HomeMy WebLinkAboutX2017-4072 - Misc (3))('IAI? -101'-
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
OWNER -BUILDER ACKNOWLEDGEMENT AND INFORMATION VERIFICATION
(HSC 19826)
NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application for a building permit has been submitted in your ryame listing y-eourself s e byilder of
the property improvements specified at Z I Z Lau f el P� • Nw Ar d, 4266
We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to
make you aware of your responsibilities and possible risk you may incur by having this permit issued in
your name as the Owner -Builder.
We will not issue a building permit until you have read, initialed your understanding of each
provision, signed, and returned this form to us at our official address indicated. An agent of the
owner cannot execute this notice unless you, the property owner, obtain the prior approval of the
permitting authority.
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information-
,:-().
I understand a frequent practice of unlicensed persons is to have the property owner obtain an
"Owner -Builder" building permit that erroneously implies that the property owner is providing his or her
own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious
financial risk for any injuries sustained by an unlicensed person and his or her employees while working
on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully
acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers
on my property.
r^S 2. 1 understand building permits are not required to be signed by property owners unless they are
responsible for the construction and are not hiring a licensed Contractor to assume this responsibility.
-3. 1 understand as an "Owner -Builder" I am the responsible party of record on the permit.
understand that I may protect myself from potential financial risk by hiring a licensed Contractor and
having the permit filed in his or her name instead of my own.
CS4. I understand Contractors are required by law to be licensed and bonded in California and to list
their license numbers on permits and contracts.
C5. I understand if I employ or otherwise engage any persons, other than California licensed
Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor
and materials, I may be considered an "employer" under state and federal law.
t' S 6. I understand if I am considered an "employer' under state and federal law, I must register with the
state and federal government, withhold payroll taxes, provide workers' compensation disability insurance,
and contribute to unemployment compensation for each "employee." I also understand my failure to abide
by these laws may subject me to serious financial risk.
r� S 7. I understand under California Contractors' State License Law, an Owner -Builder who builds
single-family residential structures cannot legally build them with the intent to offer them for sale, unless
all work is performed by licensed subcontractors and the number of structures does not exceed four
within any calendar year, or all of the work is performed under contract with a licensed general building
Contractor.
18. 1 understand as an Owner -Builder if I sell the property for which this permit is issued, I may be
held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any
latent construction defects in the workmanship or materials.
Forms\owner builder veri£doc 08/12/16 1 of
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.SEW PORT
o� CITY OF NEWPORT BEACH
u ,4 i COMMUNITY DEVELOPMENT DEPARTMENT
cg4"'oaN,r 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
Project Address:
231 Z �w
Report te:
Report
2� ZUt
CNB Inspector Name:
CNB Permit #:
20
Building Owner Name:
57wy-d
Owner's Mailing Address (if different from site);
Owner's Telephone #:
CNB Plan Check #:
C ) VN o tn-
Full Name of Structural Observer (SO):
Jo % A d2t,2NC-v
SO E-mail Address:
aFxA.r fnez gol.cork
SO Telephone #:
TN-271-q?�qS
SO License / Reg. #:
519
PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check applicable boxes)
L
FOUNDATIONS
SHEAR WALLS
FRAMES
DIAPHRAGMS
(Floor/Roof)
INDICATE LOCATION(S)
OBSERVED
DATE
OBSERVED
❑
Conventional
Footings & Slab
❑ Concrete
❑ Steel
❑ Concrete
❑ Mat Foundation,
Prestressed Concrete
❑ Masonry
❑ Concrete
❑ Steel Deck
❑
Caissons, Piles,
Grade Beams
Wood or Manuf.
Shear Panels
❑ Masonry
❑ Wood
Ty �'
-1
❑
Other:
❑ Other:
❑ Other:
❑ Other:
EMS 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. 1 am the licensed design professional retained by the owner to be in responsible
charge of the structural observation;
2. 1, 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.
-T40- 2-41 D�017
C5198r
fzJ3i
STAMP OF STRUCTURAL OBSERVER
OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CRY OF NEWPORT BEACH.
Farms\StmcturalOMervmionRepm &lnrrvctions
41a17- 401L
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 17681 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1 (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.
