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HomeMy WebLinkAboutX2014-2594 - Misc (2)4014-25911 501 Park Ave 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: so/ P.;_4 Report Date: 111 lL 20%G CNB Inspector Name: <:hV-t CNB Permit #: INDICATE LOCATION(S) v OBSERVED , s 4 Zot-f,zsq�t Building Owner Name: f-4, r Ga LCG Owner's Mailft Address (if different from site); Owner's Telephone #: CNB Plan Check #: I," e_- 9 ❑ Masonry 4 -q4 -t lvr — Full Name of Structural Observer (S(5):SO lab E-mail Address: �e SO Telephone #: SO License /Reg. #: er- rcxits� a <r90 aKI 4q4 -6T -t 5135 PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNF_CTIONR nRsctavFn lrhnrlr K. ---I FOUNDATIONS SHEAR WALLS FRAMES DIAPHRAGMS (Floor/Roof) INDICATE LOCATION(S) v OBSERVED DATE OBSERVED WConventional 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: ❑ 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; B. I understand that all deficiencies which I have documented must be corrected, prior to final acce^ce of the structural- systems by the City of Newport Beach, Building DAIFE b l AIVIV OF b 1 HUG 1 URAL UBSERVER STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH. Foms\S,maorslebszrvs�ionRzpon&Insnmaions Report of Special Inspection Project Name & Address Permit Number Inspection Type(s)®� Inspection Date(s) S ` [ ] Periodic Continuous Describe Inspection Made, including Locations: EdXy 0 F2- List F List Tests Made: S-)�"+)AL 'S1721s� t�tn wttnJ tbtltl�ri'iIAAa*'f u n, Awe e Total Inspection Time Each Dav: Date Hours I 4 List Items Requiring Correction, include uncorrected items previously listed n , . . . Q Comments: To thLbest- owled e, the work inspected was in accordance with the Building Department approwings s can ns and applicable workmanship provisions of the U.B.C. exceptSignedDate Print bill Na ii ye: a5�- © WLA ZA5-� Registration No. 0 1 H FORM SI-UiN M Report of Special Inspection Project Name & Address 7/l(ZZ AIA. X; -10iti rAj1 S01 PAe�G irk),_ Permit Number u 2DL4--Z j9 Inspection Type(s) inspection Date(s) �- Ns j ]Periodic j X ] Continuous Describe Inspection Made, including Total Inspection Time Each Day: Date Hours List Items Requiring Correction, include uncorrected items previously listed lb ePL:�- To the best of my knowledge, the work inspected was in accordance with the Building Department approved design dr s, specifications and applicable workmanship provisions of the U.B.C. except as t�ote-�above Signed: Print Full IR Date �6" 6'„t ?� Registration No. 01-7 1 FORM s1-02:90 IM 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 1lddre,OG� k- Report Dater 1 �P 1'a Inspector Spe 1, 1#: CNB x2o1q Permit2S 11 Building Owner Name: Owners Mailing Address (if different from site); Owner's Telephone 9SI.19S'33(aZ CNB Plan Check #: 20(01-2011 Full Name of Structural Observer (SO): LA-w5exi SO E-mail Address: SO Telephone #: SO License / Reg. #: ❑ Mat Foundation, Prestressed Concrete boa n B 4-01 51-343 PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check applicable boxes) FOUNDATIONS SHEAR WALLS FRAMES DIAPHRAGMS (Floor/Roof) INDICATE LOCATION(S) OBSERVED DATE OBSERVED W Conventional Footin s & 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: p ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES. C,5-66 �Crq,�BFC 6�v� A OBSERVEDCOMMENTS: at, -7D U ❑ 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: I am the licensed design professional retained by the owner to be in responsible charge of the structural observation; 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; I understand that all deficiencies which I have documented must be corrected, prior to final 99CRtance of the stpctural systems by the City of Newport Beach, Building I I GP STAMP OF STRUCTURAL OBSERVER DATE STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH. Foemsl mcwmlobs aionRWod&ingmctions Report of Special Inspection Project Name & Address SOI Permit Number X 7s�1 Q — Z-159 Inspection Type(s) Ll�o1C✓l��-�� Inspection Date(s) �� _ ) to f ] Periodic r ] Continuous M, ,, Describe inspection Made, including Locations: Y"-51 5+Tj �l'3,c,.}� ale, �t3kX)Me'V4V G„ NMNlwwC� List Tests Made: Total Inspection Time Each Day: Date I i, - Hours 4 I List Items Requiring Correction, include uncorrected items previously listed "3n': T"Yz1,37 VDiN�S S 1 4 -5h I To the best of my knowledge, the work inspected was in accordance with the Building Department approved design dras, specifications and applicable workmanship provisions of the U.B.C. except as to above? Signed: Print Full W. Date L" 8 `t ?" Registration No. X O $ FORM 51.02i90 Report of Special Inspection Project Name & Address Permit NumbKZQ- � InspectionType(s)���� Inspection Date(s) L-10-140 r] Periodic r X] Continuous Describe Inspection Made, including Locations: - I I I "pt YLt'sOr-. List Tests Made: It t — �-4yK$(tTU�2na ��l1tN2� Total Inspection Time Each Day: Date 110 f�o Hours List Items Requiring Correction, include uncorrected items previously listed To the best of my know , the work inspected was in accordance with the Building Department approved desiW drawings specifications and applicable workmanship provisions of the U.B.C. except as nqtfff above. 1 - ' "-� FORM SI.0230 0 Report of Special Inspection Project Name & Address 1ph9X 406714 )c= C� = 5C21 Permit Number k Z^ 14 — 7594 Inspection Type(s) C3DNC%1�C�.Zi_17t1�7. Inspection Date(s) C5—?A— i �— 4 ] Periodic L jC ] Continuous Describe Inspection Made, including Locations: iceCOOT- ,) Tests Made: y oh,i.ax,i,he—,.Ij)a_tlnn.