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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 ) (949) 644-3200
Structural Observation Report
Project Address:
Report Date:
$
CNB Inspector Name:
Richard LaBare
CNB Permit #:
X2017-2161
111 45th Street
2 1 l 1 )
Building Owner Name:
Owner's Mailing Address (If different from site);
Owner's Telephone #:
CNB Plan Check #:
1533-2017
Mr. Brad Roach
949-233-4545
Full Name of Structural Observer (SO):
SO E-mail Address:
SO Telephone #:
SO License I Reg. #:
Dave Anderson
dnae@cox.net
949-587-1829
C 056407
__ _—_ nvecovcn rrhark nnnurahle howasl
I-LCA3C IN V R.A
FOUNDATIONS
r C a r muu r urv+�
SHEAR WALLS
•..-�.o�.. , ., .....- _
FRAMES
_ ...__ .. _,-_ _
DIAPHRAGMS
(Floor/Roof)
INDICATE LOCATION(S)
OBSERVED
DATE
OBSERVED
N Conventional
Footings & Slab
❑ Concrete
❑ Steel
❑ Concrete
FOOT'G, AB. & HD.
2
❑ 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:
Tha 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
QPOFESSIONq
O� PND— �Fy
charge of the structural observation;
2. I, or another licensed design professional whom I have designated above and is under
y oe 2 i
my responsible charge, have performed the required site visits at each significant
w No.0056407 m
construction stage to verify that the structure is in general conformance with the
m Exp. 6-3049 s
approved construction documents;
3. 1 understand that all deficiencies which I have documented must be corrected, prior to
mr Clvlx� 3'
9rFOFCAUFOQ�
final acceptance of thestructural 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.
Famu\9maurdOMerco,ianRepon@rnzwnions
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
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.
License # LS 7421
£rtginezr/Surveyor's Name Yefim Tsd)Tk
£wgit;eer/Surveyor's Address 34 Georgetown, Irvine, CA 92612
Job Address 11145th Street, Newport Beach
Setbacks: Sketch a site plan and specify surveyed setbacks (use back page).
* Top of slab/floor elevation:
of form elevations match existing FF of 10.10 per sheet T of
—rr--
* 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: See attached Exhibits "A" & "B".
I certify that top of slab/floor elevation(s)
any deviations from plans:
February 1, 2018
Date
is ®, is not ❑, per City approved drawings. Describe
G�
£wg4jeer/Surveyor's stamp and signature
EXP. 12/31/2019
FormslSetbacksandTopotSlabElevationCert.
No. 7421
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EXHIBIT "B"
11145TH STREET
NEWPORT BEACH
BLDG PERMIT # 1533-2017
tl
IATC>NE
rgEaT �DVE/, '
je4ocFl i
G�A RAG E
'NGNCONFOPMWG' DUE TO PARKING AIA%11.1UM
ADDITION OF 16iLOF EXISJUNG FLOOR APEA.
------- ---- -- -- E
EW COL - - - NEW ----- ADV
N
DOPE OF WORK
)DING .BA([ SF OF NEW LIVING AREA (a.6,TOTAL INCREASE) AS
TOWN IN DRA4VINOS AT 2ND F,DOR BATH 3, CRAFTS11AUNDRY
A RETREAT EXISTING 2ND FOOR BATH 2 WILL BE RENOVATED.
-PLACE EXISTING FRONT WOOD 0
AD
ERIOR
;SEMBLY WITH NEW STAIR BTSTORAGE AS SIMWN IN DRWGS STAIR
:PLACE EXISTING HEAR EXTERIOR WOOD OPEN TREAD STAIR
;SEMBLY WITH NEW ENCLOSED ENTRY HALL AND STAIR S110WN.
IRT OF EXISTING SLOPED ROOF FRMPNG TO BE REMOVEO AS
TOWN FOR A NEW FLAT ROOF AREA OVER NEW ENCLOSE ATTIC
,ORAGE. PROVIDE NEW COPPER FLASHING 6 FINISHES SHOWN
L EXISTING AND NEW
ORAIN
uSHALL DISCHARGE IN
PLANTER
CONSULTANTS SHE
T
SITE
ARCHITECT
IN,
EXI!
SCAT MARTIN ARCHITECT
Al ,
APE
376 VILLA POINT DPIVF
NEWPORT BEACH. CAM-
A2
E%I;
,94914916:p1 5mtmmuwlrNmc,�L09mIDlcOm
422
ARE
CONSULTANT
A'
EiOfi
STRUCTURAL
DAENGIAENING. STRUCTURAL DESIGN RCONSULTING
4
EXIE
AS
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EMI!
