HomeMy WebLinkAboutX2017-2417 - Misc (2)X28972417
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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
CIVIL ENGINEER'S CERTIFICATION FORM
From:
Forkert Engineering & Surveying, Inc.
22311 Brookhurst St, Ste 203
Huntington Beach, CA 92646
ATTENTION: GRADING ENGINEER, BUILDING DIVISION
Date:
September 6, 2019
GPC No.: 1720-2017 Tract/Subdivision/Lot No.:
Rough: _Final: x
Project Names: 15 Deerwood Lane
Owner/Developer: Deerwood LLC
Type of Project: Notes:
_Tract: _ Drainage SFR
_ Commercial x Other
Industrial
Yardage for Project: Notes:
27 Cut: Borrow:
16 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: in conformance with,
with the following
changes to the approved grading plan.
Description of Changes:
FESS/0
� 9G
Company: Forkert Engineering & Surveying; Inc.
NO. 58627
Name: <-10 P'i (7
{r 12-31-20
(print)
8'Tq� CIVIC- wS4
License No.: RCE 58627
OF CAS
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 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 training.
Engineer/Surveyor's Name 1'4\W4`.1 j6 License #
Engineer/Surveyor's Address 47�1dt fId<-,ro ujow S^I'
Job Address IC�> . = W F),
Setbacks: Sketch a site plan and specify surveyed setbacks (use back page).
* Top of slab/floor elevation: m ,�o
* 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:'
Date
Forms/SetbacksandTopolSlabElcw.rtic
isms not ❑, per City approved drawings. Describe
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August 14, 2018
R3'
A TRUSTED PARTNER IN
INNOVATION, QUALITY & SERVICE
Re: IS Deer Wood Lane, Newport Beach, CA 92660
Project No: GE 64431
To Whom It May Concern:
Basil Ammari has been employed with Gouvis Engineering Consulting Group, Inc. since
February 2, 2004 and is still a current employee as our Vice President, Field Operations.
Zhengyang Liu (Alex) has been employed with Gouvis Engineering Consulting Group, Inc.
since August 1, 2017.
1 give authority to Alex and Basil to inspect on behalf of myself for the structural observations.
If you have any questions, please do not hesitate to contact me at (949) 752-1612.
Sincerely,
GOUVUS ENGINEERING CONSULTING GROUP, INC.
Dissakorn Eosakul
License No. C67588 / S5226
Expiration date 06/30/2019
949.752.1612
F,x °,193s,i. 53'1
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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
BUILDING HEIGHT CERTIFICATION
Project Street Address: 15 Deerwood Lane
Building Permit Number(s): 1720-2017
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 nailing 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 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 (3:11 slope or greater)
1. Approved elevation point of ridge is 133.58' and actual elevation point is 133.26'
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:
OIS in compliance with the City -approved plans.
O15 NOT in compliance with the City -approved plans (Provide explanation).
Please describe any deviation from the City -approved plans on
4
Surveyor or Civil Engineer's* signature and seal
(Wet stamp and signature required)
* License number of 33965 or lower
Fo m \Build ng Height Certification 11/02/16
4/1312018
Date
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 17681 Newport Beach, CA 92658-8915
www.newpoitbeachca.gov ( (949) 644-3200
BUILDING HEIGHT CERTIFICATION
Project Street Address: 15 Deerwood Lane
Building Permit Number(s): 1720-2017
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 O Assumed
Please provide the following elevation information far 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 133.58' and actual elevation point is 133.26'
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:
O 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
0 4/13/2018
Surveyor or Civil Engineer's* signature and seal �k i Date
(Wet stamp and signature required)
* License number of 33965 or lower
ro=NBuilding Height Certification 11102/16
CITY OF NEWPORT BEACH
COIAIUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
ww,N.newoortbeachca.gov 1(949)644-3200
PRE -GRADE MEETING AGREEMENT
DATE: Il/ 91/ 3 C.? i '.Z 0O 7 JOB ADDRESS: / ��C�'Z!2 !� %COC9%j C -!t%'•
1. The grading plan check number for this site isX1011 - 'ZN/1 and will be referred to in all reports, certifications
and correspondence.
2. 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.
3. The stamped set of approved plans shall be on the job site at all times.
4. 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 conformance with the approved grading plans, the discrepancies shall be reported immediately 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.
