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' :!1 19 1 I. • '•I 1 • 91 :� NOTE GFYC plasf c pipe fi the garage shall not lie S nn[tlers that are 5sied as `Oukk • P Response' or'ResideriW must be used CORRECTIONS AND NOTES: FIRE SPRIN R NFPA 1 SYSTEM ROUGH INSPECTION APPROVED. # PERMITS�2MI-©G3y aY: DATE Z^lO°'lid/ �on,ss\Fre sPm,wv rvcra v�o sy�-hough vispeeeon rneckrzse as/u2oss CITY OF ,, • a' • e a e ! e ' EE ! al'A` IW r.D O A • �as 1 a SYMM t AWCI ii,i iik i IE s NO 11 ■ Z Fire spr1ridersyskin bsialled per to approved plans11 ■ = 11 ■ 4. Cover piates am NOT to be hdaled, but shelf be available m the jobsifte El 11 ■ 11El 7. Prow sigraga at aG reqAred locadomAI ■ 11 ■ Locati• ofmspectoes UmmV vaim m approvediocadon11 ■ SYSTEMS: Clearances10. it ■ 11. Operaft pressure gauge irtstaled at nser mlmmg proper water pressure ■I ■ FIRE SPRINKLER NFPA 13D SYSTEM FINAL. APPROVED: PERMrr# BY: DATE: CITY OF NEWPORT BEACH COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100,Civic Center Drive I P.O. Box 1768 j Newport Beach, CA 92658-8915 www. nnewnoriheachca:aov 1 (949) 644-3200 PRE -GRADE MEETING AGREEMENT DATE:_ y b 0l z JOB ADDRESS: 1. All residential one -unit and two -unit dwelling projects must be completed Ina three (3)-year period in accordance with, Newport Beach Municipal Code 16.02.095. 2. The grading plan check number for this site Is 0 and will be referred to in all reports, certifications and correspondence. 3. 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. 4. The stamped set of approved plans shall be on the job site at all times. 5. 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 conformancewith the approved grading plans, the discrepancies shall bereportedimmediately 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 6. When importer 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. 7. Between October 1 and April 30, erosion control BMP measures shall be in place. During the remainder of the year dry season wind erosion BMP's (dust control) shall be implemented. Sediment control BMP's lshall 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 stormwater 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. 8. 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. 9. All trench (including interior and exterior utility trenches) and retaining wall backfill shall be compacted throughout to a minimum of90 percent relative compaction antl approved by the soils engineer. 10. Whenever work on which required inspectionitesting is covered by additional work without first being hispectedltested, 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. 11. Landscaping of all slopes and pads shall be in accordance with 16.10.130 of the NBMC. 12. Approved drainage provisions shall be used to protect adjoining properties during the grading operation. 13. The permittee or his agent shall notify the Building Division when the grading operation is ready for each of the followingInspections: a. PRE -GRADE MEETING: When the permittere 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: Whenallrough grading has been completed, the rough grade report shall be provided to the Building Inspector at foundation inspection or sooner based on theBuildinginspector'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. 14. 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. 