HILLS. C
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ANC
ENERGY CONSULTANT
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SOU THLAND LNERGY CONSULTANTS
GN,
FIES
"'
1491 GLENNEVHE STREET
EXHIBIT "A"
111 45TH STREET
NEWPORT BEACH
BLDG PERMIT # 1533-2017
h
SCALE: 1/160®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.newportbeachca.gov 1 (949) 644-3200
Structural Observation Report
Project Address:
Report Date:
CNB Inspector Name:
CNB Permit #:
111 45th Street
3 _ _ --3
Richard LaBare
X2017-2161
Building Owner Name:
Owner's Mailing Address (if different from site);
Owner's Telephone #:
CNB Plan Check*:
Mr. Brad Roach
949-233-4545
1533-2017
Full Name of Structural Observer (SO):
SO E-mail Address:
SO Telephone #:
SO License / Reg. #:
Dave Anderson
dnae@cox.net
949-587-1829
C 056407
PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED check applicable boxes
FOUNDATIONS
SHEAR WALLS
FRAMES
DIAPHRAGMS
(Floor/Roop
INDICATE LOCATION(S)
OBSERVED
DATE
OBSERVED
XI Conventional
Footin s & Slab
❑ Concrete
❑ Steel
❑ Concrete
Slab on Grade and
❑ Mat Foundation,
Prestressed Concrete
❑ Masonry
❑ Concrete
❑ Steel Deck
Steel Columns Anchors
❑ Caissons, Piles,
Grade Beams
❑ Wood or Manuf.
Shear Panels
❑ Masonry
❑ Wood
❑ Other:
❑ Other:
❑ Other:
❑ Other.
)Q 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
QPOFESS/O1,
charge of the structural observation;
Q0� p.NDE9
SC
2. I, or another licensed design professional whom I have designated above and is under
OP
my responsible charge, have performed the required site visits at each significant
cs No. C056407
construction stage to verify that the structure is in general conformance with the
Exp. 6-30-19
approved construction documents;
3. 1 understand that all deficiencies which I have documented must be corrected, prior to
sT clw-
grFDF
final acceptance of the structural systems by the City of Newport Beach, Building
Division.
CAUFOF
- 1
r�, p I a ---\— lv
STAMP OF STRUCTURAL OBSERVER
OF
STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH.
Poems\Strvtturo Ob ervationReportffilnst mtiosts
DEPUTY 1 INSPECTION
1-800-DEPUTYI
Gen Comr: Fernandez Const
Sub Comr:
Report of Special Inspection
Project Name Address: Roach Res / 111 45th St
Permit Number: X2017-2161
Inspection Type(s)
Inspection Date(s)
] Periodic ] Continuous
Describe Inspection Made, including Locations:
Observed the placement of Simpson SET-XP epoxy with 123l #4 rehar dowel- to the
exi.-ting concrete,
ListTests Made:
Total Inspection Time Each Day:
List Items Requiring Correction, include uncorrected items previously listed
Comments
To the best of my knowledge, the work inspected was in accordance with the Building
Department approved design drawings, specifications and applicable workmanship
provisions of the U. G Iexcgpt as noted above.
Signed: Date
Print Full Name: Chad Rnimmel RegistrationNo NR-41 1
FORM S 1-02, 90
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 1 (949) 644-3200
Structural Observation Report
Project Address:
111 45th Street
Report Date:
3 - 2.8 1 8
CNB Inspector Name:
CNB Permit #:
—
Richard LaBare
X2017-2161
Building Owner Name:
Owner's Mailing Address (if different from site);
Owners Telephone #:
CNB Plan Check #:
Mr. Brad Roach
949-233-4545
1533-2017
Full Name of Structural Observer (SO):
SO E-mail Address:
SO Telephone #:
SO License / Reg. #:
Dave Anderson
dnae@cox.net
949-587-1829
C 056407
PLEASE INDICATE STRUCTIIReI Fl FMGMTC AMn
SHEAR WALLS
FRAMES
DIAPHRAGMS
ticaOILoozesFOUNDATIONS
ON(S)
DATE(Floor/Roof) OBSERVED❑
Conventional
Footin s & Slab
❑ Concrete
❑ Steel
❑ Concrete
❑ Mat Foundation,
Prestressed Concrete
❑MasonryConcreteSteel
Deck
7SecondFloorSheathin
❑ Caissons, Piles,Wood
Grade Beams
or ManufMasonryffi
Shear Panels3
Wood
•2$ _I 8
❑ Other:
❑ Other:
❑ Other:
❑ Other:
X ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES.
