valuation Or less.) I certify that in the performance of thip 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. Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become Subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Ihereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's. Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. I certify that 1 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 represeptel. es -Of this city to enter the above- mentioned property for ins pection purpo s. `\ \\ Signature of applicant ate Mailing Address _ City, State, Zip FINANCE BUILDING: TYPE CONST A.P. Number2 Legal Description zell, Project Description OCC. GRP. 7 1 Sq. Ft. Size ,Z TED 5 No. No. Dw. Stories Units New 2%, Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. 6 Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure C,r e—Z TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated .(619) 347-8631 Date 2/22/93 1Type of Permit La Quinta: No. 112028 Permit # Log Owner. Name William Doran No. Street See Below city La Quinta Zip 92253 Study Area 112 APN # J Tract #I Lot # 0 Square Footage 14610 Type of Development Single Familv Residence No of units 0 Comments 52-392 r" At the present time, the Desert Sands Unified School District does riot collect fees on garages/ carports, covered patios/ walkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes, It has.been determined the above-named owner is exempt from paying school fees at this time due to the following reason: r EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to- - Government Code 53080 in the amount of 1.58 x 4'610. or $ 7;283.80 ; have been paid_ to D.S.U.S.D. for the property listed above and that building. permits ;and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. " Fees Paid By William Doran Telephone. 310-534-3313 Name on the check By James E. Lively Assistant Superintendent, Business Services; " Fee collected /exempted by Vickie J. Durrett !f Payment -Received L SignatureZL�iaLUA/Utk _ i-Sheck Na. 753 Collector: Attach a copy of county or city plan check application form to district copy "for allCwaivers. Embossed. Original- Building Dept./Applicant Copy - Applicant/Receipt Copy- Accounting COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL Received From: Address: Account No. 1 Lots) ' Service Address Services) ❑ Backflow(s) ❑ House Lateral(s) O Detector Check (s) ❑ Meter Surcharge Sanitation Capacity Charge 2. [-- 723�OIJ �J O W.S.B.F.C. �— C O Temporary Construction Meter . O Turn on Charge ❑ Uncollected Account -.Name '. ❑ Inspection Fee- Tract - Fee - 0. Plan Check Fees Water I Sewer - Tract - ❑ Bond Payment - A.D. - Bond Assmt. ❑ Customer Deposit ❑ Other Remarks: L"ATractC— Q G.A. Code $ �'o c , ed /,7oa•ov 3� ySo . on TOTAL $ O U ❑Copy to: Cash Water Service Check - - - Money Cashier Order �'' • ` ' C -438(11/89) DAVID C: BREIHOLZ AND COMPANY, INC. Engineering Design Construction 1852 Lomita Boulevard Lomita, California 90717 213 530 3050 FAX: 213 530 0184 — August 3, 1993 Mr. Paulden, Evans, ISID ; • • DESIGN CENTER, INC. 1525 3rd Street, Suite F Riverside; CA 92507 FAX: 909-788-40"22 RE: Evans Single Fan ily.Residence z=jooAvenida 1Pq -e _: _-La-Quinta, CA 92253 - -•_ Project #93-053E Dear Mr. Evans, To follow up our telephone conversations and your recent FAX, your standard plan details No. 1 and No: 7 are not applicable with,the concrete bearing wall alternate you used for the above reference residence. The poured -in-place exterior concrete bearing walls support all vertical, and lateral loads from the clear -span trusses such that the interior steel studs are not required to resist any loads,beyond nominal partition loading. I appreciate the opportunity to be of service. Should you have any questions please call me. Very truly yours, David C. Breiholz, P President oQVpFESS A" � DCB/jks:93-053E B �Q�' �O G' RF�y <c- 0 No. 17428 m w m. Exp, dune 300997 s9l C>NTU FOF C��\�' Civil Engineering Seismic Hazard Reduction Construction Supervision Structural Design Plan Check Service Inspection Service CALVIN C. KAMINSKAS a �: + DANAILEY o Sealer, Weights & Measures Assistant Commissioner a (714) 275-9000 (714) 275-3030 .OFFICE OF ' AGRICULTURAL COMMISSIONER ' JAMES O. WALLACE, Commissioner 83-612 Avenue 