HomeMy WebLinkAbout2510 GATEWAY RD; BLDG E; CB070430; Permit10-29-2007
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Commercial/Industrial Permit Permit No
Building Inspection Request Line (760) 602-2725
CB070430
Job Address
Permit Type
Parcel No
Valuation
Occupancy Group
Project Title
2510 GATEWAY RD CBAD
COMMIND Sub Type
2132610900 Lot#
$329,094 00 Construction Type
Reference #
OCEAN COLLECTION- BLD E
5,208 SF OFFICE SHELL
INDUST
18
VN
Applicant
DEBBIE DRAGOO
STE 175
6363 GREENWICH DR
SAN DIEGO 92122
858 638 7277
Status
Applied
Entered By
Plan Approved
Issued
Inspect Area
Plan Check#
Owner
BRESSI OCEAN COLLECTION L L C
1280 BISON AVE#B9-609
NEWPORT BEACH CA 92660
ISSUED
01/12/2007
LSM
10/29/2007
10/29/2007
TP
JPC070003
Building Permit
Add'l Building Permit Fee
Plan Check
Add1: Plan Check Fee
Plan Check Discount
Strong Motion Fee
Park Tee
LFM \ ee
Bridge Fee
BTD #2 Fee
BTD #3 Fee
Renewal Fee
Add'l Renewal Fee
Other Building Fee
Pot Water Con Fee
Meter Size
Add'l Pot Water Con Fee
Reel Water Con Fee
$1,25496 Meter Size
SO 00 Add'l Reel Water Con Fee
$81572 Meter Fee
$0 00 SDCWA Fee
$0 00 CFD Payoff Fee
$6911 PFF (3105540)
$2,083 20 PFF (4305540)
$000 License Tax (3104193)
$000 License Tax (4304193)
$0 00 Traffic Impact Fee (3105541)
$0 00 Traffic Impact Fee (4305541)
$000 PLUMBING TOTAL
SO 00 ELECTRICAL TOTAL
$000 MECHANICAL TOTAL
$6,778 00 Master Drainage Fee
D5/8 Sewer Fee
$68 00 Redev Parking Fee
$0 00 Additional Fees
HMP Fee
TOTAL PERMIT FEES
$000
$320 00
$8,984 00
$000
$5,989 51
$000
$000
$000
$780 00
$000
$7000
$11000
$000
$000
$2,059 20
$000
$000
$000
$29,381 70
Total Fees 529,381 70 Total Payments To Date $29,381 70 Balance Due $000
Inspector
FINAL APPROVAL
Date Clearance
NOTICE Please take NOTICE that approval of your project includes the Imposition of fees dedications, reservations or other exactions hereafter collectively
refeTod to as fees/exactions You have 90 days from the date this permit was issued to protest imposition of these fees/exactions If you protest them you must
loilow the protest procedures set forth in Government Code Section 66020(a) and file the protest and any other required information with the City Manager for
processing in accordance with Carlsbad Municipal Code Section 3 32 030 Failure to timely follow that procedure will bar any subsequent legal action to attack,
review set aside void or annul 'heir imposition
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity
changes nor planning zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any
fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired
City of Carlsbad
Final Building Inspection
Dept Building Engineering Planning CMWD St Lite Fire
PC070003 Date
CB070430 Permit Type
Plan Check*
Permit #
Project Name OCEAN COLLECTION- BLD E
5,208 SF OFFICE SHELL
Address 2510 GATEWAY RD
Contact Person Q.
Sewer Dist CA Water Dist CA
Lot
Sub Type
18
08/06/2008
COMMIND
INDUST
Inspected \ t j
By O&-} OkTo
I
Inspected
By
Inspected
Bv
Comments
Date
«v^ Inspected o'l'*
Date
Inspected
Date
Inspected
'C*8 Approved
Approved
Approved
\s Disapproved
Disapproved
Disapproved
Ijjir^SSj City of Carlsbad
Final Building Inspection
Dept Building Engineering Planning CMWD St Lite r^FirjeD
Plan Check # PC070003 Date
Permit # CB070430 Permit Type
Project Name OCEAN COLLECTION- BLD E Sub Type
5,208 SF OFFICE SHELL
Address 2510 GATEWAY RD Lot 18
Contact Person •jsXCV'VC'fTLJL. Phone £^*-^^ ~|£\5 3f05\*~~l
Sewer Dist CA Water Dist CA
Inspected « ^ Date " Ai / / ^s^
Bv LJ rliZtSi Inspected {/ *^ \ **i Approved ^
Inspected Date
BV Inspected Approved
Inspected Date
Bv Inspected Approved
Comments
08/06/2008
COMMIND
INDUST
Disapproved
Disapproved
Disapproved
City of Carlsbad Bldg Inspection Request
For 09/17/2008
Permit* CB070430
Title OCEAN COLLECTION- BLD E
Description 5,208 SF OFFICE SHELL
Inspector Assignment TP
2510 GATEWAY RD
Lot 18
Type COMMIND Sub Type INDUST
Job Address
Suite
Location
APPLICANT DEBBIE DRAGOO
Owner
Remarks
Phone 9497952817
Inspector
Total Time
CD Description
19 Final Structural
29 Final Plumbing
39 Final Electrical
49 Final Mechanical
Requested By NA
Entered By CHRISTINE
Act Comments
Comments/Notices/Holds
Associated PCRs/CVs Original PC# PC070003
PCR07191 ISSUED OCEAN COLLECTION- DEFERRED, FLOOR & ROOF TRUSS
PCR07199 ISSUED OCEAN COLLECTION-DEFERRED, STOREFRONT SHOPS AND CALCULATIONS FOR
Inspection History
Comments
MSB, SUB PNLS
ROOF DRAINS
roof framing
Date
08/14/2008
07/17/2008
07/03/2008
07/02/2008
05/15/2008
05/06/2008
05/06/2008
05/01/2008
04/29/2008
04/28/2008
04/18/2008
04/18/2008
Description
34
34
34
34
24
14
15
14
14
17
14
66
Rough Electric
Rough Electric
Rough Electric
Rough Electric
Rough/Topout
Frame/Steel/Bolting/Weldmg
Roof/Reroof
Frame/Steel/Bolting/Weldmg
Frame/Steel/Bolting/Weldmg
Interior Lath/Drywall
Frame/Steel/Bolting/Weldmg
Grout
Act
NR
PA
AP
NR
AP
AP
we
CO
NR
AP
AP
we
Insp
TP
TP
TP
TP
TP
TP
TP
TP
TP
TP
TP
TP
WALLS
City of Carlsbad Bldg Inspection Request
For 09/17/2008
Permit* CB070430
04/16/2008
04/08/2008
03/27/2008
03/25/2008
03/11/2008
03/10/2008
03/07/2008
03/06/2008
02/27/2008
02/19/2008
12/27/2007
12/27/2007
12/13/2007
12/13/2007
12/03/2007
12/03/2007
11/30/2007
11/30/2007
11/29/2007
11/29/2007
11/29/2007
11/19/2007
14 Frame/Steel/Boltmg/Weldmg
1 1 Ftg/Foundation/Piers
15 Roof/Reroof
15 Roof/Reroof
66 Grout
66 Grout
66 Grout
66 Grout
66 Grout
66 Grout
1 1 Ftg/Foundation/Piers
12 Steel/Bond Beam
11 Ftg/Foundation/Piers
12 Steel/Bond Beam
1 1 Ftg/Foundation/Piers
31 Underground/Conduit-Winng
1 1 Ftg/Foundation/Piers
31 Underground/Conduit-Wiring
1 1 Ftg/Foundation/Piers
31 Underground/Conduit-Wiring
31 Underground/Conduit-Wiring
21 Underground/Under Floor
AP
AP
AP
CO
AP
AP
CO
NR
AP
NR
AP
AP
AP
AP
CO
CO
CA
CA
CA
CA
CA
AP
TP
TP
TP
TP
TP
TP
TP
TP
TP
TP
TP
TP
TP
TP
JM
JM
TP
TP
PY
PY
PY
TP
TPInspector Assignment
DMZ & ELECT RM WALLS
P L @ CLMN BASES
TOP OUT LIFT
CMU LEDGER LIFT TO 17FT 4 IN, LEDGER BOLTS, HDs
CMU WALLS TO 12FT & LEDGER EMBEDS @ A LN
SOG
TRENCH FULL OF WATER
FINAL REPORT OF INSPECTION AND TESTING
City of Carlsbad Department of Building and Safety
1200 Carlsbad Village Drive
Carlsbad, CA 92008
August 8,2008
Project No 070499
Permit No Bldg A CB070435, Bldg B CB070434
Bldg C CB070433, Bldg D CB070432
Bldg E CB070430
Project Oceans Collection at Bressi Ranch
Gateway Road
Carlsbad, California
This letter may be considered the final report and is to affirm the material testing and inspections by registered
special inspectors, through Quality Assurance Inspections, Inc, on the
Reinforcing Steel: Inspect placing at job, inspection of epoxy rebar dowels, Structural Steel: Inspection of welds -
field, Brick and Block: Inspection of placing, Concrete: Inspect placing, field sampling, compression tests, pick-up
samples at job, Masonry Grout: Inspect placing, field sampling, compression tests, pick-up samples at job, Mortar:
Inspect placing, field sampling, compression tests, pick-up samples at job, Other Tests and Inspections: Periodic
inspection of built-up roofing, inspection of anchor bolt installation, Laboratory testing performed by Twining
Laboratories of Southern California
To the best of our knowledge, the work items noted above are in compliance with approved plans, revisions,
specifications, and all applicable codes
Submitted Quality Assurance jjjsaeeteasjnc^wajsaT
Linas Vitkus R C E 63163
Civil Engineer
Distnbution
(1) Addressee
(1) VPI Bressi Storage, LLC
(1) Carlsbad Self Storage Investors, LLC
(1) San Diego Contracting, Inc
(1) Raskin Engmeenng, Inc
(1) Valli Architectural Group
17942 Sky Park Circle, Suite J, Irvine, CA 92614 Phone (949) 553-0370 Fax (949) 553-0371
1 if. /loH.:
2782 LOKER AVENUE, WEST, CARLSBAD, CA 92010
i TEL-760.692 0700 FAX - 760 692 0707
1 'i 2008
811 08
To SNYDER LANGSTON-OPTYM
17962 Cowan
Irvine, CA92614
Attention TIM BELL
From. Paul Rowan
RE OCEAN COLLECTION, BRESSI RANCH
Torque Certification for building permit numbers
070435 (Building A)
070434 (Building B)
070433 (Building C)
070432 (Building D)
070430 (Building E)
Dear Mr Bell
This letter certifies that we have installed and interconnected the meter sections per the
manufacturer's recommendations Further, all bus links have been fastened and tightened with a
torque wrench calibrated to per Siemens' specifications
Respectfully
' /
Jstfbmitted
/
Paul Rowan
Rowan Electric
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949) 553-0370
Fax (949) 553-0371
wwwqannc com
04661
INSPECTION REPORT
INSPECTOR CODE
JOB NAME
j JOB NUMBER
iOf\ A-r&r
ADDRESS
ARCHITECT
uo are pn A. I tomb
ENGINEER
rtA<D4-0
DATE _ MlTJWT F S ! S•3. _. i -) -/~)O ! v-_> 1 «*-. \J Q | | /\ 1
BUILDING / OSHPD PERMIT H 1 DSA APRS DSA FILE*
GENERAL CONTRACTOR JURISDICTION
^n^d-d^" LA<\Q s~h?>o Cflrl^hr^
SUBCONTRACTOR (If Any) '
REQUIREMENTS: Limit of one job number, dVie permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
REGULAR
8-0
D Mileane
1 5X
HOURS
2X TIME IN TIMEOUT MEAL PERIOD
~7 ; OO A. ,V-N "2>' OO pi nr\
| | Expenses
|| Reinforcement,
| | Fireproofmg
I Concrete Placement.
