HomeMy WebLinkAboutF2021-0548 - Miscr2o2(-04 d
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o�E j e CITY OF NEWPORT BEACH
u 1 COMMUNM DEVELOPMENT DEPARTMENT
> BUU DING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www.newoortbeachca.cov 1 (949) 644-3200
PRE -GRADE MEETING AGREEMENT
DATE: � JOBADDRESS: ! gt7 f W, RA)y Ave—,
1. The grading plan check number for this site isJOQ -'102Dand will be referred to in all reports, certifications
and correspondence.
2. STOP ORDERS Whenever any work is being done contrary to the provisions of the City Codes, the Chief
Building Official or his authorized representative may order the work stopped by notice in writing served on any
persons engaged in the doing or causing such work to be done and any such persons shall forthwith stop such
work until authorized by the Chief Building Official to proceed with the work.
3. The stamped set of approved plans shall be on the job site at all times.
4. NOTIFICATION OF NONCOMPLIANCE If, in the course of fulfilling their responsibilities, the civil engineer,
surveyor, the soils engineer, the engineering geologist or the testing agent finds that the work is not being done
in conformance with the approved grading plans, the discrepancies shall be reported immediately in writing to
the person in charge of the grading work and to the Building Division. Recommendations for corrective
measures, if necessary, shall be submitted to the Building Division for approval.
S. When import or export of materials is required, haul routes to and from the site shall be approved by the City
Traffic Engineer and hauling procedures shall be in accordance with Chapter 15 of the Newport Beach Municipal
Code (NBMC). Contractor shall use Best Management Practices (BMP's) to insure that all water quality issues
are addressed.
6. Between October 1 and April 30, erosion control BMP measures shall be in place. During the remainder of the
year dryseason wind erosion BMP's (dust control) shall be implemented. Sediment control BMP's shall be
installed and maintained at all operational storm drain inlets internal to the project BMP's to control off-site
sediment tracking shall be implemented and maintained. Appropriate BMP's to prevent contamination of
stonnwater from construction activities shall be implemented. A "weather triggered" action plan and the ability
to deploy BMP's to protect all exposed portions of the site within 48 -hours when the National Weather Service
forecasts a 50% or greater chance of rain.
7. All fills shall be compacted throughout to a minimum of 90 percent compaction as determined by ASTM test
method 1557 and approved by the soils engineer. Compaction tests shall be performed according to the
preliminary soils report
8. All trench (including interior and exterior utility trenches) and retaining wall backfill shall be compacted
throughout to a minimum of 90 percent relative compaction and approved by the soils engineer.
9. Whenever work on which required inspection/testing is covered by additional work without first being
inspected/tested, the Chief Building Official shall require by written notice that the work be exposed for
examination. The work of exposing and recovering shall not entail or be subject to expense to the City of
Newport Beach and will be the sole expense of the Permittee.
10. Landscaping of all slopes and pads shall be in accordance with 15.10.130 of the NEMC.
11. Approved drainage provisions shall be used to protect adjoining properties during the grading operation.
12. The permittee or his agent shall notify the Building Division when the grading operation is ready for each of the
following inspections:
a. PRE -GRADE MEETING When the permittee is ready to begin work, but not less than two days before any
grading or brushing is started.
b. DRAINAGE DEVICE INSPECTION After forming of terrace drains, down drains or after placement of pipe in
subdrains, but before any concrete or filter material Is placed.
c. SPECIAL
d. ROUGH GRADING When all rough grading has been completed, the rough grade report shall be provided to
the Building Inspector at foundation inspection or sooner based on the Building Inspector's discretion.
e. FINAL When all work, including installation of all drainage structures and other protective devices, has been
completed and the as -graded plan, professional approvals and the required reports have been submitted.
13. All footing excavations, slab on grade areas and subdrains shall be inspected and approved by the Geotechnical
Engineer or Engineering Geologist Written approval shall be submitted to the Building Inspector.
