HomeMy WebLinkAboutReso 122-2018 (18-697)City of South San Francisco P.O. Box 711 (City Hall,
• 400 Grand Avenue)
South San Francisco, CA
• City Council
Resolution: RES 122 -2018
File Number: 18 -697 Enactment Number: RES 122 -2018
RESOLUTION APPROVING A BACK TO BUSINESS (B213)
PROGRAM AND AUTHORIZING THE CITY MANAGER, OR HIS
DESIGNEE, TO IMPLEMENT AND ADMINISTER THE B2B
PROGRAM TO FACILITATE THE TIMELY INSPECTION OF
DAMAGED STRUCTURES IN THE EVENT OF A MAJOR
DISASTER.
WHEREAS, in the aftermath of a major earthquake or other disaster, there may be an urgent need to
assess hundreds or thousands of damaged structures in order to determine the condition of the buildings
and infrastructure and their suitability for safe use and occupancy; and
WHEREAS, in such a major disaster, the need to conduct safety assessments may be overwhelming and
far exceed the capacity of the City's building inspectors; and
WHEREAS, the City of South San Francisco ( "City ") wishes to establish a public - private partnership
with local businesses, known as the Back to Business (132B) Program, that would prepare in advance for
the disruption and recovery caused as the result of an earthquake or other major disaster; and
WHEREAS, the B2B Program would authorize the Chief Building Official to pre - certify qualified
inspectors, such as civil and structural engineers or architects from the private sector with current
California licenses, who would be retained by private businesses to perform safety assessment
inspections on designated buildings listed under the B2B Program; and
WHEREAS, the Chief Building Official is authorized to appoint inspectors who will have such powers
as delegated by the Chief Building Official pursuant to Section 103.3 "Deputies" of the 2016 California
Building Code, as adopted under Chapter 15.08 of the South San Francisco Municipal Code; and
WHEREAS, the Chief Building Official is further authorized to make all required inspections and has
authority to accept written and certified reports of inspection by approved agencies or individuals
pursuant to Section 104.4 "Inspections" of the 2016 California Building Code, as adopted under Chapter
15.08 of the South San Francisco Municipal Code; and
WHEREAS, the B2B Program would enable the Chief Building Official and his/her authorized
representatives to post the appropriate placard at each entry point to a building or structure upon
completion of a safety assessment; and
WHEREAS, the extent of responsibility and liability for such inspections would be governed by an
City of South San Francisco Page 1
File Number. 18 -697
Enactment Number: RES 122 -2018
agreement between the participating building owner and the pre - certified inspector(s); and
NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of South San Francisco that it
hereby approves the B213 Program, attached hereto as Exhibit A, and incorporated herein.
BE IT FURTHER RESOLVED by the City Council of the City of South San Francisco that it hereby
authorizes the City Manager, or his designee, to implement and administer the B213 Program.
BE IT FURTHER RESOLVED by the City Council of the City of South San Francisco that it hereby
authorizes the City Manager, or his designee, to make any modifications deemed necessary to effectively
implement the B213 Program consistent with the intent of City Council.
At a meeting of the Special City Council on 8/8/2018, a motion was made by Richard Garbarino, seconded by
Mark Addiego, that this Resolution be adopted. The motion passed.
Yes: 5 Mayor Normandy, Mayor Pro Tern Matsumoto, Councilmember Addiego,
Councilmember `Gupta, and Councilmember Garbarino
Attest by
Kris a Nlartinell'
City of South San Francisco Page 2
EXHIBIT A
Attachment 1
To Associated Resolution
Back to Business Program
August 8, 2018
City of South San Francisco
Economic & Economic & Community
Development Department
BACK TO BUSINESS PROGRAM
(B2B)
Building Post-Disaster
Re-Occupancy Inspection
Application Instructions
B2B PROGRAM
TABLE OF CONTENTS
DESCRIPTION & INSTRUCTIONS
I. Introduction 3
II. Purpose 3
III. Definitions 3
IV. Preparation 4
V. Inspector Requirements 4
VI. Inspection Dossier 6
VII. Pre-Certification Documentation 7
VIII. Indemnification, Hold Harmless and Immunity 8
IX. Pre-Certification Acceptance 8
X. Activation 8
XI. Placard Management 9
XII. Building Official Verification 10
XIII. Termination 10
APPLICATION FORMS 11-25
Application Checklist Appendix A
Request for Pre-Certification Appendix B
Structural Inspector Authorization Appendix C
Biennial Program Renewal Appendix D
Placard Issuance Appendix E
Inspection Dossier Appendix F
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BACK TO BUSINESS (B2B) PROGRAM
I. INTRODUCTION
After an earthquake, or other disaster such as a fire, flood or terrorist Incident that may
have caused damage to buildings and/or property, buildings will be inspected and
appropriately posted for re-occupancy or closure utilizing standardized ATC-20
(www.atccouncil.org) inspection and posting procedures. The Chief Building Official
will appropriately prioritize public safety above all other concerns. At the same time,
affected businesses will seek to minimize business interruption and resume building
operations as soon as is safely possible.