�Y` IZw\i4lilta nC— 17_1Yh1A1�MM1tn 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 draw' specifications and applicable workmanship provisions of the U.B.C. except as notesY�bove. �/� Signed: Print Full W -q Date .4�) — ZA— I Co Registration No. nn g FORM SI -02i90 Report of Special Inspection Project Name &Address AN) �� t Pro J r ate.% .. nom' Permit Number Inspection Type(s) Inspection Date(s) Describe inspection Made, including Location: [ ] Periodic j p< ] Continuous ► s� t, sm �� eotnav�>us C F�q •� .1� �j , �a ?hm� ri T en► -11 It Tests Made. Total Inspection Time Each Day: Hours List Items Requiring Correction, include uncorrected items previously listed A2t'�)LZ- Comments: l `�12� f�:,l yy)?] ' % ! � —XP LL�)l -Ti-3 1 - To the best of my kno approved -gn draw except as note above. Signed: Print Ful, re, the work inspected was in accordance with the Building Department specifications and applicable workmanship provisions of the U.B.C. Date (� Registration No. 11 { FORM 51-QV90 0 z.7JAr.t Report of Special Inspection Project Name & Address `SQJ-P/12k, AUE Permit Number x wl -e–j)4 Inspection Type(s) CVP44 4." Inspection Date(s) ? `—–�z--- -.1Periodic j X ]Continuous Describe Inspection Made, including Locations: l'E/v-Yvll A Zso LtJ N e'"ek � 1 +U i Emil InawG x-hlig'- List Tests Made: �%)S�nL' - QrrX alt er �y t_1 rl'D(W's Total Inspection Time Each Day: List Items Requiring Correction, include uncorrected items previously listed 14 Comments: Yvt V ons 9 bvTle To the best of my knowledge, the work inspected was in accordance with the Building Department approved den drags, specifications and applicable workmanship provisions of the U.B.C. except as nqA above. 1 Signed: Print Full W-9 Date %' S "-I (C' Registration No. Cf1 FORM s1-02190 CITY OF NEWPORT COMMUNITY DEVELOPMENT D: BUILDING DIVISION 100 Civic Center Drive I P.O. Box 1768 1 Newport www.newoortbeachca.gov 1 (949) Structural Observation Re CA 92658-8915 Project Address: 5©/ Qv Report Date: FRAMES jJB Inspector Name: CNB Permit #: �,e nc tonin DATE OBSERVED $ Conventional JaMillftMA Slab ❑ Concrete ❑ Steel Building Owner Name: Owner's Melling Address (if different from site); I er's Telephone #: CNB Plan Check #: Full Name of Structural Ohserver (SO): SO E-mail Address: So Telephone #: SO License I Reg. M 1 ❑ Wood or Manuf. Shear Panels I PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSEI VED !check annlirahla hnYasl FOUNDATIONS SHEAR WALLS FRAMES DIAPHRAGMS (Floor/Roof) NDICATE LOCATION(S) OBSERVED DATE OBSERVED $ Conventional JaMillftMA Slab ❑ Concrete ❑ Steel ❑ Concrete �ilm�s I r aw 0?& Yvf' 6 ❑ Mat Foundation, Prestressed Concrete ❑ Masonry ❑ Concrete ❑ Steel Deck ❑ Caissons, Piles, Grade Beams ❑ Wood or Manuf. Shear Panels ❑ Masonry ❑ Wood ❑ Other: ❑ Other: ❑ Other: ❑ Other: 19 ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES. ® OBSERVEDCOMMENTS: Olas�' s (ca- l�Ec.vt•�'mNe- • �� 6 --�/, � Ol REPORT CONTINUED ON ATTACHED PAGES. ❑ FINAL STRUCTURAL OBSERVATION REPORT: The structure generally complies with the approved construction documents, and all obs I ed 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 acc enc o!/Pe structural systems by the City of Newport Beach, Building -/ S, /4 STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY Forms�5nvcnrtulObservaionRcpon&lnsvugions iG4U �t �• b��,� F.y i No. 1343 � b3 Exo�---•—��. STAMP OF STRUCTURAL OBSERVER OF THE CITY OF NEWPORT BEACH. Report of Special Inspection Project Name & Address Permit Number Y ZO14 _ 70 A,%..=Jk:, j ]periodic j '( ] Continuous Inspection Type(s) Inspection Date(s) 17 1 Total Inspection Time Each Day: Date List Items Requiring Correction, include uncorrected items previously listed t4ny-j� Comments: To the best of my knowledge, the work inspected was in accordance with the Building Department approved desig,114rawings, specifications and applicable workmanship provisions of the U.B.C. except as note ab e. n Signed: Print Full 0 Date 4;:, — ?- 9 -. ( � Registration No. n (mss FORM st-azrsa Report of Special Inspection Project Name & Address 'P-AR'�L /AJ c- 50I VAe k., A'Je- Permit Number—x Zpj Q - ZS9 4 Inspection Type(s) Inspection Date(;j (�'-P(� _ P G' j ] Periodic [ X ]Continuous Describe inspection Made, including Locations: List Tests Made: Total Inspection Time Each Day: Date (ry•-j (o Hours List Items Requiring Correction, include uncorrected items previously listed Comments: CONclAIT' S ? ptt AC"b ` N' %loda To the best of my knowledge, the work inspected was in accordance with the Building Department approved design drawings rawi specifications and applicable workmanship provisions of the U.B.C. except as notFTbove. Signed: Print Full Name:�AloV�q M 0 Date 1, -It, -I L' Registration No. © 1 FORM S1•02i40 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 (949) 644-3200 Structural Observation Report Project Address: Report Date: CNB Inspector Name: CNB Permit #: 50( PwicQ Jti„,L ;;_77' zo( 09 Conventional Slab ❑ Concrete Building Owner Name: Owner's Mailing Address (if different from site); Owner's Telephone #: CNB Plan Check A Full Name of Structural Observer (SO): SO E-mail Address: SO Telephone #: SO License I Reg. #: ❑ Caissons, Piles, Grade Beams ❑ Wood or Manuf. Shear Panels PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED /check annlirahlp hnxpsl FOUNDATIONS SHEAR WALLS FRAMES DIAPHRAGMS (Floor/Roof) INDICATE LOCATION(S) OBSERVED DATE OBSERVED 09 Conventional Slab ❑ Concrete ❑ Steel ❑ Concrete - ❑ Mat Foundation, Prestressed Concrete ❑ Masonry ❑ Concrete ❑ Steel Deck ❑ Caissons, Piles, Grade Beams ❑ Wood or Manuf. Shear Panels ❑Masonry ❑Wood G” V frJihbry� ❑ Other: ❑ Other: ❑ Other: X ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES. ❑ OBSERVEDt*.M* COMMENTS: % / l D dF= ❑ 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 