14. Prior to the start of grading, all permanent property comer monuments shall be in place. Prior to any foundation
inspections, proof of recordation of the "comer record" or "record of survey" with the County of Orange shall be
provided.
15. The undersigned acknowledge a copy of the above and agree to comply with the Grading Code of the City of
Newport Beach, the recommendations of the project soils report and any special requirements of the permit
16. Prior to foundation inspection a Line and Grade Certificate Form must signed and stamped by the surveyor of
record and submWed to the building inspector. A Structural Observation Report may be required.
17. All parties listed below must be present for the pregrade meeting unless approved by the building inspector.
18. All duplex construction requires separate utilities (sewer, water, gas, electrical, fire sprinkler risers).
OWNER/CONTRACTOR:cwr.Qom_ DESIGN CIV
By: k&� By:
Address: tOt"3 ss:
Telephone: -1_ft -, ?-!i 2- - o L S Telephone:
GEOTECHNICAL ENGINEER:1" nh %A !„' GEOLOGISI
BY � c e+�a, ��eQ✓I By:
Address: -[ Address:
C
Telephone:
GRADING CONTR.: /04
By: /9I1'01/
Address: I r.& Z 15YA-k ir- 1-f/�6
Telephone:. IN 130 L700
Telephone:
COORDINATOR:
By:
Address:
Telephone:
NEWPORT BEACH REPRESENTATIVE: PHONE
INSPECTION REQUESTS: (949) 6443255
Newport Beach Construction Hours:
Monday through Friday: 7:00 a.m. to 6:30 p.m.
Saturdays: 8:00 a.m. to 6:00 p.m.
No work on Sundays and Holidays
Fomslpmgmde meeting agreement 678
aEwP°Rr CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
— — BUILDING DIVISION
�q<tFov , 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 926588915
www.newportbeachca.gov (949) 644-3200
SETBACKS AND TOP OF SLAB/FLOOR
ELEVATION CERTIFICATE
The purpose of this certificate is to insure that the structure is located properly on site per the approved
drawings. This certificate also verifies the top of slab/floor elevation noted on the approved drawings.
After the top of slab/floor elevation is verified to match the elevation specified on the approved
drawings, the contractor and inspector can measure the height of the structure to the top of slab/floor to
verify that it is equal or less than the dimension shown on building sections and elevations.
This form must be filled out by a registered surveyor or civil engineer authorized to perform surveys.
The survey must be done after the concrete forms are in place or preferable after the concrete slab is
poured or raised floor is built, but prior to starting wall framing.
Engineer/Surveyor's Name ROH Mf0 tFA4A- License # " '-t6 S3
Engineer/Surveyor's Address ?,3016 "44 S0 /4637` nQ . # (/o% 40&//,f /Tr
Job Address 12-OcI La?. oxv
Setbacks: Sketch a site plan and specify surveyed setbacks (use back page).
* Top of slab/floor elevation: F,5 7-0 6 C ? . 43 kAy P 14,10 96-r* L_ '
* If slab/floor elevation varies, sketch a plan or section through slab on the back page and specify the
elevations. Use same datum used in the survey of record.
I certify that the setbacks
from plans:
are 11, are not ❑, per City approved plans. Describe any deviations
I certify that top of slab/floor elevation(s) is 1, is not ❑, per City approved drawings. Describe
any deviations from plans:
Ll -Z? -7
Date
FomsiSetbacksandTopotSlabElevationCen.
Engineer/Surveyor's stamp and
E
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cor G4
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engineering
geotechnical
applications
consultants
CITY OF NEWPORT BEACH May 5, 2021
Building Department Project No. W6255.2
100 Civic Center Drive
Newport Beach, CA 92660
Subject: COMPACTION REPORT FOR PLACEMENT OF FILL
FOR PROPOSED GARAGE/ADL
1209 W. BAY AVENUE
NEWPORT BEACH, CALIFORNIA
City of Newport Beach Building Permit No.: X2020-1980
Associated References:
1. "Geotechnical Investigation for Proposed Residential Remodel/Additions Located at 1209 W. Bay Avenue,
Newport Beach, California," by EGA Consultants Inc., dated August 4, 2020.