15. Prior to the start of grading, all permanent property corner monuments shall be in place; Prior to any foundation Inspections, . proof of recordation of the "corner record" or "record of survey" with the County of Orange shall be provided. 16. 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. 17. Prior to foundation inspection'a Line and Grade Certificate Form must signed and stamped by the surveyor of record and submitted to the building Inspector. A Structural Observation Report may be required, 18.-All parties listed below must be present for the pregrade meeting unless approved by the building inspector. 19., All duplex construction requires' separate utilities (sewer, water, gas,electrical; fire sprinkler risers). OWNER/CONTRACTOR: A 11 G l%7[{iLLTYd/1/ By: ��/f�tr✓ Address: Lfl��7.LM/F (p. ✓i'T� Telephone: —CA GEOTECHNICAL ENGINEER: EGACANSLflTANTej INC By: 375•C MONTE VISTAAVENUE Address: Telephone: ?- 4 y .. - 0 9 DESIGN CIVIL ENGR.: T n4 4vvc�aicr�lsllG %`arc By: .Ym' PW ASX. s Address: /34 K1r:dJrpir A10AWAW- Telephone: 949- 49l-BS,eG GEOLOGIST.: NoT 5PN7- (9 PAS 6te4bE By: AIVT A-6 ilES A!rV Ic li Address: AOT- 1voTiFir- n ii GRADING CONTR.:A//1/ COORDINATOR: By: n//✓ -c4e6 insl/ BY: Address: f/r�377 TM�t eft d� Address: / Telephone: 7lta , &A— b ? : Telephone: NEWPORT BEACH REPRESENTATIVE: PHONE #: INSPECTION REQUESTS: (949) 644-3255 Newport Beach Construction Hours: Monday through Friday: 7:00 am. to 6:30 p.m. Saturdays: 8:00 a.m. to 6:00 p.m. Nowork ion Sundays and Holidays Formslpregrade meeting agreement 3-2022 IteITT N ce 2022 1st Check 23 SXEEf=OF 1 SXACJ' DAR.P SIIA,DY: RECORD OF SURVEY No. 2022-1086 INTHHCITYOF NIMPORTBRACH, COUNTY ONORANGE, STATROFCALWORNA. N w B S rb ®U Y['AI.LI'=M STATEMENT OF PURPOSE: s xlaAxour xcxvov l5TU.."1r1m.tl11 Ur L,YYO IU.'1U.N xn MrnWx Ilxi SAG. N' U' UASISUPEEARINGS: UW\ IIrRMN APR MATT ON THE CrnTtRUNr Ur ISTrl.l..rinV AU➢r ➢PN'GrnNNAnj7A'3IW'PA9EPC0.TR.YrAU. In]AAR[Ittl)DW➢UUK IIOPRO! M6L'L W,I:LUKS MM]. AKCUPUE UI' ORAW N C4M'f ]'. l'A. BEING A SURVEY OF LOT 21 OF TRACTS.. 1973 AS PER MAP RECORDED LN BOOK 114, PAGE 42 OF MISCELLANEOUS MAPS, RECORDS OF ORANGE COUNTY, CA Wotus1A. vixa.. 55Y?RM.YR - _ _mexm.\ ND"°awaNA _ ll a\1 q5 Y11 _ N3 rWMAW\ b �=� S➢ 1� � I a s Dp ee rl a u6 E LN 'IN IN L -- �7 AA a A, I C I IT - — tl Aa Q I� __ --- xxSPtt•w "A�ry ME j 1 Ja K@Iffi� late#qp��� 23 >`, AIN J N� SLPot \ .IT P a`o- - r Jn x'IA.a ytnzA PA'ib'k° / � mru �ND.�PIKeewnsBe¢LrmaawsLe. RON MIRDF.MA, LYADA- ROM SURVP.YINO INC. AC'CLPI'LUAND I9LLU A'I"CH11 REQUESTOF 'I I IS OINNUP. CVLKI Y RURVKYOR'S OFF'ICX DAM DML ILLS BRAG PAUR HUGH NGUYPN (:UNNT'C'LERK-RB[Y)RDER by DEPUTY nsmT'c�AP�cnm rvx P�.a AAR C ,�yyEyAN� mm.,r— ,n MONUMEFTNOTES: ]1py6�NS • IN rp 1. .SNUTEn O IN4653.FisH,..mr IrosTls Elmxn. F I.L.PN :\iTercrnwL2 I Q SURVEYORS STATEMENT xrVULSI] 0 x.. 1 —J mill. u:. s RBn �zao tY MIRDPMA Hail 511➢L,In * N 4651 � a° P CPv+FUC` I� O to c IQ s'I TAI:C-. rINONN. LNm IN ITW,t SrnrNY v11IN xK—N PL uNU . Rn4,m 2��' o y * T O NY.Y N.YNIU➢FA "U"N"ItUSY'A"O"+'UR NH 8103 F &¢, '>b e r YnUv :le'rWONt Wit i :I<"Al Jdkkt I r Ia p I„ � LL3J.3+JJ/JY� r,'�e CURVY.OA"IA: 9MIW"tyYll'SY'2. 'IPI]T33tl3"R I1 1 MmuWenl a53�JM•RD 3 ± 5 ± ® tot°silt'{IUI°anvAll ltmll2x1 AU b5T ZR1 MTTIAINR /I ®"O'a,',"N11 ISwmRNI ® 253'NfP55R,,R. R>U.Wl10At p x°m3Yamvmo I.an2m.IaA1 N6,,nR. Jxzstv'.xamn / SURVEYOR'S NOTES: IVfDIY V.D I.LW.,n-IAHG NI. a.NW'asma snAT Lm lalIN.URTHATUtIONROARTHIN TATNNN .DHIlINTHR OFMITx]I'RHN0TE0.]HN.. 