S 1 AMI' Ur S 1 RUCTURAL OBSERVER STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH. Fo=VS"u IOWemtiov quo &4i fiom 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 (949) 644-3200 Structural Observation Report Project Address:,( 50 / P� Aveould�' Report Date:/ �b Zd I ` CNB Inspector Name: CNB Permit* Building Owner Name: Owner's Mailing gddress (if different from site); Owner's Telephone #: CNB Plan Check #: Full Name of Structural Observer (SO): f LR��o� SO E-mail Address: L / �ao6G� lc¢�osBµ� .ems. SO Telephone #: SO License / Reg. M 3 1343 PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check applicable boxes) FOUNDATIONS SHEAR WALLS FRAMES DIAPHRAGMS (Floor/Roof) INDICATE LOCATION(S) DATE OBSERVED OBSERVED ❑ Conventional Footings & Slab ❑ Concrete ❑ Steel ❑ Concrete ❑ Mat Foundation, Prestressed Concrete ❑ Masonry ❑ Concrete ❑ Steel Deck ❑ Caissons, Piles, Grade Beams If Wood or Manuf. Shear Panels ❑ Masonry ❑ Wood Au. o 6[fet0 MR. 4t vj6 ❑ 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 compiles 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 ofthe 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 acceptancegf;ty� structural systems by the City of Newport Beach, Building Division. /—i I / ON STAMP OF STRUCTURAL OBSERVER STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH. rorins\SimCInlalObSer ationRepon&lnsimctions Deport of Special Inspection Project Fame & Address Permit NumberA-2Q L%— 7 `"'1�] Inspection Type(s) CESY� CZ�P inspection Dates)— --- I 3 Periodic j X]Continuous ! Describe Inspection Made, including . � r��'ZR7/,\��'�'�ll�'"7CT�GT1Rs�G�111�'J�1\�r.-71y►11�J)lil�l G MA WJyam Total Inspection Time Each Day: Date Hours I L List Items Requiring Correction, include uncorrected items previously listed Comments:R,1/ t `7WJZ I&W4414S r4S TOQ Ski -2 /Qa I2-, To the best of: k dge, the work inspected was in accordance with the Building Department approved des' dr wings, specifications and applicable workmanship provisions of the U.B.C. except as no bove. Signed: Date Print Fully"�1� Registration No. O n g) FOAM St-OL90 Report of Special Inspection Project Name & Address Permit Number �( %7l Q 7S Inspection Type(s) Inspection Date(s) a- S- 1 �2 — r] Periodic j X ] Continuous Describe inspection Made, including ,k.=, 17.S11L tenni^ n.v t r,SS7 List Tests Made: Ill( R ,,: ►cu��t tial ` - Total Inspection Time Each Day: Date Hours 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 dr, specications and applicable workmanship provisions of the U.B.C. except as n9.ted)abovej , Signed: Print Fall e:�'6 1 0 . ( !2V W—: Date ' `I6 Registration No. 421:x FORM 51.02:90 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.newportbeachca.pov 1 (949) 644-3200 Structural Observation Report Project Address: �'" . l v3i2cc/ Uevt U�} Report Date: �t - � � - l CNB Inspector Name: e K CNB Permit #: • zo 64 ^ Z9`k{ Building Owner Name: Owner's Mailing Address (if different from site); Owner's Telephone #: CNB Plan Check #: ❑ Steel ,Fol P4axAvemozor- Full Name of Structural Observer (SO): A?�&rw-f- L.". 5 N SO E-mail Address: belaG 6�u Y keecow SO Telephone #: cl pq. k4d E eTw SO License / Reg. #: S ( 343 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 8 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: ❑ ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES. ❑ AND COMMENTS: / t7 �tr`ex c IDH &+ (ice 7�'�/�L[G�L(/"� �'/GC.rr ire e TO H! Al vto -Aa4 IZ14,f-- ® Coo all �tm�e ❑ REPORT CONTINUED ON ATTACHED PAGES. JW 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 oft structural systems by the City of Newport Beach, Building Divisions - STAMP OF STRUCTURAL OBSERVER STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH. Fovas\SWau 10bservnian epos&In bwjom µ CITY OF NEWP'�FJI�T B�,A C14 x2014zsau COI+r'tMUN]ITNr I)FVELOP14IENT DEFARTl4tE T 5"01 Park Ave BUILDING DIVISION . " - 1911 Givic Carter Drive l RO, Cox 17681 Newport Beach, CA 92658-8:915 nr?-ivvvrtbeacle r.�i[nt i (949) -3240 TEMPORARY POWER RELEASE APPLICATION (?YFS,r0r,rkVAi$d7dVb79Vo Fie. $146.0Q} &t&tou OWNER'SNAME: AAJrrFt1!' ujjq Gd C._. P14ONE NO; _. BUILDING PERMIT NO.Is ;7 _. 4a -5,7_17,Y', _ Request is hereby made for the release of electrical on sutP ect project only for the purpose of tasting eauian nt andlor mechsnicat systems prior to building permit final approval. I agree that no building or stru=m shall Jbe used or occupied until the Building inspector has issued a building permit final approval orrtifi to of Occupancy. Moving in furniture, staging, showing for sale* or any use otter than Construction, shall be considered use or occupancy and a violation of this agreement (CBG 711.1). Furthermore, it is not our intent to use or Gmupy this building until all City regulations and conditions concerning this building have been complied with:, and it is understood and agreed that the City of Newport Beach is hereby authorized to order disconnect of service mahout ruaiif`rcatio> for any violation of the above conditions Pdor to final approval or Certificate of Occupancy. OWNER or TENANT SIGNATURE DATE: 10--30-/b PRINT name of owner or tenant: � � � � �����+�PHONE 9 - CONTRACTOR SIGNATURE. � +` ... _ DATE: PRINT name of contractor i# {*�1�1.._.....PFIONB#:_`'1`7 (kora APPROVED BY: �srk >=�e`MvPOMRr POWER REIEFSE F.I°r LICATIQW, MrmUOM CITY OF NEWPORT BEACH COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 1Q4 ovbcG Omter orim I Pa Box 176a I Newport 13e h, CA 928513-n15 unerau.n evCcartE u tc .�ov 1(949) 644-32410 TEMPORARY POWER RELEASE APPLICATION PROJECT- 5701 MVC- A' V-')t<r� earL 6VA !SEA IVO .. IW1VER'S NAMEc_ �i!7' t . _ t? r Y( G ,._ ., ,.._ PHONE NO; ... ......