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Home My WebLink About1971 SWALLOW LN | 1973 SWALLOW LN | 1975 SWALLOW LN | 1977 SWALLOW LN | 1979 SWALLOW LN; BLDG 5 | BLDG 5 | BLDG 5 | BLDG 5 | BLDG 5; 80-956-5; PermitLICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provl• slons of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profes- sions Code, and my license Is In full force and el· feet. OWNER-BUILDER DECLARATION D I hereby affirm that I am exempt from the Con• tractor's License Law for the following reason (Sec. 7031.5,Buslness and Professions Code), Any city or county which requires a permit to con- struct, alter, Improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed state- ment that he Is licensed pursuant to the provi- sions of the Contractor's License Law (Chapter 9 commencing with Section 7000 of Division 3 of the Business and Professions Code) or that Is ex• empt therefrom and the basis for the alleged ex- emption. Any violation of Section 7031.5 by an ap- plicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). DI, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure Is not Intended or of• fered for sale (Sec. 7044, Business and Profes- sions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such Improvements are not Intended or of- fered for sale. If, however, the building or Improve- ment Is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or Improve for the purpose of sale). :JI, as owner of the property, am exclusively con- tracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not ap- ply to an owner of property t•ho builds or im• proves thereon, and who contracts for such pro- jects with a contractor(s) license pursuant to the contractor's License Law). I am exempt under Sec. _____ B. & P.C. for this reason ____________ _ Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of con· sent to self-Insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Labor Code). POLICY NO ____________ _ COMPANY ____________ _ □Copy Is flied with the city. D Certified copy Is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed If the per- mit Is for one hundred dollars (SHJ0) or less). I certify that in the performance of the work for which this permit Is Issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. NOTICE TO APPLICANT: 11, after making this Cer· tlllcate of Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. -............ -............ a,. -.. ,r1,,.._,,.. •~c .... ,...v CITY OF CARLSBAO-BUILOING DEPARTMENT APPLICATION & PERMIT 1200 ELM AVENUE (714) 438-5525 APPLICANT TO FILL IN INFOR - MATION WITHIN RED LINES. D~:s-Jo0l;z313N9 ·r?·£-7'D BLOG USE OCC. GP TYPE CONST OCC. LOAD QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT. EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU ,j --EACH BUILDING SEWER OVER 100,000 BTU EACH WATER HEATER AND/DR VENT BOILER/COMPRESSOR UPTO 3 HP EACH GAS SYSTEM 1 TD 4 OUTLETS BOILER/COMPRESSOR 3-15 HP EACH GAS SYSTEM 5 DR MORE II.All 6A 'GillPllliliiiiA 16 39 ttP --EACH INSTAL., ALTER, REPAIR WATER PIPE VENT FAN SWGLE DUCT --EACH LAWN S~RINKLER SYSTEM MECH EXHAUST -HOOD/DUCTS WATER SOFTNER CONTRACTOR TOTAL PLUMBING -V7.f'. --CONTRACTOR TOTAL MECHANICAL /..ft-,. QTY. ELECTRICAL PERMIT AMT. QTY. MOBILE HOME PERMIT AMT. NEW CONST EA AMP/SWT/BKR -1 AWNING 1 PH .25 3 PH PORCH EXIST BLOG EA AMP/SWT/BKR SET-UP 1 PH .25 3 PH RAMADA, CABANA REMODEL/ALTER PER CIRCUIT FENCE OVER 6' TEMP POLE 200 AMPS I /('). _, TOTAL MOBILE HOME OVER 200 AMPS TEMP OCCUPANCY 130 DAYSI TOTAL ELECTRICAL CONTRACTOR l""'b"2,.