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04-8154 (SFD)T-Vf 4 4 a" ). BOX 1504 495 CALLE TAMPICO QUINTA, CALIFORNIA 92253 Application Number . . Property Address . . . APN: Application description Property Zoning . . . . Application valuation . Owner BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 0-Af 00008154 Date 2/08/05 '44695 VIA ROSA 604 -032 -999 -95 -30E212 -- DWELLING - SINGLE FF.MILY DETACHED . . . LOW DENSITY RESIDENTIAL . . . 169092 LENNAR HOMES OF CALIFORNIA 78401 HIGHWAY 111, STE C LA QUINTA, CA LA QUINTA CA 92253 Contractor ------------------------ LENNAR HOMES OF CALIFORNIA INC 78401 HIGHWAY 111, SUITE C LA QUINTA CA 92253 WCC: AON RISK SRVC WC: MWC11114500 11/01/05 CSLB: 728102 09/30/06 CCC: B -------------------------- Structure Information ------------------------- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10 Flood Zone NON -AO FLOOD ZONE Other struct info . . . CODE EDITION 2001 CBC FIRE SPRINKLERS NO GARAGE SQ FTG 637.00 PATIO SQ FTG 236.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTA3E 2683.00 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 884.50 Plan Check Fee 574.93 Issue Date . . . . Valuation . . . . 169092 Qty Unit Charge Per Extension BASE FEE 639.50 70.00 3.5000 THOU BLDG 100,001-500,000 245.00 ----------------------------------------------------------------- Permit . . . . . MECHANICAL Additional desc Permit Fee . . . . 52.50 Plan Check -ee 13.13 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 2.00 6.5000 EA. MECH VENT FAN 13.00 P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: 04- 11514 Applicant: Applicant's Mailing Address: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3 • 1. 05- Architect S Architect or Engineer's Address: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirmunder enalty of perjury that I am licensed under provisions of Cha ter (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my Licens full rce and effect. censse Class ,cense No. V It ,,,,-Date V ontractor J lJ OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for 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).): U 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 or 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.). U 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. , BA P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of pedury 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. r—1 have and�,will/L11aintain workers' compensation insurance, as required by Section 3700 of the Lapn(Code, for the performance of the work for which this permit is i su .corkers' compensation i nce carrier arrier �����ffffff —---Policy Number l V I cbrNMat, 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 I forthwith comply with those previsions. Date WARNING: FAILU1:tE TO SECURE WORKERSt't3�PENSATION 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. 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 A 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 ad 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 reby authorize representatives of this count to enter upon the above-mentioned property for inspection purposes. e ignature (Applicant or Agent): Application Number . . . . . 04-00008154 Page 2 Date 2/08/05 Qty Unit Charge Per Extension 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ---------------------------------------------------------------------------- Permit . . . . . . ELEC-NEW RESIDENTIAL Additional desc . . Permit Fee . . . . 121.65 Plan Check Fee 30.41 Issue Date . . . . Valuation . . . . 0___ QtyUnit Charge Per Extension BASE FEE 15.00 2683.00 .0350 ELEC NEW RES - 1 OR 2 F1,MILY 93.91 637.