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STRUCTURAL OBSERVATION REPORT FORM
Report
Structural Observation means the visual observation of the structural system, for general conformance to the approved plans and
specifications, at significant construction stages and at completion of the system. Structural observation does not include or waive the
responsibility for the inspections required by Section 108, 1701 or other sections of the code.
This report includes all construction work through 710 day of AVUJ,\, 2011,
Project Address:
S-- l t�Lc's.1 '.�FA
il
Structural Observer of Record
(SOR)
Phone No. of SOR
G
K=ari Naraghi Aran!
(818) 865-2026
Building Permit
Structural Observation performed
Professional Lic/Reg. No, of
Phone No. of Observer
No. IJ e'-1
by: Karnran Naraghi Arani
Observer: C040985
(818) 865-2026
M A it OV 2
fl.W IM0 Y1 OBSERVED STRUCTURAL ELEMENTS AND TRUR CONNECTIONS
FOUNDATION
WALL
FRAMES
FLOOR
PORTION OBSERVED,
IF NOT WHOLE
6Footin , Stem Walls
Concrete
❑ Steel Moment Frame
❑ Concrete
Mat Foundation
❑ MasonryAu
p Steel Braced Frame
❑ Steel
A'' tLRar— A-d�'�l.
❑ Caisson, Piles, Grade
❑ Wood
❑ Concrete Moment Frame
❑ Wood
p ,L" .-
Beams
❑ Retaining Foundation
0 Other
❑ Masonry Wall Frame
❑ Others:
Hillside Special Anchors
I'
❑ Others:
❑ Others:
Observed Deficiencies: Agdu64
JG�
I declare that the following statements are true to the best of my knowledge: I am the engineer or architect retained by the
owner to be in responsible charge for the structural observation in accordance with the requirements of the County of
Orange.
1. I, or another engineer or architect who I have designated above and is under my responsible charge, has performed the
required site visits at each significant construction stage to verify if the structure is in general conformance with
approved plans and specifications.
2. All deficiencies which
3. I recommend that
deficiencies are s
Signature:
Form No. 00-03
to be corrected have been indicated above.
of the structural systems by the County of Orange be withheld until all observed