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Elevation COORDINATES (Optional) E. Units Metric ❑ U.S. Survey Foot 0 Horizontal Datum Zone Epoch Date Vertical Datum ❑ Complies with Public Resources Code §§8801-8819 El Complies with Public Resources Code §§8890-8902 PLS Act Ref: 0 8765(d) ❑ 8771 ❑ 8773 ❑ Other: Corner/ 0 Left as found ❑ Established ❑ Rebuilt ❑ Pre -Construction Monument: ❑ Found and tagged E Reestablished 0 Referenced ❑ Post -Construction Narrative of corner identified and monument as found, set, reset, replaced, or removed: See sheet #2 for description (s): SURVEYOR'S BOUNDARY NOTE: THERE ARE NO CONFLICTS WITH EXISTING VISIBLE IMPROVEMENTS AND THE EXTERIOR BOUNDARY LINE (DISTINCTIVE BORDER) OF THIS MAP AS ESTABLISHED HEREON. SURVEYOR'S STATEMENT This Corner Record was prepared by me or under my direction in conformance with the Professide Land Surveyors' Act on 04/18/2022 Signed P.L.S. No. COUNTY SURVEYOR'S STATEMENT This Corner Record was and examined and filed Signed County Surveyor's Comment P.L.S. No, 8516 MONUMENT NOTES: SCALE 1" = 40' - MONUMENTS ARE FLUSH UNLESS NOTED OTHERWISE. - A DILIGENT SEARCH FOR ALL RECORD MONUMENTS IN THE AREA WAS PERFORMED TO ASSIST IN ESTABLISHING THE BOUNDARY LINES OF THIS SURVEY. ALL OF THE MONUMENTS THAT WERE FOUND ARE SHOWN HEREON. O - SET L,T&T "PLS 8516" ❑ - SET L,T&T "PLS 8516" ON PL PROD. 7.75' FROM PC. ■ - FO 2" IP "LS 3246" PER RI & R2, ON. 0.5'. - FD BRASS DISC "LS 3246" IN WELL MON. PER R1, ON. 1.0' - FD MONUMENT AS NOTED. 82. 1" IP W/ 60D NAIL N40"09'20"W 0.08' FROM RP PER R2. - L,T&T "LS 8682" ON PL PROD. 7.75' FROM PC PER R2. REFERENCE NOTES: ( ) - INDICATES REC. OR CALAC'D FROM REC. DATA AS NOTED. (RI) - TRACT NO.7638, M.M. 306/1-9 (R2) - RS NO. 2016-1145, R.S.B. 289/33 BASIS OF BEARINGS: THE BEARINGS SHOWN HEREON ARE BASED ON THE TANGENT BEARING OF IVERNESS LANE BEING N77059'08"E PER RI. ARC TABLE NO. DELTA RADIUS LENGTH Cl 91'56'05" 48.00' 77.02' (91'32'29"R1) (76.69' Ri) (91'52'33"R2) (76.97'R2) C2 09'57'25" 680.00' 118.17' (90'57'23"Ri) (118.16'R1) N B1G Ny0 (6 54-57' R=g50 0 - ;..' � �54 5� o A=25'13'570 511 R=680,00 Lp=1516 27 ' R2ig1 28R1i d: A=15'163�415516'93( L 1g1.23� C2 w TRACT NO. 7638 o ¢I N30'00'52"E 42.16' III (42.06'R1)(42.14'R2) O 75 Mi 74po nI 0 I� NI I rn O I w( C7 I� 0 N I^ Z Z I Lo ol� �wol� Z RP_ _ _ _�_ \N58'03'03 (RAD.) BASIS OF BEARINGS N7T59'08"E 204.68'M&R1,R2 N �r N46'42'29"E 39.82' (39.50'R1)(39.84'R2) N58'06'30"W 115.25' (113.97'R1)(115.36'R2) / 73; / M.M.306/1--9 V V Llil L,' Vl V 1 lill�V 601 North Ross Street Santa Ana, 92701 t2 OC Public Works 714-6o7-sa88ss Submission Summary Project Project OCID : OC22-32149 Project Name : 19125-29 Inverness Lane -NB Project Description: 19125-29 Inverness Lane -NB Map Application SC220182:Corner Record Scope of Work: Legal Description: LOT 74, TRACT NO.7638, M.M. 306/1-9 Type : Corner Records Jurisdiction : Cities Cities : Newport Beach Number of Corner Records : 1 Corner Type : Property Date of Survey: Toe Feb 15 00:00:00 GMT 2022 Surveyor Job Number: Corner/Monument : Left as found;Reestablished;Referenced Location Contact Name Phone Email Address Type FRP 20422 Beach Blvd, #225 Paul Craft (714) 488-5006 richard@apex-ls.com Huntington Beach CA Applicant No 92948 Paul Craft (714) 488-5006 richard@apex-Is.com 19222 Parker Circle Villa Surveyor/Engineer Yes Park CA 92861 Attachment Name File Name 1st Submittal Corner Record Form CR2022-0864_(19125)-l.pdf Traverse Closures — Required if Boundary Comer Record CR2022-0864_(19125)-CLOSURES_4-18-22.txt VVllll\.,' Vl V1L111�1. OC Public Works • All Other Documents Declaration By submitting this application, I agree: 601 North Ross Street Santa Ana, CA, 92701 714-607-8888 CR2022-0864(19125)-REF.pdf 1. To the best of my knowledge that the information I have presented on this form and attached materials is true and correct and the County of Orange makes no representations regarding such information; and 2. To indemnify, defend and hold harmless the County of Orange, its officers, employees and representatives from any claim or litigation arising from or related to the submission of this application or any actions taken on the basis of this application; and 3. That I am subject to the fees, deposits, and charges as identified in the County's current fee schedules as approved by the County of Orange Board of Supervisors; including, any Road Fee Program annual rate adjustments due at the time of permit issuance as authorized per Resolution #14-053. 4. Applicant shall, at its own expense, defend, indemnify and hold harmless the County of Orange, its officers, agents and employees from any claim, action or proceeding against the County, its officers, agents or employees to attack, set aside, void, or annul any approval of the application or related decision, or the adoption of any environmental documents, findings or other environmental determination, by the County of Orange, its Board of Supervisors, Planning Commission, Zoning Administrator, Subdivision Committee, Director of OC Public Works, or Deputy Director of OC Development Services concerning this application. The County may, at its sole discretion, participate in the defense of any action, at the applicant's expense, but such participation shall not relieve applicant of his/her obligations under this condition. Applicant shall reimburse the County for any court costs and attorney's fees that the County may be required to pay as a result of such action. If litigation is filed challenging the Project, the County may, at its sole discretion, require the Applicant to post a bond, enter into an escrow agreement, obtain an irrevocable letter of credit from a qualified financial institution, or provide other security, to the satisfaction of the County, in anticipation of litigation and possible attorney's fee awards. The County shall promptly notify the applicant of any such claim, action or proceeding. Name : Paul Craft Date : 04/18/2022 Subject: Your Survey has been submitted to Orange County From: myOC eServices Email <noreply-myoceservices@ocgov.com> Date: 4/18/2022, 4:09 PM To: "richard@apex-Is.com" <richard@apex-Is.com> F 4/18/2022 SC220182 Dear Paul Craft, Thank you for your submittal to the Orange County Surveyor's office. For status, please contact Margarita Espinoza at 714-967-0847 or email to Margarita. Espinoza@ocpw_ocgov.com Questions concerning reviews, please contact the following staff: For Tract Maps/ Parcel Maps/LLA/Certificate of Compliance/Certificate of Corrections/Annexations, and Monuments Susan Ruiz Susan. Ruiz.