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 12.74 ---------------------------------------------------------------------------- Permit . . . . PLUMBING Additional desc Permit Fee . . . . 171.75 Plan Check Fee 42.94 Issue Date . . . . Valuation . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 17.00 6.0000 EA PLB FIXTURE 102.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 7.00 .7500 EA PLB GAS PIPE >=5 5.25 1.00 15.0000 EA PLB GAS METER 15.00 ---------------------------------------------------------------------------- Permit . . . . . . GRADING PERMIT Additional desc . . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension ---------------------------------------------------------------------------- BASE FEE 15.00 Special Notes and Comments SFD - LOT 95, PLAN 3XR, 2683 SF. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS, OR DRIVEWAY APPROACH ----------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 57.49 Page 3 Application Number . . . . . 04-00008154 Date 2/08/05 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . DIF FIRE PROTECTION -RES 97.00 GRADING PLAN CHECK FEE .00 DIF LIBRARIES -RES 225.00 DIF PARK MAINT FAC - RES 5.00 DIF PARKS/REC - RES 502.00 STRONG MOTION (SMI) - RES 16.90' DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged Paid Credited Due Permit Fee Total ---------- 1245.40 ------------------------------ .00 .00 1245.40 Plan Check Total 661.41 .00 .00 661.41 Other Fee Total 2479.39 .00 .00 2479.39 Grand Total 4386.20 .00 .00 4386.20 Certificate of Insulation Your Home has been insulated with CertainTeed Fiberglass insulation products, which are designed for today's safety standards and tomorrow's energy requirements. Fiberglass is inorganic and therefore permanently noncombustible, so it does not have to be treated with fire -retardant chemicals that will likely lose their effectiveness O%w time. it has not been treated with chemicals that can corrode wiring or metal. Fiberglass will not absorb moisture nor will it settle over time as may other insulation materials. This also certifies that CertainTeed Fiber Glass Insulation has been professionally installed in this home to provide the follo,.ving thermal performance: 9 D T 07 m m qg-9 0 N 0 Z F D 0 Z r) 0 Job Name: La Quints - Del Oro Tract: 30521 Phase: _ Z Lot # 95 Plan: 3XR Bldg. #: Address: 44-695 Via Rosa -.-.-----••--••-_...-..-.-- m .-- 9 — -- • •--- —.._. - - - .......--- --- _.. _ - - m w __ Knee Walls: Z Roof Ceiling. R-30 Blom interior Wells: - - - -' r --- — - •- m (Un[aced Batts used when ceiling area is not accessible) Overhangs: Cantilev eredFloors: Exterior Walls: R-13 Unlaced Batts Garage Ceiling: Garage Walls: Title 24 Caulking Included (Exterior Doors, Windows and sill plates) Subco d ctor.. 6009. Vince , As r -? Rl Inc. Conchita Ortiz, Secretary/Treasurer --or-- R. S�bet Jenkins, President—or— Lou Merola, Director of Operations Officer R- means resistance to heat (low. The higher the R. value, the greater the insulating power. Ask your builder for the fact sheet on R- values. Keep this certificate with your other valued papers. If you ever sell this home, this certificate should be passed on to the buyer. N AUG -18-2005 THU 03:08 PM TEAM HEATING & A/C FAX N0. 9516943803 HVAC INSTALLATION CERTIFICATE for Tested Dud Leakage & TXV Tract Number. 30521 Lot Number. 