Loading...
HomeMy WebLinkAboutX2017-3130 - Misc (2)0011 Pr, -1. CITY OF NEWPORT BEACH 1556 oceanB1vJ 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 CONTRACTOR/PROPERTY OWNER SELF -CERTIFICATION DECLARATION FOR PLUMBING FIXTURE REPLACEMENT Project Address: /S S(j/ r✓ 4ZCg!^_ Date -__7-i3 J9 Permit #: Xca 017 – -3130' The following is to be completed by the California licensed contractor or owner -builder Newport Beach Self -Certification Program. Please type or print. Install participating in the City of er s ame. y %lAr0 License No (if applicable)) Installer's Mailing Address: AO« f%,(cz I" -r QUI Phone �--' (required): 940 –`is Installer's Email: GkrUeC�zt' rMo ; G yf�') FAX #: Installer I certify that the installation is in compliance with applicable code requirements. I further affirm that I have reviewed and understand the requirements of the applicable 2013 California Green Code and Newport Beach Municipal Code (NBMC) Section 301.1.1 and that all self -certification reports submitted will be based on the code requirements contained therein. I declare that all plumbing fixtures subject to the NBMC 301.1.1 has been replaced meeting the low flow requirements Kitchen faucets: 1.5 gal/minute at 60 psi Shower heads: 2.0 gal/minute at 80 psi Water closet: 1.28 gal/flush Faucets: maximum flow rate of 1.5 gal/minute at 60 psi, and minimum 0.8 gal/minute at 20 psi 34_ a© je>1 Date Property Owner (P,equired) f As the property owner of the project address noted above, I have read, understand and agree to participate in the Plumbing Fixture Replacement Self -Certification Program. I further understand that by participating in this program, the plumbing system will not be inspected by a City of Newport Beach Building Inspector during construction or after installation unless requested. The Building Division may request and reserves the right to verify code compliance after the installation is complete. Property Owners Signature Date Name This form must be completed and returned to the City of Newport Beach, Building Division, for a final approval of the plumbing permit. Please return this form to the Building Division by mail or fax. Please mail to: City of Newport Beach Phone: (949) 718-1888 Community Development Department Fax #: (949) 644-3250 Building Division P. O. Box 1768 Newport Beach, CA 92658 PormslCon;racfor-OvnerSelf-CerfGeclara fion-Dishv.asherGarbage Disp�P/a LrCloset 12/11/13 I(,Z017- 3130 1556 Ocean ENJ CITY OF NEWPORT BEACH COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive I P.O. Box 1768 i Newport Beach, CA 92658-8915 www.newportbeachca.gov 1 (949) 644-3200 CIVIL ENGINEER'S CERTIFICATION FORM From: JDate: AY �• ��-�w�o� � - �- �� 4-7o w ATTENTION: GRADING ENGINEER, BUILDING DIVISION oAd-2o1-Zq GPC No.: �1� �0� Tract/Subdivision/Lot No.: Rough: _Final: Project Names: +1AVF5jPA Owner/Developer: Type of Project: Notes: _Tract: Drainage Fi11�1wue 0,1 W21 _ Commercial Other Industrial Yardage for Project: Notes: _ Cut: _ Borrow: Fill: _ 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: 