@ cpwocgov.com 714-647-3997 For Record of Survey Steven Dawson Steven. Dawson@ocpwocgov. com 714-967-0843 For Corner Records Jay Seymour Jay. Seymour@ocpwocgov.com 714-967-0830 Sincerely, Kevin R. Hills, County Surveyor 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.newi)ortbeachca.gov 1 (949) 644-3200 Structural Observation Report Project Address: Report Date: CNB Inspector Name: CNB Permit #: 29 Inverness Ave 06/1412023 Building Owner Name: Owners Mailing Address (if different from site); Owner's Telephone #: CNB Plan Check #: Burke Full Name of Structural Observer (SO): SO E-mail Address: SO Telephone #: SO License/Reg. #: Farhad Manshadi Farhad esifine.com 714-835-2800 CE36840 PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTION OBSERVED (check applicable boxes) FOUNDATIONS SHEAR WALLS FRAMES DIAPHGRAGMS (Floor/Roof) INDICATE LOCATION(S) OBSERVED DATE OBSERVED Conventional Footings & Structural Slab r Concrete Steel r Concrete rMat Foundation, Prestressed Concrete r Masonry r Concrete r Steel Deck rCaissons, Piles, Grade Beams r Wood or Manuf. Shear Panels r Masonry r Wood I ware framing and hard connections 06-14-2023 Other: r Other: r Other: r Other rVITMENS CHECKED ABOVE ARE APPROVED AND WITHOUGH DEFICIENCIES. OBSERVED DEFICIENCIES AND COMMENTS: r REPORT CONTINUED ON ATTACHED PAGES WORNAL STRUCTURAL OBSERVATION REPORT: The structural 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. 1 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 verity 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. 06-14-2023 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: Report Date: CNB Inspector Name: CNB Permit#: 29 Inverness Ave 9/7/2022 Building Owner Name: Owner's Mailing Address (if different from site); Owners Telephone #: CNB Plan Check M Burke Full Name of Structural Observer (SO): SO E-mail Address: SO Telephone #: SO License/Reg. #: Farhad Manshadi Farhad esifine.com 714-835-2800 CE36840 PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTION OBSERVED (check applicable boxes) FOUNDATIONS SHEAR WALLS FRAMES DIAPHGRAGMS (Floor/Roof) INDICATE LOCATION(S) OBSERVED DATE OBSERVED Conventional Footings & Structural Slab r Concrete r Steel r Concrete r—Mat Foundation, Prestressed Concrete masonry r Mason r Concrete r Steel Deck rCaissons, Piles, Grader Beams Wood or Manuf. Shear Panels r Masonry Wood First floor sht'g: nailing and traps g 7 2022 Other: r Other: r Other: r Other re—ITMENS CHECKED ABOVE ARE APPROVED AND WITHOUGH DEFICIENCIES. OBSERVED DEFICIENCIES AND COMMENTS: r REPORT CONTINUED ON ATTACHED PAGES rFINAL STRUCTURAL OBSERVATION REPORT: The structural 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. 1 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 verity 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. �/ 9-7-2022 Knipe, Kenneth From: Jacob Gillmore <jake@uccustomhomes.com> Sent: June 21, 2024 9:04 AM To: Knipe, Kenneth Subject: Fwd: 29 inverness sor urgent Sent from my iPhone Begin forwarded message: From: Ariyan Manshadi <ariyan@esifine.com> Date: June 21, 2024 at 8:31:34 AM PDT To: Jacob Gillmore <jake@uccustomhomes.com> Subject: Re: 29 inverness sor urgent Hi Jacob, I left the office, it's going to have to be this afternoon. Thank you, Ari Get Outlook for iOS From: Jacob Gillmore <jake@uccustomhomes.com> Sent: Friday, June 21, 2024 8:08:39 AM To: Ariyan Manshadi <ariyan@esifine.com> Subject: Re: 29 inverness sor urgent Could you send me any other framing structural observation reports you have please? Sent from my iPhone > On Jun 21, 2024, at 8:07 AM, Jacob Gillmore <jake@uccustomhomes.com> wrote: >Thankyou > Sent from my iPhone >> On Jun 21, 2024, at 7:58 AM, Ariyan Manshadi <ariyan@esifine.com> wrote: >> Hi Jacob, >> Please see attached. We call it 1 st floor sheathing (the framing above the 1 st floor) but it's below the second floor. 1 >> Thank you, >> Ari >> Ariyan M. >> ESI/FME, Inc. >> Structural Engineers >> 230 Commerce, Unit 200 >> Irvine, Ca. 92602 >> (657) 335-4113 >> ariyan@esifine.com >> visit www.esifine.com >> CONFIDENTIALITY: The information contained in this e-mail message, including any accompanying documents or attachments, is from ESI/FME, Inc. and is intended onlyforthe use of the individual or entity named above, and is privileged and confidential. If you are not the intended recipient, be aware that any disclosure, dissemination, distribution, copying or use of the contents of this message is stricly prohibited. Due to the vulnerabilities associated with electronic communications this message and any attachments should be checked for destructive content prior to executing. ESI/FME, Inc is not responsible for loss or damage arisingfrom the use of this e- mail or attachments. >> -----Original Message ----- >> From: Jacob Gillmore <jake@uccustomhomes.com> >> Sent: Friday, June 21, 2024 7:48 AM >> To: Ariyan Manshadi <ariyan@esifine.com> >> Subject: 29 Inverness sor urgent >> Hey Ari, I'm trying to get Final stretched on the house and my inspector is looking for the second floor structure report, any chance you have that and can send it? Sorrythis is kind of an emergency. He's gonna be here around 8 o'clock. >> Sent from my Whone >> <9. FIRST FLOOR SHT'G.pdf> 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.aov 1 (949) 644-3200 Structural Observation Report Project