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A,H\ E consultants CITY OF NEWPORT BEACH Building Department 100 Civic Center Drive Newport Beach, CA 92660 engineering geotechnical applications June 16, 2022 Project No. BC266.3 Attention: Chad Shelton, Building Inspector II Subject: FINAL GRADING CERTIFICATE PAD ADDITION, HARDSCAPE COMPACTION, UTILITY TRENCH BACKFILL FOR NEWLY REMODELED SINGLE FAMILY DWELLING LOCATED at 1621 DOROTHY LANE, NEWPORT BEACH, CALIFORNIA City Permit No.: X2021-0655 Associated Documents: 1. "Geotechnical Investigation for Proposed Residential Development Located at 1521 Dorothy Lane, Newport Beach, California," by EGA Consultants dated October 30, 2020. 2. 'Precise Grading and Drainage Plan for McCollum Residence, 1521 Dorothy Lane, Newport Beach, CA," by Toal Engineering, Inc., dated June 29, 2021. 3. "Foundation Plan, McCollum Residence, 1521 Dorothy Ln., Newport Beach, CA 92660," by R.M. Volpe & Associates, Inc., Consulting Engineers, dated July 6, 2021. To City Building/Grading Officials: In accordance with the City of Newport Beach building and grading requirements, we are submitting this final compaction report for the grading of the additions, utility trench backfill, and exterior improvements. The site earthworks operations were performed by the contractor, Niv Shokrian. Excavation and grading of the subject lot commenced on May 9, 2021 and was complete by June 13, 2022. Prior to the concrete pour, foundation trench bottoms were tested inspected and approved by a qualified representative employed by EGA Consultants. Due to the lack of notification for testing of the hardscape subgrade, post -construction compaction testing was performed, as much of the area is not covered with hardscape. A representative of EGA Consultants performed the tests using a combination of T-handle soils probe, and using the nuclear gauge method. Field density test results each indicate a minimum of 90% relative compaction. See Table 1, Summary of Field Density Tests. Jumping jack wackers/vibratory plates were reportedly utilized for the purpose of compaction and grading control. Water was added via a 2-inch hose and moisture contents were at near -optimum moisture levels. Though all earthwork operations were not performed under our continuous/periodic observations, it appears that the work was adequately achieved and in general conformance with the geotechnical specifications outlined in the soils report dated October 30, 2020. This opportunity to be of service is appreciated. If you have any questions, please call Very truly yours, EGA_ Consultants,�� Davtd ���LC,,JIjl� aw Worthington DAVID A. WORTHINGTON CEG 2124 * No. CEG2124 Principal Engineering Geologist/President CEHnl`MH , ENGINEERING cc: Chad & Dana McCollum 375-C Monte Vista Avenue • Costa Mesa, CA 92627 • (949) 642-9309 • FAX (949) 642-1290 TABLE 1 SUMMARY OF MOISTURE DENSITY RELATIONSHIPS (ASTM: D1556) Sample Number/ Location Depth Below Grade ft Dry Density (PCF) Moisture ` Content N Maximum Density (PCF) Optimum Moisture N Relative Compaction (°70) FD-1 2.0 112.1 11.0 123.0 9.5 91 FD-2 1.0 111.1 10.5 123.0 9.5 90 FD-3 FG 113.9 10.7 123.0 9.5 93 FD-4 FG 112.9 10.8 123.0 9.5 92 FD-5 FG 111.2 10.5 123.0 9.5 90 "FG" = Finish Grade (Ground Level Pad). TABLE 2 SUMMARY OF MAXIMUM DENSITY TEST (ASTM D 1557) Sample Maximum Optimum Location Density Moisture I PC=' oq.. Fill - per Soils Report dated 123.0 9.5 October 30, 2020 FINAL COMPACTION REPORT: 1521 Dorothy Lane, Newport Beach, CA