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HomeMy WebLinkAboutXR2023-1455 - Misc (3)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.00v 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 fo 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. ------Enae neei n (:raft L cen&G4--P.L.9 is Engineer/Surveyor's Address 20422 Beach Boulevard. Suite 225, Huntington Beach, CA 92648 Job Address 515 Signal Road, Newport Beach, CA Setbacks: Sketch a site plan and specify surveyed setbacks (use back page). * Top of slab/floor elevation: N/A * 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: I certify that top of slab/floor elevation(s) is Z1, is not ❑, per City approved drawings. Describe any deviations from plans: 11 /04/2020 Date JN:19106 Forms/SetbacksudTopofSlabElevationCert. 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 SETBACKS AND TOP OF SLAWFLOOR 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 Plnllre[I nr raicarl flnnr is hilt but prior to rstarting-wall-framing. Engineer/Surveyor's Name Paul D. License # P.L.S. 8516 Engineer/Surveyor's Address 20422 Beach Boulevard, Suite 225, Huntington Beach, CA 92648 Job Address 515 Signal Road, Newport Beach, CA Setbacks: Sketch a site plan and specify surveyed setbacks (use back page). * Top of slab/floor elevation: 85.39 finished floor * 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 x❑, is not ❑, per City approved drawings. Describe any deviations from plans: 11 /24/2021 Date Forms/Setback sand TopofSlabElevationuen, avow IVNOIS 111 66 l0 O N � � O b .W'£Z r .O6'Z m m � m n .£L•Z9 z LZ'b �i o� m m im m_ ,SL'9Z $ Fq f a W d 2 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 Qov 1 (949) 644-3200 Structural Observation Report Project Address: 515 I AL ReportDate: 05-11-22 CNB Inspector Name: CNB Permit #: NEWPORT BEACH, CA. Building Owner Name: Owners Mailing Address (if different from site); Owner's Telephone #: CNB Plan Check #: Full Name of Structural Observer (SO): FADY HAKIM SO E-mail Address: SO Telephone #: SO License / Reg. #: ADYHAKIM@FMHENGINEERIN.COM 949-245-8000 C-75736 PLEASE INDICATE STRUCTIIRAI FI FMaMTC AND FOUNDATIONS ❑ Conventional Footings & Slab - ----- - —--- SHEAR WALLS ❑ Concrete — ---•••—•-• •� ^•� ....•-,.w FRAMES ❑ Steel uv�.a voocrtv DIAPHRAGMS (Floor/Roof) ❑ Concrete ov cneCK a IICBDIB INDICATE LOCATION(S) OBSERVED ALL VISIBLE FRAMING HARDWARES & bOXBs DATE OBSERVED 05-11-22 ❑ Mat Foundation, Prestressed Concrete ❑ Masonry ❑ Concrete —.MEMBERS. ❑ Steel Deck SHEAR WALLS ❑ Caissons Piles ❑ Won Grade Beams Shear Panels ❑ Other: 1. ❑ Other: ❑Other: ❑Other: ❑ ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES. ❑ OBSERVED DEFICIENCIES AND COMMENTS: NODEFICIENCIES ❑ REPORT CONTINUED ON ATTACHED PAGES. 0 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 d ficiencies which I have documented must be corrected, prior to final acceptance e structural systems by the City of Newport Beach, Building Division. 554 — 05-11-22 a,nmr Ur a i KUUIUtt LVtlbtRVLR o 1 MV V I a� OCieNVAI ION uues NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH. Form`.S�mnunlOhscrveiionRgmtl&Inamdions 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 Structural Observation Report Project Address: 515 SIGNAL ROAD, NEWPORT BEACH, CA. Report Date: 02-01-22 CNB Inspector Name: CNB Permit#: Building Owner Name: Owner's Mailing Address (8 different from site); Owner's Telephone #: CNB Plan Check #. Full Name of Structural Observer (SO): SO E-mail Address: SO Telephone #: SO License I Reg. # FADY HAKIM ADYHAKIM@FMHENGINEERIN.COM 949-245-8000 C-75736 PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check aoolicable boxes) FOUNDATIONS SHEAR WALLS FRAMES DIAPHRAGMS (FloodRoof) INDICATE LOCATION(S) OBSERVED DATE OBSERVED ❑ Conventional Footings & Slab ❑ Concrete ❑ Steel ❑ Concrete FIRST FLOOR SHEATHING 02-01-22 ❑ Mat Foundation, Prestressed Concrete ❑ Masonry ❑ Concrete ❑ Steel Deck Fl caissons I Grade Beams or-Man Shear Panels -L-Masonq M Wood ❑ Other: ❑ Other: ❑ Other: ❑ Other: ❑ ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES. ❑ OBSERVED DEFICIENCIES AND COMMENTS: NO DEFICIENCIES ❑ REPORT CONTINUED ON ATTACHED PAGES. ❑ FINAL STRUCTURAL OBSERVATION REPORT: The structure generally complies with the approved construction documents, and all observed deficiencies were corrected. I declare that the following statements are true to the best of my knowledge: 1. 1 am the licensed design professional retained by the owner to be in responsible charge of the structural observation; 2. I, or another licensed design professional whom I have designated above and is under my responsible charge, have performed the required site visits at each significant construction stage to verify that the structure is in general conformance with the approved construction documents; 3. 1 understand thator deficiencies which I have documented must be corrected, prior to final accept in structural systems by the City of Newport Beach, Building Division. n 02-01-22 J IAW Ur JI KUU I Ur LUU=KVGK FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NE 11RT REACH FomulSwq,w10C emlbnReFnnAlnsirvdions 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: 515 SIGNAL ROAD, NEWPORT BEACH, CA. ReportDate: 12-01-21 CNB Inspector Name: CNB Permit M Building Owner Name: Owners Mailing Address (if different from site); Owner's Telephone #: CNB Plan Check #: Full Name of Structural Observer (SO): SO E-mail Address: SO Telephone M SO License / Reg. M FADY HAKIM ADYHAKIM@FMHENGINEERIN.COM 949-245-8000 C-75736 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 AT GRADE FOUNDATION DIMENSIONS AND 12-01-21 ❑ Mat Foundation, Prestressed Concrete ❑ Masonry ❑ Concrete ❑ Steel Deck REINFORCEMENT, ANCHOR BOLTS AND ❑ Caissons, Piles, ❑ Wood or Manuf. ❑ Masonry ❑ Wood HOLDOWNS hear ane s ❑ Other: ❑ Other: ❑ Other: ❑ Other: ❑ ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES. ❑ OBSERVED DEFICIENCIES AND COMMENTS: NO DEFICIENCIES ❑ REPORT CONTINUED ON ATTACHED PAGES. ❑ FINAL STRUCTURAL OBSERVATION REPORT: The structure generally complies with the approved construction documents, and all observed deficiencies were corrected. I declare that the following statements are true to the best of my knowledge: 1. I am the licensed design professional retained by the owner to be in responsible charge of the structural observation; 2. I, or another licensed design professional whom I have designated above and is under my responsible charge, have performed the required site visits at each significant construction stage to verify that the structure is in general conformance with the approved construction documents; 3. 1 understand that II deficiencies which I have documented must be corrected, prior to final acceptan of the structural systems by the City of Newport Beach, Building Division. /%e ell V 12-01-21 STAMP OF STRUCTURAL OBSERVER Forms\ tmcmralOb cnationRepoO&Instmctions WANE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH. 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.00v 1 (949) 644-3200 Structural Observation Report Project Address: 515 I N R , Report Date: 10-21-21 CNB Inspector Name: CNB Permit #: NEWPORT BEACH, CA. Building Owner Name: Owners Mailing Address (R different from site); Owner's Telephone #: CNB Plan Check #: Full Name of Structural Observer (SO): SO E-mail Address: oneO#: SO Telephone #: SO License / Reg. #: FADY HAKIM ADYHAIOM@FMHENGINEERIN.COM 949-24 C-75736 PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED check applicable boxes FOUNDATIONS SHEAR WALLS FRAMES DIAPHRAGMS (Floor/Roof) INDICATE LOCATION(S) OBSERVED DATE OBSERVED ❑ Conventional Footin s &Slab ❑ Concrete ❑ Steel ❑ Concrete STEEL REINFORCEMENT FOR THREE CAISSONS 10-21-21 ❑ Mat Foundation, Prestressed Concrete ❑ Masonry ❑ Concrete ❑ Steel Deck issens-Ri Grade Beams OftnDf.