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{"sheet":"第一面（完了検査）","index":0,"n_rows":52,"n_cols":27,"rows_kept":52,"cut":false,"hidden":false,"merged":[[74,5,74,17],[37,15,38,19],[37,12,38,14],[2,0,2,19],[4,0,4,19],[18,1,18,4],[18,5,18,17],[23,5,23,17],[14,0,14,10],[41,0,42,4],[43,0,44,4],[37,5,38,7],[39,5,40,7],[41,5,42,7],[43,5,44,7],[29,5,29,17],[6,0,12,19],[5,9,5,10],[37,0,38,4],[39,0,40,4],[37,8,38,11],[39,8,44,11],[39,15,40,19],[39,12,40,14],[41,12,42,14],[41,15,42,19],[43,15,44,19],[43,12,44,14]]}
["第十九号様式（第四条、第四条の四の二関係）（Ａ４）"]
[]
["完了検査申請書"]
[]
[]
[null,null,null,null,null,null,null,null,null,"（第一面）"]
["  建築基準法第７条第１項又は第７条の２第１項（これらの規定を同法第８７条の４又は第８８条第１項若しくは第３項において準用する場合を含む。）の規定により、検査を申請します。申請にあたっては、関西住宅品質保証株式会社確認検査業務約款及び同確認検査業務規程を遵守します。また、この申請書及び添付図書に記載の事項は、事実に相違ありません。\n確認の申請に係る手数料として、関西住宅品質保証株式会社確認検査業務手数料規程に基づき算定された、完了検査引受証に明示する額を支払います。"]
[]
[]
[]
[]
[]
[]
[]
["関西住宅品質保証株式会社  御中"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"令和",null,"年",null,"月",null,"日"]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,"申請者氏名"]
[]
[]
["第四面に記載の事項は、事実に相違ありません。"]
[]
[null,null,null,null,null,"工事監理者氏名"]
[]
[]
["【検査を申請する建築物等】"]
[null,"□","建築物",null,null,null,"□","建築設備（昇降機）",null,null,null,null,null,"□","建築設備（昇降機以外）"]
[null,"□","工作物（昇降機）",null,null,null,"□","工作物（法第８８条第１項）",null,null,null,null,null,"□","工作物（法第８８条第２項）"]
[]
[]
["※受付欄",null,null,null,null,"※検査の        特例欄",null,null,"※検査欄",null,null,null,"※決裁欄",null,null,"※検査済証欄"]
[]
[" 令和　  年     月     日",null,null,null,null,null,null,null,"(予定日)\n\n令和　 年　月　 日\n\n（実施日）\n\n令和　 年　月　 日",null,null,null,null,null,null," 令和　  年     月     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,null,null,"■"]
[null,null,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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[]
["建築主、設置者又は築造主等の概要"]
[]
["【1.建築主、設置者又は築造主】"]
[null,"【ｲ.氏名のﾌﾘｶﾞﾅ】"]
[null,"【ﾛ.氏名】"]
[null,"【ﾊ.郵便番号】"]
[null,"【ﾆ.住所】"]
[null,"【ﾎ.電話番号】"]
[]
["【2.代理者】"]
[null,"【ｲ.資格】",null,null,null,"（",null,"）建築士（",null,null,null,null,"）登録第",null,null,null,"号"]
[null,"【ﾛ.氏名】"]
[null,"【ﾊ.建築士事務所名】",null,null,null,"（",null,"） 建築士事務所   （",null,null,null,null,null,"）知事登録第",null,null,null,null,null,"号"]
[]
[null,"【ﾆ.郵便番号】"]
[null,"【ﾎ.所在地】"]
[null,"【ﾍ.電話番号】"]
[]
["【3.設計者】"]
["　　(代表となる設計者）"]
[null,"【ｲ.資格】",null,null,null,"（",null,"）建築士（",null,null,null,null,"）登録第",null,null,null,"号"]
[null,"【ﾛ.氏名】"]
[null,"【ﾊ.建築士事務所名】",null,null,null,"（",null,"） 建築士事務所   （",null,null,null,null,null,"）知事登録第",null,null,null,null,null,"号"]
[]
[null,"【ﾆ.郵便番号】"]
[null,"【ﾎ.所在地】"]
[null,"【ﾍ.電話番号】"]
[null,"【ト．作成した設計図書】"]
[]
["　　(その他の設計者）"]
[null,"【ｲ.資格】",null,null,null,"（",null,"）建築士（",null,null,null,null,"）登録第",null,null,null,"号"]
[null,"【ﾛ.氏名】"]
[null,"【ﾊ.建築士事務所名】",null,null,null,"（",null,"） 建築士事務所   （",null,null,null,null,null,"）知事登録第",null,null,null,null,null,"号"]