_... JOB ADDRESS ()( PHGNE # .[ JX i': r'k ,fid) Request is hereby made for the release of electrical an subject project only for the purpose of testing equipment andlor prior to building permit final approval. I agree that no building or sbucture shall be used or occupied until the Building inspector has issued a building permit final approval or Certificate of ter pancy- Moving in furniture, staging, showing for sale, or any use other than construction, shall he considered use or occupancy and a violation of this agreement (CBG 111 -1) - Furthermore, it is not our intent to use or occupy this building until all City regulations and conditions c onceming this building have been complied with, and it is understood and agreed that the Oily of Newport Beach is hereby authorized to order disconnect of service without notification for any vVatlon of the above oonditions. prior to final approval or Certificate of Occupancy. OWNER orTENANT SIGNATURE PRINT name of owner or tenant= (T �_j C,-5- _ PHGNE # C NT GTt]R SiGt TLiI E: DATE: PRINT name of contractor _ � # {``o r aa')�rxJ 6� a -� �..._. PHONE#-- fkw rt V KI �..+.. T ,... r f+00 MWEfRaGRMY P%W—R RFI;FhSF, APPLY—ATION. MOX2716 CITY OF NEWPO T REACH COIN^IMUNITY DEVELOPF41ENT DEPARTMENT BUILDING DIVISION 100 Civic Center Chive l P.O Box 176B I Newport Beach, CA 92658-8915 ; +d.ii t rortbe hr v I (949) 644=3200 Onsp€ etrL YAdrnin45tretnk- Fee. �148..U0) PROJECT: _ S7015, PAA ' 86(.Pjq OWNER`S NAME; ..lA r•tA of cj & a:t.' Ap i J .. _ PHt3$*i NO; ._ . .IOBADDRESS- a P,AZIX-AVLP-ka6A�130A ZS C4 l), BUILDING PERMIT NO.(s . DO V4 Q 6-9 Request is hereby made for the release of electrical on subject project only for the purpose of tines ui ment andlor mechanical Z%erns prior to building permit final approval. I agree that no building or structure shall he used or occupied until the Building inspector has issued a building permit final approval or Gedificate of Occupancy. Moving in furniture; staging, showing for sale, or any use other than construction, shallbe considereduse or occupancy aced a violation of this agreement (CB C'111.1). Furthermore, it is not our intent to use or occupy this building until all City regulations and conditions concerning this building have been complied with, and it is understood and agreed that the City of Newport Beach is hereby authorized to order disconnect of service without notification for any violation of the above conditions prior to final apprerval or to of Occupancy. OWNER or TENANT SIGNATURE ... .rl� -c� �°�t DATE: tG''�0 -1 1* PRI NT name of owner or tenant: i r r? PHONE #: CONTRACTOR SIGNATURE' QAT>E; PRINT name of contractor .._ _. eei�, .. i- FS. PFlONE #; resort (17r Pv) APPROVED BY, & aura 1R*PrGa. D19 k. Fa s%TmPOKARY PUiY A RFLEP-M, APPLICATION. rriN&aM x2011-25 +q 501 Puck Ave AIR-SOUND-HYDRONIC PROFESSIONALS IIVAC Test and Balance Report PROJECT: Park Avenue Cafe Newport Beach, Ca. CONTRACTOR: ARCHITECT: ENGINEER: K & S Air Conditioning N/A N/A REPORT CERTIFICATION NO: 37197 REPORT CERTIFICATION DATE: May 8, 2017 AND APPROVED BY: Michael Conboy ICB / TABB Certified Contractor 457 E. Arrow Hwy, Ste. D, Azusa, CA 91702 TEL: 626-915-8117 MX: 626-915-8112 E-MAIL: associatedairbalance @gmd.com uj \&Z{ \ o{>cn CD /2/\) C 20> \ aza-z $ C) yj 7 $ »zt\W / azo r / \ G) 0 \ rri C) 2 \\\ > zy, ® o % Cl) 7 /� \ r / rri C) 2 \\\ > zy, ® o % 03 R @ K =_ m }}\ }CIA $rm \ ® @\ 77 M A � 6 . � En \� r ��_ �� � 2 0 .2 z p LAN � ' k o o � � .� . R El Z" �I I 0 0 1� t3 :D 2 :D <C) <m �3 ;m . �2 U) � � C: --q m Park Avenue Cafe - Newport Beach, Ca. Table of Contents System FC -1 FC -1 SUBTOTALS EF -1, EF -4 HOOD#1 MUA-1 MUA-1 SUBTOTALS Page Number 2 3 4 �'ziCQ/ ee Page 1 AIR-SOUND-HVDROMC PROFESSIONALS Direct Drive Fan Coil Unit Test Data Job Name: Park Avenue Cafe, Newport Beach Date: 5/8/2017 System: FC -1 UNIT INFORMATION Unit Number FC -1 Location GARAGE Area Served KITCHEN, FOOD PREP, RESTROOMS, JANITOR Manufacturer ICF Model Number FEM4X48 Serial Number A162487578" AIR MEASUREMENTS DESIGN ACTUAL Total Fart CFM 1,400 1,387 Total Outlet CFM 1,400 1,387 Total Traverse CFM NVL Total Return Air CFM 1,400 1,366 Total Outside Air CFM 0 0 External Unit Static Pressure 0.50 0.45 Total Fan Static Pressure DNL Total Suction Static Pressure DNC 0.30 Total Discharge Static Pressure DNL 0.15 Fan speed Setting 5 SPEED MED -HIGH MOTOR MEASUREMENTS DESIGN ACTUAL Motor HP 3/4 3/4 Motor Voltage 208 208 Motor Phase 1 1 Motor Amperage 6.00 5.10 Motor Service Factor TP TP Motor RPM 5 SPEED MED -HIGH Overload Protection DNL N/A Room Number Size Type AlkDesign Actual FPMI I CFM FPM CFM 0 0 Remarks: i 0—Page 2 AIRSO� N►C PROFESS► Diffuser And Grille Test Data Job Name: Park Avenue Cafe - Newport Beach System: FC -1 Date: 5/8/2017 0 �—i�- P <.SY4 Az.(,Qj�2� Page AIR-SOUND-HYDRONIC PROFESSIONALS Fan Test Data Job Name: Park Avenue Cafe - Newport Beach Date: 5/8/2017 System: EXHAUST UNIT INFORMATION Desi n 2.. 1 Actual 2.0 Design 1/3 Actual 1/3 Unit Number 208 EF -1 115 EF -4 Location 3 ROOF 1 ROOF Area ServedHOOD 11.2 #1 7.0 OVEN Manufacturer CAPTIVE AIRE CAPTIVE AIRE Model Number NCA24HPFA USBi118D-4R Serial Number 1,750 2658066 1,735 2658066 DNL NA DNL NA Overload Protection AIR MEASUREMENTS ii Desi n Actual Desi n Actual Total Fan CFM 3,204 3,445 700 734 Total Outlet CFM 3;204 3,445 700 734 Total Fan Static Pressure DNL 0.61 D:30 0:31 Suction Static Pressure DNL 0.42 DNL 0:22 Discharge Static Pressure DNL ATMOS DNL ATMOS Fan RPM DNL 917 DNL 1,280 MOTOR MEASUREMENTS Motor HP Desi n 2.. 