HomeMy WebLinkAbout2662 Gateway Rd; ; CBCA2017-0013; PermitPermit
Print Date: 06/07/2019
Job Address: 2662 Gateway Rd
Permit Type: BLDG-Associated Permit Commerci Work Class:
Parcel No: 2132622100 Lot#:
Valuation: $689,330.50 Reference#:
Occupancy Group: Construction Type:
# Dwelling Units: Bathrooms:
Bedrooms: Orig. Plan Check#:
Plan Check#:
Project Title: UPTOWN BRESSI RANCH
Description: UPTOWN BRESSI: BUI LOI NG C • 11,650 SF RETAIL SHELL
Applicant:
SMITH CONSULTING ARCHITECTS
NORMAN BARRITT
13280 Evening Creek Dr S
San Diego, CA 92128-4101
858-793-4777
BUILDING PERMIT FEE ($2000+)
BUILDING PLAN CHECK FEE (BLDG)
Owner:
BRESSI RETAIL LLC
130 Vantis Dr, 200
Aliso Viejo, CA 92656-2691
858-526-6655
COMMUNITY FACILITIES DISTRICT (CFO) 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/ADDITION/REMODEL
PLUMBING BLDG COMMERCIAL NEW/ADDITION/REMODEL
PUBLIC FACILITIES FEES -inside CFD
SB1473 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 CFD
WATER METER FEE 1-1/2" Displacement
WATER SERVICE CONNECTION FEE 1-1/2" DISPLACEMENT-P
WATER TREATMENT CAPACITY CHRG 1-1/2" Displacement
Total Fees: $159,246.26 Total Payments To Date:
New
4
DEV12023
VB
PC2017-0015
$159,246.26
Status:
Applied:
Issued:
Permit
Finaled:
Inspector:
Final
Inspection:
Contractor:
CSI CONSTRUCTION CO
27216 Burbank.
{"city of
Carlsbad
Permit No: CBCA2017-0013
Closed -Finaled
11/06/2017
02/01/2018
AKrog
6/7/2019 12:05:59PM
Foothill Ranch, CA 92610-2504
949-380-3900
Balance Due: $0.00
$2,607.00
$1,024.90
$0.00
$242.00
$170.00
$4,660.00
$104.00
$124.00
$12,S45.82
$28.00
$15,297.00
$6,780.56
$6,042.98
$238.00
$56.00
$90,S76.00
$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.car1sbadca.gov
PERMIT INSPECTION HISTORY REPORT (CBCA2017-0013)
Permit Type: BLDG-Associated Permit Commercial Application Date: 11/06/2017 Owner:
Work Class:
Status:
Scheduled
Date
12/18/2018
01/10/2019
06/07/2019
June 07, 2019
New Issue Date: 02/01/2018 Subdivision:
Closed -Finaled Expiration Date: 07/09/2019 Address:
IVR Number: 7491
Actual Start Date Inspection Type Inspection No.
12(1812018 BLDG-34 Rough 079149-2018
Electrical
Checklist Item
BLDG-Building Deficiency
BLDG-Building Deficiency
BLDG-Building Deficiency
BLDG-Building Deficiency
01/10/2019 BLDG-34 Rough 080773-2019
Electrical
Checklist Item
BLDG-Building Deficiency
BLDG-Building Deficiency
BLDG-Building Deficiency
BLDG-Building Deficiency
BLDG-Building Deficiency
06/07/2019 BLDG-Final 094092-2019
Inspection
Checklist Item
BLOG-Building Deficiency
BLDG-Plumbing Final
BLDG-Mechanical Final
BLDG-Structural Final
BLDG-Electrical Final
BLDG-Fire Final 080884-2019
Checklist Item
FIRE-Building Final
Inspection Status Primary Inspector
Partial Pass Andy Krogh
COMMENTS
Trash enclosures footings as noted on site
plan
Torque test on main switch gear
Final pending t-24 and recheck of exterior
gfcis
Roof and walls
Paased Andy Krogh
COMMENTS
EV chargers 8 locations
Final pending t-24 and recheck of exterior
gfcis
Trash enclosures footings as noted on site
plan
Roof and walls
Torque test on main switch gear
Passed Andy Krogh
COMMENTS
Scheduled Cindy Wong
COMMENTS
BRESSI RETAIL LLC
2662 Gateway Rd
Cansbad, CA 92009
Relnspection
Reinspection
Passed
Yes
Yes
No
Yes
Passed
Yes
No
Yes
Yes
Yes
Passed
Yes
Yes
Yes
Yes
Yes
Passed
No
Complete
Incomplete
Complete
Complete
Incomplete
Page 3 of3
PERMIT INSPECTION HISTORY REPORT (CBCA2017-0013)
Permit Type: BLDG-Associated Permit Commercial Application Date: 11/06/2017 Owner: BRESSI RETAIL LLC
Work Class: New Issue Date: 02/01/2018 Subdivision:
Status: Closed -Finaled Expiration Date: 07/09/2019 Address: 2662 Gateway Rd
Cansbad, CA 92009
IVR Number: 7491
Scheduled Actual Inspection Type Inspection Status Primary Inspector Relnspectlon Complete Date Start Date Inspection No.
Checklist Item COMMENTS Passed
BLDG-Building Deficiency As noted on card Yes
06/28/2018 06/28/2018 BLDG-34 Rough 062667-2018 Partial Pass Andy Krogh Relnspectlon Incomplete
Electrical
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Roof and walls Yes
07/02/2018 07/02/2018 BLDG-17 Interior 062831-2018 Passed Andy Krogh Complete
Lath/Drywall
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Single sided at all party walls Yes
BLDG-24 062832-2018 Passed Andy Krogh Complete
RoughfTopout
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Roof drains Yes
07/16/2018 07/16/2018 BLDG-13 Shear 063956-2018 Pasaed Andy Krogh Complete
Panels/HD {ok to
wrap)
09/05/2018 09/05/2018 BLDG-34 Rough 069084-2018 Partial Pass Andy Krogh Reinspection Incomplete
Electrical
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Roof and walls Yes
09/11/2018 09/11/2018 BLDG-18 Exterior 069670-2018 Partial Pass Andy Krogh Relnspectlon Incomplete
Lath/Drywall
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Partial north and east wall Yes
09114/2018 09/14/2018 BLDG-34 Rough 070041-2018 Partial Pass Andy Krogh Relnspection Incomplete
Electrical
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Trash enclosures footings as noted on site Yes
plan
BLDG-Building Deficiency Torque test on main switch gear Yes
BLDG-Building Deficiency Roof and walls Yes
09/25/2018 09/26/2018 BLDG-17 Interior 071018-2018 Passed Andy Krogh Complete
Lath/Drywall
10/18/2018 10(1812018 BLDG-Electric Meter 073664-2018 Passed Andy Krogh Complete
Release
10/22/2018 10/22/2018 BLDG-33 Service 073792-2018 Passed Andy Krogh Complete
Change/Upgrade
June 07, 2019 Page 2 of3
PERMIT INSPECTION HISTORY REPORT (CBCA2017-0013)
Permit Type: BLDG-Associated Permit Commercial Application Date: 11/06/2017 Owner: BRESSI RETAIL LLC
Work Class: New Issue Date: 02/01/2018 Subdivision:
Status: Closed -Finaled Expiration Date: 07/09/2019 Address: 2662 Gateway Rd
Cansbad, CA 92009
IVR Number: 7491
Scheduled Actual Inspection Type Inspection No. Inspection Status Primary Inspector Relnspectlon Complete Date Start Date
02/02/2018 02./0212018 BLDG-SW-Pre-Con 047604-2018 Pasaed Andy Krogh Complete
02/08/2018 02/08/2018 BLDG-12 SteelfBond 048210-2018 Partial Pasa Andy Krogh Reinspectlon Incomplete
Beam
Checklist Item COMMENTS Passed
BLDG-Building Deficiency As noted on card Yes
02/16/2018 02/16/2018 BLDG-12 SteelfBond 048884-2018 Passed Andy Krogh Complete
Beam
Checklist Item COMMENTS Passed
BLDG•Building Deficiency As noted on card Yes
04/27/2018 04127/2018 BLDG-12 Steel/Bond 066291-2018 Passed Andy Krogh Complete
Beam
06/22/2018 06/2212018 BLDG-16 068761-2018 Partial Pass Andy Krogh Relnspe<:tlon Incomplete
Roof/ReRoof (Patio)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Edge nailing for parapet walls Yes
06/07/2018 06/07/2018 BLDG-14 060288-2018 Partial Pass Andy Krogh Reinspection Incomplete
F rame/Steel/Boltlng/
Welding (Decks)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency As noted on plans Yes
BLDG-16 060289-2018 Partial Pass Andy Krogh Reinspection Incomplete
Roof/ReRoof (Patio)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency As noted on plans Yes
06/18/2018 06/1812018 BLDG.13 Shear 061294-2018 Failed Andy Krogh Reinspection Complete
Panels/HD (ok to
wrap)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Not ready No
06/20/2018 06/20/2018 BLDG-13 Shear 061681-2018 Failed Andy Krogh Reinspection Complete
Panels/HD (Ok to
wrap)
Checklist Item COMMENTS Passed
BLDG•Building Deficiency Missing diagonal bracing, anchor bolts, hold No
downs, straps
06/26/2018 06/26/2018 BLDG-14 061966-2018 Partial Pass Andy Krogh Relnspection Incomplete
Frame/Steel/Bolting/
Welding (Decks)
June 07, 2019 Page 1 of3
«i~ ~ C1y y Or
CARLSBAD
~i';{:._,") w.w~. se:w7<.ers,11sa ca,.,.,
Building Division INSPECTION RECORD
It'.! INSP£cnoN RECORD CARD WITH APPROVED
PLANS MUST BE KEPT ON THE JOB
CBCA2011-0013
2662 GA TEWA y RO
''iREC:::""""' C. "·"" s, RETAIL s,eu @ CALL BEFORE 3:00 pm FOR NEXT WORK DAY INSPECTION
@ FOR BUILDING INSPECTION CALL: 760-602-2725
OR GO TO; WWW.Carlsbadca.gov/Buildl!!g AND CLICK ON "Re uest lnspectio ·· DEV
1 023
2132622100
PC2017-0015 111612017 DATE: I [
CBCA2017-0013
II "YES"" Is eheeked below that DMsioo•s app,0,.1 Is ,eq,i,ed ,lo, to" oostlo • Fioal Boildi,g lo,pealoo. II YO• ,.,, a,y qo,st10,s
pl,as, eall the applleable dl,isloo, •t the pho,o .,_mbe,s p,o,lded below.••" •II"'""' '''"'"s '" sigoed off-la, t,
760-602-8560, •m•H to bid ;., eetloos@ea,isbill_.,.,,, o, b,iog lo• COPY of this ea,d to, 1635 Fa,aday A,o., C"isbad.
