HomeMy WebLinkAboutH2021-0369 - MiscCITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
3300 Newport Boulevard I P.O. Box 1768 1 Newport Beach, CA 92658
www.newoortbeachca.gov (949) 644-3200
Structural Observation Report
Projec Address:
.1
Report date:
G 1 0 2-
CNB Inspector Name:
CNB Permit #:
Building Owner Name:
Owner's Mailing address (if different from site);
Owner's Telephone #:
CNB Plan Check #:
Full Name of Structural Observer (SO): - - -
SO email Address:
SO Telephone #:
SO License! Req.,#:
❑ Mat Foundation,
Prestressed Concrete
M Nbri
II- '1—L5
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
5... T
❑ Mat Foundation,
Prestressed Concrete
❑ Masonry
❑ Concrete
❑ Steel Deck
❑ Caissons, Piles,
Grade Beams
❑ Wood or Manuf
Shear Panels
❑ Masonry
❑ Wood
❑ Other:
❑ Other:
other: yl�❑
Other.
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TEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES.
❑ OBSERVED DEFICIENCIES AND COMMENTS:
❑ REPORT CONTINUED ON ATTACHED PAGES.
FINAL STRUCTURAL OBSERVATION REPORT:
he 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". it am the licensed design professional retained by the owner to be in responsible
charge of the structural observation;
A N PP
2. I, or another licensed design professional whom I have designated above and is under
0�
my responsible charge, have performed the required site visits at each significantNO.
57550
construction stage to verify that the structure is in general conformance with the
c,=
approved construction documents;
3. 1 understand that all deficiencies which I have documented must be corrected, prior to
. EXP „ r
Wj
5... T
final acceptance of the structural systems by the City of Newport Beach, Building
Division.
iyI C/VI4
STAMP OF STRUCTURAL OBSERVER
STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BYAUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH.
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TSI'"Hr' CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMEN'1'DEPARTMENT
1 n BUILDING DIVISION
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3300 Newport Boulevard P.O. Box 1768 76 j (Ne) port Beach, CA 92658
www nem beachca. ov 949 644-3200
Structural Observation ReporCNS t
Address
CNB PennNi:
Report date:
Pro ec Addrosa. I 11- �11 Q ._
,I r'address (If diNereM hem site); Ownela Telephone is CNB Plan Check N:
Owner's Malling
BuildinA Owner Name: SO License Y R�N:
SO Telephone N;
SO email Address:
i��
Full Name Of Structural Observer (SO): L*1) 4V d..4P Imo'. I H
r�.�n.... ..._
_ __ FRAMES
SHEAR WALLS
(FloorlJ o
FOUNDATIONS
Steel
0 Ooncrele
Conventonal
0 Concrete
Footin s S Slab
0 Concrete
❑Steel Deck
0 Met Foundation,
Prestressed Concrete0
0 Masonry
❑Masonry
wood
0 Caissons, Piles,
woad Of Ois
Shear Panels
0 Other:
Grade Beams
13 Other.. Othar.l
0 Other.
WITHOUT DEFICIENCIES.
ITEMS CHECKED ABOVE ARE APPROVED AND
p OBSERVED DEFICMENTS:
IENCIES ANDCOM
--
❑ REPORT CONTINUED ON ATTACHED PAGES
OBSERVATION REPORT:
1 dedare that the follOvdng statements are true to the best of my knowledge: cr �(�j1EES//S%�Q,bI�
am the licensed design professional retained by the owner to be in responsible
.. 1, or e of another structural licensed
r ;
p. I, or another Ilcensetl design professional whom i have designated above and is under
my responsible charge, have pedormed the required site visits at each significant NO. 57550
construction stage to verify that the structure is in general conformance with the EXP. ,
approved construction documents; 12/31/x/
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.
STAMPOF STRUCTURAL OBSERVER
(SIGNATURE OF STR l BSERVER OF RECO RD DA ---
STRUCTURAL OBSERVATION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORTBEACN.
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