- 515 LOMA VISTA ST Los Angeles Regional Uniform (LAR U CF
oFauetaL]Tor eu._a,.a"��.An;; Code Program
STRUCTURAL OBSERVATION REPORT FORM
STRUCTURAL OBSERVATION means tyre vaeudl observation of Ilia stuctural syswni forgenerel conformance to the approved
grans Ono specrucartons, at s/gndicant conotnrcbon stages and at comprdnon of trio stuctural system structural observation does
not include or N,In a the rnsporismduy tot the rn,.,ecrrons rcquticd Dy Section 106 1701 or ornerseCDons of the code _
t� n� Q Report No f
Tnls report mcluaes all construction wol through �I 1 day of ( Cu/1 20 U Page No of /
Prolett A0 irc5s i Structural Observer of Record(SO14 Phone No Of SOR
5(l V (s'UF E2 StcZo✓rn JEFFWARLING 818-363-B272
Builaing Penns No Structurd Ouscrbatlon Ponunnea by Professional be/Reg No of Observer Pnone
I , No Of Oemr
JEFF WARLING C 43743 818-3638 1
OmEXe tU]1 Nun tUXAL ELtlIE1Q5 ANU 1 ntlX CON0.tCl IUw]
FOUNDATION WALL FRAMES FLOOR PORTION OBSERVED,IF NOT WHOLE
�(Foobny Stem Wally D COnd1 eta ❑Sical Moment Frame D Concrete
❑ Mat Foundation ❑Masonry D Steel Braced Frame ❑ $teEl
❑Caisaon Pyes, Glaue Bcams D Woea ❑CdnCfeta Moment Frame ❑ WOoo
❑ Retaining Foundation ❑OUrier D M"onry Will Frame D Others
Hillside Special Ancnors
'Others S-eA- ulr- D UtnerS
OBSERVED DEFICIENCIES ry
I DECLARE THAT THE FOLLOWING STATEMENTS ARETRUE TO THE BEST OF MY KNOWLEDGE QP�FESgj�
OF THE CITY OF LOS ANGELES BY THE OWNER TO BE IN RESPONSIBLE
1 1 AM THE ENGINEER OR ARCHITECT RETAINED Q
CHARGE FOR THE STRUCTURAL OBSERVATION IN ACCORDANCE WITH THE REQUIREMENTS hQ � P•
2 1,OR ANOTHER ENGINEER OR ARCHITEC r WHO I HAVE DESIGNATED ABOVE AND IS UNDER
MY RESPONSIBLE CHARGE, HAS PERFORMED THE REQUIRED SITE VISITS AT EACH W -3743
1.0 Z a
SIGNIFICANT CONSTRUCTION STAGE TO VERIFY IF THE STRUCTURE IS IN GENERAL �'O7 z
CONFORMANCE WITH APPROVED PLANS AND SPECIFICATIONS,
3 ALL DEFICIENCIES WHICH REMAIN TO BE CORRECTED HAVE BEEN INDICATED ABOVE,
4. 1 RECOMMEND THAT ACCEPTANCE OF THE STRUCTURAL SYSTEMS BY THE CITY OF LOS Of�gLIF
ANGELES BE WITHHELD UNTIL ALL OBSERVED DEFICIENCIES ARE CORRECTED
ST raP OF STRUCTURAL OBSERVER OF RECORD
S N-IURE ( D„TE
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