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BCOM2022-0025BUILDING PERMIT DESIGN & DEVELOPMENT DEPARTMENT 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type: Building Commercial Permit Number: BCOM2022-0025 Property Address: 46805 DUNE PALMS RD APN: 600390023 Legal Description Property Zoning: Valuation: $350,000.00 PHONE (760) 777-7125 WWW.LAQUINTACA.GOV APPLIED DATE: 05/04/2022 ISSUED DATE: 09/19/2022 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: 3/2/26 12:03 pm Page 1 of 8 BUILDING PERMIT Permit Type: Building Commercial Permit Number: BCOM2022-0025 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: 3/2/26 12:03 pm Page 2 of 8 BUILDING PERMIT Permit Type: Building Commercial Permit Number: BCOM2022-0025 Property Address: 46805 DUNE PALMS RD WELBEHEALTH / 17,979SF OFFICE TI/VB/B+14-OCC/354-OL/SPRINK *"* 17,979SF SENIOR DAY CARE CENTER TI/VB/B+14 OCC/354-OL/SPRINKLED [WELBEHEALTH] THIS PERMIT DOES NOT INCLUDE BUILDING SIGNAGE OR EXTERIOR SITE IMPROVEMENTS. PATH OF TRAVEL IMPROVEMENTS ON SEPARATELY PERMITTED PRECISE GRADING PLAN. NO TUMF/MSHCP/DIF IMPACTS FOR CHANGE FROM RETAIL TO OFFICE. 2019 CALIFORNIA BUILDING CODES. ,instruction Det;:. Commercial Work Type Remodel Building/Unit B: Office, Professional, 1-4: Gross Square Footage 17979 Occupancy Adult and Child Day Care Classification(s) Conditioned Square 17979 Fire Sprinkler Square 17979 Number of Floors 2 Footage Footage Occupant Load 354 Construction Type V-B Code Edition 2019 Remodel Area Square 17979 New Electrical Square 17979 Number of 7 Footage Footage Condenser(s) Number of Air 18 Number of Ventilation 6 Number of Plumbing 74 Handling Unit(s) Fan(s) Fixtures/Traps Number of Roof Drains 1 Number of Water 2 Water System Install Yes Heater(s) or Alteration? Back Flow Prevention Yes Number of Gas 5 Transportation Uniform No Device? Outlet(s) Mitigation Fee Applicable City Development No Art in Public Places No Impact Fee Applicable Fund Exempt Type Group Sq Ft Value Printed: 3/2/26 12:03 pm Page 3 of 8 BUILDING PERMIT Permit Type: Building Commercial Permit Number: BCOM2022-0025 Property Address: 46805 DUNE PALMS RD Invoice No. Fee Fee Amount Amount Paid NOT INVOICED Credit Card Convenience Fee $218.20 $0.00 Total for Invoice NOT INVOICED $218.20 $0.00 PERMIT-BCOM2022-00: WATER HEATER/VENT $27.78 $27.78 5 GAS SYSTEM, 5+ OUTLETS PC $27.78 $27.78 VENT FAN $83.34 $83.34 NON-RESIDENTIAL, EA ADDITIONAL 2,000SF PC $88.96 $88.96 REMODEL, FIRST 100SF PC $155.06 $155.06 REMODEL, EA ADDITIONAL 500SF PC $720.36 $720.36 FIXTURE/TRAP PC $1,027.86 $1,027.86 RE -INSPECTION FEE $87.53 $87.53 GAS SYSTEM, 5+ OUTLETS $41.68 $41.68 WATER SYSTEM INST/ALT/REP $13.89 $13.89 ART IN PUBLIC PLACES - COMMERCIAL REMOD $1,250.00 $1,250.00 NON-RESIDENTIAL, EA ADDITIONAL 2,000SF $333.44 $333.44 TECHNOLOGY ENHANCEMENT FEE $5.00 $5.00 PARTIAL INSPECTION FEE $87.53 $87.53 BACKFLOW DEVICE $13.89 $13.89 VENT FAN PC $33.36 $33.36 WATER SYSTEM INST/ALT/REP PC $13.89 $13.89 FIRE COMMERCIAL TI PC $250.00 $250.00 RE -INSPECTION FEE $87.53 $87.53 NON-RESIDENTIAL, FIRST 2,000SF $125.05 $125.05 ALTERATIONS/ADDITIONS - NON-RESIDENTIAL $161.00 $161.00 WATER HEATER/VENT PC $16.68 $16.68 CONDENSER/COMPRESSOR PC $194.53 $194.53 PARTIAL INSPECTION FEE $87.53 $87.53 SMI - COMMERCIAL $98.00 $98.00 CONDENSER/COMPRESSOR $291.76 $291.76 RE -INSPECTION FEE $87.53 $87.53 REMODEL, FIRST 100SF $56.69 $56.69 AIR HANDLER PC $250.02 $250.02 ROOF DRAIN PC $13.89 $13.89 ROOF DRAIN $13.89 $13.89 RECORDS MANAGEMENT FEE - MAJOR $21.00 $21.00 AIR HANDLER $750.24 $750.24 FIRE COMMERCIAL TI $167.00 $167.00 BACKFLOW DEVICE PC $5.56 $5.56 BSAS SB1473 FEE $14.00 $14.00 FIXTURE/TRAP $1,027.86 $1,027.86 NON-RESIDENTIAL, FIRST 2,000SF PC $96.70 $96.70 REMODEL, EA ADDITIONAL 500SF $900.36 $900.36 Total for Invoice PERMIT-BCOM2022-0025 $8,728.17 $8,728.17 Grand Total for Permit $8,946.37 $8,728.17 Workflow / Inspections Printed: 3/2/26 12:03 pm Page 4 of 8 BUILDING PERMIT Permit Type: Building Commercial Permit Number: BCOM2022-0025 Property Address: 46805 DUNE PALMS RD Workflow Step / Action Name Action Type Start Date End Date Inspections v.1 05/04/2022 0:00 --------------------------------------------------------------------------------------- FINAL** v.4 Inspection 08/21/2023 15:51 ------------------- ------------------------------------------------------------------------------------------ FRAMING v.8 Inspection ----------------------------- --------------------------------------------------------------------------------------- FINAL** v.3 Inspection ------------------------------------- ----------------------------------- FINAL** v.2 Inspection -------------------------------------------------------------------------------- FINAL** v.1 Inspection -------------------------------------------------------------------------------- PLANNING FINAL v.1 Inspection --------------------------------------------------------------------------------------------------------------------------------------- FINAL FOR OCCUPANCY v.1 Inspection -------------------------------------------------------------------------------- T-BAR/OVERHEAD v.9 Inspection ---------------------------------------------------- ROUGH ELEC v.10 ---------------------------- Inspection ------------------------------------------------------ T-BAR/OVERHEAD v.8 -------------------------------------------------------------------------------- - Inspection ------------------------------------------------------------------------------------ ROUGH MECH v.5 ---------------------------------------------------- Inspection ------------------------------------------------------------------------------------ ROUGH PLBG v.8 ---------------------------------------------------- Inspection ------------------------------------------------------------------------------------ DRYWALL NAIL v.13 ---------------------------------------------------- Inspection ---------------------------------------------------------------------------------------------------------------------------------------- T-BAR/OVERHEAD v.7 Inspection ------------------------------------------------------------------------------------ T-BAR/OVERHEAD v.6 ---------------------------------------------------- Inspection ------------------------------------------------------------------------------------ T-BAR/OVERHEAD v.5 ---------------------------------------------------- Inspection ------------------------------------------------------------------------------------ T-BAR/OVERHEAD v.4 ---------------------------------------------------- Inspection ------ -- -- ------------------------------------------------------------- ROUGH-WIRE INSPECTION v.1 -- -------------------------------------------------------- Inspection ---------------------------------------------------- OVERHEAD ROUGH PIPING v.1 ----------------------------------------------------------------------------------- Inspection ---------------------------------------------------- DRYWALL NAIL v.12 ----------------------------------------------------------------------------------- Inspection ---------------------------------------------------- T-BAR/OVERHEAD v.3 ----------------------------------------------------------------------------------- Inspection ---------------------------------------------------- ROUGH PLBG v.7 ----------------------------------------------------------------------------------- Inspection ---------------------------------------------------- INSULATION v.3 ----------------------------------------------------------------------------------- Inspection ---------------------------------------------------- ROUGH MECH v.4 ---------------------------- Inspection ---------------------------------------------------- FRAMING v.7 ---------------------------- Inspection ---------------------------------------------------- ROUGH ELEC v.9 ---------------------------- Inspection ---------------------------------------------------- UNDERGROUND ELEC v.2 ---------------------------- Inspection ---------------------------------------------------- DRYWALL NAIL v.11 --------------------------- Inspection ---------------------------------------------------- ROUGH MECH v.3 ----------------------------------------------------------------------------------- Inspection ---------------------------------------------------- FRAMING v.6 ---------------------------- Inspection ---------------------------------------------------- ROUGH ELEC v.8 ---------------------------- Inspection ---------------------------------------------------- LATH v.1 ---------------------------- Inspection --------------------------------------------------------------------------- DRYWALL NAIL v.10 -- -------------------------------------------------------- Inspection --------------------------------------------------------------------------- ROUGH ELEC v.7 ----------------------------------------------------------- - Inspection ------------------------------------------------------------------------------------ ROUGH PLBG v.6 ---------------------------------------------------- Inspection ------------------------------------------------------------------------------------ ROUGH MECH v.2 --------------------------------------------- --- --- Inspection ------------------------------------------------------------------------------------ FRAMING v.5 --------------------------------------------- --- --- Inspection ------------------------------------------------------------------------------------ ROUGH ELEC v.6 --------------------------------------------- --- --- Inspection ------------------------------------------------------------------------------------ ROUGH PLBG v.5 --------------------------------------------- --- --- Inspection ------------------------------------------------------------------------------------ DRYWALL NAIL v.9 --------------------------------------------- --- --- Inspection ------------------------------------------------------------------------------------ DRYWALL NAIL v.8 WLL --------------------------------------------- --- --- Inspection ------------------------------------------------------------------------------ ROUGH ELEC v.5 ---------------------------------------------------------- Inspection Printed: 3/2/26 12:03 pm Page 5 of 8 BUILDING PERMIT Permit Type: Building Commercial Permit Number: BCOM2022-0025 Property Address: 46805 DUNE PALMS RD DRYWALL NAIL v.7 Inspection ----------------- ROUGH PLBG v.4 ---------- Inspection ----------------- DRYWALL NAIL v.6 - ------- Inspection ------------------------------------------------------------------------------------ DRYWALL NAIL v.5 ---------------------------------------------------- Inspection ------------------------------------------------------------------------------------ GAS LINE/TEST v.1 ---------------------------------------------------- Inspection ------------------------------------------------------------------------------------ DRYWALL NAIL v.4 ---------------------------------------------------- Inspection ------------------------------------------------------------------------------------ ROUGH PLBG v.3 ---------------------------------------------------- Inspection ------------------------------------------------------------------------------------ INSULATION v.2 ---------------------------------------------------- Inspection ------------------------------------------------------------------------------------ DRYWALL NAIL v.3 ---------------------------------------------------- Inspection ------------------------------------------------------------------------------------ DRYWALL NAIL v.2 ---------------------------------------------------- Inspection ------------------------------------------------------------------------------------ FRAMING v.4 ---------------------------------------------------- Inspection --------------------------------------------------------------------------------------------------------------------------------------- ROUGH ELEC v.4 Inspection ----------------------------------------------------- FRAMING v.3 ---------------------------------------------------------------------------------- Inspection ----------------------------------------------------- ROUGH PLBG v.2 ---------------------------------------------------------------------------------- Inspection ----------------------------------------------------- DRYWALL NAIL v.1 ---------------------------------------------------------------------------------- Inspection ----------------------------------------------------- ROUGH ELEC v.2 ---------------------------------------------------------------------------------- Inspection ----------------------------------------------------- FRAMING v.2 ---------------------------------------------------------------------------------- Inspection ----------------------------------------------------- ROUGH ELEC v.3 --------------------------- Inspection ----------------------------------------------------- FRAMING v.1 --------------------------- Inspection ----------------------------------------------------- ROUGH PLBG v.1 --------------------------- Inspection ----------------------------------------------------- ROUGH ELEC v.1 --------------------------- Inspection ----------------------------------------------------- ROUGH MECH v.1 --------------------------- Inspection ----------------------------------------------------- ROOF NAIL v.1 --------------------------- Inspection ----------------------------------------------------- WATER LINE v.1 --------------------------- Inspection ----------------------------------------------------- SLAB v.2 --------------------------- Inspection ----------------------------------------------------- INSULATION v.1 ---------------------------------------------------------------------------------- Inspection ----------------------------------------------------- UNDERGROUND PLBG v.2 --------------------------- Inspection ------------------------------------------------------ SLAB v.1 -------------------------------------------------------------------------------- - Inspection ---------------------------------------------------------------------------------------------------------------------------------------- UNDERGROUND ELEC v.1 Inspection ------------------------------------------------------------------------------------ T-BAR/OVERHEAD v.2 --------------------------------------------- --- --- Inspection ------------------------------------------------------------------------------------ UNDERGROUND PLBG v.1 --------------------------------------------- --- --- Inspection ------------------------------------------------------------------------------------ TEMPORARY POWER v.1 --------------------------------------------- --- --- Inspection ---------------------------------------------------------------------------------------------------------------------------------------- T-BAR/OVERHEAD 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 .1, and Email Building Permit v.1 -------------------------------------------------------------- Create Report Printed: 3/2/26 12:03 pm Page 6 of 8 BUILDING PERMIT Permit Type: Building Commercial Permit Number: BCOM2022-0025 Property Address: 46805 DUNE PALMS RD 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 Inspections - Cover No Work Until Approved v.1 ---------------------------------------------------------------------------------------------------------------------------------------- Roof Nail v.1 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- Okay to Wrap v.1 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- Rough Fire Clearance v 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 15:51 09/06/2023 8:11 ---------------------------------------------------------------------------------------------------------------------------------------- Final Fire v.1 Inspection 09/06/2023 8:10 09/06/2023 8:11 - --------------------------------------------------------------------------------------------------------------------------------------- Final Building v.1 Inspection 08/21/2023 15:51 08/21/2023 15:51 Certificate of Occupancy v ---------------------------------------------------------------------------------------------------------------------------------------- Issue Certificate of Occup, 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. Printed: 3/2/26 12:03 pm Page 7 of 8 BUILDING PERMIT Permit Type: Building Commercial Permit Number: BCOM2022-0025 Property Address: 46805 DUNE PALMS RD 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. 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 buildina official. Printed: 3/2/26 12:03 pm Page 8 of 8 CAL FIRE - RIVERSIDE UNIT RIVERSIDE COUNTY FIRE DEPARTMENT �Cv BILL WEISER - FIRE CHIEF OFFICE OF THE FIRE MARSHAL — LA QUINTA CALIFORNIA 78495 Calle Tampico, La Quinta, CA 92253 • Phone (760) 777-7074 • www.rvcfire.org October 18, 2022 MJY Group Inc. 392 N LeMay Court Orange, CA 92867 Re: Tenant Improvement Construction - Fire Plan Review — WELBEHEALTH BCOM2022-0025 / 46805 DUNE PALMS ROAD, LA QUINTA, CA 92253 The building plans you submitted for the above referenced project have been reviewed by Riverside County Fire Department - Office of the Fire Marshal personnel and are approved with the following conditions. Fire Department approval is based upon the 2019 CBC requirements for I-4 & B occupancies. It is prohibited to use, process or store any materials in the occupancy that would classify it as a Group H occupancy, without further review and approval. DEFERRED SUBMITTALS REQUIRED 1) FIRE SPRINKLER SYSTEM - New System or Tenant Improvement plans must be submitted and reference the installing contractor performing the work. Permit fees will be required. 2) FIRE ALARM/MONITORING SYSTEM - Install a AUTOMATIC fire alarm system as per NFPA 72, along with automatic smoke detection — as required by the California Building Code, California Fire Code and designed in accordance with adopted standards. A C-10 licensed contractor must submit plans to the Fire Department office for review and approval prior to installation. Permit fees will be required. PRIOR TO FINAL 1) Approved building address shall be placed in such a position as to be plainly visible and legible from the street and rear access if applicable. Building address numbers shall be a minimum of 12". All addressing must be legible and of a contrasting color with the background to be visible from the street at all hours. 2) Install Knox Key Lock box, mounted not higher than 6-feet above grade. Provide keys to the tenant space (all tenants), utility rooms and elevator services for inclusion in the main building Knox Box. Key(s) shall have durable and legible tags affixed for identification of the correlating tenant space. 3) Submit flame-retardant certification(s) by applicator or manufacturer, along with CSFM Listing, for all decorative materials used in this facility. Samples of flame-retardant material(s) may be required for flame spread testing. All required treated materials must have a current CSFM approval tag affixed to each item or panel. (Prior to building final inspection) — CFC 807.2 4) Install portable fire extinguishers per Title 19, but not less than 2AIOBC in rating. Contact a certified extinguisher company for proper placement and spacing of equipment. 5) Applicable room door(s) shall be posted "ELECTRICAL", "FACP", "FIRE RISER" and "ROOF ACCESS" on the outside of the door so it is visible and in a contrasting color. 6) Room occupancy load, as approved by the Building Official, shall be posted in a conspicuous place near the main exit from the room(s). The location shall be approved by the Fire Department office. Posting shall be by means of an approved durable sign having a contrasting color from the background to which it is attached. The owner shall maintain signs in a legible manner. No person shall deface, remove or change the occupant load on the sign except as authorized by the Building Official and/or Fire Department office. (Prior to building final inspection) 7) Illuminated Exit Signage and Egress Illumination placement and functional test will be witnessed by OFM Fire Inspector at time of final inspection. 8) Fire rated assemblies shall be maintained in compliance with applicable codes and industry standards. The Fire Department approved plans and conditions letter must be at the job site. Applicant/installer shall be responsible to contact the Fire Department to schedule inspections. Requests for inspections are to be made at least 48 hours in advance and may be arranged by calling (760)777-7131. All questions regarding the meaning of these conditions should be referred to the Office of the Fire Marshal staff at (760)777-7074. Kohl Hetrick - Fire Safety Specialist FIRE ALARM SYSTEM RECORD OF COMPLETION To be completed by the system installation contractor at the time of system acceptance and approval. 1. Protected Property Information Name of property: MSD Welbehealth La Quinta Pace Center Address: 46805 Dune Palms Road Description of property: Healthcare Facility Occupancy type: 1-4/13 Name of property representative: Hondo Shaver Address: 46805 Dune Palms Road Phone: 703.283.8327 Fax: Authority having jurisdiction over this property: Riverside County Fire Phone: Fax: Permit# 23-0001 La Quinta, Ca.92253 La Quinta, Ca.92253 E-mail: hondo.shaver@welbehealth.com E-mail: 2. Fire Alarm System Installation, Service, and Testing Information Installation contractor for this equipment: TRL Systems Address: 9531 MILLIKEN AVENUE Phone: 800-266-1392 Fax: E-mail: www.trlsystems.com Service organization for this equipment: TRL SYSTEMS Address: 9531 MILLIKEN AVENUE Phone: 800-266-1392 Fax: E-mail: www.trlsystems.com Location of as -built drawings: TRL SYSTEMS Location of Historical Test Reports: TRL SYSTEMS OFFICE Location of system operation and maintenance manuals: FACILITY MAINT. DEPARTMENT A contract for test and inspection in accordance with NFPA standards is in effect as of N/A Contracted testing company: TRL SYSTEMS INC. Address: 9531 Milliken Avenue Phone: 909 390 8392 Fax: 909-390-8397 E-mail: Contract expires: n/a Contract number: Frequency of routine inspections: 3. Type of Fire Alarm System or Service NFPA 721, Chapter Reference of System Type: CHAPTER 3 Name of organization receiving alarm signals with phone numbers (if applicable): Alarm: Rapid Response Monitoring Phone: 18002661392 Supervisory: Rapid Response Monitoring Phone: 18002661392 Trouble: Rapid Response Monitoring Phone: 18002661392 Entity to which alarms are retransmitted: Phone: Method of retransmission of alarms to that organization or location: DACT NFPA 72, Fig. 4.5.2.1 (p. 1 of 6) Copyright © 2009 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution. If Chapter 8, note the means of transmission from the protected premises to the central station: ® Digital alarm communicator ❑ McCulloh ❑ Multiplex ❑ 2-way radio ❑ 1-way radio ❑ N/A If Chapter 9, note the type of connection: ❑ Local energy ❑ Shunt ❑ N/A 3.1 System Software Operating system (executive) software revision level: Edward 1/0 1000 Site -specific software revision date: 7-26-23 Revision completed by: TRL SYSTEMS 4. Signaling Line Circuits Characteristics of signaling line circuits connected to this system (see NFPA 72 ®, Table 6.6.1): Quantity: 3 Style: W Class: B 5. Alarm -Initiating Devices and Circuits Characteristics of initiating device circuits connected to this system (see NFPA 72®, Table 6.5): Quantity: 1 Style: 4 Class: B 5.1 Manual Initiating Devices 5.1.1 Manual Pull Stations Number of manual pull stations: 7 Type of devices: ® Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A 5.2 Automatic Initiating Devices 5.2.1 Area Smoke Detectors Number of smoke detectors: 6 Type of coverage: ❑ Complete area ® Partial area ❑ Nonrequired partial area ❑ N/A Type of devices: ® Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A Type of smoke detector sensing technology: ❑ Ionization ® Photoelectric 5.2.2 Duct Smoke Detectors Number of duct smoke detectors: 6 Type of coverage: Partial Smoke coverage Type of devices: ® Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A Type of smoke detector sensing technology: ❑ Ionization ® Photoelectric 5.2.3 Heat Detectors Number of heat detectors: 2 Type of coverage: ❑ Complete area ® Partial area ❑ Nonrequired partial area ❑ N/A Type of devices: ® Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A 5.2.4 Sprinkler Waterflow Detectors Number of waterflow detectors: 1 Type of devices: ® Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A 5.2.5 Alarm Verification Number of devices subject to alarm verification: N/A Alarm verification on this system is: ❑ Enabled ❑ Disabled ❑ Set for seconds 6. Supervisory Signal -Initiating Devices and Circuits 6.1 Sprinkler System Number of valve supervisory switches: 2 Type of devices: ® Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A NFPA 72, Fig. 4.5.2.1 (p. 2 of 6) Copyright © 2009 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution. 6.2 Fire Pump Type of fire pump: ❑ Electric ❑ Diesel Type of fire pump supervisory devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter ® N/A Fire Pump Functions Supervised ❑ Fire pump power ❑ Fire pump running ❑ Fire pump phase reversal ❑ Selector switch not in auto ❑ Engine or control panel trouble ❑ Low fuel Other: None 6.3 Engine -Driven Generator Type of generator supervisory devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter ® N/A ❑ Engine or control panel trouble ❑ Generator running ❑ Selector switch not in auto ❑ Low fuel Other: None 7. Annunciators 7.1 Annunciator 1 ® Local ❑ Remote Type: o Addressable [:]Directory ❑ Graphic ❑ N/A Location: Main Entrance 7.2 Annunciator 2 ❑ Local ❑ Remote Type: ❑ Addressable ❑ Directory ❑ Graphic ❑ N/A Location: 7.3 Annunciator 3 ❑ Local ❑ Remote Type: ❑ Addressable ❑ Directory ❑ Graphic ❑ N/A Location: 8. Alarm Notification Devices and Circuits 8.1 Emergency Voice Alarm Service Number of single voice alarm channels: N/A Number of multiple voice alarm channels: Number of speakers: Number of speaker zones: 8.2 Telephone Jacks Number of telephone jacks installed: N/A Number of telephone handsets stored on site: Type of telephone system installed: ❑ Electrically powered ❑ Sound powered ❑ N/A 8.3 Nonvoice Audible System Characteristics of notification device circuits connected to this system (see NFPA 72' , Table 6.5): Quantity: 3 Style: W Class: B NFPA 72, Fig. 4.5.2.1 (p. 3 of 6) Copyright © 2009 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution. 8.4 Types and Quantities of Nonvoice Notification Appliances Installed Bells: With visual device: Chimes: With visual device: Visual devices without audible devices: 36 Horns: 20 With visual device: 20 Bells: With visual device: Other (describe): 9. Emergency Control Functions Activated ❑ Hold -open door releasing devices ❑ Smoke management or smoke control ❑ Door unlocking ® Elevator recall ❑ Other 10. System Power Supply 10.1 Primary Power Nominal voltage: 120V Overcurrent protection: Type: cir#7 breaker Location (of primary supply panelboard): FACP Disconnecting means location: 10.2 Secondary Power Location: Existing Type: Stand by Number of standby batteries: 2 Location of emergency generator: N/A Location of fuel storage: N/A Calculated capacity of secondary power to drive the system In standby mode: 24hrs. Amps: 20 AMP Amps: 20 AMP Nominal voltage: 24v Current rating: 18.0 AH Amp hour rating: 18.0 AH In alarm mode: 5 minutes NFPA 72, Fig. 4.5.2.1 (p. 4 of 6) Copyright © 2009 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution. 