STORM WATER PRECON MEETING REQUIRED 760-602-2725
IF MARKED ''YES", APPROVAL REQUIRED PRIOR TO REQUESTING BUILDING
Allow 24 hours
Fire Prevention
Planning/landscape
REINFORCED STEEL
MASONRY PRE GROUT
0 GROUT O WALL DRAINS
TILT PANELS
POUR STRIPS
COLUMN FOOTINGS
SUBFRAME O FLOOR □ CEILING
ROOF SHEATHING
EXT. SHEAR PANELS
□ SEWER &c BL/CO
UNDERGROUND □WASTE D WTR
TOP OUT □ WASTE □ WTR
TUB & SHOWER PAN
□ GAS TEST □ GAS PIPING
WATER HEATER
SOLARWATER
IUQ-RNAL
POOL EXCAV / STEEL
PLUMBING
ElEC CONDUIT/ WIRING
ll'OTEJfflAL BOND :EPUSTER I FDCE/ ALARMS
,., IUIIITE
IUNI-FINAL
Date
Date
760-602-4660 Allow 48 hours
760-944-8463 Allow 48 hours
760-438-3891
UNDERGROUND (11,12,21,31)
#82 DRYWAU,EXT LATH, GAS TES (17,18,23)
Ins ctor #83 ROOFSHEATING, EXTSHEAR(13,15)
#84 FRAME ROUGH COMBO (14,24,34,44)
Ins r
#SS r-Bar (14,24,34,44)
A/S UNDERGROUND VISUAi.
A/S UNDERGROUND HYDR
A/S UNDERGROUND FLUSH
A/S OVERHEAD VISUAL
A/S OVERHEAD HYDROSTATIC
AjS 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
COl'YOFCARD
REOUIR£0
SEE 11,\CI( FOR SPECIAL NOTES
..
ifilMOORE TWINING
Dote: 04-27-18 FIELD DAILY INSPECTION REPORT
Client Name: SHEA PROPERTIES
Project Name:
Project Address: 2662 Gateway Rd., Carlsbad, CA
Permit No: CBC2017-0013
Plan Date: 5-19-17
General Contractor: CSI
Inspector: DAVID BARNETT
Certification Number: ICC 5228298
MTA Project No.: 056625.01
Store No.: Bldg. C
Building Code: CBC 2016
Specification Date: 2-15-18
Subcontractor:
Exp. Date: 2020
Page 1 of 1
□ Building Pad □ Utilities D Pavement Sub-grade D Pavement Base D Pavement AC □ PCC Pavements D Off-Site Improvements
□ Sidewalks D Curb & Gutter I Foundations I Slab-On-Grade □ Columns D Beams D Walls □ Trusses □ Deck □ Suspended Floors
□ Roof □ Rack and Shelving □ Light Gauge Interior Walls/Framing □ Pre-Cast Concrete □ Other
□ Sampling D Earthwork Observation & In-Place Density Testing □ Reinforcing Steel Inspection D Concrete Sampling □ Concrete
Placement Inspection (including saw-cut depth , CO monitoring, curing, etc.) □ Batch Plant Inspection D Moisture Vapor Emission
Testing □ Floor Slab Relative Humidity Testing D Slip-Resistance Testing D Floor Flatness Testing D Glass Measurements
□ Joint Sealer Inspection □ Anchor Bolt Inspection and Testing □ Field Welding Inspection □ Shop Welding Inspection D NDT
□ HS Bolt Testing □ Spray Fire Proofing Inspection and Testing □ Masonry Inspection □ PaintThickness Testing □ Roof Inspection
□ Coring D Sample Pickup D Other
Inspection Date: 04-27-18
I Initial Inspection □ Re-Inspection
Weather: Clear
Samples Taken □ Yes I No Time Samples Taken:
□ Out-of-Scope Inspection or Testing
Arrived on site 12:00 for building footing and slab on grade reinforcement with :ASTM A615 Gr. 60
reinforcement:
Interior Footing at lines 1.6 / A.3 to A.7 per 2A & 11 / S701,
Perimeter Footings at lines 2 / A to D, B / 1 to 2, B / 1 to 2, A/ 1 to 2 per 17A I S701, 3A I S701
4 I S701 Typ, 12 / S701.
5" Slab on Grade with #3 at 18" O.C.E.W. perS.C.1,1,
Reinforcement noted above is secured in place to maintain required clearances and is in
compliance with the approved plans and specifications ..
Report Continued □ Yes I Na work inspected as outlined in this report is, to the best of this inspector's knowledge, in conformance
with the approved plans and specifications: I 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.mooretwining.com
QA Review-Initials.
Inspector's Signature ~~ ;, Date: 04-27-18
Supervisor's Signature Date:
Engineer'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 perfonned in accordance with generally accepted standards and
practices. This warranty is in lieu of all other warranties either expressed or implied.
/iiHMOORE TWINING
Date: 04-27-18 FIELD DAILY INSPECTION REPORT
Client Name: SHEA PROPERTIES
Project Name:
Project Address: 2662 Gateway Rd., Carlsbad, CA
Permit No: CBC2017-0013
Plan Date: 5-19-17
General Contractor: CSI
Inspector: DAVID BARNETT
Certification Number: ICC 5228298
MTA Project No.: 056625.01
Stare No.: Bldg. C
Building Code: CBC 2016
Specification Date: 2-15-18
Subcontractor:
Exp. Date: 2020
Page 1 of 1
□ Building Pad □ Utilities D Pavement Sub-grade D Pavement Base D Pavement AC D PCC Pavements D Off-Site Improvements
o Sidewalks o Curb & Gutter D Foundations D Slab-On-Grade D Columns D Beams D Walls D Trusses D Deck D Suspended Floors
o Roof o Rack and Shelving o Light Gauge Interior Walls/Framing o Pre-Cast Concrete o Other
□ Sampling □ Earthwork Observation & In-Place Density Testing D Reinforcing Steel Inspection D Concrete Sampling D Concrete
Placement Inspection (including saw-cut depth , CO monitoring, curing, etc.) D Batch Plant Inspection D Moisture Vapor Emission
Testing o Floor Slab Relative Humidity Testing o Slip-Resistance Testing o Floor Flatness Testing D Gloss Measurements
o Joint Sealer Inspection □ Anchor Bolt Inspection and Testing D Field Welding Inspection D Shop Welding Inspection D NDT
D HS Bolt Testing □ Spray Fire Proofing Inspection and Testing D Masonry Inspection D Paint Thickness Testing □ Roof Inspection
D Coring D Sample Pickup I Other Epoxy
Inspection Date: 04-27-18 Samples Taken D Yes I No Time Samples Taken:
I Initial Inspection D Re-Inspection D Out-of-Scope Inspection or Testing
Weather: Clear
Observed preparation and installation of Epoxy anchors using Simpson XP Epoxy exp. date
4-19-19. per 17 & 17A I S804.