I Quality Control
I Masonry.
Administration.
. [ | Prestress Post Ten.
. Other
Batch Plant.
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MIX USED
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DESIGN SLUMP
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Certification of Complianc
1 declare under penalty of perjury that all of the abov
and that of my own personal knowledge the work dur
by this report has been performed and installed ir
CA-rKb^i- appr°(approving authority e g DSA o
and all applicable codes, ex_
Exception(s) noted in report
(Initial at Yes / No as applicable)
Inspector's Name^S
Inspector's Signature
Inspector's ID/ Lie #
Tem ^s 5 7 - 7 0 ° F
ADMIXTURE
tv'/2.$ A- 6>i
f>('$_ ~ *Vj l)^
6re ^ tad c|,
e
e statements are true
ing the period covered
compliance with the
ted plans, specifications
SHPD City of LA etc j
:epl as noted below S"
Yes , No "n*
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DESIGN PSI ' CUBIC YARDS SPECIMENS
-1 «-7 /"-f\~>" i" 1 "*iO 0 O /S /^>/'<>/^>Afe'\_ ' r
A'^ia'T CUw!o€-5
| | Additional Page (Paqe #) CM
All inspections based on minimum of 4 hours and over 4 hours 8 hours minimum
In addition, any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed, a 2 l*ur minimum
charge will be applied /\ // *jf/J //\^-~~—~
Approved/Authorized by /^-' '
(Project Superintendent)
Submittpri by
Quality Assurance Inspections
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949) 553-0370
Fax (949)553-0371
wwwqannc com
04659
INSPECTION REPORT
INSPECTOR CODE
A * l^*t '{2;*"r i (X / /^x
JOB NUMBER
070499
JOB NAME
(~Ae o£e/vo CoU^tTi o/i M~ "^>rf^\C 'Rcta
ADDRESS I
ARCHITECT 'ENGINEER
DATE M T W
BUILDING / OSHPD PERMIT ft / DSA APP#
GENERAL CONTRACTOR
SH >-/ ^ ej" L i4r> 4 sfo n
SUBCONTRACTOR (If Any) '
T F | S
j
S
DSA F ILES
JURISDICTION
C^r-rl^JfjA-^l
REQUIREMENTS Limit of one job number, of\e permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR
8,0
1 5X _,2X TIME IN
7:^0(A.^
TIME OUT
3 ,' CD p . *\
MEAL PERIOD
u
1 Mileaqe | | Expenses
| | Reinforcement.
| | Fireproofmg
. | | Concrete Placement.
. | [ Quality Control
Masonry.
.[ | Administration.
Prestress Post Ten.
Other
Batch Plant.
', Pf
4vLL<
MIX USED DESIGN SLUMP ADMIXTURE DESIGN PSI CUBIC YARDS SPECIMENS
Certification of Compliance
I declare under penalty of perjury that all of the above statements are true,
and that of my own personal knowledge the work during the period covered
by this report has been performed and installed in compliance with the
approved plans, specifications
| | Additional Page (Page #) CM
(approving authority e g DSA OSHPD City of LA etc )
and all applicable codes ejtcepl as noted below
Exception(s) noted in report Yes No.
(Initial at Yes / No as applicable)
Inspector's Name r*\.Ar-M D u A-i )<-i i
Inspector's Signature. ""^ "
Inspector's ID / Lie # .S^T^f ^ '/ *f X/-<(
All inspections based on minimum of 4 hours and over 4 hours 8 hours minimum
In addition, any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed a 2 hour minimum
charge will be applied
Approved/Authorized by.far' fc^
(ProjecfSupenniendent)
Submitted by
Quality Assurance Inspections
04656
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949) 553-0370
Fax (949)553-0371
www qannc com
INSPECTION REPORT
INSPECTOR CODE JOB NUMBER
JOB NAME
ADDRESS
.15 1 0 G> t^hL<j A^ Re-
ARCHITECT '
(nft-fe. /nA icor^b
CiorlsioA^
ENGINEER
DAT^-loog £
T W
BUILDING / OSHPD PERMIT U I DSA APPSC&07043O
GENERAL CONTRACTOR
fSr»v^{€-C" LA^q yro/i
SUBCONTRACTOR (If Any) '
T F £S
DSA FILES
JURISDICTION
REQUIREMENTS Limit of one job number, ine permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR
£,0
1 5X 2X TIME IN
1 ''GO fli*0
TIME OUT
3> ', oe> p. y*\
MEAL PERIOD
| Mileage.II Expenses.
|| Reinforcement.
[ | Fireproofmg
. [ | Concrete Placement.
. | | Quality Control
Masonry.
Administration.
. | | Prestress Post Ten.
. Other
Batch Plant.
f?^SBffl:'ffl
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MIX USED
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Cert
1 declare under penalty of
and that of my own persor
by this report has been [
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DESIGN SLUMP ADMIXTURE
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fication of Compliance
perjury that all of the above statements are true,
al knowledge the work during the period covered
>erformed and installed in compliance with the
approved plans specifications
(approving authority e g DSA OSHPD City of LA etc )
and all applicable codes except as noted below *••
Exception(s) noted in report Yes No VfZ-fr
(Initial at Yes / No as applicable
.-r
Inspector's Name \
Inspector's Signature
Inspector's ID / Lie #
^ ^fcl/OS
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DESIGN PSI CU^IC YARDS SPECIMENS
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| | Additional Page (Paae #) CM
All inspections based on minimum of 4 hours and over 4 hours 8 hours minimum
In addition, any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed a 2 hour minimum
charge will be applied Sj s
Approved/ Authorized by /C-^^^^^S^*^
(Project Superintendent)
Submitted by
Quality Assurance Inspections
04655
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949)553-0370
Fax (949) 553-0371
www qannc com
INSPECTION REPORT
INSPECTOR CODE JOB NUMBER W T
X
JOB NAME
e.J&£-
BUILDING / OSHPD PERMIT # / DSA APP#DSA FILES
ADDRESS
f
GENERAL CONTRACTOR JURISDICTION
ei-rhhaJ
ARCHITECT ENGINEER SUBCONTRACTOR (If Any)
REQUIREMENTS. Limit of one job number, 6ne permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR 1 5X
luorK h
2X
PS r'Cpor-t-e
TIME IN
J oo*>/6f
TIME OUT
>3
ME^L PERIOD
Hj Mileage.|Expenses.
| Reinforcement | | Concrete Placement [2J. Masonry | | Prestress Post Ten | | Batch Plant.
| Fireproofmg | | Quality Control | | Administration | | Other
'•f^SVV/Vri/k®t1'?J'jr^ii'"-1i / ' • ••" j''i -I-'- • '•.io?j->'.^
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MIX USED DESIGN
Certification of
declare under penalty of perjury that a
and that of my own personal knowledge
by this report has been performed an
(rVtvjirVr'iAu^ LOC^+U^AA -H b« ^one. pri^^ ^ «^^,1 / n?
SLUMP ADMIXTURE
Compliance
II of the above statements are true,
the work dur ng the period covered
d installed in compliance with the
approved plans, specifications
(approving authority e g DSA OSHPD City of LA etc )
and all applicable codes except as noted below
Exception(s) noted in report Yes No
(Initial at Yes / No as applicable
Inspector's Name ^4-n&y Ai/*-'V$
Inspector's Signature ^^
Inspector's ID / Lie # _5",2><£7£,3$~XY X<rX
DESIGN PSI CUBIC YARDS SPECIMENS
[ | Additional Page (Page #) CM
All inspections based on minimum of 4 hours and over 4 hours 8 hours minimum
In addition, any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed a 2 hour minimum
charge will be applied xO s
Approved/ Authorized Dy /Ls"^^ ^}r&lf' * • •
(Project Superintendent)
Submitted by
Quality Assurance Inspections
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949) 553-0370
Fax (949) 553-0371
wwwqannc com
04645
INSPECTION REPORT
INSPECTOR CODE
1_
INSPA:JOB NUMBER DATE
*JOB NAME BUILDING / OSHPD PERMIT # / DSA APR*DSA FILE«
ADDRESS
f
GENERAL CONTRACTOR JURISDICTION
ARCHITECT SUBCOTACTOR (If Any)ENGINEER
REQUIREMENTS: Limit of one job number, cVie permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR 1 5X
uoorlcfrv
2X
•s nepoH-edi c
TIME IN
/•v *O*<fc» *•/*•*
TIME OUT MEAL PERIOD
I I Mileage.I I Expenses.
| | Reinforcement | [ Concrete Placement [XI Masonry
| | Fireproofmg | | Quality Control | | Administration [ | Other
Prestress Post Ten | | Batch Plant.
SffiffiiffiSi^M
V' MT,
<>i
V\o,-J for
,*L
V
,
L»J if-A
U.A<-I A
MIX USED DESIGN SLUMP ADMIXTURE DESIGN PSI CUBIC YARDS SPECIMENS
Certification of Compliance
I declare under penalty of perjury that all of the above statements are true
and that ot my own personal knowledge the work during the period covered
by this report has been performed and installed in compliance with the
approved plans, specifications
| | Additional Page (Page #) CM .
laporovng authority e g DSA OSHPD Cny o! LA etc )
and all applicable codes except as noted below
Exception(s) noted in report Yes
(Initial at Yes / No as applicable)
No.^
Inspector's Name.
Inspector's Signature.,
Inspector's ID / Lie #
l>u
All inspections based on minimum of 4 hours and over 4 hours 8 hours minimum
In addition, any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed a 2 hour minimum
charge will be applied
Approved/Authorized by.
Submitted by
Quality Assurance Inspections
(Project Superintendent)
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949) 553-0370
Fax (949)553-0371
www qannc com
04638
INSPECTION REPORT
INSPECTOR CODE
id i ix t r5t^\ ^^ "V.
JOB NUMBER
/N^^ljQCj
JOB NAME
TV>*> nf c Hr~) frt 1 1 ^friu/"* A-l" Bff ^5 IP ^.U-rtC^s
ADDRESS
ARCHITECT 'ENGINEER
CV\i ijAevKY+o
DATE
1-23-03
BUILDING / OSHPD PERMIT # / DSA APP#
C-IS070M30
GENERAL CONTRACTOR
SUBCONTRACTOR (If Any) 'MTJ.
M T W T F S S
DSA FILEJt
JURISDICTION
C f^r\ <j(c\ek^
REQUIREMENTS1 Limit of one job number, cVie' permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR
8,0
1 5X 2X TIME IN
7;oo A-.*O
TIMEOUT
!>'-OG (p /v>
MEAL PERIOD
| Mileage | | Expenses
| | Reinforcement.
| | Fireproofmg
. | | Concrete Placement.
. [| Quality Control
Masonry.
.[ | Administration.
I Prestress Post Ten.
I Other
Batch Plant.
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MIX USED DESIGN
R^O-OOC^SZ- 8"^'
Certification of
1 declare under penalty of perjury that a
and that of my own personal knowledge
by this report has been performed an
53-6*1 *F
SLUMP ADMIXTURE
^ x/ UifLffA 6>H
pfc-oniK
( ~?f0(tf~ IM)£ i '/iVd
Compliance
1 of the above statements are true,
the work during the period covered
d installed in compliance with the
approved plans, specifications
(approving authority eg DSA OSHPD City of LA etc)
and all applicable codes except as noted below s
Exception(s) noted in report Yes No V/
(Initial at Yes / No as applicable)
Inspector's Name KA-N Du A'/C>«OS/
Inspector's Signature ,/£— -£at--sS .
