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BCOM2022-0026
BUILDING PERMIT DESIGN & DEVELOPMENT DEPARTMENT 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type: Building Commercial Permit Number: BCOM2022-0026 Property Address: 46805 DUNE PALMS RD APN: 600390023 Legal Description Property Zoning: Valuation: $250,000.00 PHONE (760) 777-7125 WWW.LAQUINTACA.GOV APPLIED DATE: 05/12/2022 ISSUED DATE: 07/20/2022 CALIFORNIA Owner: Market Street 5390 Granite Lake Dr., Ste 110, Granite Bay, CA 95746 Applicant: MJY GROUP INC 392 N. Le May Court, ORANGE COUNTY, CA 92867 Contractor: GOLDEN CONSTRUCTION, INC 7271 MARS DRIVE, HUNTINGTON BEACH, CA 92647 PRIOR TO THE ISSUANCE OF THIS PERMIT FOR CONSTRUCTION, ALTERATION, IMPROVEMENT, DEMOLITION, OR REPAIR THE OWNER, APPLICANT AND/OR CONTRACTOR UNDER PENALTY OF PERJURY HAVE AFFIRMED WHEN APPLICABLE, THROUGH THE SUBMITTAL OF FORMS OR BY OTHER ELECTRONIC MEANS, THE FOLLOWING: LICENSED CONTRACTOR OR OWNER -BUILDER DECLARATION (1 or 2) 1) They are licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and the referenced License is in full force and effect, or; 2) That they are exempt from the Contractors' State License Law for the reason(s) indicated by either (2)(a) and/or (2)(b), or (2)(c) where he or she is exempt from licensure by a valid exemption. [Section 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 (commencing with Section 7000) of Division 3 of the Business and Professions Code] 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).) a) As owner of the property, or my employees with wages as their sole compensation, will do all of or portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, 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 it was not built or improved for the purpose of sale.). b) As owner of the property, will be exclusively contracting with licensed c) Are exempt from licensure under the Contractors' State License Law. As an Owner -Builder, they acknowledge that, except for their personal residence in which they must have resided in for at least one year prior to completion of the improvements covered by this permit, they cannot legally sell a structure built as an owner -builder if it has not been constructed in its entirety by licensed contractors. It is understood that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application was submitted at the following Web site: http://www.Ieginfo.ca.gov/calaw.htm1. DECLARATION REGARDING CONSTRUCTION LENDING AGENCY (If applicable) A construction lender will be used for completion of the improvements covered by this permit and the name and information of which is on file for public inspection during the regular business hours of the public entity. Failure of the applicant to indicate the construction lender on the WORKERS' COMPENSATION DECLARATION (1, 2 or 3) 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. 1) Has and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 2) Has 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. 3) Certifies that, in the performance of the work for which this permit is issued, shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, shall forthwith comply with those provisions. NOTICE TO APPLICANT (1, 2 and 3) 1) Each person upon whose behalf this application was made, each person at whose request and for whose benefit work is being 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 360 days from date of issuance of such permit, or if cessation of work for 180 days will subject permit to cancellation. On or after January 1, 2019, every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 12 months after its issuance, or if the work authorized on the site by such permit is suspended or abandoned for a period of 12 months after the time the work is commenced. 3) Certified that they read the application and state that the information provided is correct. Agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above -mentioned property for inspection purposes. IMPORTANT: An Application for Permit was made to the Building Official, subject to the conditions and restrictions set forth at the time of application, which is now hereby an Issued Permit. If any part of the information being supplied on this permit is inaccurate or untrue, please contact the City of La Quinta at (760) 777-7125 immediately for correction. Printed: 2/26/26 5:05 pm Page 1 of 6 BUILDING PERMIT Permit Type: Building Commercial Permit Number: BCOM2022-0026 Property Address: 46805 DUNE PALMS RD application does not relieve that person of the requirement to give the construction lender preliminary notice from that duty. Printed: 2/26/26 5:05 pm Page 2 of 6 BUILDING PERMIT Permit Type: Building Commercial Permit Number: BCOM2022-0026 Property Address: 46805 DUNE PALMS RD SENIOR DAY CARE CENTER / SHELL REMODEL WITH 1,963SF ADDITION *** SHELL BUILDING REMODEL WITH 1,963SF ADDITION T, 2ND LEVEL FLOOR AREA [ENGINEERED] THIS PERMIT DOES NOT INCLUDE FULL BUILD OUT OF INTERIOR TENANT SPACES OR APPROVAL FOR OCCUPANCY. TENANT IMPROVEMENTS AND PATH OF TRAVEL ACCESSIBILITY UPGRADES ARE PART OF THE PHASED APPROVAL AND WILL BE DETERMINED PRIOR TO FINAL OCCUPANCY 2019 CALIFORNIA BUILDING CODES. ,instruction Det;:. Commercial Work Type Remodel Building/Unit A-1: Theaters, Concert Gross Square Footage 1963 Occupancy Halls Classification(s) Conditioned Square 17979 Fire Sprinkler Square 17979 Number of Floors 2 Footage Footage Construction Type V-B Code Edition 2019 Remodel Area Square 16016 Addition Area Square 1963 Footage City Development No Impact Fee Applicable New Electrical Square 0 Footage Art in Public Places No Fund Exempt Footage Transportation Uniform No Mitigation Fee Applicable Type Group Sq Ft Value Invoice No. Fee PERMIT-BCOM2022-00: RECORDS MANAGEMENT FEE - MAJOR 6 NONRES ADDITION, EA ADDITIONAL 500 SF REMODEL, EA ADDITIONAL 500SF DIF - CIVIC CENTER DIF - FIRE PROTECTION HOURLY CHARGE - ESGIL CIVIL ENGINEER DIF - TRANSPORTATION ART IN PUBLIC PLACES - COMMERCIAL PARTIAL INSPECTION FEE FIRE COMMERCIAL TI PC DIF - MAINTENANCE FACILITIES REMODEL, FIRST 100SF PC REMODEL, FIRST 100SF NONRES ADDITION, FIRST 100 SF PC TECHNOLOGY ENHANCEMENT FEE SMI - COMMERCIAL REMODEL, EA ADDITIONAL 500SF PC NONRES ADDITION, EA ADDITIONAL 500 SF PC NONRES ADDITION, FIRST 100 SF BSAS SB1473 FEE TUMF 2021 - OFFICE Total for Invoice PERMIT-BCOM2022-0026 Fee Amount $21.00 $329.80 $800.32 $1,083.58 $296.41 $315.00 $12,841.95 $1,250.00 $83.37 $250.00 $734.16 $155.06 $56.69 $226.25 $5.00 $70.00 $640.32 $92.04 $161.06 $10.00 $4.789.72 aw,cn . i s Amount Paid $21.00 $329.80 $800.32 $1,083.58 $296.41 $315.00 $12,841.95 $1,250.00 $83.37 $250.00 $734.16 $155.06 $56.69 $226.25 $5.00 $70.00 $640.32 $92.04 $161.06 $10.00 $4,789.72 $24,211.73 Grand Total for Permit $24,211.73 $24,211.73 Printed: 2/26/26 5:05 pm Page 3 of 6 BUILDING PERMIT Permit Type: Building Commercial Permit Number: BCOM2022-0026 Property Address: 46805 DUNE PALMS RD Workflow Step / Action Name Action Type Start Date End Date Inspections v.1 05/12/2022 0:00 ---------------------------------------------------------------------------------------------------------------------------------------- FINAL** v.5 Inspection ------------------------------------------------------------------------------------ FRAMING v.8 ---------------------------------------------------- Inspection ------------------------------------------------------------------------------------ FINAL** v.4 ---------------------------------------------------- Inspection FINAL** v.3 Inspection FINAL** v.2 Inspection ------------------------------------------------------------------------------------- FRAMING v.7 Inspection ----------------------------------------------------------------------------------------- FINAL** v.1 Inspection ----------------------------------------------------------------------------------------- FRAMING v.6 Inspection --------------------------------------------------------------------------------------------------------------------------------------- OKAY TO WRAP v.1 Inspection ----------------------------------------------------- ROUGH MECH v.1 ---------------------------------------------------------------------------------- Inspection ----------------------------------------------------- FRAMING v.5 ---------------------------------------------------------------------------------- Inspection ----------------------------------------------------- FRAMING v.4 --------------------------- Inspection ----------------------------------------------------- ROOF DRAIN v.1 --------------------------- Inspection -------------------------------------------------------------------------------- FRAMING v.3 Inspection -------------------------------------------------------------------------------- UNDERGROUND PLBG v.1 Inspection ------------------------------------------------------------------------------- FRAMING v.2 Inspection ----------------------------------------------------- FRAMING v.1 --------------------------- Inspection ----------------------------------------------------- TEMPLATE FOOTING v.1 --------------------------- Inspection ----------------------------------------------------- SLAB v.1 ---------------------------------------------------------------------------------- Inspection ----------------------------------------------------- FOOTINGS v.3 ---------------------------------------------------------------------------------- Inspection --------------------------------------------------------------------------- FOOTINGS v.2 -- -- Inspection ------------------------------------------------------------------------ UNDERGROUND ELEC v.1 -------------------------------------------------------------- - Inspection ------------------------------------------------------ FOOTINGS v.1 -------------------------------------------------------------------------------- - Inspection