---G—Masomy Shear Panels El Wood ❑ Other: ❑ Other: ❑ Other: ❑ Other: ❑ ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES. ❑ OBSERVED DEFICIENCIES AND COMMENTS: NO DEFICIENCIES ❑ 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 t t all deficiencies which I have documented must be corrected, prior to final accep cey�� a structural systems by the City of Newport Beach, Building Division. 10-21-2021 J I Mr Ur J I KUU I Ur LUU3LKVLK s 1NU6 IaUCSENVAI SUN Does NOT WANE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH. 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: 515 SIGNAL ROAD, NEWPORT BEACH, CA. ReportDate: 08-04-21 CNB Inspector Name: CNB Permit M Building Owner Name: Owner's Mailing Address (if different from site); Owner's Telephone #: CNB Plan Check #: Full Name of Structural Observer (SO): SO E-mail Address: SO Telephone #: SO License / Reg. M FADY HAKIM FADYHAKIM@FMHENGINEERIN.COM 949-245-8000 C-75736 PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED check applicable boxes FOUNDATIONS SHEAR WALLS FRAMES DIAPHRAGMS (Floor/Roo INDICATE LOCATION(S) OBSERVED DATE OBSERVED ❑ Conventional Footings & Slab ❑ Concrete ❑ Steel ❑ Concrete TOP OF RETAINING WALL HARDWARE 08-04-21 ❑ Mat Foundation, Prestressed Concrete ❑ Masonry ❑ Concrete ❑ Steel Deck ❑ Caissons, Piles, ❑ Wood or Manuf. ❑ Masonry ❑ Wood Grade Beams ear ane s ❑ Other: ❑Other: ❑ Other: ❑ Other: ❑ ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES. ❑ OBSERVED DEFICIENCIES AND COMMENTS: NO DEFICIENCIES ❑ REPORT CONTINUED ON ATTACHED PAGES. ❑ FINAL STRUCTURAL OBSERVATION REPORT: The structure generally complies with the approved construction documents, and all observed deficiencies were corrected. I declare that the following statements are true to the best of my knowledge: 1. I am the licensed design professional retained by the owner to be in responsible charge of the structural observation; 2. I, or another licensed design professional whom I have designated above and is under my responsible charge, have performed the required site visits at each significant construction stage to verify that the structure is in general conformance with the approved construction documents; 3. 1 understand that II deficiencies which I have documented must be corrected, prior to final acceptan of the structural systems by the City of Newport Beach, Building Division. All 08-04-2021 STAMP OF STRUCTURAL OBSERVER FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH. Fomist tnimm]Obsemti nRcpon&Ivtmct6ns 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 Structural Observation Report Project Address: 515 SIGN ROAD, NEWPORT BEACH, CA. ReportDate: 07-13-21 CNB Inspector Name: CNB Permit #: Building Owner Name: Owner's Mailing Address (K different from site); Owners Telephone M CNB Plan Check #: Full Name of Structural Observer (SO): SO E-mail Address: SO Telephone #: SO License / Reg. M FADY HAKIM ADYHAKIM@FMHENGINEERIN.COM 949-245-8000 C-75736 PLEASE INDICATE STRUCTURAL ELEMENTS AND CONNECTIONS OBSERVED (check aoolicable boxes) FOUNDATIONS SHEAR WALLS FRAMES DIAPHRAGMS (Floor/Roof) INDICATE LOCATION(S) OBSERVED DATE OBSERVED ❑ Conventional Footings & Slab ❑ Concrete ❑ Steel ❑ Concrete RETAINING WALL REINFORCEMENT 07-13-21 ❑ Mat Foundation, Prestressed Concrete ❑ Masonry ❑ Concrete ❑ Steel Deck ❑ Caissons, Piles, ❑ Wood or Manuf. ❑ Masonry ❑ Wood ra a Beams 6hear Panels ❑ Other: ❑ Other: ❑ Other: ❑ Other: ❑ ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES. ❑ OBSERVED DEFICIENCIES AND COMMENTS: NO DEFICIENCIES ❑ REPORT CONTINUED ON ATTACHED