❑ OBSERVED DEFICIENCIES AND COMMENTS:
[The
❑ REPORT CONTINUED ON ATTACHED PAGES.
FINAL STRUCTU7OMSBERVATION REPORT:
structure eneolies withthe 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- 20--18
QPOFESS/pN
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c7 OP Z G'
w No. C 056407 m
Exp.. 6-3Pt9 m
CIVIL �P
9TR OF CAOF
2a —18
STAMP OF STRUCTURAL OBSERVER
a I nuU I UNAL UbbENVA IION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH.
Fomu\SlNcluralObsCrvazlOnRepoh@IrslNCllonS
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.Qov 1 (949) 644-3200
Structural Observation Report
Project
111
Address:
45th Street
Report Date:
5-1- 18
CNB Inspector Name:
Steve Lane
CNB Permit #:
X2017-2161
Building Owner Name:
Owner's Mailing Address (if different from site);
Owner's Telephone #:
CNB Plan Check #:
Mr. Brad Roach
949-233-4545
1533-2017
Full Name of Structural Observer (SO):
SO E-mail Address:
SO Telephone #:
SO License / Reg. #:
Dave Anderson
dnae@cox.net
949-587-1829
C 056407
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
Attic Sheathing
❑ Other:
❑ Other:
❑ Other:
❑ Other:
]IQ 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
Q({ur,uo/oN
charge of the structural observation;
Q�� PNDF9
2. I, or another licensed design professional whom I have designated above and is under
O
my responsible charge, have performed the required site visits at each significant
No.0056407
construction stage to verify that the structure is in general Conformance with the
ul Exp. 6-30-19
approved construction documents;
*
3. 1 understand that all deficiencies which I have documented must be corrected, prior to
`IT CIVIC -
Civil -
final acceptance of the structural systems by the City of Newport Beach, Building
grFOF Oj
Division.
Division.
Q L 5-3_IS
STAMP OF STRUCTURAL OBSERVER
OF
STRUCTURAL OBSERVATION DOES NOT WANE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH.
Forms\StNc,ure OWervMio RepoM1&L tmclions
DEPUTY 1 INSPECTION
1-800-DEPUTYI
Gen
CITY OF NEWPORT BEACH Sub Centr
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658
www.newportbeachca.gov 1 (949) 644-3200
SPECIAL INSPECTION REPORT
Project Address # I' :.._ ),i {,
Permit Number: 1
Inspection Type (s):
Inspection Date (s) -4r ii fx ( ) Periodic (-,j'Continuous
To the best of my knowledge, the work inspected was in accordance with the Building Division approved design drawings,
specifications and applicable workmanship provisions of the U.B.C. except as noted above.
Special lnspe_ctor Signature:
Date:
�
I ,-5
r
priMFull Name:
Newport Beach Registration No.:
..._,. !
SpeciallnspectionReport 8-24-15
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.00v i (949) 644-3200
Structural Observation Report
Project Address:
111 45th Street
Report Date:
- 24
CNB Inspector Name:
Steve Lane
CNB Permit
X2017-2161
Building Owner Name:
Owners Mailing Address (if different from site);
Owners Telephone #:
CNB Plan Check #:
Mr. Brad Roach
949-233-4545
1533-2017
Full Name of Structural Observer (SO):
SO E-mail Address:
SO Telephone #:
SO License / Reg. M
Dave Anderson
dnae@cox.net
949-587-1829
C 056407
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
X Steel
❑ Concrete
❑ Mat Foundation,
Prestressed Concrete
❑ Masonry
❑ Concrete
❑ Steel Deck
❑ Caissons, Piles,
Grade Beams
❑ Wood or Manuf.
Shear Panels
❑ Masonry
I
KWood
Roof Sheathing
7- 2 4- 8
❑ Other:
❑ Other:
❑ Other:
❑ Other:
Sheaf' wails
P( ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES.
❑ OBSERVED DEFICIENCIES AND COMMENTS:
❑ REPORT CONTINUED ON ATTACHED PAGES.
Pf 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
ePOFESS/O
charge of the structural observation;
Q4� PND£q
`
2. I, or another licensed design professional whom I have designated above and is under
P
o
my responsible charge, have performed the required site visits at each significant
No. C05640
construction stage to verify that the structure is in general conformance with the
¢ Exp. 6-30-19
approved construction documents;
*
3. 1 understand that all deficiencies which I have documented must be corrected, prior to
`pry CIVIL
final acceptance of the structu"asystems by the City of Newport Beach, Building
�OF
Division.