15 -'7 -lel in conformance with, with the following changes to the approved grading plan. Description of Changes: �J. 5 Company:J AIA, i¢ Name: �� c_ t (Pfilo License No.: G'�ioo) (RCE/LS) Forma\Civil Engineer's Certification Form 9-1 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.newportbeachea.gov 1 (949) 644-3200 BUILDING HEIGHT CERTIFICATION Project Street Address: 15-5-6 E, -CiFfAIV Building Permit Number(s): -2b (7 ' 3f30 X017-3130 1556 Oce4n Blvd 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: M 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 Inspectorp.e^ _ RIDGES (3:12 slope or greater) 3 r• � 17v �1� r�L 1. Approved elevation point of ridge is 39, sl and actual elevation point is 31.15' fl*yM -'2. Approved elevation point of ridge is3 9 7 / and actual elevation point is 3 7.32 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: 0 IS in compliance with the City -approved plans. OIS NOT in compliance with the City-approvdd plans (Provide Please describe any deviation from the City -approved plans on the back of tt Surveyor or Civil Engineer's* signature and seal (Wet stamp and signature required) * License number of 33965 or lower FormsABuilding Height Certification 11/02/16 s 4017-3130 1556 Ocean $ksj 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 ..4 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 Natne /Nitd EMS License # LS V45 3 Engineer/Surveyor's Address Z3 OIL LatV-e Fpto+ pr, *ky DQ Job Address 1556 Q4*An Blvd % Setbacks: Sketch a site plan and specify surveyed setbacks (use back page). * Top of slab/floor elevation: 111A5 * 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) any deviations from plans: 6-13—/4 Date Forms/SetbacksandTopofStabElevationCert. is ®, is not ❑, per City approved drawings. Describe -Engineer/Surveyor's stamp and alkpr qvr- 'cT` OF r1.2: 3.16' 3.63, At .ctf i r 0 15iMOR, Sd+b"k � v AL %16- 3'AO',• Se1b d� 0(,CAn Siva. .3 c:. 3• a' Y_ 0(,CAn Siva. .3 c:. 3• a' CORNER RECORD Agencylndex Document Number City of NEWPORT BEACH County of ORANGE California Brief Legal Description LOT 15, BLOCK I, TRACT NO. 518 M.M. 17/33-36 CORNER TYPE COORDINATES (Optional) N. E. j Government Corner ❑ Control ❑ Elevation Meander Property Units Metric ri U.S. Survey Foot -t Rancho Other Horizontal Datum Zone Epoch Date, i Date of Survey May 16, 2018 Vertical Datum ❑ Complies with Public Resources Code §§8801-8819 ❑ Complies with Public Resources Code §§8890-8902 PLS Act Ref.: 0 8765(d) 08771 ❑ 8773 ❑ Other: Corner/ ❑ Left as found ❑ Established El Rebuilt ❑ Pre -Construction Monument: ❑ Found and tagged Reestablished ❑ Referenced ❑ Post -Construction Narrative of corner identified and monument as found, set, reset, replaced, or removed: ❑✓ See sheet #2 for description(s): SURVEYOR'S STATEMENT This Corner Record was prepared by me or under my direction in conformance with the Professional LandS rvrve,,yors' Act on June 10, 2018 / Signed I" // C/20— P.L.S. or R.C.E. No. 4653 COUNTY SURVEYOR'S STATEMENT This Corner Record was received and examined