HomeMy WebLinkAbout2628 Gateway Rd; ; CBCA2017-0015; PermitPermit
Print Date: 06/07/2019
Job Address:
Permit Type:
Parcel No:
Valuation:
Occupancy Group:
# Dwe1Hng Units:
Bedrooms:
Project Title:
2628 Gateway Rd
BLDG-Associated Permit Commerci
2132621900
$431,941.00
UPTOWN BRESSI RANCH
Work Class:
Lot#:
Reference#:
Construction Type:
Bathrooms:
Orig. Plan Check#:
Plan Check#:
Description: UPTOWN BRESSI: BUILDING E-7,300 SF RETAIL SHELL
Applicant:
SMITH CONSULTING ARCHITECTS
NORMAN BARRETT
13280 Evening Creek Dr S
San Diego, CA 92128-4101
858-793-4777
BUILDING PERMIT FEE ($2000+)
BUILOING PLAN CHECK FEE (BLDG)
BUILDING PLAN CHECK FEE (BLDG)
Owner:
BRESSI RETAIL LLC
130 Vantis Dr, 200
Aliso Viejo, CA 92656-2691
858-526-6655
COMMUNITY FACILITIES DISTRICT (CFD) FEE-NON-RES
ELECTRICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL
GREEN BUILDING STANDARDS PLAN CHECK & INSPECTION
LOCAL FACILITIES MANAGEMENT ZONE (LFMZ) -ZONE 17
MECHANICAL BLDG COMMERCIAL NEW/ADD\T!ON/REMODEL
PUBLIC FACILITIES FEES-inside CFO
REFUND
5B1473 GREEN BUILDING STATE STANDARDS FEE
SDCWA SYSTEM CAPACITY CHARGE 1-1/2" Displacement
SEWER BENEFIT AREA FEES -H
SEWER CONNECTION FEE (General Capacity all areas)
SWPPP INSPECTION FEE TIER 1 -Medium BLDG
SWPPP PLAN REVIEW FEE TIER 1-MEDIUM
TRAFFIC IMPACT Commercial-Industrial w/in CFO
WATER METER FEE 1-1/2" Displacement
WATER SERVICE CONNECTION FEE 1-1/2" OISPLACEMENT-P
WATER TREATMENT CAPACITY CHRG 1-1/2" Displacement
Total Fees: $113,753.29 Total Payments To Date:
New
2
DEV12023
VB
PC2017-0015
$113,753.29
Status:
Applied:
Issued:
Permit
Finaled:
Inspector:
Final
Inspection:
Balance Due:
(city of
Carlsbad
Permit No: CBCA2017-0015
Closed -Finaled
11/06/2017
04/19/2018
AKrog
6/7/2019 12:05:22PM
$0,00
$1,804.60
$463.22
$1,263.22
$0.00
$89.00
$170.00
$2,920.00
$55.00
$7,861.33
$0.00
$18.00
$15,297.00
$4,254.88
$3,792.04
$238.00
$56.00
$56,721.00
$606.00
$17,721.00
$423.00
1635 Faraday Avenue, Carlsbad, CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov
PERMIT INSPECTION HISTORY REPORT (CBCA2017-0015)
Permit Type: BLDG-Associated Pem1it Commercial Application Date: 11/06/2017 Owner: BRESSI RETAIL LLC
Work Class: New Issue Date: 04/19/2018 Subdivision:
Status: Closed -Finaled Expiration Date: 04/16/2019 Address: 2628 Gateway Rd
Carlsbad, CA 92009
IVR Number: 7493
Scheduled Actual
Date Start Date Inspection Type Inspection No. Inspection Status Primary Inspector Re inspection Complete
06/13/2018 06113/2018 BLDG-16 060917-2018 Passed Andy Krogh Complete
Roof/ReRoof (Patio)
07/02/2018 07/02/2018 BLDG-17 Interior 062839-2018 Partial Pass Andy Krogh Reinspection Incomplete
Lath/Drywall
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Single side at electrical and fire riser room Yes
BLDG-24 062841-2018 Passed Andy Krogh Complete
Rough/Topout
08/23/2018 08/23/2018 BLDG-18 Exterior 067896-2018 Partial Pass Andy Krogh Reinspectlon Incomplete
Lath/Drywall
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Partial as noted on card Yes
09/12/2018 09/12/2018 BLDG-18 Exterior 069783-2018 Passed Andy Krogh Complete
Lath/Drywall
09/13/2018 09/12/2018 BLDG-34 Rough 069784-2018 Paased Andy Krogh Complete
Electrical
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Torque test main switch gear an house Yes
panel
BLDG-Building Deficiency At noted on plans Yes
10/18/2018 10/18/2018 BLDG-Electric Meter 073668-2018 Passed Andy Krogh Complete