[]
[null,"【ﾆ.郵便番号】"]
[null,"【ﾎ.所在地】"]
[null,"【ﾍ.電話番号】"]
[null,"【ト．作成した設計図書】"]
[]
[null,"【ｲ.資格】",null,null,null,"（",null,"）建築士（",null,null,null,null,"）登録第",null,null,null,"号"]
[null,"【ﾛ.氏名】"]
[null,"【ﾊ.建築士事務所名】",null,null,null,"（",null,"） 建築士事務所   （",null,null,null,null,null,"）知事登録第",null,null,null,null,null,"号"]
[]
[null,"【ﾆ.郵便番号】"]
[null,"【ﾎ.所在地】"]
[null,"【ﾍ.電話番号】"]
[null,"【ト．作成した設計図書】"]
[]
[null,"【ｲ.資格】",null,null,null,"（",null,"）建築士（",null,null,null,null,"）登録第",null,null,null,"号"]
[null,"【ﾛ.氏名】"]
[null,"【ﾊ.建築士事務所名】",null,null,null,"（",null,"） 建築士事務所   （",null,null,null,null,null,"）知事登録第",null,null,null,null,null,"号"]
[]
[null,"【ﾆ.郵便番号】"]
[null,"【ﾎ.所在地】"]
[null,"【ﾍ.電話番号】"]
[null,"【ト．作成した設計図書】"]
[]
["【4.工事監理者】"]
["　　（代表となる工事監理者）"]
[null,"【ｲ.資格】",null,null,null,"（",null,"）建築士（",null,null,null,null,"）登録第",null,null,null,"号"]
[null,"【ﾛ.氏名】"]
[null,"【ﾊ.建築士事務所名】",null,null,null,"（",null,"） 建築士事務所   （",null,null,null,null,null,"）知事登録第",null,null,null,null,null,"号"]
[]
[null,"【ﾆ.郵便番号】"]
[null,"【ﾎ.所在地】"]
[null,"【ﾍ.電話番号】"]
[null,"【ﾄ．工事と照合した設計図書】"]
[]
["　　（その他の工事監理者）"]
[null,"【ｲ.資格】",null,null,null,"（",null,"）建築士（",null,null,null,null,"）登録第",null,null,null,"号"]
[null,"【ﾛ.氏名】"]
[null,"【ﾊ.建築士事務所名】",null,null,null,"（",null,"） 建築士事務所   （",null,null,null,null,null,"）知事登録第",null,null,null,null,null,"号"]
[]
[null,"【ﾆ.郵便番号】"]
[null,"【ﾎ.所在地】"]
[null,"【ﾍ.電話番号】"]
[null,"【ﾄ．工事と照合した設計図書】"]
[]
[null,"【ｲ.資格】",null,null,null,"（",null,"）建築士（",null,null,null,null,"）登録第",null,null,null,"号"]
[null,"【ﾛ.氏名】"]
[null,"【ﾊ.建築士事務所名】",null,null,null,"（",null,"） 建築士事務所   （",null,null,null,null,null,"）知事登録第",null,null,null,null,null,"号"]
[]
[null,"【ﾆ.郵便番号】"]
[null,"【ﾎ.所在地】"]
[null,"【ﾍ.電話番号】"]
[null,"【ﾄ．工事と照合した設計図書】"]
[]
[null,"【ｲ.資格】",null,null,null,"（",null,"）建築士（",null,null,null,null,"）登録第",null,null,null,"号"]
[null,"【ﾛ.氏名】"]
[null,"【ﾊ.建築士事務所名】",null,null,null,"（",null,"） 建築士事務所   （",null,null,null,null,null,"）知事登録第",null,null,null,null,null,"号"]
[]
[null,"【ﾆ.郵便番号】"]
[null,"【ﾎ.所在地】"]
[null,"【ﾍ.電話番号】"]
[null,"【ﾄ．工事と照合した設計図書】"]
[]
["【5.建築設備の工事監理に関し意見を聴いた者】"]
["　　（代表となる建築設備の工事監理に関し意見を聴いた者）"]
[null,"【ｲ.氏名】"]
[null,"【ﾛ.勤務先】"]
[null,"【ﾊ.郵便番号】"]
[null,"【ﾆ.所在地】"]
[null,"【ﾎ.電話番号】"]
[null,"【ﾍ.登録番号】"]
[null,"【ﾄ．意見を聴いた設計図書】"]
[]
["　　(その他の建築設備の工事監理に関し意見を聴いた者）"]
[null,"【ｲ.氏名】"]
[null,"【ﾛ.勤務先】"]
[null,"【ﾊ.郵便番号】"]
[null,"【ﾆ.所在地】"]
[null,"【ﾎ.電話番号】"]
[null,"【ﾍ.登録番号】"]
[null,"【ﾄ．意見を聴いた設計図書】"]
[]
[null,"【ｲ.氏名】"]
[null,"【ﾛ.勤務先】"]
[null,"【ﾊ.郵便番号】"]
[null,"【ﾆ.所在地】"]
[null,"【ﾎ.電話番号】"]
[null,"【ﾍ.登録番号】"]
[null,"【ﾄ．意見を聴いた設計図書】"]
[]
[null,"【ｲ.氏名】"]
[null,"【ﾛ.勤務先】"]
[null,"【ﾊ.郵便番号】"]
[null,"【ﾆ.所在地】"]
[null,"【ﾎ.電話番号】"]
[null,"【ﾍ.登録番号】"]
[null,"【ﾄ．意見を聴いた設計図書】"]
[]
["【6.工事施工者】"]
[null,"【ｲ.氏名】"]
[null,"【ﾛ.営業所名】",null,null,null,"建設業の許可(",null,null,null,null,null,"）第",null,null,null,null,"号"]