11. Record of System Installation Fill out after all installation is complete and wiring has been checked for opens, shorts, ground faults, and improper branching, but before conducting operational acceptance tests. The system has been installed in accordance with the following NFPA standards: (Note any or all that apply.) ® NFPA 720 ® NFPA 70®, Article 760 ® Manufacturer's published instructions ❑ Other (please specify): System deviations from referenced NFPA standards: N/A Signed: J Printed name: Frank Arellano Date: 7-26-23 Organization: TRL Systems Title: Project Manager Phone: 800-266-1392 12. Record of System Operation All operational features and functions of this system were tested by or in the presence of the signer shown below, on the date shown below, and were found to be operating properly in accordance with the requirements of: ® NFPA 72® ® NFPA 70®, Article 760 ® Manufacturer's published instructions ❑ Other (please specify): ❑ Documentation in accordance with Inspection and Testing Form (Figure 10.6.2.3 of NFPA 720) is attached Signed: JinalPrinted name: Frank Arellano Date: 7-26-23 Organization: TRL Systems Title: Project Manager Phone: 800-266-1392 13. Certifications and Approvals 13.1 System Installation Contractor This system as specified herein has been installed and tested according to all NFPA standards cited herein. Signed: Printed name: Frank Arellano Date: 7-26-23 Organization: TRL Systems v Title: Project Manager Phone: 800-266-1392 13.2 System Service Contractor This system as specified herein has been installed and tested according to all NFPA standards cited herein. Signed: Printed name: Frank Arellano Date: 7-26-23 Organization: TRL Systems Title: Project Manager Phone: 800-266-1392 13.3 Central Station This system as specified herein will be monitored according to all NFPA standards cited herein. Signed: Printed name: Date: Organization: Title: Phone: 13.4 Property Representative I accept this system as having been installed and tested to its specifications and all NFPA standards cited herein. Signed: Printed name: Date: Organization: Title: Phone: 13.5 Authority Having Jurisdiction NFPA 72, Fig. 4.5.2.1 (p. 5 of 6) Copyright © 2009 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution. I have witnessed a satisfactory acceptance test of this system and fmd it to be installed and operating properly in accordance with its approved plans and specifications, its approved sequence of operations, and with all NFPA standards cited herein. Signed: Printed name: Date: Organization: Title: Phone: NFPA 72, Fig. 4.5.2.1 (p. 6 of 6) Copyright © 2009 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution. /A;�4k AMERICAN ENGINEERING LABORATORIES INC. GEOTECHNICAL MATERIALS TESTING & INSPECTION 205 West La Habra Boulevard, La Habra, California 90631 STANDARD USED: ❑ DSA Standards Project Name (per plans): Project Address (legal): Architect: INSPECTION REPORT ,A❑ ASTM Standards ❑ CBC Standards Vuel e 6CAkl to La Habra (562) 697-4000 Fax (562) 697-4009 Apple Valley (760) 961-9141 Vernon (888) 287-0875 Mailing Address P.O. Box 1816 Whittier. California 90609 Inspection Date: ❑ Other Standards: Specify Project #: DSA File No.: Application No.: Engineer: �/(�� 4S 4dr V�ifxV V— Building Permit No.: , (v m UJLZ W!�(O General Contractor: C C�8 &f INSPECTION MAT'L SAMPLING QTY MATERIAL DESCRIPTION INSPECTION CHECKLIST ❑ concrete ❑ Concrete Cylinders ❑ Reinf: Reber ❑ Plan & Specs ❑ Masonry ❑ Mortar Samples ❑ Reinf: W.W.F ❑ Clearance ❑ Structural Steel ❑ Grout Samples ❑ Reinf: Tendon ❑ Positions ❑ Welding ❑ Masonry Prisms ❑ Cone: 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 Belching ❑ 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: \,verc 6Nr \lek Wind &avte \A4v\ /S�YevIA. �)Glf a�.�,ek-V,7 IJoy�) iti )'r\1Ae& tt 2�2 1( Uwfav� Time In OV Time Out 151�� I Equipment Used: 1 Location of [ `�\-Sly rtification of Compliance: I declare, under penalty of perjury, that have read the above report and know the contenrs mereor, mar an or me awvc Ceerformed and the materials used and installed, in every material respect. statements are true, that I know of my own knowledge that the work has been p ❑ In compliance with the DSA approved plans therefore. ❑ Not in compliance with the DSA approved plans therefore. PROJECT IOR OR INSPECTOR NAME I S PERINTENDENT SIGNATURE INSPECTOR SIGNATURE CERT. # zG`/ DATE INOTE: Inspections based on 4-hour minimum, 8-hour mini m after four (4) hours, 2-hour minimum for all cancellations. ._ i 4" AMERICAN ENGINEERING LABORATORIES INC. GEOTECHNICAL MATERIALS TESTING & INSPECTION 205 West La Habra Boulevard, La Habra, California 90631 STANDARD USED: ❑ DSA Standards Project Name (per plans): Project Address (legal): Architect: Engineer: General Contractor: INSPECTION REPORT ❑ ASTM Standards ❑ CBC Standards \dAe, �et^t' Wl� " A(: z tue &Wn t 0, La Habra (562) 697-4000 Fax (562) 697-4009 Apple Valley (760) 961-9141 Vernon (888) 287-0875 Mailing Address P.O. Box 1816 Whittier, California 90609 Inspection Date: ❑ Other Standards: Specify Project #: DSA File No.: Application No.: Building Permit No.: �& CA 70-&r ol:66 INSPECTION MAT'L SAMPLING CITY MATERIAL DESCRIPTION INSPECTION CHECKLIST Concrete ❑ Concrete Cylinders 10 ❑Reinf: Rebar ❑ Plan & Specs Masonry ❑ Mortar Samples ❑ Reinf: W.W.F ❑ Clearance ❑ Structural Steel ❑ Grout Samples ❑ Reint. Tendon ❑ Posltions ❑ Welding ❑ Masonry Prisms ❑ Conc: Mix #/psi ❑ Sizes ❑ Reinforcing Steel ❑ Masonry Block ❑ Grout: Mix#lpsi ❑ Laps ❑ Non -Destructive ❑ Units (block or brick) ❑ Mortar. Mix#! si p ❑Consolidation ❑ Soils Technician ❑ Reinf. Steel ❑ Units: Block ❑ Mortar Belching ❑ 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 l�r.f.�✓�cctnev�-'fie �ow,vS� cs� VnCAVI 1tir-\C\ v �W1cv -�0 cov(:�O\�&k, CuL\CivGAr_r Cosh jC�IncK.� I t rXr'J!x0IAS wtn5 CUncta� 5c�n�\tP(� Time In b: 50 I Time Out A Equipment Used: >\f�w�� - -'� I A C r C He 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 th DSA approved plans therefore. ❑ Not in Compliance with the DSA approved plans therefore. PROJECT IOR OR INSPECTOR NAME SUPERINTENDENT SIGNATURE INSPECTOR SIGNATURE CERT. # pQ rC67�r DATE -Z.S NOTE: Inspections based on 4-ho inimum, a- a{1llr minimum after four (4) hours, 2-hour minimum for all cancellations. American Engineering Laboratories, Inc. Geotechnical Materials Testing & Inspection 14 205 W. La Habra Blvd., La Habra, CA 90631 Whittier (562) 694-000 Fax (562) 697-4009 Apple Valley (760) 961-9141 Vernon (888) 287-0875 DATA SHEET: COMPRESSIVE STRENGTH TESTING: MOLDED SPECIMENS FIELD Sample Type: Owner: Golden Construction DSA File No.: Address: Fi� Concrete Application No.: AEL Project No. 220193 Grout Date Cast: 11/28/2022 Foreman: Time Cast: 7:00 AM Contractor: JKB Construction El Mortar Time Batched: 6:00 AM Address: Specimen Size: US Prisms No. of Spec. Cast: 3 Project: WelbeHealth La Quinta Air Temp: 88 46805 Dune Palms Road El Shotcrete Conc. Temp: 68 Address: La Quinta, CA. 92253 Conc. Slump: 4 El Slurry Req'd Strength: 4000 Permit #.. 13 COM-2022-0036 Req'd. Air: N/A Supplier: Robertson Ready Mix Other Product/Mix No.: 71391C Building: Ticket#: 6952709 Total Yards Placed 40 Structure: slab Plant#: 51 Water Added: 0 Location: Electric and Plumbing trench walls Truck #: 1587 Admixture: None Cement Type: ll/V Load #: 1 Sampled By: Antonio B. Set #: LABORATORY Date Cast: Date Received: Tested By: Cylinder ID # Date Tested pec. Age (Days) # 1 # 2 # 3 # 4 # 5 # 6 idth #1 (IN) dth #2 (IN) verage (IN) ,Lrea IN Max Load (LBS) Comp. Str. (PSI) Fracture Type A - Cone Meets Re uirements B - Cone & Split C - Cone & Shear D - She E -Columnar ❑ Does Not Meet Requirements 282a Avera e 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): 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/Samole- 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 Wangrud PROJECT SUPERINTENDENT SIGNATURE INSPECTOR SIGNATURE e_4 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. THIS IS NOT A TICKET NO. ,I CONTROL ROBMTSOWS � s, NUMBER $ >` Phone 800/834-7557 San,Diego 800/870-1220 9 ` a1 t www.rrmca:co #1 RIVERSIDE -61202DthST. #13 IRWINDALE - 13631 LIVE OAK LANE OPEN 7 DAYS I #2 MORENO VALLEY- 14250 Old 215 Frontage Road 0REDLANbS-8853 ALABAMA ST #14 PASADENA- 1420 N. LINCOLN AVE. #15 VERNON-LOS ANGELES-3365 E. 26TH ST. #25 GARDENA- 301 W. ROSECRANS AVE. #4 FONTANA- 13792 SLOVER AVE. #16 ANAHEIM- 201 E. COMMERCIAL ST. #26 THOUSAND PALMS -72460 VARNER AD. #5 POMONA- 2470 POMONA BLVD. #17 SANTA ANA- 310 N. TOWNSEND ST. #27 MURRIETA -26190 ADAMS AVE. #6 HEMET/SAN JACINTO-1675 STATE ST. #18 LAKE FOREST- 25931 TOWN CENTRE DR. #28 OTAY MESA -7961 AIRWAY RD. #7 BEAUMONT- 452 W. LUIS ESTRADA RD. #19 ADELANTO - 12203 VIOLET RD. #29 EL CAJON-215 CYPRESS UN. #8 SUN CITY -27050 WATSON RD. #20 SAN CLEMENTE-116 RINCON CT. #30 CORONA- 1540 SHERBORN ST. #9 ARROWHEAD - 29750 HWY 18 #21 IRVINE- 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 AD. ,I #11 CABAZON- 13990 APACHE TRAIL #12 SAN BERNARDINO - 1955 W.9TH ST #23 PARAMOUNT- 7277 E. ROSECRANS AVE #24 RIALTO- 2601 N. ALDER AVE. #33 MIRAMAR- 5692 EASTGATE DR. #34 LUCERNE - 36555 HWY 18 PLANT DATE CUSTOMER N0: SOLD TO: ' TX CD DELIVERY ADDRESS & INSTRUCTIONS :i.Ij.tY.:$�t..�'� - cil_�S•�I-• {••'r:^yi ..1.•i..: 1� I S ORDER NO: s., METFR READING . TIME TYPFD TRU.CALIC NO. T N TP; u #35 BIG BEAR LAKE - 42025 GARSTIN DR. #45 BARSTOW - 27DO E. MAIN ST. 136 ESCONDIDO - 1310 SIMPSON WAY #46 CAL -CITY -79M MOSS AVE. 037 INDIO- 88110 FARGO CANYON RD. #47 PORT OF LONG BEACH -1602 W. PIER 1) ST, #38 RIDGECREST- 21571NYOKERN RD. #48 BANNING -1000 N. HATHAWAY 139 PALMDALE- 3779075TH ST. EAST #49 SIMI VALLEY- 4DOW. LOS ANGELESAVE. #40 ARTESIA- 13949 E. STAGE ROAD #53 SAN JUAN CAPISTRANO - 31511 GIBBY ROAD 142 VICTORVILLE - 16952 N. DST. #54 TEMESCAL VALLEY- 25050 MAITRI ROAD #43 BAKER -56500 BAKER BLVD. MULTIPLE LOCATIONS IN NEMDA MAP PAGE TICKET NO. SF 4 .., 1 CUSTOMER PO. / JOB OR LOT # u I LOADNG:,' :LUMP TRUCK: DRIVER.,:vj y=;'li:;('`� 1 !:7,F::.,7 !._!vt�i LL! DRUM u I TO JOBS' n? REVS: Job site Cylinder Test: ❑Yes TIME ON JOB _ !: ON JOB Water added on job at ;I __... Customer's request: .. I START POUR ? gals to Full Ld. als to 2/3 Ld STAND BY RATE OFX$ F_, r t l,• .l .L N I-. MIN. CHECK # J. "7 1 MIN. CHECK ❑ AMOUNT BY PER MIN. CASH ❑ AMOUNT By FINISH POUR RETURN CONIC i g $ PLANT MGR SIG % gals t0 1/3 Ld. OVERTIME CHARGE ❑ 4 min. per d. unloadingtime allowed. LEAVE JOB Y N ADJ. Meter.'.f. I' =I ,I Additinal unloading time charged at current hourly truck rate. 7 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. ✓,. EMP./# �� - � 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 pro 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 job site, Including the on -site direction of F 0 ertson'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, indemnity 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, t' 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 (n) the movement of Robertson's vehicles upon or about the delivery location. Sol elyy 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 attorne 's fees incurred by Robe fson'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 ofy1 Yz %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 c 5 . 0I: 1'"li... i'Ci: 1•.j..i.�H._0 'D1.. 56 L.. WEIGHMASTER CERTIFICATE r^ THIS IS TO CERTIFY that the following described commodity was weighed, TAX ill („' 1,;;'.i. i-1 F1: 142 0 65 . •_' Ls A L._ measured, or counted by a weighmaster, whose signature is on this certificate, 1 I •_1 „ w who is a recognized authority of accuracy, as prescribed by Chapter 7 a'lY 1. i-li ). ,' .,....: i 8 t..rA (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 C t' Pal;:-' i'*,(T 67 _t . "L _ e''' California Department of Food and Agriculture. _,'i_,;:1= L_c:' ROBERTSON'S .SUB [ 1 ,I WEIGHMASTER TOTAL III i,:j 7_' STAND BY _ BY DEPUTY °t; ; �?-y _. CHARGE dOM'CONVERSION c'Y=YR S3 '#- UNOS `GL=GAL OWS FO= NC�S'-CU=METERS3 KG=KILOGRAM L=LITERS ML=MILLILITERS CONCRETE DELIVERY TICKET TOTAL , C! PO BOX 3600 CORONA, CA 92878-3600 L AGREED TO AND RECEIVED BY CUSTOMER I THIS IS NOT A TICKET NO. CONTROL ROBERTSON'S NUMBER ; Phone 800/834-7557 San Diego 800/870-1220 #1 RIVERSIDE-6120201hST. #1 1RWINOALE-13631 LIVE OAK LANE OPEN 7 DAYS 12 MORENO VALLEY- 14250 Old 215 Frontage Road #14 PASADENA- 1420 N. LINCOLN AVE. YU II I�� 7Nll r 1 43 REDLANDS-8353 ALABAMA ST #15 VERNON-LOS ANGELES-3365 E. 26TH ST. #25 GARDENA- 301 W. ROSECRANS AVE. #4 FONTANA- 13792SLOVER AVE. #16 ANAHEIM- 201 E. COMMERCIAL ST. #26 THOUSAND PALMS -72460 VARNER RD. #5 POMONA- 2470 POMONA BLVD. #17 SANTA ANA- 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 -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 18 421 IRVINE- 16081 CONSTRUCTION CIR. WEST #31 HESPERIA. 9661 CAVE. #10 SANTA RE SPRINGS- 12311 GREENSTONE AVE. #22 NO. HOLLYWOOD- 13132 RAYMER ST. #32 CARROLLCANYON- 10050 BLACK MOUNTAIN RC �- #11 CABAZON- 13990 APACHE TRAIL #23 PARAMOUNT- 7277 E. ROSECRANS AVE. #33 MIRAMAR- 5692 EASTGATE DR. #12 SAN BERNARDINO-1955 W. 9TH ST. #24 RIALTO- 2601 N. ALDER AVE. #34 LUCERNE - 36555 HWY 18 PLANT DATE CUSTOMER NO: SOLD TO: y ) TX CD DELIVERY ADDRESS&-INSTRUCT)7IO[[NS 8(', 5 ),I L.i i `{ I:.:. f:: i'Y L.. i' l.:J R11 i !)fG ;I ORDER NO. '.1 J�f.EffjREADIN(G_, TIME TYPED IEtU,01C; L1�..f��, LOAD NO: LUMR J:`. -TRUOK::: D•ggIVER; :i; i': C; • r • r ` ` I' DRUM r REVS: Job -site Cylinder Test: ❑ Yes ..i I TOJOBTIME ON JOB gygp pt��{� Ip�ygj #35 BIG BEAR LAKE- 42025 GARSTIN DR. #45 BARSTOW-2700 E. MAIN ST. #36 ESCONDIDO-1310 SIMPSON WAY #46 CAL -CITY -79DO MOSS AVE. v #37 INDI0- Set 10 FARGO CANYON RD. #47 PORT OF LONG BEACH -1602 W. PIER 0 ST. #38 RIDGECREST- 21571NYOKERN RD. #48 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 CAPISTRAND -31511 GREY ROAD #42 VICTORVILLE -16952 N. 0 ST. #54 TEMESCAL VALLEY - 25050 MAITRI ROAD ' #43 BAKER - 56500 BAKER BLVD. MULTIPLE LOCATIONS W NEVADA MAP PAGE TICKET NO. CUSTOMER P.0 / JOB OR LOT # CHECK # ON JOB 1 4 ( Water added on job at STAND BY MIN. CHECK El Customer's request: AMOUNT RY START POUR =) ` gals t0 Full Ld. RATE OF X $ PER MIN. CASH ❑ AMOUNT RY FINISH.POUR RETURN CONIC gals to 2/3 Ld. $ PLANT MGR SIG gals to 1/3 Ld. OVERTIME CHARGE LEAVE JOB 4 min. per yd. unloading time allowed. Y N _ ADJ. Meterr� r= 'j ;..; " 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,uri penalty of perjury that the information contained in this written time record is true and correct. I EMP1# SIGNATURE u Customer agrees that the described mater))'a( has been chosen solely by Customer without Robertson's direotion, areview of any plans or ; I Customer further agrees that it shall be solely responsible for the delivery location, and discharge/placement of material on the lob site, Ini r iy location. Customer s review and approval;the described material shall be evidenced by Customer's signature and/or placement of the desc releases and agrees to defend, indemnify and hold Robertson's and its employees and agents harmless from any and all losses, damage ju arising from (i) material being inappropriate, incompatible, improper or inconsistent with plans and specifications, or with the ground so movement of Robertson's vehicles upon or about the delivery location. Soiely to the extent Customer fails to timely pa for the described `.. Customer agrees to pay such reasonable attorne 's fees incurred by Robe tson's In furtherance of such collection efforts. Robertson's .I Customer agrees to pay a time price differential ofyl Y %per month on any amounts owed to Robertson's for more than thirty (30) days, CI i Robertson's is not responsible for the results of any concrete where the coloring agent has been added at the request of the customer, ei LID QTY CUM QTY ORD QTY PROD CODE MIX AND COMMODITY ;:. TERMS AND CONDITIONS OF SALE ations relating to the pro'ect(s) where the material is to be used. the on -site irection of Robertson's vehicles to the designated iaterial on the job site. In consideration of the above, Customer p� g ties, costs and claims asserted by Customer or any third party,jpY{: Inditions on the land where the material is utilized, and (ii) the If 4 C Is, in the event Robertson's retains the services of an attorney, ;tourer disclaim attorney's fees arising from any other context. rclaimer Due to irreqularities and/or inconsistencv of materials our plant or on UOM GHE:.E _ti11'•'!i._ WEIGHMASTER CERTIFICATE �.i n•1 ..