5. When import or 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.
6. 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 shall 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.
7. 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.
8. All trench (including interior and exterior utility trenches) and retaining wall backfill shall be compacted
throughout to a minimum of 90 percent relative compaction and approved by the soils engineer.
9. Whenever work on which required inspection/testing is covered by additional work without first _being
inspected/tested, 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.
10. Landscaping of all slopes and pads shall be in accordance with 15.10.130 of the NBMC.
11. Approved drainage provisions shall be used to protect adjoining properties during the grading operation.
12. The permittee or his agent shall notify the Building Division when the grading operation is ready for each of the
following inspections:
a. PRE -GRADE MEETING When the permittee 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 When all rough grading has been completed, the rough grade report shall be provided to
the Building Inspector at foundation inspection or sooner based on the Building Inspector'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.
13. 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.
14. 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.
15. 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.
16. 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.
17. All parties listed below must be present for the pregrade meeting unless approved by the building inspector.
OWNER/CONTRACTOR: C IV/0
By. Afto
Address:
Telephone: 'C'e
GEOTECHNICAL ENGINEER:
By:
Address:
Telephone:
GRADING CONTR.: 7/1 6 bviJ7
By:
A.
Address:
Telephone: --) ( Y) G
DESIGN CIVIL ENGR.: TQ4, ?_L&1t
By: U'�ILztiT s N0x E�lk6-
Address: ST ST6.Za3 N-13, cA
Telephone: Ig— 963 — W13
GEOLOGIST.:
By:
Address:
Telephone:
COORDINATOR:
By:
Address: B��I` S+-, SAF \SO
Telephone: f�i� Z JLIZOO
NEWPORT BEACH REPRESENTATIVE: PHONE M 6411 32-(10
INSPECTION REQUESTS: (949)644-3255
Newport Beach Construction Hours:;
Monday through Friday: 7:00 a.m. to 6:30 p.m
Saturdays: 8:00 a.m. to 6:00 p.m.
No work on Sundays and Holidays
Fonns�pregrade meeting agreement 8-12
SHEET '°"
DATE OF 31 RECORD OF SURVEY NO. 2017-1026
201:
JANUARY JI, 2°I]
IN THE CITY OF NEWPORT BEACH, COUNTY OF ORANGE, STATE OF CALIFORNIA.
BEING A SURVEY OF LOT 101, TRACT NO. 7838, AS SHOWN ON A MAP FILED IN
MISCELLANEOUS MAP BOOK 306, PAGES 1 THROUGH 9, INCLUSIVE,
RECORDS OF ORANGE COUNTY, CALIFORNIA.
MICHAEL D. TORTOMASI R.C.E. 28328
ACCEPTED AND FILED AT ME
REQUEST OF
THE ORANGE COUNTY SURJEYOR's OFFICE
GATE uk*p� ��i � /,zjZalx
TIME yc�FEE 6 _ap /] AA
INSTRUMENT NO 28A/Md s 906
BOOK.ZOZ PAGEGG 1"
HUGH NGUYEN
C,O.UAN�TY T ERHNIY CLERHY
BY w.a
DEPUTY
41; 16' E
P ONL OY 300W 11 PW AIL 2800 RMNL 96.00'
'\ " g66B.00' 0=10'56'99' L -I O6. B2'
0]6'
6 5005' D�19'98 IS'R 9'R9j 5'36'58' L63. 26'
H; `ea• E L43.66 (53.6]'1 fOUNO
M D' )
P' a4j N 5' IS' O6' W 3 U D D. PFA RACCEI P E0 IIT 3931
iWND 2' iP/CONL 1W R „X BS'. PER 0 2 �' ] DX
\ •"�o Chi ONO N 1. ND PEG, e 5'0<']3" E B.13' NE39''319%P-1 OB6' 0]
\ - N IDUYIB' W 0.15' t
1\2
y\4 R6, TRACT NO. 783B
100 �,as
101 N
\ � wi � • h5 `N
CANAL
3, R6' 13.31' vo
Nm AAUE FEE. AT ID, °j6 OSS 0.^L B.DB' MRI 1'f Al LR ' 11 YDZZi
\ $� 6LE TROT PMP ERIY FOU NB 1' E TEl, O
CORXEfl LOT 99-100 0\ NS 3348 PER RI ON IO
PER R1. ,y 3T 16'Rfi" E DOG'
PYQFOUND 11
•• ERED PER X�E . MM3081L9 •� F �� 9D�---------------------
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0,P¢ z 3 Pb.UD
I" IP TAGGED
N ae PER Rl.