PAGES. ❑ FINAL STRUCTURAL OBSERVATION REPORT: The structure generally complies with the approved construction documents, and all observed deficiencies were corrected. I declare that the following statements are true to the best of my knowledge: 1. I am the licensed design professional retained by the owner to be in responsible charge of the structural observation; 2. I, or another licensed design professional whom I have designated above and is under my responsible charge, have performed the required site visits at each significant construction stage to verify that the structure is in general conformance with the approved construction documents; 3. 1 understand that II deficiencies which I have documented must be corrected, prior to final acceptan of the structural systems by the City of Newport Beach, Building Division. A.;, I 07-13-2021 W ->F STAMP OF STRUCTURAL OBSERVER FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH. Fo.ms�mmmlobsemtion2epuna.lomucuom 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 Qov 1 (949) 644-3200 Structural Observation Report Project Address: 515 I NA R ReportDate: 04-01-21 CNB Inspector Name: CNB Permit #: NEWPORT BEACH, CA. Building Owner Name: Owners Mailing Address fif diRerent from site); Owner's Telephone #: CNB Plan Check M Full Name of Structural Observer (SO): FADY HAKIM SO E-mail Address: SO Telephone #: SO License / Reg. #: ADYHAKIM@FMHENGINEERIN.COM 949-245-8000 C-75736 PLEASE INDICATE STRUCTIIRAI FI PUll:NTS AMn r•nrruerrinue nee.�e...�.. FOUNDATIONS - - --- - - - - - SHEAR WALLS ---•••_..... ..........,.,..... FRAMES nvn.a vo-orcvcu DIAPHRAGMS (FloorlRoof) juneCK appliCaUR INDICATE LOCATION(S) OBSERVED Oozes DATE OBSERVED ❑ Conventional Footings &Slab ❑ Concrete ❑Steel El Concrete MAT SLAB REINFORCEMENT, 04-01-21 ❑ Mat Foundation, Prestressed Concrete ❑ Masonry ❑ Concrete ❑ Steel Deck DIMENSIONS, ANCHOR _110LIL& HOLDOWNS B--Caissons, Piles— Grade Beams anwood Shear Panels ❑ Other: [I Other Other ❑Other: ❑ ITEMS CHECKED ABOVE ARE APPROVED AND WITHOUT DEFICIENCIES. ❑ OBSERVED DEFICIENCIES AND COMMENTS: NO DEFICIENCIES ❑ 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 con structio ocumenls; 3. 1 understand that a efts ''encies which I have documented must be corrected, prior to final acceptance tpg'ural systems by the City of Newport Beach, Building Division. 04-01-2021 s IAMF OF JI KUC I URAL OBSERVER a 1 nUU I UKAL va.1GKVA I ION DOES NOT WAIVE ANY REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THE CITY OF NEWPORT BEACH. Fonns�5iructunghsene�bnRelwn&Inaeue�ions 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: 515 Signal Road, Newport Beach, CA Building Permit Number(s): * As the surveyor of record for the project at the above address, I hereby certify that 1 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 ieosepoll rovidethefowing-elevationinformationfib, lrrgnestmafTidgesflatroofs,—o parapets/guardrails. Additional elevation points may be requested by the Building inspector. RIDGES (3:12 slope or greater) a Approved elevation point of ridge is 111.68 and actual elevation point is 111.22 a Approved elevation point of ridge is 112.33 and actual elevation point is 112.04 Q Approved elevation point of ridge is 112.33 and actual elevation point is 112.08 0° Approved elevation point of ridge is 11420 and actual elevation point is 112.04 Q Approved elevation point of ridge is 11420 and actual elevation point is 112.08 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. OIS NOT in co a with the City -approved plans (Provide explanation). Please describe any a`a vtV approved plans on the back of this form. I i' ` LK - 4/12/2022 JN: 19106 Surveyor`!gr vil ngineer s* ignature and seal Date (Wet 1 ��k` j and signature required) * License number of 33 S,6 o- r FormslBuilding Height CC[h6eatlon 11/02116.t� — BUH.DP G D1 i SilS O 100 Ci rc Center Drive I P.O. Box 17681 Ne"ort Beach, CA 92E5M915 wAwnewportbeachca.gov 1(949) 644-3200 -r.x-a E n asra'rrsr TXi 010 a x r e az r., s�azsl�a��..s;� Ar.