Inspector's ID / Lie # ^ife 763 $~*y £.t'c
DESIGN PSI CUBIC YARDS SPECIMENS
3.OOO a20 S /V/JS>V?-S
'
*
( | Additional Page fPaae #) CM
All inspections based on minimum of 4 hours and over 4 hours 8 hours minimum
In addition, any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed a 2 hour minimum
charge will be applied S\ .d
Approved/Authorized by /C?«>^^/2ir-^«i-^*"'^
(Project Superintendent)
Submitted by
Quality Assurance Inspections
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949)553-0370
Fax (949)553-0371
www qannc com
11718
INSPECTION! REPORT
INSPECTOR CODEA'kiR JOB NUMBER DATE
JOB NAME BUILDING / OSHPD PERMIT ft / DSA APP»DSA FILE!*
GENERAL CONTRACTORADDRESS JURISDICTION
iARCHITECT
UJft-re.iflnMc.ti^ie.
ENGINEER
AVU
ir, on
SUBCONTRACTOR (If Any)
MT3L
REQUIREMENTS. Limit of one job number, ne permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR 1 5X
boc-K-
2X
hrs r^?cr+ea
TIME IN
o^* m«3
TIME OUT MEAL PERIOD
D Mileage | | Expenses
[~~] Reinforcement.
| | Fireproof ing
. | | Concrete Placement.
. Q] Quality Control
| Masonry.
. [~~| Administration.
I Prestress Post Ten.
I Other
Batch Plant.
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4
^
MIX USED DESIGN SLUMP ADMIXTURE DESIGN PSI CUBIC YARDS SPECIMENS
Certification of Compliance
I declare under penalty of perjury that all of the above statements are true,
and that of my own personal knowledge the work during the period covered
by this report has_ been performed and installed in compliance with the
approved plans, specifications
[""] Additional Page (Page #) CM .
(approving authority e g DSA OSHPO City of LA etc )
and all applicable codes except as noted belom
Exception(s) noted in report Yes
(Initial at Yes / No as applicable)
Inspector's Name_.
Inspector's Signature
Inspector's ID/ Lie #
No
.,
^
All inspections based on minimum of 4 hours and over 4 hours 8 hours minimum
In addition, any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed a 2 hour minimum
charge will be applied
Approved/Authorized by
(Project Superintendent)
Submitted by
Quality Assurance Inspections
17942 Sky Park Cir^, Ste J Irvine, California 92614
Phone (949) 553-0370
Fax (949)553-0371
wwwqaunccom
0(3795
INSPECTION REPORT
D&INSPECTOR CODE JOB NUMBER DATE
JOB NAMEIE /-> Iean^ llflUfrtytfr-x BUILDING/OSHPDPERMI
_0i2
APP*DSA FILEfl
JURISDICTION
REQUIREMENTS Limit of one job number, 01^ permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR
| Mileage
1 5X 2X TIME IN TIME OUT MEAL PERIOD
I | Expenses
| I Reinforcement.
| | Fireproofing
. | | Concrete Placement.
. [ | Quality Control
. | | Masonry.
Administration
. | | Prestress Post Ten.
.Q Other
| | Batch Plant.
(VrJ >
MIX USED DESIGN SLUMP ADMIXTURE DESIGN PSI CUBIC YARDS SPECIMENS
Certification of Compliance
I declare under penalty of perjury that all of the above statements are true
and that of my own personal knowledge the work during the period covered
by tfcits- report has been performed and installed in compliance with the
*~"f J\ Jf^/"? yOnl ) approved plans specifications
(approving authority eg DSA~OSHPD City of LA etc)
and all applicable codes, except as noted below
Exception(s) noted in report
(Initial at Yes / No as applicabl
| | Additional Page (Page #) CM ._
Inspector's Name
Inspector's Signature
'nsoertor's ID / lie #
All inspections based on minimum of 4 hours and over 4 hours 8 hourt minimum
In addition, any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work^is performed a 2 hour minimum
charge will be applied if)
Approved/Authorized by.
Submitted by
(Project Superintendent)
Quality Assurance Inspections
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949) 553-0370
Fax (949)553-0371
04695
INSPECTION REPORT
www qaiinc com
INSPECTOR CODE JOB NUMBER
JOB NAME _ , _
ADDRESS
ARCHITECT ' ENGINEER
(_j A-fp VY\ A ( COi"v% b (V\ 1 y i&-w <5rti
DATE M ~-£_ W T F S S
40-08 X^\
BUILDING / OSHPD PERMIT # / DSA APPS DSA FILE*
GENERAL CONTRACTOR JURISDICTION^
5»r\w d €-r~ f— ^VT)<3 S~f~ov*\ C/^r lilo/^cA
SUBCONTRACTOR (If Any)
REQUIREMENTS. Limit of one job number, 6ne permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR 1 5X 2X
txf<rrld Ur"S oc~i/>oMi '
TIME IN TIMEOUT MEAL PERIOD
-?a 60 CM 4C' i i
1 | Mileage [ | Expenses
| I Reinforcement.
[ | Fireproofing
. I I Concrete Placement (V| Masonry | | Prestress Post Ten.
. | | Quality Control | | Administration | | Other
Batch Plant
ft^^v;;:-:' /•;/%. \-:-:;f^;^:b\
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MIX USED DESIGN SLUMP
Hub -( 60 IL
i
Certification of Comphanc
1 declare under penalty of perjury that all of the abov
and that of my own personal knowledge the work dur
by this report has been performed and installed in
C f±r- is k>-&-d approv
oo TT ; c't-fu oP LA *a:£52£> me^^-< A^v^
C) C C, 2 (
ADMIXTURE
e
e statements are true
ng the period covered
compliance with the
/ed plans, specifications
(approving authority e g DSA OSHPD City of LA etc )
and all applicable codes, gyf^nj.as noted below
Exceptmn(s) noted in report Yes . No ^^tt-V
(Initial at Yes / No as applicable)
Inspector's Name £— A-/^£>O A-l K-i
Inspector's Signari ire s-'£—~,2^'s-
Insoector's ID / Lie # . -^"-2-£ 7(e
o S
?r- v? jT-c^
DESIGN PSI CUBIC YARDS SPECIMENS
^5^0 tf
| | Additional Page (Page #) CM
All inspections based on minimum of 4 hours and over 4 hours 8 hours minimum
In addition, any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed, a 2 hour minimum
charge will be applied -^ ,
Approved/Authorized by /pZ^fZ&Z-*^^-
(Project Superintendent)
Submitted by
Quality Assurance Inspections
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949)553-0370
Fax (949) 553-0371
wwwqannc com
04677
INSPECTION REPORT
INSPECTOR CODE JOB NUMBER DATE
t
JOB NAME
TV\£CfllULC-fi!
BUILDING / OSHPD PERMIT # / DSA APPft DSA FILE*
ADDRESS
>/w
GENERAL CONTRACTOR JURISDICTION
ARCHITECT ENGINEER SUBCO'NTR'ACTOR (If Any)'
REQUIREMENTS Limit of one job number.'one permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR 1 5X
U>oM<-h
2X
-$ reported o
TIME IN
i Vifelfr
TIME OUT MEAL PERIOD
1 Mileage | | Expenses
| | Reinforcement.
Q Fireproofing
. | | Concrete Placement.
. Q Quality Control
. P^l Masonry | | Prestress Post Ten.
. | | Administration | | Other
Batch Plant.
tBtiq *t •'- -'•"?"•'' '^'r ; ^DESCRJi^ "•>?; .VhlCXSCi'^ .'
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MIX USED
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M c-firf>£- C^or-H:
DESIGN SLUMP
Certification of Comphanc
1 declare under penalty of perjury that all of the abov
and that of my own personal knowledge the work dur
by this report has been performed and installed in
f"^/~'l^> \~)&f\ appro\
(approving authority e g DSA 0
and all applicable codes ex.
Exception(s) noted in report
(Initial at Yes / No as applicable
^•^
Inspector's Name i
Inspector's Signature
Inspector's ID / Lie #
Art/>»e 4o rfit^plp-Ufrtp.
\
.,£,,, ^f
ADMIXTURE
e
e statements are true,
ng the period covered
compliance with the
/ed plans, specifications
SHPD City of LA etc )
cepl as noted below ^
Yes No *^A
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J ^f^f -*~^7 , • '
'^2£'76>
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rr-x1/ jc.cc
DESIGN PSI CUBIC YARDS SPECIMENS
| | Additional Page (Paae #) CM
All inspections based on minimum of 4 hours and over 4 hours 8 hours minimum
In addition any inspection extending past noon will be an 8 nour minimum
If inspector is called to a project and no work is performed a 2 hour minimum
charge will be applied /} // -^ *
Approved/Authorized by /t-^^W e&:t*s*-C<^
(Project Superintendent)
Submitted by
Quality Assurance Inspections
DAILY OBSERVATION REPORT
Roofing Q Wateiproofing Q Roof Deck Nailing Q Other.
Corporate Office
17942 Sky Park Circle, Suite J
Irvine, California 92614
Ph (949)553-0370
Fax (S49) 553-0371
www caiinc com
Page_/.of_/_
DATE /_ °[ -m T WEATHER
OBSERVER REGULAR O TIME (1 5X) 0 TIME (2X) TIME IN TIME OUT MEALTIME*
QAI PROJECT NO
9 , X
BUILDING / OSHPD PERMIT # / DSA-APP #
£ — ££./? 0-7V-3V30
DSA-FILE*
PROJECT ADDRESS
CLIENT CONTACT -PHONE -
G CONTRACTOR SUPERINTENDENT PHONE
SUBCONTRACTOR FOREMAN PHONE
CREW SIZE START TIME FINISH TIME //Art
ASPHALT MANUFACTURER . /-/£TYPE OF ASPHALT EVT
ASPHALT TEMPERATURES (°F)
TIME (AM / PM)INSIDE KETTLE INSIDE TANKER ON ROOF DURING APPLICATION
J2>//xJ m*^s*" ((-*—SPECIFICATIONS ^ca,xJo.
CONCISE DESCRIPTION OF WORK OBSERVED (Including description of non-compliant items & their corrections)
1^-
-^r^•*-»-'USI//S •
Is.
V
a EXPENSES
Q MILEAGE
THIS Q CONTAINS NON-COMPLIANT ITEMS
RFPORT n ^^^^ NQT CONTA,N NON-COMPLIANT ITEMS
Observer's Signature
Observer's Name
/^// ,Verified / Accepted by
Superintendent / Client s Representative
*lf time for meal was not taken today,
explain the reason why
Reason
Authorized / Verified by
N 3 Observation time is based on a minimum of 4 hours Observation time over 4 hours or extending past noon is reckoned
3 hours When an observer shows up on site, and no work is performed on that day, 2 hour charge is applied Additional Paae A
;'/OtJ'Al:|,^A's^i"rirA-Nr:P;""^^^^^^^^^B R &&£~
•PjMJT'lBBr !••• ••• 1/y4/
LW^^V | DAILY OBSERVATION REPORT
'''•^<~-^r7^^^i'|.r^PpX-r-r'>vf'rj*<r:''v-^^^^^^^^^^^^^^^^H
^"•'ii-Vrati -ii\'-l'?-*AiL^-*~i*^ J^, l^-^L---lj7<?>~^^^^^^^^^^^^^^^^^^^^^^^^^^^^H
^T Roofing Q Waterproofing (
DATE tf.'f-^&g' M (V^ W T
OBSERVED REGL
^ {,J%*fest-£ fy
QAI PRCvlECTNO
c?7 /£>{-/<f<9 5^ /fjfs^i
PROJECT Qcjgs^ t^&^^-cjr^c}^ v
CLIENT
G CONTRACTOR »S^y,£k,»t_ ^ ^j-^<J ^ ^ (T3 /C
SUBCONTRACTOR k£e~£<> /^•oj^1\>-s\
CREW SIZE ^^ /^P I/*-"*)
ASPHALT MANUFACTURER L,.'T^fi~.
TIME (AM /PM) INSIDE KE
f? /irrt t'f~&z> ^V
— — .