(32) #5 Horizontal bars with 4" embedment in to the cast in place wall with 3/4" x 4" holes at lines
1 / A
(2) 3/4" all thread rods with 8" embedment in to the cast in place wall at A /1 with 7/8" x 8" holes.
3/4" and 7/8" holes were dry, cleaned with a brush and blown out with compressed air.
Epoxy anchors installation noted above is in compliance with the manufacturers recommendations.
Report Continued o Yes I No work inspected as outlined in this report is, to the best of this inspector's knowledge, in conformance
with the approved plans and specifications: I Yes D 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.mooretwining.com
QA Review -Initials.
Inspector's Signature ~..:::i:;,# :::, Date: 04-27-18
Supervisor's Signature Date:
Engineer'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 finn is not responsible for construction safety. Our services were perfonned m accordance with generally accepted standards and
practices. This warranty is in lieu of all other warranties either expressed or implied.
l,jff MOORE TWINING
Date: 5/31/18 FIELD DAILY INSPECTION REPORT
Client Name: Shea Properties
Project Name: The Square at Bressi Ranch
Project Address: 2622 Gateway, Carlsbad, CA
PermitNo CBCA2017-0013
Plan Date 11/4/17
General Contractor: CSI
Inspector: Ethan Moore
Certification Number: ICC 52144 78
MTA Project Na.: D56624.01
Store No.: na
Building Code: 2016 CBC
Specification Date: 11/4/17
Subcontractor: PCI
Exp. Date: 7 /4/19
Page 1 of 1
□ Building Pad □ Utilities □ Pavement Sub-grade □ Pavement Base □ Pavement AC □ PCC Pavements D Off-Site Improvements
D Sidewalks D Curb & Gutter D Foundations D Slab-On-Grade D Columns □ Beams I Walls D Trusses □ Deck D Suspended Floors
D Roof □ Rack and Shelving D Light Gauge Interior Walls/Framing D Pre-Cast Concrete D Other
D Sampling □ Earthwork Observation & In-Place Density Testing □ Reinforcing Steel Inspection □ Concrete Sampling □ Concrete
Placement Inspection (including saw-cut depth, CO monitoring, curing, etc.) D Batch Plant Inspection □ Moisture Vapor Emission
Testing □ Floor Slab Relative Humidity Testing D Slip-Resistance Testing □ Floor Flatness Testing □ Gloss Measurements
D Joint Sealer Inspection D Anchor Bolt/ Epoxy Inspection D Field Welding Inspection □ Shop Welding Inspection D NDT
□ HS Bolt Testing □ Spray Fire Proofing Inspection and Testing D Masonry Inspection □ Paint Thickness Testing D Roof Inspection
□Coring □ Sample Pickup I Other shear wall nailini:i
Inspection Dale: 5/31/18 Samples Taken D Yes I No Time Samples Taken:
I Initial Inspection D Re-Inspection D Out-of-Scope Inspection or Testing
Weother: cloudy
At Building C, sections of wood panel were nailed to framing for the sections of shear wall at the
north side line A, 1-1.7, the east side line 2, A.2-A.5, and the interior shear wall by line 1.6. Nailing
has not yet been performed at line 2, A.7-B and that section remains in progress. Per the nailing
schedule 12/S-502, 10d nails were used, with a spacing of 3/12 on the east side and interior shear
wall, and 4/12 on the north side. Nails found to miss framing were replaced with new nails.
Report Continued o Yes I No
Work inspected as outlined in this report is, to the best of this inspector's knowledge, in conformance with the approved plans and
specifications: Ii 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 Date: 5/31/18
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 perfo1111ed in accordance
with generally accepted standards and practices. This warranty is in lieu of all other warranties either expressed or implied.
fiiidMOORE TWINING
Date: 5/29/18 FIELD DAILY INSPECTION REPORT
Client Nome: Shea Properties.
Project Name: Shea Proo. Carlsbad.Bressi Ranch
Project Address: Gateway Rd, Carlsbad, CA.
Permit No: GR2017.0015
Plan Date:
General Contractor: CSI
Inspector: MICHEIL SAAD
Certification Number: 5198968 City # 886
MTA Project No.: D56624.01
Store No.:
Building Code: 2013
Specification Date:
Subcontractor:
Exp. Dote: 6/29/2018
Page 1 of 1
D Building Pad D Utilities D Pavement Sub-grade D Pavement Base D Pavement AC D PCC Pavements D Off-Site Improvements
o Sidewalks o Curb & Gutter D Foundations D Slab-On-Grade D Columns D Beams I Walls D Trusses D Deck D Suspended Floors
D Roof D Rack and Shelving D Light Gauge Interior Walls/Framing D Pre-Cast Concrete D Other
o Sampling □ Earthwork Observation & In-Place Density Testing D Reinforcing Steel Inspection D Concrete Sampling D Concrete
Placement Inspection (including sow-cut depth , CO monitoring, curing, etc.) D Batch Plant Inspection D Moisture Vapor Emission
Testing o Floor Slab Relative Humidity Testing D Slip-Resistance Testing D Floor Flatness Testing D Gloss Measurements
D Joint Sealer Inspection D Anchor Bolt/ Epoxy Inspection D Field Welding Inspection D Shop Welding Inspection □ NDT
D HS Bolt Testing D Spray Fire Proofing Inspection and Testing D Masonry Inspection D Paint Thickness Testing D Roof Inspection
□ Coring o Sample Pickup I Other Shear wall nailinQ
Inspection Dote: 5/29/18 Samples Taken D Yes D No Time Samples Taken:
I Initial Inspection o Re-Inspection D Out-of-Scope Inspection or Testing
Weather: Clear
On site as requested to observing the out side Plywood shear wall nailing for building [E].
The concrete used nail size 1 0d [common wire nails] as follow:
-Nails spaced at 3" on center for the walls along grid line B between grid line 1 and 2.
-Nails spaced at 3" on center for the walls along grid line A.1 between grid line 1 and 2 for out side wall.
-Nails spaced at 4" on center for the walls along grid line 2 between grid line A and B.
Work complete for out side plywood shear wall nailing as per detail S-E-1.0 and shear wall nailing schedule detail 12/S502.
End of report
Report Continued o Yes I No
Work inspected as outlined in this report is, to the best of this inspector's knowledge, in conformance with the approved plans and
specifications: Ii Yes o 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 ~...!~.,,.·d..,,,....,====--
Supervisor's Signature
Date: 529/18
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 practices. This warranty is in lieu of all other warranties either expressed or implied.
/,idMOORE TWINING
Date: 4/28/18 FIELD DAILY INSPECTION REPORT
Client Name: Shea Properties
Project Name: The Square at Bressi Ranch
Project Address: 2662 Gateway, Carlsbad, CA
MTA Project No.: D56624.01
Store No.: na
Building Code: 2016 CBC
Specification Date: 11 /4/17
Page 1 of 3
Permit No: CBCA2017-0013
Plan Date: 1114/17
General Contractor: CSI Subcontractor: DiCarlo Concrete
Inspector: Ethan Moore
Certification Number: ICC 52144 78 Exp. Dote: 11/18/20
I Building Pad o Utilities D Pavement Sub-grade D Pavement Base D Pavement AC D PCC Pavements D Off-Site Improvements
o Sidewalks □ Curb & Gutter D Foundations D Slab-On-Grade D Columns D Beoms D Walls D Trusses D Deck D Suspended Floors
o Roof o Rock and Shelving o Light Gauge Interior Walls/Framing D Pre-Casi Concrete D Other
o Sampling □ Earthwork Observation & In-Place Density Testing D Reinforcing Steel Inspection D Concrete Sampling I Concrete
Placement Inspection (including saw-cut depth, CO monitoring, curing, etc.) D Batch Plant Inspection D Moisture Vapor Emission
Testing o Floor Slab Relative Humidity Testing o Slip-Resistance Testing o Floor Flatness Testing o Gloss Measurements
D Joint Sealer Inspection D Anchor Bolt/ Epoxy Inspection D Field Welding Inspection D Shop Welding Inspection D NDT
D HS Bolt T esling D Spray Fire Proofing Inspection and Testing D Masonry Inspection D Paint Thickness Testing D Roof Inspection
D Coring o Sample Pickup D Other
lnspecllan Dote: 4/28/18
I Initial Inspection D Re-Inspection
Weather: sunny
Samples Taken o Yes I No Time Samples Taken:
o Out-of-Scope Inspection or Testing
Concrete was placed for the slab for Pad C. The rebar was inspected yesterday, 4/27/18. 280 yards
of Cemex mix #1577781 4500 psi were placed. The concrete was placed by boom pump.