1 Actual 2.0 Design 1/3 Actual 1/3 Motor Volta e - Leg1/Leg2/Leg3 208 208 115 115 Motor Phase 3 3 1 1 Motor Amperage - Legl/Leg2/1-eg3 11.2 9.8 7.0 6.3 Motor Service Factor 1.15 1.15 1.35 1.35 Motor RPM 1,750 1,750 1,735 1,735 VFD Hz. Setting DNL NA DNL NA Overload Protection DNL NA DNL NA PULLEY & BELT DATA Motor Pulley 04Do 4" X 7/8" 1 VL40 X 1 Fan Pulley O.D. 63/4" X 1" AKA64 X 1" Belt - Quantity/Size BX29X2 AX33X1 Center Distance 7 1/2" " 11 1/2" % Sheave Adjusted: Closed 0 100% Remarks: ASSOCIATED AIR BALANCE GREASE HOOD CERTIFICATION MECHANICAL DIVISION GREASE FILTER DATA Park Avenue CafB - Newport Beach Date: 5/8/2017 NO. I GREASE FILTER MANUFACTURER FILTER SIZE NET AREA 1 KLEEN GARD 14" X 14" 1.36 2 3 4 GREASE FILTER AIR MEASUREMENTS NO: SIZE I FEET [P] FILTERMEASURE I TOTAL AVERAGE1 CFM 1 1 276 218 1 242 1.36 329 2 1 327 258 1 286 1.36 389' 3 1 388 307 1 341 1.36 464 4 1 449 355 1 394 1.36 536 5 1 442 349 387 1.36 526 6 1 393 310 344 1.36 468' 7: 1 1 330 261 295 1 1.36 1 1 401 8 1 1 278 220 1 244 1.36 332 9 10' TOTAL 3445 COMMERCIAL COOKING HOOD &SYSTEM SPECIFICATIONS HOOD OPER SIDES: 11.5 FT. .+ 4 FT. + 11.5 FT. + 4 FT 31 FEET [P] DISTANCE FROM HOOD. TO COOKING SURFACE =. 4 FEET. D] HOOD WIDTH :11.5 FT. X.HOOD LENGTH FT. .= 46 SQ.. FEET FORMULAS: #1 Q= 300AI200A #2. Q = 150AAGOA #3 Q = 100A175A #4 Q.=75AI50A FORMULA ALTERNATE FORMULAS #1 Q =:100PD #2 Q = 100PD #3 Q = 50PD #4 Q = 50PD ALT FORMULA IQ'.. X.[A].. _. REQUIRED CFM (Q] X (P] X [D] _ REQUIRED CFM NONCANOPY TYPE HOOD 300 CFM X LINEAR FEET IREQUIRED CFM.. #1 DUCT SIZE 38 IN. X 7 IN. 1144 = 1 85 ISO.. FEET #2: DUCT SIZE IN. X IN. / 144= ' SQ. FEET #3 DUCT SIZE IN.X IN. / 144 = `.. SQ. FEET `. LARGEST DUCT SIZE 38 IN. X 7 IN.. / 144 = 1.85 SQ. FEET EXHAUST AIR VOLUME THROUGH FILTERS. 3445 CFM =DUCT SIZE 1.85 SQ.. FT= 1862 F.P,M. COMMERCIAL COOKING VENTILATION SYSTEM SUMMARY INSPECTOR 1APPROVED IFAIIED D7 ln� MRSOUND-HVDRONIC PROFESSIONALS Fan Test Data Job Name: Park Avenue Cafe - Newport Beach System: MUA-1 Date: 5/8/2017 Page 5 UNIT INFORMATION Design Unit Number MUA-1 Total Fan CFM Location ROOF 2,652 Area Served HOOD #1 2,544 Manufacturer CAPTIVE AIRE Total fan Static Pressure Model Number A2 -G15 0.56 Serial Number 2658066 I DNL 1 AIR MEASUREMENTS Design Actual Design Actual Total Fan CFM 2,544 2,652 Total Outlet CFM 2,544 2,652 Total fan Static Pressure DNL 0.56 Suction Static Pressure I DNL 1 0.36 MOTOR MEASUREMENTS Design Actual Desian Actual MotorAP 2.0 2.0` Motor Voltage - Legl/Leg2/Leg3 _ 208 208 Motor Phase 3 3 Motor Amperage - Leg 1 /Leg2/Leg3 10.2 8.3 Motor Service Factor 1.15 1.15 Motor RPM 1,740 832 VFD Hz. Setting DNL NA Overload Protection DNL NA PULLEY & BELT DATA Motor Pulley 1VL40 X 7/8' Fan Pulley O.D. 7 3/4" X 1" Belt- Quantity/Size BX50X1 Center Distance 17 1/2" % Sheave Adjusted Closed 10% Remarks: Q"000 � G'! Page 6 e kY� Y�e�4GTi � i::"' AIRSOUND-HYDRONIC PROFESSIONALS Diffuser And Grille Test Data Job Name: Park Avenue Cafe - Newport Beach Date: 5/8/2017 Systems MUA-1 RHC -# : Room Number Size Type Ak Design FPM CFM Actual FPM CFM MUA-1 HOOD#1 1 _38" X 30' SCREEN 1.00 636 651 MUA-1 HOOD#1 2 38"X'30" SCREEN 1.00" 636 661" MUA-1 HOOD #1 3 _38" X 39' SCREEN 1.00 636 660 MUM HOOD #1 4 38" X 80" SCREEN 1.00' 636 680 (2544) (2652) EF -4 OVEN 1 10" X 10" DUCT 0.39 1,015 700 1064 734 EF -3 W. RR 1 10" X 10" EG 1.00 110 101 EF -3A M. RR 1 10"X10" EG 1.00 110 100 I—. A G. A. 7 E A. Yom_.._ __._...— — 0© o0 0p ®0.00000 00-0 Ail Q� pgg . 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Z F m W Od0 m vi 0dq m = :e N N AM { 0. + N d d w CL d IA N n eD J m n Z D v 0 o Z G m z o T 0Oo a r 00 0 D r m j D m 6 _. m o --0 ou m Q 0 m Koh C) r T Z w m m v m v 'm m n w Cn o_ V O O 2 m m G) { O Z T n y w n o m � z N E k ) § E 2 q § k s d / § CL mmio& � § k 2 = \ / 0 M m / )( ®S 0 _ ( ) / SL} § {\( - o _ ®/}\o4\# (§ (_\ \\ oa _ \ - � _ ( - \ \ }\ ±§ ,o)(/ _ \� #sail -«lwnj_&§ - (/ - m\_ 0 5■ °\\\}/(��\\ cl \_ i{ /mr o \ [, & - - laaj _¥ s R \ \ \ \ \ )\FF FF \ \ ( $\( � _ !}§ \ \oo6od _ - } § # � \0 0)a\ ❑ D 3 n OM Z� D M 0 z m 0 0 z p n z v r m n O O n O n Name or z 7D0 m r� A M v e '^ Item Tag n O Z O v �� n M a m 0 n r > aZ o 0 M O m m my M' ❑ 3 Z Dr w = D co c 0 Z o o 3 0Em wa m Vf Z n a 3 3 D -• n 2 n 3 P n M m Q a 3. m y O) O N m N C r N m T co A 7 0 M ]p w m 0 m " � vN o .^ Z N v D A m n Watts per O Luminaire w Zm Z r p ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ CEC Default = m A from NA8 �d n_ D Pt 3a According to 'm m u n D ❑❑❑❑❑ ❑❑❑ ❑ §130.0(c) G) n m O Number DN Luminaires N Total Installed 0 0 0 0 0 0 o 0 0 o Watts in this m area (C3 K 5 ) Z m A � ^ 3 0 3 s 3 d 0 � 3 c 0 O OG d 3 N � j H � 1I� W • 0 � S Q n s OOOOOOOOON N n 0o v m 000000000 MM 0 ❑ D 3 n OM Z� D M 0 z m 0 0 z p z v r m n O O n O n z 7D0 m r� A M v e '^ T D n O A=z n 45. v �� n M a m 0 n r > aZ o 0 M m m my ❑ 3 V Z s n N n o r z O 0 a m n m 1 T D m 0 n O a r D Z n m Zg om 00 O" D r ro ci z =a Z G) c w 0 IG + 0 0 a m M o' M z o F 3 � m O N m O 0 T m m J p A A A m Z n D m a D 3 r m o D 2 v a v A N D D v V � m v r m c D � � N Q N G c v a (p D f1 r � r o Q a Z D F m D m x Q n 3 a m � W a a m w m A Em d d D T D c o F m m J 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 x Gl D D 0 aai. � G 04 D m 0 Em m T � m J J + 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 — D m a IG + m n m O T 0 3 n z m m 0 0 a m M o' M z o F 3 � m O N m O 0 T J p A A A m n D m n m O T 0 3 n z m m / �m0 om ${} >;3r§ / (( > (§. 3 e, {\ ((7t EfE03�zz - « ■. m § �{/■ m!(£� _ » 2m §`}� I(! �z , }} ()9] { § 47 i( m(0 t2 }x } /a \� } \ \ § � r � cl ( § e} j ( \ ( \} \ }\ � °i\ _ \ _x - {\ �! } (\ {( _ \ § N / om ${} >;3r§ § 3 Etf ((7t EfE03�zz m § �{/■ m!