H Roof Deck Nailing Q Other
F S S WEATHER OM&iC/i- if"" -" ^t?1*
LAR 0 TIME (1 5X) O TIME (2X) TIME IN TIME OUT
' '7/^ //'*ftt*
BUILDING / OSHPD PERMIT # / DSA-APP #
Corporate Office
Sky Park Circle. Suite J
Irvine, California 9261 4
Ph (949)553-0370
Fax (949)553-0371
www qaimc com
Page / of /
MEALTIME*
— h
DSA-FILE*
ADDRESS j^* ^^r*-^* y /*-<#
CONTACT PHONE
SUPERINTENDENT /2., cJv^»«_j9 PHONE ^/f *]?$"- 2?/3
FOREMAN yTt^-oy PHONE £ f?- %>?/ -Xc-c/
START TIME -^^-TV-V. FINISH TIME
TYPE OF ASPHALT Type- 3 EVT -/*?i"°
ASPHALT TEMPERATURES (°F)
TTLE INSIDE TANKER ON ROOF DURING APPLICATION
& *fft? "
ON# ^cS>A^<r_
CONCISE DESCRIPTION OF WORK OBSERVED (Including description of non-compliant items & their corrections)
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&- yf-OT J?&//Jt^S f
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a EXPENSES .
a MILEAGE _
Observer's Signature ^LssS'// /* 6
Observer's Name // ^2 // J/3tf*/;'JSP <
/ 'y '
*lf time for meal was not tak^h today, F
explain the reason why f.
THIS Q CONTAINS NON-COMPLIANT ITEMS
RPPP\Df
a DOES NOT CONTAIN NON-COMPLIANT ITEMS
^^, Verified / Accepted by /^*£-^f^?r ^zz.
't*0&*^
Superintendent / Client s Representative
Reason
Authorized / Verified by
N B Observation time is based on a minimum of 4 hours Observation time over 4 hours or extending past noon is reckoned
8 hours When an observer shows up on site, and no work is performed on that day, 2-hour charge is applied Additional Page A
DAILY OBSERVATION REPORT
Roofing G Waterproofing G Roof Deck Nailing G Of/ier .
Corporate Office
17942 Sky Park Circle, Suite J
In/me, California 92614
Ph (949) 553-0370
Fax (949)553-0371
www qaiinc com
Page_/_ of
DATE - 7 W T F S S WEATHER (f *
OBSERVER REGULAR I 0 TIME (1 5X) O TIME (2X) TIME iti I TIME OUT MEALTIME*
QAI PROJECT NO BUILDING / OSHPD PERMIT # / DSA-APP #DSA-FILE*
PROJECT u ADDRESS
CLIENT CONTACT PHONE
G CONTRACTOR j^xJy/flf-X-.jS S7&SUPERINTENDENT /£_, .PHONE
SUBCONTRACTOR FOREMAN PHONE
CREW SIZE START TIME FINISH TIME
ASPHALT MANUFACTURER TYPE OF ASPHALT EVT
ASPHALT TEMPERATURES (°F)
TIME (AM / PM)INSIDE KETTLE INSIDE TANKER ON ROOF DURING APPLICATION
c ROOFING if ' MANUFACTURER SPECIFICATION #
CONCISE DESCRIPTION OF WORK OBSERVED (Including description of non-compliant items & their corrections)
'T
3.
/'*J-y?"'yi
-£ 5cr 5 —
^-7"!_£_t^ijie>j-A.C ^J ' / ,gv
EXPENSES
Q MILEAGE
THIS
REPORT
CONTAINS NON-COMPLIANT ITEMS
CONTA|N ITEMS—i ^s
Observer's Signature
Observer's Name
Verified / Accepted by
Superintendent / Client s Representative
* If time for meal was not taken today,
explain the reason why
Reason
Authorized / Verified by
N B Observation time is based on a minimum of 4 hours Observation time over 4 hours or extending past noon is reckoned
8 hours When an observer shows up on site, and no work is performed on that day, 2-hour charge is applied Additional Page A
04659
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949) 553-0370
Fax (949) 553-0371
www qaiinc com
REPORT
INS JOB NUMBER
070^/99
DATE
JOB NAME
J9£t_
BUILDING / OSHPD PERMIT # / DSA APP#DSA FILE*
ADDRESS
3.510
GENERAL CONTRACTOR JURISDICTION
ARCHITECT ENGINEER SUBCONfiACTOR (If Any)
. oneREQUIREMENTS. Limit of one job number, one permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR
8,0
1 5X 2X TIME IN
T.'tfOiA <M
TIME OUT
-) i
JS , C5O p , ,v\
MEAL PERIOD
V
I Mileage [_\ Expenses
| I Reinforcement.
Q Fireproof ing
. [~] Concrete Placement |^Q Masonry | | Prestress Post Ten | | Batch Plant.
. |~| Quality Control |~1 Administration | | Other
Rick^E( ,.
<O Y33> £ .* i) «- I f/\
X-* 'ifA-iio v! fiiv i J
rv> 4-^.^ . "T^j pi £1
DESCRIPTION OF WORK INSPECTED
, . Q-, « 'on i "hi) r o "S
I"O -VoiA 6 F t^
Ak ^i, ^ /5j f
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r )
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MIX USED DESIGN SLUMP
Certification of Complianc
1 declare under penalty of perjury that all of the abov
and that of my own personal knowledge the work dur
by this report has been performed and installed in
C-A-r-^h^ apprcn
(approving authority e g DSA 0
and all applicable codes, ex
Exception(s) noted in report
(Initial at Yes .' No as applicable)
Inspector's Name r
ADMIXTURE
e
e statements are true,
ng the period covered
compliance with the
/ed plans, specifications
SHPD City of LA etc) X
cept as noted below /
Yes . No *^'^
^A-i\3Dtj Ari)<-\t./S(
Inspector's Signature f^~Z~ — -?-~*=~^ —
DESIGN PSI CUBIC YARDS SPECIMENS
| ) Additional Page (Page #) CM
All inspections based on minimum of 4 hours and over 4 hours 8 hours minimum
In addition any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed, a 2 hour minimum
charge will be applied
Approved/Authorized by
(Project Superintendent)
Submitted by
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949)553-0370
Fax (949)553-0371
www qannc com
04655
REPORT
INSPECTOR CODE
"joi
JOB NUMBER DATE
NAME BUILDING / OSHPD PERMIT # / DSA APPS DSA FILE*
ADDRESS
f
GENERAL CONTRACTOR
SUBCONTRACTOR (If Any)
JURISDICTION
CA-r A >
ARCHITECT ENGINEER
REQUIREMENTS: Limit of one job number, 6ne permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR 1 5X
LUorK h
2X
PS repor+e
TIME IN
eJ GO OH&*
TIME OUT
•3
MEAL PERIOD
1 Mileage [ | Expenses
| | Reinforcement.
| | Fireproofmg
. [~| Concrete Placement.
. Q Quality Control
. C*l.Masonry.
Administration.
| Prestress Post Ten.
I Other
Batch Plant.
'^•IrlfT'E' ••• DESCRIPTION OF WORK INSPECTED
rth<J^rv £- /m^/7 / i-c s r&nP L-Z.da&s' /'n<;i-a.lla.~rt,',r> A-+ /2'o"^ll H H/'T,
/4iS p-&r p 1 ^j-*o -S 3 * £ *f~laor -^-riA-trt /' s> Q O 1 ri-r\ , 31, h / lA / 2. X V J -esJ&f.s-s
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MIX USED DESIGN
Certification of
I declare under penalty of perjury that a
and that of my own personal knowledge
by this report has been performed an
SLUMP ADMIXTURE
Compliance
II of the above statements are true
the work during the period covered
d installed in compliance with the
approved plans specifications
(approving authority e g DSA OSHPD City of LA etc )
and all applicable codes, except as noted below
Exception(s) noted in report Yes . No
(Initial at Yes / No as applicable)
Inspector's Name A./£/) n y
Inspector's Signature ^s^-
Inspector's ID / Lie # ^^^_
4;i<.;»<
~~7Jf***tZ-
J&fS'-jcY J~<:X
DESIGN PSI CUBIC YARDS SPECIMENS
| | Additional Page (Page #) CM
All inspections based on minimum of 4 hours and over 4 hours - 8 hours minimum
In addition, any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed a 2 hour minimum
charge will be applied /j ,/
Approved/Authorized by fL^^ ^/^
(Project Superintendent)
Submitted by
Quality Assurance Inspections
17942 Sky Park Circle, Ste J, Irvine; California 92614
Phone (949) 553-0370
Fax (949)553-0371
wwwqannccom
04645
IMSFECYIOiN REPOBT
INSPECTOR CODE JOB NUMBER
JOB NAME
ADDRESS
ARCHITECT ' ENGINEER
HJ^Tc* /v>& 1 <j3,'v» j^ iM T\»uviwi4tt
DATE M T W T F S S
BUILDING / OSHPD PERMIT I* / DSA APPS DSA FILE*
£_ f^£> 7^) "*4 ^,Q
GENERAL CONTRACTOR JURISDICTION
SUBCONTRACTOR (If Any) •
REQUIREMENTS: Limit of one job number, 6ne permit number per sheet Identify all work by type and SPECIFIC location Non-compliait work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR 1 5X 2X
coc~ic(A,"S repoi'-feJ c
TIME IN TIMEOUT MEAL PERIOD
,-\ * 0^^*1*1
I Mileage | | Expenses
^Reinforcement Q Concrete Placement [§ Masonry Q Prestress Post Ten . _ | | Batch Plant
I Fireproofing [~"1 Quality Control I I Administration I I Other
'BWiq^ £ DESCRIPTION OF WORK INSPECTED
^K^^/f^e.i'itT^
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ft ^r^vo<2. lyte-Afio/tYiA t^
L.<iA«j«r ini,i-A[i^i-
MIX USED DESIGN
Certification of
I declare under penalty of perjury that a
and that of my own personal knowledge
by this report has been performed an
h^- ol^NC^e-fV -^^ r^-^l even's ^s l">t '- DUo
^ .' 'J, y# ' ' ^ ' r '
j.i-k r\^v "h? Cc,-r if4-;/>r> cj'f-A e>«-S?/>T<OA ^
;OA '
SLUMP ADMIXTURE
Compliance
II of the above statements are true,
the work during the period covered
d installed in compliance with the
approved plans specifications
(approving authority e g DSA OSHPD City of LA etc i
and all applicable codes except as noted below
Exception(s) noted in report Yes . No *^A-P
(Initial at Yes / No as applicable)
Inspector's Name YWL.--H>w ,V« Ksi.^S.t- -j
Inspector's Signature ^2. ^-y^^-^-^ — —
Inspector's ID / Lie # O'J^tT7691T-- vV ^ C-C
DESIGNPSI CUBIC YARDS SPECIMENS
| | Additional Page (Page #) CM
All inspections based on minimum of 4 hours and over 4 hours 8 hours minimum
In addition any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed, a 2 hour minimum
charge will be applied .- *
Approved/Authorized by /£^^^&^^-->>.^
(Project Superintendent)
Submitted by
Quality Assurance Inspections
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949) 553-0370
Fax (949) 553-0371
wwwqannc com
11705
INSPECTION REPORT
INSPECTOR CODE JOB NUMBER070 qqq y
JOBlvlAME BUILDING / OSHPD PERMIT If / DSA APPii DSA FILE*
ADDRESS
ARCHITECT
AA.
GENERAL CONTRACTOR JURISDICTION
\{.O.
j ENGINEER
y>4<
IBCOWTISUBCONTRACTOR (If Any)fA-rX
REQUIREMENTS* Limit of one job number, one permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR
8,0
1 5X 2X TIME IN
1 'OO A'AS
TIMEOUT
3;-oo f>rh
MEM PERIOD
| Mileage | | Expenses
| | Reinforcement
| [ Fireproof ing
[~] Concrete Placement,
[ | Quality Control _
Masonry.
.| | Administration.
. | | Prestress Post Ten.