2. "Foundation Plan, Marvin Residence, 1209 W. Bay Avenue, Newport Beach, CA" by AQX Engineering, Inc.,
dated December 8, 2020.
3. "Precise Grading Plan for William and Michelle Marvin, 1209 West Bay Avenue, Newport Beach, CA" by
Toal Engineering, Inc., dated November 18, 2020, updated January 26, 2021.
4. 'Response to City Review Comments Dated January 5, 2021 for Proposed Garage/ADU Located at 1209
W. Bay Avenue, Newport Beach, California,' by EGA Consultants, Inc., dated January 27, 2021.
To City Building/Grading Officials:
In accordance with the City of Newport Beach building requirements, we are submitting this
compaction report for the grading of the subject building pad. This report includes the test
results performed at the subject lot during the placement of on-site soil material in the area of
the proposed building pad. The site earthworks operations were performed by the sub-
contractor, Tim Greenleaf Engineering.
Excavation and grading of the subject area of work commenced on April 12, 2021 and was
complete by April 13, 2021.
To date, site grading included the removal of the upper 3 feet of the old fill and native material
located within the limits of the proposed building pad for the residential ADU/Garage. The area
was roughly divided into halves; excavated, and recompacted to bring the entire area to finished
subgrade.
One Mini -Excavator with rubber treads, one bo -mag compactor, and a jumping jack wacker was
utilized for the purpose of compaction and grading control. On-site soils were moisture treated
via a 1 -inch diameter water hose during the grading process to bring the moisture content to
near -optimum. For cohesion -treatment, 1 (one) pallet of Portland Cement was blended into the
newly -placed fill. Each pallet contains 40 bags dry mix, each weighing 94 pounds and
approximately 1.33 cubic yards.
Prior to the placement of fill, the excavation bottoms were inspected and approved by a
Certified Engineering Geologist employed by EGA Consultants. The exposed surface was
scarified, moisture conditioned and recompacted to a minimum of 90% relative compaction.
Field density test results are tabulated on Table 1, Summary of Field Density Tests.
375-C Monte Vista Avenue • Costa Mesa, CA 92627 • (949) 642-9309 • FAX (949) 642-1290
All earthwork operations were performed under continuous observations by this firm and were
performed in accordance with geotechnical specifications outlined in the soils report by EGA
Consultants, Inc., dated August 4, 2020.
The building pad was graded in accordance with the 2019 CBC and the City of Newport Beach
Building standards and are approved for construction. Based on our continuous observations
and testing, the subject and adjacent sites are not impacted by the site grading operations to
date.
This report includes the test results performed at the subject site during the placement of on-
site soil material in the area of the proposed building pad. Additional observations and
testing are required in areas to receive exterior improvements (driveway approach,
flatwork, etc.) capillary break, footings, and utility trench backfill.
I certify that all rough grading work was done in compliance with the above -referenced Soils
Report and the work complies with City of Newport Beach grading regulations. All soils values
and geotechnical specifications outlined in the above -referenced soils report remain valid.
This opportunity to be of service is appreciated. If you have any questions, please call.
Very truly yours,
EGA Consultants, Inc.