Application Completeness Check v.1 ---------------------------------------------------------------------------------------------------------------------------------------- Submittal Document Verification v.1 Generic Action ---------------------------------------------------------------------------------------------------------------------------------------- Confirm Fees Paid v.1 Generic Action Plan Check v.1 Building Major Review v.1 Receive Submittal Permit Issuance v.1 ------------------------------------------------------------- Contractor / Owner -Builder Information v.1 -------------------------------------------------------------------------- Generic Action ------------------------------------------------------------- Verify & Invoice Fees v.1 -------------------------------------------------------------------------- Generic Action ------------------------------------------------------------- Ready to Issue v.1 -------------------------------------------------------------------------- Generic Action ------------------------------------------------------------- Verify Fee Payment & Issue Permit v.1 -------------------------------------------------------------------------- Generic Action ------------------------------------------------------------- Print, Attach, and Email Building Permit v.1 -------------------------------------------------------------------------- Create Report Inspections - Do Not Pour Concrete Until Approved v.1 --------------------------------------------------------------------------------------------------------------------------------------- Footing v.1 Inspection --------------------------------------------------------------------------------------------------------------------------------------- Setbacks v.1 Inspection --------------------------------------------------------------------------------------------------------------------------------------- Slab v.1 Inspection -------------------------------------------------------------------------------- Underground Plumbing v.1 Inspection -------------------------------------------------------------------------------- Water Line v.1 Inspection Printed: 2/26/26 5:05 pm Page 4 of 6 BUILDING PERMIT Permit Type: Building Commercial Permit Number: BCOM2022-0026 Property Address: 46805 DUNE PALMS RD Inspections - Cover No Work Until Approved v.1 --------------------------------------------------------- Roof Nail v.1 ------------------------------------------------------------------------------- Inspection ---------------------------------------------------------------------------------------------------------------------------------------- Okay to Wrap v.1 Inspection ------------------------ - -------------------------------------------------------------------------------------------------------------- Rough Fire Clearance v.1 Generic Action ---------------------------------------------------------------------------------------------------------------------------------------- Framing v.1 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- Rough Electrical v.1 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- Rough Mechanical v.1 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- Rough Plumbing v.1 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- Shower Pan v.1 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- Insulation v.1 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- Drywall Nail v.1 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- T-Bar/Overhead v.1 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- Exterior Lath v.1 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- Gas Test v.1 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- Sewer Connection v.1 Inspection Inspections - Masonry v.1 Inspections - Electrical for Meter Release v.1 ------------------------------------------------------ Temporary Power v.1 Inspection ------------------------------------------------------------------------------ Temp Use of Permanent Power v.1 Inspection Inspections - Final v.1 08/21/2023 15:53 ------------------------------------------------- Final Fire v.1 Inspection ---------------------------------------- Final Building v.1 Inspection 08/21/2023 15:53 08/21/2023 15:53 Certificate of Occupancy v.1 ---------------------------------------------------------------------------------------------------------------------------------------- Issue Certificate of Occupancy \ Create Report Construction or work for which a permit is required shall be subject to inspection by the building official and such construction or work shall remain visible and able to be accessed for inspection purposes until approved. Approval as a result of an inspection shall not be construed to be an approval of a violation of the provisions of the applicable code and other ordinances of the jurisdiction. Inspections presuming to give authority to violate or cancel the provisions of the applicable code and other ordinances of the jurisdiction shall not be valid. It shall be the duty of the owner or the owner's authorized agent to cause the work to remain visible and able to be accessed for inspection purposes. Neither the building official nor the jurisdiction shall be liable for expense entailed in the removal or replacement of any material required to allow inspection. It shall be the duty of the holder of the building permit or their duly authorized agent to notify the building official when work is ready for inspection. It shall be the duty of the permit holder to provide access to and means for inspections of such work that are required by this code. A building or structure shall not be used or occupied in whole or in part, and a change of occupancy of a building or structure or portion thereof shall not be made, until the building official has issued a certificate of occupancy therefor as provided herein. Issuance of a certificate of occupancy shall not be construed as an approval of a violation of the provisions of the applicable code and other ordinances of the jurisdiction. Certificates presuming to give authority to violate or cancel the provisions of this code or other ordinances of the iurisdiction shall not be valid. Printed: 2/26/26 5:05 pm Page 5 of 6 BUILDING PERMIT Permit Type: Building Commercial Permit Number: BCOM2022-0026 Property Address: 46805 DUNE PALMS RD A person shall not make connections from a utility, a source of energy, fuel, or power, or a water system or sewer system to any building or system that is regulated by the applicable code and other ordinances of the jurisdiction for which a permit is required, until approved by the building official. Printed: 2/26/26 5:05 pm Page 6 of 6 La Habra (562) 697-4000 41UL Fax (562) 697-4009 Apple Valley (760) 961-9141 AMERICAN ENGINEERING LABORATORIES INC. Vernon (888) 287-0875 GEOTECHNICAL MATERIALS TESTING & INSPECTION Mailing Address P.O. Box 1816 205 West La Habra Boulevard, La Habra, California 90631 Whittier, California 90609 INSPECTION REPORT STANDARD USED: ❑ DSA Standards ❑✓ ASTM Standards ❑ CBC Standards ❑ Other Standards: Specify Project Name (per plans): WelbeHealth La Quinta Project #: 220193 Project Address (legal): 46-805 Dune Palms Rd. La Quinta, CA 922 DSA File No.: N/A Architect: N/A Application No.: N/A Engineer: Greg Gularte Building Permit No.: N/A General Contractor: Golden construction INC INSPECTION MAT'L SAMPLING QTY MATERIAL DESCRIPTION INSPECTION CHECKLIST ❑ Concrete ❑ Concrete Cylinders ❑ Reinf: Rebar ❑ Plan & Specs ❑ Masonry ❑ Mortar Samples ❑ Reinf: W.W.F ❑ Clearance ❑ Structural Steel ❑ Grout Samples ❑ Reinf: Tendon ❑ Positions ❑ Welding ❑ Masonry Prisms ❑ Conc: Mix #/psi ❑ Sizes ❑ Reinforcing Steel ❑ Masonry Block ❑ Grout: Mix#/psi ❑ Laps ❑ Non -Destructive ❑ Units (block or brick) ❑ Mortar: Mix#/psi ❑ Consolidation ❑ Soils Technician ❑ Reinf. Steel ❑ Units: Block ❑ Mortar Batching ❑ Batch Plant ❑ H.S. Bolts ❑ Steel ❑ Electrode Storage ❑ Bolt Pull Test ❑ Tendon (PT Strands) ❑ H.S. Bolts ❑ Torque Applied ❑ Epoxy ❑ Soil ❑ Electrodes ❑ Corrective Action Required ❑ Sample Pick-up ❑ Agg. base ❑ Corrections Complete Comments: Location of Test/Sample: Arrived on site at time as requested and checked in with Bruce the superintendent. reviewed contractor's submitted documents for rebar/epoxy- - Observed the brushing and blowing of all holes prepared for installation of #3 #4 for footings. and rebar slab on grade and Rebar is embedded 4" and spaced at 24" OC into slab on grade and footing. , �j _ Epoxy used is Set-XP with valid date, all holes were cleaned prior to epoxy. - "�, - work was done per plans page# S1.1 detail# 1 and detail #12 with no 16 exception. Checked the bottom of all excavated footings and elevator pit footings. - Soil is dark brown silty sand. ",�:�i• Probed area throughly to confirm that soil is firm, stable and unyielding. Work is done per contractor submitted documents and geotechnical report with no exception.