Project No. BC268.3 June 16, 2022 CITY OF NEWPORT BEACH COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 926588915 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. Engineer/Surveyor's Name 904.4 1t#d% A0 License# GS Y4S Engineer/Surveyor's Address Z 3 0/6 tO Job Address �j`2/ 009-0n%y L�0 Setbacks: Sketch a site plan and specify surveyed setbacks (use back page). * Top of slab/floor elevation: 3041 E A-5 AeOW17ti1- * 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 ®, from plans: are not ❑, per City approved plans. Describe any deviations I certify that top of slab/floor elevation(s) is any deviations from plans: 5't-4-ZO Date Foims/SetbacksandTopofSlabElevationCert. is not ❑, per City approved drawings. Describe rElulq stamp and 1tre L c-.� poi 7lt y CITY OF NEWPORT BEACH a_ a COMMUNITY DEVELOPMENT DEPARTMENT u ) T BUILDING DIVISION 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 cgcrFORN�P www.newportbeachca.gov 1 (949) 644-3200 BUILDING HEIGHT CERTIFICATION Project Street Address: / J ZI DO Ro ty Building Permit Number(s): As the surveyor of record for the project at the above address, I hereby certify that I have reviewed the City of Newport Beach approved plan and original topographic survey and 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 approved plans. Use the format below on the back of this form if additional space is necessary or further explanation is needed. Provide original copy to the inspector before roof framing inspection. All elevation points are based on: O NAVD88 O NGVD29 8 Assumed Please provide the following elevation information for the highest roof ridges, flat roofs, or parapets/guardrails. Additional elevation points may be requested by the Building Inspector. RIDGES (3:12 slope or greater) 1. Approved elevation point of ridge is // 9.3f and actual elevation point is 1-/ 4• Yr 2. Approved elevation point of ridge is and actual elevation point is 3. Approved elevation point of ridge is and actual elevation point is FLAT ROOFS, PARAPETS AND GUARDRAILS 1. Approved elevation point of flat roof or parapet is and actual elevation point is 2. Approved elevation point of flat roof or parapet is and actual elevation point is � 3. Approved elevation point of flat roof or parapet is and actual elevation point is Pr I certify that the above height measurements are correct and the above project: ® IS in compliance with the City -approved plans. OIS NOT in compliance with the City -approved plans (Provide explanation). Please describe any deviation from the City -approved plans on the back of this form. Surveyor or Civil Engineer's* signature and seal (Wet stamp and signature required) * License number of 33965 or lower I'l mjs[)FMA LS4653�'� OF d -/(v . LZ Date Fo'ms\Building Height Certification 11/02/16 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 i (949) 644-3200 CIVIL ENGINEER'S CERTIFICATION FORM From: Toal Engineering; Inc. 139 Avenida Navarro San Clemente, CA 92672 ATTENTION: GRADING ENGINEER, BUILDING DIVISION Date: 6-21-22 GPC No.: 0595-2021 Tract/Subdivision/Lot No.: Rough: _Final: X Project Names: 1521 Dorothy Lane Owner/Developer: McCollum Residence Type of Project: Notes: _ Tract: _ Drainage Single Family Residence _ Commercial X Other Industrial Yardage for Project: Notes: 58 Cut: 0 Borrow: 0 Fill: 58 Export: I hereby approve the grading for this project in accordance with my responsibilities under the City Grading Code. I have