95 Project: Del Oro Ind !cats the maximum al=ft Duct Leakage and the quotation used: 0.7 x Floor Area x (0.06) for Climate Zone 8 through 15 0.5 x floor Area x (0.06) for Climate Zones 1 through 7 816 400 x (Cooling Capacity in Nominal Tons) x (0.08) 21,7 x (Heating Capacity in Thousands of O ut BTU per hour) x (0.06) Measured Fan Flow VM Pressurization Test Renu 100 x Test leakage / Fan Flow - % Leakage Cheek Box for Pass or Fail (Pass = 8% or Less) n7.24 Compliance Credit was Taken for TXV 'scat of indleata the m um a le Duct Leakage and the calculation used: 0.7 x Floor Area x (0.08) for Climate Zone 8 through 15 0.5 x Floor Area x (0.06) for Climate Zones 1 through 7 & 16 400 x (Cooling Capacity in Nominal Tors) x (0.06) 21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.08) Measured Fan Flow 71 DO Pressuraation Test Resu ' 100 x Test Leakage I Fan Flow m % Leakage Check Box for Pass or Fail (Pass = 6% or Lou) j—j7 24 Compliance Credit was Taken for TXV ySv 'ern [:::] of Indicate the maxmum alraZ&le Duct Leakage and the calculation used: 0.7 x Floor Area x (0.06) for Climate Zone 8 through 15 0.5 x Floor Area x (0.06) for Climate Zones 1 through 7 & 16 400 x (Cooling Capacity in Nominal Tons) x (0.06) 21.7 x (Heating Capacity in Thousands of output BTU per hour) x (0.06) Measured Fan Flow u Pressurisation Test Results 100 x Test Leakage / Fan Flow= % Leakage Check Box for Pass or Fail (Pass = 6% or Lasa) 7'17-24 Compliance Credit was Taken for TXV 'stemo of Indicate the mUmum a le Duct .Leakage and the calculation used: 0.7 x Floor Area x (0.06) for Cllmate Zone 6 through 15 0.5 x Floor Area x (0.08) for Climate Zones 1 through 7 & 16 400 x (Coorxcg Capacity In Nominal Tons) x (0.06) 21.7 x (Heating Capacity in Thousands of Output BTU per hou x 0.06) Measured Fan Flow DO Pressurization Test Resu 100 x Test Leakage / Fan Flow m % Leakage Check Box for Pass or Fail (Pass = 8% or Less) r--IT--24 Compliance Credit was Taken for TXV x .u0 X.06 X.06 x .0b TXV wai TXV wa: TXV we P. 23 Page 2 of 2 CF -$R Plan #. 3 Phase. 9 Builder. Lennar Homes TXV way 1. the undersigned, verify that the above diagnOsUc test results and the work 1 performed associated with the twits) is In conformance with the requirements for compliance credit (The bulkier shall provide the HERS provider a copy of the CF -6R signed by the builder empkpyeas or that diagnostic tnd Installation meet the requirements for compliance credit) 6/, W,07Tam Heating 8 Alr. Inc Tells rgna re, g Succonvactor ICE Name Performed J OR General Contractor (Co. Name) OR Owner COPY T0: Building Department HERS Provider (if applicable) Building Owner at Occupancy PAGE 2 F2001-01 (4-02) Action NowT-24CF64UD&TXV macro AUG -18-2005 THU 03:08 PM TEAM HEATING & A/C FAX N0. 9516943803 P. 22 HVAC INSTALLATION CERTIFICATE for Tested (Duct Leakage & TXV Page 1 of 2 CF -6R Site Address: 44-695 Via Rosa, La QuinW Ca Permit Number Tract Number. Lot Number: 95 Project: Dei Oro Builder. Lennar Homes An installation oenificate is required to be posted at the building site or made ava0m for all appropriate inspections. After completion of final inspection, a copy must be provided to the Builoing Vaparbnent (upon request) and the building owner at occtparwy. per Section 10.103(b). krr.. ?•f�i] Plan t: 3 Phase: HVAC SYSTEMS: of emency Duct Heating mating Equip. acne Identicte (AFUE, etc.) Location put Load Capacity T and MOW Name systemCF-1 R) (attlo. etc.) R -+value (BTU I Hr) (BTU I Hr) York Company LY0305MIZU11a c Cw iwwnen♦ r -.......a �..�..._... [Juct Cooling Cooling ktenticle (SEER. etc.) Location Duct Load Capacity Systsms (>=CF -1 R) (attic, etc.) R -value (BTU I Nr) (BTU I Hr) Type qu p and Model Number e HIP York ny H2RC035 I Z a I, me ungemignea, venry [nag atiMment nowu ✓pore u. 1) to um arwai vyuga•.w.a .w.urw, sr vyw.ap„• •-. �. ••..