+ in e /Surveyor's Name t)GQlG L A5. 0. h Ci5i Ee License # PL `j 459 9
BACK BAY SURVEYING & MAPPING
-Engineer/Surveyor's Address 2338 Tustin Avenue
Newport Beach, CA 92660
Job Address 2 312 LA U ;ZF_ L P i.,/AC 1_, N E4 [PaQT P� G-ACy4 C A
v
Setbacks: Sketch a site plan and specify surveyed setbacks (4iso-baslFpage). (a ftC1 C41 A)I
FL r m
* Top of slaWReer elevation: g• N r-�' V .f--Jl g, Q
* 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 are Yam, are not ❑, per City approved plans. Describe any deviations
from plans:
To M
I certify that top of slabfAeer elevations)
any deviations from plans:
isT, is not ❑, per City approved drawings. Describe
lo-- jc)'-IG
Date
r1pUGLAS O. .4-
U FOSTER O
Forms/SetbacksmdTapo0abEle t30
iop ert. No.4599 30
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Engineer/Surveyor's stamp signature
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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
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.
£-ngineer/Surveyor's Name DOQ`GL.A5 O, hG5 TF License# (BLS 4599
BACK BAY SURVEYING & MAPPING
-Fngincer/Surveyor's Address 2338 Tustin Avenue
Newport Beach, CA 92660
Job Address 231'2 LAURELpi/ACE =�P0P13EACtA-
Setbacks: Sketch a site plan and specify surveyed setbacks (xse bark page).(G ft-ac{�
FL r rn
* Top of Aab*eor elevation: g• .3 [! N Y .� �'
* 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 are'A are not ❑,
from plans:
fo,..m
I certify that top of slah&fleer elevation(s)
any deviations from plans:
per City approved plans. Describe any deviations
is'9 is not ❑, per City approved drawings. Describe
(O jt?-Ito
Date
V: DOUGLAS O. L
FOSTER 0
Forms/SetbacksandTopotSlabEle oT Cn No. 4599
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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
OWNER -BUILDER ACKNOWLEDGEMENT AND INFORMATION VERIFICATION
(HSC 19825)
NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of
the property improvements specified at 23 (Z kQUJE 1 /L. New oa ? )3Pwck
We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to
make you aware of your responsibilities and possible risk you may incur by having this permit issued in
your name as the Owner -Builder.
We will not issue a building permit until you have read, initialed your understanding of each
provision, signed, and returned this form to us at our official address indicated. An agent of the
owner cannot execute this notice unless you, the property owner, obtain the prior approval of the
permitting authority.
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.
�51. 1 understand a frequent practice of unlicensed persons is to have the property owner obtain an
"Owner -Builder" building permit that erroneously implies that the property owner is providing his or her
own labor and material personally. 1, as an Owner -Builder, may be held liable and subject to serious
financial risk for any injuries sustained by an unlicensed person and his or her employees while wmrkirng
on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully
acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers
on my property.
� 2. 1 understand building permits are not required to be signed by property owners unless they are
responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. -
CS 3. 1 understand as an "Owner -Builder" I am the responsible party of record on the permit. I
understand that I may protect myself from potential financial risk by hiring a licensed Contractor and
having the permit filed in his or her name instead of my own.
�s4. 1 understand Contractors are required by law to be licensed and bonded in California and to list
their license numbers on permits and contracts.
CS 5. 1 understand if I employ or otherwise engage any persons, other than California licensed
Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor
and materials, I may be considered an "employer' under state and federal law.
CS 6. 1 understand if I am considered an "employer" under state and federal law, I must register with the
state and federal government, withhold payroll taxes, provide workers' compensation disability insurance,
and contribute to unemployment compensation for each "employee." I also understand my failure to abide
by these laws may subject me to serious financial risk.
CS7. I understand under California Contractors' State License Law, an Owner -Builder who builds
single-family residential structures cannot legally build them with the intent to offer them for sale, unless
all work is performed by licensed subcontractors and the number of structures does not exceed four
within any calendar year, or all of the work is performed under contract with a licensed general building
Contractor.
C S8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be
held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any
latent construction defects in the workmanship or materials.