and filed Signed Title County Surveyor's Comment BPELSG-2016 P.L.S. or R.C.E. No Page i o/2 r4�DEM,q\ 2 � F JUN 11 2018 filler -B N20°42'00"E 138133.38_ --�--- 4 I �( G„ STREET II � 30' 10' I `° 00 m t. Ln — -- — — — — -- 'v r 0Lo N28°25'34"E RAD. m qd: J 14 0.00' y N27041'15"E RAD. 107.29' rn q, Co a 00 I J O STREETb 2 I 1 m I N24°14'20"E 114.99'014.991 - MONUMENT NOTES: 77.29'(77.28') Cl) v� i No 0 15 N`� bM O II p v II II M J 76.87' (76.93') JV N27020'43"E RAD. 106.87' 1 O / I 16 N Cl) Q� W C0� J 1\0Cq T7 O P�7 O n 0 n 30.00' Z-----I W C) L6 0 NJ 04 of rn m T 0 11 30' rn q, Co a 00 I J O STREETb 2 I 1 m I N24°14'20"E 114.99'014.991 - MONUMENT NOTES: 77.29'(77.28') Cl) v� i No 0 15 N`� bM O II p v II II M J 76.87' (76.93') JV N27020'43"E RAD. 106.87' 1 O / 16 N Cl) 0 C0� N c V 1 'o m m F SCALE 1"=30' H a a 0 1p p C? �05 0 cmn� 0C`wn m W w�WL6 z Q°r°o w Uu�U¢N W ) O ❑ Ce W ZZU L N v W Z Z a w O LLH 00c00=O F-: Cl) aUZ 3(o0 WON W 22LU (nww X: Kaf-OCa w2 x 0 CZJ H 2 a yV T Co WoN}aw wrn Cj 00:)w� Iz-Q 00Hw ❑ SET LEAD, TACK & TAG, 2' O/S P.L., TAGGED L.S. 4653. A FOUND LEAD & TAG, TAGGED LS 5280, NO REFERENCE. 46 SET LEAD, TACK & TAG, TAGGED L.S. 4653 INDICATES FOUND MONUMENT AS NOTED. 1O FOUND LT & TAG, "LS 4212", PER R.S. 2009-1180, R.S.B. 242/32-42 ACC. AS CL INTERSECT 2O FOUND LT&TAG, "LS4459", PER R.S.B. 275/6, ACC. AS CL INTERSECTION. . 3O FOUND S&W, "LS4212", PER R.S. 2009-1180, R.S.B. 242/32-42 ACC. AS CL INTERSECTION. ® FOUND S&W, "LS5507", PER R.S. 2009-1180, R.S.B. 242/32-42, ACC. AS CL INTERSECTION. BPELSG-2016 Page 2 of 2 0 n n I 0 L6 NJ 04 T 0 C-4 rn p J O 10' II I � F SCALE 1"=30' H a a 0 1p p C? �05 0 cmn� 0C`wn m W w�WL6 z Q°r°o w Uu�U¢N W ) O ❑ Ce W ZZU L N v W Z Z a w O LLH 00c00=O F-: Cl) aUZ 3(o0 WON W 22LU (nww X: Kaf-OCa w2 x 0 CZJ H 2 a yV T Co WoN}aw wrn Cj 00:)w� Iz-Q 00Hw ❑ SET LEAD, TACK & TAG, 2' O/S P.L., TAGGED L.S. 4653. A FOUND LEAD & TAG, TAGGED LS 5280, NO REFERENCE. 46 SET LEAD, TACK & TAG, TAGGED L.S. 4653 INDICATES FOUND MONUMENT AS NOTED. 1O FOUND LT & TAG, "LS 4212", PER R.S. 2009-1180, R.S.B. 242/32-42 ACC. AS CL INTERSECT 2O FOUND LT&TAG, "LS4459", PER R.S.B. 275/6, ACC. AS CL INTERSECTION. . 3O FOUND S&W, "LS4212", PER R.S. 2009-1180, R.S.B. 242/32-42 ACC. AS CL INTERSECTION. ® FOUND S&W, "LS5507", PER R.S. 2009-1180, R.S.B. 242/32-42, ACC. AS CL INTERSECTION. BPELSG-2016 Page 2 of 2 2031 S. Anne Street Santa Ana, Ca. 92704 Office (714) 557-7901 Fax (714) 241-3820 License #584915 July 25, 2018 To Whom it may concern: During the week of May 21, 2018 grading operations took place at 1556 E. Ocean Blvd, Newport Beach, shoring was installed along portions of the site to protect offsite properties. All shoring activities were observed by Coleman Geotechnical Soils Engineering. During our Over - excavation we maintained 2.5' from property line. All work was done as per plans by Jay S. Crawford Architect under the supervision of Coleman Geotechnical. Permit # X2017-3.130 Dan Powers X'411- 3130 1556 oce4n 81vj CITY OF NEWPORT BEACH COMMUNITY DEVELOPMENT DEPARTMENT 