HomeMy WebLinkAboutX2019-1562 - MiscX,201q-1562
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"FOR 100 Civic Center Drive I P.O. Box 17681 Newport Beach, CA 92658-8915
www.newportbeachca.00v 1 (949) 644-3200
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Project Address:
Report Date:
CNB Inspector Name:
CNB Permit#:
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❑ Conventional
Footings c Slab
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Building Owner Name:
Owners Mailing Address (if different from site);
Owner's Telephone #:
CNB Plan Check #:
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❑ (Masonry
❑ Concrete
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Full Name of Structural Observer (SO):
SO Email Address:
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SO Telephone #:
SO License/ Reg. #:
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PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check applicable knows
FOUNDATIONS
SHEAR WALLS
FRAMES
DIAPHRAGMS
(Floor/Roof)
INDICATE LOCATIONS)
OBSERVED
DATE
OBSERVED
❑ Conventional
Footings c Slab
_
❑ Concrete
❑ Steel
❑ Concrete
❑ Mat Foundation,
Prestressed Concrete
❑ (Masonry
❑ Concrete
❑ Steel Deck
❑ Caissons, Piles,
Grade Beams
)ff Wood or Manuf.
Shear Panels
❑ Masonry
❑ Wood
❑ Other:
❑ Other:
❑ Other:
❑ Other:
IN ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES.
❑ OBSERVED DEFICIENCIES AND COMMENTS:
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GorS. S'R"�CE�iTorl t�.s�cs p-@cie7.'LS de C'-c2ccPe iY n1'}_�`f C�r1rt. E•F'Fea-Z- G REPORT CONTINUED ON ATTACHED PAGES.
rf FINAL STRUCTURAL OBSERVATION REPORT:
The structure generally cocnpiies 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, of 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.
STAMP OF STRUCTURAL 085ERVER
STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION EYAUTHOREED EMPLOYEES OF THE CITY OF NEWPORT BEACH.
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