(£� §`}� , }} 47 i( m(0 }x } /a LAGI| ( \ \ \} °i\ _ \ {\ (\ _ \ § N n D I O O 3 D z C) m cD q m v° O; o D S Z 0 o z N ' m W dN D W m 3 0 0 O w d ti 3 0 o D d N w d N 3 j D a Z 3 T d n m D � a r 3• -_ c r 3 o V 9 d W N O y D C) g o < 6 n Z o D °�; �`�^. m N d V N O o a oy m m 70 m 0 a O O c .a `. N .d., T O = 0 T 3 — d O 0 0 o to x d p m vl T V 0 0 D o d p 3 m= O O c n O T D M c m m C) o m° �. zc m "' o'i =• ?+ no 0 .owe m oct o D A T r D d O N J d 1 o 3 m. � a '• fD � A �V N 0 3 vl 3 O N 3 n. a G) c Z 3 r `L m °:• 3 vl of n o m d 0. o � m o � 3 d d N 0 � 1 J n O N d N d a y p � 011 N d (U � s Gl oa x J d d S N N d = G < � N d N N n 3 d n 0 3 D v 3 D RL O 0 d O 0 m F � m 0 O 0 a F 00 O d n D I O O 3 D z C) m cD q m v° O; o D S Z 0 o z 1 9 W dN D W 3 3 n o o O N w d N 3 j D d n m D m a .a N rnA 3 — d O O 0 0 D o x p 0 a � 2 3 m° rt a N 0 0 - v - 0 3 v 3 m D A N O D d O N J d 1 o 3 O a m o N a (V 3 m m ° d r 3 p = o � m d C d a N 0 � 1 N W � S N d N 3 p Q 011 d (U � Gl oa m S N = G < N 3 d n O 3 D d O ° � m N O 0 a F 00 3 n D I O O 3 D z C) m cD q m v° O; o D S Z 0 n >M m 'A ^ n o o m a a v m a v O Ln K o coo00 CO w m m m 2 o O y r o O M °°° w o o'o F o -1 Z 3 frC 3 C M m w oa a c mCj) n y �� 3 v m< -i o D D m m V= m e m T m o 3 wy 0 3 O o- a e o. m m m n? i) n c a m () D D a- v m'm N N m n W N r0 =Em'm rw5'p'p om 3 a� t = i n' w O d z on �, m m j O — n ^ m n m n so 3 0 3 m m m 0 s N a a s n - ry= a Q m w a v w 0 m m o d 0R m w 3 O 3 w H o. o_3 0 o n 0 a m 3& n w -On o w Oc o fP O (P m m T n n, 6 V J N w T w >> O w J 4 00M N J m O F, a. n� v s w c a N � J W pi 00 o p m m o m a< a o• a a a o• m Q O n_ Hwy. 3 6 S m c bOa O O m 3 c o s_. w p sm y s m m p' u 0 o . o m m o n c 3 c 3 m m v d v ry p j N n s m m OCD a p -i ^ 8 T 000 r D SOD as m o 0 r S O w �0 n, nmrD Om O m D D m Z E N� m w N O m n r 5r D ^Z `/ m O O A Z D z 0 O Z X N d n o m rL z m 0 A o A i ❑❑m ❑ mm ❑om m m ❑ D D D N D r m a 3 O W m �on f 7 O O L d m �. CO ° .Ni N .Nr ,N+ .Cr I Z n j- O' = � _r j� C w d C D! d d M O. G 00 "! K m n Q Go Dm O pOq O d Q m C. Q C O O .moi• N DQ O' S .'O S ��. 5 n T( a n o i, o o °. c� c0 S. n 3, d of Da °= a c D Lo 0 j CL umi N o M o o ? N G O n o O. 0 ��*. O n O O d_ ON O O O O=< OT 0 T "— I 7 N H A C O Dq ° oa' 04 0. �^ m 3 m3 .* S 0 °- c� T rD S m a n o 0 0 o a Q m N O o "� w o an as m D. c as i c, m CD o- o o - c c �' 0 o N i �, 3 n o 0< C w a rn a w °° 0° S 3 n m° O O D] C O m N== rD C "3"� N m m — w m T Z• CL Q O 0' 0 m d m ''' m (0 3 �. c um, n o .c-.. m m o- m " wo o co, 00 .r ? r w .`Yr m N 3 ° =� O .p ,0.' N m S _CL 0 m m O_ �v'Ki 3 N C -� i m 'O D• O O= 3 O' N p- < l0 m O c' < O OQ 00 0 O_ <O 3 d v ^p c o s o m 0 w o n O O °" O m Q a N "� (D S m Da N O C DS N (D N M S 3 n = d T C c m O" W 5 0 O m O O O m O 3' Q° C w Q o w m m 0. or m o G> > m v r -o 0 o a OT O' (YQ m N .... (.n N O n I N m O T N w `< C n t<] Dl 3 d - D CL ? 3 0 o n 3 =. Q m m (D S 3 CO 'O d j• m O o .0 0 .c. c F_ m a m s W m m o m n a° n 3 m' 3 s a n 3 0 N o(Dn m 3 m m o CL ° oo vS 0 ro ? m m n CC0 . on 0 s o 1 3 m ('D ° c CL 3 C N fmA m y �- = 0 `NG 3 3 ., 3 0 naqa- 3 o n ,n. m 0 3 m m as w m < m m f., 0 0 c r,,( n .mt 0� Q CL 7 N 3 w rD 0, D OA m CL n n O N n < (n n �- DC vi S O n o 3 j O Lu rDDa m ,. s c m = O Xv O of O O N 0 O "nC o- ID p- S 0 N m O' rD — 3 n O m O' -0 a y z G n n n C w p n O 0 Q 3 m (sn ° m o 0 o O a M � — c m 0 �' n oai o p_ m ^ m D D0a �, H m ^• O C CL n O r. m m o n m — F u 3 oF, ac N m 00 o s s o (m, 0 3 d z o m N o 0 3 0 n n 0 3 a o m m O o v, o — < c 3 N 3 -0 o 3 w ¢ v o M of .mr W n N S O O - n CL �. ,n,,. ui d N UO N C v w 7 3 O A 3 N m m a T s m i Z { X L O r � O > o N T S Dl 0 . m c m CL 0 n 0 n c 3 (D 7 D! 3 N CL d ° O C 0 O 0 OA s 3 DL 0 rt O S o, w N w a n v 0- (D 0 3 m a 0 m a n m f7 D m O n 0 3 T D Z n m z G) O m MC >> C a Ai z ZI m 0 0 o r D � OD S m o OE: n ON 0 mrZ C) o �D 2 0 n O Z n Gi m 0 O Z --I O N 0 0 0 z z D m z m A m C 0 0 Z z n 0 m � o m 1 � W N r = W z � ° Gi 0° s 3 3 Q W O Z p m O y D 0 Q' Z m r o0 — 0 0 O n o 0 r Q O � � S 3 Oz °. O 0 =. o o O_ 0 n o m q in ° o S m O m m° s a Q w O N N O OC m C N Ol O M N 7 Q ° S l0 O O O 3 0 0 00 O = 3 V D m A w O 3 C fr m n x §130.2(a) 0 w §130.2(c)1 m a N d S � §130.2(c)2 „ x n m ° n 3 < o ° o 3 §130.2(c)3 6) m m m � 3 3 §130.2(c)4 x r. §130.2(c)5 — paa!nbagIsal ❑❑❑❑11❑❑❑❑0011❑❑❑❑❑ aauejdaaay;! P 00000000000000000 ssed �c �o��adsu! p!a!j 10000000000 0000000 I1ej O m MC >> C a Ai z ZI m 0 0 o r D � OD S m o OE: n ON 0 mrZ C) o �D 2 0 n O Z n Gi m 0 O Z --I O N 0 0 0 z z D m z m A m C 0 0 Z z n 0 m � o m 1 � W N n D n s lA A W N N— 9 n D p o F' G O Z > p a OD Z o W o m m a m m D D3 zN r a�... AooaD O P M 2t mm nc m D D mm D D rI o 3 Md ;�z;a� '^.ma m n m as 73, A C7 m n m� a"'2°°. o H D D a m w m m m 3 0 p D D m mm m D31 n O H N W M N ° s' E i. n O m O naw 2 3. 3 vi o, 0 N ° a J D O Z � � c 3 n °n D n d o0- z m m BE 3 3 Z 3 a Ol N N d O, S O 01 y m N m o y a m f a O a v �i o 0 m n 0 0 w " m O m n 3 2 w T N ar cD 3 n° SL m O Vt m d m m 6 -O fn '" m N j 3°m O, 3 w H m (T m 3 0 G J ao o d m 3 O. n J m Q m m a m FF m S0 n m d 3 N a ao o < a n ti, o m a a o m n O MD' � - -' 3 a o w m S m pas m d Q U_ N n m O m 3 3 a 3 a m m v w a ° d m n O m n o o m m z m m 04 c m 0Cy a Z�m T� 909 o o M D i smo0 N�O m mrz n O m iii s 0 O r n D m Z n G) m 0 0 z M 0 r D O m z m z m { O 0 z� aLD n 0 'O n m o m -Ir-I z Outdoor 1 or A. General Information Watts Project Address: 501 PARK AVE. NEWPORT BEACH, CA. 92662 Total Illuminated Hardscape Area Phase of Construction: ❑ New Construction ❑ Addition ® Alteration Outdoor Lighting Zone (OLZ) ® OLZ-1 ® OLZ-2 ® OLZ-3 ® OLZ-4 I have confirmed with the AHJ which OLZ applies to this site. For default lighting zone designations, see Title 24 Part 6, §10-114 B. LIGHTING COMPLIANCE DOCUMENTS (check box for each document included) For detailed instructions on