SIGNED SPECIAL INSP AGREEMENT.pdfoy
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4, 'ITY OF0,J)MONDS ---, ENG11\11
SPE(-,'.HA1,, RPff."&ECTION AT1,11)ITSUNG AGREEIMHENT"
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PERMIT # BLD20140074 D.ATE"__ Jung 13 2L
PR03ECT S11 ADDRESS- moro 130 7 nd Ave Ec,!LiA2ac!�
YR,OJECTNAAff. Edmonds 2021', Post 0ffi.DC'Vc!9
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SPECIALll' SPECTIONAGENCY
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*0ne form must be Complete([ by eaelh Special lnsj�e-c—flonAge-;C" r----iH-5W(TC-10r . . . ...
SPECIAL INSPIII" crioi�iS REQUTRLEDw Special inspections are required f0r this project, as
applicable, in accordance with Title, '18 Edmonds Community Development Code (Et. DC), When
rucluircd, the yA-ojecr must be installed/constructcd per approved plans and specificat 0 nex I
_iolls. I,jl.e W . - 0,
the registered desitpa professional in chargeshall cinploy an independent testing/inspection agency/special
inspector to perforin required special inspections. '1110 special inspector shall be a qualified person wid)
conipetence. for inspecting the spccific type of consh-urtion or operation rcquiring special inspection. The
owner, registered professional, mutractor and special inspector/agency Shall provide a special inspection
report detailing compliance With approved pilaris and specificztions directly to the Engineering Division.
WORK, REQill: UNG SPE, "IAL INSPECTION, Special inspections will be required for the following
(�atcgories of work related to construction of tile temporary shoring system: FOR SPECIFIC
INFORMATION REGARDING REQU11ZED SPECIAL INSPECTIONS SEI FHESTA' -ME OF
1'E, 'NT
SPECIAL INSPECTION NOTED AS A CONDITION ON THE BUILDING PEI IT AND/OR ON
THE APPROVED PLANS,
Pile drilling/driving
Tichaeldsoil mail drilling and testing
Lagging installation
BEFORE' A PERMIT CAN BE ISSUED: The owner and contractor and special inspector shall
complete this agreement and retum to a Permit Coordinator prior to permit issuance,
APPROVAL OF SPECIAL INSPECTORS: Each special illspector shall be approved by the
Engineering Division prior to perf-brming any duties or inspection,,,-. The credentials of the specific persou
perfoi-ming the inspection shall be submitted. Wien applicable, the corapany performing inspections
must be accredited by the American Association of State FjighNyay and Transportation Officiafs
(AAST-ITO) F.1 S
A. Duties and
The special inspector shall observe the site work for conformance with the approved (stamped)
plans and specifications. Special inspections arc to be performed as needed, to confirm that the
work being completed meets specifications and approved plans.
The special inspector shall bring non-confonning items to the i nmediate 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, redesign of the stormwater management
system(s), etc.
Final approval for the project will not occur until installation of an required improvements is
complete and accepted by the Special Inspector and the City.
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.
Ba 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 sWeament 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 PIANS
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. 91Y of Edmonds F I. i nDivisionResRonsibjHties
1. "PROVE
The Enginoming Divisionshallapprove
(quirem]
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2. MON11'OR SPEC"IAL, 1"N'SPECTIONS kNf) APPROVIEPREPORTS
WOFIC ITAJUififk� SPC4,ial 411,,rwotion and per fc)rxru,:w cc ofSPecial inspe(Aors shall t,�e rnoakoi-c-d by the
Engineering Division 1nspcct0r- J, 1011cering k1spector appEoval ffnIst be (,)btained pfiol- to
Placement of rx)rlcrete or Whet- Similaractivities in uldition to that of 1he special inspecLor.
3. FrNAL APPROVAL
The Engineering Division irtay provide, final �ispccfioll tPP1-0VRJ Wlef' 010 sPecial inspection
report(s) have been submit-terl aud acc�,pjed by the City.
A Owner Resp 'bilit
2n%A les
1. Theproject owneror the engincer orarchitect ofrecord acting as th(, owner's agelitM1,111 fund
,Ppccial inspeotion services.
El&gi:ne��iqr Architect of Record..11Espolk 11fies
1.Pi-cpan-,'Statement of pcciaj drys peo'oj)-
2. Review the special inspection repotis zu)d provide oorrective action fbrwork that tnay not conform
to the approved plans,
ACKN0WLE1xk'%ME1 NTS'
.I have, read aad a6wee to eompli, with the terins and conditions qjWdy agreemear.
Owner name
(Pluse julat or type)
I Tk
(-- - Date
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General Contractor C0w" 1nPany/ow(z
(plea"ont or type)
Signature
Date
Special Inspector/ Agerre y name -19, ?A2`A-AJ t+ -1153S Cr-yAf:(L'
Signate
Rt Z>, D
ate
A4 Cy, con.
Euglueer of Record name
(Plutt PArint or rape)
WmmSignature
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Rettum the wiginal. signexi agrv,,eiaresat to:
It ofEdmouds Development Serviceg Dertm,ellt
121 5k Avenue Norlb, City UHIJ Second Floor
Edmonds, WA 9802.0
ACCEFTED BY CITY OF EDMONDS LINGINEER]ING DIVISION:
City officlal slgnfttuie
6, ate
Me:
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