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NT599'OB' / l0'S6'DY E
y/ FOUND SPIKE aEa R1.
1'=30' ,\ IS ..'°s� $. .� DNDO.z'
F °J w e ,TU. a / 3 CURVE TABLE:
R_13DD3' TNI
�3 O 0.159]09' ,P1
az m' MAI
�yY't.7� cz p.III71 RI
sl (.2
. ( s'z z'sal
J i A' L-4p.J5' (9086 )
N 3]'8B'10' E` a% 4l g? C] q=B30O' MFfl1
] i P,N. Rfi.OD' R, Q y,d` p a1 31'14 ((26'39'14"1
KI G4G¢ a 2,.�(129IT)
BURNING TREE za�e "/ �`, °a o=i'FR -.1
ROAD J � �yR 1.]65\T UIS. 7`,a RI
(PRIMATE sWEED 4J� \., °ITL w. _D
BASIS OF BEARINGS:
THE BASIS OF BEARINGS FOR THIS SURVEY IS THE CENTERLINE
CHORD FOR BURNING MEE ROAD BEING N 52 53' °B" W
PER RI AS SHOWN HEREON,
STATEMENT OF PURPOSE:
THE PURPOSE OF THIS SURVEY 15 TO REESTABLISH AND REMONUMENT
THE SOUTHEASTERLY PROPERTY CORNERS OF LOT 101, TRACT NO, 7638,
PER A MAP FILED IN MISCELLANEOUS MAP DOOR 305. PAGES 1-9,
RECORDS OF ORANGE COUNTY, CALIFORNN,
MONUMENT NOTES:
• FOUND BRASS DISC IN CRY OF NEWPORT SUCH WELL PER RI
ON 1.2'.
•1 FOUND SNA55 DISC IN CITY OF NEWPORT BEACH WELL PER RI
ON 1.2'. S 63'16'39' W 0.09'
0
2 FOUND MONUMENT AS NOTED,
O SET LEAD k TAG RCgo,E 28328 ON SIDEWALK ON PROPERTY LINE
01 SET
PROLONGATION
TAG RO
CE 28320 OFFSET FCORNER.ROM PROPERTY
ON SIDEWALK N
LEAD 6M°IAL UNE
400' OFFSET FROM PROPERTY CORNER.
M MEASURED DATA PER THIS SURVEY.
STN SEARCHED, FOUND NOTHING.
REFERENCE NOTES:
RI OR ( ) RECORD (OR COMPUTED FROM RECORD) INFORMATION PER
TRACT N0. ]638. PILED IN MISCELLANEOUS MAP BOOK 3°0.
PAGES 1-9. RECORDS OF ORANGE COUNTY, CALIFORNIA.
ENGINEER'S STATEMENT:
THIS MAP CORRECTLY REPRESENTS A SURVEY MADE BY ME OR UNDER MY
DIRECTION IN CONFORMANCE WITH ME REQUIREMENTS OF ME PROFESSIONAL
LAND SURVEYORS' ACT AT THE REQUEST OF CRAIG NO2MA IN JANUARY,
//•APV NU /A Y -S -spit
MICHAEL 0.31-201 R.QE. 28328 GATE
EXPIRES 3-31-2018
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HE
COUNTY SURVEYOR'S STATEMENT:
THIS MAP HAS BEEN EXAMINED IN ACCORDANCEyIITH
PROFESSIONAL UND SURVEYORS' ACT ME _('LCDAY
SECTION 8]611 OF ME
OF A? MA
2017.
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xz017 2417
15 Deerwoo8 Ln
CITY OF NEWPORT BEACH 6115
.OAMVNI1 A "MV LOPNIM�Ni TETtRTrNAMAiT
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:
Report Date:
2 3- Zol
CNB Inspector Name:
CNB Permit #:
15 Oe e w e,
-!