--111---+----------+---~I I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT, AND DO HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE ANO CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED;To COMPLY WITH ALL CITY, COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY ANO KEEP HARM- LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. "AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER 5'·0" DEEP ANO DEMOLITION OR CONSTRUCTION OF ,STRUCTURES OVER 3 STORIES IN HEIGHT <) PERMIT NUMBER ,~'fS'b-5 6/03/Bla759 Not Valid Unl.ss M6chiM CKtifi«I 2?□1~411 BP • .... ~ 0 ~ > ~ j::: !i a. V) ~ LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provi- sions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profes- sions Code, and my license is in full force and ef- fect. OWNER-BUILDER DECLARATION D I hereby affirm that I am exempt from the Con- tractor's License Law for the following reason (Sec. 7031.5 Business and Professions Code), Any city or county which requires a permit to con- struct, alter, Improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed state- ment that he is licensed pursuant to the provi- sions of the Contractor's License Law (Chapter 9 commencing with Section 7000 of Division 3 of the Business and Professions Code) or that Is ex- empt therefrom and the basis for the alleged ex- emption. Any violation of Section 7031.5 by an ap-_ pllcant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). D I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure Is not intended or of- fered for sale (Sec. 7044, Business and Profes- sions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such Improvements are not Intended or of- fered for sale. If, however, the building or improve- ment is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or Improve for the purpose of sale). :JI, as owner of the property, am exclusively con- tracting with licensed contractors to construct the project (Sec. 7044, Business end Professions Code: The Contractor's License Law does not ap- ply to an owner of property •.•ho builds or im- proves thereon, and who contracts for such pro- jects with a contractor(s) license pursuant to the contractor's License Law). I am exempt under Sec. _____ B. & P.C. for this reason ____________ _ Date Owner WORKERS' COMPENSATION DEC~ I hereby affirm that I have a c~lfi~a sent to self-insure, or a certlfica Compensation Insurance, or a thereof (Sec. 3800, Labor Code). ~~~!:~ ~ ~- □Copy is flied with the city. □Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed If the per- mit Is for one hundred dollars ($100) or less). I certify that in the performance of the wor~ for which this permit Is Issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. NOTICE TO APPLICANT: 11, after making this Cer- tificate of Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction len· ding agency for the performance of the work for which this permit Is issued (Sec. 3097, Civil Code). CITY OF CARLSBAD-BUILDING DEPARTMENT BLDG so. n . I BLDG usE QTY.I PLUMBING PERMIT EACH FIXTURE TRAP EACH BUILDING SEWER EACH WATER HEATER ANO/OR VENT EACH GAS SYSTEM 1 TO 4 OUTLETS EACH GAS SYSTEM 5 0 R MORE EACH INSTAL., ALTER, REPAIR WATER PIPE EACH LAWN SPRINKLER SYSTEM WATER SOFTNER CONTRACTOR QTY. ELECTRICAL PERMIT NEW CONST EA AMP/SWT/BKR 1 PH .25 3 PH EXIST BLOG EA AMP/SWT/BKR 1 PH .25 3 PH REMODEL/ALTER PER CIRCUIT TEMP POLE 200 AMPS OVER 200 AMPS TEMP OCCUPANCY (30 DAYS) TOTAL ELECTRICAL CONTRACTOR APPLICATION & PERMIT 1200 El,M AVENUE (7 14) 438-5525 occ. GP I STANDARD PLAN II ~s-r; I TYPE CONST AMT. II QTY. O c MECHANICAL PERMIT INSTALL FURN. DUCTS UP TO 100,000 BTU OVER 100,000 BTU BOILER/COMPRESSOR UP TO 3 HP BOILER/COMPRESSOR 3-15 HP BOILER/COMPRESSOR 16-30 HP VENT FAN SINGLE DUCT MECH EXHAUST -HOOD/DUCTS RELOCATION OF EA FURNACE/HEATER TOTAL MECHANICAL CONTRACTOR AMT. QTY. MOBILE HOME PERMIT AWNING PORCH SET-UP RAMADA, CABANA FENCE OVER 6' TOTAL MOBILE HOME _O l) ---------APPLICANT TO FILL IN INFOR - MATION WITHIN RED LINES. PERMIT NUMBER /14>t-5f> STATE LICENSE 6/0~/8/2759 DESIGNER'S PHONE NUMBER OF STORIES Not V1/id Un"1ss M1chin1 Clrtifild OCC, LOAD AMT. .