Consolidation was performed using a vibrating screed. Sampling was performed by an ACI tech.
Report Continued I Yes o No
Work inspected as outlined in this report is, to the best of this inspector's knowledge, in conformance with the approved plans and
specifications: Iii Yes o 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.mooretwining.com
Inspector's Signature ~
Supervisor's Signature
Date: 4/28/18
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 practices. This warranty is in lieu of all other warranties either expressed or implied.
MOORE TWINING
Page 2 of 3 ----REINFORCING STEEL AND CONCRETE REPORT
Date: 4/28/18 ----------
Project Name: The Square at Bressi Ranch MT A Project No.: D56624.01 -------------
Store No.: na Inspector (Print): Ethan Moore
Project Address: 2662 Gateway _____ ;..._ _______ _ Certification No.: ICC 5214478
City, State: Carlsbad, CA ----'---------Weather: sunny
CI i en t Name: Shea Properties ___ ....;.. _________ _ General Contractor: CSI
Approved Project Plans Dated: _1_1_/4_1_17 _____ _ Specifications Dated: 11 /4/17 ---------Code/Acceptance Standards: 2016 CBC ---------Reference Section: 03300 -------------Bui Id in g Permit/ DSA No· CBCA2017-0013 ..
□REINFORCING STEEL
□Footing □Sidewalk/ Curb □Slab on grade
OTilt-up Wall Panels □Elevated Deck □shear Walls
OOther:
OFormWork Ovapor Barrier 0 Reinforcing Steel
OsubGrade □Anchors □Prr Tendons
DUiier Ground Oother
Grid Line/ Location:
IZJCONCRETE PLACEMENT 0 CONCRETE SAMPLING ONLY
□Foundation 0 Sidewalk / Curb @Slab on grade
OTilt-up Wall Panels 0 Elevated Deck
OOther:
Supplier: Cemex Concrete Mix Design No.: 1577781
Required Strength: 4500 psi
Yards Placed: 280 Method Placed: boom pump
Consolidated By: vibration
Other:
0 Please see attached Concrete Sampling Data Report
Discrepancies Issued: IZINo
Inspector Signature
CORPORATE
2527 Fresno street
Fresro, CA 93721-1004
(1559) 26S. 7021
Fax 268-7126
--=
LJ Yes (If yes, see attached Discrepanc y Report)
CORONA
500 Harrington Street, ste.I1
Ccrona, CA 92879
(951) 898-8932
Fax 89S-.8974
MONTEREY
501 Ortiz Avenue
Sand City, CA 93955
(831) 392-1056
Fa< 392-1059
4/28/18
Date
SACRAMENTO
5675 Power1nn Road, Suite c
Sacramerto, CA 95824
(916) 381-9477
Fa< 381-9478
Project Name:
Sample Sample
No. Type
Inspector Signature
h.if MOORE TWINING
Page~ of _3 __
Date: 4/28/18 The Square at Bressi Ranch MTA Project No.: 056624.01
CONCRETE SAMPLING DATA REPORT
Truck# Ticket#
CORPORATE
2527 Fresno Street Fresro, CA 93721-11114
(1559) 268-7021
F&ll 268-7126
Batch Time Ambient Truck Time Em•N Tamp
Ethan Moore
Inspector Print
CORONA
500 HalTlngton Street, ste.11 ccrona. CA 92879
(~1)896-8932
Fax 998,-8974
Concrete Slump Temp
MONTEREY
501 Ortiz Avenue
Sand Ctly, CA 93955
(831)392-1056
fl:f( 392-1009
Water
Added
Onalta
Untt Air
Waight Content
4/28/18
Date
SACRAMENTO
5675 P0¥11erlnn Road, Suite c
Sacramerto, CA 95824
(916) 381-9477
Fae 381-9478
Sample Location
I
-
/iiff MOORE TWINING
Dote: 6/27 /18 FIELD DAILY INSPECTION REPORT
Client Name: Shea Properties
Project Name: Square at Bressi Ranch
Project Address: 2662 Gateway Rd, Carlsbad, CA
Permit No CBCA2017-0013
Plan Date 11 /4/17
MTA Project No.: D56624.01
Store No.: na
Building Code: 2016 CBC
Specification Date: 11 /4/17
Page 1 of 2
General Contractor: CSI Subcontractor: Cam bell Certified
Inspector: than Moore
Certification Number: ICC 52144 78 Exp. Date: 7/4/19
□ Building Pad □ Utilities □ Pavement Sub-grade D Pavement Base D Pavement AC □ PCC Pavements D Off-Site Improvements
□Sidewalks □ Curb & Gutter □ Foundations □ Slab-On-Grade □ Columns □ Beams □ Walls □ Trusses □ Deck □ Suspended Floors
□ Roof □ Rack and Shelving □ Light Gauge Interior Walls/Framing □ Pre-Cast Concrete I Other canopy framing
D Sample Pickup D Earthwork Observation & In-Place Density Testing D Reinforcing Steel Inspection D Concrete Sampling
D Concrete Placement Inspection (including saw-cut depth , CO monitoring, curing, etc.) □ Post Tension Concrete □ Moisture Vapor
Emission Testing □ Floor Slab Relative Humidity Testing □ Slip-Resistance Tes ting □ Floor Flatness Testing □ Gloss Measurements
□ Joint Sealer Inspection □ Anchor Bolt/ Epoxy Inspection ■ Field Welding Inspection □ Shop Welding Inspection □ NDT
□ HS Bolt Testing □ Spray Fire Proofing Inspection and Testing □ Masonry Inspection □ Non-Shrink Grout □ Roof Inspection
D Coring D Nailing/Wood Framing Inspection D Other
Inspection Dale: 6/27/18 Samples Taken D Yes I No Time Samples Taken:
I Initial Inspection □ Re-Inspection □ Out-of-Scope Inspection or Testing
Weather: sunny
Welding was performed for the attachment of galvanized HSS canopy sections and C-channel
canopy at Pad C south side. HSS "eyebrow" canopy frames were welded to the HSS columns at
line Bat 1.1 and 1.3. The joints were flare-bevel per detail 17/S503. The C-channel frame was
welded to the HSS columns at 1.9-B with fillet welds top and bottom and flare bevel weld along the
front face per detail 17/S503. Per RFI #87, the top, bottom and front were welded because wood
framing in place prevented welding of the back side. Welding was performed by the welder Jesse
Barnett using FCAWwith E71T-8.
Report ContlnuedlE!Yea(]No
Work inspected as outlined in this report is, to the best of this inspector's knowledge, in conformance with the approved plans and
specificaijons:§Yes0No (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: 6/27/18
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 practices. This warranty is in lieu of all other warranties either expressed or implied.
I
fiilMOORE TWINING
FIELD WELDING INSPECTION REPORT
Project Name Square at Bressi Ranch Store# .::";;;• ____________ Date of Inspection .:6;.;/2;.;7.;./1;.;8;_ ______ _
Project Address 2628 Gateway, Ca~sbad, CA Detail(s) _;1.;.7/c:S.:.50,;.;3;._ _________ MTA Project No. .:Dc:56;;;6;:;2:.;4.;..0:..;1 _____ _
Approved Plans ..:1.::1/..:4..:/1.;.7 _____________ Specillcations 11/4/17 Inspector (Print) _E_th_a_n_M_oo_re ____ _
Bul~lng Pennit/DSANo. CBCA2017-0013 Process FCAW
WELD/CONNECTION TYPES MEMBER/JOINT TYPES
AS Arr..-.potWeld seam to Beam PC Plate to l.olumn
ce complete 11111R1111Tion Groove Weld RC Beam to COiumn TA Tube Steel to Angle
'" Flare -1~roove Weld cc Column to COiumn TR Tube Steel to N.D.T. T•,.