DATE
?-01V1F1zy1-7
Building Owner Name:
Owners Mailing Address (if different from site);
Owner's Telephone M
CNB Plan Check*
Full Name of Structural Observer (SO):
SO E-mail Address:
-. SO Telephone #:
SO License/ Reg. A
Basil Ammad
bammari@gouvisgroup.com
949-2797410
C52030
PLEASE INDICATE STRUCTURAL ELEMENTS ARID CONNECTIONS OBSERVED (check annlicahla hnwaal
FOUNDATIONS
SHEAR WALLS
FRAMES
DIAPHRAGMS
INDICATE LOCATIONS)
DATE
Floor/Root)
OBSERVED
OBSERVED
Conventional
Footn sRSlabS%t�j
❑ Concrete
❑ Steel
❑ Concrete
/ p
❑ Mat Foundation;
❑ Masonry
❑ Concrete
❑ Steel Deck
Prestressed Concrete
❑ Caissons, Piles,
❑ Wood or Manuf.
❑ Masonry
❑ Wood
Grade Beams
Shear Panels
-�
❑ Other:
❑ Other:
❑ Other:
❑ Other:
0 ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES.
❑ OBSERVED/DEFICIENCIES AND COMMENTS:
OpPOFES$/0�
c
i WN DD No. Co520g0
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❑REPORT CON EiD PAGES.
❑ FINAL STRUCTURAL OBSERVATION REPORT-
_
The structure generally
complies with the approved
construction documents, and all observed deficie es c
1 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 with the
approved construction documents;
3. 1 understand that all deficiencies which I have documented must be corrected, prior to
final acceptance Af the structural systems by the City of Newport Beach, Building
Division.
J I AMY Ul- b I NUL; I UKAL UIiStKVtK
STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH,
Fo=, Stu um[Obsa tionRepon&]nhuctiom
POaT
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c'9trFoaN�P
CITY OF NEWPORT BEACH vclb-W,6'`a?- ?_
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www.newoortbeachcagov 1 (949) 644-3200 — L 0U �
r
Structural Observation Report
ss:
Report Date:
CNB Inspector Name:
CNB Permit #:
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wjuGKa ncaD1e
DOX..
FOUNDATIONS
r Name:
tName
Owners Mailing Address (if different from site);
Owner's Telephone #:
CNB Plan Check #:
tructural Observer (SO):
SO E-mail Address:
SO Telephone #:
SO License/ Reg. #:
A - I
M
C -Son
(2ja5S
M.
PLEASE INDWATIR RTl7l Ir'TI IOA1 01 CRACAITC Aun rr�u.,r-..r,...,.. ...... �...._
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.
3—c3—
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cc
* Exp, 12/31/18
ST9TFOF CP1%
STAMP QE STRUCTURAL QBSE
•-- �,�-�����•� �. uvea nu VVAIVZ ANT rccUUlntmtN IS FUN BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH.
Poems\Svuctun106smaiioNtcpon&Ie,s[rvction5
---------------••-•••-•••••�•+�....
�.., w,..�vuacrwcv
wjuGKa ncaD1e
DOX..
FOUNDATIONS
SHEAR WALLS
FRAMES
DIAPHRAGMS
INDICATE LOCATION(S)
DATE
(Flood of)
OBSERVED
OBSERVED
❑ Conventional
❑ Concrete
❑ Steel
❑ Concrete
S�Gv, �,�•_ t •,�
Footin s 8 Sla
❑ Mat Founda' n,
❑ Masonry
❑ Concret
❑ Steel Deck
Prestressed ncrete
❑ Caisson , Piles,
❑ Wo or Manuf.
❑ Me my
❑ Wood
Grade eams
S ear Panels
❑ Oth
❑ ther:
❑ ther:
Other:
tGU �
.e Ia QV
❑ ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENICHES.
❑ OBSERVED DEFICIENCIES AND COMMENTS:
LCA •^-.... c✓.. � ac. r. c+ ..
,,
�,. K) �
d ;
❑ 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.
3—c3—
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m NO. C052030
cc
* Exp, 12/31/18
ST9TFOF CP1%
STAMP QE STRUCTURAL QBSE
•-- �,�-�����•� �. uvea nu VVAIVZ ANT rccUUlntmtN IS FUN BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH.