-94 i r SET-xa � Time In 7 : 00 / Time Out 2 : 00 .'' `" 1 , i Equipment Used: Soil Probe Certification of Compliance: I declare, under penalty of perjury, that I have read the above report and know the contents thereof, that all of the above statements are true, that I know of my own knowledge that the work has been performed and the materials used and installed, in every material respect. ❑ In compliance with the DSA approved plans therefore. ❑ in nce with the DSA approved plans therefore. PNot ROJEC�II OR �Al INSPECTOR NAME Joseph Elmasry SUPERINTENDENT SIGNATU INSPECTOR SIGNATURE CERT. # TE 9028735 6-17-2022 NOTE: Inspections based on 4-hour minimum, 8-hour minimum after four (4) hours, 2-hour minimum for all cancellations. La Habra (562) 697-4000 Fax (562) 697-4009 Apple Valley (760) 961-9141 AMERICAN ENGINEERING LABORATORIES INC. Vernon (888) 287-0875 GEOTECHNICAL MATERIALS TESTING & INSPECTION Mailing Address P.O. Box 1816 205 West La Habra Boulevard, La Habra, California 90631 Whittier, California 90609 INSPECTION REPORT STANDARD USED: ❑ DSA Standards © ASTM Standards © CBC Standards ❑ Other Standards: Specify Project Name (per plans): Welbe Health Project #: 220193 Project Address (legal): 46-805 Dune Palms rd DSA File No.: Architect: Application No.: Engineer: Brian Ross Goodnight Building Permit No.: bCom-2022-0036 General Contractor: Golden Construction INSPECTION MAT'L SAMPLING QTY MATERIAL DESCRIPTION INSPECTION CHECKLIST ❑ Concrete ❑ Concrete Cylinders ❑ Reinf: Rebar ❑ Plan & Specs ❑ Masonry ❑ Mortar Samples ❑ Reinf: W.W.F ❑ Clearance ❑ Structural Steel ❑ Grout Samples ❑ Reinf: Tendon ❑ Positions ❑ Welding ❑ Masonry Prisms ❑ Conc: Mix #/psi ❑ Sizes ❑ Reinforcing Steel ❑ Masonry Block ❑ Grout: Mix#/psi ❑ Laps ❑ Non -Destructive ❑ Units (block or brick) ❑ Mortar: Mix#/psi ❑ Consolidation ❑ Soils Technician ❑ Reinf. Steel ❑ Units: Block ❑ Mortar Batching ❑ Batch Plant ❑ H.S. Bolts ❑ Steel ❑ Electrode Storage ❑ Bolt Pull Test ❑ Tendon (PT Strands) ❑ H.S. Bolts ❑ Torque Applied © Epoxy ❑ Soil ❑ Electrodes ❑ Corrective Action Required ❑ Sample Pick-up ❑ Agg. base ❑ Corrections Complete Comments: Location of Test/SamDle: Observed epoxy and 5/8" threaded rods installed on grid line 4 and D.2 Time In 9 : 30am / Time Out 10 : 30pm Equipment Used: Hilti HIT RE 500 V3, Hilti epoxy gun, air compressor, wire brush, Milwaukee drill Certification of Compliance: I declare, under penalty of perjury, that I have read the above report and know the contents thereof, that all of the above statements are true, that I know of my own knowledge that the work has been performed and the materials used and installed, in every material respect. ❑ In compliance with the DSA approved plans therefore. ❑ Not in compliance with the DSA approved plans therefore. INSPECTOR NAME Chase WangrudPROJECT SUPERINTENDENT SIGNATURE y INSPECTOR SIGNATURE CERT. # ICC:8357220 DATE 12-11-22 NOTE: Inspections based on 4-hour minimum, 8-hour minimum after four (4) hours, 2-hour minimum for all cancellations. Overtime effective on Saturday and after 4:30 p.m. on weekdays see current Fee Schedule). After 12:00 p.m., 8-hour minimum. Date: 7/21/2022 No.: 22-03536-1 Owner: Market Street Address: 46805 Dune Palms Rd City: La Quinta Type: Commercial Lot # Street No. 46805 Comments: CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road DESERT SANDS La Quinta, CA 92253 UNIFIED (760)771-8515 SCHOOL DISTRICT Email: Jurisdiction: La Quinta Tract #: Street Name Sq. Feet APN Permit No. Dune Palms Rd 1963 600-390-023 At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking eating, or sanitation) or replacement mobile homes. It has been determined that the above -named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fess imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $0.66 X 1963 S.F. or $1,295.58 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in the proposed project may now be issued. Fees Paid By: CC/ Farmers & Merchants Bank/ Ryan Trombello Bank Name/Recipient of Certificate By Scott L. Bailey Superintendent Fee Collected/ Exempted by: Yazmin Henry Check No.: 20017306 Telephone: 714-642-3329 Funding: Commercial Certificate Fees Due: $1,295.58 Original Payment(s) Rec'd: $0.00 New Payment Rec'd: $1,295.58 Over/Under: $0.00 NOTICES: (1) PURSUANT TO GOVERNMENT CODE SECTION 66020(d), OWNER HAS A PERIOD OF 90 DAYS FROM THE DATE OF ISSUANCE OF THIS CERTIFICATE TO PROTEST THE IMPOSITION OF THESE FEES. FAILURE TO FILE SUCH PROTEST WITHIN THE 90-DAY PERIOD SHALL RESULT IN FORFEITURE OF ANY RIGHTS TO CHALLENGE SUCH FEES, THROUGH LITIGATION OR OTHERWISE. (2) If subsequent modifications to the project result in a change in project type or an increase in square footage, or if the Certificate expires prior to building permit issuance, Owner must obtain an updated Certificate from the District and pay any additional fees owing at the then -current rate before the building permit can be issued. (3) CERTI FICATE OF COMPLIANCE IS VALI D FOR THIRTY (30) DAYS FROM TH E DATE OF ISSUANCE. Notice to Building Department: THIS DOCUMENT VALID ONLY IF IMPRINTED WITH EMBOSSED SEAL. STATE OF CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF OCCUPATIONAL SAFETY AND HEALTH TEMPORARY PERMIT TO OPERATE AN ELEVATOR (Sections 7301-7315 of the Labor Code) Responsible Party: Elevator Number --2,, 7 O� -) 7 % t q / 7 -� () P, 1 �q I e). 5 Date of Inspection Void After Location 4 & e c�'-s �)o N t_ 01 UTA Street and Number City or Town Load Permissible _�� Pounds Persons Inspector pw�'D(� �"-/�)Vt-23 1p_ tYCTIP c� Passenger, Freight, etc. Machine Type STATE OF CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF OCCUPATIONAL SAFETY AND HEALTH THIS TEMPORARY PERMIT OR COPY MUST BE POSTED IN ELEVATOR CAR OSP 06 9895 July 12, 2022 City of La Quinta Phased Approval Letter (CBC 107.3.3) Status: Under Plan Check Review Plan Checked by: AJ Ortega/Esgil Telephone Number: (760) 777-7018 Phased Approval Cover Letter Kinyon + Kim Architects Address: 46805 Dune Palms Rd Description: Senior Day Care Center (Shell) Plan Check #: BCOM2022-0026 Our client is requesting a Phased Approval for Plan Check # BCOM2022-0026 pertaining specifically to the structural footings. We are at the discretion of the Building Official per CBC code section 107.3.3 Phased Approval. Our request to pull a phased or isolated permit for the structural footings concrete pour based on the drawing information already provided to the city. The Fire Department review is pending, which is why we are requesting the phased approval for the already approved portions of our project so construction can continue. Given that we have no more outstanding structural, the owner is willing to go at -risk with the installation of the structural concrete footings. We understand this may result in additional inspections, fees, and reviews with this request. We are providing the following risk acknowledgement letters from the owner, the architect and the contractor to accompany this request. If you have any questions or need additional information, please do not hesitate to reach out to us. Regards, Donald P. Kinyon, AIA Kinyon + Kim Architects, Inc. 1 1801 Oakland Blvd., Suite 320 Walnut Creek, CA 94596 925 934-1160 Fax 934-8132 Date: July 12, 2022 Permit Application Number: BCOM2022-0026 Project Street Address: 46805 Dune Palms Rd Owner, Applicant, Contractor: Market Street Development California Building Code Section 107.3.3 Policy Conditions: The owner, applicant and contractor (provide separate form for each as applicable) assume all risks associated with phasing of this project. If an issue with a subsequent phase of the project affects an earlier phase, the work of the earlier phase must be modified to mitigate the issue before proceeding. All the normal fees for General Building Permit Applications will be charged for Phased Building Permit Applications. In addition, supplementary fees will be charged at the currently approved City Fee Schedule hourly rate for the review and approval of the phased construction documents due to the additional time needed to code compliance of such applications. The applicant agrees to indemnify and hold harmless the City from any damages or claims related to delays or additional construction costs arising from changes to the project plans necessary to comply with the requirements of the State Building Code and the City's Municipal Code. The applicant acknowledges that approval of a permit for phased construction is provided by the City as a courtesy based on partial plans provided by the applicant, and the City assumes no liability for assuring that phased work is adequate in design or construction to support future work. Acknowledgment: I (print name) Market Street Development understand that a Phased Building Permit (PBP) is only available in certain situations and that if my project does not qualify, I will not receive a PBP. v I acknowledge that obtaining a PBP incurs additional project risks above and beyond / those normally associated with a Building Permit. I acknowledge that I am solely responsible for scheduling and sequencing of work / under each phase of the project. I understand that I am proceeding at my own risk, without assurance that a permit or certificate of occupancy for the building(s) will be granted until all applicable / requirements of codes, laws and regulations are met. I agree not to proceed beyond the work scope approved by the City for each phase. V I agree to assume any and all liability associated with the possibility of denials or delays associated with a Phased Building Permit. V All Parties have been advised of this policy and the added risks. D�-Y1.9 0b,T,I.rH..