DAVID A. WORTHINGTON CEG 2124
Principal Engineering Geologist
cc: (1) Addressee
(1) West Bay Balboa, LLC, Attn: Michelle P. Marvin
(1) McClary Construction, Attn: Dane
PAD CERTIFICATION REPORT:
1209 W. Bay Avenue, Newport Beach, CA
Project No. WB255.2
May 5, 2021
Mid A. N
Worthington
No. CEG2124
CERTIFIED 0
TABLE 1
SUMMARY OF MOISTURE DENSITY RELATIONSHIPS
(ASTM: D1556)
Sample
Depth
Dry
Moisture
Maximum
Optimum
Relative
Number/
Below
Density
Content
Density
Moisture
Compaction
Location
Grade
(PCF)
M
(PCF)
N
(%o)
ft
FD -1
2.5
99.8
12.0
110.0
10.0
91
ADU Pad
FD -2
2.0
102.6
11.7
110.0
10.0
93
ADU Pad
FD -3
1.5
101.0
11.0
110.0
10.0
92
ADU Pad
FD -4
0.5
105.4
11.1
110.0
10.0
96
ADU Pad
FD -5
2.5
99.8
11.9
110.0
10.0
91
ADU Pad
FD -6
1.5
103.6
11.1
110.0
10.0
94
ADU Pad
FD -7
0.5
101.9
11.2
110.0
10.0
93
ADU Pad
FD -8
FG
105.2
11.4
110.0
10.0
96
ADU Pad
FD' -9
FG
103.2
11.1
110.0
10.0
94
ADU Pad
FD -10
FG
106.5
11.3
110.0
10.0
97
ADU Pad
FD -11
FG
104.9
11.5
110.0
10.0
95
ADU Pad
"FD" =Field Density Test
"FG" = Finish Grade (Ground Level Pad)
PAD CERTIFICATION REPORT:
1209 W. Bay Avenue, Newport Beach, CA
Project No. W6255.2
May 5, 2021
TABLE 2
SUMMARY OF MAXIMUM DENSITY TEST
(ASTM D 1557)
Sample
Maximum
Optimum
Location
Density
Moisture
Pc
%
Fill/Native - Beach Sands
110.0
10,0
Per Soils Report
dated August 4, 2020
PAD CERTIFICATION REPORT:
1209 W. Bay Avenue, Newport Beach, CA
Project No. W5255.2
May 5, 2021
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1 (949) 644-3200
Structural Observation Report MK20-029-G#4
Project Address:
Report Date:
CNB Inspector Name:
CNB Permit #:
1209 W BAY AVE.
09/07/2021
❑ Concrete
❑ Steel
Building Owner Name:
Owner's Mailing Address (if different from site);
Owner's Telephone #:
CNB Plan Check #:
Full Name of Structural Observer (SO):
SO E-mail Address:
SO Telephone #:
SO License I Reg. #:
QIANG XIAO
❑ Masonry
714)662-0559
S.5289
PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check applicable boxes)
FOUNDATIONS
SHEAR WALLS
FRAMES
DIAPHRAGMS
(FloodR000
INDICATE LOCATION(S) DATE
OBSERVED OBSERVED
❑ Conventional
Footings & Slab
❑ Concrete
❑ Steel
❑ Concrete
ALL THE SHEAR WAL S,CONN.
❑ Mat Foundation,
Prestressed Concrete
❑ Masonry
❑ Concrete
❑ Steel Deck DRNGS,
ROOF SHT'G. DBL. TOP PL'
❑ Caissons, Piles,
Grade Beams
❑ Wood or Manuf.
Shear Panels
❑ Masonry
❑ Wood
STRAPS, FINAL TASKS ARE OKA
❑ Other:
❑ Other:
❑ Other:
❑ Other:
PER OUR PLANS NO INFO.
X ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES.
❑ OBSERVED DEFICIENCIES AND COMMENTS:
+++++++ THIS IS THE FINAL OBSERVATION +++++++++
❑ REPORT CONTINUED ON ATTACHED PAGES.
X FINAL STRUCTURAL OBSERVATION REPORT:
The structure generally complies with the approved construction documents, and all observed deficiencies were corrected.
I declare that the following statements are We to the best of my knowledge:
1. I am the licensed design professional retained by the owner to be in responsible
charge of the structural observation;
2. I, or another licensed design professional whom I have designated above and is under
my responsible charge, have performed the required site visits at each significant
construction stage to verify that the structure is in general conformance with the
approved construction documents;
3. 1 understand that all deficiencies which I have documented must be corrected, prior to
final acceptance of the structural systems by the City of Newport Beach, Building
Division.
09/07/2021
N0.
