20170926155129.pdfS e ��T. 6 ( ?_0 I r�
(0' L 1) 11fr). SPECIAL INSPECTION AND TESTING AGREEMENT
J.
Permit#: BLD2017-0549
Project: 742 Daley ST VV'P-J-
Prior to issuance of a permit, thisform must be completed in its entirety and returned to the Cityfor
approval. The completedform must have signatures of acknowledgment by allparties.
DUTIES AND RESPONSIBILITIES
Special Inspection Firm and Special Inspectors:
The Special Inspection firm of k M 0 Ce
will perform special inspection for the following types of work (separate forms must be, submitted if more than
one firm is to be employed): COMIPLr V-( 6FOTEC4. KE-Qm-r-s
Alllt-�-OQF-h PLAIJs AtiK co Ero -r 157e H
0 Reinforced Concrete Spray applied Fireproofing
IN - -a a- (i e, tf
0 Bolting in Concrete Smoke Control Systems CT. Xr, 9-
0 Prestressed Concrete E3 Lateral Wood Poer'
.4 E:e A 0 1Z
0 Shotcrete Structural Observation by design professional
0 Structural Masonry Grading/soils FO T15C 4 �J t c A L�
1:1 Structural Steel/Welding ElOther: [Typetextl G�)CeAVA-T(;�)
1:1 High Strength Bolting El Other: [Type text I S kk () k' �J (:;;'
-'50tL' EGW-L(M'!:�
-tkA(Nhe!�Ej
All individual inspectors to be employed on this project will be WABO certified for the type of work they arc to
inspect. If inspection is for work that is not covered by the WABO categories, or the inspector is not WABO
certified, 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 perforrn the work and testing required by the project
design and specifications.
The work shall be inspected for confonnance 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
re or shall include:
7
70 A daily 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.
A5a��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 final report.
C:\Users\kcntd\AppData\Local\Packageq\rnicrosoift-windowscommunicationsapp"wckyb3d8bbwe\Loca]StateTiles\SO\I 1922\BLD2017-0549
Special Inspection forTn[2305843009217436035].doc9/6/2017
Contractor:
The contractor shall provide the special inspector or agency adequate notification of work requiring inspection.
The City appro r 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 conticting the City to schedule regular inspections. No concrete shall be
Im
poured or other work covered until approval is given by the City inspector.
Buildinp Department:
The building department shall review any revisions and addenda. The Ciit�-- 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 andlor engineer will clearly indicate on the plans and specifications the specific types of.s.-pecial
inspection required and shall include a schedule for inspection and testing. The architect and/017 engineer will
coordinate their revi3ion and addenda process in such a -,vav as to ensure that all required City approvals are
obtained, prior to work shown on the revisions being performed in the field.
Ov,mer:
The project ow-ner. or the architect or engineer acting as the owners agent- shall employ thespecial inspector or
agency.
ENFORCEMEN'r
A failure of the special inspector or firm to perform in keepting with the requirements of the IBC, the approved
plans and this document, may void this agreement and the Building Official's approval ofthe special inspector.
In such a case a nevv special inspector and/or firm would need to be proposed for approval. A railure of the
design arid/or construction parties to perform in accordance with this agreement may rcsult in a STOP WORK
notice being posted on the project until nonconforrning items have been resolved.
ACKNOWLEDGMENTS
I have read and agree to comply with the terms and conditions of this agreement.
O%vner:CX-- KeniDietz___ __Signature Date — 9,'5i2Gl7
Contractor: Sig C -LIZ- Z,
n
Arch.,'Eng: Signature
E7
J 6e- r, -
Special Insp. §ignature
Special hisp. Agency
C�
% 1, 1 1
ACCFPTE 9
,�.J)fOR THE CITY OF EDMONDS BIMD[NG DIVISION
, //17
By Date:
C:�
Sti--cial faspectim fonn[23�1594-i(M9217436035].doci)i6.,2017
(v
M
Date:
�s 1::7 - !!�
Aj ANt
W"
t?
EFO T'6 e
f 4451pe
-r tz, 74,
0--?