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Section N: Appendix C– Certificate of Completion Approved by City Council on October 15, 2008 Page 137 APPENDIX C -CERTIFICATE OF COMPLETION - Page 1 of 4 See ordinance # 1362 Section 14.05.051, Section14.05.052, and Section14.05.061 for details on how to comply with the Certificate of Completion. This certificate is completed by the project applicant upon installation at the final field observation of a landscape project. Please complete all sections below SECTION A. PROJECT INFORMATION Date Project Name & LSP # Project Project Address and Location Street Address Parcel Number City Tract or Lot Number or LSP # State Zip Code Latitude/Longitude (optional) Please answer the questions below: 1. Did you submit a Landscape Documentation Package to the City of Palmdale? Yes No 2. Was your Landscape Documentation Package approved by the City? Yes No 3. When were you issued a permit or approval for the plan check or design review? Date: 4. Did you submit the Water Efficient Landscape Worksheet (including the Water Budget Calculations) to your local retail water purveyor? Yes, No SECTION B. FINAL INSPECTION Please use this checklist to verify the following has been completed: The preliminary field observation of the irrigation system or plumbing, prior to backfilling, is completed. Date of preliminary field observation: Date of final field observation by project applicant: The plant materials are installed as specified The Irrigation system is designed as specified. If applicable, the dual distribution system for recycled water is installed as specified. There is minimal run off or overspray from the irrigation system. The irrigation schedule is submitted for the plant establishment period. The project submittal package including any as built modifications to the landscape design or irrigation system design and a copy of this Certificate of Completion has been provided to the property owner or his/her designee. ---PAGE BREAK--- Section N: Appendix C– Certificate of Completion Approved by City Council on October 15, 2008 Page 138 Page 2 of 4 -Certificate of Completion Fill in any additional criteria or specifications from the ordinance Comments: SECTION C IRRIGATION (WATERING) SCHEDULE Attach the irrigation schedule per ordinance Section 14.05.062 SECTION D. LANDSCAPE IRRIGATION AUDIT REPORT Attach the Landscape Irrigation Audit Report per ordinance Section 14.05.064 SECTION E. SCHEDULE OF LANDSCAPE IRRIGATION AUDITS Attach the schedule of Landscape Irrigation Audits per ordinance Section 14.05.064 SECTION F. SCHEDULE OF LANDSCAPE AND IRRIGATION MAINTENANCE Attach the schedule of Landscape and Irrigation Maintenance per ordinance Section 14.05.063 SECTION G. SIGNATURES CONTRACTOR “I/we certify that work has been installed in accordance with the contract documents.” Signature of Contractor Date Telephone No. Name of Contractor –(print) Fax No. Title Email address State License No. City of Palmdale License # Company Name Street Address City State Zip Code ---PAGE BREAK--- Section N: Appendix C– Certificate of Completion Approved by City Council on October 15, 2008 Page 139 Page 3 of 4 -Certificate of Completion LANDSCAPE ARCHITECT, CERTIFIED IRRIGATION DESIGNER, OR LICENSED LANDSCAPE CONTRACTOR “I/we certify that based upon periodic site observations, the work has been substantially completed in accordance with Ordinance # 1362, Water Efficient Landscape, and that the landscape planting and irrigation installation conform with the criteria and specifications of the approved Landscape Documentation Package.” Signature of Landscape Architect/Certified Irrigation Designer/ Landscape Contractor Date Telephone No. Name of Landscape Architect/Certified Irrigation Designer/ Landscape Contractor (print) Fax No. Title Email address License No. or Certification No. Company Name Street Address City State Zip Code PROPERTY OWNER: “I/we certify that I/we have received all of the contract documents and that it is our responsibility to see that the project is maintained in accordance with the contract documents and to comply with the provisions of the ordinance pertaining to landscape irrigation audits.” Signature of Property Owner or his/her Designee Date Telephone No. Property Owner or his/her designee (print) Fax No. Title Email address Company Name Street Address City State Zip Code ---PAGE BREAK--- Section N: Appendix C– Certificate of Completion Approved by City Council on October 15, 2008 Page 140 Page 4 of 4 -Certificate of Completion THIS SECTION BELOW IS FOR LOCAL AGENCY USE ONLY. Signature of the Local Agency Representative Name of the Local Agency Representative Phone # Email address Title Name of local agency Name of Department, Division, or Unit Street Address City State Zip Code For this project, the Certificate of Completion has been Approved Date: Notes: Denied Date: Notes: For this project, the Certificate of Occupancy or Equivalent has been: Issued Date: Notes: Denied Date: Notes: End of Certificate of Completion