� rx isaa s a s�t�� ROUGHLNSPECTIIO CH Ca-�T `IE5 NO i. Riser Construction and Location Aoorovai a. Draia valve b. Baceflarrr device (single check) ❑ c. Bell activation device ❑ d. Inspectoes test valve ❑ a. Riser sized per approved plans a. System tested at operating pressure for 2 hours El b. Pressure gauge installed 0 3. Sorinker Heads shall not be installed in the fittings or,'or to the ittini being cemented in place (temporary test tlluasl a. Installation and sparing of temporary test plugs ❑ A. o ding a. Material installed per plan ❑ b. Hangers per codes/prevent upward moil ❑ c. All CPVC piping shall be installed by per -bons who have been ❑ certified by the manufacturer `or inst2tiafon of CPVC piping d. Piping protected from damage U 5. Bell a. Wiring irstatted per code ❑ b. Boxes installed at Proper locations ❑ NOTE: CPVC plat pipe in the garage shall not be exposed. Sprinklers that are listed as 'Quick Resperise° or 'Residential' must be used. CORRECTIONS AND FIRE SPPtNP -ER N3 9A 130 SYSTEM ROUGH INSPECTION APPROVED. A G r[ S PEPvtIT 2 3 �- BY. --44S / iK C/DATE- 191 A2 v.r.+=...� Snink ,sr AU0 S-R.u- !r rsen Gy.62is �r+4'7[/501�SR?JI �N'2.F1��J IYNS-'ya+�5 ❑Er Ytik %��'�Sic �_ ;s:s+c_ �-(, 31vo ��'A8 JJW-dad :Ct3ADHddV `VNL-J W31SAS QSL Vd3N'd3-DiNWdS 3231d s2toN ❑ suogaDlpaads siainroWuew jed p2l s+u! welsnS '£4 U pajjgsu! ;quanaid mog >p28 -Zt n eirssa d x9jam jadeid Bupuous lasu 7e pajp�sul a6ne6 einssaid 5upppuad0 "L L suo.pngsgo ou - jesu pus speau jaNuuds punam seoue mer+ 'o 75W3J.SAS uogeool panoiddE w anrzn 6u saD adsui =o uogeao� '6 p7sai ljaq pue pganpuoa Wai AkolU 'S swop--yol pai!nbsi lle le pa}sod 96Eubjs ladold I ❑ speau rajyuuds puna,e paljgsq wu} usiud 'g El - spe94 jaNupds wc,4 paAowai jwed pue adq lro 'C a;iSQOI ag uo ajgejjw e aq )luip piq `paj.re ST aq Cq J_i�N aJe SajEjd IaAa'J '-� C spea4 iaj�uuds wag paAowaj slaRm uoaorngsuoo jy "£ suEld pahoidde--,pjad pajjgsuj werS4s Japppds ajU -Z aas 3ado ld saiew �,a}e;M ' L ON 53A .I:SI`i�I 3m TVNM Ilk, MAS Q£T VaAST NarMadas MM o0Z£-W9 10,6i 1 n06`eaPEa%MiM9u',wMM SL69-859Z6 `do'4ssa8'uDdM N 199cLL )OD8'0-d IIBARG JO}ua3 OM DOL �iols (l i -VIffrl lq y S� S�ig-�'�g�IA3�.27tr��a�ig3f1 �1�T+�TiT3Oir3�ANTQ �iI I_�1g13IgA3J40� e 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 From: JT Consulting Engineers 11251 Gardenaire Ln Garden Grove, CA 92841 ATTENTION: GRADING ENGINEER, BUILDING DIVISION Date: June 2, 2025 GPC No.: 0663-2020 Tract/Subdivision/Lot No.: Rough: _Final: x Project Names: 515 Signal Road ndPYSOn Type of Project: Notes: Tract: x Drainage Constructed per approved plans _ Commercial Other Industrial Yardage for Project: Notes: 05 c}Cut: Borrow: Constructed per approved plans 3o gFill: 775 cy Export: 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: final grading in conformance with, drainage with the following changes to the approved grading plan. Description of Changes: None yrJES 1, I Company: JT Consulting Engineers m w Name: John Tran N . 6 33 * (print) C J '�a "FCA S License No.: 62653 (RCE/LS) Forms\Civil Engineers Certification Form 9-13 4�Y"''nkT CITY OF NEWPORT BEACH Community Development Department I Building Division ^' 100 Civic Center Dr.1 P.O. Box 1768 Newport Beach, CA 92658 www.newportbeachca.00v (949) 644-3200 �•ILILY)R��` CALGREEN DOCUMENTATION COMPLIANCE CERTIFICATION ADDRESS: 5 1 5 �J I a N !