• : 1 .. , THIS IS TO CERTIFY that the following described commodity was weighed, E i i.u. t , �, .-. , : �, measured, or counted b a wet hmaster, whose signature is on this certificate, Y 9 9 M �t 36 �f t g, t: p 11 y 1 t"i f • E n t r w - tf:JA - 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•-• Professions Code, administered by the Division of Measurement Standards of the r -• • `� California Department of Food and Agriculture. 3 t i.:, :f ;.t4,' !..%1_..z: ROBERTSON'S W EIG HMASTER 14880 c:iLs0 . 01 f^o r i€� `?(` {y s RY DEPUTY lYGM C a-iDN N; 053' ='POUNDS ZQAL CAST .�NC VCU=METERS3 KG=KILOGRAM L=LITERS ML=MILLILITERS CONCRETE DELIVERY TMKET ,I AGREED TO AND RECEIVED BY CUSTOMER PO BOX 3600 CORONA, CA 92878-3600 UNIT PR AMT TAX PREVIOUS BALANCE SUB TOTAL STAND BY CHARGE TOTAL I �..>� CONTROL THIS IS NOT A TICKET NO. ROBER"ON'S NUMBER 7 1 7 Phone 800/834-7557 SanDiego800/870-1220 www. rrmca.Corn / LS, '1y I E -g�. 1ca� 12 MORENOVALLEY 14250. #13 PA ADENA-14 0 LIVE OAK LANE OPEN 7 DAYS #2 REDLAN VALLEY-14250Old 215 Frontage Road #15 PASADENA-142o EN. LES- 365AYE. I' #3 REDLANDS-B353 ALABAMA ST. #iS VERNON-LOS ANGELES-3365 E. 26TH ST #25 GARDENA-301WROSECRANS AVE- t ' #4 FONTANA- 13792 SLOVER AVE. #16 ANAHEIM- 201 E. COMMERCIAL ST. #26 THOUSAND PALMS -72460 VARNERRD. #5 POMONA- 2470 POMONA BLVD. #17 SANTA ANA- 310 N. TOWNSEND ST #27 MURRI ETA - 26190 ADAMS AVE. #35 BIG BEAR LAKE- 42025 GARSTIN DR. #45 BARSTOW-27DO E. MAIN ST. — #6 HEMET/SAN JACINTO-1675 STATE ST #18 LAKE FOREST- 25931 TOWN CENTRE DR. #28 OTAY MESA -7961 AIRWAY RD, #36 ESCONDIDO - 1310 SIMPSON WAY #46 CAL-CITY-7900 MOSS AVE. #7 BEAUMONT452 W. LUIS ESTRADA RD. #19 ADELANTO -12203 VIOLET RD. #29 EL CAJON -215 CYPRESS UN. #37 INDIO -88110 FARGO CANYON RD. #47 PORT OF LONG BEACH -1602 W. PIER D ST. #8 SUN GITY-27050 WATSON RD. #20 SAN CLEMENTE-116 RINCON CT. #30 CORONA- 1540 SHERBORN ST. #38 RIDGECREST- 21571NYOKERN RD. #48 BANNING-1000N. HATHAWAY 09 ARROWHEAD - 29750 HWY 18 #21 IRVINE- 16081 CONSTRUCTION CIR. WEST #31 HESPERIA - 9661 CAVE. #39 PALMDALE- 3779075TH ST. EAST #49 SIMI VALLEY- 400 W. LOSANGELES AVE. I #10 SANTA HE SPRINGS- 12311 GREENSTONE AVE. #22 NO. HOLLYWOOD - 13132 RAYMER ST #32 CARROLL CANYON- 1 D050 BLACK MOUNTAIN RD. #40 ARTESIA- 13949 E. STAGE ROAD #53 SAN JUAN CAPISTRANO-31511 LIBBY ROAD 1 #11 CABAZON- 13990 APACHE TRAIL #23 PARAMOUNT- 7277 E. ROSECRANS AVE. #33 MIRAMAR- 5692 EASTGATE DR. #42 VICTORVILLE-16952 N. D ST #54 TEMESCAL VALLEY- 25050 MAITRI ROAD #12 SAN BERNARDINO. 1955 W. 9TH ST #24 RIALTO- 2601 N. ALDER AVE. #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 P.O. /JOB OR LOT # i � v 6 ww t ! ORDER 140. METER READING TIME TYPED TRUCK LIC NO. l 4�jp "j4 LOAD NO. SLUMP TRUCK DRIVER `f DRUM REVS: Job -site Cylinder Test: ❑ Yes TO JOB TIME ON JOB MIN.' CHECK # ON JOB Water added on job at STANDBY MIN. CHECK ❑ Customer's request: AMOUNT BY a START POUR gals to Full Ld. RATE OF X $ PER MIN. CASH ❑ v gals to 2/3 Li AMOUNT By v FINISH POUR RETURN CONC $ PLANT MGR SIG _ g. OVERTIME CHARGE 0 gals t0 1/3 Ld 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. EMP./# SIGNATURE TERMS AND CONDITIONS OF SALE Customer agrees that the described material hasbeen chosen solely by Customer without Robertson's direction, or review of any plans or specifications relating to the projects) 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 site, including the direction RRobertson's tt j lob on of vehicles to the designated fHy q I 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 fq releases and agrees to defend, indemnify hold Robertson's t ri I and and its employees and agents harmless from any and all losses, damages, liabilities, costs and claims asserted by Customer or any third parry, rj 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 is material utilized, and (f) the MOVE ment of 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 fees pay such reasonable attorney's 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 1/2% 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 the at our plant or on job site. LID QTY CUM QTY ORD QTY PROD CODE MIX AND COMMODITY UOM UNIT PR AMT i • 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, i is ') {t who is a recognized authority of accuracy, as prescribed by Chapter 7 @R (commencing with Section 12700) of Division 5 of the California Business and PREVIOUS ){ 4 VVV IIII i Professions Code, administered by the Division of Measurement Standards of the BALANCE T California Department of Food and Agriculture. ROBERTSON'S SUB WEIGHMASTER TOTAL STAND BY � BY DEPUTY CHARG E UOM CONVERSION CY=YARDS3 #=POUNbS GL=GALLONS FO=OUNCES CU=ME7ERS3 KG=KILOGRAM L=LITERS ML=MILLILITERS ,d CONCRETE DELIVERY `> CKET TOTAL . L I AGREED TO AND RECEIVED BY CUSTOMER PC BOX 3600 CORONA, CA 92878-3600 THIS IS NOT A TICKET NO. CONTROL ROMR"OWS 1 NUMBER :', ,.� L Phone 800/834-7557 San Diego 800/870-1220 '9 7. www,rrmca.com 1LpJII}1C11 #1 RIVERSIDE -612020thST. #13 IRWINDALE-13631 LIVE OAK LANE OPEN 7 DAYS Frontage Roatl C33 #3 REDRLANDSA 8353 ALABAMA ST.5 #15 V RNON-LOS ANGELES 5 E 26TH ST. #25 GARDENA -301 W. ROSECRANS AVE. #4 FONTANA- 13792 SLIVER AVE. #16 ANAHEIM- 201 E. COMMERCIAL ST #26 THOUSAND PALMS -72460 VARNER RD. �. #5 POMONA- 2470 POMONA BLVD. #17 SANTA ANA- 310 N. TOWNSEND ST. #6 HEMETISAN JACINTO-1675 STATE ST. #18 LAKE FOREST- 25931 TOWN CENTRE DR. #27 M U R RI ETA - 26190 ADAMS AVE. #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 IRVINE- 16081 CONSTRUCTION CIR. WEST #31 HESPERIA-951 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- 7277 E. ROSECRANS AVE. #33 MIRAMAR- 5692-EASTGATE DR. #12 SAN BERNARDINO-1955 W. 9TH ST. #24 RIALTO- 26011 ALDER AVE. #34 LUCERNE - 36555 HWY 18 PLANT DATE CUSTOMER NO: SOLD TO. s TX CD DELIVERY ADDRESS & INSTRUCTIONS � I ppp ORDER NO. METER READING TIME TYPED TRUCK LIC N0. LOAD NO: SLUMP TRUCK DRIVER i #35 BIG BEAR LAKE- 42025 GARSTIN DR. #45 BARSTOW-2700 E. MAIN ST. #36 ESCONDIDO - 1310 SIMPSON WAY #46 CAL -CITY - 7900 MOSS AVE. #37 INDIO- 88110 FARGO CANYON RD. #47 PORT OF LONG BEACH -1602 W. PIER D ST. #38 RIDGECREST-21571NYOKERN RD. #48 BANNING -1000 N. HATHAWAY #39 PALMDALE- 3779075TH ST. EAST #49 SIMI VALLEY, 400 W. LOS ANGELESAVE. #40 ARTESIA - 13949 ESTAGE ROAD #53 SAN JUAN CAPISTRANO-31511 GIBBY ROAD #42 VICTORVILLE - 16952 N.DST. 854 TEMESCAL VALLEY-25DW MAITRI ROAD #43 BAKER -5500 BAKER BLVD. MULTIPLE LOCATIONS IN NEVADA MAP PAGE TICKET NO. CUSTOMER PO. / JOB OR LOT # DRUM 1 `; REVS. Job -site Cylinder Test: ❑ Yes .d TO JOB 7 TIME ON JOB MIN. CHECK # Water added on job at ON JOB �� -� STAND BY MIN. ❑ CHECK Customer's request: AMOUNT BY START POUR gals to Full Ld. RATE OF X $ PER MIN. CASH ❑ �s- IAMOUNT BY � FINISH POUR RETURN CONC gals to 2/3 Ld. $ PLANT MGR SIG gals to 1/3 Ld. OVERTIME CHARGE 11 El 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 thisconcretewitlreduceitsstrength.Anywateraddedexceedingthedesignwaterisatcustomer'sownrisk. Signature certifying under penalty of perjury that the information contained in this written time record is true and correct. �i EMP.1# -_ 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 it be for a�1 agrees that shall solely responsible the delivery location, and discharge/placement of material on the job 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 job site. In consideration of the above.Customer tp I 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, t 144 4 t tt !tit 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 Robertson's movement of 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 attorney's fees arlsing from any other context. �. Customer agrees to pay a time price differential of 1 1A % 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. i LD.QTY.- CUM QTY ORD CITY PROD CODE MIX AND COMMODITY UOM UNIT PR AMT i F i u WEIGHMASTER CERTIFICATE l : THIS IS TO CERTIFY that the following described commodity was weighed, TAX measured, or counted by a weighmaster, whose signature is on this certificate, i6 y4 ��I 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 iJ 333116 fff i� Professions Code, administered by the Division of Measurement Standards of the BALANCE California Department of Food and Agriculture. ..� I ROBERTSON'S SUB WEIGHMASTER TOTAL f STAND BY _ BY DEPUTY CHARGE UOM CONVERSION CY=YARDS3 #=POUNDS GL=GALLONS FO=OUNCES CU=METERS3 KG=KILOGRAM L=LITERS ML=MILLILITERS „ TOTAL C! CONCRETE DELIVERY TICKET PO BOX 3600 CORONA, CA 92878-3600 L_ 1 AGREED TO AND RECEIVED BY CUSTOMER ! THIS IS NOT A TICKET NO. _ II CONTROL ,., ,.d ROBERTSON'S NUMBER 6 J 709 Phone 800/834-www San Diego � 800/870-1220 w^^"A'rrmca.co RIVERSIDE - 6120 20th ST. #13 IRWINDALE - 13631 LIVE OAK LANE OPEN 7 DAYS 1111 I11I1i ff MORENO VALLEY- 14250 Old 215 Frontage Road #14 PASADENA- 1420 N. LINCOLN AVE. 13 REDLANDS - 8353 ALABAMA ST #15 VERNON-LOS ANGELES-3365 E. 26TH ST ,#25 GARDENA- 301 W. ROSECRANS AVE. if r' #4 FONTANA- 13792 SLOVER AVE. #16 ANAHEIM- 201 E. COMMERCIAL ST. 426 THOUSAND PALMS -72460 VARNER RD. -'• U j #5 POMONA- 2470 POMONA BLVD. #17 SANTA ANA- 310 N. TOWNSEND ST. 027 MURRIETA - 26190 ADAMSAVE. #35 BIG BEAR LAKE-42025 GARSTIN DR. #45 BARSTOW-2700 E. MAIN ST. ~� #6 HEMET/SAN JACINTO-1675 STATE ST #18 LAKE FOREST- 25931 TOWN CENTRE DR. #28 OTAY MESA -7961 AIRWAY RD. #36 ESCONDIDO - 1310 SIMPSON WAY #46 CAL -CITY - 7900 MOSS AVE. #7 BEAUMONT-452 W. LUIS ESTRADA RD. #19 ADELANTO -12203 VIOLET RD. #29 EL CAJON - 215 CYPRESS UN. #37 INDIO-88110 FARGO CANYON RD. #47 PORT OF LONG BEACH -1602 W. PIER D ST. #8 SUN CITY -27050 WATSON RD, #20 SAN CLEMENTE-116 RINCON CT. #30 CORONA- 1540 SHERBORN ST. #38 RIDGECREST- 21571NYOKERN RD. #48 BANNING -1000 N. HATHAWAY #9 ARROWHEAD, 29711 HWY 18 121 IRVINE- 16081 CONSTRUCTION CIA. WEST #31 HESPERIA - 9661 CAVE. #39 PALMDALE- 3779075TH ST. EAST #49 SIMI VALLEY- 400 W. LOS ANGELES AVE. #10 SANTA HE SPRINGS- 12311 GREENSTONE AVE. #22 NO. HOLLYWOOD - 13132 RHYMER ST #32 CARROLL CANYON -.1 D050 BLACK MOUNTAIN RD. #40 ARTESIA- 13949 E. STAGE ROAD #53 SAN JUAN CAPISTRANO - 31511 GIBBY ROAD #11 CABAZON- 13990 APACHE TRAIL #23 PARAMOUNT- 7277 E. ROSECRANS AVE. #33 MIRAMAR- 5692 EASTGATE DR. #42 VICTORVILLE - 16952 N. DST. #54 TEMESCAL VALLEY- 25950 MAITRI ROAD _ #12 SAN BERNARDINO-1955 W. 9TH ST, #24 RIALTO- 2601 N. ALDER AVE. #34 LUCERNE-36555 HWY 18 #43 BAKER- 56500 BAKER BLVD. MULTIPLE LOCATIONS IN NEVADA PLANT DATE CUSTOMER NO SOLD TO: MAP PAGE TICKET NO. v u TX CD DELIVERY ADDRESS & INSTRUCTIONS CUSTOMER PO. / JOB OR LOT # I 9ry ORDER NO. METER READING TIME TYPED TRUCK LIC NO, ,l LOAD NO. SLUMP TRUCK DRIVER 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 Eltr I Customer's request: AMOUNT BY - START POUR gals t0 FUII Ld, RATE OF X IS PER MIN. CASH ❑ AMOUNT BY gals to 2/3 Ld. FINISH POUR RETURN CONIC IS PLANT MGR SIG gals t0 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 certifying under penalty of perjury that the information contained in this written time record Is true and correct. �� 4}`�) _ EMPJ# i^ SIGNATURE•`,--.��=-"`- - - - TERMS AND CONDITIONS OF SALE Customer agrees that the described material has been chosen solely by Customer without Roberts'on's direction, or review of any plans or specifications relating to the pro'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 direction of Robertson's vehicles to the designated y. 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 to 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 �J party, arising from fi) 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 (li) 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, i I i f i 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 to differential Y agrees pay a time price of 1 % 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:, AOTY.. CUM QTY ORD OTY PROD. CODE MIX AND COMMODITY UOM UNIT PR AMT :i I I WEIGHMASTER CERTIFICATE ! i THIS IS TO CERTIFY that the following described commodity was weighed, 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 Professions Code, administered by the Division of Measurement Standards of the California Department of Food and Agriculture. ROBERTSON'S WEIGHMASTER BY DEPUTY UOM CONVERSION CY=YARDS3 #=POUNDS GL=GALLONS FO=OUNCES CU=METERS3 KG=KILOGRAM L=1 ITFRS ML=MILLILITERS C! CONCRETE DELIVERY TICKET f 1 AGREED TO AND RECEIVED BY CUSTOMER PO BOX 3600 CORONA. CA 92878-3600 TAX PREVIOUS BALANCE SUB TOTAL STAND BY CHARGE TOTAL 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. THIS IS A FLAT OUT LIE ON PAPER. 