Address: Report Date: CNB Inspector Name: CNB Permit #: 29 Inverness Ave 10/25/2099 Building Owner Name: Owners Mailing Address (if different from site); Owner's Telephone #: CNB Plan Check #: Burke Full Name of Structural Observer (SO): SO E-mail Address: SO Telephone #: SO License/Reg. #: Farhad Manshadi Farhad esifine.com 714-835-2800 CE36840 PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTION OBSERVED (check applicable boxes) FOUNDATIONS SHEAR WALLS FRAMES DIAPHGRAGMS (Floor/Roof) INDICATE LOCATION(S) OBSERVED DATE OBSERVED Conventional Footings & Structural Slab I—concreter Steel r Concrete rMat Foundation, Prestressed Concrete masonry r Mason r Concrete r Steel Deck aissons, Piles, Grade Beams Woad or Manuf. Shear r Panels r Masonry � wood Roof sht'g and shear walls: ailing, straps, and shear connections 10-25-2022 Other: r Other: r Other: r Other rITMENS CHECKED ABOVE ARE APPROVED AND WITHOUGH DEFICIENCIES. OBSERVED DEFICIENCIES AND COMMENTS: r REPORT CONTINUED ON ATTACHED PAGES FFINAL STRUCTURAL OBSERVATION REPORT: The structural 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. 1 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 verity 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. � (///fyf� 10-25-2022 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.newportbeachGa.gov 1 (949) 644-3200 Structural Observation Report Project Address: Report Date: CNB Inspector Name: CNB Permit #: 29 Inverness Ave 3/14/2022 Building Owner Name: Owner's Mailing Address (d different from site); Owners Telephone #: CNB Plan Check Burke Full Name of Structural Observer (SO): SO E-mail Address: SO Telephone #: SO License/Reg. #: Farhad. Manshadi Farhad 1esifirine.com 714-835-2800 CE36840 PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTION OBSERVED (check applicable boxes) FOUNDATIONS SHEAR WALLS FRAMES DIAPHGRAGMS (Floor/Roof) INDICATE LOCATION(S) OBSERVED DATE OBSERVED Conventional Footings & Slab Concrete Steel Concrete r Mat Foundation, Prestressed Concrete Masonry F Concrete F Steel Deck r Caissons, Piles, Grade Beams �-- Wood or Manuf. Shear Panels F Masonry Wood Caisson rage rebar & Placement 3 14 22 ii Other: Other: r Other: r Other ITMENS CHECKED ABOVE ARE APPROVED AND WITHOUGH DEFICIENCIES. OBSERVED DEFICIENCIES AND COMMENTS: Note: This is specifically for the site wall caissons (PART 1) (� REPORT CONTINUED ON ATTACHED PAGES f FINAL STRUCTURAL OBSERVATION REPORT: The structural 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. 1 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 verity that the structure is in general conformance with the approved construction documents; 3. 1 understand that all deficiencies which I have docuMonted must be corrected, prior to final accepts of the structural sys y the City of Newport Beach, Building v 3-14-22 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.Dov 1 (949) 644-3200 Structural Observation Report Project Address: Report Date: CNB Inspector Name: CNB Permit* 29 Inverness Ave 4/26/2022 Building Owner Name: Owner's Mailing Address (if different from site); Owner's Telephone #: CNB Plan Check # Burke Full Name of Structural Observer (SO): SO E-mail Address: SO Telephone #. SO License/Reg. #: Farhad Manshadi Farhad esitme.com 714-6352600 --- PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTION OBSERVED (check applicable boxes) FOUNDATIONS SHEAR WALLS FRAMES DIAPHGRAGMS (Floor/Roof) INDICATE LOCATION(S) OBSERVED DATE OBSERVED Conventional Footings & Slab r Concrete r Steel r Concrete Mat Foundation, Prestressed Concrete r Masonry r Concrete F Steel Deck p— Caissons, Piles, Grade Beams r- Woad or Manuf. Shear Panels r Masonry Wood ite Wall and grade beam einforcing 4-26-22 Other: 17- Other: IF Other: r Other ITMENS CHECKED ABOVE ARE APPROVED AND WITHOUGH DEFICIENCIES. OBSERVED DEFICIENCIES AND COMMENTS: Note: This structural observation covers the remaining site walls at the front of the property. Also, the grade beam and site wall along the property line at the right of the house. F_ REPORT CONTINUED ON ATTACHED PAGES r FINAL STRUCTURAL OBSERVATION REPORT: The structural 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. 1 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 verity 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. 04/26/22 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: Report Date: CNB Inspector Name: CNB Permit#: 29 Inverness Ave 7/8/2022 Building Owner Name: Owner's Mailing Address (if different from site); Owner's Telephone #: CNB Plan Check #: Burke Full Name of Structural Observer (SO): SO E-mail Address: SO Telephone M SO License/Reg. #: Farhad Manshadi FarhadOesifme.com 714-M-2800 CE36840 PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTION OBSERVED (check applicable boxes) FOUNDATIONS SHEAR WALLS FRAMES DIAPHGRAGMS (Floor/Roof) INDICATE LOCATION(S) OBSERVED DATE OBSERVED Conventional Footings & Structural Slab r— Concrete i� Steel FConcrete Patio structural slab 7-8-2022 rMat Foundation, Prestressed Concrete Masonry, F Concrete Steel Deck r--Caissons, Piles, Grade Beams Wood or Manuf. Shear Panels r Masonry F Wood Other, IF Other: Other: Ir Other FIITMENS CHECKED ABOVE ARE APPROVED AND WITHOUGH DEFICIENCIES. OBSERVED DEFICIENCIES AND COMMENTS: r REPORT CONTINUED ON ATTACHED PAGES FINAL STRUCTURAL OBSERVATION REPORT: The structural 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. 