Fortes\owner builder verifdm 04/23/13 1 of
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Costa Mesa Sanitary District
..an Independent Special District
SEWER PERMIT
BUILDING ADDRESS: 2312 LAUREL PL CITY:
PARCEL NO: 42530315
PROPERTY OWNER NAME: STERN, CHRISTOPHER A M
CONTRACTOR NAME: OWNER/BUILDER
Newport Beach STATE: CA ZIP: 92663
PHONE NO.: 310-741-1507
PHONE NO.:
CONTRACTOR ADDRESS: CITY: STATE: CA ZIP:
STATE LICENSE NO.: CITY BUSINESS LICENSE NO.:
WORK TO BE DONE: BDR + BATHROOM ADDITIONS
l hereby acknowledge that I have read this application and state the above is correct and agree to comply with
State laws, City and County ordinances and Sanitary District ordinances pertaining to sanitary sewers. I certify I
possess the above valid State of California contractor's license or am legal ownef of the property described
above.
Signature of Permittee Date
Pursuant to the Costa Mesa Sanitary District Operations Code, section 6.8.060, Orange County Sanitation District
pretreatment requirements are herein incorporated by reference.
PERMIT FEE:
OTHER FEE:
TOTAL:
NOTES:
$ 120.00
$ 1857.75
$ 1977.75
Office Use Only
PERMIT NO.: SD16-0648
PERMIT ISSUED BY: Inv
Date
INSPECTED BY: qG 1
3 1�
Date
APPROVED: YES_ NO
ANT INFORMATION
The Sewer Permit is not effective without an authorization signature. This Sewer Permit is not a contract until
it has been accepted. Acceptance is subject to the following:
1. All sewer connections must be inspected- call Joe Limon (714) 290-6831.
2. This sewer permit is subject to all of the Terms and Conditions that are stated separately but
incorporated herein unless this sewer permit specifically states otherwise.
Report of Spec€a[ Inspection
2312 L.atlrel Place
Y2ni 7_At^t'0
Perntt Numb-,
tnoit . fypc� `y Reinforced Concrete ! Epoxy
Inspectnn Date(s) 1.30.18 FTFiodie WVan utse=4
Describe luspection Made, including locations:
Observed the installation of Simpson XP Epoxy for (7) #4 slab dowels @ 36" OC
with 4" embed and (8) #4x24 ftg dowels with 6" embed; (2) top & bottom each,
All set in Simpson XP Epoxy as per plan Sheet SD-1, Details #10 & #11.
Location: New Front Porch; New 4" concrete slab, Sheet S-2, #1 Foundation
Plan, 101SD-1.
Verified Cleaning, Embed Depths, Installation and Application.
All are set with Simpson XP Epoxy, [CC ESR - 2508
Work is per plan.
List Tests Matte
Tu--' —1-specuum Time Each Day:
j Date 1 1.30A 8
Hours 1
List Rents Reautring Correction, Inclnde Uncorrected heats Previously Listed:
NIA
To the hest of ms k: -t , Av- >;,:t ;,. .,,.._a l in aeii:rr3,ance avitb the titri#din r-+-�+h cnl "fit _,._ _ g .�.tv.. _ ..
approved design drawings, stec:iiical3or s and applicable workmanship provisions of the IBC except as
noted above.
1.30.18
Signed: 14� Date:
John Watson NB-0604
Print Full Name: Registration No
�.�;MM4
r,EV'JPpkT
�c 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.Qov 1 (949) 644-3200
Structural Observation Report
Project Address:
a eau �c�-t,
Report Date:
J�u Mz 31 20l
CNB Inspector Name:
CNB Permit #:
Bull g Owner Name: 1i ,,
Ovmer's Mailing Address (if different from site);
Owner's Telephone #:
CNB Plan Check #:
i TO Wiz- Jam'
Full N 7 a of Structural Observer (SO):
j6 qauL�
SO E-mail Address:
arbt uGcn(.Conk
SO Telephone #:
SO License / Reg. #:
C5(gq{
PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check aaplicable boxes)
FOUNDATIONS
SHEAR WALLS
FRAMES
DIAPHRAGMS
(FloorlRooll)
INDICATE LOCATION(S)
OBSERVED
DATE
OBSERVED
Conventional
Footin s & Slab
❑ Concrete
Cl Steel
El Concrete
�Ti�rs
rV7C- -/
�..0
❑ Mat Foundation,
Prestressed Concrete
❑ Masonry
❑ Concrete
❑ Steel Deck
❑
Caissons, Piles,
Grade Beams
❑ Wood or Manuf.