�L Z C� , PERMIT NO.: X 9, )U 2 3- �14 5 5 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) Franchise Hauler for Construction/Demolition Waste (65% min, reuse of nonhazardous waste) VOC Contents Limitation VFormaldehyde Emissions Limitation N9 T-24 Energy Certificate of Installations (Env., QII, Lighting, Photovoltaic, Mech., Plumb.) IV T-24 Energy Certificate of Verifications or Acceptance ( Env., QII, Lighting, Photovoltaic, Mech., Plumb., HERS) Ede Operations and Maintenance Manual MOISTURE CONTENT OF BUILDING MATERIAL (RESIDENTIAL CONSTRUCTION ONLY) Ef I 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 ® I certify under penalty of perjury, under the laws of the State of California, the information provided is true and correct. • I 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: Responsible 11'srgnature: FF AsioftLSoeJ d,e Date Signed: Position/Title: 5/ae/,25 C—t11J72.4L. C�w�2Ac �UV� CITY OF NEWPORT BEACH COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 926588915 www.newportbeachca.gov 1 (949) 644-3200 CONTRACTORIPROPERTY OWNER SELF -CERTIFICATION DECLARATION FOR PLUMBING FIXTURE REPLACEMENT Project Address: 51 Date: sLZ / pW 7EW FOP—T 5 _1ACH f CIA `1 Z (> (n 5 Permit#: )(R12o;�3— 1455 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. Pll S Installer's Name: TNT7e(„Qrly 5Utt.01riS G'ZNIA.�t. epLicensej'¢hrxTU2 No (if applicable)_ Installer's Mailing Address: Wk W• � 8TM S'K- &YW-a Vil? Aphonea# (required): 38& • (7 (j Installer's Email: t 6 q c 1y1C.- GO 1M FAX #:AJA Installer I certify that the installation is in compliance with applicable code requirements. I further affirm that I have reviewed and understand the reg 'ramentc of the 201A rnrynmia czroom Byitding 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 Water closet: 1.28 gal/flush Faucets: maximum flow rate of 1.2 gal/minute at 60 psi, and minimum 0.8 gal/minute at 20 psi L J 51:211-2025 In 'aller's Sign urea Date Property Owner (Required) 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 in pected by a City of Newport Beach Building Inspector during construction or after installation unless requested. a Bu'(�ing Divis r tray request and reserves the right to verify code compliance after the installation is complete/, I / Nh N1IW2_pK" a) VwAu000'v` Email t 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 #: (949) 644-3250 Building Division P. O. Box 1768 Newport Beach, CA 92658 Forms\Contractar-OwnerSelf-CeaDeclamtion-Plumbing Fixture Replacement 03/04/22 PROJECT SUMMARY Project Name: Address: City, State, Zip: Building Department: Permit Number: Building Energy Code: AndersonJ effRes idenceRevH 515 Signal Road Newport Beach, CA 92663 Newport Beach, City of XR2023-1455 2019 Standards HERS VERIFIABLE MEASURES ENERGY CODE COMPLIANCE Scan to Validate COMPLETE O COMPLETE O CERTIFICATE OF COMPLIANCE (CF1 R) DATE DOCUMENT TITLE REGISTRATION NUMBER STATUS 03/15/2024 CF1R-PRF-01-E Performance Compliance 424-PO 1 0046395A-000-000-0000000-0000 O CERTIFICATE OF INSTALLATION (CF2R) DATE DOCUMENT TITLE REGISTRATION NUMBER 05/13/2025 CF2R-ENV-01-E Fenestration 424-P010046395A-000-001-E01002A-0000 05/13/2025 CF2R-ENV-03-E Insulation Installation 424-PO10046395A-000-001-E03003A-0000 05/13/2025 CF2R-LTG-01-E Lighting 05/13/2025 CF2R-MCH-01a-E HVAC, Ducts and Fans 05/13/2025 CF2R-MCH-27a-H Mechanical Ventilation 05/13/2025 CF2R-MCH-32-H Local Mechanical Exhaust 05113/2025 CF2R-PLB-02a-E Single Family Hot Water 05/13/2025 CF2R-PVB-01-E Photovoltaic Systems 1 05/13/2025 CF2R-MCH-20a-H Duct Leakage 05/13/2025 CF2R-MCH-22a-H Fan Efficacy 05/13/2025 CF2R-MCH-23a-H Airflow Rate continued on next page - 424-P010046395A-000-001-L01004A-0000 424-P010046395A-000-001-M01001A-0000 424-PO 1 0046395A-000-00 1 -M27025A-0000 424-P010046395A-000-001-M32026A-0000 424-PO 1 0046395A-000-00 1 -B02027A-0000 424-PO10046395A-000-001-PO 1028A-0000 424-P010046395A-000-001-M20005A-0000 424-P010046395A-000-001-M22007A-0000 424-P010046395A-000-001-M23006A-0000 STATUS O O O O O O �1t•rtt NOTICE: This