13UMDING DIVISION 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 www.newportbeachca.aov 1 (949) 6443200 Structural Observation Report Project Address:Report Date: CNB Inspector Name: CNB Permit*, F � " N S 1_7- 9 DIAPHRAGMS (FloodRoo INDICATE LOCATIONS) OBSERVED Building Owner Name: Owner's Meiling Address (if different from site); Owner's Telephone #: CNB Plan Check*: Full Name of Structural Observer (SO): SO Email Ad ss: SO Telephone k.: SO License / Reg. #. E -/'e '-c'J /t/ 941 0 7/ Lf So o e -o 45-S70 M PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED Icheck applicable boxes FOUNDATIONS SHEAR WALLS FRAMES DIAPHRAGMS (FloodRoo 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 ❑ Other. ❑Other. D Other ❑ Other ❑ ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT _ ❑ OBSERVED DEFICIENCIES AND COMMEN r ❑ REPORT CONTINUED ON ATTACHED PAGES. 14 FINAL STRUCTURAL OBSERVATION REPORT: The structure generally complies wtth the approved consbuadon 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 witll the approved construction documents; 3. 1 understand that all deficiencies which 1 have documented must be corrected, prior to final acceptance of the structural systems by the City of Newport Beach, Building Division. 1 Fmm65uuuwdObmvmonRe}mn@IosM1uc,iom QROFESS/0' Q��SMPIE KygFIt, m No. C 045870 r,,n y� Exp. 12/31/7 c kP�gT CIVIL OBSERVER 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 (949) 6443200 Structural Observation Report Project Address: l'l -y4 U'o ��re-C-1- Report Date: G 2 a -145 lAddress`1(if CNB Inspector Name: CNB Permit M. Building Owner Name: � / Owner's Mailing different from site); Owner's Telephone #: CNB Plan Check #: Full Name of Structural Observer (SO): SO E-mail Address: h' Xa- SO Telephone #: 14 Vs-8z/�o SO License I Reg. A CIO efs",870 PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check applicable boxes) FOUNDATION SHEAR W FRAMES DIAPHRAG S fNo*r1Rq6,fji INDICATE LOCATION(S) OBSERVED DATE OBSERVED ❑ Convention Footings lab ❑ C ❑ Stft ❑ Co aet ❑ Mat Fo (dation, PrestrConcrete ❑ sonry ❑ Conc Steel eck ❑ Cai ons, Piles, de Beams � Wood or Manuf. Shear Panels ❑ so ❑ W W S� _ 7— ❑ er. Rtl Other: ore -at E❑ ❑ r ❑er: _ Z tt - (� jK ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFT IENCIES. ERVED 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 Beady, Building -)g -D PRO SMAI<Fys/0 ;fit NC, 9T � C � na FXp I2 0468�0 m �\ REQUIftEMEMS FOR BUILDING INSPECTION BY AUTHORIZED @APLOYEES OF THE CITY OF NEWORT BEACH. ^rix- f,r}r, 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 (949) 644-3200 Structural Observation Report Project Address: Report Date: wf� _ CNB Inspector Name: CNB Permit #: �ss6 DATE OBSERVED ❑nvention F 6 & n s tab ❑ C ncrete Building Owner Name: _ Owner's Meiling Address (1f different from site); Owners Telephone #: CNB Plan Check A n ❑ Me n, ❑ ❑ Deck Full Name of Stru ral Observer D): SO E-mail Ad SO Telephone t. SO License I Reg. #: 12 W Wood 4 -11, PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check applicable boxes) FOUNDATI 