45 Suite 7 I' Indio, CA, 92201 (619) 342-8291 DATE�l CASE NO­ / � 2 .00 �3 . DEVELOPER'S NAME s W '` l (< `�� ✓mac (D ✓ ADDRESS: 0 r--) TELEPHONE. C��670 � q2 Z �:� • Dear Developer: After reviewing your landscaping plans, all plant material listed is.not in : violation of quarantine laws governing the Coachella Valley. If-substitutions do occur and they differ from plant material listed, this office must be notified immediately. Thank you for protecting and preserving the Coachella Valley's pest-free environment. Agricultural Commissione Office. cc: Indio and Riverside 4080 LEMON STREET, ROOM 19, RIVERSIDE, CALIFORNIA 92501 - FAX (714) 275-3012 , DAVID C. BREIHOLZ AND COMPANY, INC. , f r 1852 Lomita Boulevard Engineering Lomita, California 90717 ' Design (213) 530.3050 Construction SUBJECANQkN.. 4\4k...Z M . ............ 'SHEET NO ...... ..1 .......... OF....�..... .....................y�.�C1L�......v[1t\�...................... OB NO .. . ............ ...... ........... :...........�';r`�.�� 1.` )... `fi -..vvz .............�. ... ........................ ... CS�.o4, BUILDING CODE: FOUNDATION SOIL: t �1iL•� 'x`�.. I STRUCTURAL CONCRETE: �IC y STRUCTURAL STEEL: PER ASTM A36 PIPE COLUMNS:, PER ASTM A53, GRADE B WELDING: ELECTRIC ARC PROCESS BY CERTIFIED WELDERS IN SHOP OF LICENSED FABRICATOR. CONCRETE BLOCK: PER ASTM C90, GRADE A- UNITS BRICK: PER ASTM C 62, MW GRADE MORTAR : 1:37::7. MIX; CEMENT, SAND AND HYDRATED LIME OR LIME PUTTY. GROUT: 1:3:2 MIX; CEMENT, SAND & 3/a" MAX. PEA GRAVEL. REINFORCING STEEL: PER ASTM A615 GRADE 40 . WOOD FRAMING': PER WCLB. GRADING RULES NO. 16 STUDS • CTS LIGHT FRAMING . �� Q?,OFESSIQy JOISTS : �F :�A:2. BEAMS . �� ;a'J ti ���. ii ��O c✓, BRFq,el POSTS :CalaS,'i, �x'� C6 GLUED — LAMINATED WOOD : DOUGLAS FIR COMB. Q 428 N DES . REF.: WEST. WOOD PROD. ASSOC. SPAN COMPUTER. PLYWOOD : STRUCTURAL PER P.S. 1-74 CONTINUOUS INSPECTION BY REGISTERED DEPUTY INSPECTOR REQUIRED FOR ,THE FOLLOWING DESIGN LOADS: Z '571 i =- No. 11 EXO. 3 � TF OF C NO :e" /w i DAVID C. ®REIHOLZ AND COMPANY, INC. 1852 Lomita Boulevard ` Engineering Lomita, California 90717 Design (310) 530-3050 Construction Fax (310) 530-0184 t `ZZ''; hut'' M\o-sma -ZL�I' okCI-p Y��, ckkz -W �0 Lit DAVID, C. SREIHOLZ AND COMPANY, INC. 1852 Lomita Boulevard Engineering Lomita, California 90717 Design (310) 530-60.50 Construction Fax (310) 530-0184 BY....................... SUBJEC. . . ....................... DATE.... ........ :., ... . ...................................................................................................... CHECKED.................................................. : .................................... ................... ...................... .................... 7 ........................ ...................................................................................................... I A.) Co's = Va. .�t' �.o ?.'ts� `ta� = ��3 SCS = 1\ Ps F \-s"Lits 94 iN0\4Z A 24 W. T VIS\Nl I V, ST) --CAR6�ttic�c�y 4AcSs�l �o�� qwj. % \tit 4.c. 4/1 Qi( 0 mr1\1 ILS DAVID C. 13REIHOLZ AND COMPANY, INC. 1852 Lomita Boulevard Engineering Lomita, California 90717 Design (310) 530-3050 Construction Fax (310) 530-0184 ®� BY. ..C,. SUBJECT.W�`�. .......P. ��.V.���.........:.......... SHEET NO ........ ;�.OF.:............. DATEAZr\............. :.... ................................................................................................... JOB No. . . \57.z ..9.......... CHECKED...........................:...................... :..................................................... .......................... ..................................................... ............................................:..................................................... ......... :.................................... .........................:................................. ' ���1�C�,L �1(CFci\��-ocF11"��� ': '�C�Y►SVE(`SE AC�SS- 4� MoE fxT 4'��ts , Its Y _ Z?4 . Z � r Ak r WV S Zo ksi x 13:3 m i W u O W Q N - J�aoer sF om m ICBG Evaluation Service, Inc. J „ •saes• TM A subsidiary corporation of the International Conference of Building Officials EVALUATION REPORT Report No. 4345 Copyright © 1991 ICBO Evaluation Service, Inc. fjUgUSt, 1991 Filing Category: DESIGN—Concrete (030) CONCRETE CONSTRUCTION FORM