- �5. Tyler Howren o'M s �' oe e9opPo . N.rNar Tyler Howren Market Street Development Date: July 12, 2022 Permit Application Number: BCOM2022-0026 Project Street Address: 46805 Dune Palms Rd Owner, Applicant, Contractor: Golden Construction California Building Code Section 107.3.3 Policy Conditions: The owner, applicant and contractor (provide separate form for each as applicable) assume all risks associated with phasing of this project. If an issue with a subsequent phase of the project affects an earlier phase, the work of the earlier phase must be modified to mitigate the issue before proceeding. All the normal fees for General Building Permit Applications will be charged for Phased Building Permit Applications. In addition, supplementary fees will be charged at the currently approved City Fee Schedule hourly rate for the review and approval of the phased construction documents due to the additional time needed to code compliance of such applications. The applicant agrees to indemnify and hold harmless the City from any damages or claims related to delays or additional construction costs arising from changes to the project plans necessary to comply with the requirements of the State Building Code and the City's Municipal Code. The applicant acknowledges that approval of a permit for phased construction is provided by the City as a courtesy based on partial plans provided by the applicant, and the City assumes no liability for assuring that phased work is adequate in design or construction to support future work. Acknowledgment: I (print name) Golden Construction understand that a Phased Building Permit (PBP) is only available in certain situations and that if my project does not qualify, I will not receive a PBP. I acknowledge that obtaining a PBP incurs additional project risks above and beyond those normally associated with a Building Permit. C I acknowledge that I am solely responsible for scheduling and sequencing of work under each phase of the project. J L I understand that I am proceeding at my own risk, without assurance that a permit or certificate of occupancy for the building(s) will be granted until all applicable requirements of codes, laws and regulations are met. L I agree not to proceed beyond the work scope approved by the City for each phase. C I agree to assume any and all liability associated with the possibility of denials or delays associated with a Phased Building Permit. 'JL All Parties have been advised of this policy and the added risks. Cdeman.g dby Jason DI 1—, Jason Coleman E vazooCcmeeooe o.•coma� co�r�,ano�, i� �. cntiaasoe coiema� Date'. 2022.0].13 10 20-0] 0]'00' Jason Coleman Golden Construction Date: July 12, 2022 Permit Application Number: BCOM2022-0026 Project Street Address: 46805 Dune Palms Rd Owner, Applicant, Contractor: Kinyon + Kim Architects, Inc. California Building Code Section 107.3.3 Policy Conditions: The owner, applicant and contractor assume all risks associated with phasing of this project. If an issue with a subsequent phase of the project affects an earlier phase, the work of the earlier phase must be modified to mitigate the issue before proceeding. All the normal fees for General Building Permit Applications will be charged for Phased Building Permit Applications. In addition, supplementary fees will be charged at the currently approved City Fee Schedule hourly rate for the review and approval of the phased construction documents due to the additional time needed to code compliance of such applications. The applicant agrees to indemnify and hold harmless the City from any damages or claims related to delays or additional construction costs arising from changes to the project plans necessary to comply with the requirements of the State Building Code and the City's Municipal Code. The applicant acknowledges that approval of a permit for phased construction is provided by the City as a courtesy based on partial plans provided by the applicant, and the City assumes no liability for assuring that phased work is adequate in design or construction to support future work. Acknowledgment: I (print name) Kinvon & Kim Architects, Inc. understand that a Phased Building Permit (PBP) is onlyavailable in certain situations and that if my project does not qualify, I will not receive a PBP. V/I acknowledge that obtaining a PBP incurs additional project risks above and beyond / those normally associated with a Building Permit. v I acknowledge that I am solely responsible for scheduling and sequencing of work under each phase of the project. V/ I understand that I am proceeding at my own risk, without assurance that a permit or certificate of occupancy for the building(s) will be granted until all applicable requirements of codes, laws and regulations are met. V/ I agree not to proceed beyond the work scope approved by the City for each phase. VI agree to assume any and all liability associated with the possibility of denials or delays associated with a Phased Building Permit. V/ All Parties have been advised of this policy and the added risks. Donald R Kinyon, Architect AIA CA #30318 1801 Oakland Blvd., Suite 320 Walnut Creek, CA 94596 925 934-1160 Fax 934-8132 Tw�t 4 4Q" DESIGN & DEVELOPMENT DEPARTMENT 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 (760) 777-7125 FAX (760) 777-7011 CERTIFICATION OF BUILDING AREA STREET ADDRESS OF JOB: 46805 DUNE PALMS RD APN: 600 — 390 — 023 DESCRIPTION OF WORK: ADDITION SQUARE FOOTAGE: 1,963 OWNER'S NAME: MARKET STREET For questions regarding this letter, please contact: City of La Quin to Permit Center (760) 777-7125 Coachella Valley Unified School District 83-733 Avenue 55 P O Box 847 Thermal, CA 92274 (760) 398-5909 Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 (760) 771-8515 CITY OF LA QUINTA BUILDING DIVISION REVIEWED FOR CODE COMPLIANCE BY: A DATE: O�i��i2O22 Please note: This letter verifies conditioned square footage. Please call your School District to verify school fees, requirement for cashier's check or money order and hours of operation. THIS IS NOT ATICKET NO. pR�'SCONTROL, - �^ NUMBER 4'1 e 800/834-7557 San,Diepo 800/870-1220 f1 RNEflSIOE-612020thST. #13 IRWINOPEN 7 DA #2 MORENOVALLEY-14250Old215FrontageRoad #14 PASADENA-1420N LINCOLNAVE OPEN 7 DAYS 03 REDLANDS-S53 8ALABAMA ST. 115 VERNON-LOS ANGELES-3365 E. 26TH ST. M GARDENA- 301 W. ROSECRANS AVE. #4 FONTANA-13792 GLOVER AVE #16 ANAHEIM- 201 E. COMMERCIAL ST #26 THOUSAND PALMS-72460 VARNER RD. #5 POMONA- 2470 POMONA BLVD. #6 HEMEUSAN JACINTO-1675 STATE ST 117 SANTA ANA- 310 N. TOWNSEND S. #27 MURRIETA-281MOADAMS AVE. 035 BIG BEAR LAKE- 42025 GARSTIN DR. #45 BARSTOW-2700 E. MAIN ST. 418 LAKE FOREST- 25931 TOWN CENTRE DR. #P8 OTAY MESA -7961 AIRWAY RD. #36 ESCONDIDO - 1310 SIMPSON WAY "6 CAL -CITY -7W MOSS AVE. f7 BEAUMONT- 452 W. LUIS ESTRADA RD. #8 SUN CITY -27050 WATSON RD. 019 ADELANTO-12203 VIOLEr RD. #29 EL CAION-215 CYPRESS UN. #37 INDIO- 88110 FARGO CANYON RD. #47 PORT OF LONG BEACH -1602 W. PIER D ST. #20 SAN CLEMENTE-116 RINCON CT. #30 CORONA- 1540 SHERBORN ST. #38 RIDGECREST- 21571NYOKERN RD. #48 BANNING -1000 N. HATHAWAY #9 ARROWHEAD -20750HWY 18 110 SANTA RE SPRING S-12311 GREENSTONE AVE. #21 IRVINE- legal CONSTRUCTION CIR. WEST #31 HESPERIA-9561 CAVE. #39 PALMDALE-3779075TH ST. EAST #49 SIMIVALLEY-400WLDSANGELESAVE M NO. HOLLYWOOD -13132 RAYMER ST #32 CARROLL CANYON- 10050 BLACK MOUNTAIN RD. #40 ARTESIA- 13949 E. STAGE ROAD #53 SAN JUAN CAPISTRANO-37511 GIBBY ROAD #11 CABAZON-13990 APACHE TRAIL #12 SAN BERNARDINO -1955 W. 91H ST J23 PARAMOUNT-7277 E. pOSECRANS AVE. #33 MIRAMAR-5692 EASTGATE DR. #42 VICTORVILLE-16952 N. DST #541EMESCAL VALLEY-26050M11 p0A0 #24 RIALTO N ALDER AVE. -2801 #34 LUCERNE - 36555 HWY 18 #43 BAKER - 56500 BAKER BLVD. MULTIPLE LOCATIONS IN NEVADA PLANT DATE CUSTOMER NO: SOLD TO: -- MAP PAGE TICKET NO. •- TX CD DELIVERY ADDRESS & INSTRUCTIONS ' CUSTOMER PO. / JOB OR LOT # 1.799 ORDER NO. ,' METER READING: TIME TYPED TRUCK LIC NO, LOAD NO. SLUMP TRUCK. DRIVER r1r i=l:. DRUM REVS. Job -site Cylinder Test: ❑ Yes TO JOB TIME ON JOB MIN. CHECK # ON JOB Water added On job at STAND BY MIN. ❑ CHECK Customers request: AMOUNT BY START POUR gals t0 FUII Ld:` RATE OF X $ PER MIN. CASH ❑ FINISH POUR RETURN CONC gals to 2/3 Ld. AMOUNT BY $ PLANT MGR SIG gals t0 1/3 Ld. OVERTIME CHARGE LEAVE JOB - 4 min. per yd. unloading time allowed. Y N ADJ. Meter Additional unloading time charged at current hourly truck rate. ARRIVE PLANT YDS Additional water added to this concrete will reduce its strength, Any water added exceeding the design water is at customer's own risk. Signature certifying under penalty of perjury that the information contained in this written time record Is true and correct. TERMS AND CONDITIONS OF SALE Customer agrees that the described material has been chosen solely by Customer without Robertson's direction, or review of any plans or specifications relating to the prolect(s) where the material is to be used Customer further agrees that it shall be solely responsible for the delivery location, and discharge/placement of material on the lob site, Including the on direction of Robertson's vehicles to the designated location. Customer s review and approval the described material shall be evidenced by Customer's signature and/or placement of the described material on the nob site. In consideration i the above; Customer releases and agrees to defend, indemnify and hold Robertson's and its employees and agents harmless from any and all losses, damages, liabilities, costs and claims asserted by Customer or any third parry, arising from ((i material being inappropriate, incompatible, improper or inconsistent with plans and specifications, or with the ground soils or conditions on the land where the material Is utilized, and (it) the movement of Robertson's vehicles upon or about the delivery location. Solely to the extent Customer fails to timely pa for the described materials, in the event Robertson's retains the services of an attorney, Customer agrees to pay such reasonable attorney's fees incurred by Robertson's in furtherance of such collection efforts. Robertson's and Customer disclaim attomey's fees arising from any other context. v Customer agrees to pay a time price differential of 1 'A % per month on any amounts owed to Robertson's for more than thirty (30) days. Color Disclaimer Due to irregularities and/or inconsistency of materials Robertson's is not responsible for the results of any concrete where the coloring agent has been added at the request of the customer, either at our plant or on the job site. LD CITY CUM QTY ORD QTY PROD CODE MIX AND COMMODITY UOM UNIT PR AMT `.n •.r :..._.I'" WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity was weighed, TAX measured, or counted by a weighmaster, whose signature is on this certificate, who is a recognized authority of accuracy, as prescribed by Chapter 7 _ (commencing with Section 12700) of Division 5 of the California Business and PREVIOUS I (.