8 8 EAR W FRAM DIAPHRAGMS FIO"1R INDICATE LOCATIONM OBSERVED DATE OBSERVED ❑nvention F 6 & n s tab ❑ C ncrete ❑ eel ❑ oncr ❑ M ation, PreConcrete ❑ Me n, ❑ ❑ Deck [I Caiss,s, Piles, GradO Beams ❑ W or Manuf. Sh r nets ❑ ry W Wood 4 -11, ❑ Ot . ''\ ❑ er: Z Othc I 1A ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES. 13 OBS CIENC -' ❑ REPORT CONTINUED ON ATTACHED PAGES. ❑ FINAL STRUCTURAL OBSERVATION REPORT: The structure genenally cornplies with the appiroved construction documents, and all observed defidencles 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 stmchrral systems by the City of Newport Beach, Building 'SS' PROFESS/� rySMAI( /fy 2y` NO (P £Xp' �/3 j�a2 DOESNOT WAIVE ANY REQUNtEMEJUS FOR BURWN0 atSMTION BY AUTHORIZE EMPLOYEES Of THE 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 (949) 6443200 Structural Observation Report Project Address: C, �e „�„ f- Report Date: q / D 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): 50 E-mail Address' 02�- � SO Telephone #: SO License I Reg. #: E N � �i - -/ -2 -940 co q 0 P1 FASF INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check anolicable boxes) FOUNDATION SH R W LS FRAME DIAPHRAGMS (Floor! o INDICATE LOCATION(S) OBSERVED DATE OBSERVED ❑ Ccr*nflonay Footirl s & Slab ❑ Con t ❑ St 1 ❑ on ete ❑ Mat FoNwallon, PrestresseckConcrete ❑ Mas o ❑ Con to ❑ teei Deck ❑ Galass, ilex, Gra Bea s ❑ W o Manuf. ear Is 011iso ry PC Wood ❑ Oth r: ❑ Other: ❑ Other. er. Wk ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES. OBSERVED DEFICIENCIES'AND COMMS S: �® ❑ REPORT CONTINUED ON ATTACHED PAGES. ❑ FINAL STRUCTURAL OBSERVATION REPORT: The structure gemerally 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: De �Al 1. 1 am the licensed design professional retained by the owner to be in responsible ���P)l KNgFF F2C charge of the structural observation; 2. 1, or another licensed design professional whom 1 have designated above and is under r2r my responsible charge, have performed the required site visits at each significant Uj a: N0. C 045870 ;tconstruction stage to verify that the structure is in general conformance with thep approved construction documents; Exp. 12/31/ CG 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 S� CIvk �Q Division. qrF OF CALIF STAMP OF REQUIREMENTS FOR BURDINe MSPEC'TION BY AUTHORED EMPLOYEES OF THE CITY OF 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: 155, ©�•p�y� �Lv Report Date: (o/yd/)g CNB Inspector Name: CNB Permit #. L(e=) U' DATE OBSERVED DQ Conventional Footings & Slab Concrete Building' er Name: Owners Mailing Address (if different from site); Owner's Telephone #: CNB Plan Check Full Name of Structural Observer (SO): SO E-mail : Address e�t?f� SO Telephone #: 7/4)s�4-8Z6c, SO license / Reg. #: eo y,g 2 e) X ❑ W r M I. Sh r Panels u PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED check applicable boxes FOUNDATIONS SHEAR WALLS FRAMES DIAPHRAGMS (FloorlRoo INDICATE LOCATION(S) OBSERVED DATE OBSERVED DQ Conventional Footings & Slab Concrete Steel Concrete �Zf%G /av�o�A /`v/Z6Jj a ❑ Mas ry ❑Con to ❑ 1 X ❑ W r M I. Sh r Panels ❑Mas ry ❑ W ❑ er ❑ er: Other. ` 10 ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES.ZLOBSERVEUDff4eMg — IES _ ... . ❑ REPORT CONTINUED ON ATTACHED PAGES. ❑ FINAL STRUCTURAL OBSERVATION REPORT: The structure neneraliv complies with the approved construction documents, and all observed deficiency 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. 