HomeMy WebLinkAboutSNEW-19-0818 (2) �
' � County of LosAngeles
` ' � DEPARTMENT OF PUBLIC WORKS BUILDING & SAFETY DIVISION
PUBLIC WORKS
` ' ; Los Angeles Regional Uniform Code Program
� �
STRUCTURAL OBSERVATION REPORT FORM
STRUCTURAL OBSERVATION means the visual observation of the structural system, for general conformance to the
approved plans and specifications, at srgnrfrcanf construcfion stages and at completion of the structura!system. Structural
observation does not include or waive the responsibility for the inspectrons required by Secfion 108, 1705 or othersections
of the Los Angeles County Building Code.
Report No.
This report includes all construction work through��day of�20 to Page No.�of 3
Project Address: �f co � S e�' /{-Ve, Structural Observer of Record(SOR): SOR Phone No.:
�rc.�d,;a . G /o 0 6 u� — Yo k.-� L i u (6.��S'1 -s�S"�
Building Permit No.: Structural Observation Observer Profession I Lic/Reg. No.: Observer Phone No.:
$l1�uv -/ � ���� Performed by: ,�, , G o��- 16a.6)S�- -3�'S�
OBSERVED STRUCTURAL ELEMENTS AND THEIR CONNECTIONS
FOUNDATION WALL FRAMES DIAPHRAGM ELEMENTS/CONNECTION
OBSERVATION LOCATION
❑ Footing, Stem Walls ❑ Concrete ❑ Steel Moment Frame ❑Concrete S't�d 7��ra�f��•1,
✓ p
❑ Mat Foundation ❑ Masonry ❑ Steel Braced Frame ❑ Steel Deck r"'oe f��►+f�� , GoA�ectrens
❑ Caisson, Piles, i�Wood ❑ Concrete Moment � Wood A a i��^ o ti C'oo� �-+��
Grade Beams Frame �// ��.y i4,r-s.�At ,J/�c�—
/ 0 -
❑ Retaining Foundation ❑ Others: ❑ Masonry Wall Frame ❑ Others: t,o//c�f,sr-s , �a-rat e
Hillside Special Anchors � ' v �'e s
��`� a-�-� Goh7<< < 7,
❑ Others /� ❑ Others:
NOTE DEFICIENCIES with the proposed corresponding corrective actions with respect to general conformance
with the approved plans: (A final report by the structural observer which states that all observed deficiencies have been
resolved is required before acceptance of the work by the building official.)
� GSS �G�q �ro-r'!� /J �t-GG Lw�(� W�t�� �1'lR S ��aI G�rlC�'�'I,
Q� �h d hfletoS Afi'f L0.�uf �/K1 S% Lt' U"�Si� Q,,S t�f�-{"�I►Gt,
I DECLARE THAT THE FOLLOWING STATEMENTS ARE TRUE TO THE BEST OF MY KNOWLEDGE:
1. I AM THE ENGINEER OR ARTICHITECT RETAINED BY THE OWNER TO BE IN RESPONSIBLE
CHARGE FOR THE STRUCTURAL OBSERVATION IN ACCORDANCE WITH THE �,r.--
REQUIREMENTS OF THE COUNTY OF LOS ANGELES. �r' , '��`�
tl � " �
2. I, OR ANOTHER ENGINEER OR ARCHITECT WHO I HAVE DESIGNATED ABOVE AND IS �� � `"' �_'�, �„�
UNDER MY RESPONSIBLE CHARGE, HAS PERFORMED THE REQUIRED SITE VISITS AT -`Y! ` i'�I � ` �`
EACH SIGNIFICANT CONSTRUCTION STAGE TO VERIN IF THE STRUCTURE IS IN .,i�' _,.. :-''".�?��
GENERAL CONFORMANCE WITH APPROVED PLAN SPECIFICATIONS; 'j r�i L� r 1
i .,-,��O-�LAt �'�
3. ALL NOTED DEFICIENCIES WHICH REMAIN TO BE CORRECTED HAVE BEEN INDICATED � • � �-'_�
ABOVE; ��''/�
� s` ��r;!
4. I RECOMMEND THAT ACCEPTANCE OF THE STRUCTURAL SYSTEMS BY THE COUNTY OF ,-''
LOS ANGELES BE WITHHELD UNTIL ALL OBSERVED DEFICIENCES ARE CORRECTED. _ .-�,=�-'
_/�. ' �/�' _�`�_� 9 _/�:_���� (STAMP OF STRUCTURAL OBSERVER)
Ql����I . if� �
SIGNATURE OF STRUCTURAL OBSERVER DATE
Version 2.0(2017 LACBC) Dec.8 2016