the use of this and all Energy Efficiency Standards compliance documents, refer to the Nonresidential Manual published by the California Energy Commission. ® NRCC-LTO-01-E Certificate of Compliance NRCC-LTO-02-E Outdoor Lighting Controls Certificate of Compliance NRCC-LTO-03-E Outdoor Lighting Power Allowance Certificate of Compliance C. Summary of Allowed Outdoor Lighting Power Watts 1. Sum Total ALLOWED Outdoor Lighting Wattage from NRCC-LTO-03-E, page 1 = 1,241 Complies ONLY if Installed 5 Allowed 2. Sum Total INSTALLED Outdoor lighting Wattage from NRCC-LTO-01-E, page 3 192 D. Declaration of Required Installation Certificates Declare by checking all Installation Certificates that will be submitted. (Retain copies and verify forms are completed and signed.) ® NRCI-LTO-01-E -Must be submitted for all buildings ® Field Inspector NRCI-LTO-02-E -Must be submitted for alighting control system, or for an ® Field Inspector Energy Management Control System (EMCS), to be recognized for compliance. E. Declaration of Required Certificates of Acceptance Declare by checking all of the Certificates of Acceptance that will be submitted. (Retain copies and verify forms are completed and signed.) ® NRCA-LTO-02-A -Must be submitted for outdoor lighting controls. 113 Field Inspector CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance August 2015 STATE OF CALIFORNIA OUTDOOR LIGHTING CERTIFICATE OF COMPLIANCE NRCC-LTO-0f1 E Outdoor Lighting (Page 2 of 4) P.Je, N... I Date Prepared: Schedule of luminaires exempt from the outdoor lighting power requirements in §140.7 I Name or Symbol I Description of exempt luminaire in accordance with the exemptions G. Schedule of luminaires exempt from the cutoff requirements in §130.2(b) Nameor Symbol Description of exempt luminaire in accordance with the exemptions F7 WATTAGE LESS THAN 150 WATTS H. Schedule of luminaires exempt from the outdoor lighting control requirements in §130.2(c) Name or Symbol I Description of exempt luminaire in accordance with the exemptions CA Building Energy Efficiency Standards -2013 Nonresidential Compliance August 2015 A C) 0 m — z — Z z -D 0 El 0 Z 0 r r 0 10 o D =O 6 CZ7 4: n w C m m = = x m 0 1 r 04 w 0 0 3 Ou 3 n a a S r mfa M a ` N 0 m 9 M r m r m r m r m r m v W m3 0 0 0 0 0 a O Z z _T fD Q O � M a O 7 M 3 Watts per i _ A m A A N o Luminaire n 2 n D s N MO ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ m m C E C D e f a u I t CL £ from NAS MO ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ A c c o r d i n g t o D C) ❑ ❑ ❑ ❑ 4130.0(c) w Number of D r N W N W V Luminaires r^ Total installed to 0 0 0 0 0 0 0 0 0 0 0 0 A N N m o' o Watts in this area N (Cx E) N V; � a G N C p m A p 3 D D C 3 c p ro o D71 9 m m n D- r �� Z Z� --1 Z N 0 W» 0 rl 00 < Li 0) d w 3 M w O 0 oa = w d d c O 3 2. w BUG Rating x o — 0 a a w m 00000000 0000 ssed000000 8N00 TN_ 000000000000 Ilea0 a a`. 3 D mm O 004 T O C r7i d A o T foo n D 80 m m o §:00 3 mrz m i a a � z m Z m z A N z O C 3 N l0 O `2 N z D Cl) f m w° m o A (n o o _2 2 w & = = .01. D r m -°° d o-° E 7 w O D -4r 3 D y D D m 2 6 3 w m 5. n, m a D 17 y 0 O m O m m m a 3¢ o a m n m (7 m (n D n �'n .1De a N °°_ A O D N D Dm o ° o 6)0 5 N in 3 ^ o. O N O A J 2 N N - a m n ,.... m n y �^ z J a D D a� m m n w ry N ti y O z n. m m N n m p y yc m c d ? n v 3 0¢ o u N m 0 F v o m a n s n m o o- m oa 3 f° 0n 3 m „ v z o o ° 4 m m ¢ m np a N Q n N m - 3 o w o v d a a n _ ° m o' m n m yo - R c c z 3 S i° a - ca- ° ¢ m o m ry o ° f° no 3 M 3 c 3MD M J 2 S N J o v s n c 'o m a ti m m s c ° m ° u n n - n N O � d O q c O m v ° a m O m - o 0 3 v o c o 3 m aiv 3 J Q O M m N M 3 m m a`. 3 D mm O 004 T O C r7i d A o T foo n D 80 m m o §:00 3 mrz m i a a � z m Z m z A _�_ { rn § 0 2 k �) § \ � M m § t m Ell / \ \ 0 / & . 2 ®�»@ .nz8—m }/� [>n� ! % }k\)� }/m Zv(I£ �Rra §@`[0 \Gi[ m`� Ek[!i _0 \*k (t§/2 lR �3 00 {E )§ §k> §{k m0! -q 2» mn0 Qy /`\\ /\ ; 9m (0 § �- \ n ;* � /# - fi §4 _ | \ / 2(A v O D -W M 0ZD zom moOo Oc0 n m w r Tp o m —5Z T (: - =: > o <_ � m T n r m Z Z N T n O M m D r r CO C D z n m 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 D w cn O -W M 0ZD zom moOo Oc0 n m w r Tp o m —5Z T (: - =: > o <_ � m T n r m Z Z N T n O M m D r r CO C D z n m w .> \}(\ § } N: � }(�pr R±r )\\( v o \(/ }ct �2 \ \ - _!� aa2& „ :,_� -f\ � {\m PL & 3o>� r I$\ § 2{3 >\e § — +&«® � ( a!!§ !(}/ 10, ¥\ , ƒ{ \\ Er S! § \ § / c\ eE! \k� )§ e0 m » § § § n D o N A W N N—= n D o p !' a 3 a m 2 3 O Tos(pmTZ2 < m3 Eo n m m m ti W > o o w a' W D `� 2 D m m �' v 0 m 3 m 'w' N S n Ui m m _. m oa O 6 r n m D D S 2 m m m 22 cn t (n m :" m w O D .°. O D m �mw rt o m�°m'm 3o 3'vAi r zN D m m N In, a J w o -U 2 Fn 3 c m cQ "f J a am w c 0 R n y CA T•2onm 3'"moon 0 U1 O D D 31 m m o 3 N omi '�' =. n, m D D 31 A m n m a a' _ a o m n a vi p 0- m w m m m S D D > a= !D O o JA D m m co O N ft W J d 0 O 0 X) u -- M N Nrr- o� o�,ms 0a O V D m mJ 3 n d OA$ �m ov = z a o� �m m m �n 0C n� om a 0, m m 01 U v. m a m 0 3 m 2 3 f° 91 m m m M in jO v=i yj � rY o m 01 s o cam o o -m vi a s^ T m o O a m m no a H O n 0 d n !=p 40 D S M N 9 n M O N >• 2 6 p m o O 3 3 m N J 3 m M J d N nam n d s n D m 3 O d n � o c m i s m m m a m co a n m T N O m mn m 5 0 n n, m 2 m V 0 O D ? W M'sd ? 