. Other
Batch Plant.
l^fe-p" DESCRIPTION W
,\ : O '' f / " J
ZrP/'L<£H- A-^TNP^ rTfA^ <~*n Si-0
1 — i>Y"V-€L \ (~ €^{ rsV-crC-f tfr^/vi" AH" (DO-£j*\'i r»Q £5l
' *
MIX USED DESIGN SLUMP ADMIXTURE
Certification of Compliance
1 declare under penalty of perjury that all of the above statements are true,
and that of my own personal knowledge the work during the period covered
by this report has been performed and installed in compliance with the
/•".A^-l^, is}S~±tl approved plans, specifications
(app?3vTrig authority e g DSA OSHPD Cily of LA etc )
and all applicable codes except as noted below
Exception(s) noted in report Yes . No Y
(Initial at Yes / No as applicable)
Inspector's Name ^-A*j£>u A-iJO/OS.r \
Inspector's Signature ^. — -^—z_ __ — ^
Inspector's ID / Lie # ^14- '?& ^-Xtf
(V(Gi^lN^e!fEt;t-i^' ;••{;'-:.•' "v WK ; •'• •• '(•• '• ;V'
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4-upx^lb SU^/^.AO, p.T'fepI Zy
je^hV^A^ A^ n^r W^-i^ iO,
'
'T~c./v^As H — > "~
DESIGN PSI CUBIC YARDS SPECIMENS
| ) Additional Page (Paae #) CM
All inspections based on minimum of 4 hours and over 4 hours 8 hours .minimum
In addition any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed a 2 hour minimum
charge will be applied ., /y ~
I/) j^^^£~~-Approved/Authonzed by /C^^^^X^*6^^
(Project Superintendent)
Submitted by
Quality Assurance Inspections
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949)553-0370
Fax (949)553-0371
www qaiinc com
11702
INSPECTION REPORT
INSPECTOR CODE
JOB NAME
"t^€" (Y -e s\f\ ( r\ \ ( $ c*V 1 o o
JOB NUMBER
Q-?OHCjCJ
c.T £ressie \£*och
ADDRESS
^•SlO Op-vCiVpUjJvcj 'Oil, CjPu~ IS, to iQ/={
ARCHITECT 'ENGINEER
DATE M T W
i-CV-Oft X
BUILDING / OSHPD PERMIT # / DSA APP#
GENERAL CONTRACTOR
T F S | S
1
DSA FILES
JURISDICTION
CAM Stored
SUBCONTRACTOR (If Any) '
(Nvr n_
REQUIREMENTS Limit of one job number, d"ne permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI. Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR i 1 5X
8.0 I
2X TIME IN
7 ' 0 0 A / A^
TIMEOUT
3. cop,,.
MEAL PERIOD
I | Mileage \ I Expenses.
[~~] Reinforcement _
[~~] Fireproof ing
. Q Concrete Placement.
. [~| Quality Control
Masonry | | Prestress Post Ten.
[ | Administration \ | Other
Batch Plant.
fet^ci^E . .-"..--' . • RE^rt^W§£^ '•-••'•: ••'••'••.;.
ob<;a<roe/m
£/?-/' L vCt-v /
worts !>v'i i v \ <
i O f* '
e^C[ i "\-QT O ^
£><; r>&-<r p («
^ Driaf^ss.
// \ «
^ ^r-yi. fSI.O "t-upivjals S(.^/-S M p T ^?^T ZM^ 1 1 / / ; \^ / J
i t
£^ MertrfVc -ii<VvY
MIX USED
t^pt-S 0/wl<.6»r
ipi€\ r'VcJquvr^
1
DESIGN SLUMP
N)
Certification of Complianc
1 declare under penalty of perjury that all of the abov
and that of my own personal knowledge the work dur
by this report has been performed and installed in
f~ £i»O 1 *-->tortiA appixn
cV Ai 5-^ctinJi (pQ LiC4- L I s\f A j^ 1
i Gift's rl2> ~ ^>^ F
ADMIXTURE
e
e statements are true,
ng the period covered
compliance with the
red plans, specifications
(approving authority e g DSA OSHPD City ot LA etc ) ;
and all applicable codes except as noted below /
Exception(s) noted in report Yes No
(Initial at Yes / No as applicable)
Inspector's Name
Inspector's Signature
Inspector's ID / Lie #
f^A^J^W A-'iic\\ rr -j
1 f **- .."^ ^ — — *^ '
^j^?^9r-/
,
j^y jL.f'C.
DESIGNPSI CUBIC YAR^S SPECIMENS
I%QO r~C\ -) "yS ''s .;
[~| Additional Page (Paae #) CM
All inspections based on minimum of 4 hours and over 4 hours - 8 hours minimum
In addition, any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed, a 2 hour minimum
charge will be applied x-s *
Approved/Authorized by ^ "^7^ <v-
(Project Superintendent)
Submitted by
Quality Assurance Inspections
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949) 553-0370
Fax (949)553-0371
wwwqaimccom
11695
INSPECTIOB4 REPORT
INSPECTOR CODE
IKLf^_
JOB NUMBER DATE s s
JOB NAME BUILDING / OSHPD PERMIT # / DSA APPi*DSA FILE*
,DDRESSa^io .4-1 fcd, C.fld-1 S b .<»^
GENERAL CONTRACTOR JURISDICTION
ARCHITECT ENGINEER
%
SUBCONTRACTOR (If Any)
MT.IC-
REQUIREMENTS. Limit of one job number, 4>ne permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR 1 5X
uJor.
2X
<L h rs r^c-jO^r
TIME IN
f-d^ on ( j k12?
TIME OUT
4
MEAL PERIOD
| Mileage 1 1 Expenses
| | Reinforcement..
| | Fireproofmg
. | | Concrete Placement.
. [~~| Quality Control
Masonry.
Administration.
. | | Prestress Post Ten
. Other
|~] Batch Plant.
%'lfi'^E • • '' ' '"'•'' ^^pESCRJFTipfr^ -,'.:.(:".^. / *.',-"• ;"•. .
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l>(?a m o v £3 ro #> ei , ^ j-l
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pr OC( r <?5T^.
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:xv(s S l.:3 /S> NJ, P , ~$ , "R?T iM u. Jtirk. <L-f/ M 1 K?/ ^ / ) * i
MIX USED DESIGN SLUMP
Certification of Comphanc
1 declare under penalty of perjury that all of the abov
and that of my own personal knowledge the work dur
by this report has been performed and installed ir
rpr\^v\n.A .. appro
ADMIXTURE
e
e statements are true,
mg the period covered
compliance with the
/ed plans specifications
(approving authority e g DSA OSHPD City of LA etc )
and all applicable codes except as noted below
Exception^) noted in report Yes . No
(Initial at Yes / No as applicable)
Inspector's Name l^flnO'-J A(fCi r^5
Inspector's Signature /"^ — -*^<z——~~
X""\ i
Inspector's ID / Lie # .^3~~& ~?<a / i~ /<
••
'<-/ X.c^c
DESIGN PSI CUBIC YARDS SPECIMENS
| ] Additional Page (Paae #) CM
Ail inspections based on minimum of 4 hours and over 4 hours 8 hours minimum
In addition, any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed a 2 hour minimum
charge will be applied ^\ ><
Approved/Authorized by /t^l^^ — .
(Project Superintendent)
Submitted by
Quality Assurance Inspections
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949) 553-0370
Fax (949)553-0371
www qaunc com
11693
INSPECTION REPORT
JOB NAME
rhe ocreon
INSPECTOR CODE JOB NUMBER DATE
2-M
M
JC.
T I W
BUILDING / OSHPD PERMIT # / DSA APRS DSA F ILE*
ADDRESS
CKXT
GENERAL CONTRACTOR JURISDICTION
ARCHITECT ENGINEER
U-
SUBCONTRACTOR (If Any)
tvAT.r.
REQUIREMENTS. Limit of one job number, Ane permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR 1 5X 2X
u;t*K H(-s. <~e-pc»<~
TIME IN
+-<J. e>-> '**" 1 I
TIME OUT MEAL PERIOD
| Mileage.I | Expenses.
[ | Reinforcement,
Q Fireproofing
. | | Concrete Placement.
. | | Quality Control
| Masonry.
Administration,
Prestress Post Ten_
Other
Batch Plant.
BU:q £* ; • DES^Rlt^lpN^F)
DD^^^UC/^OArtTjr & $ (& rv"\cdi uJT- C<ft"lu-/
fVS> p e-C~ F> ^ A-r\ fc Cn ,. ~> ^ , £5 . T LJ o i cA- Is -SI.' i / I*
ta
MIX USED DESIGN SLUMP ADMIXTURE
Certification of Compliance
declare under penalty of perjury that all of the above statements are true
by this report has been performed and installed in compliance with the
C' \firf I.S V^^CA approved plans, specifications
(approving authority e g DSA OSHPD City of LA etc )
and all applicable codes Except as noted below S
Exception(s) noted in report Yes . No v
(Initial at Yes / No as applicable)
Inspector's Name "P^.ltV<Ot>t^ .*VilC\<sSS
Inspector's Signature ^ — ~~ j_ — ^ — .
Insppntnr's in / 1 ic # < '^7 1 <o 9 •$"*- ^ M
A^RKINSPECTED^:;'" :; '•';•. ^^-'\"-\. - '. '-.
• r>s^ 1 1 A-K<5rt fc> ecj;, n (V. ti « ( S/Li " L « P-f
O If A 1 ,-A t "\ 1 - ,,j_v \ I '^/biN.t-' . vwOrN STM) »o cx-nc re^S •^ ; , | -- | >.' j
T~ ^f-l."'>'H
DESIGN PSI CUBIC YARDS SPECIMENS
i
| | Additional Page (Paae #) CM
All inspections based on minimum of 4 hours and over 4 hours 8 hours minimum
In addition any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed, a 2 hour minimum
charge will be applied .. /j
Approved/Authorized by /C'&e^l'cjjr — *~
(Project Superintendent)
Submitted by
Quality Assurance Inspections
17942 Sky Park Circle
Suite J
Irvine, CA 92614
Phone (949)553-0370
Fax (949)553-0371
Inspection Report
INSPECTOR CODE JOB NUMBER
#070499
JOB NAME
THE OCEAN COLLECTION @ BRESSI RANCH
ADDRESS CITY
2510 GATEWAY ST CARLSBAD
ARCHITECT
WARE MALCOMB
ENGINEER
MIYAMOTO
DATE
January 23, 2008
BUILDING PERMIT NUMBER/DSA/OSHPD APR FILE #
CB070430
DAY OF THE WEEK
WED
JURISDICTION
CARLSBAD
GENERAL CONTRACTOR
SNYDER & LANGSTON
SUBCONTRACTOR (IF ANY)
REQUIREMENTS Limit of one job number, one permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers building and permit granting authority officials
HOURS
REGULAR 1 5X 2X TIME IN
700AM
TIME OUT
12 00 P M
Q [Re-Inspection | [Show-Up Only | [Expenses
I Reinforcement Concrete [ [Concrete Placement | X [Masonry [ J Reinforcement Masonry [Fireproofing
[_ [Quality Control | J Administration Q]prestress/Post Tension f[ X lather \\ fj
OBSERVED THE INSTALLATION OF EPOXYED 3/4" ANCHOR BOLTS INTO FOUNDATION @ BLDG E ALL HOLES
CLEANED PER MANUFACTER'S RECOMONDATIONS. ALL HOLES DRILLED A MINIMUM 8" INTO FTGS A TOTAL OF
8 3/4" ANCHOR BOLTS EPOXYED
MIX USED DESIGN SLUMP ADMIXTURE DESIGN PSI CUBIC YARDS SPECIMENS
Additional Page (Page #) CM 3 OF 3 REPORT
[ | Contains
Non-Compliant Items
X | Does Not Contain
Certification of Compliance
I declare under penalty of perjury that all of the above statements are true
and that of my own personal knowledge the work during the period covered
by this report has been performed and installed in compliance with the
approved plans, specifications and all applicable codes
All inspections based on minimum of 4 hours nad over 4 hours - 8 hours mimimum
If inspector is called to a project and no work is performed a 2-hour minimum
charge will be applied
Inspector's Name
Inspector's Signature
Inspector's ID/ Lie #
DONALD R WELCH
— "i.y.
