About this file

This document is a Seismic Form B Certificate of Seismic Compliance for an existing building. The form is designed to document a professional engineer's evaluation of a building's seismic safety, specifically assessing whether the structure meets the Life Safety Performance Level as defined by the Interagency Committee on Seismic Safety in Construction (ICSSC) RP 10 standards. The evaluation is conducted using ASCE/SEI 41-17 methodology, with options for Tier 1, Tier 2, Tier 3, or other evaluation approaches.

The certificate requires detailed documentation, including building characteristics such as ASCE Building Type, number of stories, approximate area, building design code, year of design code, and year of construction. The engineer must indicate the level of evaluation performed, attach the ASCE/SEI 41-17 checklists for structural, nonstructural, and geologic site hazards, and provide a professional opinion on whether the building meets the specified seismic safety performance level. The form includes fields for the engineer's professional details, including name, firm, address, license information, and a space for additional comments.

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SEISMIC FORM B

CERTIFICATE OF SEISMIC COMPLIANCE

EXISTING BUILDING

Date: __________

This affirms that ________________________ served as engineer in charge of the seismic evaluation of the building located at ______________________________________________.

The building has the following characteristics:

ASCE Building Type: No. of Stories: Approx. Area:

Building Design Code: Year of Design Code: Year of Construction:

I have evaluated this building at the Life Safety Performance Level as set forth in the ICSSC RP 10, Standards of Seismic Safety for Existing Federally Owned and Leased Buildings, using ASCE/SEI 41-17 methodology:

___Tier 1 Evaluation

___Tier 2 Evaluation

___Tier 3 Evaluation

___Other (please explain below)

Documentation of this evaluation must be attached to this Certificate.

On the basis of the building characteristics and to the extent permitted by this level of evaluation it is my opinion that subject Building (check one) does / does not meet the Life Safety Performance Level of

ICSSC RP 8.

Affix Stamp and Sign Here

Engineer’s Name:

Firm:

Address:

Telephone:

License No.:

License State:

Expiration Date:

Comments:

Attach: ASCE/SEI 41-17 Checklist(s) Structural, Nonstructural, and Geologic Site Hazards and

Foundation

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