1 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 verity that the structure is in general conformance with the approved construction documents; & 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. ��' 7-8-2022 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: Report Date: CNB Inspector Name: CNB Permit* 29 Inverness Ave 6/27/2022 Building Owner Name: Owner's Mailing Address (if different from site); Owner's Telephone #: CNB Plan Check #: Burke Full Name of Structural Observer (SO): SO E-mail Address: SO Telephone #: SO License/Reg. #: Famed Manshadi Farhad esif e.com 714-835-2800 CE36a40 PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTION OBSERVED (check applicable boxes) FOUNDATIONS SHEAR WALLS FRAMES DIAPHGRAGMS (Floor/Roof) INDICATE LOCATION(S) OBSERVED DATE OBSERVED Conventional Footings & Structural Slab IF Concrete Steel r Concrete Structural slab mbar 8-27-2022 Mat Foundation, rPrestressed Concrete Masonry Concrete F Steel Deck I —Caissons, Piles, Grader Beams Wood or Manuf. Shear Panels F Mason ry Wood Other: r Other: 'r Other: Other F ITMENS CHECKED ABOVE ARE APPROVED AND WrHOUGH DEFICIENCIES. OBSERVED DEFICIENCIES AND COMMENTS: r REPORT CONTINUED ON ATTACHED PAGES rFINAL STRUCTURAL OBSERVATION REPORT: he structural 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. 1 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 verity 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.. /�� 6-27-2022 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 Observatinn Panii Project Address: Report Date: CNB Inspector Name: 291nverness Ave /8/2022Building Owner Name: Owner's Mailing Address (if different from site); Owner's Telephone #: Burke aCE36840 Full Name of Structural Observer (SO): SO E-mail Address: SO TlFarhad Manshadi Farhad esifinecom PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTION ORRFR\/Pn /chcrlr r.,.--- FOUNDATIONS SHEAR WALLS FRAMES DIAPHGRAGMS (Floor/Roof) INDICATE LOCATION(S) OBSERVED DATE OBSERVED Conventional Footings & Slab r Concrete F Steel F Concrete r- Mat Foundation, Prestressed Concrete r Masonry F Concrete F Steel Deck F,- Caissons, Piles, Grade Beams L- Wood or Manuf. Shear Panels F Masonry F Wood Grade beams, anchor bolts Hold downs, templates ("-22 Other: r Other. F Other: r Other F ITMENS CHECKED ABOVE ARE APPROVED AND WITHOUGH DEFICIENCIES. OBSERVED DEFICIENCIES AND COMMENTS: Note: F REPORT CONTINUED ON ATTACHED PAGES F FINAL STRUCTURAL OBSERVATION REPORT: The structural 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. 1 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 verity 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. G B 00-20-22 C 36840 cf\/ FP 0F C CITY OF NEWPORT BEACH COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive 1 P.O. Box 1768 1 Newport Beach, CA 92658-8915 www.newportbeachca.aov 1 (949) 644-3200 Structural Observation Report Project Address: Report Date: CNB Inspector Name: CNB Permit#: 29 Inverness Ave 4/21/2022 Building Owner Name: Owner's Mailing Address (if different from site); Owners Telephone #: CNB Plan Check* Burke Full Name of Structural Observer (SO): SO E-mail Address: SO Telephone #: SO License/Reg. #: Farhad Manshadi Farhad esifine.com 714-835-2800 CE36840 PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTION OBSERVED (check applicable boxes) FOUNDATIONS SHEAR WALLS FRAMES DIAPHGRAGMS (Floor/Roof) INDICATE LOCATION(S) OBSERVED DATE OBSERVED Conventional Footings 8 Slab F_ Concrete FSteel FConcrete Mat Foundation, Prestressed Concrete Masonry Concrete Steel Deck Caissons, Piles, Grade Beams Wood or Manuf. Shear Panels Masonry F Mason Wood Caisson cage rebar & lacement 4-25-22 Other: F Other: F Other: (— Other PO ITMENS CHECKED ABOVE ARE APPROVED AND WITHOUGH DEFICIENCIES. OBSERVED DEFICIENCIES AND COMMENTS: Note: This is specifically for the caissons at the house and include the caisson numbers below - 44,50,56,43,65,55,42,64,54,1,23,11,61,23,35,37,38,40 REPORT CONTINUED ON ATTACHED PAGES FINAL STRUCTURAL OBSERVATION REPORT: The structural 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. 1 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 verity 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. "� 04-25-22 r . .0 s Cq�rpoftN�h c 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.Dov 1 (949) 644-3200 Structural Observation Renort Project Address: `..: Report Date: CNB Inspector Name: CNBPermit #. 291nVemess.Ave .. ....,,..' 4/14/2622 Building Owner Name: Burke Owner's Mailing Address (if different from site); Owners Telephone #: - CNB Plan Check #: Full Name of Structural Observer (SO): SO E-mail Address: 'esifine.com SO Telephone #: SO License/Reg. #: FarFiad Manshadl Ferhad 714=B35-2800 CE36840: PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTION OBSERVED (check annlirahlP hnvacl FOUNDATIONS SHEAR WALLS FRAMES DIAPHGRAGMS (Floor/Roof) INDICATE LOCATION(S) OBSERVED DATE OBSERVED Conventional Footings & Slab ; Concrete Steel !Concrete Mat Foundation, r Prestressed Concrete r Masonry Concrete [Steel Deck .. r Caissons, Piles, Grade Beams t Wood or Manuf. Shear Panels 177 Masonry r Wood Caisson cage rebar & -, Placement - �� 4-12-22.; Other. - - r i Other. r Other: r Other - Site w I reb4 S i Ail 412-22 'r ITMENS CHECKED ABOVE ARE APPROVED AND WITHOUGH DEFICIENCIES. O * J OBSERVED DEFICIENCIE�,AND COMMENTS: - Note: This is specifically for caissons at the house and include the caisson numbers below - - . a91 3.2 6. Z o 22 ., - - r REPORT CONTINUED ON ATTACHED PAGES r FINAL STRUCTURAL OBSERVATION REPORT: The structural generally complies with the approved construction documents, and all observed deficiencies were corrected. 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. 1 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 verity that the structure is in general conformance With the approved construction documents; 3. 1 understand that all deficiencies which I have documenW must be corrected, prior to final acceptance of the structural syste a City of Newport Beach, Building Division. 