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. REOUIRFMENTS FOR BUILDING INSPECTION BY For=\StnuIwWObs" nits nWnrt mm �CFESSIONg4 F �� KHAF�, 2c2�c� rn A 0 p45870 tet. Exp• 12/31 OF THE WY of r1EWPORT BEACK CITY OF NEWPORT BEACH X;un 3130 Community Development Department I Building Division 1556 QceGA Q1vJ 100 Civic Center Dr.I P.O. Box 1768 Newport Beach, CA 92658 www.newportbeachca.aov (949) 644-3200 L;ALGREEN DOCUMENTATION COMPLIANCE CERTIFICATION ADDRESS: (;5lo'F 0Ceata [-,Z 1\A PERMITNO.: 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) 9 Franchise Hauler for Construction/Demolition Waste (65% min. reuse of nonhazardous waste) VOC Contents Limitation LJ Formaldehyde Emissions Limitation 6�/ T-24 Energy Certificate of Installations (Env., QII, Lighting, Photovoltaic, Mech., Plumb.) ® T-24 Energy Certificate of Verifications or Acceptance ( Env., QII, Lighting, Photovoltaic, Mech., /Plumb., HERS) 6Z Operations and Maintenance Manual MOISTURE CONTENT OF BUILDING MATERIAL (RESIDENTIAL CONSTRUCTION ONLY) C✓I 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. • I 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: 11 �rr &4n 0V� 07v-e«sS 4 . Date Siged: Position/Title: Notes: Forms\CALGreen Documentation Compliance Cert Form 1-2017 Project Status Report CaIC Effective: 07/30/2019 14:21 1 of 21 GO8RAL INFCFIi k ;ati E++a _ >, 3 Energy Standards Code Year: 2016 91 Project Name: MARK HAUPERT RESIDENCE Project Type: New Construction SFR Now- Address: 1556 OCEAN BLVD. City / State / Zip: Newport Beach / CA / 92661 L 1 Enforcement Agency: City of Newport Beach ❑ ■ ■ ■ Permit Number: X2018-3130 Easy to Verify @ calcerts.com HERS VERIFIABLECOMPLETE MEASURES: OVERALL STATUS: COMPLETE G li1 TT U ke of,Co4np iPP� fG i» e4l+�#ed Ei rgyiFeatures) r Certificate Type: Compliance Registered Form: CF1R-PRF-01 Registered Date: 04/04/2019 10:09 Registration Number: 219-P010078369A-000-000-0000000-0000 Tr u3' mu rte°t � � �.+ 7, rl ?3(Z#.` �Sx#"sMF .., Mu: X '��E£Aa'd + .R 2 .. 5" £ai'." r Ss. r�z#,mxa ✓< CF1R-SRA-Ol 07/30/2019 219-P010078369A-R01001A (Solar Ready Area) 12:39 Michael Terry 41 (GRAYSTONE CUSTOM BUILDERS INC) sofTn# '�..��z',S;�Rss�7:1�k' t �'P!P,er mstailetiAn of recd �Fed7 " �T�A�i'?