CAUFt
— 'z 4 — \ g STAMP OF STRUCTURAL OBSERVER
STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH.
Fom \Stmaurel0WcrvmionRepon&Wtmctiom
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.00v 1 (949) 644-3200
Structural Observation Report
Project Address:
111 45th Street
Report Date:
-J 8
CNB Inspector Name:
Steve Lane
CNB Permit #:
X2017-2161
Building Owner Name:
Owner's Mailing Address (if different from site);
Owner's Telephone #:
CNB Plan Check #:
Mr. Brad Roach
949-233-4545
1533-2017
Full Name of Structural Observer (SO):
SO E-mail Address:
SO Telephone #:
SO License / Reg. #:
Dave Anderson
dnae@cox.net
949-587-1829
C 056407
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
I
tX Wood
I
IRoof Sheathing
-I - 24 ^) B
❑ Other:
❑ Other:
❑ Other:
❑ Other:
Sheaf' walls
g 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.
7-24-f8
OFRECORD DATE
NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CRY OF NEWPORT BEACH.
Forma\Sts tura OMervationReport&Instructions
Scot Martin
fI r c h i t e c t
October 15, 2019
�,pc�lv�a er
COMMUNITY
DEVELOPMENT
OCT 16 2019
(ATY OF
City of Newport Beach NIOaT aEt`c�
Community Development, Building Division
100 Civic Center Drive, P. O. Box 1768
Newport Beach, California 92658-8915
RE: Notice of pending Permit Expiration/One-Time Permit Extension Request
To Whom It May Concern
In response to David Reed's October 3, 2019 letter, I am responding with this letter on
behalf of Brad & Victoria Roach, owners of the property at 111 45`]' Street, Newport
Beach, CA 92663 (Plan Check 1533-2017).
Due to unforeseen work related travel conflicts, Brad Roach would like to request an
extension for more time to complete his 45°i Street home.
Thank you for your consideration in this matter
Respectfully,
Scot Martin
Architect
cc: Albert & Nellie Mardikian
www.ScotMaifiiiAt-chitect.com 376 Villa Point Drive, Newport Beach, California 92660 (949) 697-0797
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: Report Date: i
I 1 145th Street
CNB Inspector Name: CNB Permit #:
Building Owner Name: Owner's Mailing Address (if different from
Richard LaBare X2017-2161
site);
Mr. Brad Roach
Owner's Telephone #: CNB Plan Check #:
Full Name of Structural Observer (SO): SO E-mail Address:
949-233-4545 1533-2017
Dave Anderson dnae@cox.net
SO Telephone #: SO License /Reg. #:
949-587-1829 056407
C
PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED
FOUNDATIONS SHEAR WALLS FRAMES DIAPHRAGMS
check a plicable boxes
INDICATE LOCATION(S) DATE
XI Conventional ❑ Concrete ❑ Steel (Floor/Roof)
❑ Concrete
OBSERVED OBSERVED
Pectin s & Slab
❑ Mat Foundation, ❑ Mason
Prestressed Concrete Masonry ❑Concrete El Steel Deck
FOOT'G IN THE
❑ Caissons, Piles, ❑ Wood or Manuf. ❑ Masonry ❑ Wood
FRONT OF THE DOOR I 1-5- 20
Grade Beams Shear Panels
❑ Other: ❑ Other: ❑ Other: ❑ Other:
�l ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT
DEFICIENCIES.
❑ OBSERVED DEFICIENCIES AND COMMENTS:
❑ FINAL STRUCTURAL OBSERVATION REPORT:
❑ REPORT CONTINUED ON ATTACHED PAGES.
The structure aenerally 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;
ePOFESS/DN
2. I, or another licensed design professional whom I have designated above and is under
my responsible
PNDF9s9lF`
charge, have performed the required site visits at each significant
construction stage to verify that the structure is
h�Q�o
_� pP y 20
in general conformance with the
approved construction documents;
w No. C056407 m
3. 1 understand that all deficiencies which I have documented must be corrected, prior to
final acceptance of the structural systems by
-w Exp, -3o-21 a
m 6
the City of Newport Beach, Building
Division.
rqr CIVIC ���'
C� L
-2 STAMP OF STRUCTURAL OBSERVER
ro
STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BYAUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH.