compliance summary report has been generated by a registration platform provided by CHEERS using I --I ( information that has been uploaded to that registration platform by third parties that are not affiliated or related to �.. CHEERS 1 v CHEERS. Therefore, CHEERS is not responsible for, and cannot guarantee, the accuracy or completeness of the page 1 of 4 information contained in this certificate. almglpeo slyl ul paulelum uopewolul b l0 Z 06ed a411a ssaualaidwoo ro 6ownooe 94;'aalueren63ouum pue'rol apsuodsai lou sl 9133H3 'aa4aJayl'SH33H0 3 3 H of palejar ro paleplge Sou wuu e leyl sabred prlyl6q opeld uoperlsi6ar ley) 01 papeoltln uaaq sey 1ey1 uopewrolw S 2i Buisn S833H0 Aq papinord wropeld uoperlsl6ar a 6q palerauaB uaaq sey podar Aewwns aouelldwm slgl:30LLON - eBed yeau rro penLO=- 0 0000-VZE09ZN-L00-000-V96£91700LOd-17Zb abjeyz)luma&jlaa H-gSZ-HOW-HZdO SZOZ/EL/90 0 0000-VL£OSZW-L00-000-V96E9b00LOd-bZh a6iegolueia6ulaa H-g9Z-HON-HZd0 9ZOZ/£L/S0 0 0000-VO£OSZIN-L00-000-V96E9b00LOd-bZb ableyolueaa6ulaa H-gSZ-HON-HZd0 SZOZ/EL/90 0 0000-V6Z09ZN-L00-000-V96£9b00LOd-17Zb a6jeyOluea6ulaa H-gSZ-HON-HZJO SZOZ/£L/90 [WGISAS OVAH 0 0000-VSLOEZIN-L00-000-VS6£91700LOd-17Zb aleuMOIJJ!V H-eEZ-HON-bZd0 9ZOZ/£L/90 0 0000-V6LOZZW-L00-000-VS6£9b00LOd-17Zb L0e01113 ued H-eZZ-HON-HZJO 9ZOZ/EL/90 0 0000-VLLOOZN-L00-000-V96£9b00L ID? abelealjon0 H-eOZ-H3N-8Zd0 9ZOZ/£L/90 9 0 0000-V17LOEZN-L00-000-VS6£91700LOd-bZb ale'dMOWN H-eEZ-HON-HZd0 SZOZ/EL/SO 0 0000-V8LOZZN-L00-000-V96£9b00LOd-17Zb ADe31113 ued H-eZZ-HON-HZJO SZOZ/EL/SO 0 0000-VOL00ZN-L00-000-VS6£9400LOd-4Z4 96eAeall0n4 H-eOZ-HON-dZJO SZOZ/£L/90 ti 0 0000-VELO£ZN-L00-000-V96£9b00LOd-bZb ales MOIP!V H-eEZ-HOA-H&ID SZOZ/EL/SO 0 0000-VLLOZZN-L00-000-V96E9bOOLOd-bZb A0M!113 ued H-eZZ-HON-UZAD SZOZ/EL/SO 0 0000-V6000ZN-L00-000-V96£9b00LOd-bZb 86e1e01pn4 H-eOZ-HON-FJZJO 9ZOZ/£L/SO 0 0000-VZLOEZN-L00-000-VS6£9b00LOd-17Zb sled MOIP!V H-e£Z-HON-HZd3 9ZOZ/£L/90 0 0000-V9LOZZN-LOO-000-V96E9b00LOd-17Zb /(aeoOl3ued H-eZZ-H3N-HZdD 9ZOZ/EL/90 0 0000-V8000ZN-L00-000-V96£9b00LOd-bZb abgea-llon(] H-eOZ-HON-H&Q SZOZ/EL/SO Z Sf11V1S 83aiNnN NOI1`d2i1Sl03H 31111 1N3"nooa 31VO (HZ-4O) NOIJLVI-]V1SNI =10 31` OULLM30 alep6en 01 ue0S Scan to Validate CERTIFICATE OF INSTALLATION (CF2R) DATE DOCUMENT TITLE REGISTRATION NUMBER 05/1312025 CF2R-MCH-25b-H Refrigerant Charge 424-POl0046395A-000-001-M25033A-0000 05/13/2025 CF2R-MCH-26-H High SEER & EER 424-PO10046395A-000-001-M26020A-0000 05/13/2025 CF2R-MCH-26-H High SEER & EER 424-P010046395A-000-001-M26021A-0000 05/13/2025 CF2R-MCH-26-H High SEER & EER 424-PO10046395A-000-001-M26022A-0000 05/13/2025 CF2R-MCH-26-H High SEER & EER 424-P010046395A-000-001-M26023A-0000 05/13/2025 CF2R-MCH-26-H High SEER & EER 424-P010046395A-000-001-M26024A-0000 CERTIFICATE OF VERIFICATION (CF3R) DATE DOCUMENT TITLE REGISTRATION NUMBER 05/13/2025 CF3R-MCH-27a-H Mechanical Ventilation 424-PO10046395A-000-001-M27025A- M27A 05/13/2025 CF3R-MCH-32-H Local Mechanical Exhaust 424-P010046395A-000-001-M32026A- M32A 05/13/2025 CF3R-MCH-20a-H Duct Leakage 05/1312025 CF3R-MCH-22a-H Fan Efficacy 05/13/2025 CF3R-MCH-23a-H Airflow Rate F 05/13/2025 CF3R-MCH-20a-H Duct Leakage 05/13/2025 CF3R-MCH-22a-H Fan Efficacy 05/13/2025 CF3R-MCH-23a-H Airflow Rate 3 424-PO10046395A-000-001-M20005A- M20A 424-PO10046395A-000-001-M22007A- M22A 424-P010046395A-000-001-M23006A- M23A 424-PO 1 0046395A-000-00 1 -M20008A- M20A 424-PO 1 0046395A-0 00-0 0 1 -M22016A- M22A 424-PO 1 0046395A-000-00 1 -M23012A- M23A 05/13/2025 CF3R-MCH-20a-H Duct Leakage 424-P010046395A-000-001-M20009A- M20A 05/13/2025 CF3R-MCH-22a-H Fan Efficacy 424-PO10046395A-000-001-M22017A- M22A confined on next page - ��r•r�/ CHEERS ('� NOTICE: This compliance summary report has been generated by a registration platform provided by CHEERS using ?il - C I"I E R (, information