Fiber optics are increasingly being used in structural health monitoring applications. In addition to the well-known advantages, they most reliably transmit the stress–strain condition of the structure in the long term. This article presents the results of structural health monitoring on the embedding of fiber optics in the upper layer of the raft over the entire area of a high-rise building in Astana city (Kazakhstan), including the 75-storey 320 m block R. Temperature and strain data were collected constantly via a distributed fiber optic strain sensing system (DFOSS). The analysis of strains in fiber optic chainage indicated that the compression strains were observed over the entire area of the building, with values from −20 to −40 µε and with progression of the compression loaded up to −80 µε along the core wall closer to the eastern facade of the building. Tension strains were concentrated along the extreme axes of the building, with a predominance in the southern part of the R block, as well as in the immediate vicinity of the columns, in a range of −20 to −40 µε, with separate spots from −40 to −60 µε. Individual patches of tension strains near the columns have been explained by the increased deflection of the raft under the application of a concentrated load (columns). Fiber optic monitoring results at the time of testing did not exceed the permitted values for high-rise building operation; however, they characterized the general picture of the strain in the raft plane and made it possible to determine the initiation of cracks in concrete at an early stage.