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( <br />COUNTY OF ORANGE <br />DEPARTMENT OF BUILDING AND SAFETY <br />STRUCTURAL OBSERVATION REPORT FORM <br />THIS REPORT INCLUDES ALL CONSTRUCTION WORK THROUTH 9 DAY OF 29 2017 <br />STRUC. OBS. P <br />(626)-288-1216 <br />EUILDING PERI\,1IT NO <br />OESERVED STRUCTRUAL ELEMENTS AND THEIR CONNECTIONS <br />v <br />OBSERVED OEFICIENCIES: <br />I DECLARE THAT THE FOLLOWNG STATEMENTS ARE TRUE TO THE BEST OF MY KNOWLEDGE AND <br />BELIEF <br />l IAM THE REGISTERED ENGINEER OR LICENSED ARCHIIECTIVIIO HAS RESPONSIBLE CHARGE FORTHE STRUCTURAL OBSERVATION <br />? LORANOTHERREGISTEREOENGINEERORLICENSEOARCHITECT\ /IIOHAVEOESIGNATEOANDISUNOERMY <br />RI SPONSIBLE CHASGE HAS PERFORMEO IHE REOUIREO SITE VISITS AT EACH SIGNIFICA'iT COiISTRUCTION STAGE TO VERIFY IF <br />]I]E STRUCIURE IS IN GENERAT CONFORMANCE V\'IH THE APPROVEO PTANS AND SPECIFICAIIONS <br />3 ALL OE' IC I€NC IE S wlIICH I OOC UM€NTE D HAVE BEEN CORRECTEO UNLEss OTBE RWSE INO ICATED AEOVE. <br />4IUNOERSTANOTT]ATTINALACCEPTANCEOFIHESTRUCTURATSYSTEMSEYTHEDEPARTMENTOFBULIOINGANOSATETYCANNOT <br />OCCUR wrIHOUT THE CORRECTION OF A!! OSSERVEO OEFICIENCIES, <br />5 I AM RESPONSIALE FOR THE SUEMISSION OF THE ORIGINAL OF THIS REPORT TO THE OEPARTMENT OF BUILOING ANO SAFETY. <br />CITY OF TOS AIIGELES <br />6 HAVE PROVIDEO STRUCTURAL OESERVATION ACCORDANCE WTH THE REOUIREMENIS OF IHE CIT'' OF LOSANGELES <br />!DEFtcTENCTES coNTrNUEo <br />ON ATTACHEO FORII B&S 261 A <br />1429 S Mohawk Dr, Santa Ana, <br />PROJECT ADORESS STRUCTRUAL OBSERVER <br />DAVID LI <br />OWNER LIC OR REGISTRATION NO <br />c58075 <br />LOCATION AND <br />PORTIONS OF BLDG <br />DATE <br />fl-E.\r rrrh^ rr.rir T-d-u /ar1\ t/-tt)r' <br />I l-Fnr'\Trr\r/.:c er aa.q erEr, \ rar r c --<-rEEr r,!.\irENT aoE.r^r DerzzD c <br />PRE STRESSED CONCRETE SLABS STEEL MOI\4ENT.ORDINARY tr]-crEEr.rE^r <br />'t-2 <br />-.AICCNNA DII EE NAANE REAI\,lq fl-crEEr oo^^E^Fi td) <br />fl -qI r crnE ar D-T]-^.\N^oE'rE nr r^TI E D- <br />n-T'l-^^N^oETE tr-it-ff,tl{) \Lrt+c.tL-1 9r I <br />D- <br />tr- <br />D- <br />S IAI\,4 P OF ENCINEER OR ARCHI I IC <br />,O <br />\:\ <br />2006/30/8 <br />STRUCTURAL OBSERVATION DOES NOT WAIVE ANY OF THE REOUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED <br />EMPLOYEES OF THIS DEPARTMENT <br />OISIR AUIION SIR UCIURAL OBSERVER TO SENO ORiGIN.A L TO THE BUIIDING INSPECTOR'S OFFICE. ATTACH THE F RST COPY TO IHE APPROVEO PLANS ANO KEEP SECONO COPY FOR S IRUCIIJRAL <br />ofTSERVERS RECOROANo oTSTRTSUTONS tges 261 R 12195) <br />REPORT NO. 1 <br />r trLJ 4< <br />I <br />or 9a,ft*-4lc-os2017 <br />C IT'Y <br />clv INEER OR