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[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"東京都知事"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"多摩建築指導事務所長　"]
[null,"第三十六号の二様式（第五条関係）（Ａ４）"]
[]
[null,"定期調査報告書"]
[null,"（第一面）"]
[]
[]
[]
[null,"　建築基準法第12条第１項の規定による定期調査の結果を報告します。この報告書に記載の事項は、"]
[null,"事実に相違ありません。"]
[]
[null,null,"●●●●",null,null,null,null,null,null,null,null,null,null,null,"様"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"報告者氏名"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"調査者氏名"]
[]
[]
[]
[]
[]
[]
[]
[null,"【1．所有者】"]
[null,null,null,"【イ．氏名のフリガナ】"]
[null,null,null,"【ロ．氏名】"]
[null,null,null,"【ハ．郵便番号】"]
[null,null,null,"【ニ．住所】"]
[null,null,null,"【ホ．電話番号】"]
[]
[]
[]
[]
[]
[null,"【2．管理者】"]
[null,null,null,"【イ．氏名のフリガナ】"]
[null,null,null,"【ロ．氏名】"]
[null,null,null,"【ハ．郵便番号】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※☑所有者と同一は初期時は☑が入らない。入った時点で作成開始済とみなし-”は表示対象となる"]
[null,null,null,"【ニ．住所】"]
[null,null,null,"【ホ．電話番号】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※☑所有者と同一は初期時は☑が入らない。入った時点で作成開始済とみなし--”は表示対象となる"]
[]
[]
[]
[]
[]
[null,"【3．調査者】"]
[null,null,"（代表となる調査者）"]
[null,null,null,"【イ．資格】"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,"）建築士",null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,"）登録",null,null,null,"第",null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"特定建築物調査員",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"第",null,null,null,null,null,null,"号"]
[null,null,null,"【ロ．氏名のフリガナ】"]
[null,null,null,"【ハ．氏名】 "]
[null,null,null,"【ニ．勤務先】"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,"）建築士事務所",null,null,null,null,null,null,"（",null,null,null,null,null,null,"）知事登録",null,null,null,null,null,"第",null,null,null,null,null,null,"号"]
[null,null,null,"【ホ．郵便番号】"]
[null,null,null,"【へ．所在地】"]
[null,null,null,"【ト．電話番号】"]
[null,null,"（その他の調査者）"]
[null,null,null,"【イ．資格】"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,"）建築士",null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,"）登録",null,null,null,"第",null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"特定建築物調査員",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"第",null,null,null,null,null,null,"号"]
[null,null,null,"【ロ．氏名のフリガナ】"]
[null,null,null,"【ハ．氏名】 "]
[null,null,null,"【ニ．勤務先】"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,"）建築士事務所",null,null,null,null,null,null,"（",null,null,null,null,null,null,"）知事登録",null,null,null,null,null,"第",null,null,null,null,null,null,"号"]
[null,null,null,"【ホ．郵便番号】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※☑代表となる調査者と同一は初期時は☑が入らない。入った時点で作成開始済とみなし-”は表示対象となる"]
[null,null,null,"【へ．所在地】"]
[null,null,null,"【ト．電話番号】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※☑代表となる調査者と同一は初期時は☑が入らない。入った時点で作成開始済とみなし--”は表示対象となる"]
[]
[]
[]
[]
[]
[null,"【4．報告対象建築物】"]
[null,null,null,"【イ．所在地】"]
[null,null,null,"【ロ．名称のフリガナ】"]
[null,null,null,"【ハ．名称】"]
[null,null,null,"【ニ．用途】"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"【5．調査による指摘の概要】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"指摘の内容が☑要是正の指摘ありで「第一面別紙参照」"]
[null,null,null,"【イ．指摘の内容】",null,null,null,null,null,null,null,null,null,null,null,"要是正の指摘あり",null,null,null,null,null,null,null,"(",null,"既存不適格）",null,null,null,null,null,null,null,null,"指摘なし"]
[null,null,null,"【ロ．指摘の概要】"]
[]
[]
[]
[]
[null,null,null,"【ハ．改善予定の有無】",null,null,null,null,null,null,null,null,null,null,null,"有",null,"(　　　　　年　　月に改善予定)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"無",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"改善予定が☑有で元号表示"]
[null,null,null,"【ニ．その他特記事項】"]
[]
[]
[]
[]
[]
[]
[]
[null,"　※受付欄",null,null,null,null,null,null,null,null,null,"※特記欄",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," ※整理番号欄"]
[]
[]
[null,null,null,null,null,"年",null,"月",null,"日"]
[]
[]
[null,null,"第",null,null,null,null,null,null,"号"]
[]
[]
[null,null,"係員氏名"]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"（第一面　別紙）"]
[]
[null,"5.調査による指摘の概要"]
[]
[]
[null,null,"2-1.調査の状況",null,null,null,null,null,null,"ｲ．指摘の内容",null,null,null,null,null,null,null,null,null,null,null,"要是正の指摘あり",null,null,null,null,null,null,"（",null,"既存不適格）"]
[null,null,"(敷地及び地盤)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"指摘なし"]
[null,null,"ﾛ．指摘の概要"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"3.調査者"]
[]
[]
[null,null,"（その他の調査者2）"]
[null,null,null,"【イ．資格】"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,"）建築士",null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,"）登録",null,null,null,"第",null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"特定建築物調査員",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"第",null,null,null,null,null,null,"号"]
[null,null,null,"【ロ．氏名のフリガナ】"]
[null,null,null,"【ハ．氏名】 "]
[null,null,null,"【ニ．勤務先】"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,"）建築士事務所",null,null,null,null,null,null,"（",null,null,null,null,null,null,"）知事登録",null,null,null,null,null,"第",null,null,null,null,null,null,"号"]
[null,null,null,"【ホ．郵便番号】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※☑代表となる調査者と同一は初期時は☑が入らない。入った時点で作成開始済とみなし-”は表示対象となる"]
[null,null,null,"【へ．所在地】"]
[null,null,null,"【ト．電話番号】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※☑代表となる調査者と同一は初期時は☑が入らない。入った時点で作成開始済とみなし--”は表示対象となる"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"（第二面）"]
[null,"建築物及びその敷地に関する事項"]
[]
[]
[null,"【1．敷地の位置】"]
[null,null,null,"【イ．防火地域等】",null,null,null,null,null,null,null,null,null,null,null,"防火地域",null,null,null,null,null,null,"準防火地域"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"その他（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）",null,null,null,"指定なし"]
[null,null,null,"【ロ．用途地域】"]
[]
[]
[]
[]
[]
[null,"【2．建築物及びその敷地の概要】"]
[null,null,null,"【イ．構造】",null,null,null,null,null,null,null,null,null,null,null,"鉄筋コンクリート造",null,null,null,null,null,null,null,null,null,null,null,"鉄骨鉄筋コンクリート造"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"鉄骨造",null,null,null,null,null,null,null,null,null,null,null,"その他（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[null,null,null,"【ロ．階数】",null,null,null,null,null,null,null,null,null,null,null,"地上",null,null,null,null,"階",null,null,"地下",null,null,null,null,"階"]
[null,null,null,"【ハ．敷地面積】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"㎡"]
[null,null,null,"【ニ．建築面積】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"㎡"]
[null,null,null,"【ホ．延べ面積】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"㎡"]
[]
[]
[]
[]
[]
[null,"【3．階別用途別床面積】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,"用途",null,null,null,"）",null,"（",null,"床面積",null,null,null,"）"]
[null,null,null,"【イ．階別用途別】",null,null,null,null,null,null,null,null,null,"（",null,null,null,"階）",null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,"階）",null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,"階）",null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,"階）",null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,"階）",null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,"【ロ．用途別】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null," （その他の検査者２）"]
[null,null,"【イ．資格】",null,null,null,null,null,null,"（",null,null," ）建築士",null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,null,")登録第",null,null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,"建築設備検査員",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"第",null,null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,"登録建築設備検査資格者講習を修了した者",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"第",null,null,null,null,null,null,null,"号"]