Forms\Struclurel0b,e,.tloM,p nalnstructicnc
CITY OF NEWPORT BEACH
CO-NLVITIjTI')' DE'krE4L PYNIENTDEPAEtlAVWNT
I3L n,I)I NG D CS- ISTON
iUU Cl�i:. C @t iHG r)1'Eva I P.0, Box 17688, j Newpor to Na0i CA 926 fl-89'15
tt:+w• n�wiy rtb�ach a goV1 (44R) 644-3200
ACKNOWLEDGMENT OF NO CONSTRUCTION -RELATED NOISE
ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS
On June 11, 2019, the City Council adopted an ordinance restricting
constructiun-related noise on Saturday in High Density Areas effective
August 12, 2019.
I acknowledge that any construction-r+ latbd noise, (including, but not limited
to operating power equipment or machinery in a manner that produces noise)
is not allowed on Saturday or Sunday in High Density Areas in accordance
with Newport Reach Municipal Code 10.28.040. As the owner of th e
property, I am responsible to ensure all persons working on the property
comply with this provision of the Newport Beach Municipal Code.
Project Address. ,/// 5 �WW 5 7!
Owner's Name:
----
Owner's Signature:
Contractor's Signature.
Date:
0L
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
SMOKE DETECTOR AND CARBON MONOXIDE
SELF -CERTIFICATION
(this certification is to be filled out by the permittee or homeowner)
Project Address:
41
Permit Number: XZot `T - 3 0 6 3
Property Owner:
— Licensed Contractor: c2 or zY Lic e 67 -2 3 R O
The State of California now requires that smoke and carbon monoxide detectors must be
installed in all residential buildings
California Residential Code (CRC) Section R314.1, CRC R315.2 states in part that
existing dwellings be "retrofitted with smoke detectors and carbon monoxide detectors.
CRC Section R314.3, CRC R315.3 defines required locations.
Both boxes below must be checked.
Carbon Monoxide Alarm: On the ceiling or wall outside of each separate
sleeping area in the immediate vicinity of bedrooms or in each hallway outside of
the rooms, and each level of the dwelling. Detectors are also required in
bedrooms with gas fired appliances
1aE Smoke Alarms: Installed in each room used for sleeping purposes, outside
// each sleeping area, and on each level of the dwelling unit.
Retrofitted detectors may be battery operated for buildings where no alterations are
performed on the interior. Multiple -purpose alarms (carbon monoxide and smoke alarms)
shall comply with all applicable standards and must be approved by the State Fire
Marshall. The devices must be installed per manufacturer's specifications.
I, the undersigned, hereby certify that I am the permittee or homeowner of the
project. I further certify that smoke alarms and carbon monoxide alarms are
present and tested to be functional in all the following locations:
Signature:� Date:
V
S - jb=2a
NOTE. This self -certification is only used for projects to the exterior of the structure where access to the
interior of the dwelling by the City of Newport Beach Building Inspector is not achieved during the course of
construction.
Forms\SmokeDetectomndCarbonMonoxideSelfCert 08/12/16
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: 111 45th Street, Newport Beach, CA
Building Permit Number(s): #
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 for the highest roof ridges, flat roofs, or
parapets/guardrails. Additional elevation points may be requested by the Building Inspector.
RIDGES (3.1,27 slope or greater)
Ik Approved elevation point of ridge is R,lu and actual elevation point is 33 5$
3" Approved elevation point of ridge is 33. Iv
and actual elevation point is 33 • to3
Approved elevation point of ridge is
and actual elevation point is
Approved elevation point of ridge is
and actual elevation point is
Approved elevation point of ridge is
and actual elevation point is
Approved elevation point of ridge is
and actual elevation point is
Approved elevation point of ridge is
and actual elevation point is
FLAT ROOFS, PARAPETS AND GUARDRAILS
Approved elevation point of flat roof or parapet is
and actual elevation point is
Approved elevation point of flat roof or parapet is
and actual elevation point is
Approved elevation point of flat roof or parapet is
and actual elevation point is
Approved elevation point of flat roof or parapet is
and actual elevation point is
Approved elevation point of flat roof or parapet is
and actual elevation point is
I certify h the above height measurements are correct and the above project:
IS in compliance with the City -approved plans.
OIS NOT in compliance with the City -approved plans (Provide explanation).
any deviation from the City -approved plans on the bp�ck o,.f_this form.
vvJ i � o 7 J Surveyor or Civil Engineer's* signature and seal
(Wet stamp and signature required)
* License number of 33965 or lower
a No•
o-
�i
1 Date
Forms\Bufiding Height Certification 11/02/16
"7ATP o)