^/(Project Superintendent)
> <ts -7?
S D #933 5073827-
Approved/ Authorized by
Submitted by
Quality Assurance Inspections
C (
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949)553-0370
Fax (949) 553-0371
www qannc com
11718
INSPICTION REPORT
INSPECTOR CODE JOB NUMBER DATE w
JOB NAME BUILDING / OSHPD PERMIT »I DSA APP*
C Ro7Q^ 30
DSA FILE*
ADDRESS GENERAL CONTRACTOR JURISDICTION
ARCHITECT ENGINEER SUBCONTRACTOR (If Any)
MT1L* \i\j a.r<
REQUIREMENTS: Limit of one job number, one permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR 1 5X
uoc .-«•
2X
hrs r«.pcr«-«a
TIME IN
o<\* in i 3
TIME OUT MEAL PERIOD
| Mileage I | Expenses
| | Reinforcement.
| | Fireproofmg
. | | Concrete Placement.
. | | Quality Control
. [/s] Masonry | | Prestress Post Ten.
. | | Administration | | Other
Batch Plant.
-falclq **E. DESCRIPTION OF WORK INSPECTED
prY*-HiC|KikPf qreu--t-f h€ct<- O'-li'-Pr WT, ', cleAnoui-l-s •&.- c\eb^5, r«?h&.r
<SpAonc e.vc.. Vc
|ViA<o,Arw NJc^s Si
IrViCrVl cire>0"i/\) Pt7 V^.A-T O lAf €«ir»e f\i" /V(clI \ '
/
^UfejV^yvxSrrt-
At (D LioYeis "RIFT-* -2.(o; l$€.<A-£n'V*).v\e.'yf' vJ<?f "HcAlx O'wVr op^/\'. r><; s Uikere.
/• ~ /•& \ i
fot'Jr-iVN r-.TiAo^e^ , n-ho LiA^IS ^> ( ?> / S fOc-Vt3 ci . ^"ATO^.rs,,' fl.u)i>, </•<,<: <aontr-r
p»\A-4-<* ^vv\ \r>r>/-\ A ^> f
/V^s pCj- _S£;.-Q/A
Li
1
-> „ . ' -.-/..jT
T /
^^ 4*-^^ /R<^U ^
T
MIX USED DESIGN
Certification of
1 declare under penalty of perjury that a
and that of my own personal knowledge
by this report has< been performed an
arc i^«-i i -^vpec-HGA) r
SLUMP ADMIXTURE
Compliance
II of the above statements are true,
the work during the period covered
d installed in compliance with the
approved plans, specifications
(approving authority e g DSA OSHPD City of LA etc )
and all applicable codes, except as noted below -.
Exception(s) noted in report Yes . No *•
(Initial at Yes / No as applicable)
Inspector's Name "\\AISJ P» vJ
" s? *Inspector's Signature / — ^
Inspector's ID / Lie # j£
/V«k^i
>Z1 --
&?£f r-x'Y JT,C.C
DESIGN PSI CUBIC
| [ Additional Page (Page #) CM
YARDS SPECIMENS
All inspections based on minimum of 4 hours and over 4 hours - 8 hours minimum
In addition any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed, a 2 hour minimum
charge will be applied /) S? ^n
Approved/ Authorized by /«-
Submitted by
^•^t-^X l^eZe?***^
(Project Superintendent)
Quality Assurance Inspections
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949)553-0370
Fax (949) 553-0371
wwwqannc com
10378
INSPECTION REPORT
INSPECTOR CODE
A' VO R
JOB NUMBER
monqq
JOB NAME
|~H<? GoeAn cc^lle t-f-io-n A~f tbfe-S&UL ^AocV^
ADDRESS
ARCHITECT '
\i"> ft P€ VDt^ 1 Co rwb
ENGINEER
M \v A *WO"t-G IDv4v A ^ C ,
DATE
/•2-2-g-tfY
BUILDING / OSHPD PERMIT # / DSA APP#
CftO lo^-f SO
GENERAL CONTRACTOR
S'n^de-r LA-nc/srksn
SUBCONTRACTOR (If Any) '
M T W T V 's
DSA FILE*
JURISDICTION
Cfvr ISbftdi
REQUIREMENTS Limit of one job number! one permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR 1 5X
UJcrV (f
2X
\r$ rcp<>r4-<id
TIME IN
dr, I03T9
TIME OUT ME4L PERIOD
I Mileage | | Expenses
l5Tl Reinforcement
/X
Q Fireproof ing
Concrete Placement.
Quality Control
.| | Masonry
,| | Administration.
| Prestress Post Ten.
I Other
Batch Plant.
C\ll<*(?(r\j*<?A f>/A/03 HO T&r ^ (ft- b <.''.'
^P*-5 2 , £Sl.o A; c>.^or
^/
our.
ij^(A
/f-r ^-r
MIX USED DESIGN SLUMP ADMIXTURE DESIGN PSI CUBIC YARDS SPECIMENS
^"Y5<3^
Certification of Compliance
I declare under penalty of perjury that all of the above statements are true,
and that of my own personal knowledge the work during the period covered
by this report_has been performed and installed m compliance with the
approved plans specifications
[ | Additional Page (Page #) CM.
M £
'D City of LA etc )(apprcftmg authority e g DSA OSHPD i
and all applicable codes, except as noted below
Exception(s) noted in report Yes _
(Initial at Yes / No as applicable)
Inspector's Name
Inspector's Signature_:
Inspector's ID / Lie #
No
All inspections based on minimum ot 4 hours and over 4 hours 8 hours minimum
In addition, any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed, a 2 hour minimum
charge will be applied
Approved/Authorized by _
Submitted by
Quality Assurance Inspections
(Project Superintendent)
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949)553-0370
Fax (949) 553-0371
www qannc com
10375
INSPECTION REPORT
INSPECTOR CODE JOB NUMBER DATE A
JOB NAME
r. At-
BUILDING / OSHPD PERMIT # / DSA APP#DSA FILES
ADDRESS GENERAL CONTRACTOR
Snuj&r
JURISDICTION
-^CONTI t-ARCHITECT ENGINEER
Sf
SUBCONTRACTOR (If Any)
REQUIREMENTS Limit of one job number/ one permTt number per srieet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR 1 5X
UJO^fc. KCS
2X
f*p <H-teA ^
TIME IN
1 03~7 (»
TIME OUT MEAL PERIOD
I I Mileage.I | Expenses.
| Reinforcement.
I Fireproofing
. | | Concrete Placement.
. Q] Quality Control
.[ | Masonry.
Administration.
| Prestress Post Ten.
Other
Batch Plant.
tet eta ET v DESCRIPTION QF wqftk iN^REe-TEb;
ob*3r€-<~Of^ r~<L< nrr
qr^cW_ AS p^r- S
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I A
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A-O15 ro J fv ( A- s HAT-Pr.q«n€^r (^ 1^-11^7,
MIX USED DESIGN
Certification of
1 declare under penalty of perjury that a
and that of my own personal knowledge
by this report has been performed an
£li"V<w O cftr oVjfv«A
SLUMP ADMIXTURE
Compliance
II of the above statements are true,
the work during the period covered
d installed in compliance with the
approved plans, specifications
(approving authority o g DSA OSHPD Cily of LA etc )
and all applicable codes except as noted below .^
Exception^} noted in report Yes , No ^f^^
(Initial at Yes / No as applicable)
Inspector's Name jNfr^O '-J
Inspector's Signature ..-<^-^:r a £T!--
Inspector's ID / Lie # S Q&>
A, ic\ ^
^ _£2_^ *
7Mr"-V7 4"^.-C
DESIGN PSI CUBIC YARDS SPECIMENS
| | Additional Page (Paae #) CM
All inspections based on minimum of 4 hours and over 4 hours 8 hours minimum
In addition, any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed a 2 hour minimum
charge will be applied x\ /J
Approved/Authorized by f^^^^^^
(Project Superintendent)
Submitted by
Quality Assurance Inspections
09735
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949) 553-0370
Fax (949) 553-0371
www qaunc com
INSPECTION REPORT
INSPECTOR CODE JOB NUMBER DATE
JOB NAME BUILDING / OSHPD PERMIT # / DSA APPSt DSA FILE*
ADDRESS
I O "RcJ.
GENERAL CONTRACTOR JURISDICTION
(A£ti
DNTRARCHITECT
Ulftrt3 «rmiCorrtl>
ENGINEER
jVUAmcirsMM3r, c
SUBCoTRACTOR (If Any)
D em
REQUIREMENTS Limit of one job number, one permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR
4,0
1 5X 2X TIME IN
(s-30 A</A
TIME OUT
IO;30 A AI
MEAL PERIOD
D Mileage | | Expenses
| I Reinforcement.
| | Fireproof ing
| Concrete Placement | | Masonry | | Prestress Post Ten.
| Quality Control | | Administration | | Other
Batch Plant.
DESCRIPTION OF WORK INSPECTED
rere •FT
A^-yy C (QfoH, C("7 V. C
MIX USED DESIGN SLUMP ADMIXTURE DESIGN PSI CUBIC YARDS SPECIMENS
Certification of Compliance
I declare under penalty of perjury that all of the above statements are true
and that of my own personal knowledge the work during the period covered
by this report_has been performed and installed in compliance with the
approved plans, specifications
| | Additional Page (Page #) CM.
.crbv o-fc-(approving authority e g DSA OSHPD City of LA etc )
and all applicable codes except as noted below
Exception(s) noted in report Yes
(Initial at Yes / No as applicable)
Inspector's NameJiS&MQj^
Inspector's Signature ^~
Inspector's ID / Lie #
No
All inspections based on minimum of 4 hours and over 4 hours - 8 hours minimum
In addition, any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed a 2 hour minimum
charge will be applied
(Project Superintendent)
Approved/Authorized b;
Submitted by
Quality Assurance Inspections
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949)553-0370
Fax (949) 553-0371
wwwqannc com
1U368
INSPECTION REPORT
INSPECTOR CODE JOB NUMBER DATE a -13-07
*
JOB NAME BUILDING / OSHPD PERMIT # / DSA APR*DSA FILE*/
ADDRESS GENERAL CONTRACTO JURISDICTION
ARCHITECT ENGINEER SUBCOTRACTOR (II Any)
REQUIREMENTS Limit of one job numbeTone permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR
S'O
1 5X 2X TIME IN
<£>' 3>O A* no
TIME OUT
a;$<bf,^
MEAL PERIOD
I I Mileage.|Expenses.
Reinforcement.
I Fireproof ing
. | | Concrete Placement.
. [ | Quality Control
| Masonry.
Administration.
| Prestress Post Ten_
Other
Batch Plant.
®\3aVS?ftr^ -'S^f >:!>' "".
