HomeMy WebLinkAbout5.01_Foundation Structural Ob Report_StructuralObservationReport 05_20210115CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive | P.O. Box 1768 | Newport Beach, CA 92658-8915
www.newportbeachca.gov | (949) 644-3200
Structural Observation Report
Project Address: Report Date: CNB Inspector Name: CNB Permit #:
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. #:
PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check applicable boxes)
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
Other: Other: Other: 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. I 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 ____________________________________________________________ ___________________
SIGNATURE OF STRUCTURAL OBSERVER OF RECORD DATE
STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH.
Forms\StructuralObservationReport&Instructions
3443 Pacific View Dr., Corona del Mar, CA
Harbor Day School
01/15/2021
Andrea Chiu achiu@lpadesignstudios.com 949-701-4313 S6491
1/19/2021
Report # 05
X Slab-on-grade rebar in
northern portion of building.01/15/2021
12/31/22
X 01/15/2021CMU site
wall footing
Site wall along west edge of
building