Poems\Svuctun106smaiioNtcpon&Ie,s[rvction5
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.Qov1(949)644-3200
Structural Observation Report
Project Address:
15 Deerwood Lane
Report Date:
4-16-2018
CNB Inspector Name:
CNB Permit #:
X2017-2417
Building Owner Name:
Owner's Mailing Address (if different from site);
Owners Telephone #:
CNB Plan Check #:
Full Name of Structural Observer (SO):
SO E-mail Address:
SO Telephone #:
50 License I Reg. #:
Basil Ammari
bammari@gouvisgroup.com
949-2797410
C52030
PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check aoolicable boxes)
FOUNDATIONS
SHEAR WALLS
FRAMES
DIAPHRAGMS
(Floor/Roof)
INDICATE LOCATION(S)
OBSERVED
DATE
OBSERVED
❑ Conventional
Footings & Slab
❑ Concrete
❑ Steel
❑ Concrete
Roof sheathing observation only.
4-16-18
❑ Mat Foundation,
Prestressed Concrete
❑ Masonry
❑ Concrete
❑ Steel Deck
❑ Caissons, Piles,
Grade Beams
❑ Wood or Manuf.
Shear Panels
❑ Masonry
M 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. 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.
914SU
4-16-18
DATE
i No. C052030
Exp. 12/31/18
STAMP OF STRUCTURAL OBSERVER
STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH.
Famu'\S W clurelObserve[ianRcporl&Ire W cfiare
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:
15 Deerwood Ln, Newport Beach, CA
Report Dale:
5/16/2018
GNB Inspector Name:
CNB Permit#:
Building Owner Name:
Owner's Mailing Address (if different from site);
Owner's Telephone #:
CNB Plan Check#:
Manning Homes
20151 SW Birch St Suite 150. Newport Beach, CA
949-250-4200
1720-2017
Full Name of Structural Observer (SO):
SO E-mail Address:
SO Telephone #:
SO License / Reg. #:
Basil Ammari
bammari@gouvisgroup.com
949-752-1612
C052030
PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check applicable boxes)
FOUNDATIONS
SHEAR WALLS
FRAMES
DIAPHRAGMS
(FloorlRoo
INDICATE LOCATION(S).
OBSERVED
DATE
OBSERVED
❑ Conventional
Footings & Slab
❑ Concrete
LI Steel
❑ Concrete
❑ Mat Foundation,
Prestressed Concrete
❑ Masonry
❑ Concrete
❑ Steel Deck
❑ Caissons, Piles,
Grade Beams
MI 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. 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. _ J
r�
i No. C052030
Exp. 12/31/18
STAMP OF STRUCTURAL OBSERVER
STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH.
. cross Strueu,rnlabscrvationHcpon&Inxlnmtium
September 16, 2019
Dear Mr. Manning:
X2097.A17
15 Deeavood Ln
The residential elevator installed at 15 Deerwood Lane, Newport Beach, CA 92660, was built
according to ASME A17.1 codes by the manufacturer and installed by McKinley Elevator
Corporation, a State -licensed conveyance company, in accordance with ASME 5.3 2004.
Attached are copies of both our state contractor's license and our certificate as a State -licensed
installer of conveyances.
If you have any questions regarding this elevator. I may be contacted at (949) 261-9244 or
marknmekinlevelevator.com.
Sincerely,
Mark McKinley
McKinley Elevator
1761 1 Armstrong Avenue1061555 Fulton Street, Suite 202
Irvine, California 92814 San Francisco, California 94102
949/261.-9244 415/526-9951
FAX 949/S55-3675 vAA/w.mcklnleyelevator.com FAX 4151626-9954
CONTRACTORS
sraacriuiicEA
n°i°sR°
wTACw 114
861406 -.CORP
MCKINLEY ELEVATOR
CORPORATION
_.....m.,.. C11 CG 1021 CGi>'B24
07i3ii2021 www.csin.ca gov
X2Oil -zsl7
15 Deerwooc81n
wpo CITY OF NEWPORT BEACH
,? °n Community Development Department Building Division
N o 100 Civic Center Dr.1 P.O. Box 1768 Newport Beach, CA 92658
o
www.newportbeachea.gov (949) 644-3200
o �T
qt/kONt`.