Release
06/07/2019 06/07/2019 BLDG-Fina I 094098-2019 Passed Andy Krogh Complete
Inspection
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
BLDG-Plumbing Final Yes
BLDG-Mechanical Final Yes
BLDG-Structural Final Yes
BLDG-Electrical Final Yes
BLDG-Fire Final 080886-2019 Scheduled Cindy Wong Incomplete
Checklist Item COMMENTS Passed
FIRE-Building Final No
June 07, 2019 Page 2 of 2
PERMIT INSPECTION HISTORY REPORT (CBCA2017-0015)
Permit Type: BLDG-Associated Permit Commercial Application Date: 11/06/2017 Owner: BRESSI RETAIL LLC
Work Class: New Issue Date: 04/19/2018 Subdivision:
Status: Closed -Finaled Expiration Date: 04/16/2019 Address: 2628 Gateway Rd
Cansbad, CA 92009
IVR Number: 7493
Scheduled Actual
Date Start Date Inspection Type Inspection No. Inspection Status Primary Inspector Reinspection Complete
04/2312018 04/2312018 BLOG-12 Steel/Bond 066707-2018 Failed Andy Krogh ReinspecUon Complete
Beam
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Not ready No
04/26/2018 04/26/2018 BLOG-12 Steel/Bond 056988-2018 Passed Andy Krogh Complete
Beam
05/11/2018 05/11/2018 BLDG-16 067812-2018 Partial Pass Andy Krogh Reinspection Incomplete
Roof/ReRoof (Patio)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Perimeter nailing ok to set parapet walls Yes
05/21/2018 05/21/2018 BLDG-34 Rough 058542-2018 Partial Pass Andy Krogh Reinspection Incomplete
Electrtcal
Checklist Item COMMENTS Passed
BLDG-Building Deficiency At noted on plans Yes
05/25/2018 06/25/2018 BLDG-14 059214-2018 Failed Andy Krogh Reinspectlon Complete
Frame/Steel/Bolting/
Welding (Decks)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Requires special inspection, hold downs No
missing nuts, straps incomplete
06/04/2018 06/04/2018 BLDG-13 Shear 059827-2018 Partial Pass Andy Krogh Reinspection Incomplete
Panels/HD (ok to
wn,p)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency First layer Yes
BLDG-15 059826-2018 Passed Andy Krogh Complete
Roof/ReRoof (Patio)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Perimeter nailing ok to set parapet walls Yes
BLDG-Building Deficiency Diagonal bracing at Parapet walls Yes
06/06/2018 06/06/2018 BLDG-14 060085-2018 Partial Pass Andy Krogh Reinspectlon Incomplete
Frame/Steel/Bolting/
Welding (Decks)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Exterior walls ok to sheet all but ones that Yes
have plumbing
BLDG-16 060086-2018 Partial Pass Andy Krogh Reinspectlon Incomplete
Roof/ReRoof (Patio)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Roof as noted on card Yes
June 07, 2019 Page 1 of2
~ CARLSBAD
Building Division INSPECTION RECORD
@ INSPECTION RECORD CARD WITH APPROVED
PLANS MUST BE KEPT ON THE JOB
CBCA2017--0015
2628 GA TEWA y RO
@ CALL BEFORE 3:00 Pm FOR NEXT WORK DAY INSPECTION
@ FOR BUILDING INSPECTION CALL: 760-602-2725
OR GO TO: www.Carlsbadca.gov/Buildlng AND CLICK ON
"Request Inspection"
DATE: -(9-I(;
UPTO\NN BRESSI BUILDlNG E -7,300 SF RETAIL SHELL
"''' E. 2132621900 PC~17-0015 111612011
CBCA2017-0015
If ''YES" is checked below that Division's approval is required prior to.J~_sfulg a Final Building Inspection. If you have any questions
please call the applicable divisions at the phone numbers provided below. After all required approvals are signed off-fax to
760-602-8560, email to bid ins ections@c_arlsbad~ or bring In a COPY of this card to: 1635 Faraday Ave., Carlsbad.
