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Los Angeles Regionol Unilorm <br />Code Progrom <br />STRUCTURAL OBSERVATIOil REPORT FORM <br />0EPtiTIlt{T oru ,onc lI0 tltEIy <br />STRUCIURAL OBSERVATION means the visual observation of lhe structural system, tor general conformance to the <br />approved plans and specifications, al significant construclion stages and at completion of the structural system. Struclural <br />obseNation does not include or waive the responsibility tot the inspections required by Section 108, 1704 or other sections ol <br />the code. <br />Report No ..* <br />This report includes all construction wolx through 2j day of .20 lSPage No a/ of ol <br />eroile(tgd!$s: */hn l2-.-- <br />/q32 - /q{o /+/rL" )..t _ <br />Structulal Observer of Record (SOR) <br />EJ.-/ 6.n,hnnu)n. <br />Phone No of SOR <br />?1,,- ?L(-37," <br />tqs6't + tolq <br />uilding Permil No Prolessional Lic./Reg No of Observer:cG 4?s3r <br />Phone No of Observer <br />3la-\Lf-)?o <br />+ lD\SI OBSEBVEO STRUCTURAL ELEMENTS ANO THEIB CONNECTIONS <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 conformance <br />with the approved plans o. in the load palh: (A final repoft by the structural obseruer which states that atl obseNed <br />deficiencies have been resolved is required before acceptance ol the work by the building oflickts.) <br />FOUNDATION WALL FRAME FLOOB ELEMENT/ CONNECTION <br />OBSEBVATION LOCATION <br />Dooting, Stem Walls, Piers OConcrete Esteel Moment Frame EConcrete <br />EModulus of Elasticity' <br />Concrete Shear Walls ESteel Braced Frame lsteel Deck <br />!Caisson, Piles, Grade <br />Beams flMasonry EConcrele Moment Frame Dood <br />Detaining Foundation <br />Hillside Special Anchors OWood !Modulus of Elasticity' <br />Seismic Moment Frames <br />Itrers EOthers flttrers J <br />2 17f-E _/1 <br />7 G Lk;) <br />I OECLARE THAT THE FOLLOWING STATETIENTS AFE TRUE TO THE BEST OF MY KNOWLEDGE: <br />1, I AM THE ENGINEER OB ARCHITECT RETANEO BY THE OWNER TO BE IN RESPONSIBLE <br />CHAFGE FOB THE STRUCTURAL OBSEBVATION IN ACCOROANCE WITH THE REOUIBEMENTS <br />OF THE CITY OF LOS ANGELES. <br />2. I, OB AI.IOTHER ENGINEER OB ABCHITECT WHO I IIAVE DESIGNATEO ABOVE ANO IS UNOER <br />MY RESPONSIBLE CHAFGE, HAS PERFORMED THE REQUIBED SITE VISITS AT EACH <br />STGNIFICANT CO STRUCTION STAGE TO VEBIFY IF THE STBUCTURE IS IN GENERAL <br />CONFORMA CE WITH APPROVEO PLAI{S ANO SPECIFICATIONS; <br />3. ALL NOTEO DEFICIENCIES WHICH REMAN TO BE CORFECTEO HAVE BEEN INDICATEO <br />ABOVE; <br />4. I RECOMMENO THAT ACCEPTATC€ OF THE STBUCTURAL SYSTEMS BY THE CITY OF LOS <br />ANGELES BE HELO TIL OBSERVEO OEFICIENCIES AFE CORRECTED <br />SIGNATURE STRUCTU <br />il <br />/a <br />ifuFm c18 (PErr 1)(Rev @r9r7) <br />SERVER DA STAMP OF SIR I]CTI]RAL OBSE RVE R <br />I Structu.al Observalron performed oyI a-t.-/ c^ -L^-.:. <br />Dat Foundation <br />!others.