FW FIiiet Weid DB Oeci< to Beam AB Angle to Beam V ocouaJ
"" 1"'8nemmnn hfOOV8 Weld hK Gusset Plate to Beam TS T"be to IU "'61 u, trason1c I WU!OQ .. Stsel Stud hL Gusset Plate to Column JC Joist to l.:ilrder Ml MagneUc l"llfical Testing
AA Angle to Angle "' Rebar to Angle UT Dye Penetrant Testing
PB Plate to Beam AJ Angle to Joist
Detail Weld/Connection MemberlJolnt Item N.D.T. -R~oet In Complelt Remarks/Notes
Type T-Type --171S503 FB BC HSS canopy beam to HSS column at tine B, 1. 1 and 1.3 V X
17/S503 FB/FW BC C-channel canopy beam to HSS column at B-1.9 V X X
Notes:---------------------------------------------
D~crepancies Issued: @ No O Yes (If yes, see attached Discrepancy Report)
,2_,d--~ ~ ICC5214478
Inspector Signature cc:::::: AWS/ICC Certification No. ro_,. ,.,,,,,..,"",..,_ r,e,ro c,. 9)>11,100-,
';!;',';:;&;'.~~-·
ro~~ ·,w ~, • .,,r-o,,~--,... .,
""""' c .... .,,,, 1..,,,., .... ,io
'""'''"'""
~~,
C'Ji'-°"''"'"'-" ~l'lOC,fy ,,_,.,.')'!
1:~',';/",'~o'
6127/18
Date --, . ..,,,,.,,,.,.,.,00~, ... s..,.,. '"'"''"''" ,: .. ,'IC,., ,;;:i,~~-;~~,
,
fiiidMOORE TWINING
Date: 6/27/18 FIELD DAILY INSPECTION REPORT
Client Nome: Shea Properties
Project Name: Square at Bressi Ranch
Project Address: 2662 Gateway Rd, Carlsbad, CA
Permit No: CBCA2017-0013
Plan Date: 11 /4/17
MTA Project No.: D56624.01
Store No.: na
Building Code: 2016 CBC
Specification Date: 11 /4/17
Page 1 of 2
General Contractor: CSI
Inspector: Ethan Moore
Certification Number: ICC 5214478
Subcontractor Campbell Certified
Exp. Dote: 7/4/19
□ Building Pad □ Utilities □ Pavement Sub-grade D Pavement Base D Pavement AC D PCC Pavements D Off-Site Improvements
D Sidewalks D Curb & Gutter D Foundations D Slab-On-Grade □ Columns □ Beams □ Walls □ Trusses D Deck □ Suspended Floors
□ Roof □ Rack and Shelving □ light Gauge Interior Walls/Framing □ Pre-Cast Concrete I Other canopy framing
□ Sample Pickup □ Earthwork Observation & In-Place Density Testing D Reinforcing Steel Inspection D Concrete Sampling
□ Concrete Placement Inspection (including saw-cut depth , CO monitoring, curing, etc.)□ Post Tension Concrete D Moisture Vapor
Emission Testing □ Floor Slab Relative Humidity Testing D Slip-Resistance Testing □ Floor Flatness Testing D Gloss Measurements
□ Joint Sealer Inspection □ Anchor Bolt/ Epoxy Inspection ■ Field Welding Inspection □ Shop Welding Inspection D NDT
□ HS Bolt Testing □ Spray Fire Proofing Inspection and Testing □ Masonry Inspection □ Non-Shrink Grout D Roof Inspection
D Coring D Nailing/Wood Framing Inspection D Other
Inspection Dote: 6/27/18 Samples Taken D Yes I No Time Samples Taken:
I Initial Inspection D Re-Inspection □ Out-of-Scope Inspection or Testing
Weather: sunny ,_,
Welding was performed for the attachment of galvanized HSS canopy sections and C-channel
canopy at Pad C south side. HSS "eyebrow" canopy frames were welded to the HSS columns at
line B at 1.1 and 1.3. The joints were flare-bevel per detail 17/S503. The C-channel frame was
welded to the HSS columns at 1.9-8 with fillet welds top and bottom and flare bevel weld along the
front face per detail 17/S503. Per RFI #87, the top, bottom and front were welded because wood
framing in place prevented welding of the back side. Welding was performed by the welder Jesse
Barnett using FCAWwith E71T-8.
Report ConttnuedlB]veaONo
Work inspected as ouijined in this report is, to the best of this inspector's knowledge, in conformance with the approved plans and
specificabons: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.mooretwininq.com
Inspector's Signature Date: 6/27/18
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 film is not responsible for construction safety. Our seivices were perfo1111ed in accordance
with generally accepted standards and practices. This warranty is in lieu of all other warranties either expressed or implied.
fiilMOORE TWINING
FIELD WELDING INSPECTION REPORT
Project Name ..;S:.:qc:u.::•':.:•c:•::t.;;;B.;.re:.:•:.:•;..i R..;•::n.cchcc.. ________ Store # c.":.:• ____________ Date of Inspection 6127/18
Project Address .;;;2;:;62::;8:..G.::a:ct;:;ew::.•:,Yc:., .;;;C.::•~c:•:.:b.::•d:.:•..;C.;.A;_ _____ Delail(s) ..;1.:.7/:.:S:.:5.:.03:.._ _________ MTA Project No. D56624.01
Approved ~ans .,;1.;;1/;..4;,,;/1.:.7 _____________ Speclflcatlons 11/4/17 lnspector(Pnnt) Ethan Moore
Building Permit f DSA No. .:;C.::BC:cA2=0..:.17:...-0:c0:..:1.::3 _____ Process FCAW
WELD/CONNECTION TYPES MEMBER/JOINT TYPES
" Arc Spot Weld Beam to ,am ,. Plate to Column
c, t,nrnplele Penetration Groove Weld er. Beam to lumn A TuhA Steel to Angle
Flare -Groove Weld cc Column to lumn T Tube :-.teel to Beam N.D.T. T ~
FW r-Mle!Weld DB Ded<to m A Angle to Beam V Visual
"'~ net l,;jroove Weld "" Gusset Plate to RAam TuhA ~!eel to I ube tileel u, Ultrasonic 1esting
::steel ::itud GC Gusset Plate to Column J Joist to l;;lrder MT Magnetic t-'l:Wtical Testing .. Angle to Ango RA Rebar to Angle Dt Dye trant I esllng
PB Plateto-m AJ Angle to Joist
Detail WIid/Connection MembtrlJolnt ...... N.O.T. At<ept Reject In Complete RemarktMotff
T-Type Type Progree1
17/$503 FB BC HSS canopy beam to HSS column at line B, 1.1 and 1.3 V X
17/S503 FB/FW BC C-channel canopy beam to HSS column at B-1.9 V X X
Notes:---------------------------------------------
Docrepancies Issued: IZJ No □ Yes (tt yes, see attached Discrepancy Repoo) ~ ~ ICC 5214478 6/27/18
Inspector S<gnature == AWS/ICC cer1ificallon No. Date ~---','Ji,_,,,,~_.,,._. ,.,,,.,_.,.,.,.,~,..,,s_.. •. _
~l"IOC..,, ,,, S:9'~ 11!:',;;:c:~· SIIC~"le,<o,,:;,~-i, 'l.!.:\~~·;;:;;'
/riff MOORE TWINING
Date: 6/7/18 FIELD DAILY INSPECTION REPORT
Client Name: Shea Properties
Project Name: The Square at Bressi Ranch
Project Address: 2674 Gateway, Carlsbad, CA
Permit No CBCA2017-0013
Plan Date: 11 /4/17
MTA Project No.: D56624.01
Store No.: na
Building Code: 2016 CBC
Specification Date: 11 /4/17
Page 1 of 3
General Contractor: CSI Subcontractor: DiCarlo Concrete
Inspector: Ethan Moore
Certification Number: ICC 5214478 Exp. Date: 11/18/20
D Building Pod D Utilities D Pavement Sub-grade D Pavement Bose D Pavement AC D PCC Pavements D Off-Site Improvements
o Sidewalks o Curb & Gutter I Foundations D Slob-On-Grode D Columns D Beams D Walls D Trusses D Deck D Suspended Floors
o Roof o Rack and Shelving o light Gauge Interior Walls/Framing o Pre-Cost Concrete D Other
D Sampling D Earthwork Observation & In-Place Density Testing I Reinforcing Steel Inspection D Concrete Sampling D Concrete
Placement Inspection (including saw-cut depth , CO monitoring, curing, etc.) D Batch Plant Inspection D Moisture Vapor Emission
Testing D Floor Slob Relative Humidity Testing D Slip-Resistance Testing D Floor Flatness Testing D Gloss Measurements
o Joint Sealer Inspection o Anchor Bolt/ Epoxy Inspection D Field Welding Inspection o Shop Welding Inspection o NOT
D HS Bolt Testing D Spray Fire Proofing Inspection and Testing D Mosonry Inspection D Paint Thickness Testing D Roof Inspection
D Coring D Sample Pickup D Other
Inspection Date: 6/7 /18
I Initial Inspection D Re-Inspection
Weather: sunny
Samples Token D Yes I No Time Samples Taken:
D Out-of-Scope Inspection or Testing
Rebar is being placed for the Building H footings. The bars are being placed per the details on page
S-701. Rebar is being placed for the pour strips along the perimeter and in the interior. Placement
of bars and anchors is in progress and won't be completed today.
