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LETTER OF AGENCY FOR RBC BUILDERS GROUP LIC # 1066904
October 28, 2020
City Building, Planning, Permitting & Business Departments
To Whom it May Concern at City of Newport Beach,
Lutfi Bustami is the Corporate Vice President and Senior Project Manager for RBC Builders Grouop and is authorized to
conduct business and obtain permits on behalf of RBC Builders Group Lic # 1066904
Thank you,
Dgnna°C,00per
President
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.pov 1 (949) 644-3200
Structural Observation Report
Project Address: t�
12i ��
Report Date:
c
CNB Inspector Name:
CNB Permit #:
Building Owner Name:
Owner' ailing Address (if different from site);
Owners Telephone #:
CNB Plan Check #:
Fu I Name of Structural Observer (SO):
SO E-mail Address:
SO Telephone M j'� O)
SO License / Reg. #:
b
PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check applicable boxes) J
FOUNDATIONS
SHEAR WALLS
FRAMES
DIAPHRAGMS
(FloodRoofl
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
Other:
Other:
❑ Other:
Other:
f�
�I ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES. f:;:Z"(
❑ 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.
S 1 AMP UI- S I KUL; I UKAL UMitKV tK
STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH.
forms\Stme�nr+lObservntiunRepotl&Ins\mc�ions
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
Project Address:
Z
Report to
Tj � py
CNB Inspector Name:
CNB Permit#:
Building Owner Name.
Owners Mailf ddress (if different from site);
Owners Telephone #:
CNB Plan Check #:
Full Name of Structural Observer (SO): _
SO E-mail Address*
SO Telephone #:
SO License I Reg. #:
CC GCLertQ
'S�i ® a�ur?
K �b Sb2
ell 6
PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check annticable hnYasl
FOUNDATIONS
SHEAR WALLS
FRAMES
DIAPHRAGMS
(Floor/Rocip
INDICATE LOCATION(S)
OBSERVED
DATE
OBSERVED
• Conventional
Footings & Slab
❑ Concrete
❑ Steel
❑ Concrete
❑ Mat Foundation,
Prestressed Concrete
0 Masonry
❑ Concrete
❑ Steel Deck
❑ Caissons, Piles,
Grade Beams
❑ Wood or Manuf.
Shear Panels
❑ Masonry
❑ Wood
❑ Other:
C(Other.
$Other;
Other.
5/E� y UJ
1 d
ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES.
❑ OBSERVED DEFICIENCIES AND COMMENTS:
❑ REPORT CONTINUED ON ATTACHED PAGES.
❑ FINAL STRUCTURAL OBSERVATION REPORT:
The structure_9enerally 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.
STAMP OF STRUCTURAL OBSERVER
STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CRY OF NEWPORT BEACH.
Forms`Svu:NralOb'vm'AvnReprntP&struniom
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
Project Address:
rl I5 rw?J
Report Date:
- Z-
CNB Inspector Name:
i.NB Permit #:
Building Owner Name:
Owner's Mailing Address (if different from site);
Owner's Telephone #:
INB Plan Check M
h
Full Name of Structural Observer (SO):
SO E-mail Address:
SO Telephone M
pO License I Reg. M
4-4-e� 3
CTURAL ELEMENTS AND CONNECTIONS OB ERVEDicheckapplic 'ijle boxes
PLEASE INDICATE
FOUNDATIONS
STRU
SHEAR WALLS
FRAMES
DIAPHRAGMS
(Floor/Roof)
INDICATE LOCATION(:;
OBSERVED
DATE
OBSERVED
❑ Conventional
Footings & Slab
❑ Mat Foundation,
Prestressed Concrete
❑ Concrete
❑ Masonry
❑ Steel
❑ Concrete
❑ Concrete
❑ Steel Deck
�..
3
❑ Caissons, Piles,
Grade Beams
❑ Wood or Manuf.
Shear Panels
❑ Masonry
� Wood
��j,i,��Y C 3
�((!
❑ Other:
❑ Other:
❑ Other:
❑ Other:
f
❑ ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES.
1t
❑ OBSERVED DEFICIENCIES AND COMMENTS:
❑ REPORT CONTINUED 0�4 ATTACHED PAGES.
❑ FINAL STRUCTURAL OBSERVATION REPORT:
The structure generallycomplies with the approved construction documents, and all observed deficiencies werf(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.