- .. Professions Code, administered by the Division of Measurement Standards of the BALANCE California Department of Food and Agriculture. ROBERTSON'S SUB - _ WEIGHMASTER TOTAL BY CEPUTv - STAND BY NOM CONVERSION CV=VARDS3 #=POUNDS GL=GALLONS FO=OUNCES CU=METER53 KG=KILOGRAM L=LITERS ML=MILLILITERS CHARGE Q CONCRETE DELIVERY TICKET TOTAL AGREED TO AND RECEIVED BY CUSTOMER PO BOX 3600 CORONA, CA 92878-3600 THIS IS NOT A TICKET NO.CONTROROBERTWN'S NMBERL� 1 I Phone 800 /834=7557 S D' 800/870-1220 #35 BIG BEAR LAKE -42025 GARSTIN DR. #45 BARSTOW - 2700 E. MAIN ST. #36 ESCONDIDO - 1310 SIMPSON WAY 146 CAL -CITY - 7900 MOSS AVE 137 INDIO- 88110 FARGO CANYON RD. #47 PORT OF LONG BEACH -1602 W. PIER D ST. #38 RIDGECREST- 21571NYOKERN RD. #48 BANNING -100QN. HATHAWAY #39 PALMDALE- 3T79076TH ST FAST #49 SIMI VALLEY- 400 W. LOS ANGELES AVE 140 ARTESIA- 13949 E. STAGE ROAD #53 SAN JUAN CAPISTRANO - 31511 GIBBY ROAD #42 VICTORVILLE -16952 N D ST. 154 TEMESCALVALLEY - 25NO MA TRI ROAD 043 BAKER -W500 BAKER BLVD. MULTIPLE LOCATIONS IN NEVADA MAP PAGE TICKET NO CUSTOMER P.O. / JOB OR LOT # ,c5 f : " 4: L_A � f k:;(:S �t? s ORDER NO:.METER READING • d)-4y LOAD NO( SLUMP TRUCK i I > DRUM REVS: TO JOB �d. I n o TIMETYPED J.Z TRUCK LIC NO. DRIVER ..,. L (._ r'. _.. „ (; r: __i_�--. I ; ),- 1 iWt_ "i • ; i._, •-i.._ _ti Job -site Cylinder Test: ❑Yes TIME ON JOB MIN. CHECK # ON JOB a� -� l Water added on job at STAND BY MIN. CHECK ❑ Customer's request: AMOUNT BY START POUR �,_.) '' y gals to Full Ld. RATE OF X $ PER MIN. CASH ❑ AMOUNT BY FINISH POUR RETURN CONC gals to 2/3 Ld. $ PLANT MGR SIG gals to 1/3 Ld. OVERTIME CHARGE 4 min. per yd. unloading time allowed. LEAVE JOB Y N ADJ. Meter - Additional unloading time charged at current hourly truck rate. ARRIVE PLANT YDS Additional water added to this concrete will reduce its strength. Any water added exceeding the design water is at customer's own risk. Signature cerlitying under penalty of perjury that the information contained in this written time record is true and correct. EMPJ# SIGNATURE TERMS AND CONDITIONS OF SALE Customer agrees that the described material has been chosen solely by Customer without Robertson's direction, or review of any plans or specifications relating to the prol'ect(s) where the material is to be used Customer further agrees that it shall be solely responsible for the delivery location, and discharge/placement of material on the lob site, Including the on -site Irection of Robertson's vehicles to the designated location. Customer s review and approval the described material shall be evidenced by Customer's signature and/or placement of the described material on the'ob site. In consideration of the above, Customer releases and agrees to defend, indemnify and hold Robertson's and its employees and agents harmless from any and all losses, damages, liabilities, costs an� claims asserted by Customer or any third party, arising from (i) material being inappropriate, incompatible, improper or inconsistent with plans and specifications, or with the ground soils or conditions on the land where the material is utilized, and (it the I movement of Robertson's vehicles upon or about the delivery location. Solely to the extent Customer fails to timely pay for the described materials, In the event Robertson's retains the services of an attorney, Customer agrees to pay such reasonable attorney's fees incurred by Robertson's in furtherance of such collection efforts. Robertson's and Customer disclaim attorney's.fees arising from any other context. Customer agrees to pay a time price differential of 1 %a % per month on any amounts owed to Robertson's for more than thirty (30) days. Color Disclaimer Due to irregularities and/or inconsistency of materials if'results .`, t I y (Q} t i "Y the '.ycoloringt g request customer, either at our plant or on the job site. 7% UNIT PR AMT Robertson's Is not responsible or t e resU is 0 an concrete where t e a ent aS been added at the r uest o the LD.OTY CUM OTY ORD TY PROD CODE MIX AND COMMODITY _ t WEIGHMASTER CERTIFICATE Z c �j"•( IF 1 1-421-;r `9 ()GAL THIS IS TO CERTIFY that the following described commodity was weighed, �4 NP e measured, or counted by a weighmaster, whose signature is on this certificate, 1+•;;-j;q tDD 1120 2'; ,. (_,}CI'.AL who is a recognized authority of accuracy, as prescribed by Chapter 7 (commencing with Section 12700) of Division 5 of the Cal'domia Business and 7 ,j1j t } „ t-! {,_, 2 i Professions Code, administered by the Division of Measurement Standards of the +„ 7 ,� ,• -_, _ i ) C7'}t} . (_•l...ki California Department of Food and Agriculture. j.°i AGIF-i 12090 0L F, ROBERTSON'S WEIGHMASTER rr i I ! +ldyy 'ni4!y��:, � r- l- i r FbArEF'Z T'-+.T.=%AR-C' 15(3A.i,) . )LIS 201 . �}F{-_O/ BY DEPUTY UOMCONVERSION CY=YARDS3 hPOUNDS GL=GALLONS FO=OUNCES CU=METERS3 KG=KILOGRAM L=LITERS ML=MILLILITERS ffi C! CONCRETE DELIVERY TICKET �• AGREED TO AND RECEIVED BY CUSTOMER PO BOX 3600 CORONA, CA 92878-3600 TAX PREVIOUS BALANCE SUB TOTAL STAND BY CHARGE TOTAL - THIS IS NOT A TICKET NO. j CONTROL. CONTROL - NUMBER i Phone 806/834-7557 San Diego 800/870-1220 , ry��II4yMy flIVERSIDE-6120201h ST #2 MORE11.1 1.EY-14250011215Fronie11Roatl #13 IRWINDALE- 13631 LIVE OAK LANE NM/W'rr 7 DAYS #14 PASADENA- 1420 N. UNCOLN AVE. OPEN 7 DAYS AVE. d II Iiir 1� I - tt'r1 Y j /3 REDLANDS-8353 ALABAMA ST. #15 VERNON-LOS ANGELES-3365E.26rH Sr. #25 GARDENA- 301 W. RDSECRANS VARNER RD. - I #4 FONTANA- 13792 SLOVER AVE. ,5 POMONA- 2470 POMONA BLVO. #16 ANAHEIM- 201 E. COMMERCIAL ST. #26 THOUSAND PALMS -72460 #17 SANTAANA-310N.TOWNSENDST #27 MURRIETA-26190 ADAMS AVE #35 BIG BEAR LAKE- 42025 GARSTIN DR. #45 BARSTOW-2700 E. MAIN ST. #28 OTAY MESA -7961 AIRWAY RD. #36 ESCONDIDO-131051MPSON WAV #46 CAL -CITY MOSS AVE. #6 HEMET/SAN JACINTD-1675 STATE ST #7 BEAUMONT- 452 W. L 11S ESTflADA RD. Y78 LAKE FOREST- 25931 TOWN CENTRE DR. #19 ADELANTO -12203 VIOLET RD. 129 EL CAION - 215 CYPRESS UN. #37 INDIO - 88110 FARGO CANYON RD. 147 PORT OF LONG BEACH -1602 W. PIER D ST. 03 #30 CORONA- 1540 SHEABORN ST. #38 RIDGECflEST- 21571NYOKERN RD. #48 BANNING -1000 N. HATHAWAY #8 SUN CITY-27050 WATSON RD. 19 ARROWHEAD-29750 HWY 18 #20 SAN CLEMENTE RINCON Cr #21 IRVINE-16DB1 CONSTRUCTION CIR. WEST #31 HESPERIA-9661 CAVE. •39 PALMDALE- 3779075TH ST FAST #49 SIMI VALLEY- 4DO W LOS ANGELES AVE. #22 NO. HOLLYWOOD -13132 RAYMER ST #32 CARROLL CANYON -10050 BLACK MOUNTAIN RD. #40 ARTESIA-13949 E. STAGE ROAD 153 SAN JUAN CAPISTRANO - 31511 BIBBY ROAD #10 SANTA RESPRINGS -12311 GREENSTONE AVE. #11 CABAZON- 138NeAPACHE TRAIL APAC ET #23 PARAMOUNT- 7277 E. ROSECRANS AVE.- � #33 MIRAMAR- 5692 EASTGATE DR. #42 VICTORWLLE-16952 N. DST. #54 TEMESCALVALLEY - 25050 MAITRI ROAD NT #34 LUCERNE HWY 18 #43 BAKER-565M BAKER BLVD. MULTIPLE LOCATIONS IN NEVADA -1 #12 SAN BERNARDI90 ST #24 RIALTO N. ALDER AVE MAP PAGE TICKET NO. PLANT DATE CUSTOMER NO: SOLD TO: L_ ?i� to .{...._ TX CD DELIVERY ADDRESS 8, INSTRUCTIONS CUSTOMER P.O. / JOB OR LOT # (f';c�t F'ta1._r`'±:.:` I ...i.) C 0i;_'LR r'_ _ I' eC LA �I_ll.N r ".c,') qir.179 1.554 ::l} L..A.;_6 • ORDER NE).�h :r A�Ef.E{'3}fkEADlt .} TIME TAPED 5 i_: { iWII,J& 68-46. - fsray��t•j, �i !'• y� 111 V' vLOAD NCti S-UMP?I_) .... .._ _ r r .I r1 fL rY'..1 , �.. ti r!I`'1 h::.fl� 1. tf�l L_ l_. �•�t:$ uEfL.)_ f:,i....•.%t'`f{;�. �.,_L.I; 1.,L: lRLIGK`r dr�l-------------- `- nf.` ^" g O S DRUM 1 REVS: ?,-• T '`° Job site Cylinder Test: Yes TIME ON JOB MIN. CHECK # TO JOB - "" a Water added on job at STAND BY MIN. CHECK ❑ ON JOB START POUR Customer's request: AMOUNT BY gals to Full Ld. RATE of x $ PER MIN. CASH AMOUNT BY — v POUR RETURN CONIC gals to 2/3 Ld. $ PLANT MGR SIG FINISH OVERTIME CHARGE gals to 1/3 Ld. ; ❑ I ❑ -{ {'' .f i'. 4 min. per yd. unloading time allowed. LEAVE JOB y N ADJ. Meter Additional unloading time charged at current hourly truck rate. Addilional water added to this concrete will reduce its strength. Any water added exceeding the design water is at customers own ARRIVE PLANT YDS SI net certffyln under otiosity of perjury that the information contained in this written time record is true and correct. IN L EMPJ# �rx,.�', SIGNATURE"'i-°r-- TERMS AND CONDITIONS OF SALE Customer agrees that the described material has been chosen solely by Customer without Robertson's direction, or review of any plans or specifications relating to the proket(s) where the material is ro e used. Customer further agrees that it shall be solely responsible for the delivery location, and discharge/placement of material on the lob site, including the on -site direction of Robertson's vehicles to the desi noted , �, location. Customer s review and approval the described material shall be evidenced by Customer's signature and/or placement of the described material on the ob site. In consideration of the above, Customer releases and agrees to defend, indemnify and hold Robertson's and its employees and agents harmless from any and all losses, damages, liabilities, costs an � claims asserted by Customer or any third party, $ d arising from (I materal being inappropriate, incompatible. improper or inconsistent with plans and specifications, or with the ground sods or conditions on the land where the material is utilized, and III) the movement of Robertson's vehicles upon or about the delivery location. Solely to the extent Customer sails to timely paw for the described materials, in the event Robertson's retains the services of an attorney Customer agrees to pay such reasonable attorney's fees Incurred by Robertson's In furtherance of such collection erts. Robertson's and Customer disclaim attorney's•fees arising from any other conteM� Customer agrees to pay a time price differential of 1 h % per month on any amounts owed to Robertson's for more than thirty (30) days. Color Disclaimer Due to !me) sh ees and/or inconsistency of materials Robertson's Is not responsible for the results of any concrete where the coloring agent has been added at the request of the customer, either at our plant or on the job she. LD QTY : CUM QTY ORD QTY PROD... CODE MIX AND COMMODITY UOM UNIT PR AMT Ili,} ;�:.':,;ir;t_}i} L...'>'.t.., 4 )0L i l4f F.I•-��"} :.iL_i...i•�vVG_�..' •_:r_,5.!J{:.:ii{.._ !"1j: I•'•I ht••tl klf"��_ / .:.8 4 • '•-t_n-i{-- WEIOHMAS7ERCERTIFICATE (._it 11,j-•(•( I�,E. f^I'L i c1�„f ^ (,t{ryL;;iL THIS IS TO CERTIFY that the following described commodity was weighed, measured, or counted by a weighmaster whose signature is on this certificate, r: - , t-H.0 f ! (' L, I-} '� I'!LJ W�{ who is a recognized authority of accuracy, as prescribed by Chapter 7 (commencing with Section 12700) of Division 5 of the California Business and 1 ,- r i%J - a-.. `••'i !-C 71? " ! f 17 OLD =--fir Professions Code, administered by the Division of Measurement Standards of the ,; 6 California Department of Food and Agriculture. { cy'rji-} , i_ ; ROBERTSON'S WEIGHMASTER - :Ijr-C q THY r a t,_)i I_-0 1_ eroErur t;�; , . UOM CONVERSION CY=YARDS3 #--POUNDS GL=GALLONS FO=OUNCES CU�METERS3 KG=KILOGRAM L=LITERS ML=MILLILITERS CONCRETE DELIVERY TICKET AGREED TO AND RECEIVED BY CUSTOMER PO BOX 3600 CORONA, CA 92878-3600 _ TAX PREVIOUS BALANCE SUB TOTAL STAND BY CHARGE TOTAL THIS IS NOT A TICKET NO. CONTROL ROBMTSON9S ., 1 NUMBER P tl 9 Phone 800/834-7557 Sah Diego 800/870-1220 ' 1 11 RNERSIDE-612020U13T #13 IRWINDALE-13631 LIVE OAK LANE www.rrmca.co lgt #2 M."ENOVALLEY- 14250 Old 215 Frorde9e R-d #14 PASADENA-1420 N. UNOOLNAVE. OPEN 7 DAYS .l fY yp I K3 REDLANDS-8353ALABAMAST. #15 VERNON-LOS ANGELES-3365 E. 26TFI ST. #25 .CMDENA-301W.ROSECRANSAVF i#4 FONTANA- 137926LOVERAVE. 05 POMONA- 2470 POMONA BLVD. 016 ANAHEIM- 201 E. COMMERCIAL ST. #17 SANTAANA- 310 N. TOWNSEND ST. #26 'THOUSAND PALM" -72460 VARNER RD. #27 MURRIETA-26190 ADAMS AVE. — #6 HEMET!SAN JACINTO-1675 STATE ST 118 LAKE FOREST- 25931 TOWN CENTRE DR. yyS #28 OTAY MESA -7961 AIRWAY RD, #7 BEAUMONT- 452 W LUIS ESTRADA RD. #19 ADELANTO - 12203 VIOLET RD. #29 EL CAJON-215 CYPRESS LN. #8 SUN CITY -27050 WATSON RD. #20 SAN CLEMENTE-116 RINCON CT. #30 CORONA- 1540 SHERBORN ST. #9 ARROWHEAD - 29750 HWY 18 #21 1RVINE- 16081 CONSTRUCTION CIR. WEST #31 HESPERIA - 9661 CAVE. #10 SANTA FE SPRINGS -12311 GREENSTONE AVE. #22 NO. HOLLYWOOD - 13132 RAYMER ST. #32 CARROLL CANYON -10050 BLACK MOUNTAIN fl #11 CABAZON- 13990 APACHE TRAIL #23 PARAMOUNT- 7277 E. ROSECRANS AVE. #33 MIRAMAR- 5692 EASTGATE DR. #12 SAN BERNARDINO-1955 W. 9TH ST 124 RIALTO -2601 N. ALDER AVE #34 LUCERNE - 36555 HWY 18 . jPLANT DATE CUSTOMER NO SOLD TO: ). t..,0F'Fc.).1Ii TX CD DELIVERY ADDRESS & INSTRUCTIONS 4 0 F;,P 1 Jt A T F C E: IN TP, E I., F-1. ORDER Nd". i METEB'READING. LOAD NO.i SLUMP DRUM I TO JOB REVS: TIMETYPED ... TRUCKL(C`116. #35 BIG BEAR LAKE -42025 GARSTIN DR. #45 BARSTOW 2700 E. MAIN ST. #36 ESCONDIDO - 1310 SIMPSON WAY 146 GAL-CITY-79DO MOSSAVE. 037 INDIO- 88110 FARGO CANYON RD. #47 PORT OF LONG BEACH -1602 W. PIER 0 ST #38 RIDGECREST- 21571NYOKERN RD. #48 BANNING -ION) N. RATHAWAY 039 PALMDALE- 3779075TH ST. EAST #49 SIMI VALLEY- 400 W. LOS ANGELES AVE. D. #40 ARTESIA- 13949 E. STAGE ACAD #53 SAN JUAN CAPISTRANO - 31511 GIBBY ROAD #42 WCTORVILLE-1B952 N. DST #54 TEMESGAL VALLEY- 25050 MATTRI ROAD 043 BAKER -56500 BAKER BLVD. MULTIPLE LOCATIONS IN NEVADA MAP PAGE TICKET NO. CUSTOMER P.O. / JOB OR LOT # 10 d e1 • S 1"• L: i ..- _ _.... ._ 1 _.�. .. TRUCK'..; DRIVER,..; .t�-.tt,,-r' .I. C'�IL.!{•:t�_�': , :.TF::.,� a"' I:.F�.YI...�ilvll"1I::.r-il.�..i. (-11... 7I..(�> JOB Job -site Cylinder Test: ❑ Yes TIME ON JOB MIN, CHECK # tr I� ION ON JOB !7 -i• Water added on job at STAND BY MIN. CHECK ❑ Customer's request: AMOUNT BY START POUR f gals to Full Ld. RATE of X $ PER MIN, CASH ❑ gMouNr By FINISH POUR RETURN CONICgals to 2/3 Ld. $ PLANT MGR SIG O gals to 1/3 Ld. OVERTIME CHARGE LEAVE JOB '•i i"i .�. t'+.E 4 min. per yd. unloading time allowed. ... v N — ADJ. Meter Additional unloading time charged at current hourly truck rate. ARRIVE PLANT YDS Additional water added to this concrete wil I reduce its strength. Any water added exceeding the design water is at customer's own risk. Signature certifying under penalty of perjury that the information contained in this written time record is true and correct. EMPJY SIGNATURE TERMS AND CONDITIONS OF SALE Customer agrees that the described material has b en chosen solely by Customer without Robertson's direction, or review of any plans or specifications relating to the prole ER where the material is to be used. ..i Customer further agrees that it shall be solely resp�flsible for the delivery location, and discharge/placement of material on the fob site, including the on -site direction of Robertson's vehicles to the designated 4? "' ocation. Customer s review antl approval the described material shall be evidenced by Customer's signatureand/or placement of the descr bed material on the'ob site. In consideration of the above; Customer eleases and agrees to defend, indemnify and hold Robertson's and its employees and agents harmless from any and all losses, damages, Iiabilfties, costs an� claims asserted by Customer or any third party, I I j j:'3"1 arising from (i1 material being inappropriate, incompatible, improper or inconsistent with plans and specifications, or with the ground soils or conditions on the land vhlere the material is utilized, and (ii) the movement o obertson's vehicles upon or about the delivery location. Solely to the extent Customer fails to timely pa for the described materials, in the event Robertson's retains the services of an attorney, Customer agrees to pay such reasonable attorneys fees incurred by Robertson's in furtherance of such collection efforts. Robertson's and Customer disclaim attorneys fees arising from any other context, Customer agrees to pay a time price differential of 1 Y2 % per month on any amounts owed to Robertson's for more than thi ty (30) days. Color'facialmerDue toirregularitiesand/or Inconsistency of materials Robertson's Is not responsible for the results of any concrete where the coloring agent has been added at the request of the customer, either at our plant or on the job site. LD. QTY CUM QTY ORD QTY PROD CODE MIX,AND COMMODITY UOM UNIT PR AMT t r,, r t I i.IPF' 1-12 0 6.1 « (_'GAL. WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity was weighed, '� j'7(._'_X ;,y')D F-120 , a_:1 511(14 measured, or counted by a weighmaster, whose signature is on this certificate, recognized authority of accuracy, as prescribed b Chapter 7 who is a reco ni y y p y p _ 2 r .1 , _) �- B (commencing with Section 12700) of Division 5 of the California Business and Professions Code, administered by the Division of Measurement Standards of the California Department of Food and AgdcuRure. GG ROBERTSON'S WEIGHMASTER i _: pi¢9 u?Ysl S'y6 t =,'L:= . UOM CONVERSION CY=YARDS3 #= POUNDS GL=GALLONS FO=OUNCES CU=METERS3 KG=KILOGRAM L=LITERS ML=MILLILITERS TAX PREVIOUS BALANCE SUB TOTAL STAND BY CHARGE C! CONCRETE DELIVERY TICKET TOTAL L PO BOX 3600 CORONA, CA 92878-3600 AGREED TO AND RECEIVED BY CUSTOMER . THIS IS NOT TICKET NO, CONTROL RO�TS�11oT'Si "�. 7 NUMBER 7 si y Phone 800/834-7557 San Die 800/870-1220 �i X r, o www rrmca.com t - #1 RIVERSIDE -812020VIST. #13 IRWINDALE - 13631 LIVE OAK LANE #2 MORENO VALLEY -14250 OM 215 F—twe Road #14 PASADENA- 1420 N. LINCOLN AYE. OPEN 7 DAYS .#3 REDIANDS-B953 ALABAMA ST. #15 VERNON-LDS IINGELES-3365 E. 26TH ST. #25 GARDENA-301 W. ROSECRANS AVE 14 FONTANA+ 13792 SLOVER AVE. #16 ANAHEIM- 201 E. COMMERCIAL ST 126 THOUSAND PALMS -72460 VARNER RD. #5 POMONA- 2470 POMONA BLVD. #17 SANTA AMA- 310 N. TOWNSEND ST #27 'MURRIETA-26190 ADAMS AVE. — #6 HEMETISAN JACINTO-1675 STATE ST. #18 LAKE FOREST- 25931 TOWN CENTRE DR. #28 OTAY MESA -7951 AIRWAY RD. #7 BEAUMONT- 452 W LUIS ESTRADA RD. #19 ADELANTO-12203 VIOLET RD. #29 EL CAION-215 CYPRESS LN. #8 SUN CITY - 27050 WATSON RD, #20 SAN CLEMENTE-116 RINGON C. #30 CORONA -1540 SHERSORN ST #9 ARROWHEAD -29750 HWY 18 - #21 IRVINE- 16D81 CONSTRUCTION CIR. WEST #31 HESPERIA - 9661 CAVE. #10 SANTA HE SPRINGS- 12311 GREENSTONE AVE. 022 NO. HOLLYWOOD - 13132 RAYMER SE #32 CARROLL CANYON- 1D050 BLACK MOUNTAIN R #11 CA3AZON- 13990 APACHE TRAIL #23 PARAMOUNT- 7277 E. ROSECRANS AVE. #33 MIRAMAR- 5692 FASTGATE DR. #12 SAN BERNARDINO -1955 W. 9IH ST #24 RIALTO- 2601 N. ALDER AVE. #34 LUCERNE - 36555 HWY 18 PLANT DATE CUSTOMER NO: SOLD TO: .:i i':7 t_+ �..) I'". _ Fe. r:� t... 0F.,!F_'LJ�i h'1 (.� t-.)r\I TX CD DELIVERY ADDRESS & INSTRUCTIONS S ' L Csi�:F't:16•�;�1TL CENTRE., ;_IR t_;a ill?J:h�1'r, P 'Fir„)! f i.,:. e f 9 `�, .1. 1 V_i t_)';! - - 1sE its �d pTi , !ORDER NO. .�. METER.READINC',f T1MET1tF'.Ebt?C7 !_%TRUCKLICNO. LOAD WE,' SLUMP DRUM TO JOB 1 REVS: ifr WR 4 DHIl R 1. (.., i:, to a (Zo 1_, E. G7._ (.a P J Job -site Cylinder Test: ❑ Yes #35 BIG BEAR LAKE -42025 GARSTIN DR. #45 BARSTOW - 2700 E. MAIN ST. 136 ESCONDIDO - 1310 SIMPSON WAY #46 CALCITY-CITY MOSS AVE. #37 INDIO- 88110 FARGO CANYON RD. #47 PORT OF LONG BEACH -1602 W. PIER D ST. #38 InDGECREST- 21571NYOKERN RD. 148 BANNING -1000 N. HATHAWAY #39 PALMDALE- 3779075TH ST EAST 1 #49 SIMIVALLEY 400 W. LOS ANGELES AVE D. #40 ARTESIA- 13949 E. STAGE ROAD #53 SAN JUAN CAPISTRANO - 31511 GIBBY ROAD #42 VICTORVILLE - 16952 N.DST. #64 TEMESCAL VALLEY -25M MAITRI ROAD #43 BAKER- 56500 BAKER BLVD. MULTIPLE LOCATIONS IN NEVADA MAP PAGE TICKET ±N�O. .rI CUSTOMER P.O. / JOB OR LOT # .2083 2 o!'. 2 MIN. CHECK # �J ON JOB . JV "1 Water added on job at 'w.