STORM WATER PRECON MEETING REQUIRED 760-602-2725 Allow 24 hours
IF MARKED "YES". APPROVAL REQUIRED PRIOR TO REQUESTING BUILDING
Fire Prevention
Planning/Landscape
CM&I (Engineering Inspections)
#12 REINFORCED STEEL
#66 MASONRY PRE GROUT
0 GROUT D WALL DRAINS
#10 TILT PANELS
#11 POUR STRIPS
#11 COLUMN FOOTINGS
#l4 SUBFRAME D FLOOR D CEILING
#15 ROOF SHEATHING
#13 EXT. SHEAR PANELS
#21 UNDERGROUND □WASTE D WTR
#24 TOP OUT O WASTE WTR
TUB & SHOWER PAN
GAS TEST D GAS PIPING
#2S WATER HEATER
#2S SOLAR WATER
BLDG-ANAL
POOL EXCAV / STEEL
PLUMBING
#S3 ELEC /CONDUIT/WIRING
EQUIP01£NTIAL BOND
#S4 PR_, ar«D / FENCE/ AlARMS #155 ,:.ruo,,, ....
#17 GUNITE
BLDG-FINAL
Date
760-602--4660
760-944-8463
760--438-3891
Ins
Allow 48 hours
Allow 48 hours
Call before 2 pm
#35 PHOTO VOLTAIC
#38 SIGNS
BLDG-FINAL
CODE# COMBO INSPECTION
UNDERGROUND (11,12,21,31)
#82 DRYWALL,EXT LATH, GAS TES (17,18,23)
#83 ROOF SHEATING, EXT SHEAR (13,15)
#84 FRAME ROUGH COMBO (14,24,34,44)
A/S UNDERGROUND VISUAL
A/S UNDERGROUND HYDRO
A/S UNDERGROUND FLUSH
A/S OVERHEAD VISUAL
A/S OVERHEAD HYDROSTATIC
A/S FINAL
F/A ROUGH-IN
F/AFINAL
FIXED EXTINGUISHING SYSTEM ROUGH-IN
FIXED EXTING SYSTEM HYDROSTATIC TEST
FIXED EXTINGUISHING SYSTEM FINAL
MEDICAL GAS PRESSURE TEST
MEDICAL GAS FINAL
-----• •
Date
COl'YOFCARO
REOUIREO
Ins ector
SEE BACK FOR SPECIAi. HOTES
SEe S,.CJ< FOR SPECIAL NOTES
/iiff MOORE TWINING
Date: 04/25/2018 FIELD DAILY INSPECTION REPORT
Client Name: Shea Properties
Project Name: Bressi Ranch Retail
Project Address: 2628 Gateway Road,
Permit No: CBCA2017-0015
Plan Date: 05/19/2017
MTA Project Na.: D56624.01
Stare No.: Building E
Carlsbad, CA 92009
Building Code: 2016 CBC
Specification Date: 05/19/2017
Page 1 of 3
General Contractor: CSI Construction Subcontractor: Dicarlo Concrete Inc.
Inspector: Osama Daoud
Certification Number: ICC # 5098536 Exp. Dote: 04/14/2020
□ Building Pad □ Utilities □ Pavement Sub-grade □ Pavement Base □ Pavement AC □ PCC Pavements □ Off-Site Improvements
o Sidewalks o Curb & Gutter I Foundations I Slab-On-Grade o Columns o Beams o Walls □ Trusses D Deck o Suspended Floors
D Rao!□ Rack and Shelving □ Light Gauge Interior Walls/Framing □ Pre-Cast Concrete □ Other
□ Sampling □ Earthwork Observation & In-Place Density Testing I Reinforcing Steel Inspection □ Concrete Sampling □ Concrete
Placement Inspection (including saw-cut depth , CO monitoring, curing, etc.) o Batch Plant Inspection o Moisture Vapor Emission
Testing D Floor Slab Relative Humidity Tes ting D Slip-Resistance Testing D Floor Flatness Testing D Gloss Measurements
□ Joint Sealer Inspection □ Anchor Bolt/ Epoxy Inspection □ Field Welding Inspection □ Shop Welding Inspection □ NDT
□ HS Bolt Tes ting □ Spray Fire Proofing Inspection and Testing □ Masonry Inspection □ Paint Thickness Testing □ Roof Inspection
□ Coring □ Sample Pickup D Other
Inspection Date: 04/25/2018
I Initial Inspection o Re-Inspection
Weather: Clear
Samples Taken o Yes I No Time Samples Taken:
o Out-al-Scape Inspection or Testing
Inspected rebar placement for the Building foundation and Slab-On-Grade at the area between A to
Band from 1 to 2, the rebar installed for the wall footings around according to details 9A/S-701 &
1/S-701 & 14/S-701 & 2/S-701 & 15/S-701 Footing schedule & 10/S-701 Column schedule &
3/S-701 & 4/S-701 & 8/S-701 in the approved plan and also the rebar installed for Slab-On-Grade
WI# 3@ 18" O.C.E.W. according to the information on sheet# S-E-1.0 in the approved plan for
Retail Building E.