~ b PLAN CHECK AMT. TOTAL PLUMBING ELECTRICAL MECHANICAL MOBILE HOME SOLAR TOTAL FEES PAYABLE 1:12. 9,:, ~ < 0 ~ ~ ;:: ~ 0.. V') ~ I HAVECAREFULLYEXAMINEOTHECOMPLETEO "APPLICATIONANOPERMIT,ANOOO FOREXCAVATION-~OVE. -~l--fi-e:_ 1,... , ~ ~ HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE ANO CORRECT ANO I OR CON OF A o/ FURTHER CERTIFY AND AGREE 1F A PERMIT 1s 1ssuEo;To COMPLY WITH ALL c1TY. 1GHT F Fa., j t/11 I COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER ~~"~~~2,~ ..,____ C '==' SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY ANO KEEP HARM-~ ,,_..,--~ % LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS ANO _;::i. EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEOUENC,$...-71"'-:--::::---:-:--:-:-nr_-----=-----:-::-------------'-::=:-::::-::::----:-:-----;=--r:~===-::c::----------/,'9t;:a,o:-,/-•I OF THE GRANTING OF THIS PERMIT. OWNER□ CONTRACTOR□ A OVEO BY 'I' AGENT □ BY PHONED -• • • • LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under prov!• slons of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profes- sions Code, and my license Is In full force and ef- fect. OWNER-BUILDER DECLARATION 0 1 hereby affirm that I am exempt from the Con- tractor's License Law for the following reason (Sec. 7031.5,Buslness and Professions Code), Any city or county which requires a permit to con- struct, alter, improve, demolish, or repair any structure, prior to its Issuance also requires the applicant for such permit to Ille a signed stale· menl that he is licensed pursuant to the prov!• sions of the Contractor's License Law (Chapter 9 commencing with Section 7000 of Division 3 of the Business and Professions Code) or that is ex- empt therefrom and the basis for the alleged ex- emption. Any violation of Section 7031.5 by an ap- plicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). D I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or of- fered for sale (Sec. 7044, Business and Profes- sions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such Improvements are not intended or of- fered for sale. 11, however, the building or Improve- ment is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or Improve for the purpose of sale). ~I, as owner of the property, am exclusively con- tracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not ap· ply to an owner of property ,.ho builds or im- proves thereon, and who contracts for such pro- jects with a contractor(s) license pursuant to the contractor's License Law). I am exempt under Sec _____ B. & P.C. for this reaso,,_ ___________ _ Date Owner WORKERS. COMPENSATION DECLARATION I hereby affirm that I have a certificate of con- sent to self-Insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Labor Code). POLICY NO---------~-"-- COMPANY \'1 □Copy is flied with the city. \." □Certified copy Is hereby furnished. CERTIFICATE OF EXEMPTION IR M WORKERS' COMPENSATION INSUR C (This section need not be complete the p, mil is for one hundred dollars ($100) ss). I certify that in the performance of t ork for whl_s:h this permit Is issued, I shall not employ any person In any manner so as to become subject to the Workers' Compensation Laws of