[]
[null,"【ﾊ.郵便番号】"]
[null,"【ﾆ.所在地】"]
[null,"【ﾎ.電話番号】"]
[]
["【7.備考】"]
[null,"【建築物の名称又は工事名】"]
[null,null,"【名称のﾌﾘｶﾞﾅ】"]
[null,null,"【名称】"]

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["申請する工事の概要"]
[]
["【1.建築場所、設置場所又は築造場所】"]
[null,"【ｲ.地名地番】"]
[null,"【ﾛ.住居表示】"]
[]
["【2.工事種別】"]
[null,"【ｲ.建築基準法施行令第１０条各号に掲げる建築物の区分】",null,null,null,null,null,null,null,null,null,null,null,null,null,"第",null,"号"]
[null,"【ロ.工事種別】",null,null,null,"□","新築",null,"□","増築",null,"□","改築",null,"□","移転",null,null,null,null,null,null,null,null,null,null,null,null,null,"■"]
[null,null,null,null,null,"□","大規模の修繕",null,null,null,"□","大規模の模様替",null,null,null,"□","建築設備の設置",null,null,null,null,null,null,null,null,null,null,null,null,"□"]
[null,"【ﾊ.建築基準法第６８条の２０第２項の検査の特例に係る認証番号】"]
[]
[]
["【3.確認済証番号】",null,null,null,null,"第",null,null,null,null,null,null,null,null,"号"]
[]
["【4.確認済証交付年月日】",null,null,null,null,null,"令和"," ","年"," ","月"," ","日"]
[]
["【5.確認済証交付者】",null,null,null,null,null,"関西住宅品質保証株式会社"]
[]
["【6.工事着手年月日】",null,null,null,null,null,"令和"," ","年"," ","月"," ","日"]
[]
["【7.工事完了（予定）年月日】",null,null,null,null,null,"令和"," ","年"," ","月"," ","日"]
[]
["【8.検査対象床面積】",null,null,null,null,null," ",null,null,"㎡"]
[]
["【9.検査経過】",null,null,null,null,null,"（","第"," ",null,null,null,null,"回","）","（","第",null,null,null,null,null,"回","）"]
[null,"【ｲ.特定工程】",null,null,null,null,"（"," ",null,null,null,null,null,null,"）","（",null,null,null,null,null,null,null,"）"]
[null,"【ﾛ.中間検査合格証交付者】",null,null,null,null,"（"," ",null,null,null,null,null,null,"）","（",null,null,null,null,null,null,null,"）"]
[null,"【ﾊ.中間検査合格証番号】",null,null,null,null,"（"," ",null,null,null,null,null,null,"）","（",null,null,null,null,null,null,null,"）"]
[null,"【ﾆ.交付年月日】",null,null,null,null,"（","令和"," ","年"," ","月"," ","日","）","（","令和",null,"年",null,"月",null,"日","）"]
[]
["【10.確認以降の軽微な変更の概要】"]
[null,"【ｲ.変更された設計図書の種類】"]
[null,"【ﾛ.変更の概要】"]
[]
[]
[]
[]
[]
["【11.備考】"]

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["工事監理の状況"]
[null,"確認を行つた           部位・材料の                      種類等","照合内容","照合を行つた              設計図書","設計図書の                内容について               設計者に                         確認した事項","照合方法","照合結果"]
[null,null,null,null,null,null,"（不適の場合                        には建築主に                               対して行つた                             報告の内容）"]
["敷地の形状、高さ、衛生及び安全"]
["主要構造部及び主要構造部以外の構造耐力上主要な部分に用いる材料（接合材料を含む）の種類、品質、形状及び寸法"]
["主要構造部及び主要構造部以外の構造耐力上主要な部分に用いる材料の接合状況、接合部分の形状等"]
["建築物の各部分の位置、形状及び大きさ"]
["構造耐力上主要な部分の防錆、防腐及び防蟻措置及び状況"]
["特定天井に用いる材料の種類並びに当該特定天井の構造及び施工状況"]
["居室の内装の仕上げに用いる建築材料の種別及び当該建築材料を用いる部分の面積"]
["天井及び壁の室内に面する部分に係る仕上げの材料の種別及び厚さ"]
["開口部に設ける建具の種類及び大きさ"]
["建築設備に用いる材料の種類及びその照合した内容並びに当該建築設備の構造及び施工状況（区画貫通部の処理状況を含む。）"]
["備         考"]

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