20150528163722908.pdfCITY OF EDMONDS! DIVISION
SPECIAL INSC OAND TESTING AGREEMENT
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PERMIT # PLN20141182 MATE: 5,22,15
PROJECT SITE ADDRESS: 23200 100't' Ave W, Edmonds WA, 98026
PROJECT NAME: Old Woodway Playfields
SPECIAL INSPECTION AGENCYAssociated Earth Sciences Inc
*One form must be completed by each Special Inspection Agency or Inspector.
SPECIAL INSPECTIONS REQUIRED: Special inspections are required for this project, as
applicable, in accordance with Title 18 Edmonds Community Development Code (ECDC). When
required, the project must be installed/constructed per approved plans and specifications. The owner or
the registered design professional in charge shall employ an independent testing/inspection agency/special
inspector to perform required special inspections. The special inspector shall be a qualified person with
competence for inspecting the specific type of construction or operation requiring special inspection. The
owner, registered professional, contractor and special inspector/agency shall provide a special inspection
report detailing compliance with approved plans and specifications directly to the Engineering Division.
WORK REQURING SPECIAL INSPECTION: Special inspections will be required for the following
categories of work: FOR SPECIFIC INFORMATION REGARDING REQUIRED SPECIAL
INSPECTIONS SEE THE STATEMENT OF SPECIAL INSPECTION NOTED AS A CONDITION ON
THE BUILDING PERMIT AND/OR ON THE APPROVED PLANS.
® Turf subgrade
® Erosion and Sediment Control
® Stormwater Treatment System Installation
BEFORE A PERMIT CAN BE ISSUED: The owner and contractor and special inspector shall
complete this agreement and return to a Permit Coordinator prior to permit issuance.
APPROVAL OF SPECIAL INSPECTORS: Each special inspector shall be approved by the
Engineering Division prior to performing any duties or inspections. The credentials of the specific person
performing the inspection shall be submitted. When applicable, the company performing inspections
must be accredited by the American Association of State Highway and Transportation Officials
(AASHTO) R 18.
The special inspector shall observe the site work for conformance with the approved (stamped)
plans and specifications. Special inspections are to be performed as needed, to confirm that the
work being completed meets specifications and approved plans.
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2. REPORT NONCONFORMING ITEMS
The special inspector shall bring non -conforming items to the immediate attention of the
contractor and engineer of record. The special inspector shall provide a report to the Engineering
Division notifying of any items not resolved and/or not installed per the approved plans and
specifications.
Items not constructed per the approved plans and specifications will result in a review of the plans
to determine what requirements will be needed for the project to meet the necessary stormwater
requirements; such as removal and reconstruction, re -design of the stormwater management
system(s), etc.
Final approval for the project will not occur until installation of all required improvements is
complete and accepted by the Special Inspector and the City.
3. FINAL CONSTRUCTION REPORT
The special inspector or inspection agency shall submit a final signed report or Certificate of
Compliance to the City stating that all items requiring special inspection and testing were fulfilled
and reported. The report shall also include a statement from the inspector stating to the best of
his/her knowledge the project is in conformance with the approved plans, specifications, and
approved plan revisions, if any. Items not in conformance, unresolved items or any discrepancies
in inspection coverage (i.e., missed inspections, periodic inspection when continuous inspections
were required, etc.) shall be specifically addressed in this report.
B. Contractor Responsibilities
1. NOTIFY THE SPECIAL INSPECTOR OF ALL REQUIRED SPECIAL INSPECTIONS
It is the duty of the contractor to notify the special inspector when work is ready for special
inspection. Note, the items listed under the statement of special inspection on the building permit
and as noted on the approved plans and specifications are required to have special inspections.
Adequate notice shall be provided by the contractor so that the special inspector has time to
become familiar with the project. All work requiring special inspection must be approved prior to
concealing or covering said work.
2. PROVIDE ACCESS TO APPROVED PLANS
The contractor is responsible for providing the special inspector access to approved plans at the
jobsite.
3. RETAIN SPECIAL INSPECTION RECORDS
The contractor is responsible to retain at the jobsite all special inspection records submitted by the
special inspector. These records are to be provided to the City Engineering inspector upon request
and upon completion of work.
C. City of Edmonds Engineering Division Responsibilities
1. APPROVE SPECIAL INSPECTION
The Engineering Division shall approve all Special Inspectors and special inspection requirements.
2. MONITOR SPECIAL INSPECTIONS AND APPROVE REPORTS
Work requiring special inspection and performance of special inspectors shall be monitored by the
Engineering Division Inspector. Engineering Inspector approval must be obtained prior to
placement of concrete or other similar activities in addition to that of the special inspector.
3. FINAL APPROVAL
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The Engineering Division may provide final inspection approval after the special inspection
report(s) have been submitted and accepted by the City,
D. Qwney� e. onsibilities
L The project owner or the engineer or architect of record acting as the owner's agent shall fund
special inspection services.
E. Lujg:wLej:±rAnhitect of Record fities
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1. Prepare Statement of Special Inspections,
2, Review the special inspection reports and provide corrective action ffir work that may not conforni
to the approved plans.
ACKNOWLEDGEMENTS
1have read and agree to comi)ly with lite teiwis and conefiflons of'11ily agreeinent
Owner name EdmondsScholm District Matt Finch
Date 5.21.15
General Contractor Company/Owner name,
M
Sigllalure,
Date ",N
Special Inspector/Agency name --Aeak.,&
(piea.qL print or type)
Si
Date
gluxtur L
Engineer OfIlecord JIHIII aviAnderson
(plemse print or type)
Signature Date, 5.21-15
Return the original signed agreeknent to:
City of Edmouds Development Services Departinent
1215"1 Avenue North, City Hall Second Floor
Edmands, 'WA 98020
ACCEP,rED:ll Y CITY OF EDMOND,$ EN
Imam=
um
DIVISION,
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