Certificate of Seismic Compliance.doc

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Real Estate Acquisition
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WP10867
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LIFE SAFETY COMPLIANCE/SEISMIC CERTIFICATION

Instructions: Building owner must have a licensed structural engineer evaluate the building and fill out the below certification.

Date: ____________

Address: _______________________________________________________________

City, State, and Zip code: __________________________________________________ I certify that the building above (check one):

FORMCHECKBOX

is a New Building or Major Renovations are planned to the existing building where renovation costs exceed 50% of replacement cost of building and the building meets appropriate seismic provisions of _____________________________ (IBC or local seismic building code, if more stringent than IBC) edition of ___________________. (Attach documentation confirming compliance).

The below apply only to Existing Buildings not undergoing Major Renovations:

FORMCHECKBOX

was designed, built and maintained to the requirements of seismic standards RP-8 as specified in Section 2.2 of Standards of Seismic Safety for Existing Federally Owned or Leased Buildings and Commentary issued by the Interagency Committee on Seismic Safety in Construction as ICSSC RP-8, Seismic Standards for Existing Federally Owned and Leased Buildings, Dec 2011. (Attach documentation confirming compliance.)

FORMCHECKBOX

meets the minimum acceptable performance seismic standard of ‘Life Safety’ using the American Society for Civil Engineers (ASCE) 31-03, Seismic Evaluation of Existing Buildings. (Attach documentation confirming compliance.)

FORMCHECKBOX

is a benchmark building according to RP-8 Section 1.3.1. (Attach documentation confirming compliance.)

Structural Engineer completing certificate:

(Print name)

(Signature) License No. ____________________________ Field of Practice _________________________________

SEAL Expiration Date: _______________

2.6.4 Life Safety Compliance/Seismic Certification

October 2014

OMB Control No. 2120-0595

Pg. 2

File details come from the government source that posted it. Updated .