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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
Structural Observation Report
Project Address:
1651 Pegasus St. Newport Beach CA92707
Report Date:
03/03/2021
CNB Inspector Name:
CNB Permit #:
Building Owner Name:
Owner's Mailing Address (if different from site);
Owner's Telephone #:
CNB Plan Check #:
Shawn Hunt
909-945-8505
Full Name of Structural Observer (SO):
SO E-mail Address:
SO Telephone #:
SO License / Reg. #:
Sami Maalouf
sami@midesigncorp.com
818-402-4485
C53210
PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check aoolicable boxes)
FOUNDATIONS
SHEAR WALLS
FRAMES
DIAPHRAGMS
(Floor/Roof)
INDICATE LOCATION(S)
OBSERVED
DATE
OBSERVED.
0 Conventional
Footings & Slab
❑ Concrete
❑ Steel
❑ Concrete
Simpson hanger
03/03/2021
❑ 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:
It is okay the way that two hangers were welded in the field.
The two hangers above the back door were welded in the field are safe and sufficient.
❑ 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.
03/03/2021
DATE
No. C53210
EqL 06-3--21
.TAMP CIF gTRI ICTI IRAI
STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BYAUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH.
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