Some building owners may proactively develop private inspection programs for their
buildings to facilitate rapid, individualized, building re-occupancy inspections. The Back
to Business (B2B) Program establishes an agreement between owners and tenants, the
City and designated certified deputized inspectors to allow private, post-disaster re-
occupancy inspection satisfying accepted standards and procedures in response to a
locally declared emergency.
II. PURPOSE
The purpose of a pre-certified inspection program is to provide a prioritized, thorough
evaluation of possible damage to a structure by qualified persons familiar with the
structural design and life-safety systems of the building. This private inspection program
allows rapid decisions regarding the closure or re-occupancy of buildings to be made by
individuals pre-certified by the Chief Building Official for a specified property. The
program reduces inspection delays and eases the burden of inspection by government
entities that may need to focus resources on more severely stressed areas or areas of
greater public hazard, which may not include the property of interest to a business.
III. DEFINITIONS
A. Applicant – Individual or entity in possession of title for land, building, or other
item. The owner may be responsible for paying taxes in relation to property.
Applicant may also be a lessee or tenant of the property or building authorized by
the owner.
B. Deputized Inspectors – Person(s) deputized by the City under the B2B program.
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IV. PREPARATION
Applicants may request participation in this program at any time except 60 days
following a local declared disaster. A building designated as having met the
requirements outlined herein shall be placed on a list of buildings accepted for private
re-occupancy inspection. Applicants may participate in this program, subject to the
requirements listed below:
A. Select inspection team;
B. Develop inspector response plan(s) and compile building structural drawing(s),
safety plan template(s), equipment and drawing location(s), and other pertinent
information; arrange for submission or electronic posting of documentation
availability to the City;
C. Assemble the Inspection Dossier located in Section VI.
D. Obtain, document, and store safety and inspection equipment/supplies;
E. Update inspection plan, supplies, team member changes, and training as
necessary;
F. Submit the Biennial Program Renewal form before each biennial anniversary of
initial approval date (Appendix D).
V. INSPECTOR REQUIREMENTS
Applicant will partner with structural inspector(s) to assemble an Inspection Team and to
apply for B2B program pre-certification. The structural inspector shall be a Civil or
Structural Engineer licensed in the State of California. Additional architect(s) or
engineer(s) trained in ATC-20 procedures (www.atcouncil.org) may be pre-certified to
supplement the inspection team as required. Though architects may consider structural
inspections outside their purview, architects can add expertise to an inspection team by
addressing nonstructural hazards such as blockage of exits, facade and ceiling
assembly hazards and life-safety system performance. Engineers/architects
experienced with historical structures should be considered for the inspection of historic
buildings.
In accordance with Section 103.3 “Deputies” of the
California Building Code, as adopted under Ch apter
15.08 of the South San Francisco Municipal Code , the
Chief Building Official has authority to appoint inspectors who will have such powers as
delegated by the Chief Building Official. Further Section 104.4 “Inspections” of the
California Building Code, the Chief Building Official is authorized to make all of the
required inspections and has authority to accept written and certified reports of
inspection by approved agencies or individuals.
The extent of responsibility and liability is governed by the agreement between the
Applicant and inspectors.
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A. Minimum Qualifications and Requirements
1. Structural Inspectors
a. Current California license as a professional civil or structural
engineer or architect;
b. Relevant experience in the structural design and/or inspection of
similar buildings;
c. Demonstrated proficiency in ATC-20 Rapid and Detailed Evaluation
Procedures.
