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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（ＫＴ-07）"]
[null,null,null,null,null,null,null,null,null,null,null,"㈱都市居住評価センター"]
[null,"構造計算適合性判定　事前相談等申込書"]
[]
["　　　　下記フォームにご記入いただき、電話連絡の上、事前相談等申込書をメールまたはFAXにて送付してください。"]
["　　　　なお、未定または不明な項目については空欄で結構です。"]
["　　　                           送付先：　構造適合性判定事業部 E-mail　：　tekihan@uhec.co.jp"]
["　　　　　　　　　　　　　　　　　　　　　　　　　　　     　　　　　　　　　 　 TEL ：　03-3504-2390　/  FAX　：　03-3595-0902　　　　　　　　　　　　　　　　　　　　　　　　　　　　"]
[]
["□申込者名　",null,"申し込される方を選択して下さい。："]
["　申込者名",null,null,"名称",null,null,null,null,null,null,null,null,null,null,null,"構造設計事務所"]
[null,null,null,"部署",null,null,null,null,null,"氏名",null,null,null,null,null,"意匠設計事務所"]
[null,null,null,"電話",null,null,null,null,null,"ＦＡＸ",null,null,null,null,null,"代理者"]
[null,null,null,"メールアドレス",null,null,null,null,null,null,null,null,null,null,null,"その他　（　右記のとおり　）　："]
[]
["□構造設計者名（申込者と異なる場合はご記入下さい。）"]
["　構造設計事務所名",null,null,"名称"]
[null,null,null,"部署",null,null,null,null,null,"氏名"]
[null,null,null,"電話",null,null,null,null,null,"ＦＡＸ"]
[null,null,null,"メールアドレス"]
[]
["□建築主事・指定確認検査機関名"]
["　建築確認の申請",null,null,"名称"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"未定"]
[null," "]
["　　物件名称　："]
[]
["　建築概要　（構造計算適合性判定申請書を別途に添付していただく場合は、空欄で結構です。）"]
["　　建築場所　："]
["　　主要用途　：",null,null,null,null,null,null,"　構造種別　："]
["　　総延床面積 （ｍ２）：",null,null,null,null,"㎡",null,"　　判定構造棟数　：",null,null,null,null,"棟"]
["　　高さ　：",null,null,null,null,"ｍ",null,"軒の高さ　：",null,null,null,null,"ｍ"]
["　　階数　：",null,null,"地上　",null,"階　","地下",null,"階","塔屋",null,"階"]
["　確認概略工程"]
["　　確認申請受付予定日",null,null,null,null,null,null,"頃"]
["　　適合判定受付予定日",null,null,null,null,null,null,"頃"]
["　　適合判定通知書予定日",null,null,null,null,null,null,"頃"]
["　事前相談内容（建築物の特徴、事前相談事項等をご記入下さい。）"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["　備考欄（その他連絡事項などがありましたらご記入下さい。）"]
[]
[]
[]
[]
["申請図書の詳細な事前相談は、以下の書類を提出してください（事前相談時は、設計者押印は不要です）"]
["・構造計算適合性判定　事前相談等申込書"]
["・構造計算適合性判定申請書"]
["・図書（意匠図、構造図、構造計算書及び地盤調査報告書）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"20150601版"]