20140416094150344.pdfcu
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Penn't I/ BID 2014-0143
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IT/or brksumm/»/a pei-iiiii,&hisfiiwimoist be coitipleled hi Usmiilire�p aiid i*ehiviyed to the Qyft)y'
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E0MIES/&ND RESPONSIBILITIES ,� �n �
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TbuSpuoio|luupoo(ioo�nuof Special
inspection for the RAlowing types of work (separate forms mug be submitted if more than one firm is to be
_inI,6co Concrete
Hnhin6 in Conortsio
_yrest rtyaodConcrete
_
Structural Masonry
___SbnuNru| Steel/Welding
--l-ligh Bolting
Spray applied Fireproofing
Immal Wood
SkudomlOb#nationbydeign mnAmsiono|
__ _
0/odioe/moi|u
_
urn�r
Other
All individual inspectors to be employed on this pinj*/xvviU be VV&D0otdiOcd for the iypoofvvorkLhov o,* to
inspect- If inspection in for work that is not covered by the VY/\BO oa1uQnriou` or die iuopc*hur is not YV/\B0
ccdiNod,odo{ai|udresume ofthninspector andfirm must bunnhnoiUod. The ro:ummmuo(show that 1ho
inspector and the Dnn are qualified by education and experience to p*rhonn the "ark and testing required by the
prqject design and specifications.
The work ahuU be inspected kxuonfbrmmux with dbu plans and upecitoa|iona approved by the City, Revisions
and w1dwida Owds will W be used Rw inspection, infless they have been approved by the City. Inspection
rocmdushall include:
/\ daily record to be maiui bux ou site i<emidugdbo inspections performed. Any nonconforming work
oboU be broud)t0o to imuuodiu[ouUcudou ofthocoutraotorfor resolution.
/\wooNyrcpodmhoUbosubmitodto(hoCi<y;detaiUogibcinxpcc(innaaud1cyiingporfbrmcJ,|iadnt",,
any nonconforming work and resolution ofnoncoufb/miugituma,
/\ final report shall be submitted to We huiNiugdopudn un1 prior {othe Codibou|uofOccupancy being
issued. This report will indicate that iuupcoiioo and testing was cuuop|ohod in uool'onnnoucvvitb tbo
oppcovody|un:,specihoa1iooaand approved revisions orWWI- Any unresolved discrepancies must
Contractor,
TFI—ec—oi-it"T'a-c-tor shall provide the special inspector or agency adequate notification of work requiring inspection,
`File City approved plan and specifications must be made available, at the jobsitc for the use of tic special
inspector and the City inspector. T'he contractor shall maintain all daily inspection reports, oil site, for review by
all parties,
The special inspection functions are considered to be ill addition to the normal inspections porfornied by the City
all(] 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.
!I! Lfl�jklg I!.
q?tm ,qLen ' t:
The building depailment shall review any revisions and addenda. T'he City inspector will monitor the special
inspection functions for cornpliance with the agreerrient and the approved plans. The City inspector shall be
responsible For approving variouSSI-AgCS Of COMARICtiOn to be covered and for work to proceed.
De, 11 . sionals:
�jg_
Tiie architect and/or trig incen- will clearly indicate on the plans and specifications tile specific types; ofspecial
inspection required and shall inclUoic a schedule for inspection and testing. 'file architect and/or engineer will
coordinate their revision and addenda process in such a way as to ensure that all required City approvals are
obtained, prior to work shown on the revisions being perfori-ned in the field.
ownel.:
........... . I--
`File project owner, or the architect or engincer acting as the owners agent, shall erriploy the special inspector or
agenq.
ENFORCEMENT
A failure of the special inspector or firrn to perform in keeping with the requirements of the IBC, the approved
plans and this dOCUITIOnt, III-cly Void this agreement and the Building Official's approval of the special inspector,
In such a ease a new special inspector and/or firrn Nvould need to be proposed for approval. A failure of the
design and/or construction parties to perform in accordance with this agreement may I'Mllt in a STOP WORK
notice being posted oil the project until nonconforming items have been resolved.
ACKNOWLEDGMENT'S
f have read and agree, to comply with the terms and conditions of this agreement.
:1
Owner: ---------mm Date
Contractor: Date:
----------
Arch,/Eng: Sif,)n8tUr0__._ Date:
Special Insp.. Date:
Special Insp. Agency
ACCETTE,14 Ury) OF ]-,DMONDS BUILDING DDT .
"A/Date:
By:
CAI, Jsers\1).jorl)i(,k\Desktol)\Btti I ding New Folkr 201(W0"1IS\Spe(,LaI inspection form.dod/21/2014
Conti -actor:
The contractor shall provide the special inspector or agency adequate notification of work requiring inspection.
The City approved plan and specifications must be made available, at the jobsite for the use of the special
inspector and the City inspector. The contractor shall maintain all daily inspection reports, on site, for review by
all parties.
The special inspection functions are considered to be in addition to the normal inspections 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.
BuildinLDe jLartment-
_
The building department shall review any revisions and addenda, The City inspector will monitor the special
inspection functions for compliance with the agreement and the approved plans, The City inspector shall be
responsible for approving various stages of construction to be covered and for work to proceed.
Design (Professionals:
The architect and/or engineer will clearly indicate on the plans and specifications the specific types of special
inspection required and shall 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 are
obtained, prior to work shown on the revisions being performed in the field.
Owner:
The project owner, or the architect or engineer acting as the owners agent, shall employ the special inspector or
agency.
EW4 ORCEME NT
A failure 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 Official's approval of the special inspector.
In such a case a new special inspector and/or firm would need to be proposed for approval. A failure of the
design and/or construction parties to perform in accordance with this agreement may result in a STOP WORK
notice being posted on the project until nonconforming items have been resolved.