Report Continued I Yes o No
Work inspected as outlined in this report is, to the best of this inspector's knowledge, in conformance with the approved plans and
specifications: 11 Yes o 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.mooretwining.com
lnspector'sSignature ~ Date: 6/7/18
Supervisor's Signature Date:
We do not undertake the guarantee of construction nor do we relieve the contractor of his primary responsiblity to complete the project in
accordance with the plans and specifications. Our finn is not responsible for construction safety. Our services were performed in accordance
with generally accepted standards and practices. This warranty is in lieu of all other warranties either expressed or implied.
'
-~ -.
MOORE TWINING
Page 2 of 3 ----REINFORCING STEEL AND CONCRETE REPORT
Date: 6ni18 ----------Project Name: The Square at Bressi Ranch MT A Project No.: 056624.01 -----------Store No.: _n_a ____________ _ 1 n spec tor (Print): Ethan Moore -----------
Project Address: ..:2..:6_62_G_a_te_w_a;..:y~--------Ce rt i fi cation No.: ICC 5214478 -------------
City, State: Carlsbad, CA ---'---------Weather: _s_u_nn-=y~----------
CI i en t Name: Shea Properties -----'-----------General Contractor: cs,
Approved Project Plans Dated: 11 /4/17 Specifications Dated: 11 /4/17 ------------------
Code/Acceptance Standards: 2016 CBC Reference Section: 03300 -----------Bu ii ding Permit/ DSA No· CBCA2017-0013 ..
IZJ REINFORCING STEEL
@Footing □Sidewalk/ Curb □Slab on grade
0Tilt-up Wall Panels □Elevated Deck □Shear Walls
Oother:
□Form Work □Vapor Barrier IZI Reinforcing Steel
□sub Grade □Anchors □PIT Tendons
Dutter Ground Oother
Grid Line/ Location:
Building H footinos
□CONCRETE PLACEMENT 0 CONCRETE SAMPLING ONLY
□Foundation 0 Sidewalk / Curb □Slab on grade
0Tilt-up Wall Panels 0 Elevated Deck
OOther:
Supplier: Concrete Mix Design No.:
Required Strength:
Yards Placed: Method Placed:
Consolidated By:
Other:
0 Please see attached Concrete Sampling Data Report
Discr a cies I ued: @No
Inspector Signature
CORPORATE
2527 Fresno Street
Fresro, CA 93721-1804
(ei69) 268-7021
Fax 268-7126
U Yes If es see attached Discre anc Re ort ( y ' p y p )
CORONA
500 Harrington Street, ste.11
Corona, CA 92879
(951)898-8932
Fax 898-8974
MONTEREY
501 Orttt Avenue
Sand City, CA 93955
(831) 392-1056
Fae 392-1059
6/7/18
Date
SACRAMENTO
5675 Powerlnn Road, Suite c
sacramerto, CA 95824
(916)381-9477
Fa< 381-947B
Project Name:
Sampl• Sample
No. Typo
'2,;1--:
Inspector Signature
i,iff MOORE TWINING
Page~ 01_3_
Date: 6/7/18 The Square at Bressi Ranch MTAProjectNo.: D56624.01
CONCRETE SAMPLING DATA REPORT
Truck# Ticket#
~
CORPORATE
2527 Fresno Street Fresro. CA 93721-1004 (~9) 268-7021
FIK 266-7126
Batch Time Ambient Truck Time Em••• Temp
Ethan Moore
Inspector Pnnt
CORONA
500 Harrington Street. Ste.11 ca-ana, CA 92879
(91:il) 898-8932
Fax 898-8974
Concrete Slump Temp
MONTEREY
501 Ortiz Avenue
Sana City, CA 93955
(B31) 392-1056 F~ 392-Hl59
Water
Added
Onelte
Untt Air
Weight Content
6/7/18
Date
SACRAMENTO
5675 POV11er1nn Road, Suite c
sacramerto, CA 958.14
(916) 381-9477
flt( 381-9478
Sample Location
fiidMOORE TWINING
Date: 6/9/18 FIELD DAILY INSPECTION REPORT
Client Nome: Shea Properties
Project Nome: The Square at Bressi Ranch
Project Address: 2674 Gateway, Carlsbad, CA
PermitNo: CBCA2017-0013
Plan Dote: 1114/17
MTA Project No.: D56624.01
Store No.: na
BuildingCoce: 2016 CBC
Specification Date: 11 /4/17
Page 1 of 3
General Contractor: CSI Subcontractor: DiCarlo Concrete
Inspector: Ethan Moore
Certification Number: ICC 52144 78 Exp. Dote: 11 /18/20
□ Building Pad □ Utilities □ Pavement Sub-grade D Pavement Base D Pavement AC D PCC Pavements D Off-Site Improvements
□Sidewalks □ Curb & Gutter I Foundations I Slob-On-Grode □ Columns □ Beoms □ Wolls □ Trusses D Deck □ Suspended Floors
o Roof o Rack and Shelving o light Gauge Interior Walls/Framing D Pre-Cast Concrete D Other
□ Sampling □ Earthwork Observation & In-Place Density Testing □ Reinforcing Steel Inspection □ Concrete Sampling □ Concrete
Placement Inspection (including saw-cut depth, CO monitoring, curing, etc.) D Batch Plant Inspection □ Moisture Vapor Emission
Testing D Floor Slab Relative Humidity Testing D Slip-Resistance Testing D Floor Flotness Testing D Gloss Measurements
D Joint Sealer Inspection o Anchor Bolt/ Epoxy Inspection D Field Welding Inspection D Shop Welding Inspection o NOT
□ HS Bolt Testing □ Spray Fire Proofing Inspection ond Testing □ Mosonry Inspection □ Paint Thickness Testing □ Roof Inspection
D Coring D Sample Pickup D Other
Inspection Dale: 6/9/18
I Initial Inspection □ Re-Inspection
Weather: sunny
Samples Taken I Yes D No Time Samples Taken:
□ Out-of-Scope Inspection or Testing
The wall and column footings and slab pour strips were poured for Building H today. The rebar was
previously inspected on 6/8/18 by another inspector. 140 yards of Cemex mix #157787 4 4000 psi
were placed at Building H today. The concrete was placed by boom pump and consolidated by
vibration. Three samples were taken of the concrete placed at this building, with the following
results: sample #1 slump 3. 75", air temp 68 and mix temp 83, Sample #2 slump 4.5" air temp 65
and mix temp 81, and Sample #3 slump 3", air temp 68 and mix temp 82.
Report Continued I Yes □ No
Work inspected as ouHined in this report is, to the best of this inspector's knowledge, in conformance with the approved plans and
specifications: Iii Yes o 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.mooretwining.com
Inspector's Signature ~
Supervisor's Signature
Date: 6/9/18
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 seivices were perfonned in accordance
with generally accepted standards and practices. This warranty is in lieu of all other warranties either expressed or implied.
