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Home My WebLink AboutStructural Observation Program Application 2013CITY OF PALM DESERT DEPARTMENT of BUILDING and SAFETY STRUCTURAL OBSERVATION PROGRAM AND DESIGNATION OF THE STRUCTURAL OBSERVER PROJECT ADDRESS: ________________________ PROJECT NO.:_________________________ Description of Work:___________________________________________________________________ Owner: ______________________ Architect: _____________________ Engineer:_________________ STRUCTURAL OBSERVATION (only checked items are required) Firm or Individual to be responsible for the Structural Observation: Name: Phone: ( ) Calif. Registration: FOUNDATION WALL FRAME DIAPHRAGM  Footing, Stem Walls, Piers  Concrete  Steel Moment Frame  Concrete  Mat Foundation  Masonry  Steel Braced Frame  Steel Deck  Caisson, Piles, Grade Beams  Wood  Concrete Moment Frame  Wood  Stepped/Retaining Foundation  Hillside Special Anchors  Others:  Masonry Wall Frame  Others:  Others:   Others:  DECLARATION BY OWNER I, the Owner of the project, declare that the above listed firm or individual is hired by me to be the Structural Observer per CBC Section 1704.5. Signature Date DECLARATION BY ARCHITECT OR ENGINEER OF RECORD (required if S.O. is different from the A/E of Record) I, the Architect or Engineer of record for the project, declare that the above listed firm or individual is designated by me to be responsible for the Structural Observation. Signature License No. Date