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szu Los Angeles Regionol Uniform <br />Code Progrom <br />STRUGTURAL OBSERVATION REPORT FORM <br />OE'ISTXENT Of BUILDIIIG AIIO SATETT <br />STBUCTURAL OBSERVATION means the visualobseruation of the structural syslem, lor general conlormance to the <br />approved plans and specilications, at significant construction stages and at completion ol the structunl system. Structural <br />obseruation does not include or waive the responsibility tor the inspections requied by Section 108, 1704 or other seclions of <br />the code. <br />Thls report includes all construction work through /3 aay ol <br />Report No. <br />,201a$Page No. a/of ot <br />60 / <br />Phone No of SOR. <br />3./- -?/-9'-31 r, <br />Structural ObseNer of Record (SOR)r <br />/'t/,/?a-,/- At l.ozc rz Aa na. <br />Project Address; <br />n32 E De-o,--.- Ar. <br />Structuraiobseryation performed by: <br />E-_/-./ 6---t- ^-..^ <br />Professional Lic./Reg. No. of Observer: <br />C€+I?\9 <br />Phone No. of Observer <br />1i-- Z.t9> 3' <br />Building Permit No <br />/d?-s,/+< <br />OBSERVEO STRUCTURAL ELEMENTS AND THEIR CONNECTIONS <br />FOUNOATION WALL FRAME FLOOR ELEMENT/ CONNECTION <br />OBSERVATION LOCATION <br />Elooting, Stem Walls, Piers Econcrete Esteel Moment Frame EConcrete <br />Dat Foundation EModulus of Elasticity' <br />Concrete Shear Walls OSteel Braced Frame flsteel Deck <br />[Caisson, Piles, Grade <br />Beams !Masonry Econcrete Moment Frame Dood <br />Betaining Foundation <br />Hillside Special Anchors Ewooa EN4odulus of Elasticityr <br />Seismic Momenl Frames Eothers <br />[}ttrers;' .9,4:-s 9l--a.EOthers [thers: <br />* For concrete buildings more than 160 feet in Structural Height: Concrete mix meets the modulus of elasticity <br />requirements in design for seismic force resisting systems. <br />NOTED DEFICIENCIES with the proposed corresponding corrective actions with respect to general conlormance <br />with the approved plans or in the load path: (A final repoft by the structural obseruer which states that all observed <br />deficiencies have been rcsolved is required betore acceptance of the work by the building ofticials.) <br />A1 .)-^ -/t- <br />I DECLARE THATTHE FOLLOWING STATEMENTS ARE TBUE TO THE BEST OF MY KNOWLEDGE: <br />1. I AM THE ENGINEER OR AFCHITECT RETAINED BY THE OWNER TO 8E IN RESPONSIBLE <br />CHARGE FOR THE STRUCTUBAL OBSERVATION IN ACCORDANCE WITH THE BEOUIREMENTS <br />OF THE CITY.OF LOS ANGELES. <br />2. I, OR ANOTHER ENGINEER OR ABCHITECT WHO I HAVE DESIGNATED AAOVE ANO IS UNDER <br />MY RESPONSIBLE CHAFGE, HAS PERFORMEO THE REOUIREO SITE VISITS AT EACH <br />SIGNIFICANT CONSTRUCTION STAGE TO VERIFY IF THE STRUCTURE IS IN GENERAL <br />CONFORMANCE WITH APPROVED PLANS AND SPECIFICATIONS; <br />3. ALL NOTED DEFICIENCIES WHICH REMAIN TO BE CORRECTED HAVE BEEN INDICATEO <br />ABOVE; <br />4. I RECOMMEND T T PT E OF THE STRUCTURAL SYSTEMS BY THE C'TY OF LOS <br />ANGELES BE <br />SIGNATURE CTURAL <br />lN/Fom 08 (Pad 1) (Rov 6/1917) <br />UNTI <br />OATE <br />I <br />STAMP OF STRUCTURAL OBS€ RVE R <br />OBSERVEO OEFICIENCIES AFE CORRECTED.