MOORE TWINING
Page 2 of 3 _;_ __ _
REINFORCING STEEL AND CONCRETE REPORT
Date: 6/9/18 -----------Project Name: The Square at Bressi Ranch MT A Project No.: 056624.01 -------------Store No.: _n_a ____________ _ 1 n spec tor (Print): Ethan Moore -------------Ce rt i fi cation No.: ICC 5214478 Project Address: 2662 Gateway ------'-----------------------City, State: _c_a_rl_s_ba_d..;.,_c_A _______ _ Weather: sunny ---=------------Genera I Contractor: CSI Client Name: Shea Properties ------'----------------------Approved Project Plans Dated: 11 /4/17 ---------Specifications Dated: _1_1_/4_/_17 _______ _
Code/Acceptance Standards: 2016 CBC Reference Section: 03300 -------------Bui Id in g Permit/ DSA No.: CBCA2017-0013
0 REINFORCING STEEL
□Footing □Sidewalk/ Curb □Slab on grade
□Tilt-up Wall Panels □Elevated Deck □shear Walls
Oother:
□Form Work □Vapor Barrier D Reinforcing Steel
□sub Grade □Anchors □PIT Tendons
DUiier Ground Oother
Grid Line/ Location:
@CONCRETE PLACEMENT 0 CONCRETE SAMPLING ONLY
@Foundation 0 Sidewalk / Curb @Slab on grade
□Tilt-up Wall Panels D Elevated Deck
0Other:
Supplier: Cemex Concrete Mix Design No.: 1577874
Required Strength: 4000 psi
Yards Placed: 140 Method Placed: boom pump
Consolidated By: vibration
Other:
@Please see attached Concrete Sampling Data Report
Discrepanci s Issued: @No
Inspector Signature
CORPORATE
2527 Fresno street
Fresro, CA 93721-1804
(569) 268-7021
Fa>< 268-7126
c..:::::
U Yes (If yes, see attached Discrepancy Report)
CORONA
500 Han1ngton Street, Ste.11
Ccrona, CA 92879
(9.51) 698-8932
Fax B98-8974
MONTEREY
501 Ortiz Avenue
Sand City, CA 93955
(831) 392-1056
f@( 392-1059
6/9/18
Date
SACRAMENTO
5675 Power1nn Roaa, Suite c
sacramerto, CA 95824 (916)381-9477
Fae 3B1-9478
/iilMOORE TWINING
Page~of_3_
Date: 6/9/18 Project Name: The Square at Bressi Ranch MTA Project No.: D56624.01
CONCRETE SAMPLING DATA REPORT
Sample Sample Truck# Ticket# No. Typo
1 4x8 10067852 27794487
2 4x8 10037102 27794617
3 4x8 10065804 27794823
~, ----, .,,....,, <'.._
Inspector Signature
CORPORATE
2527 Fresno Street
Fm,no, CA 93721.1004
(~9) 268-7021
FIil! 268-7126
Batch Time Ambient Tnack Time Em""' Tamp
7:00A 8:30A 68
7:46A 9:05A 68
9:03A 9:59A 68
Ethan Moore
Inspector Pnnt
CORONA
1500 Harrington Street, Ste. l 1
Ccnma, CA 92879
(951)898-8932
Fax 898-8974
Concrete Slump Temp
83 3.75
81 4.5
82 3
MONTEREY 501 Ort~ Avenue
sand City. CA 93955
{831) 392-1056
Fi!II! 392-1Cl59
Water
Added
Onan.
10
0
0
Unit Air
Weight Content
na na
na na
na na
6/9/18
Date
SACRAMENTO
5675 Power inn Roa::1. Surte C
Sacramerto, CA 95824
(916)381-9477 Far: 381-9478
Sample Location
footing
pour strip
footing
fidMOORE TWINING
Date: 6/9/18 FIELD DAILY INSPECTION REPORT
Client Name: Shea Properties
Project Name: The Square at Bressi Ranch
Project Address: 2668 Gateway, Carlsbad, CA
MTA Project No.: D56624.01
Store No.: na
Building Code: 2016 CBC
Specification Date: 11 /4/17
Page 1 of 3
Permit No CBCA2017-0013
Plan Date: 1114/17
General Contractor: CSI Subcontractor: DiCarlo Concrete
Inspector: Ethan Moore
Certification Number: ICC 5214478 Exp. Date: 11 /18/20
□ Building Pad □ Utilities D Pavement Sub-grade D Pavement Base D Pavement AC D PCC Pavements □ Off-Site Improvements
D Sidewalks D Curb & Gutter I Foundations I Slab-On-Grade □ Columns D Beams D Walls □ Trusses D Deck □ Suspended Floors
D Roof D Rack and Shelving D Light Gauge Interior Walls/Framing D Pre-Cast Concrete D Other
□ Sampling D Earthwork Observation & In-Place Density Testing □ Reinforcing Steel Inspection D Concrete Sampling □ Concrete
Placement Inspection (including saw-cut depth , CO monitoring, curing, etc.) D Batch Plant Inspection D Moisture Vapor Emission
Testing □ Floor Slab Relative Humidity Testing D Slip-Resistance Testing □ Floor Flatness Testing D Gloss Measurements
D Joint Sealer Inspection o Anchor Bolt/ Epoxy Inspection D Field Welding Inspection □ Shop Welding Inspection □ NDT
□ HS Bolt Testing □ Spray Fire Proofing Inspection and Testing □ Masonry Inspection □ PaintThickness Testing D Roof Inspection
D Coring □ Sample Pickup D Other
lnspectton Date: 6/9/18 Samples Taken I Yes □ No Time Samples Taken:
I Initial Inspection □ Re-Inspection □ Out-al-Scope Inspection or Testing
Weather: sunny
Concrete was placed for the footings and pour strips for Building G today, after the pour for Building
H. The rebar had been previously inspected on 6/8/18 by another inspector. 127 yards of Cemex
mix #1577874 4000 psi were placed. The concrete was placed by boom pump and consolidated by
vibration. Three samples were taken, with the following results: sample #4 slump 3.5", air temp 73
and mix temp 88, sample #5 slump 4", air temp 74 and mix temp 86, and sample #6 slump 4.5", air
temp 76 and mix temp 86.
The following discrepancy occurred: the Cemex mix #1577874 was used, however, the concrete
submittal has Building G specifically excluded by the engineer. The superintendent Derek Davis
was informed before placement for Building G, and the superintendent chose to allow placement at
their own risk. Approval of use of this mix for Building G is required.
*Note 6/13/18: an email from the engineer dates 5/21 /18, which was not available at the time of the
pour, was received, and approved the use of 4000 psi concrete for Pad G.
Report Continued I Yes o No
Work inspected as outlined in this report is, to the best of this inspector's knowledge, in conformance with the approved plans and
specifications: □ Yes I 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 Date: 6/9/18
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 practices. This warranty is in lieu of all other warranties either expressed or implied.
MOORE TWINING
Page 2 of_3:__ __
REINFORCING STEEL AND CONCRETE REPORT
Date: 6/9/18 ...;_ _______ _
Project Name: The Square at Bressi Ranch MTA Project No.: _D_5_6_6_24_._0_1 _______ _
Store No.: _n_a ____________ _ Inspector (Print): Ethan Moore
Project Address: 2662 Gateway ------''---------Certification No.: ICC 5214478
City, State: ..;C_a_rl::..sb::..a..;d.;., _C,;.A...;_ ______ _ Weather: sunny
Client Name: Shea Properties General Contractor: CSI ----'--------------------
Approved Project Plans Dated: 11 /4/17 ---------Specifications Dated: 11 /4/17 ---------
Code/Acceptance Standards: 2016 CBC Reference Section: 03300 -------------
Building Permit/ DSA No.: CBCA2017-0013
0 REINFORCING STEEL
□Footing □Sidewalk / Curb □Slab on grade
□Tilt-up Wall Panels □Elevated Deck □Shear Walls
□Other:
□Form Work □Vapor Barrier D Reinforcing Steel
□sub Grade □Anchors □Prr Tendons
Duffer Ground OOther
Grid Line/ Location:
@CONCRETE PLACEMENT 0 CONCRETE SAMPLING ONLY
@Foundation 0 Sidewalk / Curb @Slab on grade
□Tilt-up Wall Panels D Elevated Deck
□Other:
Supplier: Cemex Concrete Mix Design No.: 1577874
Required Strength: 4000 psi
Yards Placed: 127 Method Placed: boom pump
Consolidated By: vibration
Other:
@Please see attached Concrete Sampling Data Report
Discre ancies Issued: p ONo
Inspector Signature
CORPORATE
2527 Fresno street
Fresno, CA 93721-1004
(559) 268-1021
Fax 268-7126
Iii Yes If es, see attached Discre anc Re ort ( y p y p )
CORONA
500 Hanington Street, ste.I1
Caona, CA 92879
(951)898-8932
Fax 898-8974
MONTEREY
501 OrtlZ Avenue
Sand City, CA 9'3955
(831) 392-1056
Fa< 392-1059
6/9/18
Date
SACRAMENTO
5675 Power inn ~oad, Suite c
sacramerto, CA 95824
(916)381-9477
Fa< 381-9478
Project Name:
Sample Sample
No. Type
4 4x8
5 4x8
6 4x8
Inspector Signature
iijlMOORE TWINING
Page~of~
Date: 6/9/18 The Square at Bressi Ranch MTA Project No.: D56624.01
CONCRETE SAMPLING DATA REPORT
Truck# Ticket#
10065826 27795002
10067852 27795138
10065815 27795335
CORPORATE
2527 Fresno stref!t Fresno. C-', 93721-1804
{559) 268-7D21
Fax268-7'46
Batch Time Ambient Truck Time Em••· Temp
10:16A 12:05P 73
11:44A 12:◄◄P 74
1:40P 2:30P 76
Ethan Moore
Inspector Print
CORONA
500 Harrington Street, Ste.11
Corona, CA 92879
(951)098-8932
FIIK 898-8974
Concrete Slump Temp
88 3.5
86 4
86 4.5
MONT'EREV
50 1 Ortiz Avenue
SanCI City, CA 93955
(831) 392-1056
Fei:392-1059
Water
Added
Onette
0
5
5
Unit Air
Weight Content
na na
na na
na na
6/9/18
Date
SACRAMENTO
~75 Power inn Roal, Suite c
Sacramerto, CA 958:14 (916)381-9477
flt( 381-9478
Sample Location
footing
poll' strip
poLr strip
i,idMOORE TWINING
Date: 6/9/18 FIELD DAILY INSPECTION REPORT
Client Name: Shea Properties
Project Nome: The SQuare at Bressi Ranch
Project Address: 2668 Gateway, Carlsbad, CA
Permit No: CBCA2017-0013
Plan Date 11 /4/17
MTA Project No.: D56624.01
Store No.: na
Building Code: 2016 CBC
Specification Date: 11 /4/17
Page 1 of 3
General Contractor: CSI Subcontractor: DiCarlo Concrete
Inspector: Ethan Moore
Certification Number: ICC 52144 78 Exp. Date: 11 /18/20
□ Building Pad □ Utilities o Pavement Sub-grade D Pavement Base D Pavement AC D PCC Pavements D Off-Site Improvements
o Sidewalks D Curb & Gutter I Foundations I Slab-On-Grade D Columns D Beams D Walls D Trusses D Deck D Suspended Floors
D Roof D Rack and Shelving D Light Gauge Interior Walls/Framing D Pre-Cast Concrete D Other
D Sampling o Earthwork Observation & In-Place Density Testing D Reinforcing Steel Inspection D Concrete Sampling D Concrete
Placement Inspection (including saw-cut depth , CO monitoring, curing, etc.) D Batch Plant Inspection D Moisture Vapor Emission
Testing o Floor Slab Relative Humidity Testing o Slip-Resistance Testing D Floor Flatness Testing D Gloss Measurements
o Joint Sealer Inspection D Anchor Bolt/ Epoxy Inspection D Field Welding Inspection D Shop Welding Inspection D NDT
D HS Bolt Testing D Spray Fire Proofing Inspection and Testing D Masonry Inspection D Paint Thickness Testing D Roof Inspection
D Coring D Sample Pickup D Other
Inspection Date: 6/9/18 Samples Token I Yes D No Time Samples Token:
I Initial Inspection D Re-Inspection
Weather: sunny
D Out-of-Scope Inspection or Testing
Concrete was placed for the footings and pour strips for Building G today, after the pour for Building
H. The rebar had been previously inspected on 6/8/18 by another inspector. 127 yards of Cemex
mix #1577874 4000 psi were placed. The concrete was placed by boom pump and consolidated by
vibration. Three samples were taken, with the following results: sample #4 slump 3.5", air temp 73
and mix temp 88, sample #5 slump 4", air temp 74 and mix temp 86, and sample #6 slump 4.5", air
temp 76 and mix temp 86.