�Jj �/yj�•� Customer's request: STAND � MIN. CHECK ❑ AMOUNT BY START POUR r l..mC.. gals to Full Ld. RATE OF x $ PER MIN. CASH ❑ d` AMOUNT BY - J FINISH POUR RETURN CONIC gals to 2/3 Ld. $ � CHARGE PLANT MGR SIG 0 gals to 1/3 Ld. I OVERTIME I LEAVE JOB 4 H I i 4 min. per yd. unloading time allowed. Y N ADJ. Meter Additional unloading time charged at current hourly truck rate. J IARRIVE PLANT YDS Additional water added to this concrete will reduce its strength. Any water added exceeding the design water is at customer's own risk. Signature certifying under penalty of perjury that the information contained in this written time record is true and correct. EMPJ# SIGNATURE TERMS AND CONDITIONS OF SALE Customer agrees that the described material has been chosen solely by Customer without Robertson's direction, or review of any plans or specifications relating to the prole ER where the material is to be used ,.►/ lCustomer further agrees that it shall be solely responsible for the delivery location, and discharge/placement of material on the lob site, Including the on -site direction of Robertson's vehicles to the designated location. Customer s review and approval the described material shall be evidenced by Customer's signature and/or placement of the described material on the'ob site. In consideration of the above, Customer releases and agrees to defend, indemnify and hold Robertson's and its employees and agents harmless from any and all losses, damages, liabilities, costs an � claims asserted by Customer or any third party, ii ,I 7 V j arising from (q material being inappropriate, incompatible, improper or inconsistent with plans and specifications, or with the ground soils or conditions on the land where the material Is utilized, and (I) the In of Robertson's vehicles upon or about the delivery location. Solely to the extent Customer fails to timely pa for the described materials, in the event Robertson's retains the services of an attorney, lCustomer agrees to pay such reasonable attorne .'s fees incurred by Robertson's in furtherance of such collection efforts. Robertson's and Customer disclaim attorney's fees arising from any other context. � Customer agrees to pay a time price differential of 1 'h %per month on any amounts owed to Robertson's for more than thirty (30) days. Color Disclaimer Due to irregularities and/or inconsistency of materials Robertson's is not responsible for the results of any concrete where the coloring agent has been added at the request of the customer, either at our plant or on the job site. LID QTY CUM QTY ORD QTY PROD CODE MIX AND COMMODITY UOM UNIT PR AMT I J H 'i } 1'=tl...I-.C.lir E1.) ':.r:7;`1,. 0Eip')L.. I)F I_- t Fit"1[;:i�k: I '�./ I `�{(:,i ,L I j•1�••;�_ H.2(.) 69 „ ("i;{irdl.... WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity was weighed, pp I i 1r9.. ADDt-{;;_(_) liltlilt 2 .5G.ii �I, measured, or counted by a weighmaster, whose signature is on this certificate, who is a recognized authority of accuracy, as prescribed by Chapter 7 N 67 0 (..!L.. 91 (commencing with Section 12700) of DMsion 5 of the California Business and (3 ,:, „ 3600 _ , 13 Professions Code, administered by the Division of Measurement Standards of the California Department of Food and Agriculture. 11 .� ..1r• I"-;t. i J,.2�1C) „(-)'„.,�i ROBERTSON'S WEIGHMASTER WATF-..F? F:F.l. UCE 204 o t_)I" I....(7) % i�a're_Y14��i'1 ills 1�f?'•i UOM CONVERSION CY=YARDS3 *'-POUNDS GL_=GALLONS FO=DUNCES CU=METERS3 KG --KILOGRAM L=LITERS ML=MILLILITERS C! CONCRETE DELIVERY TICKET j AGREED TO AND RECEIVED BY CUSTOMER r: 1 PO BOX 3600 CORONA, CA 92878-3600 TAX PREVIOUS BALANCE SUB TOTAL STAND BY CHARGE TOTAL THIS IS NOT A TICKET NO. ROBERTS�N'S . CONTROL = �"+ �j �y r Phone 800/834-7557 S to Die 800/870 1220t, NUMBER �� 6 i ! 10 � 7557 mca.co _ $1 RIVERSIDE-612020NSL #13 IRWINDALECOIN -13e31 LIVE OAK LANE OPEN 7 DAYS #2 MORFN,, VALLEY-142500H 215 Frontage R�tl #15 N--LOB pNGELE3 365 E. 26TH SL $2fi TMD�VDPALMSR072460 ARNER RD.AVE.� R35 61G BEAR lN(E - 4z025 GARSTIN DR. #45 BARSTOW -2700 E. MAIN ST. #3 REOLANDS-353 pLABAMAST. #16 ANAHEIM-201 E. COMMERCUU. ST' #27 MUflRIETA-26190 ADAMS AVE. #4 FOFI7ANA-13792 SLOVER AVE. ,,, #17 SAFITA ANA-310 N. TOWNSEND ST. #36 ESCONOIDO-131051MPSON WAV #46 CAL-CIlY-7900 MOSSA #5 POMONA-247o POMONA BLVD. #18 LAKE FOREST- 25931 TOWN CENTRE DR. 0TAC0.10N-215 CVPPESS LNO.. #37 INDIO-88110 FARGO CANYON RD. 1 47 Pogo', LONG BEACH-1602 W. PIER DST. $6 HEMEX1 1ACINTO-1675STATE SL #19 ppELANTO-12203 VIOLET RD. #30 CORONA-1540 SHERBORN ST. #37 INDIC CREST- 21671NYOKERN RO. #48 SHINING-1000 N.HATHAWAY #7 BEAUMONT-452 W.LUIS ESTRADA RD. #� SAN CLEMENTE-116 RINCON CT' #31 HESPERIA-9661 CAVE. $39 PALMDALE-3779075TH ST FAST p53 SAN JUAN CAPISTAPNO S3157`1 GIBBY ROAD #B SUN CITY-27050 WATSON RD. #21 IRVINE- 16081 CONSTRUCTION CIR WEST $9 ARROWHEAD- 29750 HWY 18 $32 CARROLL CANYON-10050 BlACKMOUNTAIN flD. Y42 VIL'TOIP_LLEE16952 N.DST #54 TELEBCCATION F!-250r0 MAITRI ROPD #10 SANTA FE SPRINGS-1311 GREENSTONE AVE. #22 N0. HOLLVWOOD -13132 SECRAN SWEET #43 BAKER _ r TOO ggKER BLVD. MULTIPLE LOCATIONS IN NEVAOA #11 CABAZON-13990APACHETflAIL #23 PARAMOUFIT-7277�.ROSECRANSAVE.� MUCRERNE-36555H18TEDR. TICKET NO; #24 RIALTO-2601N.ALDEflAVE MAP PAGE #12 SPNBERMARDIND-1955W.9TFIST SOLD TO, CUSTOMER NO: PLANT DATE ...tp: ...., , r . + ` 1,.' % C,Ur•:i`1.i; 9 , 1_!t'-9 n t,i ! ! �. ' : r ' CUSTOMER P.O. I JOB OR LOT # TX CD DELIVERY ADDRESS & INSTRUCTIONS 46 i.T ) "r=ALt'9 F.l, i1L. 4 E ri 1( 9l.91r, �� , , _ .. cwILIRF'f.�l r.9 _;rF; _ _ ,7.y - � ORDER NO •-MSELIUEMRfA�[E!AD(MtS�) Ti�Crrl!tT._jIME D,E...iIVrf, ITRUCKLC,N-O.1-:.:l9m 1r j. 'A 141"l II LOAD NOs= DRUM Yes MIN. CHECK - -rrsj REVS: Job site Cylinder Test: ❑ TIME ON JOB ITO JOB `J Water added on job at STAND BY MIN. CHECK ❑ AMOUFfr aY ON JOB Customers request: PER MIN. CASH ❑ , _ gals to Full Ld. RATE of x $ AMOUM I START POUR gals to 2/3 Ld. $ PLANT MGR SIG .._. I FINISH POUR RETURN CONC OVERTIME CHARGE gals to 1/3 Ld. t7, I., u t;) 4 min. per yd. unloading time allowed. ADJ. Meter ❑ ❑ l �. 1 Additional unloading time charged at current hourly truck rate. LEAVE JOB Y N Additional water added to this concrete will reduce its strength. Am/ water added exceeding the design water is at customer's own risk. ARRIVE PLANT YDS Signature Cerlttying Under panelty Ot parlory that the In}OrI11alI0D contained 10 this Wrlilan time record IS true and correct.TERMS AND CONDITIONS OF SALE EMPJ#-__�, SIGNATURE 11 location, and discharge/placement of material on the lobtsite' including n udin tth eneuex ( on the site.finconsideration of the above, Customer Customer agrees that the descrlbed material has been chosen solely by Customer without Robertson's direction, or review of any plans or specifications relating to the pro obey where the material a cl use Customer further agrees that it shall be solely responsible for the delivery d location. Customer s review and approval the descrlbed material shall be evidenced by Customer's signature and/or placement of the the or Inconsistent with plans and specifications, or with the r scribed Imatedalsconditions the event Robertson's. retains he service! improper of aria orney, releases and agrees to defend, indemnify and hold Robertson's and its employees and agents harmless from any and all losses, damages, liabilities, costs and claims asserted by Customer or any third pa arising from (I) material being inappropriate, incompatible, Improper gg movement of Robertson's vehicles upon or about the delivery location. Solely to the extent Customer falls to timely pa for the de _ Customer agrees er pay such reasonable attorneys fees Incurred io Robertson's in furtherance r such collection efforts. Robertson's and Customer disclaim attorneys fees arising from anyAMT other context. Customer agrees to pay a lime price differential e 1 h %per month on any amounts owed to Robertson's for more than thirty (30) days. Color at our plant Due to ejo U1NIT PR and/or inconsistency of in Robertson's Is not responsible for the results of any concrete where the coloring agent has MIen added at the request of X AND COMMODITY a customer, either at our plant r on the job site. LD QTY CUM QTY ORD QTY PROD CODE s 1 I .._. 7, I•. OGAL ;, % 2 r.GAL WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the followingdescribed commodity was weighed. T ,• 1 h1C9 l::>> i L9t,:E H (j 7 i ? !.?tn r,9.••. measured, or counted by a weighmaster, whose signature is on this certificate, who is a recognized authority of accuracy, as prescribed by Chapter _,C_+F`tL. (commencing with Section 12700) of Division 5 of the California Business and BA�NCE M ir} x i•A ()1) i'9.r:. t_) ^- dTe DivLsion of Measurement Standards of the '., Professions Code, administered by C^ • E 1-1 f, _ 9>,9 t' , 9 i (-' " t^r L_ .(�' California Department of Food and Agriculture. ROBERTSON'S SUB rt G61 :56 )i„7 a i„ri._i'� WEIGHMASTER TOTAL :A GG 1. 2 1.'1 0.0L.B - - STAND BY t) • m!.?FLOZ JC�ir'i:�-) T0rq `_7l11f' �% CHARGE -DUCEUOM CONVERSION CY=YARDS3 #=POUNOS GL=GALLONS FO=OUNCES CU=METERS3 KG=KILOGRAM L=LITERS ML=MILLILITERS TOTAL CONCRETE 3600 DELIVERORONA, CA Y TICKET —' .__, AGREED TO AND RECEIVED BY CUSTOMER THIS IS NOT A TICKET NO. CONTROL RTSO S �� NUMBER 7 C � 0 9 Phone 800/834-7557 San Diego 800/870-1220 SJ wvvw.rrmra.com #1 RIVERSIDE -6120201hST. #13 IRWINDALE - 13631 LIVE OAK LANE OPEN 7 DAYS 42 MORENO VALLEY- 14250 Old 215 Frontage Road #3 REILANDS-8353ALABAMAST. #14 PASADENA- 1420 N. UNCOLN AVE. #15 VERNON-LOS ANGELES-3365 E. 26TH ST #25 GARDENA-301 W. ROSI.CRAMS AVE. #4 FONTANA- 13792 SLOVER AVE. #16 ANAHEIM- 201 E COMMERCIAL ST. _ #28 THOUSAND PALMS -72460 VARNER RD. #5 POMONA- 2470 POMONA BLVD. #17 SANTAANA- 310 N. TOWNSEND ST.