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. NOT COMPLETE YET 3. The shear wall along line 4 has had some missing floor to floor holdown straps per detail 14/S1.3. NO DIRECTION TO GOTO A SPECIFIC DETAIL 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. ARE WE TO BUILD OFF A PICTURE NO DETAIL PROVIDED 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 ' Structur all 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 QROFESS /p� BOSS & T"--L C') m G� No. S4429 �+ z Brian Goodnight, SE * Exp. 12/31/22 President `P' s 9�F rRUCTU�P OQ`� Oz ^1,x \F CC: David Kim, K2A 1 0 -s- -z-� -' Page 2 of 2 9628 Conda Way, Elk Grove, CA 95624 brian@goodnightse.com Phone (916) 2124021 CERTIFICATE OF INSTALLATION NRCI-LTI-01-E Indoor Ligbtmg Project Name: MSD WelbefieaM La Quints IlEnforcemew Agency CITY OF LA QuiNTA jPennk Number. BCOM2022-0025 Project Address: 46-805 Dune Palms Rd. jCky. La Quints JjZip Cade: 92253 General Information uilding Type: r Nonresidential r High -Rise Res (Common Areal r Hotel/Motel (Common Area) -'hase of Construction: r New Construction r Addition r Alteration r Unconditioned Scope of Responsibility _er the date of approval by enforcement agency of the Certificate of Compliance that provides the specifications for the energy efficiency measures for the scope of responsibility for this Installation Certificate. Date: 9/19/2022 12:00:00 AM Document Title or Description Partial Floor Plans 2nd Floor Applicable Sheets or Pages, Tables, Schedules, etc. E-102A, E-102B Date Approved By the Enforcement Agency 9/19/2022 12:00:00 AM Partial Floor Plans 1st Floor E-101A, E-101B 9/19/2022 12:00:00 AM Lighting Circuit Schedules E-103 9/19/2022 12:00:00 AM Lighting j Power Control Schedules E-411 9/19/2022 12:00:00 AM Title 24 G4-012, G4-013 9/19/2022 12:00:00 AM C�� \` TP California Advanced Lighting Controls Training Program This is page 1 of 2 CERTIFICATE OF INSTALLATION NRCI-LTI-01-E Indoor Lighting Project Name: MSD WelbeHeahh La Quints IlEnforcemew Agency: CITY OF LA QUINTA jPennft Number. BCOM2022-0025 Project Address: 46-805 Dune Palms Rd. lCity. La Quints IlZip Cade: 92253 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT I certify that this Certificate of Acceptance document is accurate and complete. - ocumentation Author Company Name ame Jeff Bernardino -ddress 3312 Limerick Lane City 'ip Code -EA/ATT Certification Identification (if pplicable) ate of Signature 92882 TC-A813601 08./01!2023 Phone Author Signature Integrated Power & Lighting, Inc. Corona (951)270-0575 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the folloving under penalty of perjury, under the lays of the State of California: 1. I am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies ,nth the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. a. I have confirmed that the Certificates) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available vnth the building permits) issued for the building. 5. I vAll ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available vAth the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included vdth the documentation the builder provides to the building ovmer at occupancy. =esponsible Acceptance Company Name -arson Name Jeff Bernardino Integrated Power & Lighting, Inc. -ddress: City 3312 Limerick Lane Corona =ip Code Phone 92882 (951)270-0575 SLB License Position vdth Company 993105 (Title) ATT/RP esponsible Acceptance Person Signatur ate of Signature: 08/01/2023 C�� \` TP California Advanced Lighting Controls Training Program This is page 2 of 2 CERTIFICATE OF INSTALLATION CI-LTO-01-E Outdoor Lighting Project Name: MSD WeIeHeaM La Quinta IlEnforcemern Agency CITY OF LA QuiNTA Permit Number. BCOM2022-0025 Project Address: 46-805 Dune Palms Rd. ICiy. La Quinta Zip Cade: 92253 OUTDOOR LIGHTING CERTIFICATE OF INSTALLATION General Information Building Type: W Nonresidential Phase of Construction: r New Construction r Addition r Alteration Scope of Responsibility Enter the date of approval by enforcement agency of the Certificate of Compliance that provides the specifications for the energy fficiency measures for the scope of responsibility for this Installation Certificate. 9/19/2022 12:00:00 AM In the table below, identify all construction documents that show that the outdoor lighting and controls were installed as it was proposed in the Certificates of Compliance. Site Electrical E-011 9/19/2022 12:00:00 AM Partial Floor Plan - 1st Floor Lighting E-101B 9/19/2022 12:00:00 AM Title 24 G4-013 9/19/2022 12:00:00 AM C�� \` TP California Advanced Lighting Controls Training Program This is page 1 of 2 CERTIFICATE OF INSTALLATION CI-LTO-01-E Outdoor Lighting Project Name: MSD WelbeHeahh La Quints IlEnforcemew Agency: CITY OF LA QUINTA jPmnft Number. BCOM2022-0025 Project Address: 46-805 Dune Palms Rd- lCiLy. La Quints IlZip Cade: 92253 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT I certif; that this Certificate of Acceptance document is accurate and complete. ocumentation Author Company ame Jeff Bernardino -ddress _ City -EA/ATT Certification dentification (if pplicable) RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the follovnng under penalty of perjury, under the lava of the State of California: 1. I am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, :onstruction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies vnth the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. I have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed is posted or made available vnth the building permit(s) issued for the building. 5. I vnll ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available vnth the building permits) issued for the 'wilding, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included -nth the documentation the builder provides to the building ovmer at occupancy. __ponsible Acceptance Company Name -erson Name Jeff Bernardino Integrated Povrer &Lighting, Inc. ddress: City 3312 Limerick Lane Corona -ip Code 92882 -SLB License 993105 -esponsible Acceptance Person Signature =te of Signature: 08.+01;'2023 Phone Position vnth Company (Title) (951)270-0575 ATT/RP C�� \` TP California Advanced Lighting Controls Training Program This is page 2 of 2 CERTIFICATE OF INSTALLATION CI-LTO-M-E Outdoor EMCS or Lighfuig Control System Project Name: MSD WelbeHeahh La Quinta Enforcemem Agency CITY OF LA QuiwA Permit Number. BCOM2022-0025 Project Address: 46805 Dune Pahns Rd. City. La Quinta Zip Code: 92253 ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM CERTIFICATE OF INSTALLATION General Information Building Type: r Nonresidential Outdoor Lighting 'hase of Construction: r New Construction r Addition F Alteration ,cope of Responsibility =nter the date of approval by enforcement agency of the Certificate of Compliance that provides the specifications for the energy efficiency measures for the scope of responsibility for this Installation Certificate. Date: 9/19/2022 12:00:00 AM Requirements in the Standards: §130.4(b) Before an Energy Management Control System (EMCS), or Lighting Control System can be recognized for compliance with the lighting control requirements in Part 6 of Title 24, the person who is eligible under Division 3 of the Business and Professions Code to accept responsibility for the construction or installation of features, materials, components, or manufactured devices shall sign and submit this Installation Certificate. If any of the requirements in this Installation Certificate fail the Energy Management Control System or Lighting Control System installation requirements, these options for controlling lighting shall not be recognized for compliance with the Building Energy Efficiency Standards. Check all that apply PART 1 What type of Lighting Control System has been installed? r A. Energy Management Control System (EMCS) - Is a computerized control system designed to regulate the energy consumption of a building by controlling the operation of energy consuming systems, such as the heating, ventilation and air conditioning (HVAC), lighting, and water heating systems, and is capable of monitoring environmental and system loads, and adjusting HVAC operations in order to optimize energy usage and respond to demand response signals. r The Energy Management Control System has been installed to function as a lighting control required by Part 6 and functionally meets all applicable requirements for each application for which it is installed, in accordance with Sections 110.9, 130.0 through 130.S, 140.6 through 1S0.0, and 1S0.2; and complies with Reference Nonresidential Appendix NA7.7.2. r The EMCS has been separately tested for each respective lighting control system for which it is installed to function as. B. Lighting Control System - Requires two or more components to be installed in the buildings tC p1-CIVI& all of the functionality required to make up a fully functional and compliant lighting control. C�� \` TP California Advanced Lighting Controls Training Program This is page 1 of 5 CERTIFICATE OF INSTALLATION CI-LTO-02-E Outdoor EMCS or Lighfuig Control System Project Name: MSD WelbeHeahh La Quinta Enforcemem Agency CITY OF LA QuiwA Permit Number. BCOM2022-0025 Project Address: 46805 Dune Pahns Rd. ICiy. La Quinta Zip Code: 92253 PF The installed Lighting Control System complies with the requirements checked below; and all components of the system considered together as installed meet all applicable requirements for the application for which they are installed as required in Sections 130.0 through 130.S, Sections 140.6 through 140.8, Section 141.0, and Section 1S0.0(k). PART 2 Lighting Control Functional requirements: Check all that apply when verifying the installation of an EMCS or Lighting Control System. r A. All outdoor lighting controls and equipment have been installed in accordance with the manufacturer's instructions. r B. The manufacturer has provided instructions for calibration. C. If indicator lights are integral to any components, such indicator lights consumes no more than 1 watt of power per indicator light. r D. Components that are regulated by the Title 20 Appliance Efficiency Regulations have been certified to the Energy Commission. r17 E. The EMCS or Lighting Control System functions as one or more of the Time -Switch Lighting Controls checked below, and complies with all of the following requirements: r 1. Automatic Time -Switch Controls meeting all requirements for Automatic Time Switch Control devices in the Title 20 Appliance Efficiency Regulations, including the requirements below: a. Commercial automatic time -switch controls meet the following requirements: i. Has program backup capabilities that prevent the loss of the device's schedule for at least 7 days, and the device's date and time for at least 72 hours if power is interrupted; ii. Is capable of providing manual override to each connected load and shall resume normally scheduled operation after manual override is initiated within 2 hours for each connected load; and iii. Incorporates an automatic holiday shutoff feature that turns off all connected loads for 1r least 24 hours and then resumes normally scheduled operation. r 2. Astronomical Time -Switch Controls meeting all requirements for Astronomical Time -Switch Control devices in the Title 20 Appliance Efficiency Regulations, including the requirements below: a. Meets the requirements of an automatic time -switch control; b. Has sunrise and sunset prediction accuracy within plus -or -minus 1S minutes and timekeeping accuracy within S minutes per year; c. Is capable of displaying date, current time, sunrise time, sunset time, and switching times for each step during programming; d. Has an automatic daylight savings time adjustment; and e. Has the ability to independently offset the on and off for each channel by at least 99 minutes before and after sunrise or sunset. r 3. Multi -Level Astronomical Time -Switch Controls, in addition to meeting all of the requirements for Astronomical Time -Switch Controls, includes at least 2 separately programmable steps per zone. F F. The EMCS or Lighting Control System functions as one or more of the Daylighting Controls listed below: C�� \` TP California Advanced Lighting Controls Training Program This is page 2 of 5 CERTIFICATE OF INSTALLATION CI-LT0-02-E Outdoor EMCS or Lighfuig Control System Project Name: MSD WelbeHeahh La Quinta Enforcemem Agency CITY OF LA QUINTA Permit Number. BCOM2022 0025 Project Address: 46805 Dune Pahns Rd. ICiy. La Quinta Zip Code: 92253 r 1. Automatic Daylight Controls meet all requirements for Automatic Daylight Control devices in the Title 20 Appliance Efficiency Regulations, including the following: a. Is capable of reducing the power consumption in response to measured daylight either directly or by sending and receiving signals; b. If the system includes a dimmer, complies with the Dimmer Control device requirements in the Title 20 Appliance Efficiency Regulations. c. Automatically return to its most recent time delay settings within 60 minute_ when put in calibration mode; d. Has a set point control that easily distinguishes settings to within 10 percent of full scale adjustment; e. Has a light sensor that has a linear response within 5 percent accuracy over the range of illuminance measured by the light sensor; <br /A Has a light sensor that is physically separated from where the calibration adjustments are made, or is capable of being calibrated in a manner that the person initiating the calibration is remote from the sensor during calibration to avoid influencing calibration accuracy; and g. Complies with the Title 20 requirements for photo controls if the system contains a photo control component. 