Report Continued o Yes I No
Work inspected as outlined in this report is, to the best of this inspectors knowledge, in conformance with the approved plans and
specifications: Ill Yes □ No (If no, inspector shall complete and attach a Discrepancy Report).
MTA Corporate address: 2527 Fresno Street, Fresno, CA 93721 (800.268.7021). Website: www.mooretwininq.com
Inspector's Signature C:::,~&::22,, s / Date: 04/25/2018
Supervisor's Signature Date:
We do not undertake the guarantee of construction nor do we relieve the contractor of his primary responsibility to complete the project in
accordance with the plans and specifications. Our firm is not responsible for construction safety. Our selVices were performed in accordance
with generally accepted standards and practices. This warranty is in lieu of all other warranties either expressed or implied.
,JMOORE TWINING
Page 2 of 3 ----REINFORCING STEEL AND CONCRETE REPORT
Date: 04/25/2018 ---------Project Name: Bressi Ranch Retail MTA Project No.: D56624.01
Store No.: Building E Inspector (Print): Osama Daoud
Project Address: 2656 Gateway Road, Certification No.: ICC # 5098536
City, State: Carlsbad, CA 92009 Weather: Clear
Client Name: Shea Properties ___ .:,_ _______ _ CSI Construction General Contractor:
Approved Project Plans Dated: 05/19/2017 Specifications Dated: 05/19/2017 --------Code/Acceptance Standards: 2016 CBC Reference Section: -------------Bui Id in g Permit/ DSA No· CBCA2017-0015 ..
IZJ REINFORCING STEEL
@Footing □Sidewalk/ Curb
□Tilt-up Wall Panels □Elevated Deck
□Other:
□Form Work □Vapor Barrier
□Sub Grade □Anchors
0Uffer Ground Oother
Grid Line / Location:
The Building foundation and Slab-On-Grade at
the area between A to B and from 1 to 2 for
Retail Building E.
□CONCRETE PLACEMENT 0 CONCRETE SAMPLING ONLY
□Foundation 0 Sidewalk / Curb
0Tilt-up Wall Panels D Elevated Deck
□Other:
Supplier: Concrete Mix Design No.:
Required Strength:
Yards Placed: Method Placed:
Consolidated By:
Other:
□Please see attached Concrete Sampling Data Report
Discre ancies Issued: p @No
C?'?f'Jl ~ ahas /
Inspector Signature
CORPORATE
2527 Fresno Street
Fresoo, CA 93721-1804
(569) 268-7021
Fax 265-7126
D Yes (If es, see attached Discrepanc Re ort y y p )
CORONA
500 Harrington Street, Ste. It
Ccrona, CA 92879
(951)898-8932
Fax 898-8974
MONTEREY
501 Ortiz Avenue
Sand City, CA 93955
(831) 392-1056
f@( 392-1059
@Slab on grade
□shear Walls
0 Reinforcing Steel
□PIT Tendons
□slab on grade
04/25/2018
Date
SACRAMENTO
5675 Power Inn Road, Su~e c
Sacramerto, CA 95824
(916)361-9477
Fa< 381-9478
Project Name:
Sample Sample
No. Type
.fief MOORE TWINING
Bressi Ranch Retail
Truck# Ticket#
MTAProjectNo.: D56624.01
CONCRETE SAMPLING DATA REPORT
Batch Time Ambient Concrete Water
Truck Slump Added Time em-·· Temp Temp OnelOJ
Unit
Weight
Page~o1_3 __
Date: 04/25/2018
Air Sample Location Content
C??rn0-aha, ✓ Osama Daoud 04/25/2018
Inspector Signature
CORPORATE
2527 Fresno street Fresro, CA 93721-1E04
(559) 26S-7021
Fa~ 268-7126
Inspector Print
CORONA
500 Harr1ngton Street, Ste. I I
CCJ'ona, CA 92879
(951) 898-8932
F11X 898-8974
MONTEREY
501 Ort~ Avenue
Sand City, CA 939:55
(831) 39::2.1056
Fit< 392-1059
Date
SACRAMENTO