CALGREEN DOCUMENTATION COMPLIANCE CERTIFICATION
ADDRESS: 15 Deerwood Lane, Newport Beach 92660 PERMIT NO.: X2017-2417
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)
t� Franchise Hauler for Construction/Demolition Waste (65% min. reuse of nonhazardous waste)
dJ VOC Contents Limitation
Formaldehyde Emissions Limitation
>� T-24 Energy Certificate of Installations (Env., Qll, Lighting, Photovoltaic, Mach., Plumb.)
S6 T-24 Energy Certificate of Verifications or Acceptance ( Env., QII, Lighting, Photovoltaic, Mech.,
Plumb., HERS)
f� Operations and Maintenance Manual
MOISTURE CONTENT OF BUILDING MATERIAL (RESIDENTIAL CONSTRUCTION ONLY)
16 1 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
I certify under penalty of perjury, under the laws of the State of California, the information
provided is true and correct.
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.
Person's Name:
Michael Manning
9/10/19
Notes:
Forms\CALGreen Documentation Compliance Cert Form i-tuv
Project
Project Status Report CaICERTS, Inc
Effective: 09/06/2019 10:09 1 of 3
Energy Standards Code Year: 12016
Project Name:]15 Deerwood Lane
Project Type: New Construction SFR
Address: 15 Deerwood Lane
City / State / Zip: Newport Beach / CA / 92660
Enforcement Agency:1City of Newport Beach
Permit Number:IX2017-2417
MEASURES:ICOMPLETE
Registered Date: 09/04/2019 09:35
Registration� `
Number: 217-P010253146D Q00-000-0000000=0(500
Number]
Easv to Verifv @ calcerts.com
CF1R-SRA-01 09/06/2019 3aym
(Solar Ready Area) 10:07 (Maxi Carden
(Maximum Performance
HERS Provider: CaICERTS Inc.
rn o,�n.+:..,. r..,....., rcc:..:,...,.., c•-..a-�a� �m c n....:a....�:..i r�,......r......,, n.... onm
CF2R-ENV-0I-E
09/05/2019
Craig Kozma ---- VVV ---------- ----
(Fenestration Installation)
11:25
(Manning Homes)
CF2R-ENV-03-E
09/05/2019
217-P010253146D-000-001-E03001A-0000
Craig Kozma
(Insulation Installation)
11:25
(Manning Homes)
CF2R-ENV-21-H
09/05/2019
217-P010253146D-000-001-E21001B-0000
(QII-AIS-Batt, Loose Fill,
11:25
Craig Kozma
and SPF)
(Manning Homes)
CF2R-ENV-22-H
09/05/2019
217-P010253146D-000-001-E22001A-0000
Craig Kozma
(QII-Air Infiltration Sealing)
11:25
(Manning Homes)
CF2R-ENV-23-H
09/05/2019
217-P010253146D-000-001-E23001B-0000
Craig Kozma
(QII-Installation)
11:25
(Manning Homes)
CF2R-LTG-01-E
09/05/2019
217-P010253146D-000-001-LO1001A-0000
Craig Kozma
(Lighting)
11:25
(Manning Homes)
CF2R-MCH-01-E
09/06/2019
217-P010253146D-000-001-MO1001B-0000
(Space Conditioning
09'58
Craig Kozma
Systems, Ducts and Fans)
(Manning Homes)
HERS Provider: CaICERTS Inc.