California. NOTICE TO APPLICANT: If, after making this Cer• tificate of Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction len- ,unn AnAnl""v fnr thA nArfnrmanl"o t"lf th.a \Mt"lrlt fr.r CITY OF CARLSBAD-BUILDING DEPARTMENT APPLICATION & PERMIT BLDG SQ. FT. BLDG USE QTY. PLUMBING PERMIT EACH FIXTURE TRAP EACH BUILDING SEWER EACH WATER HEATER ANO/OR VENT EACH GAS SYSTEM 1 TO 4 OUTLETS EACH GAS SYSTEM 5 OR MORE EACH INSTAL., ALTER, REPAIR WATER PIPE EACH LAWN SPRINKLER SYSTEM WATER SOFTNER issue TOTAL PLUMBING CONTRACTOR QTY. ELECTRICAL PERMIT NEW CONST EA AMP/SWT/BKR I PH .25 3 PH EXIST BLOG EA AMP/SWT/BKR I PH .25 3 PH REMODEL/ALTER PER CIRCUIT TEMP POLE 200 AMPS OVER 200 AMPS TEMP OCCUPANCY (30 DAYSI issue TOTAL ELECTRICAL CONTRACTOR 1200 ELM AVENUE occ. GP I ST AND ARD PLAN II TYPE CONST AMT. QTY. MECHANICAL PERMIT INSTALL FURN. DUCTS UP TO 100,000 BTU OVER 100,000 BTU BOILER/COMPRESSOR UP TO 3 HP BOILER/COMPRESSOR 3-15 HP BOILER/COMPRESSOR 16-30 HP VENT FAN SINGLE OUCT MECH EXHAUST -HOOO/OUCTS RELOCATION OF EA FURNACE/HEATER 3.00 issue TOTAL MECHANICAL CONTRACTOR AMT. QTY. MOBILE HOME PERMIT AWNING PORCH SET-UP RAMAOA, CABANA FENCE OVER 6' TOTAL MOBILE HOME 2.00 AMT. AMT. APPLICANT TO FILL IN INFOR- MATION WITHIN RED LINES. PERM IT NUMIIER --fst-5/:J 6/03/81276~ Nor Valid Un/Bss Machin, C,,rifi«J OCC. L OAD TOTAL PLUMBING ELECTRICAL MECHANICAL MOBILE HOME SOLAR Stron Motion MICO -FILM School Fees o?. I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT, AND D O HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE I F A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCT ION, WHET HER SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM• LESS THE CITY OF CAR LS BAO AGAINST ALL LIABILIT IES. JUDGMENTS. COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE ~s IN HEIGHT \=--'r Fic.e:.. $ .~ b ---AO\. I ,.-, OF THE GRANTING OF THIS PERMIT. OWNER□ CONTRACTOR□ AGENT O BY PHONE 0 ,,a. BP ! ~ > t5 j::: ~ ~ V'l ~ i /% City of Carlsbad APPLICATION FOR CERTIFICATE OF OCCUPANCY BUILDING DEPARTMENT 1200 ELM 438-5525 Address where Business will be conducted 1961 thru 1979 Name of Occupant Mola Develo me nt Swallow Lane Bldg. # 5 Address of Home Office of h Occupant lfdifferentfromabove 808 Adams Ave, Huntington Beac , CA VALIDATION Building Permit No. Business Phone 80 -956-5 536-2547 Home Offic5 3 6-2 5 4 7 PhOne Owner of Building Address 8 08 Adams Ave . Phone 5 3 6 -2 5 4 7 Type of Business 10 Unit Condo Describe exact use of all portions of each building and lot Previous use of Building none, Type of flammable or explosive liquids to be used, If any Dated this Signature of Applicant Use Zone Planning Department Engineering Department Fire Prevention Health Department Building Department 2 Date Date Date White -Building Dept. residential condominium none ppllcation; that they are true and correct, and that I make this statement under penalty of perjury. Signature of Building Official Type of Construction , Disapproved By Disapproved By Disapproved By Disapproved By lsapproved By Yellow -Applicant Pink -Finance Gold -Fire Dept. .,i;;uut:ST FOR INSPECTION INSPECTOR--~---'"--'-------PERMIT NO _______ DATE: OWNER ___ /YZo __ ~....:--M~~~~~,;..------------------ ADDRESS_..L.~~~V~2ji~~~~~Jl!J!~i~}f-~Ja,!_,6~'l.L)~~~-.....L_M~Z'>~-~~)1__ ______ _ BUILDING 0 FOUNDATION 0 REINFORCING STEEL □ MASONRY □ GROUT· GUNITE □ FLOO AND CEILING FRAME 0 S ATHING/"° • FRAME ( 12~ <j) 0 EXTERIOR LATH / □ INSULATION □ INTERIOR LATH OR DRYWALL D FINAL PLUMBING 0 UNDERGROUND PLUMBING / / s - 0 UNDERGROUND WATER 0 ROUGH PLUMBING 0 TOP OUT PLUMBING 0 SEWER AND PL/CO D TUB OR SHOWER PAN 0 GAS TEST D WATER HEATER D FINAL READY FOR INSPECTION: □MONDAY DA.M. 0P,M. □TUESDAY ELECTRICAL 0 TEMPORARY SERVICE 0 ELECTRIC UNDERGROUND 0 ROUGH ELECTRIC 0 POOL BONDING 0 ELECTRIC SERVICE D CEILING HEAT D G.F.1. 