B. Required documents, Equipment and Supplies
1. Copy of Building Inspection Dossier;
2. Structural, architectural, and/or life-safety system drawings; as-built
drawings; or, if structural drawings are unreadable, incomplete, or do not
exist, a clear written description of the structural system and any known
weaknesses and unique features;
3. Personal safety equipment including hardhat, etc., defined by Applicant or
inspector company safety officer;
4. Inspection equipment including flashlights, measuring devices, ladders, and
other applicable items;
5. ATC-20 Rapid and Detailed Evaluation forms (latest edition) for reporting
inspection findings to the Chief Building Official;
6. Yellow Caution and Red Danger tape or barricades;
7. Portable radios or other communication devices for large buildings, if
applicable.
8. Sufficient green, yellow, and red official City safety assessment placards to
allow appropriate posting at each entrance to the building, to be supplied by
City upon approval of application.
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VI. INSPECTION DOSSIER
Applicant or each Inspector, as defined in written company program, shall maintain hard
and electronic copies of the Inspection Dossier, and the Dossier shall be readily
available to each Inspector for use and reference following a triggering event. The
Dossier shall include the following Information:
A. Emergency Notification Contact List of the Building B2B Inspection Team
Members
1. Licensed engineers/architects certified for structural inspection;
2. Applicant’s site workers responsible for the building;
B. Building Information
1. Photograph of building;
2. Address;
3. Description of building including year of original occupancy, number of
stories, size, materials of construction, and structural system type;
4. Building floor plans showing entrances, evacuation routes, and
recommended locations for observation;
5. Number and location of building entrances per building to be posted with
safety assessment placards;
6. Specified building use(s) (e.g., offices, apartments, manufacturing, etc.);
7. Description of life-safety system including location of emergency power
generator;
8. Description of building fire detection and suppression systems;
9. Description and locations of potential falling hazards;
C. Emergency Response Requirements and Information
1. Trigger for activation of emergency response (earthquake, fire, flood or
terrorist incident that may have impacted buildings or property);
2. Rally location for the Applicant’s emergency response and command and
control organization;
3. Access procedures and/or location of keys for entrance to the site and all
building areas;
4. Inventory and location of required documents, equipment and supplies;
5. Location, type, and handling instructions for any hazardous material.
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D. Inspection Procedure
1. ATC-20 Procedures for Post-Earthquake Safety Evaluation of Buildings
including Rapid and Detailed Evaluation Procedure. Recommended
methodology for welded steel joint inspection is FEMA 352 where required.
These inspections may be required by the Structural Inspector(s) or the City
of South San Francisco. For special inspection or materials testing, use only
inspectors pre-certified by the City.
2. Fire/Life-Safety System Checklist (if applicable);
3. Instructions or drawings indicating where to look, what to look for; and to re-
inspect following aftershocks;
VII. PRE-CERTIFICATION DOCUMENTATION
Pre-certification must occur before the incident. No applications for pre-certification will
be accepted for a period of at least 60 days after a declared state of emergency.
Exceptions may apply only due to limited City resources and the nature of the
emergency. Applications may be accepted before the 60 day period ends at the
discretion of the Chief Building Official; however, business shall not expect applications
to be reviewed during a locally declared emergency.
Submit the following to the Building Division:
A. Completed B2B Application Checklist (Appendix A);
B. Request for Pre-Certification form signed by Applicant (Appendix B);
C. Inspection Authorization form providing evidence of qualifications for the
Inspection Team (Appendix C);
1. Signed Inspector Authorization form (Appendix C) showing current
California License Number as a professional civil or structural engineering
or architect and relevant experience in the structural design and/or
inspection of buildings of similar size, construction, and complexity;
2. One-page resume describing education and experience relevant to
inspection duties.
D. Copy of Inspection Dossier or link to electronic file (Appendix F, see content
requirements [Section VI.]).
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VIII. INDEMNIFICATION AND HOLD HARMLESS
Each party in the B2B Program agrees to defend, indemnify, hold harmless every party,
including the City of South San Francisco, its officers, agents and members of each
other party departments and agencies, from all liability, damage (whether in contract or
tort), including personal injury, death at any time, or property damage, costs and
financial loss, including all costs and expense of litigation, for the sole wrongful or
negligent acts or omissions of the indemnifying party’s officers, agents or department
members in the performance of any services described in this Agreement that
cause such liability, damage, costs and financial loss. If the injury, death or loss that
forms the basis of any claim, suit or judgment is determined to have been caused by
the combined negligent or willful acts or omissions of more than one party in the
performance of any services described in this Agreement, each such party agrees to
bear its respective share of the payment of any award, settlement, or judgment, and
each such party shall bear its own costs of defense, including attorneys’ fees.