2. Photo Controls meet all requirements for Photo Control devices in the Title 20 Appliance Efficiency Regulations, including the following that it does not have a mechanical device that permits disabling of the control. r G. The EMCS or Lighting Control System functions as a Dimmer and meets all requirements for a Dimmer Control device in the Title 20 Appliance Efficiency Regulations, including the following: 1. Is capable of reducing power consumption by a minimum of 65 percent when the dimmer is at its lowest level; 2. Includes an off position which produces a zero lumen output; and 3. Does not consume more than 1 watt per lighting dimmer switch leg when in the off position. 4. Dimmer controls that can directly control lamps provide electrical outputs to lamps for reduced flicker operation through the dimming range so that the light output has an amplitude modulation of less than 30 percent for frequencies less than 200 Hz without causing premature lamp failure. 5. If designed for use in three way circuits is capable of turning lights off, and to the level set by the dimmer if the lights are off. F_ H. The EMCS or Lighting Control System meets the following requirements: 1. Is capable of automatically turning off controlled lights in the area no more than 30 minutes after the area has been vacated; 2. Allows all lights to be manually turned off regardless of the status of occupancy; and 3. Has a visible status signal that indicates that the device is operating properly, or that it has failed or malfunctioned. The visible status signal may have an override switch that turns off the signal. 4. All occupant sensing devices that utilize ultrasonic radiation for detection of occupants meet the Ultrasound Maximum Decibel Values in the Title 20 Appliance Efficiency Regulations 5. All occupant sensing devices that utilize microwave radiation for detection of occupants meet the radiation requirements in the Title 20 Appliance Efficiency Regulations 6. Occupant sensing devices incorporating dimming comply with the requirements for dimmer controls in the Title 20 Appliance Efficiency Regulations 7. The EMCS or Lighting Control System functions as one or more of the Occupant Sensing Controls Checked Below: 7 a. Motion Sensors meeting all applicable requirements for Motion Sensor Controls devices in the Title 20 Appliance Efficiency Regulations, including that motion sensors are rated for outdoor use. r b. Partial -ON Sensors meeting all applicable requirements for partial on sensing devices in the Title 20 Appliance Efficiency Regulations, including the following: i. Has two poles each with automatic -off functionality; ii. Has one pole that is manual -on and does not incorporate DIP switches, or other manual means, for conversion between manual and automatic functionality; and iii. Has one pole that is automatic -on and is not be capable of conversion by the user to manual -on functionality. r c. Partial -OFF Sensors meet all applicable requirements for partial off sensing devices in the Title 20 Appliance Efficiency Regulations, including the following: i. Has two poles; ii. Has one pole that is manual -on and manual off; and iii. Has one pole that is automatic -on and automatic -off and is not capable of conversion by the user to manual -on only functionality. C�� \` TP California Advanced Lighting Controls Training Program This is page 3 of 5 CERTIFICATE OF INSTALLATION CI-LT0-02-E Outdoor EMCS or Lighfuig Control System Project Name: MSD WelbeHeahh La Quinta Enforcemem Agency: CITY OF LA QuiNTA Permit Number. BCOM2022-0025 Project Address: 46805 Dune Palms Rd. ICiy. La Quinta Zip Code: 92253 3ART 3 Requirements for which the control is being installed to complied with: .a=ntify all requirements in the Standards for which the EMCS or Lighting Control System is installed to function as and complie- with: =heck all that are applicable I7 A. Section 130.2(c)1 Photocontrol F, B. Section 130.2(c)1 Outdoor astronomical time -switch control r C. Section 130.2 (c)3 Motion Sensor r D. Section 130.2 (c)4A Part -Night Outdoor Lighting Control r E. Section 130.2 (c)4B Motion Sensor r F. Section 130.2 (c)SA Part -Night Outdoor Lighting Control r G. Section 130.2 (c)SB Motion Sensor r H. Section 130.2 (c)SC Centralized time -based zone lighting control. C�� \` TP California Advanced Lighting Controls Training Program This is page 4 of 5 CERTIFICATE OF INSTALLATION CI-LTO-M-E Outdoor EMCS or Lighfuig Control System Project Name: MSD WelbeHeahh La Quinta Enforcement Agency: CITY OF LA QUINTA Permit Number. BCOM2022-0025 Project Address: 46-805 Dune Palms Rd- ICiy. La QWnta 114 Code: 92253 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT I certif; that this Certificate of Acceptance document is accurate and complete. ocumentation Author Company ame Jeff Bernardino -ddress _ City -EA/ATT Certification dentification (if pplicable) RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the follovnng under penalty of perjury, under the lava of the State of California: 1. I am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, :onstruction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies vnth the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. I have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed is posted or made available vnth the building permit(s) issued for the building. 5. I vnll ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available vnth the building permits) issued for the 'wilding, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included -nth the documentation the builder provides to the building ovmer at occupancy. __ponsible Acceptance Company Name -erson Name Jeff Bernardino Integrated Povrer &Lighting, Inc. ddress: City 3312 Limerick Lane Corona -ip Code 92882 Phone (951)270-0575 -SLB License Position vnth Company 993105 (Title) ATT/RP -esponsible Acceptance Person Signature =te of Signature: 08.+01;'2023 C�� \` TP California Advanced Lighting Controls Training Program This is page 5 of 5 JJ JENSEN J ENGINEERING Ami INC. 1 Augustu 2023 Mr. David Kim Kinyon + Kim Architects, Inc. 1801 Oakland Blvd Suite 320 Walnut Creek, CA 94596 Telephone: 925-214-0911 ext. 111 Via Email: david(@k2a-inc.com Regarding: Welbe Health — La Quinta, California Electrical Panelboard Directory Review Mr. Kim: Electrical Engineers I am in receipt of the panelboard circuit directories that will be installed at the Welbe Health clinic located in La Quinta, California. I have reviewed the directories and I take no exception to the proposed circuit configurations or directory descriptors. I trust the above is clearly stated; however, if I may be of any further assistance, please contact me. Respectfully, George . Jens , PE 9655 Gateway Dr. Suite A Reno, Nevada 89521-2968 Phone: (775) 852-2288 Fax: (775) 852-3388 email: george.jensen@jeneng.com CIRCUIT DIRECTORY ELEV ELEVATOR PANEL PIT LIGHT 1 2 PIT GFI IRRIGATION 3 4 MACH ROOM MACH ROOM LIGHT 5 6 DED RECEPT FACP R ROOM LIGHT 7 8 SPARE FIRE BELL 9 10 SPARE SPACE 11 12 SPACE SPACE 13 14 15 SPACE 16 SPACE 17 SPACE 18 SPACE 19 SPACE 20 SPACE 21 SPACE 22 SPACE 23 SPACE 24 SPACE 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 CIRCUIT DIRECTORY K 1 (2) ICE MAKER 2 (15) HOLDING CABINET 3 (3) WAREWASHER 4 (25) FREEZER 5 (20) WAREWASHER 6 (26) REFRIGERATOR 7 (30) 1/2 SIZED CONVECT OVEN 8 (32) OVEN MICROWAVE 9 (34) TOASTER 10 (36) BLENDER 11 (37) COFFEE MAKER 12 (40) HOT FOOD STATION 13 (44) HEATED DISPENSER 14 RECEPTACLES 15 RECEPTACLES 16 SPARE 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 CIRCUIT DIRECTORY LTG RECEPTION GREAT ROOM (LIGHTING) 1 2 STAIR LIGHTING 1ST FLOOR LIGHTING 1ST FLOOR LIGHTING 3 4 1ST FLOOR LIGHTING 1ST FLOOR LIGHTING 5 6 1ST FLOOR LIGHTING 1ST FLOORING OUTDOOR 7 8 LIGHTING 2ND FLOOR LIGHTING ADIN OPEN WORK LIGHTING 9 10 2ND FLOOR LIGHTING 2ND FLOOR OUTDOOR 11 12 LIGHTING SPACE SPACE 13 14 SPACE SPARE 15 16 SPACE E-ROOM LIGHTS 17 18 SPACE SPARE 19 20 SPACE SPACE 21 22 SPACE SPACE 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 CIRCUIT DIRECTORY MECH ERV-1-1 ERV-1-2 1 2 ERV-1-1 ERV-1-2 3 4 ERV-1-3 ERV-2-1 5 6 ERV-1-3 ERV-2-1 7 8 BC-1 & BC-2 CU-A/FC-A 9 10 BC-1 & BC-2 CU-A/FC-A 11 12 CU-B/FC-B FC-1-1 & FC-1-2 13 14 15 CU-B/FC-B 16 FC-1-1 & FC-1-2 17 FC-1-3, FC 1-4, FC 1-5 18 FC-1-6 & FC-1-7 19 FC-1-3, FC 1-4, FC 1-5 20 FC-1-6 & FC-1-7 FC-2-1, FC-2-2, FC-2-4 FC-2-3, FC-2-5, FC-2-6 21 22 FC-2-1, FC-2-2, FC-2-4 FC-2-3, FC-2-5, FC-2-6 23 24 FC-2-7, FC-2-8, FC-2-9 SERVICE RECEPTICLES 25 26 FC-2-7, FC-2-8, FC-2-9 EF-1 27 28 WATER HEATERS & PUMPS SPACE 29 30 AC -I -ECONOMIZER SPACE 31 32 AC-1-1E AC -I -ECONOMIZER SPACE 33 34 AC-1-1E AC -I -ECONOMIZER SPACE 35 36 AC-1-1E AC-2-ECONOMIZER AC-3 ECONOMIZER 37 AC-2/2E 38 AC-3/3E AC-2-ECONOMIZER AC-3 ECONOMIZER 39 40 AC-2/2E AC-3/3E AC-2-ECONOMIZER AC-3 ECONOMIZER 41 AC-2/2E 42 AC-3/3E CIRCUIT DIRECTORY PWR2 2ND FLOOR RECEPTACLES 2ND FLOOR RECEPTACLES 1 2 2ND FLOOR RECEPTACLES DIED I.T. RECEPTACLES 3 4 DIED I.T. RECEPTACLES I.T. RACK 5 6 DIED I.T. RECEPTACLES I.T. RACK 8 DIED I.T. RECEPTACLES U.C. REFRIGERATOR 9 10 2ND FLOOR RECEPTACLES STAFF LOUNGE APPLIANCE 11 12 2ND FLOOR RECEPTACLES STAFF LOUNGE APPLIANCE 13 14 STAFF LOUNGE REFRIGERATOR STAFF LOUNGE REFRIGERATOR 15 16 2ND FLOOR RECEPTACLES 2ND FLOOR RECEPTACLES 17 18 2ND FLOOR RECEPTACLES 2ND FLOOR RECEPTACLES 19 20 2ND FLOOR RECEPTACLES 2ND FLOOR RECEPTACLES 21 22 2ND FLOOR RECEPTACLES 2ND FLOOR RECEPTACLES 23 24 2ND FLOOR RECEPTACLES 2ND FLOOR RECEPTACLES 25 26 2ND FLOOR RECEPTACLES FUTURE EV CHARGERS 27 28 FUTURE EV CHARGERS FUTURE EV CHARGERS 29 30 FUTURE EV CHARGERS FUTURE EV CHARGERS 31 32 FUTURE EV CHARGERS FUTURE EV CHARGERS 33 34 FUTURE EV CHARGERS FUTURE EV CHARGERS 35 36 FUTURE EV CHARGERS FUTURE EV CHARGERS 37 38 FUTURE EV CHARGERS SPACE 39 40 SPACE SPACE 41 42 1ST FLOOR RECEPTACLES CIRCUIT DIRECTORY PWR1 2 W.C. STORAGE RECEPTACLES 3 FITNESS EQUIPMENT 4 TREADMILL 5 TREADMILL 6 1ST FLOOR RECEPTACLES 1ST FLOOR RECEPTACLES 1ST FLOOR RECEPTACLES 1ST FLOOR RECEPTACLES 1ST FLOOR RECEPTACLES V ^„ 1ST FLOOR RECEPTACLES 1ST FLOOR RECEPTACLES 13 WASHER 14 DRYER 15 1ST FLOOR RECEPTACLES 16 DRYER 17 TUB 18 1ST FLOOR RECEPTACLES ^„ 1ST FLOOR RECEPTACLES 1ST FLOOR RECEPTACLES DRINKING FOUNTAIN L `T 1ST FLOOR RECEPTACLES 1ST FLOOR RECEPTACLES 1ST FLOOR RECEPTACLES 1ST FLOOR RECEPTACLES 1ST FLOOR RECEPTACLES 27 1ST FLOOR RECEPTACLES 28 IVIED FRIDGE 1ST FLOOR RECEPTACLES 1ST FLOOR RECEPTACLES 31 STERILIZER 32 1ST FLOOR RECEPTACLES 33 VACUUM 34 COMPRESSOR 35 VACUUM 36 COMPRESSOR 37 DENTAL POWER 38 CONTROL VALVE 1ST FLOOR RECEPTACLES 'T V 41 SPARE 42 1ST FLOOR RECEPTACLES ^� Golden Construction Inc Project: 413020 WelbeHealth La Quinta Ph. 4 r 7271 Mars Drive 46-805 Dune Palms Road GOLDEN Huntington Beach, California 92647 La Quinta, California 92253 J CONSTRUCTION, INC. P: 714-847-8080 "`iNeBuifdLife" F:714-847-8815 Submittal #21.1 - Revised Woodworks Grille Submittal Revision 1 Submittal Manager Shawna Jensen (Golden Construction, Inc) Status Open Date Created Dec 9, 2022 Issue Date Dec 7, 2022 Spec Section Responsible Accurate Acoustics, Inc. Received From Contractor Received Date Nov 18, 2022 Submit By Nov 18, 2022 Final Due Date Dec 2, 2022 Lead Time Cost Code Location Type Product Information Approvers David Kim (Kinyon + Kim Architects, Inc.) Ball in Court David Kim (Kinyon + Kim Architects, Inc.) Distribution Esperanza Barajas (Kinyon + Kim Architects, Inc.), Shawna Jensen (Golden Construction, Inc), Don Kinyon (Kinyon + Kim Architects, Inc.), Bruce Tiffany (Golden Construction, Inc), Ryan Tombrello (Golden Construction, Inc) Description Hello, Please review the attached Grid System Submittal for your review and approval. Submittal Workflow Name General Information Attachments David Kim Sent Date Due Date Returned Date Response Attachments Dec 9, 2022 Dec 2, 2022 Kinyon + Kim Architects NO EXCEPTION TAKEN CHECKING IS ONLY FOR GENERAL CONFORMANCE WITH DESIGN CONCEPT OF PROJECT AND GENERAL COMPLIANCE INFORMATION GIVEN IN CONTRACT DOCUMENTS. ANY ACTION SHOWN IS SUBJECT TO THE REQUIREMENTS OF PLANS AND SPECIFICATIONS. CONTRACTOR IS RESPONSIBLE FOR DIMENSIONS WHICH SHALL BE CONFIRMED AND CORRELATED AT THE JOB SITE, FABRICATION PROCESSES, TECHNIQUES OF CONSTRUCTION COORDINATION OF THEIR WORK WITH THAT OF ALL OTHER TRADES AND THE SATISFACTORY PERFORMANCE OF THEIR WORK. ANY REVIEW OR COMMENTS GIVEN HEREIN FOR SUBSTITUTIONS WHICH HAVE NOT BEEN PREVIOUSLY IDENTIFIED AND PROPERLY PROCESSED AS SUCH OR HAVE BEEN OTHERWISE INADVERTENTLY REVIEWED BY THE ARCHITECT OR THEIR CONSULTING ENGINEERS SHALL BE WITHOUT STANDING AND THE CONTRACTOR'S RESPONSIBILITIES FOR THE SUBSTITUTIONS AS DESCRIBED IN THE CONTRACT DOCUMENTS SHALL REMAIN ENFORCE. Reviewed by: David kim Date:17 December 2022 Pending Revised Woodwork Grille.pdf Golden Construction Inc Page 1 of 1 Printed On: Dec 17, 2022 12:32 PM PST r-, GOLDEN LCONSTRUCTION, INC. J "We Build.Gife" TO: Kinyon + Kim Architects, Inc. 1801 Oakland Blvd. Suite 320 Walnut Creek, CA 94596 DATE: 12/7/2022 JOB: WelbeHealth La Quinta Ph. 4 ATTENTION: David Kim TRANSMITTAL: 95 RE: Kinyon + Kim Architects, Inc. WE ARE SENDING YOU: ❑ Attached VIA: ❑ U.S. Mail ❑ Under Separate Cover ❑ Fax, Total No. of Pages: ❑ Other THE FOLLOWING ITEMS: [Q Submittal ❑ Request For Proposal ❑ Request For Change ❑ Request For ❑ Information ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ WE ARE SENDING YOU: W For Approval ❑ For Your Use ❑ As Requested ❑ For Review ❑ ❑ ❑ Approved As Submitted ❑ Approved As Noted ❑ Revise And Resubmit ❑ Rejected ❑ ❑ REMARKS Hello David, Please review the attached Revised Woodworks Grill for your review and approval for Welbe La Quinta. COPY TO: SIGNED: DATE: WOODWORKS° Grille Solid Wood Backer, Dowel, and Backer & Dowel Combination r WoodWorks® Custom Installation — Grille Faceted Ceiling 2-1/4" panels in Grille White with Backer These warm, natural wood ceilings offer installation flexibility and a variety of design options. KEY SELECTION ATTRIBUTES 13 pre -designed panels with new slat heights and widths Custom slat sizes and finishes available for every project Now, painted White finish for maximum design flexibility Install in the ceiling, on the wall, or create 901 angled or faceted ceiling -to -wall transitions Easy installation with dowel or backer, or backer and dowel combination FSC® and Rainforest Alliance Certified wood options available FINISH SELECTION Due to printing limitations, shade may vary from actual product. Grille White Grille Maple Grille Light Grille Da Grille Walnut (GWH) (GMP) Cherry (GLC) Cherry (GD (GWN) NOTE: Panel backers are black. Custom backer colors tom Finishes Available CAD/RevitO drawings at: armstrongEeilings.com armstrongceilings.com/capabilities See more photos at: armstrongceilings.com/photogallery 187 Techl-ine 877 276-7876 (A)rmstrong- armstrongceilings.com/woodworks KDF CEILING & WALL SOLUTIONS For LIED contribution contact TechUne WOODWORKSO Grillep Solid Wood W £ �e — �� a=� a '•d —dm�" Backer, Backer LOCATION DEPENDENT INFILL VISUAL SELECTION ACOUSTICAL INFORMATION PANEL Dots represent high level of performance. Slat Edge Item Slat Slat Slats Spacing Dimensions (Inches) Profile No. ♦ Width Height Per Panel (Nominal) Nominal W x L x H* a y E c o WOODWORKS Grille —Backer, Dowel, and Backer &Dowel Combination == + Backer, Dowel, or 7263 5/8" 1-3/8" 6 slats 1-3/8" 12 x 96 x 1-7/8" Backer Only 5823 0.85 28 — Backer & Dowel 12 x 96 x 1-3/8" Dowel Only Combination 7264_ _ _ _ _ 5/8" 1-3/8" 8 slats 7/8" 12 x 96 x 1-7/8" Backer Only 12 x 96 x 1-3/8" Dowel Only 7265 5/8" 2-1/4" 6 slats 1-3/8" 12 x 96 x 2-3/4" Backer Only iO..