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["建築物耐震診断等概要表",{"$nulls":29},"(様式-2)"]
["１　建 物 概 要"]
["建物名、建物区分(棟番号)"]
["面積",{"$nulls":7},"(建築面積)",{"$nulls":7},"㎡",null,"(対象面積)",{"$nulls":7},"㎡"]
["用途"]
["建築年月日、構造、階数"]
["建物所有者名／申込者名"]
["建物所在地"]
["申込み要件（評価区分）",{"$nulls":8},"耐震診断",{"$nulls":5},"耐震補強計画",{"$nulls":6},"総合判定"]
["基礎、地盤条件"]
["構造上の特徴",{"$nulls":7},"平面(",null,null,null,"ほぼ整形・",null,null,null,"不整形",null,")","、",null,"立面(",null,null,null,"ほぼ整形・",null,null,null,"不整形",null,")"]
[{"$nulls":8},"構造形式 ",null,null,"(X方向：",{"$nulls":9},"Y方向：",{"$nulls":9},")"]
[{"$nulls":8},"極脆性柱 ",null,null,"(",null,"有","・",null,"無",")","、",null,"下階壁抜",null,null,"(",null,"有","・",null,"無",")"]
[{"$nulls":8},"平面柱抜 ",null,null,"(",null,"有","・",null,"無",")","、",null,"PCａ屋根　",null,null,"(",null,"有","・",null,"無",")"]
["２　診 断 方 針"]
["診断法(計算法)",{"$nulls":8},"第2次診断",null,null,"、",null,"第3次診断",null,null,"、",null,"屋体診断基準",null,null,null,"、",null,"応答解析",null,null,"、"]
[{"$nulls":9},"その他 (",{"$nulls":13},")",null,null,null,"(",null,"手計算、",null,null,null,"電算機 )"]
["電算ソフト(ﾊﾞｰｼﾞｮﾝ)/(作成者)"]
["診断実施者\n(会社名、氏名、資格)\n連絡先住所\n(TEL/FAX/E-mail)",{"$nulls":16},"印",null,"(1級建築士登録番号：第",{"$nulls":11},"号)"]
[{"$nulls":8},"事務所名："]
[{"$nulls":8},"住所："]
[{"$nulls":8},"TEL：",{"$nulls":8},"FAX：",{"$nulls":8},"E-mail："]
["診断実施年月",{"$nulls":7},"平成",null,null,null,"年",null,null,"月"]
["材料調査：調査値、設計値、診断使用値\n等（ｺﾝｸﾘｰﾄ調査値は全標本中の最小と最大\nを記す。ｶｯｺ内：標準偏差）\n",{"$nulls":7},"ｺﾝｸﾘｰﾄ:調査値=",{"$nulls":4},"～　　　(　　 ～　　 )",{"$nulls":5},"設計値(Fc)=",{"$nulls":5},"診断使用値=",{"$nulls":5},"～",null,null,"(N/㎜2)"]
[{"$nulls":8},"鉄筋：",{"$nulls":7},"設計値(σy)=",{"$nulls":8},"診断使用値=",{"$nulls":8},"(N/㎜2)"]
[{"$nulls":8},"鉄骨：",{"$nulls":7},"設計値(σy)=",{"$nulls":8},"診断使用値=",{"$nulls":8},"(N/㎜2)"]
["３　診 断 結 果　（Is値、CTU･SD又はq･ St値（何れか＊欄に付記）を記入。右欄に調査、診断及びISOとの関係等の所見を簡潔に記載。）"]
[{"$nulls":5},"補強前",{"$nulls":7},"補強後",{"$nulls":7},"(調査および診断に関する所見)"]
[{"$nulls":5},"X方向",null,null,null,"Y方向",null,null,null,"X方向",null,null,null,"Y方向",null,null,null,"目標値：",null,null," Iso=",{"$nulls":4},"CTU･SD="]
[{"$nulls":5},"Isx",null,null,"*","Isy",null,null,"*","Isx",null,null,"*","Isy",null,null,"*",{"$nulls":8},"（ q･St）"]
["5F"]
["4F"]
["3F"]
["2F"]
["1F"]
["最小値"]
["４　補 強 計 画　（補強方法別（評定等を受けた工法はその名称）に各階の補強箇所数､合計数を記入､所見に判定､Isoとの関係等を記入）"]
["構造上の階数\n（PHは補強の有\nる場合に記入）",{"$nulls":4},"壁増設","壁補強","袖壁増設","袖壁補強","柱増設","柱補強","ブ増設","ブ補強","スリット","基礎補強","荷重軽減","その他",null,"（補強に関する所見）"]
[{"$nulls":18},"目標値：",null,null," Iso=",{"$nulls":6},"CTU･SD="]
[{"$nulls":28},"（ q･St）"]
[]
["5F"]
["4F"]
["3F"]
["2F"]
["1F"]
["合計"]
["５　付 図　Ⅰ（補強前後の代表階の①CT‐F関係､主要のCT値(RC造)､又は ②q･ ST値(S造)、及びISOの線を記入）"]
["X方向〔",{"$nulls":10},"階〕",{"$nulls":6},"Y方向〔",{"$nulls":10},"階〕"]
[null,"C値，qSt値",{"$nulls":17},"C値，qSt値"]
[null,null,"1.0",{"$nulls":17},"1.0"]
[null,null,"0.9",{"$nulls":17},"0.9"]
[null,null,"0.8",{"$nulls":17},"0.8"]
[null,null,"0.7",{"$nulls":17},"0.7"]
[null,null,"0.6",{"$nulls":17},"0.6"]
[null,null,"0.5",{"$nulls":17},"0.5"]
[null,null,"0.4",{"$nulls":17},"0.4"]
[null,null,"0.3",{"$nulls":17},"0.3"]
[null,null,"0.2",{"$nulls":17},"0.2"]
[null,null,"0.1",{"$nulls":17},"0.1"]
[null,null,null,"0",null,"0.5",null,"1",null,"1.5",null,"2",null,"2.5",null,"3","F値",{"$nulls":4},"0",null,"0.5",null,"1",null,"1.5",null,"2",null,"2.5",null,"3","F値"]
["６　特記",null,null,"※原則としてコンクリートのコア抜きは各期、各階3本以上とする。"]