0652_001.pdfqp EUMo SPECIAL INSPECTION AND TESTING AGREEMENT
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Permit #: BLD2018-0576
Project: $lO Upton ST SFk_$IruGiurAl
Prior to. issuance of erperm!!, Mk form must be completed In its entirely and returned to the LYty for
approval. The completed form must have signatures of acknowledgment by all parties.
DUTIES AND RESPONSIBILITIES
Smeclal Insuecllon Firm and Sneclol Inemeetou;
The Special Inspection firm of _ 0116 R o S vu 1 � A-t s a t;tg."rf r
will perform special inspection for the following types of work (separate forms must be submitted Ifmore than
one firm is to be employed):
® Structural Masonry
® Other. Epoxy Anchors
All Individual inspectors to be employed on this project will be WABO certified for the type ofwork they are to
inspect. If inspection is for work that is not covered by the WABO categories, or the inspector is not WABO
cerdfied, a detailed resume of the Inspector and firm must be submitted. The resume must show that the Inspector
and the firm are qualified by education and experience to perform the work and testing required by the project
design and specifications.
The work shall be inspected for conformance with the plans and specifications approved by the City. Revisions
and addenda sheets will not be used for inspection, unless they have been approved by the City. Inspection
records shell include:
• A dolly record to be maintained on site, itemizing the Inspections performed. Any nonconforming work
shall be brought to the Immediate attention of the contractor for resolution.
• A weekly report shall be submitted to the City; detailing the Inspections and testing performed, listing any
nonconforming work and resolution of nonconforming items.
• A final report shall be submitted to the building department prior to the Certificate of Occupancy being
Issued. This report will indicate that inspection and testing was completed In conformance with the
approved plans, specifications and approved revisions or addenda. Any unresolved discrepancies must be
detailed in the Mal report
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The contractor shall provide the special Inspector or agency adequate notification ofwork requiring inspection.
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Special Imp Agreaoenl.doWI Sa01 g
The City approvad plan and specifications must be made available, at the jobalte for the use of the epedal
Inspector and the City Itlapcctor, The contractor shall maintain all daily inspection reports, on site, for review by
all parties.
The special bnspcc:ion functions are considered to be in addition to the normal ImspeeNons performed by the City
and the contractor is responsible for contacting the City to schedule regular inspections. No concrete shall be
poured or other work covered until approval is given by the City inspector.
Bulldlna Denariment:
The building department shell review any revisions and addenda. Ilia City Inspector will mordtor the special
inspection functions for compliance with the agreement and the approved plans. The City inspector shall be
responsible for approving various stages ofconstruction to be covered and for work to proceed.
The architect and/or engineer will clearly Indicate on the plans and specifications the speclfle types of special
inspection required and shell Include a schedule for Inspection and testing. The architect and/or engineer will
coordinate their revision and addenda process in such a way as to ensure that all required City approvals ere
obtained, prior to work shown on the revisions being performed in the field.
The project owner, or the architect or cnglneer acting as the owners agent, shall employ the special Inspector or
ENFORCEMENT
A fallure of the special Inspector or firm to perform in keeping with the requirements of the IBC, the approved
plans and this document, may void this agreement and the Building Offielel's approval of the special Inspector.
In such a race a new apaclal Inspector end/or turn would reed to be proposed for approval. A (allure of the
design and/or construction parties to perform In accordance with this agreement may result In it STOP WORK
notice being posted on the project until nonconforming Itams have been resolved.
ACKNOWLEDGMENTS
1 have read and agree to comply with the terns and conditions of�`-th�is agreement.
Owner. •'tit • •N+��r. Signature j:r .•�I = ^ Data JILlr
Contracfor:_�y� Signahue j (/q�,��yq Dne:s
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ArchlEng:_ Cornell Burt Signature 61f�1A Date:
Special Insp. SG ati &_Signatura_ &A Date: t? I A
Special Insp. Agency &fh Rajey-as,. f 4-e'feerw+u
ACCEPTED FOR THE QTY OF EDMONDS BUILDING DIVISION
By: Date:
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