Pursuant to California Code Section 8655, etc. seq., the state or its political
subdivisions shall not be liable for any claim upon the exercise or performance, or the
failure to exercise or perform, a discretionary function or duty on the part of a state or
local agency or any employee of the state or its political subdivisions in carrying out
the provisions of the California Services Act.
IX. PRE-CERTIFICATION ACCEPTANCE
Application for the B2B Program will be reviewed by the Chief Building Official
and determination will be made within 14 business days after submittal. The Building
Division will add the building to the list of buildings approved for the B2B Program and
provide the following upon acceptance of pre-certification documentation:
A. Building Official-signed Appendix A, Checklist, accepting the Inspection Dossier;
B. Building Official-signed Appendix B, Request for Pre-certification form;
C. Building Official-signed copy of each Appendix C, Inspector Authorization form;
D. Official placards for posting at predetermined building entrances;
E. Certificate of approval.
X. ACTIVATION
A. Upon proclamation of a local emergency that may have caused damage to
buildings and/or property, initiate and direct the inspection program as agreed
between Applicant and pre-certified deputized Inspection Team;
B. Contact the City Building Division at (650) 829-6670 immediately if building or
area (including sidewalk, street, or parking area) presents a public safety hazard,
or if emergency demolition or shoring is required;
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C. Arrange for barricading or taping off of all unsafe areas. Contact the City Public
Works Department at (650) 877-8550 immediately if areas barricaded include a
public street or otherwise adversely affect City services, or if barricades available
to Applicant are insufficient;
D. Complete rapid inspection per ATC-20 only rapid evaluation adequate to placard
unless concerns observed, then proceed to detailed evaluation as soon as
reasonably possible, if required.
E. Take preventive measures regarding gas leaks, hazardous material spills, or
other life-safety mitigation
F. Post building (green, yellow, or red) at the main entry of the building and at all
entrances of multi-entrance buildings. Elevator and life-safety inspection may
occur separately from structural inspection;
G. Submit ATC-20 Rapid and/or Detailed Evaluation Report signed and dated by
pre-certified deputized Inspector to the Building Division as soon as reasonably
practical, preferably within 72 hours of the declared local emergency.
Note: If reports are not received within 72 hours, an inspection may be made by City
building inspectors or deputized volunteer inspectors using standard City-wide
inspection criteria.
XI. PLACARD MANAGEMENT
Safety Assessment placards are controlled documents and recipients must carefully
manage their storage and use. Applicants and Inspectors must adhere to the following
protocol in order to participate in the B2B program:
A. Placards must be stored in a locked and secure location accessible only to the
Applicant and designated Inspector(s);
B. Each placard must clearly display a unique identification number assigned by the
City of South San Francisco;
C. Applicant and/or Inspector must carefully document the posting of every safety
assessment placard. Documentation must include placard identification number,
building address and entrance where posted, date and time of posting, and name
of pre-certified Inspector who authorized the placard posting by the Inspection
Team. This information must be provided to the Chief Building Official along
with the Inspection documentation.
D. Placards shall not be destroyed or discarded. If a placard is erroneous, damaged,
or is superseded, the Inspector shall fully mark the front of the placard with an "X",
and return the placard to the Chief Building Official.
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Important: Failure to follow the protocol for safety assessment placards may result in
termination from the B2B Program.
XII. BUILDING OFFICIAL VERIFICATION
The City Building Division in the Economic & Community Development Department
may perform inspection of the B2B designated building under any of the following
conditions:
A. The Inspector has reported the building unsafe and has posted it with a red
placard;
B. There is reason to believe that unsafe conditions exist;
C. Applicants, tenants, other public agencies, or members of the general public
express specific concerns.
XIII. TERMINATION
Before each biennial anniversary of original approval date, a courtesy reminder notice
will be sent to the Applicant via email. If there is no response from the Applicant within
180 calendar days, or for one or more of the following reasons, the building may be
removed from the B2B Program:
A. Biennial renewal forms have not been submitted;
B. Partnership or agreement between Applicant and inspection team has been
terminated;
C. Changes in inspection team members have not been submitted and/or do not
meet minimum requirements;
D. Alterations made to the building affecting seismic response or inspection
procedures have not been reflected in the Inspection Dossier;