STAMP OF STRUCT(AAL OBSERVER
STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITYk`)F NEWPORT BEACH.
I'o=%SmmnimlOb,cry tionecpooal.,tmctions
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
Project Address: rA.
Report Date: ' /
CNB Inspector Name:
: CNB Permit #:
s
Building Owner Name:
Owner's Mailing Address (if different from site);
Owner's Telephone #:
CNB Plan Check #:
Full Name of Structural Observer (S
SO E-m it Address:
SO Telephone #: �j'',
SO License / Reg. #:
iGc 7e t
S ®
cewo
PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check applickble boxes)
FOUNDATIONS
SHEAR WALLS
FRAMES
DIAPHRAGMS
(Floor/Roof)
INDICATE LOCATION
OBSERVED
S)
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
0 Wood
❑ Other:
❑ Other:
❑ Other:
❑ Other:
r'
❑ ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES.
r
❑ OBSERVED DEFICIENCIES AND COMMENTS:
I'
r,
1,
❑ REPORT CONTINUED {.=N ATTACHED PAGES.
❑ FINAL STRUCTURAL OBSERVATION REPORT:
The structure generally complies with the approved construction documents, and all observed deficiencies weE>'e 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.
NO. 1�.403
Exp —(t—
STAMP OF STRUCTiORAL OBSERVER
STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF
Form95wnuralOW cno,ianRcponSingmaiau
NEWPORTBEACH.
CaF W PpkT
o� CITY OF T
u y s COMMUNITY DE
cy�P BUI
100 Civic Center Drive I P.O.
Structural
WPORT BEACH
LOPMENT DEPARTMENT
NG DIVISION
1768 1 Newport Beach, CA 92658-8915
;hca.00v1(949)644-3200
Report
Project Address:
Report Date:
CNB Inspector Name.
i`'NB Permit*
l21t�od-
Building Owner Name:
Owner's Mailing
kddress (if different from site);
Owners Telephone #:
i--;NB Plan Check #:
r:
Full Name of Structural Observer (SO):
iG
SO E-mail AcIlcm
ss:
(� aGlov.
SO Telephone #:
S3o)3oxt
t 90 License / Reg. M
i
p �u GGnr�
StNu witaQ
-sus
44o3
PLEASE INDICATE STRUCTURAL ELEMENTS AND
f
CONNECTIONS OBSERVED check a lical'„Ie boxes
FOUNDATIONS
SHEAR WALLS
FRAMES
DIAPHRAGMS
INDICATE LOCATION((,')
DATE
(Floor/Roof)
OBSERVED „'
OBSERVED
❑ Conventional
❑ Concrete
❑ Steel
❑ Concrete
Footings & Slab
❑ Mat Foundation,
❑ Masonry
❑ Concrete
❑ Steel Deck
Prestressed Concrete
ull CPiles,
❑ Wood orManuf.
❑ Masonry
❑Wood
Zntior F[rue�. d',Ng
!r -z(
rade Beams
Shear Panels
❑ Other:
❑ Other:
❑ Other:
❑ Other:
�j ITEMS CHECKED ABOVE ARE APPROVED AND WITHOU r DEFICIENCIES.
❑ OBSERVED DEFICIENCIES AND COMMENTS:
❑ REPORT CONTINUED OR ,ATTACHED PAGES.
❑ FINAL STRUCTURAL OBSERVATION REPORT:
4'
The structure generally complies with the approved construction documents, and all observed deficiencies were,
;orrected.
il`.
I declare that the following statements are true to the best of my
1. I am the licensed design professional retained by the c
charge of the structural observation;
2. I, or another licensed design professional whom I have des
my responsible charge, have performed the required sit
construction stage to verify that the structure is in gene
approved construction documents;
3. 1 understand that all deficiencies which I have documented
final acceptance of the structural systems by the City o'
Division.
ier to be in responsible
sated above and is under
visits at each significant
al conformance with the
wst be corrected, prior to
Jewport Beach, Building
NO
STAMP OF STRUCTURAL OBSERVER
STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR $UILOING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF �IEWPORT BEACH.
I'omu6tmoomlObscrvationitcpon&Instninions
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
BUILDING HEIGHT CERTIFICATION
-L
Project Street Address: �2� '5�4 SZ he goQ.T 16E-AA4
Building PermitNumber(s): xsolul-'5LI2
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: ® NAVD88 O NGVD29 O 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) s
1. Approved elevation point of ridge is and actual elevation point is s 6
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
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.