04-14-22 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.newoortheachea.aov 1(949) 644-3200 Structural Observation Report Project Address: Report Date: CNB Inspector Name: CNB Permit 29 Inverness Ave 4112t2022 Building Owner Name: Owner's Mailing Address (If different from site); Owners Telephone #. CNB Plan Check #. Burke Full Name of Structural Observer (SO): SO E-mail Address: SO Telephone #: SO LicenselReg. #: Farhad Manshadi Farhad esifine.com 714-835.2800 CE36840 PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTION OBSERVED (check applicable boxes) FOUNDATIONS SHEAR WALLS FRAMES DIAPHGRAGMS (Floor/Roof) INDICATE LOCATION(S) OBSERVED DATE OBSERVED Conventional Footings & Slab :Concrete - Steel r Concrete Mat Foundation, Prestressed Concrete Masonry r Concrete r Steel Deck w. Caissons, Piles, Grade Beams . Wood or Manuf. Shear Panels r Masonry r Wood Caisson cage rebar & Placement g 4-12-22 Other: ...- Other: F Other. - Other ,Y ITMENS CHECKED ABOVE ARE APPROVED AND WITHOUGH DEFICIENCIES. OBSERVED DEFICIENCIES AND COMMENTS: Note: This is specifically for the caissons at the house and include the caisson numbers below - '3 3 141 i5 i(P 4 2yg zr 2 i 26g REPORT CONTINUED ON ATTACHED PAGES r FINAL STRUCTURAL OBSERVATION REPORT: he structural 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; 2. 1 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 verity 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. 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.aov 1 (949) 644-3200 Structural Observation Report Project Address: Report Date: CNB Inspector Name: CNB Permit#: 29 Inverness Ave 4/01/2022 Building Owner Name: Owner's Mailing Address (if different from site); Owner's Telephone #: CNB Plan Check #: Burke Full Name of Structural Observer (SO): SO E-mail Address: SO Telephone #: SO License/Reg. #: Farhad Manshadi Farhad esifine.com 714-835-2800 CE36840 PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTION OBSERVED (check applicable boxes) FOUNDATIONS SHEAR WALLS FRAMES DIAPHGRAGMS (Floor/Roof) INDICATE LOCATION(S) OBSERVED DATE OBSERVED Conventional Footings &Slab r Concrete Steel Concrete Mat Foundation, Prestressed Concrete Masonry F Concrete F Steel Deck Caissons, Piles, Grade Beams Wood or Manuf. Shear Panels �- Masonry Wood Caisson cage rebar & Placement 4-01 -22 F Other: 'T_ Other: Other: Other By ITMENS CHECKED ABOVE ARE APPROVED AND WITHOUGH DEFICIENCIES. OBSERVED DEFICIENCIES AND COMMENTS: Note: This is specifically for the caissons at the house and include the caisson numbers below - 9,10,20,21,22, 28,30,32,33,34,41,45,46,47,48,49,51,52,53,54,56,57,63 REPORT CONTINUED ON ATTACHED PAGES r FINAL STRUCTURAL OBSERVATION REPORT: The structural 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 am the licensed design professional retained by the owner to be in responsible charge of the structural observation; 2. 1 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 verity 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. 04-01-22 CITY OF NEWPORT BEACH COMAI2UNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive I P.O. Box 1768 ( Newport Beach, CA 92658-8915 www.newportbeachca.gov 1 (949) 644-3200 Structural Observation Report Project Address: Report Date: CNB Inspector Name: CNB Permit #: 29 Inverness Ave 3/18/2022 Building Owner Name: Owner's Mailing Address (if different from site); Owner's Telephone #: CNB Plan Check #: Burke Full Name of Structural Observer (SO): SO E-mail Address: SO Telephone #: SO License/Reg. #: Farhad Manshadi Farhad@esifme.com 714-835-2800 CE36840 PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTION OBSERVED (check applicable boxes) FOUNDATIONS SHEAR WALLS FRAMES DIAPHGRAGMS (Floor/Roof) INDICATE LOCATION(S) OBSERVED DATE OBSERVED Conventional Footings & Slab Concrete r Steel Concrete r Mat Foundation, Prestressed Concrete F Masonry F Concrete F Steel Deck Caissons, Piles, Grade Beams Wood or Manuf. Shear Panels i� Masonry Wood Caisson ca a rebar & Placementg 3-18-22 j Other: Other: (� Other. Other ITMENS CHECKED ABOVE ARE APPROVED AND WITHOUGH DEFICIENCIES. OBSERVED DEFICIENCIES AND COMMENTS: Note: This is specifically for the site wall caissons (PART II). This structural observation includes the remaining site wall caissons F REPORT CONTINUED ON ATTACHED PAGES I FINAL STRUCTURAL OBSERVATION REPORT: The structural generally complies with the approved construction documents, and all observed deficiencies were corrected. 1 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; .. 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 verity that the structure is in general conformance with the approved construction docume s; I understand that all deficiencies which I hasda6urnentecl must be corrected, prior to final acceptance of the structural ems by the City of Newport Beach, Building Division. _A /I , /� 3-18-22 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 BUILDING HEIGHT CERTIFICATION Project Street Address: 29Inverness Lane, Newport Beach Building Permit Number(s): As the surveyor of record for the project at the above address, I hereby certify that I have reviewed the City of Newport Beach approved plan and original topographic survey and based the elevations listed below on those plans. Elevations shall include an allowance for roofing material thickness if not yet installed. Provide each critical ridge and flat roof, or roof deck railing elevations indicated on the approved plans. Use the format below on the back of this form if additional space is necessary or further explanation is needed. Provide original copy to the inspector before roof framing inspection. All elevation points are based on: O NAVD88 O NGVD29 O Assumed Please provide the following elevation information for the highest roof ridges, flat roofs, or parapets/guardrails. Additional elevation points may be requested by the Building Inspector. RIDGES (3:12 slope or greater) Approved elevation point of ridge is 251.75 and actual elevation point is 251.56 QApproved elevation point of ridge is 252.92 and actual elevation point is 251.68 Qc Approved elevation point of ridge is 25333 and actual elevation point is 253.33 Approved elevation point of ridge is and actual elevation point is Approved elevation point of ridge is and actual elevation point is Approved elevation point of ridge is and actual elevation point is Approved elevation point of ridge is and