567!'1 Power inn Roaci, Suite c
sacramerto. CA 9582d
(916) 381-9477
Fa< 381-9478
{;iff MOORE TWINING
Date: 6/26/18 FIELD DAILY INSPECTION REPORT
Client Name: Shea Properties
Project Name: Square at Bressi Ranch
Project Address: 2628 Gateway Rd, Carlsbad, CA
Permit No: CBCA2017-0015
Pion Dote: 11 /4/17
MTA Project No.: D56624.01
Store No.: na
Building Code: 2016 CBC
Specification Dote: 11/4/17
Page 1 of 2
General Contractor: CSI
Inspector: Ethan Moore
Certification Number: ICC 52144 78
Subcontractor: Campbell Certified
Exp. Dote: 7 /4/19
□ Building Pod □ Utilities □ Pavement Sub-grade □ Pavement Bose D Pavement AC □ PCC Pavements □ Off-Site Improvements
D Sidewalks D Curb & Gutter □ Foundations D Slob-On-Grode □ Columns □ Beams D Walls D Trusses D Deck □ Suspended Floors
□ Roof □ Rock ond Shelving □ Light Gouge Interior Wolls/Froming □ Pre-Cost Concrete I Other canopy framing
□ Sample Pickup □ Earthwork Observation & In-Place Density Testing □ Reinforcing Steel Inspection □ Concrete Sampling
D Concrete Placement Inspection (including sow-cut depth , CO monitoring, curing, etc.)□ Post Tension Concrete D Moisture Vapor
Emission Testing □ Floor Slob Relative Humidity Testing D Slip-Resistance Testing D Floor Flatness Testing D Gloss Measurements
□ Joint Sealer Inspection □ Anchor Bolt/ Epoxy Inspection ■ Field Welding Inspection D Shop Welding Inspection D NDT
□ HS Bolt Testing □ Spray Fire Proofing Inspection and Testing □ Masonry Inspection □ Non-Shrink Grout □ Roof Inspection
□ Coring □ Nailing/Wood Framing Inspection □ Other
Inspection Date: 6/26/18 Samples Token □ Yes I No Time Samples Token:
I Initial Inspection D Re-Inspection □ Out-of-Scope Inspection or Testing
Weather: sunny
Welding was performed for the attachment of galvanized HSS "Eyebrow" canopy sections at
Building E line 2 at A.5 and A.6. The canopy frames were welded to the HSS 5x5 columns at the
openings. Per detail 17/S503, the HSS beams were welded to the columns using flare bevel welds.
As allowed by RFI #87, the beams were welded on the top, bottom and front sides, because the
back side was inaccessible do to wood framing in place. Welding was performed by the welder
Jesse Barnett using FCAWwith E71T-8. The joints were marked "VTOK EM 6/26" in green.
The canopy to column weld at 1-A.7 noted on 6/21/18 as having undercut was repaired today.
Report ContlnuedlE!Yea0No
Work inspected as outlined in this report is, to the best of this inspector's knowledge, in oonformance with the approved plans and
specifications:IE!Yea0No (If no, inspector shall complete and attach a Discrepancy Report).
MTA Corporate address: 2527 Fresno Street, Fresno, CA 93721 (800.268.7021). Website: www.mooretwining.com
Inspector's Signature Date: 6/26/18
Supervisor's Signature Date:
We do not undertake the guarantee of construction nor do we relieve the contractor of his primary responsibility to complete the project in
accordance with the plans and specifications. Our firm is not responsible for construction safety. Our services were performed in accordance
with generally accepted standards and prac1ices. This warranty is in lieu of all other warranties either expressed or implied.
...
