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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: 58 VICTORIA , NEWPORT BEACH
Report Date: 8/4/18
CNB Inspector Name:
CNB Permit#:��
Building Owner Name:
Owner's Mailing Address (if different from site);
Owner's Telephone #:
CNB Plan Check #:
Cindy Chin
❑ Concrete
Full Name of Structural Observer (SO):
SO E-mail Address:
SO Telephone #:
SO License / Reg. #:
Mansour Ahmadi
Mansour(Mcal roen ineerin .com
949-715-9990
C-76370
PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check -applicable boxes
FOUNDATIONS
SHEAR WALLS
FRAMES
DIAPHRAGMS
(Floor/Roof)
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
A Wood
woo Or �/'s+n• �
�•2'1-( g
❑ Other:
❑ Other:
IN Other:
❑ Other:
5he,.- V - vi
J] ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES.
❑ OBSERVED DEFICIENCIES AND COMMENTS:
❑ REPORT CONTINUED ON ATTACHED PAGES.
K 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. 1 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 th 11 deficiencies wlIyydl I ave document¢ must be corrected, prior to
final accepts of the structur 1�sy ms by the City f Newport Beach, Building
Division. '/, Q 0
' C 76370
EXP. LLI J6
C(VII�
STAMP OF STRUCTURAL OBSERVER
STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BYAUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH.
Forms\StmoutdObservationR¢port&lnstructiom