actual elevation point is FLAT ROOFS, PARAPETS AND GUARDRAILS Approved elevation point of flat roof or parapet is and actual elevation point is Approved elevation point of flat roof or parapet is and actual elevation point is Approved elevation point of flat roof or parapet is and actual elevation point is Approved elevation point of flat roof or parapet is and actual elevation point is Approved elevation point of flat roof or parapet is and actual elevation point is I certify that the above height measurements are correct and the above project: OIS in compliance with the City -approved plans. LEE Please JN: 19125 Survk or r Civil Engi ( is a • License number o 65 otlbt Fo m \Building Height CWHication 1IY02/16 the City -approved plans (Provide explanation). plans on the back of this form. ;nature and seal required) 10i27/2022 Date a From: 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 CIVIL ENGINEER'S CERTIFICATION FORM Thomas M. Ruiz, C.E. 11 Thornbird Aliso Viejo ATTENTION: GRADING ENGINEER, BUILDING DIVISION Date: June 14, 2024 GPC No.: 2116-2021 Tract/Subdivision/Lot No.: Rough: _Final: x Project Names: Owner/Developer: Type of Project: _ Tract: _ Commercial Industrial 29 Inverness Lane Damian Burke Notes: Drainage Single Family Residence x Other Yardage for Project: 0 Cut: _ Borrow: 198 Fill: _ Export: Notes: I hereby approve the grading for this project in accordance with my responsibilities under the City Grading Code. I have inspected the project and hereby certify that all areas exhibit positive surface flow to public ways or City approved drainage devices. The grading has been completed: x in conformance with, with the following changes to the approved grading plan. Description of Changes: Company: Thomas M. Ruiz, C.E. Name: Thomas Ruiz (pant) License No.: C58627 RCE/LS) (sign) NN, 110" e. CITY OF NEWPORT BEACH Community Development Department I Building Division 100 Civic Center Dr.I P.O. Box 1768 Newport Beach, CA 92658 www.newportbeachca.gov (949) 644-3200 CALGREEN DOCUMENTATION COMPLIANCE CERTIFICATION ADDRESS: 29 Inverness Ln PERMIT NO.: X2021-2460 THIS FORM SHALL BE COMPLETED AND SIGNED PRIOR TO REQUEST FOR FINAL BUILDING INSPECTION. ONE COPY OF THIS FORM SHALL BE SUBMITTED TO THE BUILDING INSPECTOR AT FINAL INSPECTION AND ONE SHALL BE PROVIDED TO THE BUILDING OWNER AS PART OF THE CAL GREEN CERTIFICATION PACKAGE. The following section shall be completed by a person with overall responsibility for the planning and design portion of the project. REQUIRED DOCUMENTATIONS PROVIDED TO THE PROPERTY OWNER(S) K Franchise Hauler for Construction/Demolition Waste (65% min. reuse of nonhazardous waste) 10 VOC Contents Limitation ® Formaldehyde Emissions Limitation ® T-24 Energy Certificate of Installations (Env., QII, Lighting, Photovoltaic, Mach., Plumb.) ® T-24 Energy Certificate of Verifications or Acceptance ( Env., QII, Lighting, Photovoltaic, Mech., Plumb., HERS) id Operations and Maintenance Manual MOISTURE CONTENT OF BUILDING MATERIAL (RESIDENTIAL CONSTRUCTION ONLY) R 1 certify that the moisture content of the wall and floor framing is less than 19 percent as determined in accordance with Section 4.505.3 of CAL Green prior to being enclosed. DECLARATION STATEMENT • 1 certify under penalty of perjury, under the laws of the State of California, the information provided is true and correct. • 1 certify that the installed measures, materials, components, or manufactured devices identified on this certificate conform to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcing agency. Responsible Person's Name: Peter Dunn 06/18/2024 Notes: Residential Director Forms\CALGreen Documentation Compliance Cert Form 1-2017 Effective 06/16/2024 13:08 (Page 1 of 4) I K91114;A1 91n;1*131T, utrel:I Energy Standards Code Year: 2019 Project Name: Burke ■ ■ Project Type: New Construction SFR Address: 29Inverness Lane ■ City/State/Zip: Newport Beach / CA / 92660 L ■ Enforcement Agency: City of Newport Beach N ■ Easy to Verify @ calcerts.com Permit Number: X2021-3335 OVERALL STATUS COMPLETE HERS VERIFIABLE MEASURES: COMPLETE CF1R INFORMATION - Certificate of Compliance (Document Lists Required Energy Features) Certificate Type Compliance Registered Form CF1R-PRF-01 Registered Date 2023-07-1814:24:47 Registration Number 221-P010186092D-000-000-0000000-0000 CF2R INFORMATION - Certificate of Installation (Documents the proper installation of required energy features) V/ System Form Registered Date Registration Number CF2R-ENV-01-E 221-P010186092D-000-001-E01001A-0000 Fenestration Installation 2024-06-14 18:36:05 Cory Elliott V/ (BREEZY AIR) CF2R-ENV-03-E 221-P0l0186092D-000-001-E03001A-0000 Insulation Installation 2024-06-14 18:36:05 Cory Elliott (BREEZY AIR) CF2R-ENV-04-E 221-P010186092D-000-001-E04001A-0000 Roofing -Radiant Barrier 2024-06-14 18:36:05 Cory Elliott (BREEZY AIR) CF2R-LTG-01-E 221-P010186092D-000-001-L01001A-0000 Lighting 2024-06-14 18:36:05 Cory Elliott ,%/ (BREEZY AIR) CF2R-MCH-01-E 221-P0l0186092D-000-001-M01001A-0000 Space Conditioning 2024-06-14 18:36:05 Cory Elliott ,V/_ Systems, Ducts and Fans (BREEZY AIR) HERS Providers raICPRTS Inc Effective 06/16/2024 13:08 (Page 2 of 4) I System 1: Location MR-MCH-20-1-1 221-P010186092D-000-001-M20001A-0000 1 Duct Leakage 2024-06-1418:36:05 Cory Elliott/ (BREEZY AIR) System 2: Location CF2R-MCH-20-H 2024-06-14 18:36:05 221-PO10186092D-000-001-M20002A-0000 Cory Elliott (/ 2 Duct Leakage (BREEZY AIR) System 3: Location CF2R-MCH-20-H 221-P010186092D-000-001-M20003A-0000 3 Duct Leakage 2024-06-14 18:36:05 Cory Elliott (BREEZY AIR) System 1: Location CF2R-MCH-23-H 221-P010186092D-000-001-M23001A-0000 1 Airflow 2024-06-14 18:36:05 Cory Elliott (BREEZY AIR) System 2: Location CF2R-MCH-23-H 2024-06-14 18:36:05 221-PO10186092D-000-001-M23002A-0000 Cory Elliott 2 Airflow (BREEZY AIR) System 3: Location CF2R-MCH-23-H 2024-06-1418:36:05 221-P010186092D-000-001-M23003A-0000 Cory Elliott 3 Airflow (BREEZY AIR) System 