�� efflclent than that specified in of eampI- (Form CFA R) submitlad for compliance with the Energy Efficiency standards for reside 'al k1' s, sq M that meets or exceeds the appropriate requfremsrtts for manufactured devices (from t Ap n ns or Part 6)1wfryeapplicable. Team Heating & Air. Inc TMIR SuScommmi, Mo. Rama OR General Conbactor (Co. Name) OR Owner MINIMUM REQUIREMENTS FOR DUCT LEAKAGE COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) CFA: System of Indicate them mum a le Dud Leakage and the calculation used: 0.7 it Floor Area x (0.06) for Climate Zone 8 through 15 0.5 x Floor Area x (0.08) for Climate Zones 1 Waugh 7 a 16 x 400 x (Cooling Capacity in Nominal Tons) x (0.08) 21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.08) Measured Fan Flow TW Pressurization Test Results (Cf -1111 a 25 Pxr- 100 x Test Leakage I Fan Flow = % Leakage Check Box for Pass or Fail (Pass = 5% or Less) T-24 Compliance Credit was Taken for TXV m©of (�F] Indicate the m�-ax mum a Duct Leakage aro the calculation used: 0.7 x Floor Area x (0.08) for Climate Zone 8 through 15 0.5 x Floor Area x (0.08) for Climate Zones 1 through 7 3 16 x 400 x (Cooling Capacity in Nominal Tons) x (0.06) 21.7 it (Heating Capacity in Thousands of Output BTU per hour) x (0.06) Measured Fan Flaw DO Pressurization TestResults 100 x Test Leakage I Fan Flow a % Leakage Check Box for Pass or Fall (Pass = 6% or Less) ©T-24 Compliance Credit was Taken for TXV X.06 TXV wad TXV way PAGE 1 F2001-01 (4-02) Action Now T-24CF6-RTDATXV macro Ca10ERTS Certified Rating This Com liance ratin is for the home located sit* August, 18 2005 44695 Via Rosa p g La Quinta CA, Certificate Number: CC3-1798349647 Date Inspected: August, 18 2005``' Ca10ERTS Rater: William Henson C 2683 Square Feet CC2004076 E HERS Analyst: N/A R Builder/Developer: Lennar Homes Project: T La Quinta Del Oro Plan Name: Plan 3 Lot Number: 095 Specifics about this home: General Information Proposed Conditioned Floor Area: 2683 Square Feet Conditioned Volume: 0 Cubic Feet Front Orientation: N/A Number of Stories: 1 Heating and Cooling Systems Heating Equipment: Cooling Equipment: HVAC Air Distribution Duct Location: Attic Duct Leakage Target: 6.0 Duct Insulation R -Value: 4.2 Air Infiltration Blower Door Target: 96.0 Water Heating S stem Prosed TY I Size I Fuel I EF I Distribution Water Heating System Actual TY Size I Fuel I EF I Distribution Testing Results Associated to Group #9061 BuildingEnvelo e Surface I Area Proposed Actual R U Value Factor R Value U I Factor Windows Orientation AreaSHGCJ Pro osed Actual U Value SHGC U Value =TESTED APPROVED AS PART OF SAMPLE GROUP FIRM: BCI TESTING ADDRESS: 77-760 COUNTRY CLUB DRIVE, SUITE I PALM DESEERT, CA. 92211 PHONE: 760-772-2954 The energy efficiency rating of this home is determined using California Home Energy Rating System (C -HERS) rules. The rating considers heating, cooling and water heating and assumes average weather, thermostat settings, and quantities of hot water for a typical household. Actual energy use will vary according to occupant behavior. This Rating Completion Summary is provided only after the features listed have been verified and approved by the Ca10ERTS Certified Rater shown above. If you have a concern or complaint regarding this report of the services used in obtaining it, you may contact: CaICERTS - Customer CERTIFYING SIGNATURE DATE The energy efficiency rating of this home is determined using California Home Energy Rating System (C -HERS) rules. The rating considers heating, cooling and water heating and assumes average weather, thermostat settings, and quantities of hot water for a typical household. Actual energy use will vary according to occupant behavior. This Rating Completion Summary is provided only after the features listed have been verified and approved by the Ca10ERTS Certified Rater shown above. If you have a concern