�'�dti a?t1a" .k(NE mti iy �- CF2R-ENV-01-E 07/30/2019 219 P010078369A-000-001-E01001B-0000 (Fenestration Installation) 14:19 Michael Terry 4 (GRAYSTONE CUSTOM BUILDERS INC) CF2R-ENV-03-E 07/30/2019 219-P010078369A-000-001-E03001B-0000 (Insulation Installation) 14:19 Michael Terry (i% (GRAYSTONE CUSTOM BUILDERS INC) CF2R-LTG-01-E 07/30/2019 219-P010078369A-000-001-LO1001B-0000 (Lighting) 14:19 Michael Terry (GRAYSTONE CUSTOM BUILDERS INC) CF2R-MCH-01-E 219-P010078369A-000-001-MO1001B-0000 (Space Conditioning 14/19/2019 Michael Terry Systems, Ducts and Fans) (GRAYSTONE CUSTOM BUILDERS INC) CF2R-MCH-20-H 07/30/2019 System 1 (Duct Leakage) 14:19 MI haelTerry369A-000-001-M20002B-0000 (GRAYSTONE CUSTOM BUILDERS INC) CF2R-MCH-20-H 07/30/2019 System 2 (Duct Leakage) 14:19 Michael Terr8369A-000-001-M20003B-0000 (GRAYSTONE CUSTOM BUILDERS INC) CF2R-MCH-23-H 07/30/2019 System 1 (Airflow) 14:19 M1 haelTerry369A-000-001-M23002B-0000 (GRAYSTONE CUSTOM BUILDERS INC) HERS Provider: CaICERTS Inc. rn o���ia:..., v..,....., ofn..::..,,.., c«......�....a.. nn�c n....:,+....«:..i r........r......,, n.... nm c Project Status Report CaICERTS, Inc Effective: 07/30/2019 14:21 2 of 2 System 2 CF2R-MCH-23-H 07/30/2019 219-P010078369A-000-001-M23003B-0000 Michael Terry 41 (Airflow) 14:19 (GRAYSTONE CUSTOM BUILDERS INC) System 1 CF2R-MCH-22-H 07/30/2019 219-P010078369A-000-001-M22002B-0000 Michael Terry (Fan Efficacy) 14:19 (GRAYSTONE CUSTOM BUILDERS INC) System 2 CF2R-MCH-22-H 07/30/2019 ,)— Michael Terry (Fan (Fan Efficacy) 14:19 (GRAYSTONE CUSTOM BUILDERS INC) CF2R-MCH-26-H 07/30/2019 -PO10078369A-000-001-M26002B-0000 System 1 (Rated Equipment) 14:19 1219 Michael Terry (GRAYSTONE CUSTOM BUILDERS INC) System 2 CF2R-MCH-26-H 07/30/2019 219-P010078369A-000-001-M26003B-0000 Michael Terry (Rated Equipment) 14:19 (GRAYSTONE CUSTOM BUILDERS INC) CF2R-MCH-27-H 07/30/2019 219-P010078369A-000-001-M27001B-0000 Michael Terry (IAQ and MV) 14:19 (GRAYSTONE CUSTOM BUILDERS INC) CF2R-PLB-02-E 07/30/2019 219-P010078369A-000-001-B02004B-0000 Michael Terry (SD HWS Distribution) 14:19 (GRAYSTONE CUSTOM BUILDERS INC) C 3A i#idat k f - i t :rfilsr i t ve PFA"afigt � �4r$) ', : Iyer • � CF3R-MCH-20-H 07/30/2019 219-P010078369A-000-001-M20002B-M20B System System 1 (Duct Leakage) 14:20 Rex Hoefer Dang (REX QUE HOEFERDANG) CF3R-MCH-20-H 07/30/2019 219-P010078369A-000-001-M20003B-M20B System 2 (Duct Leakage) 14:20 Rex Hoefer Dang (REX QUE HOEFERDANG) CF3R-MCH-23-H 07/30/2019 219 P010078369A-000-001-M23002B-M23B System 1 (Airflow). 14:20 Rex Dang (REX QUE QUE,- HOEFERDANG) CF3R-MCH-23-H 07/30/2019 219-P010078369A-000-001-M23003B-M23B System 2 (Airflow) 14:20 Rex Hoefer Dang (REX QUE HOEFERDANG) CF3R-MCH-22-H 07/30/2019 219-P010078369A-000-001-M22002B-M22B System 1 (Fan Efficacy) 14:20 Rex Hoefer Dang (REX QUE HOEFERDANG) CF3R-MCH-22-H 07/30/2019 219-P010078369A-000-001-M22003B-M22B System 2 (Fan Efficacy) 14:20 Rex Hoefer Dang (REX QUE HOEFERDANG) CF3R-MCH-26-H 07/30/2019 219-P010078369A-000-001-M26002B-M26B System 1 (Rated Equipment) 14:20 Rex Hoefer Dang 4 (REX QUE HOEFERDANG) CF3R-MCH-26-H 07/30/2019 219-P010078369A-000-001-M26003B-M26B System 2 (Rated Equipment) 14:20 Rex Hoefer Dang (REX QUE HOEFERDANG) CF3R-MCH-27-H 07/30/2019 219-P010078369A-000-001-M27001B-M27B (IAQ and MV) 14:20 Rex Hoefer Dang (REX QUE HOEFERDANG) HERS Provider: CaICERTS Inc. rn o��ua:.... v.....,.., ou:,.:,......, aa....w....a,. nn�c n,...�a...a;..i r.......r......., n..,. ons e