rn o,�n.+:..,. r..,....., rcc:..:,...,.., c•-..a-�a� �m c n....:a....�:..i r�,......r......,, n.... onm
Project Status Report CaICERTS, Inc
Effective: 09/06/2019 10:09 2 of 3
System 1
CF2R-MCH-20-H
09/06/2019
217-P010253146D-000-001-M20002A-0000
Craig Kozma
(Duct Leakage)
09:58
(Manning Homes)
System 2
CF2R-MCH-20-H
09/06/2019
217-P010253146D-000-001-M20003A-0000
Craig Kozma
(Duct Leakage)
09:58
(Manning Homes)
System 3
CF2R-MCH-20-H
09/06/2019
217-P010253146D-000-001-M20004A-0000
Craig Kozma
(Duct Leakage)
09:58
(Manning Homes)
System 1
CF2R-MCH-23-H
09/06/2019
217-P010253146D-000-001-M23002A-0000
Craig Kozma
(Airflow)
09:58
(Manning Homes)
CF2R MCH -23-H
09/06/2019
217-P010253146D-000-001-M23003A-0000
System 2
(Airflow)
09:58
Craig Kozma
(Manning Homes)
System 3
CF2R-MCH-23-H
09/06/2019
217-P010253146D-000-001-M23004A-0000
Craig Kozma
(Airflow)
09:58
(Manning Homes)
System 1
CF2R-MCH-22-H
09/06/2019
217-P010253146D-000-001-M22002A-0000
Craig Kozma
%
(Fan Efficacy)
09:58
(Manning Homes)
System 2
CF2R-MCH-22-H
09/06/2019
217-P010253146D-000-001-M22003A-0000
Craig Kozma
(Fan Efficacy)
09:58
(Manning Homes)
CF2R MCH -22-H
09/06/2019
217-P010253146D-000-001-M22004A-0000
System 3
(Fan Efficacy)
09:58
Craig Kozma
(Manning Homes)
CF2R-MCH-27-H
09/06/2019
217-P010253146D 000-001-M27001A-0000
Craig Kozma
(IAQ and MV)
09:5,8
(Manning"Ho'mes)
CF2R-PLB-02-E
09/05/2019
217-P010253146D-000-001-B02006A-0000
Craig'Kozma
(SD HWra_Distribution)
7,1:25
(Manning Homes)
CF3R-ENV-21-H
09/06/2019
217-P010253146D-000-001-E21001B-E21A
(QII-AIS-Batt, Loose Fill,
10:08
Jayme Carden
and SPF)
(Maximum Performance Housing, Inc.)
CF3R-ENV-22-H
09/06/2019
217-P010253146D-000-001-E22001A-E22A
Jayme Carden
(QII-Air Infiltration Sealing)
10:08
(Maximum Performance Housing, Inc.)
CF3R-ENV-23-H
09/06/2019
217-P010253146D-000-001-E23001B-E23A
Jayme Carden
(QII-Installation)
10:08
(Maximum Performance Housing, Inc.)
System 1
CF3R-MCH-20-H
09/06/2019
217-P010253146D-000-001-M20002A-M20A
Jayme Carden
(Duct Leakage)
10:08
(Maximum Performance Housing, Inc.)
System 2
CF3R-MCH-20-H
09/06/2019
217-P010253146D-000-001-M20003A-M20A
Jayme Carden/
(Duct Leakage)
10:08
(Maximum Performance Housing, Inc.)
System 3
CF3R-MCH-20 H
09/06/2019
217-P010253146D-000-001-M20004A-M20A
Jayme Carden
(Duct Leakage)
10:08
(Maximum Performance Housing, Inc.)
System 1
CF3R-MCH-23-H
09/06/2019
217-P010253146D-000-001-M23002A-M23A
Jayme Carden
(y
(Airflow)
10:08
(Maximum Performance Housing, Inc.)
System 2
CF3R-MCH-23-H
09/06/2019
217-P010253146D-000-001-M23003A-M23A
Jayme Carden
(Airflow)
10:08
(Maximum Performance Housing, Inc.)
System 3
CF3R-MCH-23-H
09/06/2019
217-P010253146D-000-001-M23004A-M23A
Jayme Carden
(Airflow)
10:08
(Maximum Performance Housing, Inc.)
HERS Provider: CaICERTS Inc.
Project Status Report CaICERTS, Inc
Effective: 09/06/2019 10:09 3 of 3
System 1
CF3R-MCH-22-H
09/06/2019
217-P010253146D-000-001-M22002A-M22A
Jayme Carden
(Fan Efficacy)
10:08
(Maximum Performance Housing, Inc.)
CF3R-MCH-22-H
09/06/2019
217-P010253146D-000-001-M22003A-M227
System 2
(Fan Efficacy)
10:08
Jayme Carden
(Maximum Performance Housing, Inc.)
System 3
CF3R-MCH 22 H
09/06/2019
217-P010253146D-000-001-M22004A-M22A
Jayme Carden
(Fan Efficacy)
10:08
(Maximum Performance Housing, Inc.)
F(Maximum
CF3R-MCH-27-H
09/06/2019
217-P010253146D-000-001-M27001A-M27A
Jayme Carden
(IAQ and MV)
10:08
Performance Housing, Inc.) -
HERS Provider: CaICERTS Inc.
