EVALUATION FORM FOR MASONRY BUILDINGS

General Information:
Name of the building Owner / Date

Building ID

Address

Construction Year

Coordinates

1. In what age group are you?

2. Gender:
Male
Female

3. In terms of your current occupation, how would you characterize yourself?

Engineer
Doctor
Journalist
Secretary
Academic
Professional
Technical expert
Student
Designer
Administrator/Manager
Other, please specify:

4. Number of earthquakes this structure faced with?

5. Number of Rooms in this building

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6. Type of structure
Confined masonry
Un-Confined masonry
Other

7. How many doors in each room

1
2
More

8. Is the owner familiar with UMS and CMS?

Yes
No

9. Load-Baring wall material

Stone
CMU
Solid brick
Perforated brick
Hybrid
Un-Identified

10. Do the owner know about seismic bands?

Yes
No

11. What do you think of he role of Structural engineer to build a safe building?
Effective
Not-Effective
None

12. Is your structure confined masonry? (If yes please describe shortly why you have chosen this
type of structure)

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Structure Shape and specific details
Plan Geometry :

Rectangular Small Projections

Photo of the
Building
Non - Parallel axis Highly irregular

L - Shaped

Occupancy Type Residential Commercial Industrial Public

Occupancy Distribution All stories same Above ground floor residential

Number of Stories ( ) Normal + ( ) Mezzanine + ( ) Penthouse = ( ) Total

Total Length (Front Façade) (meters)

Total Opening Length (Front F.) (meters)

Total Length (Lateral Façade) (meters)

Total Opening Length (Lateral F.) (meters)

Horizontal Bond Beam? Floor level Over window None

Vertical Alignment of Openings Regular In Between Not Regular

Floor Type RC Wooden Unidentified

Building height difference in the Yes No

case of adjacency
Floor height difference in the case Yes No
of adjacency
Roof Geometry Flat Shed Hipped Gable
Roof Material Tile RC Slab Metal Sheet Earthen

Basement Yes No Unidentified

Apparent Condition Good In between Poor

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