or complaint regarding this report of the services used in obtaining it, you may contact: CaICERTS - Customer Southwest Inspection and Testing, Inc. 10826,South Norwalk Blvd., Santa Fe Springs, CA 90670 (562) 941-2990 • (714) 526-8441 - Fax (562) 946-0026 REGISTERED INSPECTORS'S DAILY REPORT 11 SWIT Job No. q6 it Date <flq 05 - TYPE OF ❑ Reinforced Concrete' ❑ S"ctural Steel Assembly ❑ Quality Control INSPECTION ❑ Post Tensioned Concrete ❑ Fire Proofing .j Other REQUIRED ❑ Reinforced Masonry ❑ Asphalt C p�idpere Si r, Job Address C/ _ . /1 (I J+� Clss�ur Job Nome / _ s� (�� �+I— r�� [,( Permit No. _ Type of Structure t Architect �{ Material Description (type. grade. source) Engineer � !f �" a Contractor �TO� Inspector(s) Name/ L -'*4,a4 � Subcontractor i ♦_ „rel f TESTS PERFORMED��� TYPE OF SAMPLE SLUMP QUANTITY IN SET ADDITIONAL REMARKS ON SAMPLES (0 xt cry, S 3 —rti? r (A'a" Cvse. 76° INSPECTION SUMMARY — LOCATIONS OF WORK INSPECTED, TEST SAMPLES TAKEN, WORK REJECTED, JOB PROBLEMS, PROGRESS, REMARKS, ETC. INCLUDES INFORMATION ABOUT - AMOUNTS OF MATERIAL PLACED OR WORK PERFORMED, NUMBER, TYPE & IDENT. NO'S OF TEST SAMPLES TAKEN: STRUCT. CONNECTIONS (WELD MADE H.T. BOLTS TORQUED) CHECKED, ETC. A " "— 7- . -Ac CERTIFICATION OF OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE OBSERVED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE NO THIS WORK TO COMPLY WITH THE APPROVED PLANS, SPECIFICAV6NS, 4ND APPLICs!l3LE SEC NS OF THE GOVERNING BUILDING LAWS, V — vSIGNATURE OF REGISTERED INSPECTOR #lL177-81 AiC-T-- SPECIALTY NO. AGENCY CONTINUED ON NEXT PAGE ❑ PAGE 1 _ OF TIME IN I TIME OUT I REG. HOURS O.T. HOURS CYLINDERS *S 1 1 3 All inspections b a minimum of hours and over 4 hours - 8 hour minimum. In ad Rion, a y inspion a to ding past noon hour will be an 8 hour minimum. \`\� Approved by Project Superintendent Southwest 11"specti®n and Testing, Inc. 10826 South Norwalk Blvd., Santa Fe Springs, CA 90670 (562) 941-2990 - (714) 526-8441 - Fax (562) 946-0026 SWIT Job No. Date REGISTERED INSPECTORS'S DAILY REPORT I 4-/61[(Q 'glg10$- TYPE OF p Reinforced Concrete ❑ Strcictural Steel Assembly ❑ Quality Control INSPECTION ❑ Post Tensioned Concrete ❑ Fire Proofing )RI Other REQUIRED ❑ Reinforced / ReinforrcedMasonry El Asphalt Job Address C^ As/1M.4 City / - QLMX-CrfDA+�I- CF�$E JI}1t t Job Nome � �/' � Permit N;.� Z-115—Issu2�� ` 1�FF Type of Structure L� Architect Z_ I r L Material Description (type. grade. source) Engineer Contractor �$ Inspectors) Nome 46mm / ,, �a Subcontractor /_ TESTS PERFORMED TYPE OF SAMPLE SLUMP QUANTITY IN SET ADDITIONAL REMARKS ON SAMPLES X C � r l INSPECTION SUMMARY — LOCATIONS OF WORK INSPECTED. TEST SAMPLES TAKEN, WORK REJECTED. JOB PROBLEMS, PROGRESS, REMARKS. ETC. INCLUDES INFORMATION ABOUT - AMOUNTS OF MATERIAL PLACED OR WORK PERFORMED. NUMBER. TYPE & IDENT. NO'S OF TEST SAMPLES TAKEN: STRUCT. CONNECTIONS (WELD MADE H.T_ BOLTS TORQUED) CHECKED, ETC. kv1wjTI= - r);;Pi 'Fr'r1DV rANIADV A lYYlr lnrrrn,r- —W ..--" ...... I--- ..._.._ I..__.. I CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE OBSERVED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE NO THIS WORK TO COMPLY WITH THE APPROVED PLANS, SPECIFICATAANS,AND AP LE SEC NS THE GOVERNING BUILDING LAWS SIGNATURE OFREGISTTEEREDINSPECTOR �]''' lLIZ f1 ' `""� SPECIALTY NO. AGENCY CONTINUED ON NEXT PAGE ❑ PAGE_ TIME IN Tl EOUT REG. HOURS O.T.HOUIS r l Q Cxi All inspection on a m' imum 14 ours and o minimum. In rtriitinn, ny in coon rten inq past noon hour minimu Approved by Project Superintendent OF CYLINDERS er 4 hours - B hour hour will boon 8 kv1wjTI= - r);;Pi 'Fr'r1DV rANIADV A lYYlr lnrrrn,r- —W ..--" ...... I--- ..._.._ I..__..