ACKNOWLEDGMENTS
I have read and agree to comply with the terms and conditions of this agreement,
Owner:
Contractor:
Signature
Signature,
Arch./Eng: ---Signature
Date
Date:
e
J"
Special Wsp.11-,� Signature- ", Date: 4"
Special Insp. Agency 0",� "see
ACCEPT FOR. THE CITY OF EDMONDS BUILDING DEPT. t,A
By: Date:
C:\Users\bjorbool�\Dcsktop\Btii[diiig New Foldej-201fforms\Special inspection forndod/2 I J2014
Contractor.:
The contractor shall provide the special inspector or agency adequate notification of work requil'ing inspection.
The City approved plan and specifications must be made available, at thojobsite for the use of the special
inspector and the City inspector. The contractor shall maintain all daily inspection reports, oil site, for review by
all parties.
The special inspection functions are considered to be in addition to the normal inspections performed by the City
and the contractor is responsible for contacting the City to schedule regular inspections. No concrete shall be
POLIM(l or other work covered until approval is given by the City inspector.
1 Lu Lldiqg Department:
The building department shall review any revisions and addenda, The City inspector will monitor the special
inspection functions for compliance with the agreement and the approved plans. The City inspector shall be
responsible for approving Val-iOLIs stages of construction to be covered and for work to proceed.
Design Pmfe,ssionals:
The architect and/or engineer will clearly indicate oil the plans and specifications the specific types of special
inspection required and shall include a selledule 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 are
obtained, prior to work shown on the revisions being performed in the field,
Owner:
The project owner, or the architect or engincer acting as the owners agent, shall employ the special inspector or
agency.
ENFORCEMENT
A failure of the special inspector or firm to perform it) keeping with the requirements of the IBC, the approved
plans and this document, may void this agreement and the Building Official's approval of the special inspector,
In such a case a new special inspector and/or firm would need to be proposed for approval. A failure of the
design and/or construction parties to perform in accordance with this agreement may result in a STOP WORK,
notice being posted on the pro.ject until nonconforming items have been resolved.
ACKNOWLEDGMENTS
I have read and agree to comply with tire terms and conditions of this agreement,
Owner:
Signature
Contractor: Signature
Arch./Elig:
Special Insp,
Special Insp. Agency
Signature.
Signature
I f
ACCEPI rEF'� OR. TFIE C F EDMONDS BUILDING DEPT,
By: A Date:
.... . . ....
(,':\IJsei-s\t)joi-I),,ick\Dcslctol)\Btii I (I ing New Folder 201 (IForniM I) :vial inspection forn 1. (106/2 1/2014
Date
Date:
late:
Date:
Coa-fi-!Ltar 4:-:
' ire "clurti-ador Aiall pmviclu Me x"chd impmun- or agmwy, admItinte nodfiCaJjicaj requiring aisp=tion,
Tic C!, appixwed plan arml specilIndons rim be nuirle WNW, at thejoWim Or be use orme spessi
Inspeckii, and the (.Jty ims'poctol'. The ccol(ractor shall Inaim"ain IIH daily insptclifll) reportS5 orl site, for reviovi lay
au lirinks,
The sjwcial insla"dion finwtions are considered to be in addition to th nonnal inspedians rwOrtned by the Chy
and the ocliarmor is resplotiqUe hm cmincliq die City a) mledule mgWwr impeedmu, No ammse rile H be,
poumd or adwr work, covered unlil upproval is given 11; the Cky hispector,
1-31(ilditw—D wntwjn.,
'Mc bWWhWdqanmwH AmH Wen,wiy mWons and addenda, 'Die City inWectorwHI monkor Tespmhll
Spohn Rmohns for complAnce with Mv nWvmwnf;urJ the apluinS phum Thu Chy impedor AN be
rupixishk Rw ;ipproving vowkis siagus uf construction to be. covered and Ar i"A to proueed,
Ilaea w,chn.co and/or unt""hwer will (.1cady AW&W on the p1mis and wednemsis uw s"we Yp" ul-wemi
hisprction required and shall indude as KKK Aw hs"Akm mid Wing, Ae uruhima ariAlur engineer mdll
WOrdinale dicir rcvidon and allmou PMUMS W Mich as wVay as to ensure threat: ak required city 'approv"'lls acre;
oliWined, pric)r 10 v,mr1r, Mmwn on Me mvisions bdng P;TvmNHn be W,
Qla!mna
he pr(.aje'c( owner,, or the archheef or engineer acdng as the owners ngull(, sholl 1.',Illllll)Y (lit', sp(xiill inspector or
ngerwy,
F:NFORCEMENT
A III= of We spW hisy=Aar Hnn to pedbnu in Wwong MTh tile OJQ 4ll)Pi-oV0,d
pinns and this l.4.)ctnnCnL =W void this agreernwit and dw Widn (Houirs amovniof to wedw hIRPMrr.
In Such a u1se as neev special invmW awor Wri wwdd need M he lireposed fear approval, A thHure ofthe
dwign mWkr corisumabn pnnhs k) perhvni in accordance with 11aas, asgrccnjcnr unay r"uh an as SUHI WRK,
itudco hOng pasned on to lama CO Until nonconAnnhig it have been ivsolv&
I have mad and agme U"ompo "A IlAdams mid cmWitions (qMis agrecirinit.,
(iWilet ,4
vf --signature -,,lk' )atc,
Cofflra'ictol (Yarn:
Arch,/hang: -1-1 11 - .- .. . ..... . . Sipimurg,
S'pecial Date:
Insp. Apen(:,,y - 11
'OR 111E (ATY ( F FJ)[%40T\1l)S HIALIANG DEP F,
By: Date:
( Acw Vwd(�;