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Home My WebLink AboutX2021-3325 - MiscDEPUN 1 INSPECTION 1-800-DEPU Gen Contr. i Sub-Contr: �� S CITY OF NEWPORT BEACH COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive I P.O. Box 17681 Newport Beach, CA 92658 www.newoortbeachca.00v l (949) 644-3200 SPECIAL INSPECTION REPORT Project Address: f ' A. A L_ I•t Permit Number: 02 Z Inspection Type (s): L' Inspection Date (s): S 22 ( )Periodic i y • `_SCE®� Mill.. i—S To the best of my knowledge the work insp n accordance with the Building Division approved design drawings, specific ns and ap le Zr an rovisions of a U.B.C. except as noted above. peclal In ector nature: Date: S fa 2Z Print Full Name: Newport Beach Registration No.: 1--kgw�,AMmAt -o-w-s SpedallmpecnonRepon S-24-15 OF ��WIPiR @ CITY OF NEWpORT BEACH COMMUNITY DEVELOPMENT DEPARTMENT > BUILDING DIVISION CgCI FOM1��P 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 926588915 www.newj)ortbeachca.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. Engineer/Surveyor's Name RVAZ A11/L-p(-74V,4 License# LS W 5- 3 Engineer/Surveyor's Address Z.30& L4j�5E-/j211�-3r l),d- ft 9 G1}Gy��/t�fiGCS Job Address 1 / 15-- / ! / 4 A A/E Setbacks: Sketch a site plan and specify surveyed setbacks (use back page). • Top of slab/floor elevation: SiAMc- Vf% &6 • 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 from plans: are 11, are not 0, per City approved plans. Describe any deviations I certify that top of slab/floor elevation(s) is 0, is not 0, per City approved drawings. Describe any deviations from plans: 5 to , ZZ ["/-W Ate_ Date Engineer/Surveyor's stamp and signah Forms/SetbwkswdTopotSlabElevationCen. N MIEDEMA Lsam rage 'I oT a 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: 1615 Lincoln Lane, Newport Beach, CA Report Date: May 12, 2022 CNB Inspector Name: John Bueckle CNB Permit #: X 2021-3325 Building Owner Name: Owner's Mailing Address (if different from site); Owner's Telephone #: CNB Plan Check #: Walter Kosich --- 949.836.1280 2884-2021 Full Name of Structural Observer (SO): SO E-mail Address: SO Telephone #: SO License / Reg. #: Eyass Khansa newleafengineeringla.com 562.508.3037 C91758 PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check applicable boxes) FOUNDATIONS SHEAR WALLS FRAMES DIAPHRAGMS (FlooHRoof) INDICATE LOCATION(S) OBSERVED DATE OBSERVED 0 Conventional Footings & Slab ❑ Concrete ❑ Steel ❑ Concrete New Addition @ front right, left behind Garage & @ rear right. 05/12/2022 ❑ Mat Foundation, Prestressed Concrete ❑ Masonry ❑ Concrete ❑ Steel Deck ❑ Caissons, Piles, Grade Beams ❑ Wood or Manuf. Shear Panels ❑ Masonry ❑ Wood C& Other: Anchor bolts & hold-down bolts ❑ Other: ❑ Other: ❑ Other: New Addition anchors & hold-down anchors only, Anchor bolts & hold- 05/12/2022 E ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES. down bolts to be epoxied will e later. ❑ 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 1 have documented must be corrected, prior to final acceptance of the structural systems by the City of Newport Beach, Building Division. STAMP OF STRUCTURAL OBSERVER STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH. Forms\Stmdure ObservationRepat&Instmctions Page 2 of 3 tl7'HDV391HOdM3N Olm�I ff rig z 3NVI NIODNII Stgl smao� MOW s s 9NI1300W3N p ..J W) i3 x, it S g!o 3Sf10H A801S 3N0 I� O w u 3WVNll3fatld Y a 1 a :n OL rl �1 1 reL I 1 I 1 I � 1 I � 1 < I �8 [l oK n z4 Vlv o -s c � Y i s�5ggg5 � g EM W- EN Him 3,11 ySga & nuc __ E o .s_ = E e M £ � I s R - e nli -11L 1= 1I`? �L lopga e_ rage a of o STRUCTURAL OBSERVATION REPORT INSTRUCTIONS When structural observation is required for a project, the structural observer shall perform site visits at significant construction stages throughout the progress of the work. Site visit frequency shall allow for correction of observed deficiencies without substantial effort or uncovering of the completed work. Structural observation site visits shall be performed for each construction stage identified on the approved construction documents. The structural observer may utilize the City of Newport Beach "Structural Observation Report" form, or a similarly formatted report, to record the required observation visits. If the City's form is not used the alternate report shall be on the structural observer's letterhead, state the site address, plan check and permit numbers, stages and elements observed, date observed, and complete contact information for the structural observer. All structural observation reports, regardless of form used, shall include the license stamp and wet signature of the structural observer responsible for the project. OBSERVED DEFICIENCIES When a deficiency is noted, the structural observer shall give copies of the completed structural observation report to the owner or owner's representative, project contractor, and the Chief Building Official or designee. The contractor shall resolve all deficiencies prior to final inspection or acceptance of the structural work by the Chief Building Official, or designee. FINAL STRUCTURAL OBSERVATION REPORT The structural observer shall submit a final structural observation report to the Chief Building Official, or designee, upon completion of the structural system. The final structural observation report shall state that the structural system conforms to the approved construction documents and that all previously observed deficiencies have been corrected. Final inspection or other acceptance of the structural system by the Chief Building Official, or designee, will not occur until the final structural observation report is received.