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PLUMP ENGINEERING, INC <br />914 E. Katella Ave.,2"d Floor <br />Anaheim, CA 92805 <br />STRUCTURAL OBSERVATION REPORT FORM <br />STRUCTURAL OSERSERVATION means lhe visudl obsoruation ol lhe sbucfurcl system, lor ganeral confomance lo the approved plans dnd <br />specillcelions. et significant conslruction slages ancl el cofiplolion ol lhe sltuctual syslem- Sl.uctural obseNaion does nol include or waiw <br />lh6 rcsponsibilily lor lhe inspeclions rcquhod by Section 108, 1701 ot dhor seclbns ol the code <br />This re udes ll construction wolk lh 17 2018 <br />Report No. 170518 <br />Job No. S.1804073 <br />OASERVEO <br />No.1 of 1 <br />ANO THEIR CONNECTIONS <br />OBSERVEO DEFICIENCIES <br />1971 East 4rh Streot <br />Santa Ana. CA 92701 <br />Struclural Obervsr ol Rscord (sORI <br />GREGORY PANEK. P.E. <br />Phons No. oISOR <br />7r4,385-1835 <br />Building Pennii No <br />t0t9 6254 <br />Shrctural Obsarvalbn perfo.med byi <br />GREGORY PANEK, P,E, <br />Prcfessional Lic./Reg. No. of Obserysr: <br />c79't 48 <br />Phone No. ol Obsery€r <br />714-385-1835 <br />FOUNDATION FRAMES FLOOR PORTION OBSERVED, IF NOT WHOLE <br />E Footing, Stem Walls E concrete E st6el Momont <br />Frams O Concrei6 <br />D Masonry E SleelBraced <br />Frame E steet <br />E Caisson, Piles, Grade <br />Beams D wood 0 Concrete Momenl <br />Frame E wooa <br />E Retaining Foundation <br />Hillside Specjal Anchors E other I Masonry Wall D others <br />E others B orh'",|;H;Hi Final <br />None <br />I OECLARE THAT THE FOLLOWING STATEMENTS ARE TRUE TO THE BEST OF MY KNOWLEDGE: <br />IRECOMMENO TIIAT ACCEPTANCE OF THE STRUCfURAL SYSTEMS BYTHE LOCAL <br />WTTHHELD UNTIL ALL OBSERVEO OEFICIENCIES ARE CORRECTEO <br />05/17l18 <br />c 7s14p <br />xp. el2lzo <br />c <br />M. <br />IAM THE ENGINEER OR ARCHITECT RETAINED BY lHE OW]tER TO BE IN RESPONSIBLE <br />CHARGE FOR THE STRUCTURAL OBSERVATIOII lN ACCOROANCE wlTH THE REQUTREMENTS <br />OF THE LOCAL JURISDIGTION. <br />2.I, OR ANOTHER ENGINEER OR ARCHIIECTWHO IHAVE DESIGNATED ABOVE ANO IS UNOER <br />MY RESPONSIBLE CHARGE, HAS PERFORMEO THE REOUIREO SITE VISITS AT EACH <br />SIONIFICANT CONSTRUCTION STA6E TO VERIFY IF THE SRUCTURE IS IIiI GENERAL <br />CONFORMANCE WITH APPROVED PLANS ANO SPECIFICATIONSi <br />ALL OEFICIENCIES WHICH REMIAi,I TO BE CORRECTEO HAVE EEEN INOICATEO ABOVEi3. <br />4. <br />JURISDICTION <br />SIGNA OATE <br />E Mat Foundation