PLASTI-PERSONALITIES, INCORPORATED 1214 WEST 252 STREET HARBOR CITY, CALIFORNIA 90710 I. Subject: Concrete Construction Form. II. Description: A. General: The concrete construction forms are for re- inforced concrete walls in one- and two-story buildings. Each form con- sists of two identical facings attached with wire dividers to form units 48 inches long and 16 inches high with various widths. Each facing has 1 -inch offset edges at the top, bottom and ends to allow interlocking with adjacent forms. Facings are expanded from Huntsman Chemical Corpora- tion, Type 3486A, 44868 or 47868 polystyrene beads (NER-384) to a maximum density of 2.0 pcf. The expanded beads have a Class 1 flame -spread rating and smoke -density rating of less than 450. Wire dividers are manufactured from No. 12 gauge galvanized wire. No. 2 Ponderosa pine wood batts have a net thickness and width of 3/4 and 11/2 inches, respectively, and are located in molded grooves spaced 16 inches on center. They are attached to the form by the wire dividers which are run through the batt, bent over and stapled to the batt. Concrete construction forms are available with different wire dividers that provide for concrete thicknesses of 4 or 6 inches and facing thicknesses of 2, 3 or 4 inches. See Table No. I and Figure No.1 for additional details. Additional wire dividers and wood batts are furnished to assemble forms at corners. Redwood batts are also furnished for the wall base. B. Installation: The construction forms are placed on concrete founda- tions with wood batts aligned vertically. Redwood batts are installed with wire dividers at the wall base as noted in Figure No. 3. All vertical wood batts must bear firmly on the redwood base. See Figures Nos. 2 and 3 for installation at corners and openings. Vertical and horizontal steel rein- forcement is placed in the wall cavity prior to initial placement of concrete after laying the second course of forms. Concrete is placed to mid height of the upper course prior to vibrating or tamping. Successive courses of forms are laid and concrete placed in the same manner. Anchor bolts as required, are located in the uncured concrete at the top of the wall and ver- tically as necessary prior to concrete placement. To determine that con- crete has been completely and properly placed, a sharp instrument such as an ice pick is used to penetrate the foam to the concrete. Probe the form at 32 inches on center horizontally to verify complete and solid placement of concrete. Electrical conduit and outlet boxes are located in the wall by cutting channels in the foam plastic facing with a sharp knife, hot-wire cutter or grinding wheel on an electric drill. The voids must be filled with plaster of parts or equivalent. Plumbing and vent pipes are installed in interior walls. The interior wall surface is covered with'/2-inch-thick gypsum wall- board placed vertically and attached to the wood batts and top and bottom plates with Type W drywall screws at 7 inches on center having sufficient length to provide a minimum 5/8 -inch wood penetration. Gypsum wall- board panel edges must bear on wood batts or wood plates. A weather -resistive barrier installed over the exterior wall surface in ac- cordance with Section 1707 (a) of the code is covered with wire lath and exterior plaster. Wire lath is installedwith staples in accordance with Sec- tion 4706 of the code, except staples 'Ire spaced 3 inches on center, maxi- mum. Pairs of staples may be spaced 6 inches on center maximum. Exteri- or plaster must comply with Section. 4708 of the code. See Figure No. 4 for additional details. C. Design: Concrete walls must be Designed in accordance with Chapter 26 of the code with calculations and p ins submitted to the building official for approval. D. 1990 Accumulative Supplement to the U.B.C.: This report is unaf- fected by the Supplement. E. Identification: Each concrete co.utruction form bears a label noting the manufacturer's name and addre,�s, evaluation report number, flame - spread rating, smoke -developed rath.q and the name of the quality control agency (Smith -Emery Company AA -:)54). III. Evidence Submitted: Test re; orts of flame -spread and smoke - developed ratings, quality control m:!nual and installation instructions. Findings