ODS(?'ruec\ AfolST Gc <bO r€
e^r £X-t-eri'^
52 /£. .5>c.h?A
n ftsn-Winq^ /
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* -W,D^e* ^s -De^r <,l,\/J,<5 fo c^ox^Op^T" - T / ' p ^~ ^
MIX USED DESIGN SLUMP
Certification of Comphanc
1 declare under penalty of perjury that all of the abov
and that of my own personal knowledge the work dur
by this report has been performed and installed in
f* f'faf &*^ {?<Ar/& h'^-ff't approv
ADMIXTURE
e
e statements are true,
ng the period covered
compliance with the
/ed plans, specifications
(appAwng authority e g DSA OSHPD City ol LA etc )
and all applicable codes, except as noted below J
Exception(s) noted in report Yes . No l^/f K_
(Initial at Yes / No as applicable)
•
Inspector's Name /
Inspector's Signature
Inspector's ID / Lie #
^/UJ n is AS /<{ *
^^2^ 76
OJ
f.r"- v9
DESIGN PSI CUBIC YARDS SPECIMENS
| | Additional Page (Paae #) CM
All inspections based on minimum of 4 hours and over 4 hours 8 hours minimum
In addition, any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed a 2 hour minimum
charge will be applied >"O /
Approved/Authorized by /^-*&^^g,&C~ff
(Project Superintendent)
Submitted by
Quality Assurance Inspections
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949) 553-0370
Fax (949)553-0371
www qannc com
10364
INSPECTION REPORT
INSPECTOR CODE JOB NUMBER070 *m
JOB NAME c
~tft\(> /jC^-o-f- Ce. \ V^cdKO~> AT^ T^f^*Sl<L ^VW"\<ZV>
ADDRESS
2^-10 fe>ATeu]A.4J CAr(-bbp»d
ARCHITECT 'ENGINEER __,
DATE M
& Il-a8-07
BUILDING / OSHPD PERMIT # / DSA APP#
CBC70H30
GENERAL CONTRACTOR
*?fsuA€.r- UlVic <.4oo
SUBCONTRACTOR (If Any) \
' "X T F £S
DSA FILE*
JURISDICTION
CArh (Jil^
REQUIREMENTS. Limit of one job number/ one permit number per sheet Identify all work by type and SPECIFIC location Non-comphanl work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR 1 5X 2X
VOorK hrs or
TIME IN
r?por-t *ioo.
TIME OUT
y\
MEAL PERIOD
Mileage.I I Expenses.
| Reinforcement.
| Fireproofmg
. | | Concrete Placement.
. | | Quality Control
Masonry
,| | Administration.
. | [ Prestress Post Ten.
. Other
Batch Plant.
Bi^q-E * DESCRIPTION OF WORK INSPECTED / ;
ftb^ri"'* AfelS 6rfcO r^'ir^r^rr^rv* oU«?.^^4- ^r-uLrp-r^rvf -^o r ^+er/o^
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tAjflrK *sri 11 /A Droore^^\ \
*fe p^r OA^S -hfpe'fV 52, E <,bbe.<iu^- r r
KeJfer&oc<> infe S2./6 . oeo
MIX USED DESIGN SLUMP
Certification of Complianc
1 declare under penalty of perjury that all of the abov
and that of my own personal knowledge the work dur
by this report has been performed and installed ir
Cv-H opo^UW^ aPPro
(approvinglauthorny eg DSA 0
and all applicable codes §x
Exception(s) noted in report
(Initial at Yes / No as applicable
Inspector's Name jh
Inspector's Signature
Inspector's ID / Lie #
5(,O tsP/ fou^AM-c^ cNe-V^-ns 5(,| S(.2-
ADMIXTURE
e
e statements are true,
ng the period covered
compliance with the
/ed plans, specifications
SHPD City ot LA etc )
cept as noted below -,
Yes No «^W
1 /^i— -<=r"
-^h2G?69-c^ ^^
DESIGN PSI CUBIC YARDS SPECIMENS
( ] Additional Page ^Paae #) CM
All inspections based on minimum of 4 hours and over 4 hours 8 hours minimum
In addition any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed, a 2 hour minimum
charge will be applied j
Approved/Authorized by / C^* * **"%!? flZf** * ~a^^i^^^^~~~~~-~^.
(Project Superintendent)
Submitted by
Quality Assurance Inspections
10367
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949) 553-0370
Fax (949) 553-0371
www qannc com
INSPECTION REPORT
INSPECTOR CODEA; M *JOB NUMBER DATE
JOB NAME BUILDING / OSHPD PERMr » ! DSA APR*DSA FILE"
ADDRESS GENERAL CONTR JURISDICTION
C rV-
ARCHITECT ENGINEER SU TRACTOR (If Any)
cn r\
C
REQUIREMENTS: Limit of one job number, fcne permit number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc ) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR
8-0
1 5X 2X TIME IN
£,- 2>O A rnk
TIME OUT
jLl^op n^
MEAL PERIOD
| Mileage.Expenses.
Reinforcement.
|| Fireproof ing
. | | Concrete Placement.
. [~1 Quality Control
| Masonry.
Administration.
. | | Prestress Post Ten.
. Fl Other
Batch Plant.
•1Sffo: 'fe'-S;- - • •& . ^;\ ^ESGRIRTION^p^ -j^ £$•; , -^ - ; '^
cok^rued^ AKo\S C
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y r (a O r\? i o fc rc z^tn ^r»~t- "^ ( A c: €. ^e'fr.'f , -^c^ c,u. re ip\ p/st
N J /» "\ ' i f***
WorKsHliin procjre-ss .
Refer^t-^ iA-fc ^2
MIX USED DESIGN
Certification of
1 declare under penalty of perjury that a
and that of my own personal knowledge
by this reportj^as been performed an
* tL o'^^1 ^I'O, YQi j ftAiOFTinr^ n^.Vcvi is Sl-l . S / . 2—
SLUM^ ADMIXTURE
Compliance
II of the above statements are true,
the work during the period covered
d installed in compliance with the
approved plans specifications
approviijg authority e g DSA OSHPD City of LA etc ) S
and all applicable codes except as noted below /^
Exception(s) noted in report Yes
(Initial at Yes / No as applicable)
Inspector's Name f^^-J DIJ
Inspector's Signature S*~*~-^
Inspector's ID / Lie # **T5
No^V
drfci'AJr
r^-tr— — —
DESIGN PSI CUBIC YARDS SPECIMENS
l^ | Additional Page (Paae #) CM
All inspections based on minimum of 4 hours and over 4 hours 8 hours minimum
In addition any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no wo>*-re>pertojTned a 2 hour minimum
charge will be applied / s^ )
Approved/ Authorized by >--~~j(
/" (Pro/Set Superintendent)
Submitted by
Quality Assurance Inspections
17942 Sky Park Circle, Ste J, Irvine, California 92614
Phone (949)553-0370
Fax (949)553-0371
www qannc com
10368
INSPECTION REPORT
INSPECTOR CODE JOB NUMBER DATE
- 1-3-6 7
JOB NAME BUILDING / OSHPD PERMIT # / DSA-APP*DSA-FILE#
ADDRESS GENERAL CONTRACTO
o*y
SUBCONTI
<j£-h>i
JURISDICTION
£^<
ARCHITECT ENGINEER RACTOR (If Any)
REQUIREMENTS: Limit of one job number one perrnrt number per sheet Identify all work by type and SPECIFIC location Non-compliant work must be
specifically identified Communication (RFI, Sketch, etc) voiding previous non-compliant items must be listed, record conversations and communications
with project designers, building and permit granting authority officials
HOURS
REGULAR
£>.£
1 5X 2X TIME IN
<JG> < 3>0 R * nr>
TIME OUT
3,;$op,^
MEAL PERIOD
| Mileage.I | Expenses.
M Reinforcement.ft
| | Fireproofmg
. | | Concrete Placement.
. | | Quality Control
. | | Masonry
.[ | Administration.
. | | Prestress Post Ten.
. Other
Batch Plant.
l?>\^a it 1 "'"• ;:<• -:-..-.--t.. « PElCRJRT!^ --.-: -:'-l.;r?;-. :;fc^:-^;
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i ' , ' ' . ' AdJ .- ' ' 'v T c?^-> pv A"*s^< ^ O€-r 'SIM/ .^5\^ " - T /
MIX USED DESIGN SLUMP
Certification of Complianc
I declare under penalty of perjury that all of the abov
and that of my own personal knowledge the work dur
by this report has been performed and installed in
/* ftfaj ^y<^^ (*j£."/t3' fa'l-e-f appro*
fepp/bving authority e g fJSA 0
and all applicable codes, ex
Exception(s) noted in report
(Initial at Yes / No as applicable
Inspector's Name /
Inspector's Signature
Inspector's ID / Lie #
ADMIXTURE
e
e statements are true,
ng the period covered
compliance with the
/ed plans, specifications
SHPD City of LA etc)
cept as noted below /
Yes . No «/rf t
3^.,^/C;,
3 S^- '-\~ •*
fi^5J2/, 76
OJ
?.r~- ?tf
DESIGN PSI CUBIC YARDS SPECIMENS
| | Additional Page (Page #) CM
All inspections based on minimum of 4 hours and over 4 hours - 8 hours minimum
In addition any inspection extending past noon will be an 8 hour minimum
If inspector is called to a project and no work is performed a 2 hour minimum
charge will be applied
Approved/Authorized by
(Project Superintendent)
Submitted by
Quality Assurance Inspections
TWINING
LABORATORIES
01 sou iHERN CALIFORNIA
3310 Airport Way, Long Beach, CA 90806
Ph 562 426 3355 pax 562 426 6424
www twimnglabs com
Compression Test On Concrete
Customer QUALITY ASSURANCE INSPECTIONS
17942 SKY PARK CIRCLE
SUITE J
IRVINE, CA 92614
Project QAI - OCEAN COLLECTION AT BRESSI RANCH
CORNER OF (NOVATION AND GATEWAY
CARLSBAD, CA
Architect
WARE MALCOMB
Engineer
MIYAMOTO INT INC
Client's Customer
Contractor
SNYDER LANGSTON
Subcontractor
DEMEON
Print Date 01/15/2008
Lab Number 2-11-070086897
Project No 0704992
Permit No CB070430
OSHPD
DSA AP #
DSA File #
Sampled From EXTERIOR
Specified
Slump (in) 4 +-1
Air Content (%)
Density (pcf)
Ambient Temp (F)
Concrete Temp (F)
Test Date 12/21/2007
Specimen # 1-1
Cust Spec # 1
Age (Days) 7 Day
Dims (in) 601X1200
Area (sq in) 28 37
L/D or hp/tp 2 00
Total Load (Ibf) 114748
Comp Str (psi) 4045
Corr Factor 1 00
Corr Str (psi) 4050
FOOTINGS AT LINE 1/C AT BLDG E
Measured Date Cast 12/14/2007
45 Received On 12/17/2007
M|X 4533500
48 Spec Str (Psi) 4500
58 Spec Str (Psi) 0
1/11/2008 1/11/2008
2-2 3-3
2 3
28 Day 28 Day
601X1200 601X1200
28 37 28 37
2 00 2 00
145164 147980
5117 5216
1 00 1 00
5120 5220
Average 28 Day Strength
Specimen By RANDY AIKINS-QAI
Delivered By TLSC
@ 28 Days
@ 0 Days
4-4
4
Hold
5170
Procedures ASTM C31 (Specimen Prep), ASTM C39 (Compressive Strength), ASTM C143 (Slump) Specimen Shape Cylinders
Compliance Most Recent Test Results |0Comply Q Did Not Comply With Specified Strength
QUALITY ASSURANCE INSPECTION
Comments
BENITO CABAN - FILE COPY
Hung Nguyen Engineer 'Date