E. Placards have not been properly managed.
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APPENDIX A
APPLICATION CHECKLIST
Building Address/Location and Number:
Appendix A: This Checklist, marked by applicant to show all items submitted
Appendix B: Request for Pre-certification - signed by Applicant
Appendix C: Inspector Authorization - signed, include one form for each inspector,
with 1-page resume
Appendix D: Biennial Program Renewal Form
Appendix E: Copy of Complete Inspection Dossier or link to electronic filing,
including:
Part A. List of Individual’s Contact Information for this building
1. Licensed engineers applying for pre-certification as re-occupancy
inspectors for structural inspection
Part B. Building Information
1. Photograph of building
2. Address
3. Description of building, including year of original occupancy, number of
stories, size, materials of construction, and structural system type
4. Building floor plans showing entrances; evacuation routes; stairs;
elevators; and recommended locations of observation for detecting
structural distress
5. Number of building entrances to be posted with City placards
6. List of building use(s) - offices, apartments, manufacturing, etc.
7. Description of life-safety system including location of emergency power
generator with description of building fire detection and suppression
systems.
8. Description and locations of potential falling hazards, noted on drawings or
other documentation
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Part C: Response requirements and information, including:
1. Trigger for activation of response (earthquake, fire, flood or terrorist
incident that may have impacted buildings or property)
2. Rally location for the Applicant’s emergency response and command and
control organization;
3. Access procedures and/or location of keys for entrance to the site and all
building areas;
4. Inventory and location of required documents, equipment and supplies,
including:
a. Structural, architectural, and/or life-safety system drawings;
as-built drawings, or (if structural drawings are unavailable or
otherwise inadequate) a clear description of the structural
system and any known weaknesses and unique features
b. Personal safety equipment including hardhat
c. Inspection equipment including flashlights, measuring
devices, ladders, other applicable items
d. ATC-20 Rapid and Detailed Evaluation Forms (latest edition)
for reporting inspection findings to the Chief Building Official
e. Caution/Danger tape and/or barricades
f. Handheld radios or other communication devices for large
buildings, if applicable
5. Location, type, and handling instructions for hazardous response plan
material
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Part D: Inspection procedure, including:
1. Latest edition of ATC-20-1 Field Manual for Post-Earthquake Safety
Evaluation of Buildings including Rapid and Detailed Evaluation
Procedures
2. [Optional] Accelerometer placement - may reduce requirement for
inspection of welded joints
Completed By Applicant
Name/Date:
Reviewed & Accepted by Chief Building Official
Name/Date:
RETURN ONE COPY OF THIS FORM TO APPLICANT AFTER REVIEW &
ACCEPTANCE
Last Updated Date:
Original Approval Date:
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APPENDIX B
REQUEST FOR PRE-CERTIFICATION
When used for Biennial Renewal, complete only if Applicant has changed during last
year.
Company Name, Building Address/Location and Number:
is hereby requested for acceptance in the City B2B Program. I certify that:
1. The Owner of the building at the above address is:
Applicant’s Address:
Applicant Phone:
Applicant E-Mail:
2. I am the Building owner or I am authorized to act as the Owner's agent in requesting
participation in program.
3. The enclosed or linked Pre-Certification Documentation and Inspection Dossier
comply with the minimum requirements of the City’s B2B Program.
4. Inspectors have been given access to a copy of the Inspection Dossier for the
building at the address listed above.
5. Inspectors have been given instructions regarding obtaining accompanied access or
have been provided a means of access to all areas of the building at all times of day
and night if safe. Business emergency command/site crisis management teams
responsible for respective buildings at the time must authorize entry and track
deployment and return of Inspection Teams.
6. Inspectors have access to the most recent accurate copies of all relevant structural,
architectural, and life-safety drawings at all times, if available, or maintain detailed
layout plans with information necessary to complete inspection, including entrances,
evacuation routes, stairs, elevators, and recommended locations of observation for
detecting structural distress.
7. All Inspectors will receive immediate notification of any changes in factors affecting
the Inspection Dossier (e.g. changes to contact information, structural or life-safety
systems, access to buildings, etc.).
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Certified by:
Signature of Applicant
Date:
Print/Type Name
Company
Do Not Write Below/For Use of Authorizing Building Official Only
[ ] The pre-certification documentation for this building has been accepted by the City
Building Division in the Economic & Community Development Department. The
building will be placed on the list of buildings for the B2B Program.
Accepted by:
Name:
Date:
RETURN ONE COPY OF THIS FORM TO APPLICANT AFTER REVIEW &
ACCEPTANCE
Last Updated Date:
Original Approval Date:
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APPENDIX C
STRUCTURAL INSPECTOR AUTHORIZATION
When used for biennial renewal, complete only for NEW Inspectors.