S. 5289
EXP. 6/30/22
STAMP OF STRUCTURAL OBSERVER
STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH.
FamrtVSlrvnwalOhrervatloNtrarr&Immictwus
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www.newoortbeachca.Qov 1(949)644-3200
Structural Observation Report MK20-029-G#3
Project Address:
Report Date:
CNB Inspector Name:
CNB Permit #:
1209 W BAY AVE.
06/15/2021
❑ Conventional
Footings & Slab
❑ Concrete
Building Owner Name:
Owner's Mailing Address if different from site);
Owner's Telephone #:
CNB Plan Check #:
Full Name of Structural Observer (SO):
SO E-mail Address:
SO Telephone #:
SO License / Reg. #:
QIANG XIAO
. ARE OKA
714)662-0559
S.5289
PI FASF INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check applicable boxes)
FOUNDATIONS
SHEAR WALLS
FRAMES
DIAPH
[Flooi(RooV
INDICATE LOCATION(S)
OBSERVED
DATE
OBSERVED
❑ Conventional
Footings & Slab
❑ Concrete
❑ Steel
❑ Concrete
ALL THE SHEAR WALL
S,CONN.
❑ Mat Foundation,
Prestressed Concrete
❑ Masonry
❑ Concrete
0 Steel Deck
DRAGS, ROOF SHT'
. ARE OKA
❑ Caissons, Piles,
Grade Beams
'XWood or Me
Shear Pa el
[5 [5Masonry
(Wood
PER OUR PLANS
ND INFO.
❑ Other:
❑War':
❑ Other:
❑ er:
X ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES.
❑ OBSERVED DEFICIENCIES AND COMMENTS:
❑ REPORT CONTINUED ON ATTACHED PAGES.
❑ FINAL STRUCTURAL OBSERVATION REPORT:
Th. <frl,rtllre nenerafly cemoUes with the aooroved construction
documents, and all observed deficiencies were corrected.
I declare that the following statements are true to the best of my knowledge:
1. I am the licensed design professional retained by the owner to be in responsible
charge of the structural observation;
2. I, or another licensed design professional whom I have designated above and is under
my responsible charge, have performed the required site visits at each significant
construction stage to verify that the structure is in general conformance with the
approved construction documents;
3. 1 understand that all deficiencies which I have documented must be corrected, prior to
final acceptance of the structural systems by the City of Newport Beach, Building
Division.
06/16/2021
N0.
S. 5289
EXP. 6/30/22
STAMP OF STRUCTURAL OBSERVER
STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH.
Fo,m SlmoumlObsomlianRe aal.wclio.
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1 (949) 644-3200
Structural Observation Report MK20-029-G#2
Project Address:
1209 W BAY AVE.
Report Date:
05/16/2021
CNB Inspector Name:
CNB Permit #:
Building Owner Name:
Owner's Mailing Address (H different from site);
Owner's Telephone #:
CNB Plan Check #:
Full Name of Structural Observer (SO):
SO E-mail Address:
SO Telephone M
SO License! Reg. #:
QIANG XIAO
714)662-0559
S.5289
PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check applicable boxes)
FOUNDATIONS
SHEAR WALLS
FRAMES
D GMS
(Floo Roof)
INDICATE LOCATIONS)
OBSERVED
DATE
OBSERVED
❑ Conventional
Footings & Slab
❑ Concrete
❑ Steel
❑ Concrete
ALL THE SHEAR WALL
S,CONN.
❑ Mat Foundation,❑Masonry
Prestressed Concrete
❑ Concrete
❑ Steel Deck
DRAGS, FLOOR SHTr
. ARE OKA
11 Caissons, Piles,
Grade Beams
)Wood or Manuf.
Shear Pa el
❑ Masonry
Wood
PER OUR PLANS
ND INFO.
L1Other.
❑ er:
❑Other:
❑ er:
X ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES.
❑ OBSERVED DEFICIENCIES AND COMMENTS:
❑ REPORT CONTINUED ON ATTACHED PAGES.