All Reports Remain The Property Of TWINING LABORATORIES of SOUTHERN CALIFORNIA, INC Authorization For The Publication Of Our Reports,
Conclusions, Or Extracts From Or Regarding Them Is Reserved Pending Our Written Approval As A Mutual Protection To Clients, The Public And Ourselves
TWINING
LABORATORIES
OT-' SOU I'M ERN CALI FORM IA
3310 Airport Way, Long Beach, CA 90806
Ph 5624263355 Fax 5624266424
www twinmgiabs com
Compression Test On Concrete
Customer QUALITY ASSURANCE INSPECTIONS
17942 SKY PARK CIRCLE
SUITE J
IRVINE, CA 92614
Project QAI - OCEAN COLLECTION AT BRESSI RANCH
CORNER OF INOVATION AND GATEWAY
CARLSBAD, CA
Architect
WAREMALCOMB
Engineer
MIYAMOTO INT INC
Ghent's Customer QUALITY ASSURANCE INSPECTION
Contractor
SNYDER LANGSTON
Subcontractor
DEMCON
Print Date 02/28/2008
Lab Number 2-11-070087791
Project No 0704992
Permit No
OSHPD
DSA AP #
DSAFile#
Sampled From BLDG "E"
Specified
Slump (in) 4
Air Content (%)
Density (pcf)
Ambient Temp (F)
Concrete Temp (F)
Test Date 1/4/2008
Specimen # 1-1
Cust Spec # 1
Age (Days) 7 Day
Dims (in) 601X1200
Area (sq in) 28 37
UDorhp/tp 200
Total Load (Ibf) 100750
Comp Str (psi) 3551
Corr Factor 1 00
Corr Str (psi) 3550
INTERIOR
Measured
5
62
64
SLAB ON GRADE @ LINE 2/B 5
Date Cast 12/28/2007 Specimen By RANDY AIKINS - QAI
Received On 12/31/2007 Delivered By WT--TLSC
M|X 4533500
Spec Str (Psi) 4500 @ 28 Days
Spec Str (Psi) 0 @ 0 Days
1/25/2008 1/25/2008
2-2
2
28 Day
601X12
2837
200
128228
4520
1 00
4520
3-3 4-4
3 4
28 Day Hold
00 601X1200
2837
200
132684
4677
100
4680
Average 28 Day Strength 4600
Procedures ASTM C31 (Specimen Prep) , ASTM C39 (Compressive Strength), ASTM C143 (Slump) Specimen Shape Cylinders
Compliance Most Recent Test Results 0 Comply Did Not Comply With Specified Strength
QUALITY ASSURANCE INSPECTION
Comments
BENITO CABAN - FILE COPY
Shafiq Popalzai Staff Engineer Date
All Reports Remain The Property Of TWINING LABORATORIES of SOUTHERN CALIFORNIA INC Authorization For The Publication Of Our Reports,
Conclusions Or Extracts From Or Regarding Them Is Reserved Pending Our Written Approval As A Mutual Protection To Clients, The Public And Ourselves
TWINING
LABORATORIES
or SOUTHERN CALIFORNIA
3310 Airport Way, Long Beach, CA 90806
Ph 562 426 3355 Fax 562 426 6424
www twimnglabs com
Compression Test On Concrete
Customer QUALITY ASSURANCE INSPECTIONS
17942 SKY PARK CIRCLE
SUITE J
IRVINE, CA 92614
Project QAI - OCEAN COLLECTION AT BRESSI RANCH
CORNER OF INOVATION AND GATEWAY
CARLSBAD, CA
Architect
WARE MALCOMB
Engineer
MIYAMOTO
Client's Customer
Contractor
SNYDER LANGSTON
Subcontractor
MTI
Print Date 03/24/2008
Lab Number 2-11-080090365
Project No 0704992
Permit No CB0704
OSHPD
DSA AP #
DSA File #
Sampled From BLDG E,
Specified
Slump (in) N/A
Air Content (%)
Density (pcf)
Ambient Temp (F)
Concrete Temp (F)
Test Date 2/20/2008
Specimen # 1-1
Oust Spec # 1
Age (Days) 7 Day
Dims (in) 2 00X4 00
Area (sq in) 314
LID or hp/tp 2 00
Total Load (Ibf) 12262
Comp Str (psi) 3903
Corr Factor 1 00
Corr Str (psi) 3900
2ND 6'8" LIFT 5'4-12" HT AT LINE A/3 7
Measured Date Cast 2/13/2008
N/A Received On 2/14/2008
Mix
55 Spec Str (Psi) 1800
Spec Str (Psi) 0
3/12/2008 3/12/2008
2-2 3-3
2 3
28 Day 28 Day
2 00X4 00 2 00X4 00
314 314
2 00 2 00
16239 15898
5169 5060
1 00 1 00
5170 5060
Average 28 Day Strength
Specimen By RANDY AIKINS-QAI
Delivered By TLSC
@ 28 Days
@ 0 Days
5115
Procedures ASTM C31 (Specimen Prep), ASTM C39 (Compressive Strength), ASTM C143 (Slump) Specimen Shape Cylinders
Compliance Most Recent Test Results 0 Comply Did Not Comply With Specified Strength
QUALITY ASSURANCE INSPECTION
Comments
BENITO CABAN - FILE COPY
Shafiq Popalzai Staff Engineer Date
All Reports Remain The Property Of TWINING LABORATORIES of SOUTHERN CALIFORNIA, INC Authorization For The Publication Of Our Reports,
Conclusions, Or Extracts From Or Regarding Them Is Reserved Pending Our Written Approval As A Mutual Protection To Clients, The Public And Ourselves
SEP-06-2007 THU 03:16 PM CITY OF CARSLBAD FAX NO. 760 602 8558 P. 21
COMMUNITY FACILITIES DISTRICT No. 1
NON-RESIDENTIAL CERTIFICATE NON-RESIDENTIAL LAND OWNER, PLEASE
READ THIS OPTION CAREFULLY AND BE SURE YOU THOROUGHLY UNDERSTAND
BEFORE SIGNING THE OPTION YOU CHOSE WILL AFFECT YOUR PAYMENT OF THE
DEVELOPED SPECIAL TAX ASSESSED ON YOUR PROPERTY THIS OPTION IS
AVAILABLE ONLY AT THE TIME OF THE FIRST BUILDING PERMIT ISSUANCE
PROPERTY OWNER SIGNATURE is REQUIRED BEFORE SIGNING YOUR SIGNATURE is
CONFIRMING THE ACCURACY OF ALL INFORMATION SHOWN
BRESSI OCEAN COLLECTION LLC
NAME OF OWNER
128O BISON B9-6O9
ADDRESS
NEWPORT BEACH CA 9266O
714638-7277
TELEPHONE
2510 GATEWAY RD BLDG E
PROJECT ADDRESS
CARLSBAD, CA 92009
CITY, STATE
213261 O900
ZIP
UOTlC
CITY, STATE ZIP
ASSESSOR PARCEL NUMBER(S) OR APN(s) AND LOT NUMBERS(S) IF NOT YET SUBDIVIDED BY COUNTY ASSESSOR
CBO7O43Q
BUILDING PERMIT NUMBER(S)
AS CITED BY ORDINANCE NO NS-1 55 AND ADOPTED BY THE CITY OF CARLSBAD. CALIFORNIA,
THE CITY IS AUTHORIZED TO LEVY A SPECIAL TAX IN COMMUNITY FACILITIES DISTRICT NO 1 ALL
NON-RESIDENTIAL PROPERTY, UPON TH£ ISSUANCE OF A BUILDING PERMIT SHALL HAVE THE
OPTION TO (1) PAY THE SPECIAL DEVELOPMENT TAX ONE TIME OR (2) ASSUME THE
ANNUAL SPECIAL TAX - DEVELOPED PROPERTY FOR A PERIOD NOT TO EXCEED TWENTY
FIVE (25) YEARS PLEASE INDICATE YOUR CHOICE BY INITIALIZING THE APPROPRIATE LINE BELOW
OPTION (1) I ELECT TO PAY THE SPECIAL TAX-ONE TIME NOW, AS A ONE-TIME PAYMENT
AMOUNT OF ONE-TIME SPECIAL TAX- $ 4,491.38
OWNER s INITIALS
OPTION (2) I ELECT TO PAY THE SPECIAL DEVELOPMENT TAX ANNUALLY FOR A
PERIOD NOT TO EXCEED TWENTY-FIVE (25) YEARS
MAXIMUM ANNUAL SPECIAL TAX: $ 620,26
OWNER'S INITIAL
I DO HEREBY CERTIFY UNDER PENALTY OF PERJURY THAT THE UNDERSIGNED IS
THE PROPERTY OWNER OF THE SUBJECT PROPERTY AND THAT I UNDERSTAND
AND WILL COMPLY WITH THE PROVISION AS STATED ABOVE
SIGNATURE OF PROPERTY OWNER TITLE
PRINT NAME DATE
4)11107
THE CITY OF CARLSBAD HAS NOT INDEPENDENTLY VERIFIED THE INFORMATION SHOWN ABOVE THEREFORE,
WE ACCEPT NO RESPONSIBILITY AS TO THE ACCURACY OR COMPLETENESS OF THIS INFORMATION
LAND USE, FY, FACTOR INDUST 3/O3 .8624 x SQUARE FT 5.2O8- 4,491 38
SEP-06-2007 THU 03:09 PM CITY OF CARSLBAD FAX NO. 760 602 8558 P. 07
City of Carlsbad
Building Department
CERTIFICATE OF COMPLIANCE
PAYMENT OF SCHOOL FEES OR OTHER MITIGATION
This form must be completed by the City, the applicant, and the appropriate school districts and returned to the City
prior to issuing a building permit The City will not issue any building permit without a completed school fee form
Project Name
Building Permit
Plan Check Number
Project Address
APN
Project Applicant
(Owner Name)
Project Description
Building Type
Residential
Second Dwelling Unit
Residential Additions
Commercial/Industrial
City Certification of
Applicant Information
OCEAN COLLECTION @ BRESSI
CB070430
2510 GATEWAY RD.
2132610900
BRESSI OCEAN COLLECTION LLC
OFFICE SHELL BLD E
V-N
New Dwelling Units
Square Feet of Living Area in New Dwelling
Square Feet of Living Area in SOU
Net Square F'eet New Area
5,208 Square Feet l:loor Area
SCHOOL DISTRICTS WITHIN THE CITY OF CARLSBAD
Carlsbad Unified School District
6225 El Cammo Real
Carlsbad CA 92009 (331-500
Vista Unified School District
1234 Arcadia Drive
Vista CA 92083 (726-2170)
San Marcos Unified School District
2J5MataWay
San Maaos, CA 92069 (290-2649)
Contact Nancy Dolce (By Appt Only)
Encinitas Union School District
101 South Rancho Santa Tc Rd
tncmitas, CA 92024 (944-4300 ext 166)
San Dieguito Union High School District
7JO Encinitaa Blvd
Encmitas, CA 92024 (753-6491)
Certification of Applicant/Owners The person executing this declaration ("Owner") certifies under penalty of perjury that (1) the
information provided above is correct and true to the bes,t of the Owner's knowledge, and that the Owner will file an amended
certification of payment and pay the additional fee if Owner requests an increase in the number of dwelling units or square
footage after the building permit is issued or if the initial determination of units or square footage is found to be incorrect, and
that (2) the Owner is the owner/developer of the above described project(s), or that the person executing this declaration is
authorized to sign on behalfof the Owner
Signature ( X.
Reviicd 3/30/2006
Date gin 01
SEP-06-2007 THU 03:10 PM CITY OF CARSLBAD .FAX NO, 760 602 8558 P. 08
SCHOOL DISTRICT SCHOOL FEE CERTIFICATION
(To be completed by the school distnct(s))
****************************** lrt**»******»*****»*****»****^^
THIS FORM INDICATES THAT THE SCHOOL DISTRICT REQUIREMENTS FOR THE
PROJECT HAVE BEEN OR WILL BE SATISFIED
SCHOOL DISTRICT
The undersigned, being duly authorized by the applicable School District, certifies that the
developer, builder, or owner has satisfied the obligation for school facilities This is to certify that
the applicant listed on page 1 has paid all amounts or completed other applicable school
mitigation determined by the School District The City may issue building permits for this project
SIGNATURE OF AUTHORIZED SCHOOL
DISTRICT OFFICIAL
TITLE
NAME OF SCHOOL DISTRICT
DATE
PHONE NUMBER
WALTER FREEMAN
ASSISTANT SUPERINTENDENT
CARLSBAD UNIFIED SCHOOL DISTRICT"
6225 EL CAMNO REAL
92009
Revised 3/30/2006