20170530142848.pdf\v: V i)
TING AGREEMENT
SPECIAL INSPECTION AND TES
Permit #: BLD2017-0496
Projeet: _1015 12"' AVE N EDMONDS.WA 98020
Prior to issuance. of a permit, ihisform must be completed in Us entirety and retarned to the Chyfor
approval. Tike completedform must have signatures. of acknowledgment by all parties.
J)UTIES AND RESPONSID111TIES
Snecial lasoection Firm and Siveciall Inspectors:
The Special Inspection firm Of aAln �')fk_zec XA99Q2��ill Letform Special
inspectionfor the following types of work (sepaTate forms Must be submitted if more than one firm is to be
employed):
_X —Bolting in Concrete
—X—Structural Observation by design professional
_X_Grad.ing/soils
X Structural Steel/Welding
All individual inspectors to,be employed on this project will be WABO certified for the type of work they are to
inspect. If inspection is for work that is hot covered by the WABO categories, or the Inspector is not WABO
�ertified, a detailed resurneof the inspector and firm must be Submitted, The resume must show that the
.inspector qftd . the, firin art qualified by.educaticiii and experienct to�petform the work and testing required by the
project design and Specifications.
Th6 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 havc� been. approved by the City. inspection
records shall include,,
A daily record to be maintained on site, itemizing the inspections peeformed. Any nonconforming work
shall be ught to the immediate attention of the contractor for resolution.
,, bro
s A weekly re ort shallbe submitted to the City; detailing the inspections and testing performed, list'
F Ing
any nonconforming work and resolution of nonconforming items.
A final report shall be submitted to the building department prior to the CertificatiD of Occupancy being
is,sued, This report will Indicate that inspeotion and testing was completed in conformance with the
approved plans, specifications and approved revisions or addenda-. Any unresolved discre ancies must
p
be detailed in the final report.
Contractor:
The contractor shall provide the special inspector or agency adequate notification of work requiring inspection.
d:kljsdts\mbaile)AAppDala\Local\MicrosoftkWindows\Tcmpormy Wernet Files\Content.Outlook\OWNW4rn'I\SpeciaI Inspection fbnn
BLD2017-0496.dodh/2017
The City approved plan and specifications must be made available, at the Jobsite for the use of the special
in.s toy. The contractor shall maintain all daily inspection reports, on site, for review by
, pector and the City insper
all parties.
The special inspection functions are considered to be in addition to the normal inspections performed by thp City
and the contractor is responsible , for contacting the City to schedule reguilar inspections. No concrete shal I be
poured or other work covered until approval is given by the City inspector.
Building Degartment:
The building department shall review any revisions and addenda. The City. inspector will monitor the special
inspection functions for com lans. The City inspector shall be
pliance with the agreement and the approved p
responsible for approving various stages of construction to be covered and for work to proceed.
Desiom Professionals -
The architect and/or engineer will clearly indicate on the plus 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 revis I on 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 agen4 shall employ the special inspector or
agency.
ENFORCEMENT
A failure, of the special inspector or firm to perform in keeping with the require.i.bents of the IBC, the approved
plans and this docuinenti may void this agreement and the Building Official's approval (if 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
des . ign 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 agareement.
Owner: 1AA4* A -------,Signature Date
I
1W4AVW\( etteym.-rwl
Contractor, w1ccliv..A. 1�01 A Signature Datej-i--i7
%
Arch./Eng: WICAVS-S Signature Date:
Special Insp. %) A2-f Signatu
Special Insp. Agency
ACCE PT F r, HE CITY OF EDMONDS BUILDING DEPT.
By: Date:4
CtlUscrs\mbiiiloy\AppData\LopaiNicrosoft\Windows\Temporary Interna Files\Con(ent.Outloc)k�OMNW4TTI\SpeoiaI inspection form
BLD2017.0496.60/1/2017