Inspector Name:
Inspector’s Phone:
Company:
Inspector’s Email:
I request pre-certification as a Structural Inspector for the building located at:
Address:
I am a ( ) structural engineer; ( ) civil engineer; ( ) architect, licensed in the State of
California.
License No. Exp. Date
I am applying to be a Structural Inspector for this building. Note: Primary Structural
Inspector must be a California licensed structural or civil engineer.
Attach 1-page resume to this Appendix for each Structural Inspector; including
education and experience relevant to inspection duties, in addition to brief experience
descriptions below.
I certify that:
1. I have relevant experience in the design and/or inspection of similar buildings:
Building Address Building Type No. stories
2. I have completed training in ATC-20 Rapid and Detailed Evaluation Procedures and
will complete any additional and/or refresher training in a manner consistent with
maintaining readiness.
ID # Exp. Date:
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I understand that while I am acting as an Inspector under this B2B agreement, my
activities are in no way affiliated with the Cal-EMA Safety Assessment program and I
am not entitled to worker's compensation benefits or limited immunity from liability
provided by the State of California Disaster Service Worker Volunteer Program.
3. I am familiar with and have access to a complete and current copy of the Inspection
Dossier for this building.
4. I am familiar with and will adhere to the management protocol for Safety
Assessment Placards.
5. I accept authorization as a Deputized Inspector by the City Building Division upon
emergency declaration and will present this form upon request.
Signature Date:
Do Not Write Below/For Use of Authorizing Building Official Only
The individual listed above is certified as a deputized Inspector for the above-listed
building by the City Building Division in the Economic & Community Development
Department and is authorized to post this building with official City post-disaster
safety assessment re- occupancy placards. All evaluations and placard postings by
designated Inspectors are subject to review by the Chief Building Official, and ultimate
occupancy posting is at the sole discretion of the Chief Building Official.
Accepted by: Date:
RETURN ORIGINAL OF THIS FORM TO APPLICANT AFTER REVIEW &
ACCEPTANCE
APPLICANT TO GIVE ORIGINAL TO INSPECTOR FOR IDENTIFICATION
PURPOSES
Last Updated Date:
Original Approval Date:
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APPENDIX D
BIENNIAL PROGRAM RENEWAL
TO BE SUBMITTED BIENNIALY PRIOR TO ANNIVERSARY OF DATE OF ORIGINAL
APPROVAL
Applicant Name(s):
Building Address/Location and Number:
( ) No change has been made to any element of Inspection Dossier.
( ) All equipment and supplies for the program have been checked and updated as
necessary.
( ) The Applicant has/have changed.
The Applicant is
A Request for Pre-Certification form completed and signed by the new owner is
enclosed.
( ) Inspector/ has changed. Completed Inspector Authorization forms for all new
inspectors are enclosed, and Inspection Dossier has been updated and a
copy/link provided herewith.
( ) Changes have been made to the building affecting the Inspection Dossier.
Inspectors have been provided access to revised drawings for all relevant
changes to the building. Inspection Dossier has been updated and a copy/link
provided herewith.
Designated contact person for biennial update (Applicant):
Signature:
Date:
Print/Type Name:
Phone:
Company:
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Do Not Write Below/For Use of Authorizing Building Official Only
The updated documentation for this building has been accepted by the City Building
Division in the Economic & Community Development Department. The building remains
on the list of buildings for the B2B Program.
Accepted by:
Title
Date:
Last Updated Date:
Original Approval Date:
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APPENDIX E
PLACARD ISSUANCE
TO BE COMPLETED BY BUILDING OFFICIAL
Applicant Name:
Building Address/Location and Number:
The following Safety Assessment Placards have been issued to the Applicant:
Placards Quantity Identification Numbers (Range)
Red (Unsafe- No Entry)
Yellow (Restricted Use)
Green (Inspected - Lawful
Occupancy Permitted)
( ) Each Pre-certified Deputy Inspector has confirmed understanding of placard
management protocol and has indicated intent to adhere to protocol by signing the
Structural Inspector Authorization form.
Building Official Signature:
Date:
Last Updated Date:
Original Approval Date:
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CITY OF SOUTH SAN FRANCISCO
ECONOMIC & COMMUNITY DEVELOPMENT
DEPARTMENT
B2B PROGRAM
APPENDIX F
INSPECTION DOSSIER
(Attach Complete Dossier or Attach Link)
2958272.1