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CITY OF YORBA LINDA BUILDING DIVISION (714) 961-7120 (City of Yorba Linda)

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CITY OF YORBA LINDA
4845 Casa Loma Avenue Yorba Linda, California 92886
BUILDING DIVISION (714) 961-7120
Created 02/18/2020 Page 1
STRUCTURAL OBSERVATION REPORT FORM
STRUCTUR
AL 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 structural system. Structural
observation does not include or waive the responsibility for the inspections required by Section 108, 1701 or other
sections of the code.
Per the 2019 California Building Code, Section 17045-1704.6.2 structural observations shall be required for the following:
• All new Commercial and industrial structures being constructed from the ground up.
• This shall include tract developments, condominiums, apartments and single-family homes.
Struc
tural observations shall be made as required by the engineer or architect of record, but at a minimum of the required
notes below. Each observation shall be accompanied by a completed structural observation form.
• Footing
• Slab
• Framing, prior to rough mechanical, electrical, and plumbing inspection.
This r
eport includes all construction through ______________ to _______________
Job Address: Permit Number:
Structural Observer of Record (SOR): Phone No. of SOR:
Structural Observer Performed by: Phone No. of Observer:
Professional Lic./Reg. No. of Observer:
OBSERVED
STRUCTURAL ELEMENTS AND THEIR CONNECTIONS
FOUNDATI
ON WALL FRAMES FLOOR
ELEMENTS/CONNNECTION
OBSERVATION LOCATION
Footing, Stem Walls
Concrete
Steel Moment Frame Concrete
Mat Foundation
Masonry
Steel Braced Frame Steel Deck
Caisson, Piles Grade
Beams
Wood
Co
ncrete Moment Frame Wood
Retaining Foundation
Hillside Special
Anchors
Other:
Masonry Wall Frame
Other:
Other: ___________
Other:_______________
____________________
____________
____________
___________
___________
CITY OF YORBA LINDA
4845 Casa Loma Avenue Yorba Linda, California 92886
BUILDING DIVISION (714) 961-7120
Created 02/18/2020 Page 2
NOT
ED DEFICIENCIES with the proposed corresponding corrective actions with the respect to general
conformance with the approved plans or in the load path: (A final report by the structural observer which states that
all observed deficiencies have been resolved is required before acceptance of the work by the Building Official.)
Please List Deficiencies:
ST
AMP OF STRUCTURAL OBSERVER
_______
_______________________________ ____________________
Signature of Structural Observer Date
I DECLARE THAT THE FOLLOWING STATEMENTS ARE TRUE TO
THE BEST OF MY KNOWLEDGE:
1. 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 CITY OF YORBA LINDA
2. 1, OR ANOTHER ENGINEER OR ARCHITECT WHO I HAVE
DESIGNATED ABOVE IS UNDER MY RESPONSIBLE CHARGE,
HAS PERFORMED THE REQUIRED SITE VISTS AT EACH
SIGNIFICANT CONSTRUCTION STAGE TO VERIFY IF THE
STRUCTURE IS IN GENERAL CONFORMANCE WITH
APPROVED PLANS AND SPECIFICATIONS;
3. ALL NOTED DEFICIENCIES WHICH REMAIN TO BE
CORRECTED HAVE BEEN INDICATED ABOVE;
4. I RECOMMEND THAT ACCEPTANCE OF THE STRUCTURAL
SYSTEMS BY THE CITY OF YORBA LINDA BE WITHHELD
UNTIL ALL OBSERVED DEFICIENCES ARE CORRECTED.
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Completed 25 March 2021

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