—..O i/An ,. n. 8200100 0.90 28 — • 7266_ _ _ _ _ 5/8" 2-1/4" 8 slats 7/8" 12 x 96 x 2-3/4" Backer Only 12 x 96 x 2-1/4" Dowel Only 7091 5/8" 3-1/4" 5 slats 1.75" 12 x 96 x 3-3/4" Backer & Dowel 12 x 96 x 3-1/4" Dowel Only 7092 5/8" 3-1/4" 6 slats 1-3/8" 12 x 96 x 3-3/4" Backer & Dowel 12 x 96 x 3-1/4" Dowel Only 7093 5/8" 4-1/4" 5 slats 1.75" 12 x 96 x 4-3/4" Backer & Dowel 12 x 96 x 4-1/4" Dowel Only 7094 _ _ _ _ _ 1" 2-1/4" 4 slats 2" 12 x 96 x 2-3/4" Backer Only 12 x 96 x 2-1/4" Dowel Only 7095 _ _ _ _ _ 1" 3-1/4" 4 slats 2" 12 x 96 x 3-3/4" Backer Only 12 x 96 x 3-1/4" Dowel Only 7096 1" 4-1/4" 4 slats 2" 12 x 96 x 4-3/4" Backer & Dowel 12 x 96 x 4-1/4" Dowel Only 7097 _ _ _ _ _ 1-1/4" 3-1/4" 3 slats 2-3/4" 12 x 96 x 3-3/4" Backer Only 12 x 96 x 3-1/4" Dowel Only 7098 1-1/4" 4-1/4" 3 slats 2-3/4" 12 x 96 x 4-3/4" Backer & Dowel 12 x 96 x 4-1/4" Dowel Only 7099 1-1/4" 5-1/4" 3 slats 2-3/4" 12 x 96 x 5-3/4" Backer & Dowel 12 x 96 x 5-1/4" Dowel Only ♦ When specifying or ordering please include the installation type and color suffixes (e.g., 7092 B D G L C — 6 slats 3-1/4" Backer & Dowel in Grille Light Cherry). Installation suffixes: BO = Backer, DO = Dowel, BD = Backer & Dowel Combination NOTE: For additional color and size options, or curved applications options with flexible Backers (special order), call TechLine at 1 877 276-7876 * Actual panel length is 95" NOTE: Panel backers are black. Custom backer colors available. SUFFIX GUIDE ACCESSORIES Item Description No. ♦ Dimensions Nominal W x L Inches Color PCs/ (Refer to Ctn Pg. 185) Item Number ♦ Dimensions Description Nominal W x L Color WIs (Refer to Pg. 185) PCs/ Ctn 5672 _ _ _ Junction — 1-3/8" 1-1/2 x 96 x 2" All finishes Bulk 5688 tr Dowel Clip 3/8 x 7/8 x 7/8" N/A 250 pcs/pail Q 5674 _ _ _ End Cap—1-3/8" 3/4 x 96 x 2" All finishes Bulk o 5671 _ _ _ Ledger 1 x 96 x 1/4" All finishes Bulk 5675 _ _ _ End Cap — 2-1/4" 3/4 x 96 x 2-3/4" All finishes Bulk 7891 12 Gauge Soft 144" Length N/A 140 Hanger Wire 7170 End Cap — 3-1/4" 3/4 x 96 x 3-3/4" All finishes Bulk _ _ _ 92715A620 Self -tapping Screws #2 x 3/4" Length Black 25 7171 _ _ _ End Cap — 4-1/4" 3/4 x 96 x 4-3/4" All finishes Bulk 6459BL Uptight Clip 5-1/2 x 1-3/4" Black 25 7172 _ _ _ End Cap — 5-1/4" 3/4 x 96 x 5-3/4" All finishes Bulk RC2131. RC2 Radius Clip N/A Black 205 5687 Backer Clip 3/8 x 11/16 x 7/8" N/A 250 When specifying or ordering, include the 3-letter color suffix that coordinates with your pcs/pail WoodWorks ceiling: (e.g., 5671 G M F ). SUSPENSION SYSTEMS TRIM AND ACOUSTICAL INFILL PANELS 15/16" Trim and infill panels available. See pages 199-200 n this catalog or visit armstrongceilings.com/woodworks Heavy Duty Prelude® XL® (Black recommended) TechLine 877 276-7876 �mstrong 88 armstrongceilings.com/woodworks CEILING & WALL SOLUTIONS WOODWORKS° Grille Solid Wood Backer, Dowel, and Backer & Dowel Combination STANDARD SIZES 1-1/4" SLAT WIDTH 1" SLAT WIDTH 5/8" SLAT WIDTH 3 Slats Per Panel 4 Slats Per Panel 5 Slats Per Panel 6 Slats Per Panel 8 Slats Per Panel x co w x J N a0 M IQ M Item 7097_ _ _ _ _♦ Backer Only or Dowel Only L x cs x a J N V 7 Item 7098_ _ _ _ _♦ Dowel Only or Backer & Dowel L x c� LU x J N V 7 Item 7099_ _ _ _ _♦ Dowel Only or Backer & Dowel Item 7094_ _ _ _ _♦ Backer Only or Dowel Only Item 7095_ _ _ _ _♦ Backer Only or Dowel Only Item 7096_ Dowel Only or Backer & Dowel Item 7091_ _ _ _ _♦ Dowel Only or Backer & Dowel Item 7093_ Dowel Only or Backer & Dowel Backer Unly or Dowel Only Item 7265_ _ _ _ _♦ Backer Only or Dowel Only Item 7092 _ _ _♦ Dowel Only or Backer & Dowel Backer Only = BO Dowel Only = DO Backer & Dowel Combination = BD Backer Only or Dowel Only Item 7266_ _ _ _ _♦ Backer Only or Dowel Only ♦ When specifying or ordering please include the installation type and color suffixes (e.g., 7092 B D G L C — 6 slats 3-1/4" Backer & Dowel in Grille Light Cherry). 89 Techl-ine 877 276-7876 (A)rmstrong- armstrongceilings.com/woodworks KDF CEILING & WALL SOLUTIONS WOODWORKS° Grille Solid Wood Backer, Dowel, and Backer & Dowel Combination SYSTEM INSTALLATION DETAILS Prelude® XL® Heavy- Duty Suspension p System in Black 0 0 2-1/4" Slat Dowel Clip Dowel° y} Ceiling Dowel Assembly #6 x 1-1/4" bugle head Hi-Lo drywall screw ` Prelude® XL® Heavy- Duty Suspension System in Black 1-3/8" Slat Backe Y Backer Clip Ceiling Backer Assembly Prelude® XL® Heavy Duty Suspension System Backer 2-1/4" Slat Screw Attachment Detail NOTE: See Woodworks® Grille installation instructions for details on faceted installation. ACOUSTICAL PERFORMANCE Noise Reduction Coefficient, or NRC, is a measure for rating the overall sound absorption of a material when used in an enclosed architectural space such as an office, where sound is reflected at many angles of incidence. WoodWorks® Grille has an NRC value of 0.85 when installed with a BioAcoustic'" infill panel 5823. NRC is important in any closed space where reverberation time and noise levels are an issue: Closed offices, conference rooms Classrooms/core learning areas, Mixed plan office gymnasiums, cafeterias Lobby, reception, and work areas Retail spaces; checkout and other customer contact areas Factors that may affect the installed acoustical performance relative to the published results are: Size of area Suspension distance below exposed Number of panels deck or finished ceiling Layout of panels Other surfaces in the space PHYSICAL DATA Material Dowel, Slats, Backers, and Tegular panels — solid Poplar (yellow or hybrid). Surface Finish Clear or tinted semigloss coating on all finishes except Grille White (GWH). Grille White (GWH) has a lacquer finish. Fire Performance Solid Poplar (yellow or hybrid) Hardwood Slats and Backers Solid Poplar (yellow or hybrid) Hardwood Slats and Backers — Class C ASTM E84 surface burning characteristics. Flame Spread Index 200 or less. Smoke Developed Index 450 or less. Fire performance will vary between wood species. Contact TechLine at 1 877 276-7876 for details. These panels, as with other architectural features located at the ceiling, may obstruct or skew the planned fire sprinkler water distribution pattern, or possibly delay or accelerate the activation of the sprinkler or fire detection systems by channeling heat from a fire either toward or away from the device. Wall � Grille Panel < Grille Furring Backer Strips Screws Wall Backer Assembly Slat sizes over 2-1 /4" are not recommended for wall applications. Contact TechLine for details at 1 877 276-7876. Ceiling Exposed Structure Ultima® WoodWorks Grille (no Ceiling) (100% Ceiling) (100% Ceiling) Reverberation Time 3.4 seconds 0.5 seconds 0.5 seconds (RT) RT Improvement N/A 85% 85% Background N/A 4.7dB 5.8clB Noise Reduction in Decibels (dB) NOTE: You can calculate the acoustical difference that WoodWorks Grille panels can make in your space by using our online Reverb Calculator Tool at armstrongceilings.com/reverbtool Consult a fire protection engineer, NFPA 13, and local codes for guidance where automatic fire detection and suppression systems are present. Application Considerations Variation among panels may occur due to the natural characteristics of the wood and grain. Design Considerations Custom slat and panel sizes available. Backer & Dowel For slat heights over 5", both Dowels and Backers are required for stability. Backer height is 1/2". Panel backers are black. Custom backer colors available. Inflill Panel Use If no infill panel is used, unfinished parts of the suspension system and Axiom® trim will be visible from below. Site Conditions It is very important that panels are climatized prior to installation. Relative humidity between 25% and 55% and temperatures between 50°F and 86°F must be maintained. Installation Consideration When junction accessory is not used, the result will be a 1" gap between slat lengths. Seismic Restraint WoodWorks® Grille panels have been engineered, tested, and approved for application in all seismic areas when installed per Armstrong Ceilings installation instructions. Warranty Details at armstrongceilings.com Weight 7263 — 2.0 Ibs/SF 7264 — 2.6 Ibs/SF 7265 — 2.8 Ibs/SF 7091 — 3.2 Ibs/SF 7093 — 3.0 Ibs/SF 7092, 7094, 7097 — 3.4 Ibs/SF 7095 — 3.5 Ibs/SF 7266, 7096, 7098 — 3.6 Ibs/SF 7099 — 4.37 Ibs/SF LEED® is a registered trademark of the U.S. Green Building Council Revie is a registered trademark of Autodesk, Inc. TechLine / 1 877 276-7876 FSC® is a registered trademark of FSC Forest Stewardship Council A.C.., "' armstrongeeilings.eom/woodworks license code FSC-0007626. All other trademarks used herein are / /� )Y�C•7 ` }�O��y- .1 O (search: woodworks grille) the property of AWI Licensing LLC and/or its affiliates "/�1 y BPCS-5106-1217 02016-2017 AWI Licensing LLC Printed in the United States of America CEILING & WALL SOLUTIONS Equipment Alert Wet -Ring Vacuum system must be installed per local plumbing and electrical codes. Allow Wet -Ring Vacuum system to reach room temperature before installing. Refer to "Site Requirements" and "Site Layout" in this manual for site restrictions and piping layout. Do not turn water by-pass valve.The valve is factory set for recycler mode in CLOSED postion. (Refer to ClassicSeries° Service Manual on www.Documark.com formore information) Remote Low Voltage Leads Anti -Siphon Vacuum Breaker Motor Water By -Pass Valve- Closed Positon For Recycler Mode (Recycler Models Only) Fuse �. Air Filter/Cap Hour Meter Electrical Box Vacuum Relief Valve i= Cl) Solenoid Vacuum Gauge a� Vacuum Housing Line Connection to Operatory Vacuum Inlet Strainer AA185600 Fresh Water Supply Connection Single Recycler Model Shown ©MidmarkCorporation 2007 1 60 Vista Drive Versailles, OH 45380 USA 1 1-800-643-6275 1-1937-526-3662 1 midmark.com 1 10546400 Rev. U (3/28/14) Wet -Ring Vacuum Site Requirements Equipment Alert Harmful odors, vapor contaminants and nitrous oxide gasses are vented out the top of the separator, while liquid waste flows out of the lower drain and into a "P"-Trap or floor sink. Verify all local codes before installing. Models Electrical single Models Twin Models •• CV3 CV3R CV5 CVSR CV6 CV6R CV10 CV10R Voltage 115 or 208-230 115 or 208-230 208-230 208-230 115 or 208-230 (Each Pump) 115 or 208-230 (Each Pump) 208-230 (Each Pump) 208-230 (Each Pump) Phase Single Phase, 50 / 60 Hz Wire Size to Control Panel 18 / 3 Jacketed Bell Wire Branch Circuit Breaker Size 20 AMP Minimum (per each pump) .• 115 VAC 50/60 HZ 15.0 AMPS 15.0 AMPS 15.0 AMPS 15.0 AMPS 208/230 VAC 50/60 HZ 8.2 AMPS 8.2 AMPS 13.1 AMPS 13.1 AMPS 8.2 AMPS 8.2 AMPS 13.1 AMPS 13.1 AMPS Plumbing Type PVC Line Sizing 1" Hose with 3/4" NPT Connection 1 1/2" Hose with 1 1/4" NPT Connection Type Poly Tubing Line Sizing 1/2" NPT x 1/4" 1/2" NPT x 3/8" Pressure Range 20-120 psi / 1.4-8.3 bar Water Temperature Range 35-80° F / 2-12° C • . Small Large (Vent Size 1 2" Inlet Hose 3/4" NPT 1 1/4" NPT Drain Hose 3/4" NPT 1" NPT . Type N/A Clear Vinyl Size N/A 3/8" OD Type I PVC Line Sizing 1" Hose with 3/4" NPT Connection 1 1/2" Hose with 1 1/4" NPT Connection Environmental Equipment Room Ambient Temperature - Operational 40° - 104° Fahrenheit / 4° - 40° Celsius © Midmark Corporation 2007 2 Wet-Rina Vacuum Site Reauirement Lavout To prevent moisture from entering the vacuum: • Vent should be routed to outside air source through wall or roof. • Use one or more 900elbows to cap an outside vertical vent line. Disconnect Box Vent Refer to "Electrical" on Site Requirement sheet. (Provided by Electrician) Air/Water Separator Height - Top bracket mounting screws 1 1/2"P-Trap With 1 "Air Gap — • located 28" (70 cm) above vacuum supporting surface. or Floor Sink (Floor, shelf, stack rack etc..) (Provided by Plumber) Operatory Air Line Connection 1+ i 6" - 12"- - f AA188500 r- Max OEquipment Alert • When performing positive pressure leak tests to validate plumbing installation, verify vacuum systems are not connected to office piping. VACUUM LINE SIZING CHART Number of Operatories Main Line Supplied Through Line (PVC Sch 40) Pipe Diameter in Inches 1-2 314 3-4 1 5-6 1 1/4 7-10 1 1/2 AA188601 0 Midmark Corporation 2007 3 Wet -Ring Vacuum Site Requirement Layout continued... Micro Mini Muffler/VRV (pn 77005027) to be Installed at Top of Vent Line in Each Operatory 112" Vent Line Installed With VRV Above Inverted P-Trap Allows Air Into System to Prevent Gurgling in Vacuum Lines u u 01 u Equipment Alert Subfloor plumbing is preferred. Operatory utilization to be modified to allow flow up walls. Upsize pump as per number of operatories. At least % user per VRV and 8 ft. riser. More than 8ft riser requires more pump capacity. Inverted P-Trap 011, 21A IN", I � nil Trunk Lines: Follow Sizing Guide for Under Floor Installation and Add One User Vacuum System Vacuum Piping to be Type M or Schedule 40 PVC Maintain a 114" Slope per 10 feet of Piping (toward pump) Always Stagger branch lines from main trunk Do not use 4-way Cross Fittings AA2400i © Midmark Corporation 2007 4 Important Information Intended Use To provide suction during general examinations and procedures conducted by qualified dental professionals. Electromagnetic Interference This Midmark Wet -Ring Vacuum is designed and built to minimize electromagnetic interference with other devices. However, if interference is noticed between another device and these units: • Remove interfering device from room • Plug interfering device into an isolated circuit • Increase separation between unit and interfering device • Contact Midmark if interference persists Disposal of Equipment At the end of product life, the unit(s), accessory, and other consumable goods may become contaminated from normal use. Consult local codes and ordinances for proper disposal of equipment, accessories and other consumable goods. Transportation / Storage Conditions Ambient Temperature Range: .............................. 