that has been uploaded to that registration platform by third parties that are not affiliated or related to �. v CHEERS. Therefore, CHEERS is not responsible for, and cannot guarantee, the accuracy or completeness of the information contained in this certificate. STATUS O O O O O STATUS O O Page 3 of 4 aleoulvao slgl ul paulelum uollewlolul 1,10 b 86ed all;o ssaualeldwoo JO I( emcee agl'a9luwen6 iouuee pue'lol alglsuodsal lou sl SH33HO'ale19la41"SH33H0 of polelw to paleg!4je lou ale legs salved pngl 6q wolleld ualellsift legl Ol papeoldn ueeq seg legl uogewolul 6ulsn Sa33HO Fq Papinmd wolleld uopwlsl6al a 6q palelaua6 uaaq seg pedal fiewwns aouepdwoo slgl :30110N O V9ZW -VOZ09ZW-L00-000-V96E91700LOd-bZb O V9ZW -V4Z09ZW-L00-000-V96£9b001Od-17Zb O tl9ZW -VLZ09ZW-L00-000-tl56£9b00LOd-bZb © V9ZW -VEZ09ZW-1.00-000-V96E9b00LOd-bZb O tl9ZW -VZZ09ZW-L00-000-tlS6E9b00lOd-bZb O V9ZW -VZ£09ZW-L00-000-VS6S91700LOd-bZb © `dSZW -tll£09ZW-l00-000-V96£917001Od-17Zb O tlSZW -V££09ZW-1.00-000-tl96E91700LOd-17Zb O VSZW -tl0£05ZW-L00-000-VS6£9b001Od-bZb O VSZW -V6ZOSZW-l00-000-tl96£917001Od-17Zb tlEZW -tlSLOEZW-L00-000-VS6£9b001Od-17Zb © tlZZW -V6LOZZW-L00-000-tlS6£9b00LOd-bZb © `dOZW -tlLL00ZW-L00-000-VS6E91700lOd-17Zb tl£ZW -tlbl0£ZW-L00-000-tlS6£9b00LOd-bZb © VZZW -VS LOZZW-LOD-000-VS6£9b00LOd-bZb O tlOZW -VOLOOZW-LOD-000-tlS6£9b00LOd-bZb 833'S H33S 461H 833 8 H33S 461H H33'9 H33S 46!H 833 '8 H33S 461H H33'9 833S 46!H sd33H:) Nov. 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Box 1768 1 Newport Beach, CA 92658-8915 S EP 2 0 2023 www.newportbeachca.gov 1 (949) 644-3200 CITY OF NEWPORT BEACH Three Year Construction Time Limit Extension Building Official Application Project I515 Signal Rd._ New Receipt No.: Address: er 10/15/2020 Project # : Date 20 Fee Permit o 1, - 9266 - ......_.....------.......-----.- j Original Permit Extension Fee: Date Fee P id: No.: X2020-0937 Issued Date: 8�/Y o9 k3812(�2023 PETITIONER/PROPERTY OWNER INFORMATION Name (Must be payor of fees): Company Name: Jeffrey Anderson Integrity Builders General Contractors, Inc. Street Address: _.._....... ...... —.._—..._............—....._.__....—State.t....._........_. ItY : Zip Code: 866 West 18th Street Costa . Mesa I Ca _........_............_._...-.'--......__...—..—..__.._......_. —_ _. 92627 Email:.............__.........._.....15P....-----......._._._. h—one: Jeff@ibecinc.com I 714-783-5275 PROJECT INFORMATION Length ot extension requested: 1 Year New end date if request is approved: 10/15/2024 Previous Extension(s) Granted? (YIN): - A/ If Yes, How Many?: Description of 1! Construction of a new 6995 sq. it. SFR including an 1800 sq. ft. subterranean basement, new pool and spa Work Under ! — ----- Permit: t__.....—._.—._....__.._...._.— ----- _-------- Reason for (Attach Supporting Documents as Needed) Extensiono... ............... ...... ---...... _...........----.....—.—.—.._.—.._._..__._...._...-----.._.._._.... _....._—.._._....... —..—....._...... _.._ Request Supporting documents _ have been given to Jamie Molina, Building Inspector II .—...__—.__.....—._—_--------- —_.._—_..._..—.._—....—....___..._—....._..._...___..._....—......_._ —... / HEREBY CERTIFY THAT THE ABOVE STATEMENT IS TRUE. Petitioner's Signature:...—.._._....__.ropert.....Owne---._....—_... _ Relationship to Property Owner: TDate: Jeffrey Anderson is the Property owner and Contractor 09 / 19 / 2023 Department Action: JApproved ❑Denied _.—.. . Conditions '....----......__....-----....._—......_.... of A ppiuvalor %r7l.L �� ..__......_......_._.._..----....__..:...._ Comments: F7 CO -- Building Inspector i Name: Signature: Dat Reviewed: e. Building Official i Namet..h... i.s'._........_ _ _....._. , ?a_ 2 Approval: Date: BuildingOfficia13YearE1ten1i1n Valid until104/22/2025 Ordinance 2022-8 / NBMC 15.02.095-6-16-22