#27 MURRIETA-25190 ADAMS AVE. #6 HFMFT,SAN JACINTO-1675 STATE ST. #18 LAKE FOREST- 25931 TOWN CENTRE DR. #28 OTAY MESA -7961 AIRWAY RD. #7 BEAUMONT-452 W. LUISESIRPDARD. #19 ADELANTO-12203 VIOLET RD. #29 EL CAJON-215 CYPRESS LN. #8 SUN CITY -27050 WATSON RD. 020 SAN CLEMENTE-116 RINCON C. #30 CORONA- 1540 SHERBORN ST. - 49 ARROWHEAD - 29750HWY18 #21 IRVINE- 16C81 CONSTRUCTION CIR. WEST #31 HESPERIA-9661 CAVE. #10 SANTA HE SPRINGS- 12311 GREENSTONE AVE. #22 NO. HOLLYWOOD - 13132 RAYMER ST #32 CARROLL CANYON- 10050 BLACK MOUNTAIN RD. #11 CABAZON- 13990 APACHE TRAIL #23 PARAMOUNT- 7277E.ROSECRANSAVE. #33 MIRAMAR- 5692 EASTGATE DR. #12, SAN BERNARDINO-1955 W. 9THST. #24 RIALTO- 2801 N. ALDER AVE. #34 LUCERNE'-36555 HWY 18` PLANT DATE CUSTOMER NO: - SOLD TO! TX CD DELIVERY ADDRESS & INSTRUCTIONS L ME #35 BIG BEAR LAKE- 42025 GARSTIN DR. #45 BARSTOW-2700E. MAINST. 036 ESCONDIDO - 1310 SIMPSON WAY #46 CAL-CITY-7900 MOSS AVE. MOSS AVE #37 INDIO- 88110 FARGO CANYON RD. #47 PORT OF LONG W. PIER D ST. #38 RIDGECREST- 21571NYOKERN RD. 048 BANNING- 1000 N. HATHAWAY #39 PALMDALE- 3779075TH ST EAST #49 SIMI VALLEY- 400 W. LOS ANGELES AVE. #40 ARTESIA- 13949 E. STAGE ROAD #53 SAN JUAN CAPISTRANO - 31511 GIBBY ROAD #42 VICTO RVILLE - 16952 N. DST. #54 TEMESCAL VALLEY- 25050 MAITRI ROAD #43 BAKER- 56500 BAKER BLVD. MULTIPLE LOCATIONS IN NEVADA MAP PAGE TICKET NO. CUSTOMER P.O. / JOB OR LOT # (1t_PPORAT'r" t:;�.:i~-{"FF-E R _r`4 !:!(.�Ii'. r-hi<'-r:?L._r�Sl j..j. j.::)I:J f'hoif—1 ? r ORDER No ' METER READLNG TIME TYPED •'_, 6i`i TRUCK LIC NO. LOAD NO! SLUMP'..` .TRICK DRUM TO JOB _ '4-- REVS: 1 L.L. . r,...hi L::.1j ,._ Rl L. r i i.'{ J p Job -site Cylinder Test: ❑ Yes TIME ON JOB MIN. CHECK # J ON JOB C.>> G%i r `;t Water added on job at STAND BY MIN. CHECK ElCustomer's request: AMOUNT BY START POUR gals t0 FUII Ld. BATE OF X $ PER MIN. CASH ❑ AMOUNT BY FINISH POUR RETURN CONC gals to 2/3 Ld. $ PLANITMGRSIG gals to 1/3 Ld. , OVERTIME CHARGE LEAVE JOB `� MIN 4 min. per yd. unloading time allowed. Y N ADJ. Meter Additional Unloading time charged at current hourly truck rate. J jARRIVE PLANT YDS Additional water added to this concrete will reduce its strength. Any. water added exceeding the design water is at customer's own risk. Signature certifying under penalty of perjury that the information contained in this written time record is true and correct. r�,•f" ' "°" H 1, ,, ....t 111 EMPJ# - SIGNATURE - TERMS AND CONDITIONS OF SALE Customer agrees that the described material has been chosen gplely by CustomerySithout Robertson's direction, or review of any plans or specifications relatin to the pro'ect(s) where the material is to be used. — Customer further agrees that it shall be solely responsible for t e delivery location, and discharge/placement of material on the job site, Including the on -site erection of Robertson's vehicles to the designated location. Customer s review and approval the described material shall be evidenced by Customer's signature and/or placement of the described material on the job site. In consideration of the above, Customer releases and agrees to defend, indemnify and hold Robertson's and its employees and agents harmless from any and all losses, damages, liabilities, costs and claims asserted by Customer or any third party, arising from (i) material being inappropriate, incompatible, improper or inconsistent with plans and specifications, or with the ground soils or conditions on the land where the material is utilized, and (Ii) the movement of Robertson's vehicles upon or about the delivery location. Solelyy to the extent Customer fails to timely pa for the described materials, in the event Robertson's retains the services of an attorney, Customer agrees to pay such reasonable attorney's fees incurred by Rober[I on's in furtherance of such collection efforts. Robertson's and Customer disclaim attorney's fees arising from any other context. Customer agrees to pay a time price differential of 1 '/a % per month on any amounts owed to Robertson's for more than thirty (30) days. Color Disclaimer Due to irregularities and/or inconsistency of materials Robertson's is not responsible for the results of any concrete where the coloring agent has been added at the request of the customer, either at our plant or onthejob site. LID QTY CUM ,.1 QTY ORD QTY PROD CODE MIX AND COMMODITY UO_M UNIT PR AMT r..,I = (lr..} ,(`. n (.:(•) .... 3 ., L_._I _ t-' 1 . ,y J,ei! .. !'2(_' A1._I__c::UIc-:D (::L: AL- j — 70 , (")GALL. WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity was weighed, TAX measured, or counted by a weighmaster whose signature is on this certificate, l lf,-I i H.L S1 ii.i_'(_J t Li0 , who is a recognized authority of accuracy, as prescribed by Chapter 7 Section ._ 'I' .y �r r.., :.A4„J , r �l_. };.S (commencing with 12700) of Division 5 of the California Business and Professions Code, administered by the Division of Measurement Standards of the PREVIOUS BALANCE California Department of Food and Agriculture. ROBERTSON'S SUB T^ _ !iS]f'1 1_:; '(_if_j i.. i....L WEIGHMASTER TOTAL WIC) j I i. r f -1 ;:a STAND BY _ER REDUC CHARGE ERSION CY=YARDS3 #--POUNDS GL=GALLONS FO=OUNCES CU=METERS3 KG=KILOGRAM L=LITERS ML=MILLILITERS CONCRETE DELIVERY TICKET TOTAL 7EED TO AND RECEIVED BY CUSTOMER PO BOX 3600 CORONA, CA 92878-3600 Golden Construction Inc Project: 413996 WelbeHealth La Quinta Ph. 1-3 7271 Mars Drive 46-805 Dune Palms Road GOLDEN Huntington Beach, California 92647 La Quinta, California 92253 CONSTRUCTION, INC. P: 714-847-8080 J We OuifdLife" F: 714-847-8815 RFI #19: HSS Column Reinforcement Confirmation Status Open To David Kim (Kinyon + Kim Architects, Inc.) From Ryan Tombrello (Golden Construction, Inc) Date Initiated Jul 25, 2022 Due Date Jul 28, 2022 Location Project Stage Course of Construction Cost Impact No Schedule Impact No Spec Section Cost Code Drawing Number S2.1 & S2.4 Reference Linked Drawings Received From Ryan Tombrello (Golden Construction, Inc) Copies To Jason Coleman (Golden Construction, Inc), Allison Mercado (Golden Construction, Inc), Ian Storlie (Market Street Development), Bruce Tiffany (Golden Construction, Inc) Activity Question Question from Ryan Tombrello Golden Construction,lnc on Monday, Jul 25, 2022 at 09:17 AM PDT Sheet S2.1 directs the team to detail 11 on sheet S4.2 for reinforcement of the existing HSS columns however upon demolition it was discovered these columns have existing reinforcement. The existing 5"x5" HSS column has 2"x5" HSS welded on (2) sides, the welds are 4" stitch welds occurring at 18" OC, this additional steel runs the full length of the column. Please confirm the additional reinforcements called out by detail 11 on sheet S4.2 will NOT be required due to the existence of the 2°x5° steel already in place. See attached for reference. Attachments rfi 19.pdf Awaiting an Official Response Confirmed, no additional reinforcement at the column on grid line 4.2 & D.6. This was reflected on the structural steel submittal markups. I I i DET. 1 FA176 1-3-1i2XVt2X% I i I i (E) HSSSXS Angles not required -----------, - �a 1------------ at existing HSS — —-------- �!-tii----------— —4— I i I I I A16 1-3-1i2XVt2X1/4 j I i I I —------- --- — J------------------------------ Golden Construction Inc Page 1 of 1 Printed On: Jul 25, 2022 01:00 PM PDT goodnight structural engineering October 5, 2022 Ian Storlie MARKDEV-WH La Quinta, LLC 5390 Granite Lake Drive, Ste. 110 Granite Bay, CA 9574 Subject: WelbeHealth La Quinta Building Shell Remodel 46805 Dune Palms Road, La Quinta, CA GSE Project No. 1922-105 RE: Site Observations Dear Ian, Site Observations Project No. 1922-105 I visited the site the afternoon of October 4, 2022 and met with Ryan Tombrello, & Bruce Tiffany (GCDI), and David Kim (K2A) to observe the current construction. Also present were representatives from the framing subcontractor to discuss alternate framing details. The Contractor is currently constructing the new structural framing and modifying the existing framing. Observations and Comments: 1. The elevator guide rail post were missing some of the bracing framing from details 11/S4.1 at the floor and 1/S4.3 at the roof level. The north/south framing was missing at the roof and floor levels. Please see the repair detail 1/AS15 for the replacement blocking at the guiderail post conditions. COMPLETED PER PLANS 2. There is some missing column non shrink grout below the base plate at an interior column that needs to be installed. COMPLETE BG 3. The shear wall along line 4 has had some missing floor to floor holdown straps per detail 14/S1.3. COMPLETE BG 4. The south stairs has a continuous 4x12 intermediate landing beam in lieu of the two individual 4x12 intermediate landing beams shown on S2.2. Please see the repair detail for the as -built condition in 1/AS14. COMPLETE BG No destructive testing was incorporated during the site visits, and these observations are not to be interpreted as inspections. These observations do not assure that the construction is in complete conformance with the construction documents. We do not guarantee the performance of the contractor and shall not be responsible for the original contractor's failure Page 1 of 2 9628 Conda Way, Elk Grove, CA 95624 brian@goodnightse.com Phone (916) 2124021 goodnight ' structural engineering Site Observations Project No. 1922-105 to perform its work in accordance with the contract documents or any applicable laws, codes, rules, or regulations. Please feel free to call should you have any questions. Sincerely, GOODNIGHT STRUCTURAL ENGINEERIN By: O of ESS BOSS �. 1IL- cCO � No. S4429 �+ Brian Goodnight, SE * Exp. 12/31/22 President NA srRi/rTk P- CC: David Kim, K2A �r lu-s- - Z� Page 2 of 2 9628 Conda Way, Elk Grove, CA 95624 brian@goodnightse.com Phone (916) 2124021 COMMERCIAL - 48605 DUNE PALMS eii LTE C� 89% M O AA Q A 14 AM Thu Jul 28 l AND ; Ab 4 MIC9+mm•71 / �mmrl ,�®.wwxm. j I II _ _ ____ slty—_ I I • II I 21Imsl.s II m,l rl eY — _ _—e»Ixrl I ILr li_mvwgrsl — — a — mm.lra � �Imltlb IHlm lsl�� I � I ff + — t �_ Ilnrt mlalro W .m ronrlrop Ixmmm. w imn arm 2GP41R M1e. 7 I _ Mlxss I !Iro releawr+YJ ro m r I I I .x»»lel I I I I��robMiro I I W I I I I .n�s• ! I I — F I I I I!'// �H�Cp.J AS! 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