0 SMOKE DETECTOR D FINAL MISCELLANEOUS 0 PLENUM AND DUCTS 0 COMBUSTION AIR D PATIO 0 SIGN 0 GRADING 0 DRIVEWAY □ CONDITIONED AIR SYSTEMS 0 REFER PIPING D FINAL D WEDNESDAY 7HURSDAY D FRIDAY SPECIAL INSTRUCTIONS _________________________ _ ✓~~ REQUESTED BY ___ C./_~ _____________ PHONE NO·-----:---- PERS0N TAKING REPORT-~,""~c......----- REQUEST •FOft.,, INSPECTION TIME· '_ INSPECToRt;;i, ¼,~b -PERMIT No. l?o -;S'(, ~TE, ( -! . OWNER ____ ~-,-....c.-----,.;.-----------,,-------------- ADDRESS~/..___._f_S-J._JJ_ ~---~-~--~~-~---------+, - BUILDING ELECTRICAL D FOUNDATION 0 REINFORCING STEEL 0 TEMPORARY SERVICE 0 MASONRY D ELECTRIC UNDERGROUND 0 GROUT -GUNITE 0 ROUGH ELECTRIC 0 FLOOR AND CEILING FRAME 0 POOL BONDING D SHEATHING 0 ELECTRIC SERVICE 0 FRAME D CEILING HEAT 0 EXTERIOR LATH D G.F.1. 0 INSULATION D SMOKE DETECTOR 0 INTERIOR LATH OR DRYWALL ' D FINAL D FINAL ..l / '\ I \1 ;,, ( PLUMBING / / !-L-;-" MISCELLANEOUS D UNDERGROUND PLUMBING V 0 PLENUM AND DUCTS ~NDERGROUND WATER OUGH PLUMBING 0 COMBUSTION AIR D PATIO 0 TOP OUT PLUMBING 0 SIGN i SEWER AND PL/CO TUB OR SHOWER PAN D GRADING D DRIVEWAY 0 GAS TEST D CONDITIONED AIR SYSTEMS D WATER HEATER D REFER PIPING D FINAL 'J w~ D FINAL ' READY FOR INSPECTION: D MONDAY D TUESDAY WEDNESD~ D THURSDAY D FRIDAY DA.M. DP.M. SPECIAL INSTRUCTIONS _________________________ _ REQUESTED BY _ __,:'7"-~/4~~-J;;;:;. __ ~_. ________ PHONE NO. ,)~, ' -y Y / / ~ z .. PERSON TAKING REPORT _______ _ J'. 0, REGISTERED INSPECTOR'S WEEKLY REPORT •891 MERCURY 5 TREE I SAN DEIGO. CA 92111 Construction Laboratories I 71•1 292 ·9565 JOB NQ 220 COVERING WORK PERFORMED ~ REINFORCED CONCRETE 0 STRUCT.STEEL ASSEMBLY WHICH REQUIRED APPROVAL BY 0 PRE-STRESSED CONCRETE 0 REINFORCED GYPSUM OGWE • LAM.FABRICATION THE SPECIAL INSPECTOR OF 0 REINFORCED MASONRY 0 PILE DRIVING 0 OTHER JOB ADDRESS I FO R WEEK 19 81 19SS SWrillow Lane NO ENDING 6/26 OWNER OR PROJECT NAME BLDG PERMIT Nu r LAN FILE NO TAl<>!=:t: 'R1 ,,ff North (Buildinq #4) 80-956-4 CONS TR MAT L (TYPE.GRADE, ECT.I ARCHITECT The Architect's Group DESIGN STRENGTH r OURCE OR MFGR ENGINEER F 1 r -1nnn PST Conrock The Archirect's Group DESCRIBE MAT'L I MIX DESIGN, RE BAR GRADE & Mr GR GENERAL CONTRACTuR Reinf-steel: ASTM A615. Grade 40 Mnlr1 Development CONTR DOING REPuRTED WORK Concrete: #C517CWP4. 5.5 sk. Oranae Countv Concrete LAB RECE IVING & TESTING CONSTR MA!'L SAM Pl ES Construction Laboratories INSP'N. LOCATIONS OF WORK INSPECTED, TEST SAMPLES TAKEN, WORK REJECTED, JOB PROBLEMS, PROGRESS, REMARKS, ETC. Includes information about-amounts of material placed or work performed; number, type, and identity numbers of test samples DATE token; structural connections ( welds made, h .t. bolts torqued l checked ; etc. 6/22 Inspected the placinq of 168.0 cubic vards of concrete in oost-tensioned slab on arade. Inspection included the locatina of nost-tensioned cable within the s lab. Made 1 set (3) of concrete cylinders. ,,...,_ ., c.c,:-,,,~ ,_ f I •VJ::.!_} -v ' IH81 f" ,..,.., .I - -· I ! _U/-CARI ~,..._ II - .,,ma1ng Depart~:"::..,,U -... CERTIFICATION OF COMPLIANCE /Yi< A fla✓ ,~ _, I HEREBY CERTIFY THAT I HAVE INSPECTED ALL OF THE ABOVE REPORTED WORK, UNLESS OTHERWISE NOTED I HAVE FOUND THIS WORK TO COMPLY WITH THE APPOVED PLANS SPECIFICATIONS ,8 APPLICABLE SECTIONS OF THE CITY OF SAN DIEGO BUILDING LAWS. /slGNATURE 1 0F REGISTERED INSPEC TOR 6/26/81 C-160 DA TE OF RE PORT REGISTER NUM6E R