[null,null,"【ロ．氏名のフリガナ】"]
[null,null,"【ハ．氏名】"]
[null,null,"【ニ．勤務先】"]
[null,null,null,null,null,null,null,null,null,"（",null,null," ）建築士事務所",null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,null,")知事登録第",null,null,null,null,null,null,null,"号"]
[null,null,"【ホ．郵便番号】"]
[null,null,"【ヘ．所在地】"]
[null,null,"【ト．電話番号】"]
[]
[]
[]
[]
[]
[null,"【4．性能検証法等の適用】",null,null,null,null,null,null,null,null,null,null,null,null,null,"耐火性能検証法",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"防火区画検証法"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"区画避難安全検証法（",null,null,null,null,null,null,null,null,null,null,null,null,"階）",null,null,null,"階避難安全検証法（",null,null,null,null,null,null,null,null,null,null,null,"階）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"全館避難安全検証法"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"その他（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[]
[]
[]
[]
[null,"【5．増築、改築、用途変更等の経過】"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日",null,null,"概要（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日",null,null,"概要（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日",null,null,"概要（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日",null,null,"概要（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"【6．関連図書の整備状況】"]
[null,null,null,"【イ．確認に要した図書】",null,null,null,null,null,null,null,null,null,null,null,null,"有（",null,null,"各階平面図あり）",null,null,null,null,null,null,null,null,"無"]
[null,null,null,"【ロ．確認済証】",null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,"無"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"交付番号",null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日","第",null,null,null,null,null,null,null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"  交付者",null,null,null,null,null,"建築主事",null,null,null,null,null,"指定確認検査機関（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[null,null,null,"【ハ．完了検査に要した図書】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,"無"]
[null,null,null,"【ニ．検査済証】",null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,"無"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"交付番号",null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日","第",null,null,null,null,null,null,null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　交付者",null,null,null,null,null,"建築主事",null,null,null,null,null,"指定確認検査機関（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[null,null,null,"【ホ．維持保全に関する準則又は計画】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,"無"]
[null,null,null,"【ヘ．前回の調査に関する書類の写し】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,"無",null,null,"対象外"]
[null," （その他の検査者２）"]
[null,null,"【イ．資格】",null,null,null,null,null,null,"（",null,null," ）建築士",null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,null,")登録第",null,null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,"建築設備検査員",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"第",null,null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,"登録建築設備検査資格者講習を修了した者",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"第",null,null,null,null,null,null,null,"号"]
[null,null,"【ロ．氏名のフリガナ】"]
[null,null,"【ハ．氏名】"]
[null,null,"【ニ．勤務先】"]
[null,null,null,null,null,null,null,null,null,"（",null,null," ）建築士事務所",null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,null,")知事登録第",null,null,null,null,null,null,null,"号"]
[null,null,"【ホ．郵便番号】"]
[null,null,"【ヘ．所在地】"]
[null,null,"【ト．電話番号】"]
[]
[]
[]
[null,"【7．備考】"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"（第二面　別紙）"]
[null,"3．階別用途別床面積"]
[]
[]
[null,"階＼用途",null,null,null,"各階合計"]
[]
[]
[]
[]
[]
[null,"延べ面積",null,null,null,null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡"]
[null,"地下1",null,null,"階",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡"]
[null,"地下2",null,null,"階",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡"]
[null,"地下3",null,null,"階",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡"]
[null,"地下4",null,null,"階",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡",null,null,null,null,"㎡"]
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[]
[null,"（第三面）"]
[null,"調査等の概要"]
[]
[]
[null,"【1．調査及び検査の状況】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"完全未入力判定（0で完全未入力／既存の判定欄より）"]
[null,null,null,"【イ．今回の調査】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日実施"]
[null,null,null,"【ロ．前回の調査】",null,null,null,null,null,null,null,null,null,null,null,"実施（",null,null,null,null,null,null,"年",null,null,"月",null,null,"日報告）",null,null,null,null,null,"未実施"]
[null,null,null,"【ハ．建築設備の検査】",null,null,null,null,null,null,null,null,null,null,null,"実施（",null,null,null,null,null,null,"年",null,null,"月",null,null,"日報告）",null,null,null,null,null,"未実施"]
[null,null,null,"【ニ．昇降機等の検査】",null,null,null,null,null,null,null,null,null,null,null,"実施（",null,null,null,null,null,null,"年",null,null,"月",null,null,"日報告）",null,null,null,null,null,"未実施"]
[null,null,null,"【ホ．防火設備の検査】",null,null,null,null,null,null,null,null,null,null,null,"実施（",null,null,null,null,null,null,"年",null,null,"月",null,null,"日報告）",null,null,null,null,null,"未実施"]
[]
[]
[]
[]
[]
[null,"【2．調査の状況】"]
[null,null,"（敷地及び地盤）"]
[null,null,null,"【イ．指摘の内容】",null,null,null,null,null,null,null,null,null,null,null,"要是正の指摘あり ",null,null,null,null,null,null,null,"（",null,"既存不適格）",null,null,null,null,null,null,null,null,"指摘なし"]
[null,null,null,"【ロ．指摘の概要】"]
[null,null,null,"【ハ．改善予定の有無】",null,null,null,null,null,null,null,null,null,null,null,"有",null,"（　　　　　年　　月に改善予定）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"無"]
[null,null,"（建築物の外部）"]
[null,null,null,"【イ．指摘の内容】",null,null,null,null,null,null,null,null,null,null,null,"要是正の指摘あり ",null,null,null,null,null,null,null,"（",null,"既存不適格）",null,null,null,null,null,null,null,null,"指摘なし"]
[null,null,null,"【ロ．指摘の概要】"]
[null,null,null,"【ハ．改善予定の有無】",null,null,null,null,null,null,null,null,null,null,null,"有",null,"（　　　　　年　　月に改善予定）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"無"]
[null,null,"（屋上及び屋根）"]
[null,null,null,"【イ．指摘の内容】",null,null,null,null,null,null,null,null,null,null,null,"要是正の指摘あり ",null,null,null,null,null,null,null,"（",null,"既存不適格）",null,null,null,null,null,null,null,null,"指摘なし"]
[null,null,null,"【ロ．指摘の概要】"]
[null,null,null,"【ハ．改善予定の有無】",null,null,null,null,null,null,null,null,null,null,null,"有",null,"（　　　　　年　　月に改善予定）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"無"]
[null,null,"（建築物の内部）"]
[null,null,null,"【イ．指摘の内容】",null,null,null,null,null,null,null,null,null,null,null,"要是正の指摘あり ",null,null,null,null,null,null,null,"（",null,"既存不適格）",null,null,null,null,null,null,null,null,"指摘なし"]
[null,null,null,"【ロ．指摘の概要】"]
[null,null,null,"【ハ．改善予定の有無】",null,null,null,null,null,null,null,null,null,null,null,"有",null,"（　　　　　年　　月に改善予定）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"無"]
[null,null,"（避難施設等）"]
[null,null,null,"【イ．指摘の内容】",null,null,null,null,null,null,null,null,null,null,null,"要是正の指摘あり ",null,null,null,null,null,null,null,"（",null,"既存不適格）",null,null,null,null,null,null,null,null,"指摘なし"]
[null,null,null,"【ロ．指摘の概要】"]
[null,null,null,"【ハ．改善予定の有無】",null,null,null,null,null,null,null,null,null,null,null,"有",null,"（　　　　　年　　月に改善予定）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"無"]
[null,null,"（その他）"]
[null,null,null,"【イ．指摘の内容】",null,null,null,null,null,null,null,null,null,null,null,"要是正の指摘あり ",null,null,null,null,null,null,null,"（",null,"既存不適格）",null,null,null,null,null,null,null,null,"指摘なし"]
[null,null,null,"【ロ．指摘の概要】"]
[null,null,null,"【ハ．改善予定の有無】",null,null,null,null,null,null,null,null,null,null,null,"有",null,"（　　　　　年　　月に改善予定）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"無"]
[]
[]
[]
[]
[]
[null,"【3．石綿を添加した建築材料の調査状況】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（該当する室）"]
[null,null,null,"【イ．該当建築材料の有無】",null,null,null,null,null,null,null,null,null,null,null,null,null,"有（飛散防止措置無）",null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有（飛散防止措置有）",null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"無"]
[null,null,null,"【ロ．措置予定の有無】",null,null,null,null,null,null,null,null,null,null,null,null,null,"有（",null,null,null,null,null,"年",null,null,"月に改善予定）",null,null,null,null,null,null,null,null,null,"無"]
[null," （その他の検査者２）"]
[null,null,"【イ．資格】",null,null,null,null,null,null,"（",null,null," ）建築士",null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,null,")登録第",null,null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,"建築設備検査員",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"第",null,null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,"登録建築設備検査資格者講習を修了した者",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"第",null,null,null,null,null,null,null,"号"]
[null,null,"【ロ．氏名のフリガナ】"]
[null,null,"【ハ．氏名】"]
[null,null,"【ニ．勤務先】"]
[null,null,null,null,null,null,null,null,null,"（",null,null," ）建築士事務所",null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,null,")知事登録第",null,null,null,null,null,null,null,"号"]
[null,null,"【ホ．郵便番号】"]
[null,null,"【ヘ．所在地】"]
[null,null,"【ト．電話番号】"]
[]
[]
[]
[]
[]
[null,"【4．耐震診断及び耐震改修の調査状況】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"診断予定年月完全未入力（0で完全未入力：既存の判定欄使用につき1ではない）"]
[null,null,null,"【イ．耐震診断の実施の有無】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,"無（",null,null,null,null,null,"年",null,null,"月に実施予定）",null,null,null,null,null,null,null,null,"対象外",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"←（今回の調査　実施日の完全未入力判定兼用）"]
[null,null,null,"【ロ．耐震改修の実施の有無】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,"無（",null,null,null,null,null,"年",null,null,"月に実施予定）",null,null,null,null,null,null,null,null,"対象外",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"←（今回の調査　実施日の完全未入力判定兼用）"]
[]
[]
[]
[]
[null,"【5．建築物等に係る不具合等の状況】"]
[null,null,null,"【イ．不具合等】",null,null,null,null,null,null,null,null,null,null,null,"有",null,null,"無"]
[null,null,null,"【ロ．不具合等の記録】",null,null,null,null,null,null,null,null,null,null,null,"有",null,null,"無"]
[null,null,null,"【ハ．改善の状況】",null,null,null,null,null,null,null,null,null,"実施済",null,null,null,null,"改善予定",null,null,null,"（",null,null,null,null,"年",null,null,"月に改善予定）",null,null,null,null,null,null,null,null,"予定なし"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"【6．備考】"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"（第三面　別紙1）"]
[]
[null,"２.　調査の状況"]
[]
[]
[null,null,"2-1.調査の状況",null,null,null,null,null,null,"ｲ．指摘の内容",null,null,null,null,null,null,null,null,null,null,null,"要是正の指摘あり",null,null,null,null,null,null,"（",null,"既存不適格）"]
[null,null,"(敷地及び地盤)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"指摘なし"]
[null,null,"(敷地及び地盤)",null,null,null,null,null,null,"ﾛ．指摘の概要"]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,"ﾊ．改善予定の有無",null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,"(令和",null,null,"年",null,null,null,null,null,null,null,null,null,"無"]
[null,null,"2-2.調査の状況",null,null,null,null,null,null,"ｲ．指摘の内容",null,null,null,null,null,null,null,null,null,null,null,"要是正の指摘あり",null,null,null,null,null,null,"（",null,"既存不適格）"]
[null,null,"(建築物の外部)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"指摘なし"]
[null,null,"(建築物の外部)",null,null,null,null,null,null,"ﾛ．指摘の概要"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,"ﾊ．改善予定の有無",null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,"(令和",null,null,"年",null,null,null,null,null,null,null,null,null,"無"]
[null,null,"2-3.調査の状況",null,null,null,null,null,null,"ｲ．指摘の内容",null,null,null,null,null,null,null,null,null,null,null,"要是正の指摘あり",null,null,null,null,null,null,"（",null,"既存不適格）"]
[null,null,"(屋上及び屋根)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"指摘なし"]
[null,null,"(屋上及び屋根)",null,null,null,null,null,null,"ﾛ．指摘の概要"]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,"ﾊ．改善予定の有無",null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,"(令和",null,null,"年",null,null,null,null,null,null,null,null,null,"無"]
[null,null,"2-4.調査の状況",null,null,null,null,null,null,"ｲ．指摘の内容",null,null,null,null,null,null,null,null,null,null,null,"要是正の指摘あり",null,null,null,null,null,null,"（",null,"既存不適格）"]
[null,null,"(建築物の内部)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"指摘なし"]
[null,null,"(建築物の内部)",null,null,null,null,null,null,"ﾛ．指摘の概要"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,"ﾊ．改善予定の有無",null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,"(令和",null,null,"年",null,null,null,null,null,null,null,null,null,"無"]
[null,null,"2-5.調査の状況",null,null,null,null,null,null,"ｲ．指摘の内容",null,null,null,null,null,null,null,null,null,null,null,"要是正の指摘あり",null,null,null,null,null,null,"（",null,"既存不適格）"]
[null,null,"(避難施設等)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"指摘なし"]
[null,null,"(避難施設等)",null,null,null,null,null,null,"ﾛ．指摘の概要"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,"ﾊ．改善予定の有無",null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,"(令和",null,null,"年",null,null,null,null,null,null,null,null,null,"無"]
[null,null,"2-6.調査の状況",null,null,null,null,null,null,"ｲ．指摘の内容",null,null,null,null,null,null,null,null,null,null,null,"要是正の指摘あり",null,null,null,null,null,null,"（",null,"既存不適格）"]
[null,null,"（その他）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"指摘なし"]
[null,null,"（その他）",null,null,null,null,null,null,"ﾛ．指摘の概要"]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,"ﾊ．改善予定の有無",null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,"(令和",null,null,"年",null,null,null,null,null,null,null,null,null,"無"]
[]
[]
[null,"（第四面）"]
[]
[null,"建築物等に係る不具合等の状況"]
[]
[]
[null,"不具合等を把握した年月",null,null,null,null,null,"不具合等の概要",null,null,null,null,null,null,null,null,null,"考えられる原因",null,null,null,null,null,null,null,null,null,"改善（予定）",null,null,null,null,null,"改善措置の概要等"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年月"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"(注意)"]
[null,"1. 各面共通関係"]
[null,"　①　※印のある欄は記入しないでください。"]
[null,"　②　数字は算用数字を、単位はメートル法を用いてください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　②　数字は算用数字を、単位はメートル法を用いてください。","　②　数字は算用数字を、単位はメートル法を用いてください。","　②　数字は算用数字を、単位はメートル法を用いてください。"]
[null,"　③　記入欄が不足する場合は、枠を拡大、行を追加して記入するか、別紙に必要な事項を記入し添えて"]
[null,"　　ください。"]
[null,"2. 第一面関係"]
[null,"　①　調査者が２人以上のときは、代表となる調査者を調査者氏名欄に記入してください。"]
[null,"　②　１欄及び２欄は、所有者又は管理者が法人のときは、「ロ」はそれぞれ法人の名称及び代表者氏名"]
[null,"　　を、「ニ」はそれぞれ法人の所在地を記入してください。"]
[null,"　③　３欄は、代表となる調査者及び当該建築物の調査を行ったすべての調査者について記入してくださ"]
[null,"　　い。当該建築物の調査を行った調査者が１人の場合は、その他の調査者欄は削除して構いません。"]
[null,"　④　３欄の「イ」は、調査者の有する資格について記入してください。調査者が特定建築物調査員であ"]
[null,"　　る場合は、特定建築物調査員資格者証の交付番号を「特定建築物調査員」の番号欄に記入してくださ"]
[null,"　　い。"]
[null,"　⑤　３欄の「ニ」は、調査者が法人に勤務している場合は、調査者の勤務先について記入し、勤務先が"]
[null,"　　建築士事務所のときは、事務所登録番号を併せて記入してください。"]
[null,"　⑥　３欄の「ホ」から「ト」までは、調査者が法人に勤務している場合は、調査者の勤務先について記"]
[null,"　　入し、調査者が法人に勤務していない場合は、調査者の住所について記入してください。"]
[null,"　⑦　第三面の２欄のいずれかの「イ」において「要是正の指摘あり」のチェックボックスに「レ」マー"]
[null,"　　クを入れたときは、５欄の「イ」の「要是正の指摘あり」のチェックボックスに「レ」マークを入れ、"]
[null,"　　それ以外のときは、「指摘なし」のチェックボックスに「レ」マークを入れてください。また、第三"]
[null,"　　面の２欄の「イ」の「要是正の指摘あり」のチェックボックスに「レ」マークを入れたものの全てに"]
[null,"　　おいて、「既存不適格」のチェックボックスに「レ」マークを入れたときは、併せて５欄の「イ」の"]
[null,"　　「既存不適格」のチェックボックスに「レ」マークを入れてください。"]
[null,"　⑧　５欄の「ロ」は、指摘された事項のうち特に報告すべき事項があれば記入してください。"]
[null,"　⑨　５欄の「ハ」は、第三面の２欄のいずれかの「ハ」において改善予定があるとしているときは「"]
[null,"　　有」のチェックボックスに「レ」マークを入れ、第三面の２欄の「ハ」に記入された改善予定年月の"]
[null,"　　うち最も早いものを併せて記入してください。"]
[null,"　⑩　５欄の「ニ」は、指摘された事項以外に特に報告すべき事項があれば記入してください。"]
[null,"3. 第二面関係"]
[null,"　①　この書類は、建築物ごとに作成してください。"]
[null,"　②　敷地が複数の地域にまたがるときは、１欄の「イ」は、該当するすべてのチェックボックスに「"]
[null,"　　レ」マークを入れてください。建築基準法第22条第１項の規定により地域指定がされている場合、災"]
[null,"　　害危険区域に指定されている場合その他建築基準法又はそれに基づく命令により地域等の指定がされ"]
[null,"　　ている場合は、「その他」のチェックボックスに「レ」マークを入れ、併せてその内容を記入して下"]
[null,"　　さい。"]
[null,"　③　１欄の「ロ」は、該当する用途地域名を全て記入してください。"]
[null,"　④　２欄の「イ」は、該当する全てのチェックボックスに「レ」マークを入れてください。なお、その"]
[null,"　　他の構造からなる場合には、「その他」のチェックボックスに「レ」マークを入れ、併せて具体的な"]
[null,"　　構造を記入してください。"]
[null,"　⑤　３欄の「イ」は、建築基準法別表第一（い）欄に掲げる用途に供する部分について、最上階から順"]
[null,"　　に記入し、当該用途に供する部分の床面積を記入してください。ただし、特定行政庁が報告の必要が"]
[null,"　　ある用途を定めている場合には、その用途について記入して下さい。該当する用途が複数あるときは"]
[null,"　　、それらを全て記入してください。"]
[null,"　⑥　３欄の「ロ」は、「イ」の用途ごとに床面積の合計を記入してください。"]
[null,"　⑦　４欄は、建築基準法施行令第108条の３第２項に規定する耐火性能検証法により耐火に関する性能"]
[null,"　　が検証されたときは「耐火性能検証法」のチェックボックスに、同令第108条の３第５項に規定する"]
[null,"　　防火区画検証法により遮炎に関する性能が検証されたときは「防火区画検証法」のチェックボックス"]
[null,"　　に、同令第128条の６第３項に規定する区画避難安全検証法により区画避難安全性能が検証されたとき"]
[null,"　　は「区画避難安全検証法」のチェックボックスに、同令第129条第３項に規定する階避難安全検証法に"]
[null,"　　より階避難安全性能が検証されたときは「階避難安全検証法」のチェックボックスに、同令第129条の"]
[null,"　　２第４項に規定する全館避難安全検証法により全館避難安全性能が検証されたときは「全館避難安全"]
[null,"　　検証法」のチェックボックスに、それぞれ「レ」マークを入れ、「区画避難安全検証法」の場合は区"]
[null,"　　画避難安全性能を検証した階を、「階避難安全検証法」の場合は階避難安全性能を検証した階を、併"]
[null,"　　せて記入してください。建築基準法第38条（同法第66条、第67条の２及び第88条第１項において準用"]
[null,"　　する場合を含む。）の規定による特殊構造方法等認定、同法第68条の25第１項の規定による構造方法"]
[null,"　　等の認定又は建築基準法の一部を改正する法律（平成10年法律第100号）による改正前の建築基準法"]
[null,"　　第38条の規定による認定を受けている建築物のうち、当該適用について特に報告が必要なものについ"]
[null,"　　ては「その他」のチェックボックスに「レ」マークを入れ、その概要を記入してください。"]
[null,"　⑧　５欄は、前回調査時以降の建築（新築を除く。）、模様替え、修繕又は用途の変更（以下「増築、"]
[null,"　　改築、用途変更等」という。）について、古いものから順に記入し、確認（建築基準法第６条第１項"]
[null,"　　に規定する確認。以下同じ。）を受けている場合は建築確認済証交付年月日を、受けていない場合は"]
[null,"　　増築、改築、用途変更等が完了した年月日を、併せて記入し、それぞれ増築、改築、用途変更等の概"]
[null,"　　要を記入してください。"]
[null,"　⑨　６欄の「イ」は、最近の確認について、当該確認に要した図書の全部又は一部があるときは「有」"]
[null,"　　のチェックボックスに「レ」マークを入れ、そのうち各階平面図のみがあるときは併せて「各階平面"]
[null,"　　図あり」のチェックボックスに「レ」マークを入れてください。"]
[null,"　⑩　６欄の「ロ」は、最近の確認に係る確認済証について、該当するチェックボックスに「レ」マーク"]
[null,"　　を入れてください。「有」の場合は、確認済証の交付年月日を記入し、交付者に関するチェックボッ"]
[null,"　　クスに「レ」マークを入れ、「指定確認検査機関」の場合は、併せてその名称を記入してください。"]
[null,"　⑪　６欄の「ハ」は、直近の完了検査について、当該完了検査に要した図書の全部又は一部があるとき"]
[null,"　　は「有」のチェックボックスに「レ」マークを入れてください。"]
[null,"　⑫　６欄の「ニ」は、（注意）⑩に準じて記入してください。"]
[null,"　⑬　６欄の「ホ」は、建築基準法第８条第２項に規定する維持保全に関する準則又は計画について記入"]
[null,"　　してください。"]
[null,"　⑭　６欄の「ヘ」は、前回の定期調査の結果を記録した書類の保存の有無について記入してください。"]
[null,"　⑮　建築基準法第86条の８又は同法第87条の２の規定の適用を受けている場合において、７欄にその旨"]
[null,"　　を記載してください。"]
[null,"　⑯　ここに書き表せない事項で特に報告すべき事項は、７欄又は別紙に記載して添えてください。"]
[null,"4.第三面関係"]
[null,"　①　この書類は、建築物ごとに、当該建築物の敷地、構造及び建築設備の状況（別途建築設備の検査を"]
[null,"　　行っている場合は建築設備の設置の状況に係るものに限る。）に関する調査の結果について作成して"]
[null,"　　ください。"]
[null,"　②　１欄の「イ」は、調査が終了した年月日を記入してください。"]
[null,"　③　１欄の「ロ」から「ホ」までは、報告の対象となっていない場合には「未実施」のチェックボック"]
[null,"　　スに「レ」マークを入れてください。"]
[null,"　④　１欄の「ハ」から「ホ」までは、直前の報告について、それぞれ記入してください。"]
[null,"　⑤　２欄の「イ」は、調査結果において、是正が必要と認められるときは「要是正の指摘あり」のチェ"]
[null,"　　ックボックスに「レ」マークを入れ、建築基準法第３条第２項（同法第86条の９第１項において準用"]
[null,"　　する場合を含む。）の規定の適用を受けているものであることが確認されたときは併せて「既存不適"]
[null,"　　格」のチェックボックスに「レ」マークを入れてください。"]
[null,"　⑥　２欄の「イ」の「要是正の指摘あり」のチェックボックスに「レ」マークを入れたとき（「既存不"]
[null,"　　適格」のチェックボックスに「レ」マークを入れたときを除く。）は、「ロ」に指摘の概要を記入し"]
[null,"　　て下さい。"]
[null,"　⑦　２欄の「イ」の「要是正の指摘あり」のチェックボックスに「レ」マークを入れた当該指摘をうけ"]
[null,"　　た項目について改善予定があるときは「ハ」の「有」のチェックボックスに「レ」マークを入れ、併"]
[null,"　　せて改善予定年月を記入してください。改善予定がないときは「ハ」の「無」のチェックボックスに"]
[null,"　　「レ」マークを入れてください。"]
[null,"　⑧　３欄は、建築基準法第28条の２の規定の適用を受ける石綿を添加した建築材料について記入してく"]
[null,"　　ださい。「イ」の「有（飛散防止措置無）」又は「有（飛散防止措置有）」のチェックボックスに「"]
[null,"　　レ」マークを入れたときは、当該建築材料が確認された室を記入してください。当該建築材料につい"]
[null,"　　て飛散防止措置を行う予定があるときは、「ロ」の「有」のチェックボックスに「レ」マークを入れ、"]
[null,"　　併せて措置予定年月を記入してください。措置を行う予定がないときは、「ロ」の「無」のチェック"]
[null,"　　ボックスに「レ」マークを入れてください。"]
[null,"　⑨　４欄は、建築物の耐震改修の促進に関する法律（平成７年法律第123号）第２条第１項又は第２項に"]
[null,"　　規定する耐震診断又は耐震改修の実施の有無について記入してください。耐震診断又は耐震改修の実"]
[null,"　　施の予定があるときは、実施予定年月を記入し、具体的な耐震改修の内容を定めている場合は別紙に"]
[null,"　　記入し添えてください。"]
[null,"　⑩　前回調査時以降に把握した屋根ふき材、内装材、外装材等及び広告塔、装飾塔その他建築物の屋外"]
[null,"　　に取り付けられたものの脱落、バルコニー、屋上等の手すりその他建築物の部分の脱落等（以下「不"]
[null,"　　具合等」という。）について第四面の「不具合等の概要」欄に記入したときは、５欄の「イ」の「有"]
[null,"　　」のチェックボックスに「レ」マークを入れ、当該不具合等について記録が有るときは「ロ」の「有"]
[null,"　　」のチェックボックスに「レ」マークを入れ、記録が無いときは「ロ」の「無」のチェックボックス"]
[null,"　　に「レ」マークを入れてください。また、第四面に記入された不具合等のうち当該不具合等を受け既"]
[null,"　　に改善を実施しているものがあり、かつ、改善を行う予定があるものがない場合には「ハ」の「実施"]
[null,"　　済」のチェックボックスに「レ」マークを入れ、第四面に記入された不具合等のうち改善を行う予定"]
[null,"　　があるものがある場合には「改善予定」のチェックボックスに「レ」マークを入れ、第四面の「改善"]
[null,"　　（予定）年月」欄に記入された改善予定年月のうち最も早いものを併せて記入し、これら以外の場合"]
[null,"　　には「予定なし」のチェックボックスに「レ」マークを入れてください。"]
[null,"　⑪　各欄に掲げられている項目以外で特に報告すべき事項は、６欄又は別紙に記入して添えてください。"]
[null,"5.第四面関係"]
[null,"　①　第四面は、前回調査時以降に把握した建築物等に係る不具合等のうち第三面の２欄において指摘さ"]
[null,"　　れるもの以外のものについて、把握できる範囲において記入してください。前回調査時以降の不具合"]
[null,"　　等を把握していない場合は、第四面を省略することができます。"]
[null,"　②　「不具合等を把握した年月」欄は、当該不具合等を把握した年月を記入してください。"]
[null,"　③　「不具合等の概要」欄は、当該不具合等の概要を記入してください。"]
[null,"　④　「考えられる原因」欄は、当該不具合等が生じた原因として考えられるものを記入してください。"]
[null,"　⑤　「改善（予定）年月」欄は、既に改善を実施している場合には実施年月を、改善を行う予定がある"]
[null,"　　場合には改善予定年月を記入し、改善を行う予定がない場合には「－」マークを記入してください。"]
[null,"　⑥　「改善措置の概要等」欄は、既に改善を実施している場合又は改善を行う予定がある場合に、具体"]
[null,"　　的措置の概要を記入してください。改善を行う予定がない場合には、その理由を記入してください。"]
[]
[null,"　　"]

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[]
[]
[]
[null,"第三十六号の三様式（第五条、第六条の三、第十一条の三関係）（Ａ４）"]
[]
[null,"定期調査報告概要書"]
[]
[]
[null,"（第一面）"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,"調査等の概要"]
[]
[]
[]
[]
[]
[]
[]
[null,"【1．所有者】"]
[null,null,null,"【イ．氏名のフリガナ】"]
[null,null,null,"【ロ．氏名】"]
[null,null,null,"【ハ．郵便番号】"]
[null,null,null,"【ニ．住所】"]
[]
[]
[]
[]
[]
[]
[null,"【2．管理者】"]
[null,null,null,"【イ．氏名のフリガナ】"]
[null,null,null,"【ロ．氏名】"]
[null,null,null,"【ハ．郵便番号】"]
[null,null,null,"【ニ．住所】"]
[]
[]
[]
[]
[]
[]
[null,"【3．調査者】"]
[null,null,"（代表となる調査者）"]
[null,null,null,"【イ．資格】"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,"）建築士",null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,"）登録",null,null,null,"第",null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"特定建築物調査員",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"第",null,null,null,null,null,null,"号"]
[null,null,null,"【ロ．氏名のフリガナ】"]
[null,null,null,"【ハ．氏名】 "]
[null,null,null,"【ニ．勤務先】"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,"）建築士事務所",null,null,null,null,null,null,"（",null,null,null,null,null,null,"）知事登録",null,null,null,null,null,"第",null,null,null,null,null,null,"号"]
[null,null,null,"【ホ．郵便番号】"]
[null,null,null,"【へ．所在地】"]
[null,null,null,"【ト．電話番号】"]
[null,null,"（その他の調査者）"]
[null,null,null,"【イ．資格】"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,"）建築士",null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,"）登録",null,null,null,"第",null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"特定建築物調査員",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"第",null,null,null,null,null,null,"号"]
[null,null,null,"【ロ．氏名のフリガナ】"]
[null,null,null,"【ハ．氏名】 "]
[null,null,null,"【ニ．勤務先】"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,"）建築士事務所",null,null,null,null,null,null,"（",null,null,null,null,null,null,"）知事登録",null,null,null,null,null,"第",null,null,null,null,null,null,"号"]
[null,null,null,"【ホ．郵便番号】"]
[null,null,null,"【へ．所在地】"]
[null,null,null,"【ト．電話番号】"]
[]
[]
[]
[]
[]
[null,"【4．報告対象建築物】"]
[null,null,null,"【イ．所在地】"]
[null,null,null,"【ロ．名称のフリガナ】"]
[null,null,null,"【ハ．名称】"]
[null,null,null,"【ニ．用途】"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"【5．調査による指摘の概要】"]
[null,null,null,"【イ．指摘の内容】",null,null,null,null,null,null,null,null,null,null,null,"要是正の指摘あり",null,null,null,null,null,null,null,"(",null,"既存不適格）",null,null,null,null,null,null,null,null,"指摘なし"]
[null,null,null,"【ロ．指摘の概要】"]
[]
[]
[]
[]
[null,null,null,"【ハ．改善予定の有無】",null,null,null,null,null,null,null,null,null,null,null,"有（",null,null,null,null,null,"年",null,null,"月に改善予定）",null,null,null,null,null,null,null,null,null,"無"]
[null,null,null,"【ニ．その他特記事項】"]
[]
[]
[]
[null,"【6．調査及び検査の状況】"]
[null,null,null,"【イ．今回の調査】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日実施"]
[null,null,null,"【ロ．前回の調査】",null,null,null,null,null,null,null,null,null,null,null,"実施（",null,null,null,null,null,null,"年",null,null,"月",null,null,"日報告）",null,null,null,null,null,"未実施"]
[null,null,null,"【ハ．建築設備の検査】",null,null,null,null,null,null,null,null,null,null,null,"実施（",null,null,null,null,null,null,"年",null,null,"月",null,null,"日報告）",null,null,null,null,null,"未実施"]
[null,null,null,"【ニ．昇降機等の検査】",null,null,null,null,null,null,null,null,null,null,null,"実施（",null,null,null,null,null,null,"年",null,null,"月",null,null,"日報告）",null,null,null,null,null,"未実施"]
[null,null,null,"【ホ．防火設備の検査】",null,null,null,null,null,null,null,null,null,null,null,"実施（",null,null,null,null,null,null,"年",null,null,"月",null,null,"日報告）",null,null,null,null,null,"未実施"]
[]
[]
[null,"【7．建築物等に係る不具合等の状況】"]
[null,null,null,"【イ．不具合等】",null,null,null,null,null,null,null,null,null,null,null,"有",null,null,"無"]
[null,null,null,"【ロ．不具合等の記録】",null,null,null,null,null,null,null,null,null,null,null,"有",null,null,"無"]
[null,null,null,"【ハ．不具合等の概要】"]
[null,null,null,"【ニ．改善の状況】",null,null,null,null,null,null,null,null,null,null,null,"実施済",null,null,null,null,"改善予定（",null,null,null,null,null,null,null,null,"年",null,null,"月に改善予定）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"予定なし",null,null,null,null,null,null,"（理由：",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"（第一面　別紙）"]
[]
[null,"5.調査による指摘の概要"]
[]
[]
[null,null,"2-1.調査の状況",null,null,null,null,null,null,"ｲ．指摘の内容",null,null,null,null,null,null,null,null,null,null,null,"要是正の指摘あり",null,null,null,null,null,null,"（",null,"既存不適格）"]
[null,null,"(敷地及び地盤)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"指摘なし"]
[null,null,"ﾛ．指摘の概要"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"3.調査者"]
[]
[]
[null,null,"（その他の調査者2）"]
[null,null,null,"【イ．資格】"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,"）建築士",null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,"）登録",null,null,null,"第",null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"特定建築物調査員",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"第",null,null,null,null,null,null,"号"]
[null,null,null,"【ロ．氏名のフリガナ】"]
[null,null,null,"【ハ．氏名】 "]
[null,null,null,"【ニ．勤務先】"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,"）建築士事務所",null,null,null,null,null,null,"（",null,null,null,null,null,null,"）知事登録",null,null,null,null,null,"第",null,null,null,null,null,null,"号"]
[null,null,null,"【ホ．郵便番号】"]
[null,null,null,"【へ．所在地】"]
[null,null,null,"【ト．電話番号】"]
[]
[]
[]
[null,"7.建築物等に係る不具合等の状況"]
[]
[]
[null,null,"ﾊ．不具合等の概要"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"（第二面）"]
[null,"建築物及びその敷地に関する事項"]
[]
[]
[null,"【1．敷地の位置】"]
[null,null,null,"【イ．防火地域】",null,null,null,null,null,null,null,null,null,null,null,"防火地域",null,null,null,null,null,null,"準防火地域"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"その他（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）",null,null,null,"指定なし"]
[null,null,null,"【ロ．用途地域】"]
[]
[]
[]
[]
[]
[null,"【2．建築物及びその敷地の概要】"]
[null,null,null,"【イ．構造】",null,null,null,null,null,null,null,null,null,null,null,"鉄筋コンクリート造",null,null,null,null,null,null,null,null,null,null,null,"鉄骨鉄筋コンクリート造"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"鉄骨造",null,null,null,null,null,null,null,null,null,null,null,"その他（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[null,null,null,"【ロ．階数】",null,null,null,null,null,null,null,null,null,null,null,"地上",null,null,null,null,"階",null,null,"地下",null,null,null,null,"階"]
[null,null,null,"【ハ．敷地面積】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"㎡"]
[null,null,null,"【ニ．建築面積】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"㎡"]
[null,null,null,"【ホ．延べ面積】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"㎡"]
[]
[]
[]
[]
[]
[null,"【3．階別用途別床面積】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,"用途",null,null,null,"）",null,"（",null,"床面積",null,null,null,"）"]
[null,null,null,"【イ．階別用途別】",null,null,null,null,null,null,null,null,null,"（",null,null,null,"階）",null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,"階）",null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,"階）",null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,"階）",null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,"階）",null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,"【ロ．用途別】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,"）",null,"（",null,null,null,null,"㎡","）"]
[null," （その他の検査者２）"]
[null,null,"【イ．資格】",null,null,null,null,null,null,"（",null,null," ）建築士",null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,null,")登録第",null,null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,"建築設備検査員",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"第",null,null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,"登録建築設備検査資格者講習を修了した者",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"第",null,null,null,null,null,null,null,"号"]
[null,null,"【ロ．氏名のフリガナ】"]
[null,null,"【ハ．氏名】"]
[null,null,"【ニ．勤務先】"]
[null,null,null,null,null,null,null,null,null,"（",null,null," ）建築士事務所",null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,null,")知事登録第",null,null,null,null,null,null,null,"号"]
[null,null,"【ホ．郵便番号】"]
[null,null,"【ヘ．所在地】"]
[null,null,"【ト．電話番号】"]
[]
[]
[]
[]
[]
[null,"【4．性能検証法等の適用】",null,null,null,null,null,null,null,null,null,null,null,null,null,"耐火性能検証法",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"防火区画検証法"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"区画避難安全検証法（",null,null,null,null,null,null,null,null,null,null,null,null,"階）",null,null,null,"階避難安全検証法（",null,null,null,null,null,null,null,null,null,null,null,"階）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"全館避難安全検証法"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"その他（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[]
[]
[]
[]
[null,"【5．増築、改築、用途変更等の経過】"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日",null,null,"概要（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日",null,null,"概要（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日",null,null,"概要（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日",null,null,"概要（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"【6．関連図書の整備状況】"]
[null,null,null,"【イ．確認に要した図書】",null,null,null,null,null,null,null,null,null,null,null,null,"有（",null,null,"各階平面図あり）",null,null,null,null,null,null,null,null,"無"]
[null,null,null,"【ロ．確認済証】",null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,"無"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"交付番号",null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日","第",null,null,null,null,null,null,null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"  交付者",null,null,null,null,null,"建築主事",null,null,null,null,null,"指定確認検査機関（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[null,null,null,"【ハ．完了検査に要した図書】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,"無"]
[null,null,null,"【ニ．検査済証】",null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,"無"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"交付番号",null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日","第",null,null,null,null,null,null,null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　交付者",null,null,null,null,null,"建築主事",null,null,null,null,null,"指定確認検査機関（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[null,null,null,"【ホ．維持保全に関する準則又は計画】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,"無"]
[null,null,null,"【ヘ．前回の調査に関する書類の写し】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,"無",null,null,"対象外"]
[null," （その他の検査者２）"]
[null,null,"【イ．資格】",null,null,null,null,null,null,"（",null,null," ）建築士",null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,null,")登録第",null,null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,"建築設備検査員",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"第",null,null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,"登録建築設備検査資格者講習を修了した者",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"第",null,null,null,null,null,null,null,"号"]
[null,null,"【ロ．氏名のフリガナ】"]
[null,null,"【ハ．氏名】"]
[null,null,"【ニ．勤務先】"]
[null,null,null,null,null,null,null,null,null,"（",null,null," ）建築士事務所",null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,null,")知事登録第",null,null,null,null,null,null,null,"号"]
[null,null,"【ホ．郵便番号】"]
[null,null,"【ヘ．所在地】"]
[null,null,"【ト．電話番号】"]
[]
[]
[]
[null,"【7．備考】"]
[]
[]
[]
[]
[]
[]
[]
[null,"（注意）"]
[null,"　この様式には、第三十六号の二様式に記入した内容と同一の内容を記入してください。なお、第一面"]
[null,"の５欄の「ロ」及び「ニ」は同様式第三面の２欄から４欄において指摘があつた項目について、第一面"]
[null,"の７欄の「ハ」は同様式第四面に記入されたものについて、すべて記入してください。"]
[]
[]
[null,"（第二面　別紙）"]
[null,"3．階別用途別床面積"]

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["別記第一号（A４)　"]
["調査結果表"]
[]
["当該調査に関与した調査者",null,null,"　　氏　名",null,null,null,null,"調査者番号"]
[null,null,"代表となる調査者"]
[null,null,"その他の調査者"]
[]
[]
["番号","調　査　項　目",null,null,null,null,"調査結果",null,null,"担当\n調査者\n番号"]
[null,null,null,null,null,null,"指摘\nなし","要是正"]
[null,null,null,null,null,null,null,null,"既　存\n不適格"]
[1,"敷地及び地盤"]
["(1)","地盤",null,null,"地盤沈下等による不陸、傾斜等の状況"]
["(2)","敷地",null,null,"敷地内の排水の状況"]
["(3)","敷地内の通路",null,null,"敷地内の通路の確保の状況"]
["(4)",null,null,null,"有効幅員の確保の状況"]
["(5)",null,null,null,"敷地内の通路の支障物の状況"]
["(6)","塀",null,null,"組積造の塀又は補強コンクリートブロック造の塀等の耐震対策の状況"]
["(7)",null,null,null,"組積造の塀又は補強コンクリートブロック造の塀等の劣化及び損傷の状況"]
["(8)","擁壁",null,null,"擁壁の劣化及び損傷の状況"]
["(9)",null,null,null,"擁壁の水抜きパイプの維持保全の状況"]
[2,"建築物の外部"]
["(1)","基礎",null,null,"基礎の沈下等の状況"]
["(2)",null,null,null,"基礎の劣化及び損傷の状況"]
["(3)","土台（木造に限る。）",null,null,"土台の沈下等の状況"]
["(4)",null,null,null,"土台の劣化及び損傷の状況"]
["(5)","外壁","躯体等",null,"外壁、軒裏及び外壁の開口部で延焼のおそれのある部分の防火対策の状況"]
["(6)",null,null,null,"木造の外壁躯体の劣化及び損傷の状況"]
["(7)",null,null,null,"組積造の外壁躯体の劣化及び損傷の状況"]
["(8)",null,null,null,"補強コンクリートブロック造の外壁躯体の劣化及び損傷の状況"]
["(9)",null,null,null,"鉄骨造の外壁躯体の劣化及び損傷の状況"]
["(10)",null,null,null,"鉄筋コンクリート造及び鉄骨鉄筋コンクリート造の外壁躯体の劣化及び損傷の状況"]
["(11)",null,"外装仕上げ材等",null,"タイル、石貼り等（乾式工法によるものを除く。）、モルタル等の劣化及び損傷の状況"]
["(12)",null,null,null,"乾式工法によるタイル、石貼り等の劣化及び損傷の状況"]
["(13)",null,null,null,"金属系パネル（帳壁を含む。）の劣化及び損傷の状況"]
["(14)",null,null,null,"コンクリート系パネル（帳壁を含む。）の劣化及び損傷の状況"]
["(15)",null,"窓サッシ等",null,"サッシ等の劣化及び損傷の状況"]
["(16)",null,null,null,"はめ殺し窓のガラスの固定の状況"]
["(17)",null,"外壁に緊結された広告板、空調室外機等",null,"機器本体の劣化及び損傷の状況"]
["(18)",null,null,null,"支持部分等の劣化及び損傷の状況"]
[3,"屋上及び屋根"]
["(1)","屋上面",null,null,"屋上面の劣化及び損傷の状況"]
["(2)","屋上周り（屋上面を除く。）",null,null,"パラペットの立ち上り面の劣化及び損傷の状況"]
["(3)",null,null,null,"笠木モルタル等の劣化及び損傷の状況"]
["(4)",null,null,null,"金属笠木の劣化及び損傷の状況"]
["(5)",null,null,null,"排水溝（ドレーンを含む。）の劣化及び損傷の状況"]
["(6)","屋根",null,null,"屋根の防火対策の状況"]
["(7)",null,null,null,"屋根の劣化及び損傷の状況"]
["(8)","機器及び工作物（冷却塔設備、広告塔等）",null,null,"機器、工作物本体及び接合部の劣化及び損傷の状況"]
["(9)",null,null,null,"支持部分等の劣化及び損傷の状況"]
[4,"建築物の内部"]
["(1)","防火区画","令第112条第11項から第13項までに規定する区画の状況"]
["(2)",null,"令第112条第1項、第4項、第5項又は第7項から第10項までの各項に規定する区画の状況"]
["(3)",null,"令第112条第18項に規定する区画の状況"]
["(4)",null,"防火区画の外周部",null,"令第112条第16項に規定する外壁等及び同条第17項に規定する防火設備の処置の状況"]
["(5)",null,null,null,"令第112条第16項に規定する外壁等及び同条第17項に規定する防火設備の劣化及び損傷の状況"]
["(6)","壁の室内に面する部分","躯体等",null,"木造の壁の室内に面する部分の躯体の劣化及び損傷の状況"]
["(7)",null,null,null,"組積造の壁の室内に面する部分の躯体の劣化及び損傷の状況"]
["(8)",null,null,null,"補強コンクリートブロック造の壁の室内に面する部分の躯体の劣化及び損傷の状況"]
["(9)",null,null,null,"鉄骨造の壁の室内に面する部分の躯体の劣化及び損傷の状況"]
["(10)",null,null,null,"鉄筋コンクリート造及び鉄骨鉄筋コンクリート造の壁の室内に面する部分の躯体の劣化及び損傷の状況"]
["(11)",null,"耐火構造の壁又は準耐火構造の壁（防火区画を構成する壁に限る。）",null,"準耐火性能等の確保の状況"]
["(12)",null,null,null,"部材の劣化及び損傷の状況"]
["(13)",null,null,null,"鉄骨の耐火被覆の劣化及び損傷の状況"]
["(14)",null,null,null,"給水管、配電管その他の管又は風道の区画貫通部の充填等の処理の状況"]
["(15)",null,"令第114条に規定する界壁、間仕切壁及び隔壁",null,"令第114条に規定する界壁、間仕切壁及び隔壁の状況"]
["(16)",null,"令第128条の5各項に規定する建築物の壁の室内に面する部分",null,"室内に面する部分の仕上げの維持保全の状況"]
["(17)","床","躯体等",null,"木造の床躯体の劣化及び損傷の状況"]
["(18)",null,null,null,"鉄骨造の床躯体の劣化及び損傷の状況"]
["(19)",null,null,null,"鉄筋コンクリート造及び鉄骨鉄筋コンクリート造の床躯体の劣化及び損傷の状況"]
["(20)",null,"耐火構造の床又は準耐火構造の床（防火区画を構成する床に限る。）",null,"準耐火性能等の確保の状況"]
["(21)",null,null,null,"部材の劣化及び損傷の状況"]
["(22)",null,null,null,"給水管、配電管その他の管又は風道の区画貫通部の充填等の処理の状況"]
["(23)","天井","令第128条の5各項に規定する建築物の天井の室内に面する部分",null,"室内に面する部分の仕上げの維持保全の状況"]
["(24)",null,null,null,"室内に面する部分の仕上げの劣化及び損傷の状況"]
["(25)",null,"特定天井",null,"特定天井の天井材の劣化及び損傷の状況"]
["(26)","防火設備（防火扉、防火シャッターその他これらに類するものに限る。以下この表において同じ。）又は戸（令第112条第19項第2号に掲げる戸に限る。以下この表において同じ。）",null,null,"区画に対応した防火設備又は戸の設置の状況"]
["(27)",null,null,null,"居室から地上へ通じる主たる廊下、階段その他の通路に設置された防火設備又は戸におけるくぐり戸の設置の状況"]
["(28)",null,null,null,"防火扉又は戸の開放方向"]
["(29)",null,null,null,"常時閉鎖又は作動した状態にある防火設備（防火扉を除く。）又は戸（以下この表において「常閉防火設備等」という。）の本体及び枠の劣化及び損傷の状況"]
["(30)",null,null,null,"各階の主要な常閉防火設備等の閉鎖又は作動の状況"]
["(31)",null,null,null,"常閉防火設備等の閉鎖又は作動の障害となる物品の放置並びに照明器具及び懸垂物等の状況"]
["(32)",null,null,null,"常時閉鎖した状態にある戸の固定の状況"]
["(33)","照明器具、懸垂物等",null,null,"照明器具、懸垂物等の落下防止対策の状況　"]
["(34)","警報設備",null,null,"警報設備の設置の状況"]
["(35)",null,null,null,"警報設備の劣化及び損傷の状況"]
["(36)","スプリンクラー設備",null,"令和6年国土交通省告示第284号第1第1号又は第2号ニに規定するスプリンクラー設備","スプリンクラー設備の設置の状況"]
["(37)",null,null,null,"スプリンクラー設備の劣化及び損傷の状況"]
["(38)","居室の採光及び換気",null,null,"採光のための開口部の面積の確保の状況"]
["(39)",null,null,null,"採光の妨げとなる物品の放置の状況"]
["(40)",null,null,null,"換気のための開口部の面積の確保の状況"]
["(41)",null,null,null,"換気設備の設置の状況"]
["(42)","石綿等を添加した建築材料　",null,null,"吹付け石綿及び吹付けロックウールでその含有する石綿の重量が当該建築材料の重量の0.1パーセントを超えるもの（以下「吹付け石綿等」という。）の使用の状況"]
["(43)",null,null,null,"吹付け石綿等の劣化の状況　",null,null,null,null,null,null,"　"]
["(44)",null,null,null,"除去又は囲い込み若しくは封じ込めによる飛散防止措置の実施の状況　"]
["(45)",null,null,null,"囲い込み又は封じ込めによる飛散防止措置の劣化及び損傷の状況　",null,null,null,null,null,null,"　"]
[5,"避難施設等"]
["(1)","令第120条第２項に規定する通路",null,null,"令第120条第２項に規定する通路の確保の状況"]
["(2)","廊下",null,null,"幅の確保の状況\n"]
["(3)",null,null,null,"物品の放置の状況"]
["(4)","出入口",null,null,"出入口の確保の状況"]
["(5)",null,null,null,"物品の放置の状況"]
["(6)","屋上広場",null,null,"屋上広場の確保の状況"]
["(7)","避難上有効なバルコニー",null,null,"避難上有効なバルコニーの確保の状況"]
["(8)",null,null,null,"手すり等の劣化及び損傷の状況"]
["(9)",null,null,null,"物品の放置の状況"]
["(10)",null,null,null,"避難器具の操作性の確保の状況"]
["(11)","階段","階段",null,"直通階段の設置の状況"]
["(12)",null,null,null,"幅の確保の状況"]
["(13)",null,null,null,"手すりの設置の状況"]
["(14)",null,null,null,"物品の放置の状況"]
["(15)",null,null,null,"階段各部の劣化及び損傷の状況"]
["(16)",null,"屋内に設けられた避難階段",null,"階段室の構造の状況"]
["(17)",null,"屋外に設けられた避難階段",null,"屋内と階段との間の防火区画の確保の状況"]
["(18)",null,null,null,"開放性の確保の状況"]
["(19)",null,"特別避難階段",null,"令第123条第3項第1号に規定するバルコニー（以下単に「バルコニー」という。）又は付室（以下単に「付室」という。）の構造及び面積の確保の状況"]
["(20)",null,null,null,"階段室又は付室（以下「付室等」という。）の排煙設備の設置の状況"]
["(21)",null,null,null,"付室等の外気に向かって開くことができる窓の状況"]
["(22)",null,null,null,"物品の放置の状況"]
["(23)","排煙設備等","防煙壁",null,"防煙区画の設置の状況"]
["(24)",null,null,null,"防煙壁の劣化及び損傷の状況"]
["(25)",null,"排煙設備",null,"排煙設備の設置の状況"]
["(26)",null,null,null,"自然排煙口の維持保全の状況"]
["(27)","その他の設備等","非常用の進入口等",null,"非常用の進入口等の設置の状況"]
["(28)",null,null,null,"非常用の進入口等の維持保全の状況"]
["(29)",null,"非常用エレベーター",null,"令第129条の13の3第3項に規定する乗降ロビー（以下「乗降ロビー」という。）の構造及び面積の確保の状況"]
["(30)",null,null,null,"昇降路又は乗降ロビー（以下「乗降ロビー等」という。）の排煙設備の設置の状況"]
["(31)",null,null,null,"乗降ロビー等の外気に向かって開くことができる窓の状況"]
["(32)",null,null,null,"物品の放置の状況"]
["(33)",null,"非常用の照明装置",null,"非常用の照明装置の設置の状況"]
[6,"その他"]
["(1)","特殊な構造等","膜構造建築物の膜体、取付部材等",null,"膜体及び取付部材の劣化及び損傷の状況"]
["(2)",null,null,null,"膜張力及びケーブル張力の状況"]
["(3)",null,"免震構造建築物の免震層及び免震装置",null,"免震装置の劣化及び損傷の状況（免震装置が可視状態にある場合に限る。）"]
["(4)",null,null,null,"上部構造の可動の状況"]
["(5)","避雷設備",null,null,"避雷針、避雷導線等の劣化及び損傷の状況"]
["(6)","煙突","建築物に設ける煙突",null,"煙突本体及び建築物との接合部の劣化及び損傷の状況"]
["(7)",null,null,null,"付帯金物の劣化及び損傷の状況"]
["(8)",null,"令第138条第１項第１号に掲げる煙突",null,"煙突本体の劣化及び損傷の状況"]
["(9)",null,null,null,"付帯金物の劣化及び損傷の状況"]
[7,"上記以外の調査項目"]
[]
[]
[]
["その他確認事項"]
["法第12条第3項の規定による検査を要する防火設備の有無"]
["□有（　　階）　□無"]
["特記事項"]
["番号","調査項目",null,"指摘の具体的内容等",null,"改善策の具体的内容等",null,null,null,"改善（予定）年月"]
[]
[]
[]
[]
[]
[]
["（注意）"]
["①","　この書類は、建築物ごとに作成してください。"]
["②","　記入欄が不足する場合は、枠を拡大、行を追加して記入するか、別紙に必要な事項を記入して添えてください。"]
["③","　「当該調査に関与した調査者」欄は、建築基準法施行規則別記第36の２様式第一面３欄に記入した調査者について記入し、「調査者番号」欄に調査者を特定できる番号、記号等を記入してください。当該建築物の調査を行った調査者が１人の場合は、その他の調査者欄は記入不要です。"]
["④","　該当しない調査項目がある場合は、その「調査結果」欄及び「担当検査者番号」欄に「－」を記入してください。"]
["⑤","　「調査結果」欄は、別表第１（い）欄に掲げる各調査項目ごとに記入してください。"]
["⑥","　「調査結果」欄のうち「要是正」欄は、別表第１（い）欄に掲げる調査項目について（は）欄に掲げる判定基準に該当する場合に○印を記入してください。"]
["⑦","　「検査結果」欄のうち「指摘なし」欄は、⑥に該当しない場合に○印を記入してください。"]
["⑧","　「既存不適格」欄は、「要是正」欄に○印を記入した場合で、建築基準法第３条第２項の規定の適用を受けているものであることが確認されたときは、○印を記入してください。"]
["⑨","　「担当調査者番号」欄は、「調査に関与した調査者」欄で記入した番号、記号等を記入してください。ただし、当該建築物の調査を行った調査者が１人の場合は、記入不要です。"]
["⑩","　７「上記以外の調査項目」欄は、第２の規定により特定行政庁が調査項目等を付加している場合に、当該調査項目等を追加し、⑤から⑨までに準じて調査結果等を記入してください。"]
["⑪","「その他確認事項」は、法第12条第３項の規定による検査を要する常時閉鎖した状態にある防火扉（各階の主要なものに限る。）及び随時閉鎖又は作動できる防火設備（防火ダンパーを除く。）の設置の有無を確認し、該当するチェックボックスに「レ」マークを入れてください。「有」の場合は、当該防火設備が設置されている階を記入してください。"]
["⑫","　「特記事項」は、調査の結果、要是正の指摘があった場合のほか、指摘がない場合にあっても特記すべき事項がある場合に、該当する調査項目の番号、調査項目を記入し、「指摘の具体的内容等」欄に指摘又は特記すべき事項の具体的内容を記入するとともに、改善済みの場合及び改善策が明らかになっている場合は「改善策の具体的内容等」欄にその内容を記入し、改善した場合は「改善（予定）年月」欄に当該年月を記入し、改善予定年月が明らかになっている場合は「改善（予定）年月」欄に当該年月を（　）書きで記入してください。"]
["⑬","　配置図及び各階平面図を別添１の様式に従い添付し、指摘(特記すべき事項を含む）のあった箇所や撮影した写真の位置等を明記してください。"]
["⑭","　要是正とされた調査項目（既存不適格の場合を除く。）については、要是正とされた部分を撮影した写真を別添２の様式に従い添付してください。"]

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3","9建物及びその敷地の概要-構造-その他","9建物及びその敷地の概要-階数-地上-階","9建物及びその敷地の概要-階数-地下-階","9建物及びその敷地の概要-敷地面積-㎡","9建物及びその敷地の概要-建築面積-㎡","10性能検証法等の適用-耐火性能検証法","10性能検証法等の適用-防火区画検証法","10性能検証法等の適用-区画避難安全検証法","10性能検証法等の適用-区画避難安全検証法-階","10性能検証法等の適用-階避難安全検証法","10性能検証法等の適用-階避難安全検証法-階","10性能検証法等の適用-全館避難安全検証法","10性能検証法等の適用-その他","10性能検証法等の適用-その他-詳細","11増築、改築、用途変更等の経過-年月日-元号_1","11増築、改築、用途変更等の経過-年月日-年1","11増築、改築、用途変更等の経過-年月日-月1","11増築、改築、用途変更等の経過-年月日-日1","11増築、改築、用途変更等の経過-工事種別1","11増築、改築、用途変更等の経過-概要1","11増築、改築、用途変更等の経過-年月日-元号_2","11増築、改築、用途変更等の経過-年月日-年2","11増築、改築、用途変更等の経過-年月日-月2","11増築、改築、用途変更等の経過-年月日-日2","11増築、改築、用途変更等の経過-工事種別2","11増築、改築、用途変更等の経過-概要2","11増築、改築、用途変更等の経過-年月日-元号_3","11増築、改築、用途変更等の経過-年月日-年3","11増築、改築、用途変更等の経過-年月日-月3","11増築、改築、用途変更等の経過-年月日-日3","11増築、改築、用途変更等の経過-工事種別3","11増築、改築、用途変更等の経過-概要3","11増築、改築、用途変更等の経過-年月日-元号_4","11増築、改築、用途変更等の経過-年月日-年4","11増築、改築、用途変更等の経過-年月日-月4","11増築、改築、用途変更等の経過-年月日-日4","11増築、改築、用途変更等の経過-工事種別4","11増築、改築、用途変更等の経過-概要4","12関連図書の整備-直近の確認申請-確認に要した図書","12関連図書の整備-直近の確認申請-確認-確認済証の有無","12関連図書の整備-直近の確認申請-確認-工事種別","12関連図書の整備-直近の確認申請-確認-交付年月日-元号","12関連図書の整備-直近の確認申請-確認-交付年月日-年","12関連図書の整備-直近の確認申請-確認-交付年月日-月","12関連図書の整備-直近の確認申請-確認-交付年月日-日","12関連図書の整備-直近の確認申請-確認-交付番号-号","12関連図書の整備-直近の確認申請-確認-交付者","12関連図書の整備-直近の確認申請-確認-検査機関","12関連図書の整備-直近の確認申請-完了検査に要した図書","12関連図書の整備-直近の確認申請-完了-検査済証の有無","12関連図書の整備-直近の確認申請-完了-交付年月日-元号","12関連図書の整備-直近の確認申請-完了-交付年月日-年","12関連図書の整備-直近の確認申請-完了-交付年月日-月","12関連図書の整備-直近の確認申請-完了-交付年月日-日","12関連図書の整備-直近の確認申請-完了-交付番号-号","12関連図書の整備-直近の確認申請-完了-交付者","12関連図書の整備-直近の確認申請-完了-検査機関","12関連図書の整備-新築時の確認申請-直近と記載の確認と同一-","12関連図書の整備-新築時の確認申請-確認に要した図書-","12関連図書の整備-新築時の確認申請-確認-確認済証の有無","12関連図書の整備-新築時の確認申請-確認-工事種別","12関連図書の整備-新築時の確認申請-確認-交付年月日-元号","12関連図書の整備-新築時の確認申請-確認-交付年月日-年","12関連図書の整備-新築時の確認申請-確認-交付年月日-月","12関連図書の整備-新築時の確認申請-確認-交付年月日-日","12関連図書の整備-新築時の確認申請-確認-交付番号-号","12関連図書の整備-新築時の確認申請-確認-交付者","12関連図書の整備-新築時の確認申請-確認-検査機関","12関連図書の整備-新築時の確認申請-完了検査に要した図書-","12関連図書の整備-新築時の確認申請-完了-検査済証の有無","12関連図書の整備-新築時の確認申請-完了-交付年月日-元号","12関連図書の整備-新築時の確認申請-完了-交付年月日-年","12関連図書の整備-新築時の確認申請-完了-交付年月日-月","12関連図書の整備-新築時の確認申請-完了-交付年月日-日","12関連図書の整備-新築時の確認申請-完了-交付番号-号","12関連図書の整備-新築時の確認申請-完了-交付者","12関連図書の整備-新築時の確認申請-完了-検査機関","12関連図書の整備-維持管理保全に関する準則又は計画","12関連図書の整備-前回の調査に関する書類の写し","13備考-備考（第二面）","14調査及び検査の状況-今回の調査　実施日-令和","14調査及び検査の状況-今回の調査　実施日-年","14調査及び検査の状況-今回の調査　実施日-月","14調査及び検査の状況-今回の調査　実施日-日","14調査及び検査の状況-前回の調査-有無","14調査及び検査の状況-前回の調査-実施日-元号","14調査及び検査の状況-前回の調査-実施日-年","14調査及び検査の状況-前回の調査-実施日-月","14調査及び検査の状況-前回の調査-実施日-日","14調査及び検査の状況-建築設備の検査-有無","14調査及び検査の状況-建築設備の検査-実施日-元号","14調査及び検査の状況-建築設備の検査-実施日-年","14調査及び検査の状況-建築設備の検査-実施日-月","14調査及び検査の状況-建築設備の検査-実施日-日","14調査及び検査の状況-昇降機等の検査-有無","14調査及び検査の状況-昇降機等の検査-実施日-元号","14調査及び検査の状況-昇降機等の検査-実施日-年","14調査及び検査の状況-昇降機等の検査-実施日-月","14調査及び検査の状況-昇降機等の検査-実施日-日","14調査及び検査の状況-防火設備の検査-有無","14調査及び検査の状況-防火設備の検査-実施日-元号","14調査及び検査の状況-防火設備の検査-実施日-年","14調査及び検査の状況-防火設備の検査-実施日-月","14調査及び検査の状況-防火設備の検査-実施日-日","15石綿を添加した建築材料の調査状況-該当建築材料-有無","15石綿を添加した建築材料の調査状況-該当建築材料-該当する室","15石綿を添加した建築材料の調査状況-措置予定-有無","15石綿を添加した建築材料の調査状況-措置予定-改善予定年月-令和","15石綿を添加した建築材料の調査状況-措置予定-改善予定年月-年","15石綿を添加した建築材料の調査状況-措置予定-改善予定年月-月実施予定","16耐震診断及び耐震改修の調査状況-耐震診断-有無","16耐震診断及び耐震改修の調査状況-耐震診断-実施予定年月-令和","16耐震診断及び耐震改修の調査状況-耐震診断-実施予定年月-年","16耐震診断及び耐震改修の調査状況-耐震診断-実施予定年月-月実施予定","16耐震診断及び耐震改修の調査状況-耐震改修-有無","16耐震診断及び耐震改修の調査状況-耐震改修-実施予定年月-令和","16耐震診断及び耐震改修の調査状況-耐震改修-実施予定年月-年","16耐震診断及び耐震改修の調査状況-耐震改修-実施予定年月-月実施予定","17建築物等に係る不具合等の状況-不具合等","17建築物等に係る不具合等の状況-不具合等の記録","17建築物等に係る不具合等の状況-不具合等を把握した年月-元号_1","17建築物等に係る不具合等の状況-不具合等を把握した年月-年_1","17建築物等に係る不具合等の状況-不具合等を把握した年月-月_1","17建築物等に係る不具合等の状況-不具合等の概要_1","17建築物等に係る不具合等の状況-考えられる要因_1","17建築物等に係る不具合等の状況-改善の状況_1","17建築物等に係る不具合等の状況-改善（予定）年月-年（令和）_1","17建築物等に係る不具合等の状況-改善（予定）年月-月_1","17建築物等に係る不具合等の状況-改善措置の概要等又は改善の予定がない場合は理由_1","17建築物等に係る不具合等の状況-不具合等を把握した年月-元号_2","17建築物等に係る不具合等の状況-不具合等を把握した年月-年_2","17建築物等に係る不具合等の状況-不具合等を把握した年月-月_2","17建築物等に係る不具合等の状況-不具合等の概要_2","17建築物等に係る不具合等の状況-考えられる要因_2","17建築物等に係る不具合等の状況-改善の状況_2","17建築物等に係る不具合等の状況-改善（予定）年月-年（令和）_2","17建築物等に係る不具合等の状況-改善（予定）年月-月_2","17建築物等に係る不具合等の状況-改善措置の概要等又は改善の予定がない場合は理由_2","17建築物等に係る不具合等の状況-不具合等を把握した年月-元号_3","17建築物等に係る不具合等の状況-不具合等を把握した年月-年_3","17建築物等に係る不具合等の状況-不具合等を把握した年月-月_3","17建築物等に係る不具合等の状況-不具合等の概要_3","17建築物等に係る不具合等の状況-考えられる要因_3","17建築物等に係る不具合等の状況-改善の状況_3","17建築物等に係る不具合等の状況-改善（予定）年月-年（令和）_3","17建築物等に係る不具合等の状況-改善（予定）年月-月_3","17建築物等に係る不具合等の状況-改善措置の概要等又は改善の予定がない場合は理由_3","17建築物等に係る不具合等の状況-不具合等を把握した年月-元号_4","17建築物等に係る不具合等の状況-不具合等を把握した年月-年_4","17建築物等に係る不具合等の状況-不具合等を把握した年月-月_4","17建築物等に係る不具合等の状況-不具合等の概要_4","17建築物等に係る不具合等の状況-考えられる要因_4","17建築物等に係る不具合等の状況-改善の状況_4","17建築物等に係る不具合等の状況-改善（予定）年月-年（令和）_4","17建築物等に係る不具合等の状況-改善（予定）年月-月_4","17建築物等に係る不具合等の状況-改善措置の概要等又は改善の予定がない場合は理由_4","17建築物等に係る不具合等の状況-不具合等を把握した年月-元号_5","17建築物等に係る不具合等の状況-不具合等を把握した年月-年_5","17建築物等に係る不具合等の状況-不具合等を把握した年月-月_5","17建築物等に係る不具合等の状況-不具合等の概要_5","17建築物等に係る不具合等の状況-考えられる要因_5","17建築物等に係る不具合等の状況-改善の状況_5","17建築物等に係る不具合等の状況-改善（予定）年月-年（令和）_5","17建築物等に係る不具合等の状況-改善（予定）年月-月_5","17建築物等に係る不具合等の状況-改善措置の概要等又は改善の予定がない場合は理由_5","18備考-備考（3）","19外装仕上げ材等について-外装仕上材のタイル・石貼り等、モルタル塗り等の仕様","19外装仕上げ材等について前面打診等の実施状況","19外装仕上げ材等について-前面打診等の実施状況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5階","階別用途別床面積-3-1階","階別用途別床面積-3-2階","階別用途別床面積-3-3階","階別用途別床面積-3-4階","階別用途別床面積-3-5階","階別用途別床面積-3-6階","階別用途別床面積-3-7階","階別用途別床面積-3-8階","階別用途別床面積-3-9階","階別用途別床面積-3-10階","階別用途別床面積-3-11階","階別用途別床面積-3-12階","階別用途別床面積-3-13階","階別用途別床面積-3-14階","階別用途別床面積-3-15階","階別用途別床面積-3-16階","階別用途別床面積-3-17階","階別用途別床面積-3-18階","階別用途別床面積-3-19階","階別用途別床面積-3-20階","階別用途別床面積-3-21階","階別用途別床面積-3-22階","階別用途別床面積-3-23階","階別用途別床面積-3-24階","階別用途別床面積-3-25階","階別用途別床面積-3-26階","階別用途別床面積-3-27階","階別用途別床面積-3-28階","階別用途別床面積-3-29階","階別用途別床面積-3-30階","階別用途別床面積-3-31階","階別用途別床面積-3-32階","階別用途別床面積-3-33階","階別用途別床面積-3-34階","階別用途別床面積-3-35階","階別用途別床面積-3-36階","階別用途別床面積-3-37階","階別用途別床面積-3-38階","階別用途別床面積-3-39階","階別用途別床面積-3-40階","階別用途別床面積-3-41階","階別用途別床面積-3-42階","階別用途別床面積-3-43階","階別用途別床面積-3-44階","階別用途別床面積-3-45階","階別用途別床面積-3-46階","階別用途別床面積-3-47階","階別用途別床面積-3-48階","階別用途別床面積-3-49階","階別用途別床面積-3-50階","階別用途別床面積-4-大分類","階別用途別床面積-4-小分類","階別用途別床面積-4-地下1階","階別用途別床面積-4-地下2階","階別用途別床面積-4-地下3階","階別用途別床面積-4-地下4階","階別用途別床面積-4-塔屋 1階","階別用途別床面積-4-塔屋 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5階","階別用途別床面積-4-1階","階別用途別床面積-4-2階","階別用途別床面積-4-3階","階別用途別床面積-4-4階","階別用途別床面積-4-5階","階別用途別床面積-4-6階","階別用途別床面積-4-7階","階別用途別床面積-4-8階","階別用途別床面積-4-9階","階別用途別床面積-4-10階","階別用途別床面積-4-11階","階別用途別床面積-4-12階","階別用途別床面積-4-13階","階別用途別床面積-4-14階","階別用途別床面積-4-15階","階別用途別床面積-4-16階","階別用途別床面積-4-17階","階別用途別床面積-4-18階","階別用途別床面積-4-19階","階別用途別床面積-4-20階","階別用途別床面積-4-21階","階別用途別床面積-4-22階","階別用途別床面積-4-23階","階別用途別床面積-4-24階","階別用途別床面積-4-25階","階別用途別床面積-4-26階","階別用途別床面積-4-27階","階別用途別床面積-4-28階","階別用途別床面積-4-29階","階別用途別床面積-4-30階","階別用途別床面積-4-31階","階別用途別床面積-4-32階","階別用途別床面積-4-33階","階別用途別床面積-4-34階","階別用途別床面積-4-35階","階別用途別床面積-4-36階","階別用途別床面積-4-37階","階別用途別床面積-4-38階","階別用途別床面積-4-39階","階別用途別床面積-4-40階","階別用途別床面積-4-41階","階別用途別床面積-4-42階","階別用途別床面積-4-43階","階別用途別床面積-4-44階","階別用途別床面積-4-45階","階別用途別床面積-4-46階","階別用途別床面積-4-47階","階別用途別床面積-4-48階","階別用途別床面積-4-49階","階別用途別床面積-4-50階","階別用途別床面積-5-大分類","階別用途別床面積-5-小分類","階別用途別床面積-5-地下1階","階別用途別床面積-5-地下2階","階別用途別床面積-5-地下3階","階別用途別床面積-5-地下4階","階別用途別床面積-5-塔屋 1階","階別用途別床面積-5-塔屋 2階","階別用途別床面積-5-塔屋 3階","階別用途別床面積-5-塔屋 4階","階別用途別床面積-5-塔屋 5階","階別用途別床面積-5-1階","階別用途別床面積-5-2階","階別用途別床面積-5-3階","階別用途別床面積-5-4階","階別用途別床面積-5-5階","階別用途別床面積-5-6階","階別用途別床面積-5-7階","階別用途別床面積-5-8階","階別用途別床面積-5-9階","階別用途別床面積-5-10階","階別用途別床面積-5-11階","階別用途別床面積-5-12階","階別用途別床面積-5-13階","階別用途別床面積-5-14階","階別用途別床面積-5-15階","階別用途別床面積-5-16階","階別用途別床面積-5-17階","階別用途別床面積-5-18階","階別用途別床面積-5-19階","階別用途別床面積-5-20階","階別用途別床面積-5-21階","階別用途別床面積-5-22階","階別用途別床面積-5-23階","階別用途別床面積-5-24階","階別用途別床面積-5-25階","階別用途別床面積-5-26階","階別用途別床面積-5-27階","階別用途別床面積-5-28階","階別用途別床面積-5-29階","階別用途別床面積-5-30階","階別用途別床面積-5-31階","階別用途別床面積-5-32階","階別用途別床面積-5-33階","階別用途別床面積-5-34階","階別用途別床面積-5-35階","階別用途別床面積-5-36階","階別用途別床面積-5-37階","階別用途別床面積-5-38階","階別用途別床面積-5-39階","階別用途別床面積-5-40階","階別用途別床面積-5-41階","階別用途別床面積-5-42階","階別用途別床面積-5-43階","階別用途別床面積-5-44階","階別用途別床面積-5-45階","階別用途別床面積-5-46階","階別用途別床面積-5-47階","階別用途別床面積-5-48階","階別用途別床面積-5-49階","階別用途別床面積-5-50階","階別用途別床面積-6-大分類","階別用途別床面積-6-小分類","階別用途別床面積-6-地下1階","階別用途別床面積-6-地下2階","階別用途別床面積-6-地下3階","階別用途別床面積-6-地下4階","階別用途別床面積-6-塔屋 1階","階別用途別床面積-6-塔屋 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5階","階別用途別床面積-6-1階","階別用途別床面積-6-2階","階別用途別床面積-6-3階","階別用途別床面積-6-4階","階別用途別床面積-6-5階","階別用途別床面積-6-6階","階別用途別床面積-6-7階","階別用途別床面積-6-8階","階別用途別床面積-6-9階","階別用途別床面積-6-10階","階別用途別床面積-6-11階","階別用途別床面積-6-12階","階別用途別床面積-6-13階","階別用途別床面積-6-14階","階別用途別床面積-6-15階","階別用途別床面積-6-16階","階別用途別床面積-6-17階","階別用途別床面積-6-18階","階別用途別床面積-6-19階","階別用途別床面積-6-20階","階別用途別床面積-6-21階","階別用途別床面積-6-22階","階別用途別床面積-6-23階","階別用途別床面積-6-24階","階別用途別床面積-6-25階","階別用途別床面積-6-26階","階別用途別床面積-6-27階","階別用途別床面積-6-28階","階別用途別床面積-6-29階","階別用途別床面積-6-30階","階別用途別床面積-6-31階","階別用途別床面積-6-32階","階別用途別床面積-6-33階","階別用途別床面積-6-34階","階別用途別床面積-6-35階","階別用途別床面積-6-36階","階別用途別床面積-6-37階","階別用途別床面積-6-38階","階別用途別床面積-6-39階","階別用途別床面積-6-40階","階別用途別床面積-6-41階","階別用途別床面積-6-42階","階別用途別床面積-6-43階","階別用途別床面積-6-44階","階別用途別床面積-6-45階","階別用途別床面積-6-46階","階別用途別床面積-6-47階","階別用途別床面積-6-48階","階別用途別床面積-6-49階","階別用途別床面積-6-50階","階別用途別床面積-7-大分類","階別用途別床面積-7-小分類","階別用途別床面積-7-地下1階","階別用途別床面積-7-地下2階","階別用途別床面積-7-地下3階","階別用途別床面積-7-地下4階","階別用途別床面積-7-塔屋 1階","階別用途別床面積-7-塔屋 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[null,null,"その他",null,"第二種中高層住居専用地域",null,"その他",null,null,null,"※自由入力可",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"住居系施設1",null,"観覧場（屋外観覧場を除く）",null,null,null,null,null,"助産所","美術館","物品販売業を営む店舗","公衆浴場","テレビスタジオ","診療所（患者の収容施設がないもの）"]
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[null,null,null,null,"近隣商業地域",null,null,null,null,null,"改築",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"物販店等",null,null,null,null,null,null,null,"小規模多機能居宅介護の事業所","水泳場",null,"ダンスホール"]
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[]
["12 関連図書の整備",null,"14 調査及び検査の状況",null,"１５.石綿",null,"16 耐震診断及び耐震改修の調査状況",null,"17 建築物等に係る不具合等の状況",null,"19 外装仕上げ材等について",null,"２０　設備（法第12条第三項関係など）",null,null,null,null,null,null,null,null,null,null,null,null,"4_入力シート【写真】"]
["確認に要した図書",null,null,null,"該当建築材料",null,null,null,"改善の状況"]
[]
[null,null,null,null,null,null,"耐震診断",null,"不具合等",null,"外装仕上げ材のタイル、石貼り等、モルタル塗り等の使用"]
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["有(各階平面図のみあり)",null,"未実施",null,"有（飛散防止措置有）",null,"未実施",null,"無",null,"―　未使用",null,"無",null,null,null,null,null,null,null,null,null,null,null,null,"☐"]
["無",null,"対象外",null,"無",null,"対象外"]
[null,null,null,null,"未調査",null,null,null,null,null,null,null,"対象"]
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["無",null,"平成",null,"措置予定",null,"改修済",null,"無",null,"全面打診等の実施から10年以内"]
[null,null,"令和",null,"有",null,"未実施",null,null,null,"竣工（改修含む）から10年以内"]
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["有",null,null,null,"未定",null,null,null,"昭和",null,"全面打診等が実施できていない（実施の必要がある）"]
["無",null,null,null,null,null,null,null,"平成",null,"タイル貼等は手の届く範囲のみで今回全面打診等を実施"]
[null,null,null,null,null,null,null,null,"令和",null,"その他"]
[null,null,null,null,null,null,null,null,"※自由入力可"]
["工事種別"]
["新築",null,null,null,null,null,null,null,null,null,"平成"]
["増築",null,null,null,null,null,null,null,"改善の状況",null,"令和"]
["改築",null,null,null,null,null,null,null,"実施済"]
["移転",null,null,null,null,null,null,null,"改善予定"]
["用途変更",null,null,null,null,null,null,null,"予定なし"]
["大規模の修繕"]
["大規模の模様替え"]
["※自由入力可"]
[]
["和暦"]
["昭和"]
["平成"]
["令和"]
["※自由入力可"]
[]
["交付者"]
["建築主事"]
["指定確認検査機関"]
[]
[]
["維持管理保全に関する準則又は計画"]
["有"]
["無"]
[]
["前回の調査に関する書類の写し"]
["有"]
["無"]
["対象外"]
[]
["22 調査結果"]
["調査結果"]
["―対象外"]
["○指摘なし"]
["×要是正（既存不適格以外）"]
["△既存不適格"]
[]
[]
["調査者番号（1）は入力不要"]
[1]
[2]
[3]
["※自由入力可"]
[]
["改善（予定）年月 状況"]
["予定"]
["改善済"]
["未定"]