�n o..:u�..., c........, cac:..:....,.., c«,.. a...,�.. �n� c n,...: a,...«:..i r.......u.,....,, n,... �m c
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
CONTRACTOR/PROPERTY OWNER SELF -CERTIFICATION DECLARATION
FOR PLUMBING FIXTURE REPLACEMENT
Project Address: 15 Deerwood Lane, Newport Beach 92660
Date: 9/10/19
Permit #:X2017-2417
The following is to be completed by the California licensed contractor or owner, participating in the City of Newport
Beach Self -Certification Program. Please type or print.
Installer's Name: Trilogy Plumbing License No (if applicable)
Installer's Mailing Address: Phone # (required): (714) 888-8575
Installer's Email: mlangenwalter@matrixbeyond.com 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
�Gt�Z�2jLf�f/?/L 9/10/19
Instal 's Signature Date
Property Owner (Required)
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 installatio corn
.Li�e_ 9/10/19
Property Owk!ry signature Date
Michael Manning michael@manninghomes.com
Print Name Email
This form must be completed and returned to the City of Newport Beach, Building Division, for a final approval
of the combination permit. Please return this form to the Building Division by mail or fax.
Please mail to: City of Newport Beach
Community Development Department
Building Division
P. O. Box 1768
Newport Beach, CA 92658
Forms\Contractor-OwnerSelf-CertDeclaralion-Plumbing Fixture Replacement 08/11/16
Phone: (949) 718-1888
Fax #: (949) 644-3250
CITY OF NEWPORT BEACH
Community Development Department I Building Division
w '•,'' r 100 Civic Center Dr.1 P.O. Box 1768 1 Newport Beach, CA 92658
www.newl)ortbeachca.gov 1 (949) 644-3200
°trroaT'�"
FORMALDEHYDE EMISSIONS VERIFICATION CHECKLIST
ADDRESS: 15 Deerwood Lane, Newport Beach 92660 PERMIT NO.: X2017-2417
Formaldehyde emissions verification of non-structural engineered wood, hardwood plywood, particleboard,
and medium density fiberboard composite wood shall be identified on this checklist. Formaldehyde limits
shall meet the limits specified in the 2016 Edition of the CAL Green Code.
Attach product specification sheets and other supporting documents. Use additional sheets, if necessary.
y
o ss".:r F.v
Prod[ft�t d8te
v( BaP per,
t,i.. s sd✓h.F'S-,tye�.' f .:w�, isr
,s.��,{.�,
L "` y
?:,^",¢¢rk,,rC.a.. Y5/�7p,,;'r. " �,.
,
,r .,rfs. r.o._d,_ at. ,
„ dp
r?t�)�
k`f
sTh
Ba d
1
Plywood
Subfloor
Roseboro
.002
.05
2
MDO / Extira
Building Wrap
Jeld Wen
0
.05
3
MDF
Cabinets
William Ohs
0
.05
NOTES:
Forms Formaldeh de Emissions Verifications Checklist 12-2016
i� wpokT CITY OF NEWPORT BEACH
° .' ° Community Development Department I Building Division
n 100 Civic Center Dr.] P.O. Box 1768 Newport Beach, CA 92658
f www.newportbeachca.gov (949) 644-3200
cOtiron��p
VOC CONTENT VERIFICATION CHECKLIST
ADDRESS: 15 Deerwood Lane, Newport Beach 92660 PERMIT NO.: X2017-2417
VOC content verification of paints, coatings, carpets, cushions, resilient flooring, adhesives, sealants, and
caulks shall be identified on this checklist. VOC limits shall meet the limits specified in the 2016 Edition of the
CAL Green Code.
Attach product specification sheets and other supporting documents. Use additional sheets, if necessary.
(arcductate o s v
d00 ive)
` Id�thgProd4tcf
@�)�
i�r6sJ5�4"t"'
Mattufaetyrer
f
se 8a�a�e
�l0 r) frtF<
1
Paint
Whole House
Vista
Polytec
50
150
2
Paint
Walls
Vista
Coverall
0
50
3
Carpet
Bedrooms
Shaw
25
50
4
Wood Sealer
Whole House
Bona
Traffic
100
275
5
Wood Adhesive
Whole House
Bostik
Vapor Lack
0
100
NOTES:
Forms\VOC Content Verification Checklist 1-2017