IV. Findings: That the Concrete Cctistruclion Form for walls complies with the 1988 Uniform Building Code, subject to the following condi- tions: 1. Special inspection is providi:d in accordance with Section 306 of the code. When approved by the building official, special in- spection is not necessary for installation of single -story maxi- mum 8 -toot -high walls housing Group R-3 or M-1 Occupancies, provided the following conditions are met: a. Maximum height of individual concrete pours is 48 inches. b. Installation is by trained installers approved by the manufac- turer. c. Half the allowable design stresses are used for the design of the walls. 2. The walls are constructed in , ccordance with this report and the manufacturer's instructions. 3. Installation is limited to area: subject to a maximum basic wind speed of 80 miles per hour ..JIh Exposure C with a maximum height of 40 feet. 4. Structural calculations on the Nvall and attachments must be sub- mitted to the building officia: for approval. 5. Walls are considered combustible construction. 6. The building interior is separated from the foam plastic by the 1/2 -inch -thick gypsum wallboard installed on the interior wall surface in accordance with S•!ction II B of this report. 7. The concrete construction forms are fabricated at the manufac- turer's Tactility at 1225 West i:52 Street, Harbor City, California, with follow-up inspections conducted by Smith -Emery Com- pany. This report is subject to re-examination in two years. Evaluation reports of /CUD Evaluation Service, Inc., are issued solely to provide information to Class A members of ICBG, tit ilizingthe code upon which lite report is based. Evaluation reports are not to be construed as representing aesthetics or any other attributes not specifically addressc(; noras an endorsement orrecommen- dation for use of the subject report. This report is based upon independent tests or other technical data submitted by the applicant. The /CBO Evaluation Service. Inc., technical staff has reviewed the test results and/or other data, but does not possess lest facilities to make an independent verification. There is no warranty by I CBO Evaluation Service, Inc., express or implied, as to any "Finding" or othermatter in the report oras to any product covered by the report. This disclaimer include,. but is not limited to, merchantability. Page 1 of 5 OVERALL FOAM FORM WIDTH (Inches) CONCRETE _ WALL THICKNESS (Inches) i FOAM FORM SIDEWALL THICKNESS (Inches) 8 4 2 10 6 2 10 4 3 12 6 . 1. 3 12 4 4 14 6 4 r- of 11 71 4 . l-II�G `}Zc(c�ZS + - /x 2 n'ooA + HoL1;5 + BATTENS I I t t r T j I 54� _2 j ��� VISI--� •, III 13/4" TYP. . (&".(TYR) A III WIRE -� vim u VRR/ES �1 /12 OR 3 • _ iii � �, 4' Oly`-vr W -16 - WIRE 5EPA9ATOR5/TIE5 THF -L). !14Y cp HOLE 5 IN BA?TEN 4 FdRM ,W/ �. VgRlES I/( 13END VOR CS.4TT6N , AND /`� FTA PLE (NTo T P4 T2N - FIGURE NO. 1—CONSTRUCTION FORM Iii? METAL ' WA SNER %b Co S TAPL G' /8 GA WIA-- (Tr.c?) / x 2 GATN @ co R CORNER ISOMETRIC ' Page 9 ! Report No. 4345 7 -YO. MOLDEDFOAM SEGT/GYVS EA. S/DE TY1� A�/2 fY/RE /�//.TNiS9ETAG WASHER @ EA Cy SAO METAL H'A9HER ON PYG P/PE FOR oNC S/OE ANO. T/EO '�. � EL EC TR: CAL. Ta T/1E OTHER"/R,6 /Y//ERE cc /R5 TYP. (2 6/,, O. C. '#/2 MZE T/ED RE/it/,�O�C EO AS S//OYY/V � GONCRET.� , GORE A. �ELECTR/CAG Re ,0rlC4E TYP /x 2 LATH /Y1�/'2 iV/Re STOCK TNRu e�ORM poaR ✓; • •. NOTE.. .vOTE: ^ '' */2 W/RE SPACED 0 Beo.c.NoQr. FOR WMENS/ONS AND 4a,:'0.C. Y. -R7 TYP.) NOT SNO/✓N SL C CORNER PLAN ' Q ..•.',•�. rY104* Iii? METAL ' WA SNER %b Co S TAPL G' /8 GA WIA-- (Tr.c?) / x 2 GATN @ co R CORNER ISOMETRIC r F -age 4 of 5 Report No. 4345 A. n� - r�H car -ITR• f -(A• txLJeL LAf �r12 Nl 80 c TIC \1 W, WALL t)ckkL APPROVED STgPLj- -.DXYYVALI- roR MORE LATH O 9 •II ' R BW 111111 CONCRETE V IIIJIIII. FOOT) rt6 (1=_ 1111. 0 11= IIII III cr I • 4 � . 2><! Jnr-18��ILL Ap. O IG'oc. • (�UNT��SI�II�) i x0.111 .[F{�I� 51b. o(�-III-1� .' r ' FIGURE NO. 3—TYPICAL INSTALLATION DETAILS r .Page 5 of 5 Report No. 4345 -"Ts L4 A ., tvG�� �1A�L�►Jl++t � , i�oo� f-N` i EFh x nt,o i 14 , �. E � SNED� Corl►�C,G?oF-S f. C.ONCRE'TE COME FOAM VEKT/CAL S-'ECL ReiNFOKCEMCA, 6,TdCC O 0-4er- RI?-LONTAL STEEL E I N FORCE M E N T STEEL REIN FOPCEMGNT PovV ESS, GOf-�TIN�Ol�4 Lo�� Fovri�G� MeHr