inspected the project and hereby certify that all areas exhibit positive surface flow to public ways or City approved drainage devices. The grading has been completed: x ilk°b �Iti91mance with, x with the following changes to the approved grading plan. Description of Changes: QROFEssip r Q. Company: Toal Engineering, Inc. 9TF, IL o��\ Name: Caleb Rios F CAL1F (print) (s2g License No.: 57587 RCE (RCE/LS) Fvuu.w;m; n.'w..' s Ceiba uun run',u-w 20205FGC ''`9110RT CITY OF NEWPORT BEACH Community Development Department I Building Division 100 Civic Center Dr.1 P.O. Box 1768 1 Newport Beach, CA 92658 I ^ www.newoortbeachca.gov 1(949) 644-3200 CALGREEN DOCUMENTATION COMPLIANCE CERTIFICATION ADDRESS: 1�2X y1UT Y LAli, PERMIT NO.: yiLom �D6S5 THIS FORM SHALL BE COMPLETED AND SIGNED PRIOR TO REQUEST FOR FINAL BUILDING INSPECTION. ONE COPY OF THIS FORM SHALL BE SUBMITTED TO THE BUILDING INSPECTOR AT FINAL INSPECTION AND ONE SHALL BE PROVIDED TO THE BUILDING OWNER AS PART OF THE CAL GREEN CERTIFICATION PACKAGE. The following section shall be completed by a person with overall responsibility for the planning and design portion of the project. REQUIRED DOCUMENTATIONS PROVIDED TO THE PROPERTY OWNER(S) dFranchise Hauler for Construction/Demolition Waste I/ VOC Contents Limitation Formaldehyde Emissions Limitation pJ T-24 Energy Certificate of Installations (Env., QII, Lighting, Photovoltaic, Mach., Plumb.) T-24 Energy Certificate of Verifications or Acceptance ( Env., QII, Lighting, Photovoltaic, Mach., Plumb., HERS) Operations and Maintenance Manual MOISTURE CONTENT OF BUILDING MATERIAL (RESIDENTIAL CONSTRUCTION ONLY) /I certify that the moisture content of the wall and floor framing is less than 19 percent as determined in accordance with Section 4.505.3 of CAL Green prior to being enclosed. DECLARATION STATEMENT • 1 certify under penalty of perjury, under the laws of the State of California, the information provided is true and correct. • 1 certify that the installed measures, materials, components, or manufactured devices identified on this certificate conform to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcing agency. Responsible Person's Name: Responsible Person's Signature: f4w 6W Date Si ned: Position/Title: 6 7o I ��-� G .G/ owN Notes PROJECT STATUS REPORT CaICERTS, Inc Effective 06/27/2022 16:07 (Page 1 of 3) p✓ jfff•'/' H ! *L / J liRVGI�FAYMI�VLI�NLFM1 db ?. ,, ,.�, ,3"./!. ..,... Energy Standards Code Year: 2019 ❑ ❑ Project Name: McCcollum REV2 • Project Type: New Construction SFR ■ Address: 1521 DOROTHY LN ■ City/State/Zip: Newport Beach / CA / 92660 L � • ■ Enforcement Agency: City of Newport Beach Easy to Verify @ calcerts.com Permit Number: 0595-2021 OVERALL STATUS COMPLETE HERS VERIFIABLE MEASURES: COMPLETE fiCF112INFORMATION - Certificate of Compliance (Document Lists Required Energy Features) , �✓ Certificate Type Compliance i Re istered Farm 9 CF1R-PRF-01 Registered Date 2021-08-19 `6:01:21 Registration Number 221-PO10174349A-000-00o-OOOOOOQ-0000 - CF2R INFORMATION - Certificate of Installation (Documents the proper, installation of required energy features) I 1 s� >; System Form Registered Date . Registration Number - 221-PO10174349A-000-001-EO1001A-0000 CF2R-ENV-01-E 2022-06-11 12:48:30 Niv Shokrain r�e_ Fenestration Installation (N I V CONSTRUCTION) 221-PO10174349A-000-001-EO3001A-0000 CF2R-ENV-03-E 2022-06-11 12:48:30 Niv Shokrain Insulation Installation (N I V CONSTRUCTION) 