Shear Panels
❑ Masonry
❑ Wood
❑
Other:
❑ Other:
❑ Other:
❑ Other:
I�QTEMS
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.
k
31GNATURE STRUCTURAL ORSEIRVER OF RECORD DATE
STAMP OF STRUCTURAL OBSERVER
WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH.
Forma\SwcmrvlObsmrtioMepon&Inxwctianx
Q ��W PpR�
! e CITY OF NEWPORT BEACH
u y COMMUNITY DEVELOPMENT DEPARTMENT
c,9 BUILDING DIVISION
roRN 100 Civic Center Drive i P.O. Box 1768 i Newport Beach, CA 92658-8915
www.newportbeachca.Qov i (949) 644-3200
Structural Observation Report
Project Address:
y3i2 I-1��JR��►-
RepoTtD e:
f�-� 5 2�►+'�
CNB Inspector Name:
CNB Pernik #:
�vl�- 0
BuildingA4vpFTe�r jJeme: !
of'' 181
Owner's Mailing Address (if different from site);
Owner's Telephone #:
CNB Plan Check #:
Full Name ofuctturel>Observer (SO):
JC7�G hl2S 1�
SO -mall Address:
aEx� ckeZ (9 aaf, c
SO Telephone #:
SO License / R . #:
V
PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED check applicable boxes
FOUNDATIONS
SHEAR WALLS
FRAMES
DIAPHqAGW
(Floo Ro
INDICATE LOCATIONS)
OBSERVED
DATE
OBSERVED
❑ Conventional
Footings & Slab
❑ Concrete
❑ Steel
❑ Concrete
❑ Mat Foundation,
Prestressed Concrete
❑ Masonry
❑ Concrete
❑ Steel Deck
❑ Caissons, Piles,
Grade Beams
Wood or Manuf.
Shear Panels
❑ Masonry
-Wood
(.j!
('�.1_ Qi
/
❑ Other:
❑ Other:
I
❑ Other:
1
❑ Other:
p(LC
ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES.
❑ OBSERVED DEFICIENCIES AND COMMENTS:
(N 4f l® OtjTv, evyr)
Doo2,
&JUT C1�Cg,---7
❑ 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. 1 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.
S, 2v18
STAMP OF S I RUU I UKAL UtiStRVEK
DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CRY OF NEWPORT BEACH.
Formvl5wra 10l crveoonit p nMm"coou
4EW Pp,yT
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.gov 1 (949) 644-3200
Structural Observation Report
Project Address:
�Cc
RerDae(� 5►v
CNInspector Name:
CNBIermit #:
_f7
7
Build iny Owner Name
ST d
Owner's Mailing Address (if different from site);
Owner's Telephone #:
CNB Plan Check #:
C �(S
Full Name of ructural Observer (SO):
'SvyL f tL&Lie"v
SO mail Address:
ct �X i^a�z C aril, c�
SO Telephone #:
�i q -�., gbC15
SO License / R . #
r` l j q ,
PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED check applicable boxes
FOUNDATIONS
SHEAR WALLS
FRAMES
DIAPH
(Floo 00
INDICATE LOCATION(S)
OBSERVED
DATE
OBSERVED
❑ Conventional
Footings & Slab
❑ Concrete
❑ Steel
❑ Concrete
❑ Mat Foundation,
Prestressed Concrete
❑ Masonry
❑ Concrete
❑ Steel Deck
❑ Caissons, Piles,Wood
Grade Beams
or Manuf.
Shear Panels
❑ Masonry
Wood
/
FIP
1
❑ Other:
❑ Other:
❑ Other:
❑ Other:
e l
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.
SIrNATI _ OF STRLIC%TLIRAL1013SFRVFR OF RECORD DATE
DOES NOT WAIVE
STAMP OF STRUCTURAL OBSERVER
BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CRY OF NEWPORT BEACH.