❑ FINAL STRUCTURAL OBSERVATION REPORT:
The structure generally complies with the approved construction documents, and all observed deficiencies were corrected.
I declare that the following statements are true to the best of my knowledge:
1. I am the licensed design professional retained by the owner to be in responsible
charge of the structural observation;
2. I, or another licensed design professional whom I have designated above and is under
my responsible charge, have performed the required site visits at each significant
construction stage to verify that the structure is in general conformance with the
approved construction documents;
3. 1 understand that all deficiencies which I have documented must be corrected, prior to
final acceptance of the structural systems by the City of Newport Beach, Building
Division.
05/17/2021
SIGNATURE OF STRUCTURAL OBSERVER OF RECORD DATE
N0.
S. 5289
Up. 6/30/22
STAMP OF STRUCTURAL OBSERVER
STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH.
Formt.Stmcmral01 ervntinllR,un&InstmcLionv
NEWS
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100
<� Civic Center Drive I P.O. Box 1768 ]Newport Beach, CA 92658-8915
FOAN`A- www.newportbeachca.gov{ (949) 644-3200
BUILDING HEIGHT CERTIFICATION
Project Street Address:
Building Permit Number(s):
As the Surveyor of record for the project at the above address, I hereby certify that l have reviewed the
City of Newport Beach approved plan and original topographic surveyand based -the elevations listed
below on those plans.
Elevations shall include an allowance for roofing material thickness if not yet installed. provide
each critical ridge and flat roof, or roof deck railing elevations indicated on the approveYhplaris,
Use the format below on the back of this form if additional space is necessary or furtfier,
explanation is needed. Provide original copy to the inspector before.roof framing inspecfion.
All elevation points are based on: �;NAVD88 O NGwD29 OAssumed:-
Please provide the following elevation informabonjor the lilghestroof edges flgtraa�s or
parapets/guardrails. Additional elzYaaon points maybe eh 0i, fie Efurld IniYor
e
RllJCrES [3 Zzslope or gryedte�L '
1 AppUoved eievaton pbrrrtaf ridge Is�� nydal�,is`' m
Approved elevaiton potht of nclgg �s -m�ail u X i itn of t s x
z Approved elevation porrd of fldge is • ?`a ' i`' ui elrr3n
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Response' or wRssUaute trust be used
CORFEC71ONS AND NOTES:
FIRE SPRINKLER NFPA 930 SYSTEM ROUGH INSPECTION APPROVEg -
BY: ,n PERMrr
lf DATE
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Response' or wRssUaute trust be used
CORFEC71ONS AND NOTES:
FIRE SPRINKLER NFPA 930 SYSTEM ROUGH INSPECTION APPROVEg -
BY: ,n PERMrr
lf DATE
OF ' ! ' BEACH
1 1- -➢ B 1 � 0
Z CA 92658-8915
3r00
rSPRE.,a:r 1 1 SYSTEM
YES
2- Fee spi kids rysiern hd3W per to approved PWm
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SYSTEMSa- mawiest coxicied and bel
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FIRE SPRINKLER NFPA 13D SYSTEM FKAK. APPROVED:
PERMIT
Zo2►-�5 K�
#�
BY: DATE:
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1(949) 644-3200
SMOKE DETECTOR AND CARBON MONOXIDE
SELF -CERTIFICATION
(this certification is to be filled out by the permittee or homeowner)
Project Address: 12 v 7� c✓ --bh-
Permit Number: X Z-0 2 0 ._ i
Property Owner: lA I t_ t.t v_ (--i- eZ iL4 rye-vt J
Licensed Contractor: Q f M ce LAZ,14f c. , _ Lie #: % c '3
The State of California now requires that smoke and carbon monoxide detectors must be
installed in all residential buildings
California Residential Code (CRC) Section R314.1, CRC R315.2 states in part that
existing dwellings be "retrofitted with smoke detectors and carbon monoxide detectors.