221-PO10174349A-000-001-LO1001A-0000 CF2R-LTG-01-E 2022-06-11 12:48:30 Niv Shokrain Lighting (N I V CONSTRUCTION) CF2R-MCH-01-E 221-PO10174349A-000-001-MO1001A-0000 Space Conditioning 2022-06-11 12:48:30 Niv Shokrain Systems, Ducts and Fans (N I V CONSTRUCTION) 221-POl0174349A-000-001-M20001A-0000 System 1: Mas.Bed CF2R-MCH-20-H 2O22-06-11 12:48:31 Niv Shokrain & Rooms Duct Leakage IN I V CONSTRUCTION) 221-PO10174349A-000-001-M20002A-0000 System 2: Main & CF2R-MCH-20-H 2022-06-11 12:48:31 Niv Shokrain �x Ll Living Duct Leakage IN I V CONSTRUCTION) HERS Provide,: CaICERTS Inc. CA Building Energy Efficiency Standards 2019 Residential Compliance Dec 2019 CITY OF NEWPORT PEACH COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 www.newporkbeachca. ov 1 (949) 644-3200 Structural Observation Report Project Address: Report ate.-] CNB Inspector Name: CNB Permit #: Buildi g Owner N me: evllum Owner's ailing Address (if different from site); Owner's Telephone #: CNB Plan Check #: a, Full N of Structural O server (SO): SOLE --mail Address: SO Telephone #: SO License / Reg. #: dL (9f: e %50[SGa IQr •VOG/a LV Wi✓1 IIf I 3t7S Y746 ee-ZW-/46 PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED /check annlicahle homes) FOUNDATIONS SHEAR WALLS FRAMES DIAPHRAGMS (Floor/Roofl INDICATE LOCATION(S) OBSERVED DATE OBS RVED ❑ Conventional Footings & Slab ❑ Concrete ❑ Steel ❑ Concrete &"r-/z& ❑ Mat Foundation, Prestressed Concrete ❑ Masonry ❑ Concrete ❑ Steel Deck ❑ Caissons, Piles, Grade Beams Wood or Manuf. hear Panels ❑ Masonry Wood (� ❑ Other: ❑ Other: Other: aJO ❑ Other: ❑ 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 acceptpaee-o( the structural systems by the City of Newport Beach, Building "0 CE 25115 F G EXp. 1213-114 f, >ti STAMP OF STRUCTURAL OBSER` STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPOr Fomss".Str turalObsorvatici tgoa&Instructions A CITY OF NEWPORT BEACH COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive I P.O. Box 17681 Newport Beach, CA 92658-8915 www.newoortbeachca.Gov 1 (949) 644-3200 Structural Observation Report Protect Address: SZ�` Report Datel 2/ CNB Inspector Name: CNB Permit#: Buildi g Owner N me: Owner's Melling Address (A different from site); Owner's Telephone A CNB Plan Check #: - �� Full N of Structural O server (SO): o� 50 E-mail Address: SO Telephone #: SO License / Reg. #: a beQ1»vocP6.G�,+, �f,L93oS'F7ao Ce2i7iG FOUNDATIONS SHEAR WALLS FRAMES DIAPHRAGMS ❑ Conventional ❑ Concrete ❑ Steel Footin s &Slab (Floor/Roo ❑ Concrete " ❑ Mat Foundation, ❑ Masonry ❑ Concrete Prestressed Concrete ❑ Steel Deck ❑ Caissons, Piles, Wood or Manuf. ❑ Masonry Grade Beams Woo hear Panels a ❑ Other. ❑ Other. Other: t •. ❑ Other: O rJ O ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES. ❑ OBSERVED DEFICIENCIES AND COMMENTS: 0 FINAL STRUCTURAL OBSERVATION REPOR ,i ❑ REPORT CONTINUED ON ATTgCHED PAGES. I observed deficiencies were corrected 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 p{tOFEss� H / charge of the structural observation; o 0 2. I, or another licensed design professional whom I have designated above and is under �Lq- Oe@RT: VO � my responsible charge, have performed the required site visits,at each significantf. qwconstruction stage to t r; approved construction documents; nts; that a structure: is in general conformance with the a CE 25116 3. 