40'F to 104°F (4°C to 37°C) Relative Humidity................................................10% to 90% (non -condensing) Atmospheric Pressure.........................................500hPa to 1060hPa (0.49atm to 1.05atm) Keep dry 2 Maximum stacking height (palletted units) A E V Fuse rating specification SSS Caution hot surface I PXO Ordinary Equipment Consult User Guide • for important information. tt Proper shipping orientation TFragile OProtective earth ground This product has been evaluated with respect to electrical shock, fire & mechanical hazards only, in accordance with UL60601-1 and CAN/CSA C22.2 NO. 601.1. Q$8_A330,�+ DENTAL VACUUM PUMP A 94XM U L60609-9 , OHC60601-1, CAN/CSA C22.2 No. 60U 20 AMP BRANCH CIPCU H` THERMALLY PROTECTED CALMON: ®® NOT OPERATE WV4a®U T FRESH WATER SUPPLY AT 20420 PSV. AMMENT TEMPERA gU1 E SDI®U LD NOT EXCEED 40 C 904 E. 061-1030-00 Safety Symbols ADANGER Indicates an imminently hazardous situation which will result in serious or fatal injury if not avoided.This symbol is used only in the most extreme conditions. WARNING ! Indicates a potentially hazardous situation which could result in serious injury if not avoided. CAUTION ! Indicates a potentially hazardous situation which may result in minor or moderate injury if not avoided. It may also be used to alert against unsafe practices. Equipment Alert ! Indicates a potentially hazardous situation which could result in equipment damage if not avoided Note Amplifies a procedure, practice, or condition. 0 Midmark Corporation 2007 5 Before you Install... Pre -Install steps.. A. Remove vacuum(s) from shipping platform. B. Move vacuum to a dry, well ventilated area on a solid, level surface. C. Verify all sides of Vac Unit are not obstructed. D. Unpack installation kit. E. Install rubber feet. (Single Pump Models Only) F. Verify water by-pass valve is in recycler positon, CLOSED. Single Models Bushing Clamp oty 1 Oty 4 Nipple OC Fitting Oty 2 oty 1 inrarce i cxnausr nose 1"IDx84" oty 1 Rubber Feet — Water By -Pass Valve Single Recycler Model Shown AA185800 Install Kits Twin Models ® Bushing Clamp oty 1 Oty 4 0 QC Fitting Mount with Nut Lock Nipple oty 1 Pipe Plug Oty 3 Oty 4 \n-IREN Oty 1 Fresh Water Intake Hose 114"ODx72" oty 1 F) Vacuum Inlet Strainer Cap oty 1 oty 1 P'"Intake Hose 1 112" ID x 96" oty 1 Fresh Water Intake Hose %EA 318" OD x 72" Oty 1 Platform Drain Hose 318" OD x 96'; Oty 1 © Midmark Corporation 2007 6 Installation Plumbing Connections - Single Models with Air/Water Separator Single Models Air/Water Plumbing... A. Mount Separator 28" (70 cm) above vacuum supporting surface. B. Install exhaust silencer into 1 " exhaust hose from vacuum to P-trap if applicable. If not using an exhaust silencer.... C. Connect exhaust hose from vacuum to separator. D. Connect 3/4"hose from separator to drain or P-trap. E. Connect 2" PVC to top of separator and out to vent. F. Connect 1/4"poly tube from vacuum to water supply. G. Connect 3/4"NPT fitting and hose clamp from vacuum line to operatory. Water Source Exhaust Hose Line *Install Exhaust Silencer Here" i 61 I _ I \\ I It I II I II I II I II I In from Operatory Note Exhaust silencer installation is an optional for the Wet -Ring Vacuums. Wet -Ring Vacuums are operational without exhaust silencer. Drain AA185900 Vent I l \ I P-Trap drain with Air/Water Separator i Exhaust From Pumps 0 Midmark Corporation 2007 7 © Midmark Corporation 2007 Installation Plumbing Connections - Twin Models with Air/water Separator Note Exhaust and inlet connections can be installed on either the RH or LH sides Install hose connections to one end and plug/cap the other end. Plug ( Cap Twin Model Plumbing... A. Mount Separator 28" (70 cm) above vacuum supporting surface. B. Connect exhaust hose from exhaust to separator. C. Install plug in exhaust end not in use. D. Connect 1 "hose from separator to drain or P-trap. E. Connect 2" PVC to top of separator and out to vent. F. Install inlet strainer to one end of the inlet piping. Cap off other end. G. Connect 1 1/4"NPT fitting and hose clamp to inlet strainer from operatory. H. Connect 3/8"poly tube from vacuum to water supply. I. Install 3/8"platform drain hose from platform to drain or sewer. (_ 1 Venter i Exhaust L l —*—Vent \ I P-Trap drain U xhaust From with Vacuums I ; Air/Water r Separator WateP Source i i i p \ � AA199200 Drain ® Platform I I Drain Vacuum 1 1 Inlet In From Operatory I < 0 Midmark Corporation 2007 © Midmark Corporation 2007 10 Installation - Single Models Electrical Convert Voltage 115 Voltage Configuration applicable) K rruceeu iu ouppy oux and Remote Panel Installation 0 Midmark Corporation 2007 11 Installation - Single Models Electrical Connections for 1 114 HP 208-230 Voltage To connect 1 114 HP Motor to 208-230V ... A. Loosen screws on electrical box to remove cover. B. Install line voltage conduit with conduit connector in side of vacuum electrical box. C. Connect line voltage to leads at terminals X1 (Black) and X2 (Red). D. Connect ground wire to ground (green/yellow) lead. E. Verify jumper locations ... X2 and X3 X6 and X7 208-230 Voltage Configuration Conduit Entry Proceed to Supply Box and Remote Panel Installation © Midmark Corporation 2007 12 Installation - Single Models Electrical Connections - 2 HP 208-230 Voltage To connect 2Hp Motor to 208-230V ... A. Loosen screws on electrical box to remove cover. B. Install line voltage conduit with conduit connector in side of vacuum electrical box. C. Connect line voltage to Red and Black contactor leads. D. Connect ground wire to ground (green/yellow) lead. Conduit AA186400 Proceed to Supply Box and Remote Panel Installation 0 Midmark Corporation 2007 13 Installation - Twin Models Electrical Connections - Convert 1 114 HP models to 115 Voltage (if applicable) NX � CONTACTOR N-�, ) Note CV6 and CV6R Models are factory configured for 208-230 Volt operation and can be rewired to operate on 115 Voltage. All vacuum systems are to be installed according to local electrical codes. Refer to Specification Sheet for Electrical Ratings located in this manual. To convert 1 114 HP Motor from 208-230V to 115V... A. Loosen screws on electrical box to remove cover. B. Disconnect red line voltage wire from red jumper. Replace nut on red jumper wire. C. Connect red voltage wire with white jumper from X4. D. Remove all three jumpers from terminal block and relocate at ... X3 and X4 X5 and X6 X7 and X8 115 Voltage Configuration X1 X2 X`' X4 X5 X6 X7 X? ME N AA200100 Proceed to Supply Box and Remote Panel Installation © Midmark Corporation 2007 14 Installation Electrical Connections - Supply Box and Remote Panel Electrical Connections... A. Connect conduit cable(s) to user supplied electrical box(s). B. Connect remote panel wires to Low Voltage Control wires if applicable. Note: All vacuum systems are to be installed according to local electrical codes. Never operate the equipment without complete and proper grounding. Refer to Specification Sheet for Electrical Ratings, located in this manual. SUPpIV BOX *1 114 HP Models 115 Volt Source OR 208-230 Volt Source Single Phase, 50160 Hz Recommended - 20 Amp Fuse Disconnect Box (Eletrician Supplied) *2 HP Models 208-230 Volt Source Single Phase, 50160 Hz Recommended - 20 Amp Fuse Disconnect Box (Eletrician Supplied) Green/Yellow = Ground Red and Black Connect to Electrical Suaaly* Transformer High Voltage Relay (Conta, Remote Panel Control Panel Reference Cross Wiring Brand Wire A B (Light) C Midmark Blue White Red Air Techniques Yellow Brown Orange DentalEZ Black Brown Yellow Apollo Blue White Red Matrx Red Blue White © Midmark Corporation 2007 15 Installation Check & Test Equipment Alert OPerform Checks before operation. • Turn only one vacuum on at a time while checking. Operating vacuum without full pressure water supply will result in serious seal damage. Initial Start-up Checks,Verify... A. All water supply valves are "OPEN" B. Exhaust hoses have water flowing through each pump and no leaks are present. C. Check vacuum gauge to ensure it reads 10 "Hg. Note: If necessary perform Vacuum Relief Valve adjustment as shown below. © Midmark Corporation 2007 16 AA186600 Breaker Vacuum Max. Width Depth Height Weight Total Voltage Size per Inlet Drain Fresh Water Connection Connection Connection Model Users (IN.) (IN.) (IN.) (LBS.) HP (50/60 Hertz) Pump Size (IN.) Size (IN.) Size (FNPT) (Amps) CV3 3 12" 13" 15" 54 1 1 /4 115 / 208-230 20 ill ill 1 /2" CV3R 3 12" 13" 15" 56 1 1 /4 115 / 208-230 20 ill ill 1 /2" CV5 5 12" 13" 17" 63 2 208-230 20 ill ill 1 /2" CV5 R 5 12" 13" 17" 65 2 208-230 20 ill ill 1 /2" CV6 6 25 1 /2" 20" 18 1 /2" 134 2 1 /2 115 / 208-230 20 1 1 /4" 1 1 /4" 1 /2" CV6 R 6 25 1 /2" 20" 18 1 /2" 134 2 1 /2 115 / 208-230 20 1 1 /4" 1 1 /4" 1 /2" CV 10 10 25 1 /2" 20" 18 1 /2" 154 4 208-230 20 1 1 /4" 1 1 /4" 1 /2" CV 10 R 10 25 1 /2" 20" 18 1 /2" 154 4 208-230 20 1 1 /4" 1 1 /4" 1 /2" www.Midmark.com • 1-800-Midmark 0 Midmark Corporation 2007 17 This page was intentionally left blank. © Midmark Corporation 2007 18 Midmark Corporation For contact information, go to: www.midmark.com Because we care. 0 Midmark Corporation 2007 19 SENIOR DAYCARE CENTER - 46805 Dune Palms Rd, La Quinta, California Plan Check Fees for Percentage of Fee Calculation (Remodel/Addition Construction Only) Application 4 BCOM2022-0025 Note: Highlighted Cells are User -Entry Fields inn A Addition Square Footage Remodel Square Footage 17,979 Valuation Residential or Non -Residential? Non -Residential < Select Residential or Non -Residential Addition Building Plan Check Fee (from adopted schedule) Addition - $226.25 for the First 100SF and $23.01 for each additional 500 SF First 100 SF 0 0 remainder div by 500 # of 500's multiplier 0.00 0.00 0.00 23.01 $ - Total Building Plan Check Fee Plan Check Fee (from adopted schedule) Remodel Non -Structural Review- $155.06 for the First 100SF and Remodel Building $20.01 for each additional 500 SF First 100 SF 155.06 155.06 remainder div by 500 # of 500's multiplier 17879.00 35.76 36.001 20.01 $ 720.36 Total Building Plan Check Fee $875.42 Construction Plan Check Fee (from Base Plan Check Fee Plus Electrical New adopted schedule) Unit Quantity Extension $ 96.70 for the first 2,000 1 $ 96.70 $ 11.12 for each add'I 2,000 1 8 $ 88.96 Total Electrical Plan Check Fee $185.66 SENIOR DAYCARE CENTER - 46805 Dune Palms Rd, La Quinta, California Plan Check Fees for Percentage of Fee Calculation (Remodel/Addition Construction Only) Application 4 BCOM2022-0025 Note: Highlighted Cells are User -Entry Fields ermit & Plan Check Fees (from adopted schedule) Item Quantity Plan Check fee, ea Plan Check Fees Furnace, including ducts 0 Heater, susp., recessed, floor 0 Mech system, add, alt, repair 2 Boiler/compr., install, relocate 3 Air handler, including ducts 16 Evap. Cooler, non -portable 4 Vent fan, single duct 6 Exhaust hood, including ducts 0 Mechanical equip., other 0 $ 27.79 $ $ - $ 13.89 $ 5.56 $ 11.12 $ 27.79 $ 83.37 $ 13.89 $ 222.24 $ 13.89 $ 55.56 $ 5.56 $ 33.36 $ 5.56 $ - $ 41.68 $ - Total Mechanical Permit & Plan Check Fees $405.65 Plan Check fee, ea Plan Check Fees Item Quantity Plumbing fixture 67 Sewer Connection (usually 1) 1 Roof drain 0 Waterheaterand/orvent 2 Grease interceptor 1 Water piping, add, alt, repair 1 Backflow prevention device 0 Gas piping system, 1 to 4 outlets 1 Gas piping system, 5 or more outlets 0 Solar Thermal 0 $ 13.89 $ 930.63 $ 19.45 $ 19.45 $ 13.89 $ - $ 8.34 $ 16.68 $ 13.89 $ 13.89 $ 13.89 $ 13.89 $ 5.56 $ - $ 27.79 $ 27.79 $ 27.79 $ - 1 $ 27.79 1 $ Total Plumbing Permit & Plan Check Fees M $1,022.33 SENIOR DAYCARE CENTER - 46805 Dune Palms Rd, La Quinta, California Plan Check Fees for Percentage of Fee Calculation (Remodel/Addition Construction Only) Application 4 BCOM2022-0025 Note: Highlighted Cells are User -Entry Fields Electrical Permit & Plan Check Fees (from adopted schedule) . Item Quantity Plan Check fee, ea Plan Check Fees Receptacle, switch, etc. (first 20 = 1) 0 Receptacle, switch, etc., ea add'I 0 Lighting fixture (first 20 = 1) 0 Lighting fixture , ea add'I 0 Pole light, alt, repair only (first 10 =1) 0 Pole light, alt, repair only, ea add'I 0 Residential appliance 0 Non-residential appliance 0 Power apparatus (motors, etc.), ea 0 Sign, outline lighting system, ea 0 Service, ea 0 Temporary power service 0 Electrical equip., other 0 Solar (PV) system <10kW 0 Solar (PV) system >10kW 0 Solar (PV) system, ea add'I string (>20) 0 $ 27.79 $ - $ 0.69 $ - $ 27.79 $ - $ 0.69 $ - $ 27.79 $ - $ 0.69 $ - $ 13.89 $ - $ 27.79 $ - $ 27.79 $ - $ 55.58 $ - $ 13.89 $ - $ 19.45 $ - $ 27.79 $ - $ 27.79 $ - $ 41.68 $ - $ 0.69 $ - Total Other Electrical Permit & Plan Check Fees $0.00 SENIOR DAYCARE CENTER - 46805 Dune Palms Rd, La Quinta, California Plan Check Fees for Percentage of Fee Calculation (Remodel/Addition Construction Only) Application 4 BCOM2022-0025 Note: Highlighted Cells are User -Entry Fields er Fees (from adopted schedule) Item Formula or Rate Per Category Multiplier Total Fee Hourly Plan Check, Structural per hour 0.0 $ Hourly Plan Check, City Staff $ 167.00 L per hour Add'I Plan Review 0.0 $ - Total Other Fees $0.00 Total (Estimated) Plan Check Fees AJ Ortega $2,489.06 Consultant Fee at 75% $1,866.80 Prepared by: Date: 5/11/2022