1: Location CF2R-MCH-22-H 2024-06-14 18:36:05 221-P010186092D-000-001-M22001A-0000 Cory Elliott 1 Fan Efficacy (BREEZY AIR) System 2: Location CF2R-MCH-22-H 221-P010186092D-000-001-M22002A-0000 2 Fan Efficacy 2024-06-1418:36:05 Cory Elliott (BREEZY AIR) System 3: Location CF2R-MCH-22-H 2024-06-14 18:36:05 221-13010186092D-000-001-M22003A-0000 Cory Elliottf 3 Fan Efficacy (BREEZY AIR) CF2R-MCH-25-H 221-PO10186092D-000-001-M25001A-0000 System 1 Refrigerant Charge 2024-06-14 18:36:05 Cory Elliott �( (BREEZY AIR) CF2R-MCH-25-H 221-PO10186092D-000-001-M25002A-0000 System 2 Refrigerant Charge 2024-06-14 18:36:05 Cory Elliott V/ (BREEZY AIR) CF2R-MCH-25-H 221-P010186092D-000-001-M25003A-0000 System 3 Refrigerant Charge 2024-06-1418:36:05 Cory Elliott (BREEZY AIR) CF2R-MCH-26-H 221-P010186092D-000-001-M26001A-0000 System 1 Rated Equipment 2024-06-1418:36:05 Cory Elliott (BREEZY AIR) CF2R-MCH-26-H 221-P010186092D-000-001-M26002A-0000 System 2 Rated Equipment 2024-06-14 18:36:05 Cory Elliott (BREEZY AIR) CF2R-MCH-26-H 221-P010186092D-000-001-M26003A-0000 System 3 Rated Equipment 2024-06-14 18:36:05 Cory Elliott (BREEZY AIR) CF2R-MCH-27-H 221-P010186092D-000-001-M27001A-0000 IAQ and MV 2024-06-14 18:36:05 Cory Elliott (BREEZY AIR) HERS ProviderCaICERTS Inc Effective 06/16/2024 13:08 (Page 3 of 4) CF2R-PLB-02-E 221-P010186092D-000-001-B02001A-0000 2024-06-1418:36:05 Cory Elliott( SD HWS Distribution (BREEZY AIR) CF2R-PVB-01-E 221-P010186092D-000-001-V01001A-0000 Photovoltaic Systems 2024-06-14 18:36:05 Cory Elliott V (BREEZY AIR) CF3R INFORMATION - Certificate of Verification (Documents the verification of HERS Measures) V/ System Form Registered Date Registration Number System 1: Location CF3R-MCH-20-H 221-P010186092D-000-001-M20001A-M20A 1 (Dud Leakage) 2024-06-14 17:36:07 AMIN FARSI (CC2017004) (ECO HERS) System 2: Location CF3R-MCH-20-H 221-P010186092D-000-001-M20002A-M20A 2 (Dud Leakage) 2024-06-14 17:36:14 AMIN FARSI (CC2017004) V/ (ECO HERS) System 3: Location CF3R-MCH-20-H 221-P010186092D-000-001-M20003A-M20A 3 (Dud Leakage) 2024-06-14 17:36:21 AMIN FARSI (CC2017004) (ECO HERS) System 1: Location CF3R-MCH-23-H 221-P010186092D-000-001-M23001A-M23A 1 (Airflow) 2024-06-14 17:36:29 AMIN FARSI (CC2017004) (ECO HERS) System 2: Location CF3R-MCH-23-H 221-P010186092D-000-001-M23002A-M23A 2 (Airflow) 2024-06-1417:36:38 AMIN FARSI (CC2017004) (ECO HERS) System 3: Location CF3R-MCH-23-H 221-P010186092D-000-001-M23003A-M23A 3 (Airflow) 2O24-06-14 17:36:46 AMIN FARSI (CC2017004) X/ (ECO HERS) System 1: Location CF3R-MCH-22-H 221-P010186092D-000-001-M22001A-M22A 1 (Fan Efficacy) 2024-06-14 17:36:57 AMIN FARSI (CC2017004) (ECO HERS) System 2: Location CF3R-MCH-22-H 221-P010186092D-000-001-M22002A-M22A 2 (Fan Efficacy) 2024-06-14 17:37:06 AMIN FARSI (CC2017004) (ECO HERS) System 3: Location CF3R-MCH-22-H 221-P010186092D-000-001-M22003A-M22A 3 (Fan Efficacy) 2024-06-1417:37:14 AMIN FARSI (CC2017004) (ECO HERS) CF3R-MCH-25-H 221-P010186092D-000-001-M25001A-M25A System 1 (Refrigerant Charge) 2024-06-1417:37:27 AMIN FARSI (CC2017004) (ECO HERS) CF3R-MCH-25-H 221-P010186092D-000-001-M25002A-M25A System 2 (Refrigerant Charge) 2024-06-1417:37:41 AMIN FARSI (CC2017004) (ECO HERS) CF3R-MCH-25-H 221-P010186092D-000-001-M25003A-M25A System 3 (Refrigerant Charge) 2024-06-14 17:37:57 AMIN FARSI (CC2017004) (ECO HERS) CF3R-MCH-26-H 221-P010186092D-000-001-M26001A-M26A System 1 (Rated Equipment) 2024-06-14 17:38:26 AMIN FARSI (CC2017004) (ECO HERS) HERS ProAdeo CaICERTS Inc. Effective 06/16/2024 13:08 (Page 4 of 4) I CF3R-MCH-26-H 221-P010186092D-000-001-M26002A-M26A System 2 (Rated Equipment) 2024-06-1417:38:43 AMIN FARSI (CC2017004) (ECO HERS) CF3R-MCH-26-H 221-P010186092D-000-001-M26003A-M26A System 3 (Rated Equipment) 2024-06-14 17:39:01 AMIN FARSI (CC2017004) (ECO HERS) CF3R-MCH-27-H 221-P010186092D-000-001-M27001A-M27A (IAO and M� 2024-06-1417:39:14 AMIN FARSI (CC2017004) (ECO HERS) � � � alma t J` m 4 �+✓ d�, hSpd ,a HERS ProviderCaICERTS Inc. `'tl p `'� CITY OF NEWPORT BEACH t COMMUMTV DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 926588915 www.newportbeachr-a.gov 1(949) 644-3200 CONTRACTOR/PROPERTY OWNER SELF -CERTIFICATION DECLARATION FOR PLUMBING FIXTURE REPLACEMENT Project Address: 29Inverness Ln., Newport Beach, CA 92660 Date: 06/18/2024 Permit #: X2021-2460 The following is to be completed by the California licensed contractor or owner, participating in the City of Newport Beach Self -Certification Program. Please type or print. Installers Name: Josh Moreno License No (rf applicable) 0688233 Installer's Mailing Address:17512 Grinin lane unit #2 Huntington Beach, CA 92647 Phone # (required): 714-8414930 Installers Email: admin@aeativedesignplumbing.com FAX #: Installer certify that the installation is in compliance with applicable code requirements. 1 further affirm that I have reviewed and understand the requirements of the 2019 California Green Building Standards Code (CGBSC) Section 301.1.1 and that all self -certification reports submitted will be based on the code requirements contained therein. I declare that all plumbing fixtures subject to the CGBSC 301.1.1 has been replaced meeting the low flow requirements: Kitchen faucets: 1.8 gal/minute at 60 psi Shower heads: 1.8 gal/minute at 80 psi r-oset: 1 Water cl.28-- gal/flush -� Faucets: maximum flow rate of 1.2 gallminute at 60 psi, and minimum 0.8 gal/minute at 20 psi nstaller-s sigmtuie Property wner rRequired) As the property owner of the project address noted above, I have read, understand and agree to participate in the Plumbing Fixture Replacement Self -Certification Program. I further understand that by participating in this program, the plumbing system will not be inspected by a City of Newport Beach Building Inspector during construction or after installation unless requested. he Bu I g Division may request and reserves the right to verify code compliance after the installation is complete. Properly Owne/s