' W(.— y�0 pS.A yq �'QL -5 i 942I
Surveyor or Civil Engineer's* signaturQ a t,P ? FO Date
(Wet stamp and signature required n X
* No.9385
*License number of33966orlower d' `e3g,2( �\Q,
Fot \Building Height Certification11/02116 ��OFCA��FO�
Report of Special Inspection
Project Name & Address Sandie Margaret A Residence Remodel 121 39th Street
Permit Number X2019-3612
inspection Type(s)
inspection
Epoxy/ DIA
Describe hrspection Made, including locations:
Observed the installation of (170) #4 A615 rebar dowels at 6" minimum embedment.
Observed the installation of (30) #5 A615 rebar dowels at 6" minimum embedment.
At the following locations:
(E) SOG/ footings for (N) footings and grade beams in the center of residence
Verified holes for size, depth, cleanliness and clearance prior to application of Simpson
SET-XP, exp. 10-1B-2022
U.N.O. all work observed was completed in accordance to City approved plans and
specifications.
List Tests Made
Total hrspection Time Each Day:
List Items Requiring Correction, Include Uncorrected Items Previously Listed:
To the best of my knowledge, the work inspected was in accordance with the Building Department
approved design drawings, specifications and applicable workmanship provisions of the IBC except as
noted above.
signea: v--- 12-30-2020 —
Dare:
Print Full Name: Nathan Haley Master of SI 1487
Registration No.
MRM 81-0;"14
KLING
Consulting
�W_
Group, Inc.
18008 Sky Park Circle, Suite 250, Irvine, C
TO (949) 797_6241 Fax (949) 797-626C
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121 39th Street. Newport Beai
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House Foundation
FIELD MEMORANDUM
NO.
19034-00
Construction c% Luke
Brad Hulse
2.0
Observed and inspected the Foundation Excavations for the proposed new 2nd and 3rd story additions at the Sisson
Residence located at 121 39th Street, Newport Beach. The approximate 24 deep continuous foundation excavations to
support the additions appeared to be founded in competent material . Manual probing indicated firm and unyielding
conditions. The foundation excavations for the proposed new 2nd and 3rd story additions at the Sisson Residence located
Bit 121 39th Street as observed on this date are considered suitable for their intended purpose from a geotechnical
standpoint.
*This memo is not intended to verify foundation location, size, or reinforcement requirements or that the foundations are
free of loose debris at the time of concrete placement and does not constitute authority for placing concrete without the
approval from the governing Building Official.
** Excavations were relatively free of loose material and debris at the time of this observation.
***Reinforcement was NOT in place at the time of this observation.
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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
GAS METER RELEASE
APPLICATION
(Inspection/Administrative Fee: $168.00)
PROJECT: Sandie Duplex
OWNER'S NAME: Rudy Sisson PHONE NO: (916) 690-7815
JOB ADDRESS: 121 39th Street, Newport Beach
BUILDING PERMIT No(s):_ X2019-3612
Request is hereby made for the early release of the -gas meter on the subject property only for the purpose
of testing mechanical systems prior to Certificate of Occupancy.
I HEREBY DECLARE:
• 1 agree not to occupy the building or structure until the Building Division has issued a Certificate of
Occupancy. (Initial RS )
• 1 agree not use or have this building used or occupied until all City regulations and conditions have
been complied with. (Initial RS )
• I agree and understand the following must be completed and approved prior to the release of the
gas meter. (Initial RS )
1. Electrical system shall be completed and inspected.
2. The fire sprinkler system and alarm bell shall be operational and tested.
3. The project is four (4) weeks away from final completion.
4. Clear all holds from City Departments.
• 1 agree not to stage or store any furniture inside the building prior to Certificate of Occupancy.
(Initial RS )
• I understand the City of Newport Beach may order the service be discontinued without notification
forat2.PaKtftof Occupancy. (Initial RS )
OWNER ✓ DAT-
PRINT name of owner or tenant: Rudy Sisson PHONE #: (16) 690 7815
CONTRACTOR SIGNATURE: / _ DATE: 06/30/2022
PRINT name of contractor RBC uflders Group PHONE #: (949) 374 4546
APPROVED BY:
Building inspector
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Date