0 O 0=a p m c N co 3w w m v in' m N •'• N v N V N �_ 0 M m w V u w' 0 3 O m lD a 3� a o 3 O QO a 0 n 7 N J 3 9 m at o mw m a 0- � o- � o n rt J o 20° ? o m � m a J � n a v s o m a T m d s m m wO N 0 < FF O a n m o C ° 0 3 3 3 c I m v a v m n M T n O m o m m S N 00 m m 9 Z yDy A Z 0 RI T M 001 0 m m m 6 wrp o m z_ v O <. n d 3 � v o n r D m G) � _ Z 0.0 m 0 Q O C O G m D r o 0 fD D D 0 m tD D T 0 z z D m A 0 3 Z 3 v n n o m z 4� = o _:p CERTIFICATE of INSTALLATION (Part 1 of 2) NRCI-MCH-01-E PROJECT NAME: Park Ave Cafe LATE: 5/8/17 PROJECT ADDRESS: Building Pelmrt 501 Park Ave, Newport Beach CA 92662 Ch.ck<dbv/Date DATE OF BUILDING PERMIT p ztyfor uz PERMIT # BUILDING TYPE Nonresidential ❑ High -Rise Residential ❑ Hotel/Motel Guest Room PHASE OF CONSTRUCTION ❑ New Construction ❑ Addition Alteration ❑ Unconditioned If more than one person hasres onsib'zl' 1 ding construction, each person shall prepare and sign an Installation Certificate document applicable to the portion of construction for which they are responsible; alternatively, the person with chiefresponsibilityfor construction shall prepare and sign the Installation Certificate document(s) for the entire construction. DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). • I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the Certificate of Compliance that apply to the installation have been met. • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building Permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: K&S Air Conditioninq 's Name: Responsible Persor Kevin Patz I Ket-I , 483431 1Ltl1' oignea: Position With Company: 5/8/17 PM SCOPE OF RESPONSIBILITY Enter the date of approval by enforcement agency of the Certifzca. the specifications for the energy efficiency measures for the scope thatprovides I Date: for this ..wLou: spectry me requirements for the scope of res onsibili for this Installation Certificate. Document Title or Description tion MECH PLANS Date Approved By Applicable Sheets or Pages, Tables, Schedules, etc. the Enforcement ' M-1.0 & M-3.2 A enc 2013 Nonresidential Compliance Forms February 2013 CERTIFICATE of INSTALLATION (Part 2 of 2) NRCI-MCH-01-E In the table below identify all applicable construction documents that speck the requirements for the scope of responsibility reported by this Installation Certificate (continued). Document Title or Description I Applicable Sheets or Pages, Tables, Schedules, etc. 2013 Nonresidential Compliance Forms February 2013 STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE A R COND T ON R AND HEAT PUMP UNITARY SYSTEMS (PACKAGED AND SPLIT) CEC-NRCA-MCH-03-A Revised 12/75 CERTIFICATE OF ACCEPTANCE Constant Volume, Single Zone, Unitary ProJe<t Name: Park Cafe Pr°jed Address: 501 Park Ave System Name or Itlentificatlon�Tag: CU-1/FC-1 Note: Submit one Certificate of Acceptance j demonstrate compliance. A- Construction Insnerrir,., ged and Split) Air Conditioner and Heat Pump Enforcement Agency: cry: Newport Beach System Locatlon °rgrea Served: Kitchen system that must Enforcement Agenly:Usei.. CP 92662 =�-y/uare.: OMMISSI- NRCA-MCH-03_-A (Page 1 of 3) 1. Supporting documentation needed to perform test includes, but not limited to: a. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7,5.2 Constant Volume, Unitary Air Conditioner and Heat Pumps Systems Acceptance At -A -Glance). Single -zone, b. 2013 Building Energy Efficiency Standards Manual. 2. Instrumentation to perform test includes, but not limited to: a. Temperature Meter b. Amp Meter 3. Installation (check if applies): ❑✓ Thermostat is located within the space -conditioning zone that is served by the HVAC system. 4, Programming (check all those that apply): ❑ Thermostat meets the temperature adjustment and dead band requirements of 2013 Building Energy Efficiency Standards Manual section 120.2(6). ❑Minimum heating setpoint: 68 °F. Maximum cooling setpoint 72 ✓ Occupied, unoccupied, and holiday schedules have been programmed per the acility,s schedule. ❑✓ Pre -occupancy purge has been programmed to meet the requirements of 2013 Building section 120.1(1)2, g Energy Efficiency Standards Manual 1. Check method used to determine pre -occupancy purge: ❑✓ Lesser of: conditioned floor area times ventilation rate from 2013 BuildingEner 120.1-A or 15cfm per person times the expected number of occupants. Energy Efficiency Standards TABLE 3 complete air chanees. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance December 2015 STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-03-A (Revised 12/151 SPLIT) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume, Single Zone, Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 3 of 3) Project Name: Park Cafe Enforcement Agency: Permit Number: Project Address: 501 Park Ave City: Newport Beach Zip Code: 92662 System Name or Identification/Tog: CU-1/FC-1 System Location or Area Served: Kitchen DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Kevin Patz Documentation Author Signature: Xv"M OU4 Documentation Author Company Name:K&S AIR CONDITIONING Date Signed: 5/8/17 Address: 143 E. Meats Ave ATT certification Identification (If applicable): city/State/zip: Orange, CA 92865 Phone: 714-685-0077 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: Jeff Tureck / Field Technician Signature: ¢ qwr P.(w Field Technician Company Name:K&S AIR CONDITIONING Position with Company(Title): SERVICE MANAGER Address: 143 E. Meats Ave ATT Certification Identification (if applicable): City/state/Zip: Orange CA 92865 Phone: 714-685-0077 Date signed: 5/8/17 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. 1 am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permit(s) issued for the building. 5. 1 will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance Person Name: Kevin Patz n Responsible Acceptance Person Signature: X'uqm` wvL Responsible Acceptance Person Company Name:K&S AIR CONDITIONING Position with Company (Title): PM Address: 143 E. Meats Ave CSLa License: 483431 City/state/zip: Orange, CA 92865 Phone: 714-685-0077 Date signed: 5/8/17 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance December 2015