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X2019-0861 - Permits
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LU ma > Z 0 0 N� 0Oz O O �o W o °v a �° F� ¢ F- oa: Q cau CL ,2 s (n D w 10—QSv NOd ca ZC CN � L . r_ZQ /f < Ln 3 E J N 3 c c 0 O O O C C U m m 0 O � w0 o� O Q �o O ovcoa) 4- y V N .D tp 0 O Z m am) t v ,c10_) co) 0 0 a o m o o Q F an d � o 0.2 o 0 C Z� a) o m cc a) ❑ m U C U aL-. +gym+ CC3 a�o a 3 0 a)E 15W0 'a (Da o �w CL a� c( L) L c a s E d a) o o O O O O a) LO. p ¢ )€ m m N N O N a u F�W.c Q 0 .N m Z m '� > N L d L O 'C — O >, In 'N E m O) 7 Z a) U w C V E m L m m c 0ZD 1�1 _ 7 1 I t m = a) m ... c0 Q - a C a a (UN O 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 dregsG: ,,,, Report Dat; ` 45 o• CNB Inspector Name: CNB Permit #: Building er Name: Owner's Mailing Address (if different from site); Owner's Telephone #: CNB Plan Check #: Cel ❑ Concrete 66lAa FW4*-h1 S"'10•�14 1 RdName of Structural Observer (SO): S��ail Address: SO Telephone #: SO License / Reg. #: ICk 6 jC%k-V - ltb �"w+Se• (A Cl ` - ❑ Wood or Manuf. I Shear Panels PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check a=111cable boxes) FOUNDATIONS SHEAR WALLS FRAMES DIAPHRAGMS (Floor/Root) INDICATE LOCATION(S) OBSERVED DATE OBSERVED OL Conventional Footings & Slab ❑ Concrete ❑ Steel ❑ Concrete 66lAa FW4*-h1 S"'10•�14 1 ❑ Mat Foundation, Prestressed Concrete ❑ Masonry ❑ Concrete ❑ Steel Deck ❑ Caissons, Piles, Grade Beams ❑ Wood or Manuf. I 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. 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 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. S to Lo SIGNATURE OF STRUT OF RECORD DATE STAMP 01 "S UCTURAL OBSERVER STRUCTURAL OBSEWATION DOES NOT WANE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH. Fomv \StmcturalObservationReport&Instructions 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 Projectdre s- 1& Report ate: - ' ^ CNB Inspector Name: CNB Permit #: Building O er ame: Owner's Mailing Address (if different from site); Owner's Telephone #: CNB Plan Check #: r ❑ Concrete Ful�ll aff+aof ructu al r ( O): SOMI A dr ss: elephone M SO License / Reg. M /bssery 'OA e 10A - Z.S %I fsq PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED fchPck annlicahlP hnYpcl 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 ❑ Other: ❑ Other: ❑ Other: ❑ Other: W P( 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 II deficiencies which I have documented must be corrected, prior to final acceptance of the structural systems by the City of Newport Beach, Building Division. �r C1(.'.AIATI IRF ()P STRI IRT IR I (1RCF R DF RF(`f1Rf1 nATC 13 AJ a :Y. l `� vc STAMP 6P-STRUCTURALTOBSERVER STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH. Fom \StmctmIObservationReport&Instructions ProjectNarne &Address PermitNumber a Report of Special Inspection InspecdonType(s) 1(1 11 01 /LVI� li 91 s rf C V 4, _j, Continuous InspectionDate(s) Periodic Descn-beinspeotion-Made,,iucludingLocatio.ns:- List Tests Made., . Total 1=ection Time Each Day: Oe,� Lisatems'Requiring Correction, includeuncorrected itemsPreVIOU81Y listed Comments: 4, Tothe best ofinyknowledgp, the work inspected was in accordencewiffitheBuRdingDepadment approved design. drawings, specifications and applicable workmanship provisions ofihoU B C. except as noted above. Signed: Date Date PriatFuliName: ;4 RegistrationNo. doors FORM St -02,01 Lisatems'Requiring Correction, includeuncorrected itemsPreVIOU81Y listed Comments: 4, Tothe best ofinyknowledgp, the work inspected was in accordencewiffitheBuRdingDepadment approved design. drawings, specifications and applicable workmanship provisions ofihoU B C. except as noted above. Signed: Date PriatFuliName: ;4 RegistrationNo. FORM St -02,01 DON CARD Deputy Inspectlon Services 218 W. Ave. Cordoba San Clemente, Calif. 92672 Phone (949) 413-6248 Fax (949) 361-2118 Project Name & Address Report of Special Inspection List Tests Made: Total Inspection Time Each Day: Date Hours List Items Requiring Correction, include uncorrected items previously listed Comments: i 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.B.C. except as noted above. All inspections based on four hour minimum. Inspections exceeding four hours will be billed at eight hours. Any inspections beginning before 12:00 noon and,end after 12:00 noon will be billed as eight hours Signed: i ;% Date Print Full Name: Registration No. FORM SI -02,01 DON CARD Deputy Inspectlon Services 218 W. Ave. Cordoba San Clemente, Calif. 92672 Phone (949) 413-6248 Fax (94.9) 361-2118 Report of Special Inspection i Project Name & Address Permit Number r' ' Inspection Type(s) Inspection Date(s) [ ] Periodic [ ] Continuous Describe Inspection Made, includipg Locations: ` List Tests Made Total Inspection Time Each Day: Date Hours List Items Requiring Correction, include uncorrected items previously listed 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.B.C. except as noted above. All inspections based on four hour minimum. Inspections exceeding four hours will be billed at eight hours. Any inspections, beginning before 12: oon an d aft 12:00 noon will be billed as eight hours Signed: Date Print Full Name: ' Registration No. FORM SI -02,01