The following discrepancy occurred: the Cemex mix #1577874 was used, however, the concrete
submittal has Building G specifically excluded by the engineer. The superintendent Derek Davis
was informed before placement for Building G, and the superintendent chose to allow placement at
their awn risk. Approval of use of this mix far Building G is reQuired.
Report Continued I Yea o No
Work inspected as outlined in this report is, to the best of this inspector's knowledge, in conformance with the approved plans and
specifications: o Yea I 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.mooretwining.com
Inspector's Signature ~
Supervisor's Signature
Date: 6/9/18
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 seivices were performed in accordance
with generally accepted standards and practices. This warranty is in lieu of all other warranties either expressed or implied.
1'fMOORE TWINING
Page 2 of 3 ----REINFORCING STEEL AND CONCRETE REPORT
Date: 6/9/18 ----------Project Name: The Square at Bressi Ranch MT A Project No.: D56624.01 -------------
Store No.: na Inspector (Print): _E_th_a_n_M_o_o_re _______ _
Certification No.: ICC 5214478 -------------Project Address: 2662 Gateway -------''---------Weather: sunny City, State: Carlsbad, CA -----------------''-----------
CI i en t Name: Shea Properties --------------General Contractor: _c_s_I ________ _
Approved Project Plans Dated: _1_1_/4_1_17 _____ _ Specifications Dated: 11 /4/17 ----------Code/Acceptance Standards: 2016CBC Reference Section: 03300 -------------Building Permit/ DSA No· CBCA2017-0013 ..
0 REINFORCING STEEL
□Footing □Sidewalk/ Curb D Slab on grade
□Tilt-up Wall Panels D Elevated Deck □shear Walls
Oother:
□Form Work □Vapor Barrier D Reinforcing Steel
□sub Grade □Anchors D PIT Tendons
Duffer Ground □other
Grid Line/ Location:
@CONCRETE PLACEMENT 0 CONCRETE SAMPLING ONLY
@Foundation 0 Sidewalk / Curb @Slab on grade
□Tilt-up Wall Panels D Elevated Deck
□Other:
Supplier: Cemex Concrete Mix Design No.: 1577874
Required Strength: 4000 psi
Yards Placed: 127 Method Placed: boom pump
Consolidated By: vibration
Other:
@Please see attached Concrete Sampling Data Report
Discre ancies Issued: □No
Inspector Signature <-::.:::
CORPORATE
2527 Fr~no Street
Fresro, CA 93721-1004
(569) 268-7021
Fax 268-7126
lll Yes If es, see attached Discrepanc Re ort ( y y p )
CORONA
:500 Harr1ngton Street, ste.11
cocona, CA 92879
(951) 898-8932
Fax 898-6974
MONTEREY
501 Orttz Avenue
Sand City, CA 93955
(831) 392-1056
F.:D< 392-1059
6/9/18
Date
SACRAMENTO
~75 Power Inn Roaj, Su~ C
Sacramerto, CA 95824
(916) 381-9477
Fa< 381-9478
Project Name:
Sample Sample
No. Type
4 4x8
5 4x8
6 4x8
J
,
Inspector Signature
J.Jf MOORE TWINING
Page~of_3 __
Date: 6/9/18 The Square at Bressi Ranch MTAProjectNo.: D56624.01
Truck# Ticket#
10065828 27795002
10087852 27795138
10085815 27795335
~
CORPORATE
2527 Fresno street
Fresro, CA 93721-1004
(5159) 268--7021
FaM 268--7126
CONCRETE SAMPLING DATA REPORT
Batch Time Ambient Truck Time Em-•• Temp
10:16A 12:05P 73
11:44A 12:44P 74
1:40P 2:30P 76
Ethan Moore
Inspector Pnnt
COAO,.._
500 HarnngtOnStl'ltet, ste 11
Corona, CA 92879
(9151) 898-8932
Fa>< 898-8974
Concrete Slump Temp
88 3.5
86 4
86 4.5
MONTEREY
:rn1 OrtttAvenue
Sano Clt'f, CA 93905
(831)392-1056 Fa< 392-1059
Water
Added
Onelte
0
5
5
Unit Air
Weight Content
na na
na na
na na
6/9/18
Date
SACRAMENTO
5675 Power Inn Road, Suite c sacrametto. CA 95B24
(916) S81-9477
Fae 381-9478
Sample Location
footing
pour strip
pour strip
/ii3MOORE TWINING
DEVIATION/ DISCREPANCY REPORT (Page __ of __ ) Item Number _____ _
Client Name: Shea Properties MTA Project No.: D56624.01
Project Name: Square at Bressi Ranch Store No . .;.".:.."-------------
Project Address: (Street, City & State) 2668 Gateway, Cansbad, CA
Permit No. CBCA2017-0013 Building Code: _2_01_6_C_B_c __________ _
Plan Date: _1_11_41_11 ____________ Specification Date: _1_1,_4,_11 ___________ _
General Contractor: CSI Subcontractor: DiCano Concrete
Inspector (Print): .c:Ec:."'.:c"".;.M.c.oo;.cc.;"'____________ ICC Certification Number: .c•2.:..1_••_1_a _______ _
Inspection Date: 6/9/18 ICC Certification Exp. Date: _1_1,_18_12_0 ________ _
Type: II 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 □ Other _____________________ _
Locations (Define Location by Grid Lines or Intersections, etc.): Building G footings and pour strips
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 Cemex mix#1577874 4000 psi was used at Building G. Pnorto placement, the supenntendent
was consulted about the concrete submittal specifically excluding Building G. The superintendent chose to allow placement of this mix at Building G
at their own risk, although no approval of the use of this mix at this location could be found. Approval required.
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): -'-R'-FI'------------------------------
Contractor Personnel Notified: _________ Signature: ___________ Date: ___ _
Client Personnel Notified: ~ Signature: Date:
Inspectors' Signature: ~ < Date Issued: -'-6/-'-9'-'/1.:..8 ________________ _
Deviation Corrected? □ Yes □ No Date Resolved: ________ Observed By:
Corrective Action Taken?-------------------------------
Client Notified: Signature: Date:
Inspectors' Signature: Date: