Dsa Form 6 Ae PDF Details

In the realm of construction, particularly for educational institutions, ensuring that buildings are safe, accessible, and comply with fire safety standards is paramount. The Division of the State Architect (DSA) plays a critical role in this process within California, overseeing the construction of schools to ensure they meet the rigorous standards set forth in the California Code of Regulations, Title 24, Part 1. An essential tool in this oversight is the DSA 6 AE form, a document meticulously completed by architects or structural engineers in charge and those with delegated responsibilities. This form is foundational in the process, tied to observations of construction as reported on the Application for Approval of Plans and Specifications, known as the DSA 1 form. It serves multiple purposes: it can be an interim or final verified report, cover deferred submittals, or even report the termination of services or suspension of construction work. It demands a comprehensive account of any changes to the DSA approved construction documents, requiring full disclosure and, if necessary, a detailed description of changes not approved by the DSA. The professional in charge must attest to the accuracy of the report, under penalty of perjury, ensuring that every material used and the work performed complies with approved documents. This form, once completed, is submitted to the DSA regional office with oversight authority, a critical step in maintaining the safety and integrity of school construction projects across California.

QuestionAnswer
Form NameDsa Form 6 Ae
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesCalifornia, Deferred, Frontera, interim verified report

Form Preview Example

This form shall be completed by the Architect or Structural Engineer in General Responsible Charge and those architects or engineers

with delegated responsibility for observations of construction, as reported on the Application for Approval of Plans and Specifications

(form DSA 1), in accordance with California Code of Regulations, Title 24, Part 1, Sections 4-336 or 4-240.

School District/Owner:

 

DSA File #:

-

 

 

 

 

Project Name/School:

 

DSA App. #:

-

 

 

 

 

Date of Report:

Number of Attached Pages:

DSA 152 Card #(s):

 

 

(If none, enter zero.)

 

 

Note that DSA approved construction documents, referred to below, are those portions of

 

 

the construction documents, duly approved by the DSA, that contain information related to

List all inspection card numbers for

and affecting the Structural Safety, Fire/Life Safety, and Accessibility portions of the project.

which this verified report applies.

 

 

 

 

COMPLETE SECTIONS 1 & 2 AND PROVIDE ALL REQUIRED DOCUMENTATION

1. REASON FOR FILING THIS VERIFIED REPORT (Check applicable box.)

Interim Verified Report: List affected form DSA 152 Inspection Card Section #(s):

Final Verified Report: Construction of all work, shown in the DSA approved construction documents, is complete. The Design Professional in Responsible Charge shall complete the following:

Deferred Submittals: One of the following must be checked in order to file a Final Verified Report

This project does not require deferred submittals

All deferred submittals are approved by the DSA.

Termination of services prior to completion of all work shown in the DSA approved construction documents. The A/E in General Responsible Charge, and the professional whose services are terminated, as indicated below, shall sign the report.

Arch/Eng. in General Responsible Charge

Structural Engineer

Mechanical Engineer

Electrical Engineer

Construction work suspended for more than one month. Provide date of last construction activity:

DSA Request Dated:

2. CONSTRUCTION CHANGES AS OF THE DATE OF THIS REPORT (Check applicable box.)

There are no changes to the DSA approved construction documents.

All changes to the DSA approved construction documents have been approved by the DSA.

There are changes to the DSA approved construction documents that have not been approved by the DSA. (Briefly describe the changes. Attach additional pages if necessary.)

I attest that, based on my own personal knowledge (as defined in California Code of Regulations, Title 24, Part 1, Sections 4-336 and 4-214) that, except as marked in Section 2, as of the date of this report, the work has been performed and materials have been used and installed, in every material respect, in compliance with the DSA approved construction documents. I declare under penalty of perjury that I prepared this report and that all statements are true.

Design Professional in General Responsible Charge: (Signature)

Print Name:

 

CA Registration No:

 

Date:

 

Architect with delegated responsibility: (Signature)

 

 

 

 

 

Print Name:

 

 

CA Registration No:

 

Date:

 

 

 

 

Structural Engineer with delegated responsibility: (Signature)

 

 

 

 

 

 

Print Name:

 

CA Registration No:

 

Date:

 

 

 

 

Mechanical Engineer with delegated responsibility: (Signature)

 

 

 

 

 

 

Print Name:

 

CA Registration No:

 

Date:

 

 

 

 

 

 

 

 

 

 

 

Electrical Engineer delegated responsibility: (Signature)

 

 

 

 

 

Print Name:

 

 

CA Registration No:

 

Date:

 

 

 

 

Submit completed form to the DSA Regional Office with construction oversight authority for the project.

DSA OAKLAND

1515 Clay Street, Suite 1201 Oakland, CA 94612

DSA SACRAMENTO

1102 Q Street, Suite 5200 Sacramento, CA 95811

DSA LOS ANGELES

700N. Alameda Street, Suite 5-500 Los Angeles, CA 90012

DSA SAN DIEGO

10920 Via Frontera Rd., Suite 300 San Diego, CA 92127

Revised 03/22/13

 

Page 1 of 1

DIVISION OF THE STATE ARCHITECT

DEPARTMENT OF GENERAL SERVICES

STATE OF CALIFORNIA

How to Edit Dsa Form 6 Ae Online for Free

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1. First of all, while filling out the Frontera, start out with the area containing subsequent blank fields:

dsa interim verified report conclusion process detailed (portion 1)

2. The next stage is to fill in the next few blank fields: There are no changes to the DSA, All changes to the DSA approved, There are changes to the DSA, I attest that based on my own, Design Professional in General, Print Name, Architect with delegated, Print Name, Structural Engineer with delegated, Print Name, Mechanical Engineer with delegated, Print Name, Electrical Engineer delegated, Print Name, and CA Registration No.

Writing section 2 in dsa interim verified report

3. This third step should be quite straightforward, Submit completed form to the DSA, DSA OAKLAND, Clay Street Suite Oakland CA, DSA SACRAMENTO Q Street Suite, DSA LOS ANGELES, DSA SAN DIEGO, N Alameda Street Suite Los, Via Frontera Rd Suite San Diego, Revised DIVISION OF THE STATE, DEPARTMENT OF GENERAL SERVICES, and Page of STATE OF CALIFORNIA - all of these empty fields will have to be completed here.

dsa interim verified report conclusion process shown (step 3)

Be extremely mindful while completing Page of STATE OF CALIFORNIA and Via Frontera Rd Suite San Diego, since this is the part where many people make mistakes.

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