Slgrreturc --r Date Aftm A-r1 64reeA�av�A1(1�(�r�FS cctr� Print Name Emal1 This form must be completed and returned to the City of Newport Beach, Building Division, for a final approval of the combination permit. Please return this form to the Building Division by mail or fax. Please mail to: City of Newport Beach Phone: (949) 718-1888 Community Development Department Fax M (949) 544-3250 Building Division P. O. Box 1768 Newport Beach, CA 92658 Fo%Conpacor-0wnerSelFCertOodmUW-Plumbirg FaNre Replacement o3tu4p4 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 1 (949) 644-3200 SETBACKS AND TOP OF SLAB/FLOOR ELEVATION CERTIFICATE The purpose of this certificate is to insure that the structure is located properly on site per the approved drawings. This certificate also verifies the top of slab/floor elevation noted on the approved drawings. After the top of slab/floor elevation is verified to match the elevation specified on the approved drawings, the contractor and inspector can measure the height of the structure to the top of slab/floor to verify that it is equal or less than the dimension shown on building sections and elevations. This form must be filled out by a registered surveyor or civil engineer authorized to perform surveys. The survey must be done after the concrete forms are in place or preferable after the concrete slab is poured or raised floor is built, but prior to starting wall framing. Engineer/Surveyor's Name Paul D. Craft License # P.L.S. 8516 Engineer/Surveyor's Address 17853 Santiago Boulevard, Ste. 107-285, Villa Park, CA 92861 Job Address 29 Inverness Lane, Newport Beach Setbacks: Sketch a site plan and specify surveyed setbacks (use back page). * Top of slab/floor elevation: Top of Forms = 225.50 & 225.00 * If slab/floor elevation varies, sketch a plan or section through slab on the back page and specify the elevations. Use same datum used in the survey of record. I certify that the setbacks are 0, are not ❑, per City approved plans. Describe any deviations from plans: I certify that top of slab/floor elevation(s) is 0, is not ❑, per City approved drawings. Describe any deviations from plans: 6/15/2022 Date JN:19125 Fonrd/SetbwksandTopo61abE1evati � I I ory 0 (YO9z �o ,so'zz � I 1 I 1 I li ,L9'b N N � N ,99'LZ I �o I .90 9 W Q N II z L r Wo t Om cc I ex 1 G r^� n Fri= I O _ ��\N ,N ♦°i 9ry 00 _ q � ZO \ a a 90'OZ N � I t7 m I SL'VL Z I � � I �� Sa3y o y'J'i�l �=U — — w19oi WD m 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 1 (949) 644-3200 SETBACKS AND TOP OF SLABYLOOR ELEVATION CERTIFICATE The purpose of this certificate is to insure that the structure is located properly on site per the approved drawings. This certificate also verifies the top of slab/floor elevation noted on the approved drawings. After the top of slab/floor elevation is verified to match the elevation specified on the approved drawings, the contractor and inspector can measure the height of the structure to the top of slab/floor to verify that it is equal or less than the dimension shown on building sections and elevations. This form must be filled out by a registered surveyor or civil engineer authorized to perform surveys. The survey must be done after the concrete forms are in place or preferable after the concrete slab is poured or raised floor is built, but prior to starting wall framing. Engineer/Surveyor's Name Paul D. Craft License # P.L.S. 8516 Engineer/Surveyor's Address 17853 Santiago Boulevard, Ste. 107-285, Villa Park CA 92861 Job Address 29 Inverness Lane, Newport Beach, CA 92660 Setbacks: Sketch a site plan and specify surveyed setbacks (use back page). Retaining Wall *Top of slab/fieerelesaiiea: TW=224.90' - TW=222.50 * If slab/floor elevation varies, sketch a plan or section through slab on the back page and specify the elevations. Use same datum used in the survey of record. I certify that the setbacks are Z1, are not ❑, per City approved plans. Describe any deviations from plans: Retaining Wail I certify that top of-slebfAeer elevation(s) any deviations from plans: 5/10/2022 Date JN: 19125 Focmv/Setbacks.dTopofSlabElevati.....,_.. is x❑, is not ❑, per City approved drawings. Describe `$� } ■�q 2&� - S§ log , E L , �§ � m§ | .,, ■.,. -• ■| §■ O � � ° (" �/. f5 � 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.newportbeachGa.gov 1(949) 644-3200 SETBACKS AND TOP OF SLABYLOOR ELEVATION CERTIFICATE The purpose of this certificate is to insure that the structure is located properly on site per the approved drawings. This certificate also verifies the top of slab/floor elevation noted on the approved drawings. After the top of slab/floor elevation is verified to match the elevation specified on the approved drawings, the contractor and inspector can measure the height of the structure to the top of slab/floor to verify that it is equal or less than the dimension shown on building sections and elevations. This form must be filled out by a registered surveyor or civil engineer authorized to perform surveys. The survey must be done after the concrete forms are in place or preferable after the concrete slab is poured or raised floor is built, but prior to starting wall framing. Engineer/Surveyor's Name Paul D. Craft License # P.L.S. 8516 Engineer/Surveyor's Address 5104 San Joaquin Plaza, Newport Beach, CA 92660 Job Address 29 Inverness Lane, Newport Beach, CA 92660 Setbacks: Sketch a site plan and specify surveyed setbacks (use back page). *Top ofsleb/Aeerelent im: wall Column Forms * If slab/floor elevation varies, sketch a plan or section through slab on the back page and specify the elevations. Use same datum used in the survey of record. I certify that the setbacks are x❑, are not ❑, per City approved plans. Describe any deviations from plans: I certify that top of slab/floor elevation(s) is ❑, is not ❑, per City approved drawings. Describe any deviations from plans: 1/29/2024 Date JN: 19125 Forms/SetbacksmdTopofSlabElevabonCe . --