liiff MOORE TWINING
FIELD WELDING INSPECTION REPORT
Project Name Square at Bressi Ranch Store# na Date of Inspection 6/26/18 ------------------------Project Address 2628 Gateway, Carlsbad, CA Detail(s) 1715503 MTAProjectNo. _D_58_6_2_4_.0_1 _____ _
Approved PIMS _1_11_41_1_7 _____________ Speclllcatlons 11/4/17 lnspector(Pnnt) _E_lh_a_n_M_oo_re ____ _
Build"!JPermlt/DSANo. CBCA2017--0015 Process FCAW
WELD/CONNECTION TYPES MEMBER/JOINT TYPES
A> Affi Spot Weld DD Beam to Beam cu Plate to Column
UC LOmple'8 nmsmmon Groove Weld ~ Beam to Column TA Tube Steel to Angle
FB Flare i,ievel Groove Weld cc COiumn to COiumn TB Tube Steel to Beam N.D.T. T ,a
,w Fllo!Weld DB Deck to Beam AB Angle to Beam V Visual
c"' netratlon 1,:,roove Weld Gusset Plate to cieam ,, ,ube I to I Ube ;:,tee I u, trasonic , esllng
" ;:,teel ;:,tud '" Gusset Plate to CC lumn ·"' Joist to Girder ., IMagnettc ..-wnr~ Testing
AA Angie to Angle RA Rebar to Angle o, Dye Penetran!T esting
PB Plate to Beam AJ Angle to Joist
Detail Weld/Connection MemberlJolnt Item N.D.T. Accept Reject In Complete Remarkdlotes
Type Type Type p,....,.
17/$503 FB BC HSS canopy beam to HSS column at line 1-A.7 V X X
17/5503 FB BC HSS canopy beam to HSS column at 2-A.5 and 2-A.6 V X X
Notes:----------------------------------------------------
Disaepancies Issued: @ No D Yes (tt yes, see attachoo Discrepancy Reporl) ~ ICC5214478
Inspector Signature =. ~A""W~S/~IC~C~Cefti,-,'llca,-ti~on~N~o-. ----------~ ,.,.,►,.,,,0,1,..i r .. ,,., u .,,,,_,,.,.,
, .. ,;~702' ,..;,,.,,,~-.
~-,..,., __ A,.....,
~ •. .,,.., c .... ,,,. .. 1a,,, ..-:.1oes r,.,,0,1-,;s
6/26/18
Date
filMOORE TWINING
DEVIATION/ DISCREPANCY REPORT (Page __ of __ ) Item Number _____ _
Client Name: Shea Properties MTA Project No.: D56624.O1
Project Name: Square at Bressi Ranch Pad E Store No._ .. ____________ _
Project Address: (Street, City & State} '2628 Gateway. Carlsbad, CA
Permit No. CBCA2O11-OO15 Building Code: .::2:.;O1.::6..:C.::B.::C __________ _
Plan Date: _1_11◄_1_11 ___________ Specification Date: _1_11◄_1_11 __________ _
General Contractor: CSI Subcontractor: Campbell Certified
Inspector (Print): _E_tha_n_M_oo_re___________ ICC Certification Number: _,c_c_s_21_«_1_s ______ _
Inspection Date: 6121118 ICC Certification Exp. Date: _11_◄1_1_0 ________ _
Type: □ Building Pad □ Utilities □ Pavement Sub-grade □ Pavement Base □ Pavement AC □ PCC Pavements
□ Sidewalks □ Curb & Gutter □ Off-Site Improvements □ Foundations □ Slab-On-Grade □ Columns □ Beams □
Walls □ Trusses □ Deck □ Suspended Floors □ Roof □ Rack & Shelving □ Sidewalks □ Curb & Gutter □ Light Gauge
Interior Walls/Framing □ Pre-Cast Concrete I!! Other ... ca::.ncco::.:py __ 1ra ...... m __ 1ng=------------------
Locations (Define Location by Grid Lines or Intersections, etc.}: Building E line 1 atA.7 HSS canopy framing
Deviation Description (Describe why the work deviates from the approved plans and specifications and reference
the specific part of the plans such as the Sheet and Detail and/or the specific section of the specifications that the
work did not comply): the weld connecting the HSS canopy beam to the south HSS column was found to have undercut
Reference Documents: List and attach any reference documents that assist in describing the deviation such as
sketches, photographs, e-mails, etc.: ___________________________ _
Action Required (such as Repair per plans and specifications, RFI, Repair as required by the Professional of Record,
and Work in Progress}: _rec.pa_,_, ____________________________ _
Contractor Personnel Notified: _________ Signature: __________ Date: ___ _
Client Personnel Notified: Signature: Date:
Inspectors' Signature: ~ Date Issued: 6121118 ----
Deviation Corrected? I!! Yes □ No Date Resolved: ..:.612.::6::.l:.:18'------Observed By: _E_th_an_M_oo_re ____ _
Corrective Action Taken? _we.::l.::d.:.:w.::as:.:re.:cpc:a::.ire:.:dc_ _________________________ _
Client Notified: Signature: Date:
Inspectors' Signature: Date: 6126118