1 understand that all deficiencies which I have documented must be corrected, prior to # EXP 1y31/L71 a ?? final accep the structural systems by the City of Newport Beach, Building Division. �9 C/Vll ', # P OF CALIF ) 3 zJ Ilr SIGNA UR OF STRUCTURAL 13SERVER OF RECORD pqT STAMP OF STR CTURq[OBSERt(E STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION SYAUTNORRED EMPLOYEES OF TFIEC r „ Fa�SwouN0lnmeduatNr���lom _ ii PI'I'YOFN' ORT BEi rt rP Scanned with CamScanner CITY OF NEWPORT BEACH COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 3300 Newport Boulevard I P.O. Box 1768 1 Newport Beach, CA 92668 (949) 644-3200 Structural Observation Report Project Address: �5-2/ ! UtJ Report date: CNB Inspector Name: CNB Permit#: Building Owner Name: �/✓sAG a �er's ailinTaddress Of different from site); Ovmers Telephone#: CNB Plan Check Full Nam StNdural Observer(SO): n SO email Address: SO Telephone #. SO License I Reg. #: T/ © �' r� la M t7 PLEASE INDICATE ATRIf TuaAr .r . FOUNDATIONS ❑ Conventional a Sl Footin s 8 Slab O Mat Foundation, Prestressed Concrete ❑ Caissons, Piles, Grade Beams ❑ Other: X ITEMS CHECKED ABOVE ----•-•••-^^��r,...G..,rvrraVoUtKveD checka Ilcableboxes SHE WALLS FRAMES DIAPHRAGMS INDICATE LOCATIONS) FloodRoo OBSERVED d Concrete ❑ Steel ❑ Concrete ❑ Masonry ❑Concrete ❑ Steef Deck ❑ Wood or Manuf. ❑Masonry ❑Wood Shear Panels ❑ Other: Other. ❑Other: ARE APPROVED AND WITHOUT DEFICIENCIES. DATE OBSERVED ❑ OBSERVED DEFICIENCIES AND COMMENTS: ❑ FINAL STRUCTURAL OBSERVATION REPORT: The structure generally 00111131198 with the approved construction documents, and all 0-REPORT CONTINUED ON ATTACHED PAGES. observed deficiencies were corrected. I declare that the foilowing statements are true to the best of my knowledge t. 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 acoeptan of the structural systems by the City of Newport Beach, Building Division. % SIGNA E STRUC TU L OBSERVER OF RECoan v - ravm Vr a I KVG t UKAL OBSERVER STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH. r611N-$INKY,elnbllfv.L'u,lRgM(!it®NtlgN CITY OF NEWPORT REACH COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive ( P.O. Box 1768 1 Newport Beach, CA 92658-8915 www.newportbeachca.gov 1 (949) 644-3200 Structural Observation Report Project Address: / ,¢o a /�� Report Date, CNB Inspector Name: CNB Permit #: Building Owner N e: Owners ailin Address (if different from site); Owner's Telephone #: CNB Plan Check #: �v 1/ Full N me of Struct ral Ob erver (SO): SO E-mail Address: SO Telephone #: SO License / Reg. #: a V�® r kibbC Qa�d6l PCs w. Is! PLEASE PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check annlicable boxes) FOUNDATIONS SHEAR WALLS FRAMES DIAPHRAGMS (FloodRoof) INDICATE LOCATION(S) OBSERVED DATE OBSERVED F__cnven+ional Fodtin s & Slab ❑ Concrete ❑ Steel ❑ Concrete p ❑ Mat Foundation, Prestressed Concrete ❑ Masonry ❑ Concrete ❑ Steel Deck -P ,5zc �4X31� b ❑ Caissons, Piles, Grade Beams ❑ Wood or Manuf. Shear Panels ❑ Masonry ❑ Wood X Ot r: t ❑ Other: ❑ Other: ❑ Other: Y/ y ❑ ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES. Pt —A A/ kr3 ❑ OBSERVED DEFICIENCIES AND COMMENTS: n 6 ❑ 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 docu 3. 1 understand that all deft ' ncies hich I haveidocumented must be corrected, prior to final acceptance oft structu I ys ms the C'it of New ort Beach, Buildin Division.. y / y p g n.M FAA RT t`p\ �O (p CE 25116 EXP. 12/31/ STAMP OF STRUCTURAL OBSERVER STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH. Farms,SmlctnralObscrv811onRepon&lnsimclions