Farms\SwwmlObsmationRcpon&Ivswc�ions
Project Status Report CaICERTS, Inc
Effective: 10/24/2018 06:16 1 of 2
GENERAL INFORMATION
Energy Standards Code Year:
2013
N
Project Name:
2312 LAUREL, NB
Project Type:
Alterations SFR
Address:
2312 LAUREL PLACE
City / State / Zip:
Newport Beach / CA / 92663
❑�
Enforcement
Agency:
City of Newport Beach
Easy to Verify @ calcerts.com
Permit Number / Date:
X2016-2446 / 9/21/2016
HERS VERIFIABLE
COMPLETE
MEASURES:
OVERALL STATUS:
I COMPLETE
CF1R INFORMATION - Certificate of Compliance (Lists Required Energy Features)
Certificate Type:
Compliance
Registered Form:
CF1R-PRF-01
Registered Date:
10/03/2017 13:22
Registration Number:
217-A0341078A-000000000-0000
CF2R INFORMATION - Certificates of Installation (Documents the proper installation of require;'
energy features)
System
Form
Registered
Date
Registration Number
CF2R-ENV-0I-E
10/14/2017
217-A034107BA-EOIO000IA-0000
(Fenestration Installation)
19:16
Paulamarie Stern
f
(Homeowner - Installer)
CF2R-ENV-02-E
10/14/2017
217-A0341078A-E0200001A-0000
(Envelope Air Sealing)
19:16
Paulamarie Stern
(Homeowner -Installer)
CF2R-ENV-03-E
10/14/2017
217-A034107BA-E0300001A-0000
(Insulation Installation)
19:16
Paulamarie Stern
(Homeowner -Installer)
CF2R-ENV-21-H
10/04J2017
217-A034107BA-E2100001C-0000
(QII-AIS-Batt, Loose Fill, and SPF)
18:13
Paulamarie Stern
(Homeowner -Installer)
CF2R-ENV-22-H
10/04/2017
217-A0341078A-E2200001B-0000
(QII-Air Infiltration Sealing)
18:13
Paulamarie Stern
(Homeowner -Installer)
CF2R-ENV-23-H
10/04/2017
217-A0341078A-E2300001B-0000
(QII-Installation)
18:13
Paulamarie Stern
(Homeowner - Installer)
CF2R-MCH-01-E
1 0/04/2017
217-A0341078A-MO100001A-0000
(Space Conditioning Systems,
10/048:13
Paulamarie Stern
Ducts and Fans)
(Homeowner - Installer)
System 1
CF2R-MCH-20-H
10/04/2017
217-A034107BA-M2000001A-0000
Paulamarie Stern
(Duct Leakage)
18:13
(Homeowner - Installer)
System 1
CF2R-MCH-23-H
10/04/2017
217-A0341078A-M2300001A-0000
Paulamarie Stern
(AirHow)
18:13
(Homeowner - Installer)
System 1
CF2R-MCH-22-H
10/04/2017
217-A0341078A-M2200001A-0000
Paulamarie Stern
(Fan Efficacy)
10/048:13
(Homeowner - Installer)
-
CF2R-MCH-27-H
10/04/2017
217-A0341078A-M2700001A-0000
(IAQ and MV)
18:13
Paulamarie Stern
-
(Homeowner -Installer)
System 1
CF2R-PLB-02-E
10/14/2017
217-A0341078A-B0200001A-0000
Paulamarie Stern
(SD HWS Distribution)
19:16
(Homeowner - Installer)
`/
HERS Provider: CaICERTS Inc.
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NOISE LEVEL AGREEMENT
Date: 6-6-18
DAVID PEDERSEN . owner
Print affected adjacent property Owner's Name (owner)
of 2316 LAUREL PL. NEWPORT BEACH GA. 92663
Print affected adjacent property Owner's Address (owner address)
authorize the installation of air conditioning unit(s) at the following neighbor's address,
2312 LAUREL PL. NEWPORT BEACH CA. 92663 1 am aware the noise will
Print neighbor's address with AC unit(s) which exceed 55 db (neighbor's address)
exceed 55 db (decibels) to a maximum rating of 65 db with a timer installed on the equipment
to shut off between 10 PM and 7 AM. I give my authorization to install the unit(s) not to exceed
65 db per the Newport Beach Municipal Code Section 10.26.045.
Thank you,
(Signature of affected property owner) Under penalty of perjury 1 attest that I am the current
affected property owner.
DAVID PEDERSEN
(Print Name of affected property owner)
2312 LAUREL PL. NEWPORT BEACH GA. 92663
(Property Address)
Forms\CNB NoiseLeve ftreement 05/24/2017