HomeMy WebLinkAbout2.01_Line and Grade Survey Cert_20210128 Slab Cert South_SetbacksandTopofSlabFloorE
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive | P.O. Box 1768 | 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 _____________________________________ License # _______________
Engineer/Surveyor’s Address ___________________________________________________________
Job Address _________________________________________________________________________
Setbacks: Sketch a site plan and specify surveyed setbacks (use back page).
* Top of slab/floor elevation: ___________________________________________________________
* 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 , are not , per City approved plans. Describe any deviations
from plans: __________________________________________________________________________
I certify that top of slab/floor elevation(s) is , is not , per City approved drawings. Describe
any deviations from plans: ______________________________________________________________
______________________________ _____________________________________________
Date Engineer/Surveyor’s stamp and signature
Forms/SetbacksandTopofSlabElevationCert.
Christopher W. Daniels, IMEG Corp.PLS 6328
901 Via Piemonte, Suite 400 Ontario, CA 91764
3443 Pacific View Drive, Corona Del Mar, CA 92625
FF=310.00, TOP 6" STEM WALL=310.50
X
X
JANUARY 28, 2021
Certifying South half of building only, from the previous concrete pour bulkhead between gridlines U & V to the
south end of the building. See sketch.
Certifying South half of building only, to +/- 0.10', from the previous concrete pour bulkhead
between gridlines U & V to the south end of the building. See sketch.
*SOUTH HALF OF BUILDING SLAB*
F7
F7
F9
F7
F6
F5
F9
F7
F7
K
M
N
S
S
P
R
Q
CC
CC
1
1
4
4
10
10
18
18
22
22
25
25
27
27
Z
Z
AA
AA
2
2
6
6
3
3
5
5
23
23
21
21
24
24
26
26
S
S
T
U
X
Y
W
V
DD
19
19
16
16
13
8
BB
23.5
HARBOR DAY SCHOOL
Building Certification - SOUTH
2021-01-25
No Scale
FF=310.00
TOP STEM WALL/CURB
AT PERIMETER=310.50