CRC Section R314.3, CRC R315.3 defines required locations.
Both boxes below must be checked:
000 Carbon Monoxide Alarm: On the ceiling or wall outside of each separate
sleeping area in the immediate vicinity of bedrooms or in each hallway outside of
the rooms, and each level of the dwelling. Detectors are also required in
bedrooms with gas fired appliances
Smoke Alarms: Installed in each room used for sleeping purposes, outside
' each sleeping area, and on each level of the dwelling unit.
Retrofitted detectors may be battery operated for buildings where no alterations are
performed on the interior. Multiple -purpose alarms (carbon monoxide and smoke alarms)
shall comply with all applicable standards and must be approved by the State Fire
Marshall. The devices must be installed per manufacturer's specifications.
1, the undersigned, hereby certify that I am the permittee or homeowner of the
project. I further certify that smoke alarms and carbon monoxide alarms are
present Rad -tested to be functional in all the following locations:
Date: h J a <r/-2_ e
NOTE: This se)ficertification is only used for projects to the exterior of the structure where access to the
interior of the dwelling by the City, of Newport Beach Building Inspector is not achieved during the course of
construction.
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1 (949) 644-3200
SMOKE DETECTOR AND CARBON MONOXIDE
SELF -CERTIFICATION
(this certification is to be filled out by the permittee or homeowner)
Project Address: IGEJ % Lr
Permit Number: p<2_0ZD ^ Z(`7S1 4 xZ07,0—t1.0 fj
Property Owner: K4 r (4(z --k "_rETI M644 --\J k tJ — —
Licensed Contractor: Lic #: S 13 0% 3
The State of California now requires that smoke and carbon monoxide detectors must be
installed in all residential buildings
California Residential Code (CRC) Section R314.1, CRC R315.2 states in part that
existing dwellings be "retrofitted with smoke detectors and carbon monoxide detectors.
CRC Section R314.3, CRC R315.3 defines required locations.
Both boxes below must be checked.
109, Carbon Monoxide Alarm: On the ceiling or wall outside of each separate
sleeping area in the immediate vicinity of bedrooms or in each hallway outside of
the rooms, and each level of the dwelling. Detectors are also required in
bedrooms with gas fired appliances
Smoke Alarms: Installed in each room used for sleeping purposes, outside
each sleeping area, and on each level of the dwelling unit.
Retrofitted detectors may be battery operated for buildings where no alterations are
performed on the interior. Multiple -purpose alarms (carbon monoxide and smoke alarms)
shall comply with all applicable standards and must be approved by the State Fire
Marshall. The devices must be installed per manufacturer's specifications.
I, the undersigned, hereby certify that I am the permittee or homeowner of the
project. I further certify that smoke alarms and carbon monoxide alarms are
prese nd tested to be tsti nal in all the following locations:
Sign Date:
NOTE: This self -certification is only used for projects to the exterior of the structure where access to the
interior of the dwelling by the City of Newport Beach Building Inspector is not achieved during the course of
construction.
---
S.TREETRAUE'.
CITY OF NEWPORT BEACH
A;- CONMUNM DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 17681 Newport Beach, CA 92658-8915
www .newportheachca.00v 1 (949) 644-3200.
THIS AGREEMENT has been entered into by the following property owners for the construction
Of a common property line fence where 50% of the wall thickness and foundation will be btult
�wer the adjacent property,
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SUBJECT , 'PROPERTY ADDRESS: IaNq WEST BAY AV
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PRINT NAME
1
,ADDRESS OF ADJOINING PROPERTY I (See k plan)
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PRINT E SIGNAIU�iE OF PROPERTY OWNHi DATE
ADDRESS OF ADJOINING PROPERTY 3 (See keyrdan, I
ADDRESS OF ADJOINING PROPERTY 3 (See key plan):
PRINT NAME SIGNATURE OF PROPERTY OWNER DATE
KEY PLAN
PROPERTY2
pFtQP. SUBJECT PROPERTY: ROPERT1Y 3.
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