20180806150610.pdfSPECIAL INSPECTION AT\{D TESTING AGREEMENT
Permit #: BLD201 8-0946
Project: SternDeckAddition
príor to lssuance of a permlt, this form must be completed tn lts entlreþ and returned to the Cíty Íor
approval. The compleredfoim mist høve sígnatures of acknowledgment by all parties'
DUTIES A}ID RESPONSIBILITIES
Soecial Insnection Eirm and Snecia! Inspectors:
The Special InsPection firm
for the followi ng types of work (seParate forms must be submitted if more thanwill perform special insPection
one firm is to be emPloYed):
-Reinforced
Concrete
_Bolting in Concrete
Prestressed Concrete
_ Shotcrete
Structural Masonry
-Spray
applied FireProofing
-Smoke
Control SYstems
LateralWood
(6 eNçWæ.tpf + -X-structural observation by desígn professional
þf.wts 1ØrqtlPt fit-
-Gtading/soils\Þ-X-Other
-Pipe Pil i ng I nstal lation
-structural
Steel/Welding
-High
Strength Bolting Other
All individual inspectors to be ernployed on this project will be ï/ABo certified for the type of work they are to
inrp."t. If inspeciion is for work that is not covered by the 1ù/ABO categories, or the inspector is not WABO
.".t¡fìrd, a detailed resume of the inspector and fìrm must be submitted, The resume must show that the inspector
*J tnr ti* *r qualified by educatión 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 specifrcations approved by the City. Revisions
and addenda sheets will not be used for inspection, unless they have been approved by the City. Inspection
records shall include:
o A daily rccord to be maintained on site, itemizing the inspections performed. Any nonconforming work
shall be brought to the immediate attention of the contractor for resolution'
o A weekly reporl shall be submitted to the City; detailing the inspections and testing performed, listing any
nonconforming work and resolution of nonconforming items.
o A fînal report shall be submitted to the building department prior to the Certificate of Occupancy being
issued. T-his report will indicate that inspection and testing was completed in conformance with the
$EDMSVR-Ðgprf S\lBuild ing\Handouts
Inspection Agre€ment.docTnól2o1 I
lnformation by chuck\plan rcvicuÀcommenls - Buildíng Division rcvicws\2Q18{946 spccial
ffi',"rshallprovidethespecialinspectororagency{e-quatenotiflcationofworkrequiringinspection.
The city approved ptan ana specificationt inuriur mide aïailauie, at the jobsite for the use of the special
inspector and the city inspector. The ,ontru.t*,t arimaintain ail daily iñspection reports, on site, for revierv by
all parties.
The special inspection functions are considered to be in addition to the normal inspections performed by the city
and the contractor i, t"rpãnriuiã ior contact¡ng thr city to schedule regular inspections. No concrete shall be
;ilã oi otttrr work covered until approval is given by the City inspector'
Bulldins lrenartment:
The building departmåt shall review any revisions and addenda. The city-inspector will monitor the special
inspection fllnctions ror.o'opr¡*ce rvitú the agreement and the approved plans. The city inspector shall be
responsible for approvin;#i*" ti"ges of coñstruction to be covered and for wolk to proceed'
Design Profe$iongls: i --- r -.^-^:¡:^^4:^-^ +L^ -^-¡i,
The architect andior eågineer will clearly indicate on the plans and specifications the.specific types of special.
inspecrion required andîail include u r.tt"¿oir ror inspettion and tãsting. The architect andlor engineer wìll
coordinate their revision and addenda process in such a way ar to ensure that all required city approvals are
obtained, prior to work shown on the revisions being performed in the field'
ûwner:
The project owner, of the architect or engineer acting as the owners agent, shall employ the special inspector or
agency.
ENFORCEMENT
A failure of the special inspector or firm to perform in keeping with the requirements of the IBC, the approved
piun, *d this document, may void this agrãement and the Building ofücial's approval of the special inspector'
In such a case u n** rprtiul inspector unÚo, frrm rvould need to bè proposed for approval' A failure ofthe
design and/or constructi;; parties to perform in accordance rvith this agreement may result in a sToP woRK
noiiãe Ueing posted on the project uniil nonconforming items have been resolved.
ACKNOWLEDGMENTS
I have read and agree to comply with the terms and conditions of this agreement'
approved plans, specifrcations and approved revisions or addenda. Any unresolved discrepancies must be
detailed in the final rePort.
L-out" F- 7-2ù lY
Date:
0wner:
Contractor:
¡r"n.nn$d åGále'ræäilJe s rrnu*r" frlM M Date
Date:
-
Special
Special Insp,
ACCEPTED FOR THE CITY OF EDMONDS BUILDTNG DIVISION
By Date:
\\ËDMSVR-DEP{FS\Buildingwandours tnformorion by Chuckþlan rcviewkommcnts - Building Division revie\¡s\2o18'0946 Special
lnspection Agreement.docT26l201 8
SPECIAL INSPECTION AND TESTING AGREEMENT
Permit
ProJccfi Stem Deck Addition
Príor to lssaønce of ø permlt, thls form must be complelcd ln its entlreE snú ¡eturneú to the Clg foF
appruvaL The conpletedþrm mast høw slgnotures of øcknowledgnent by aII paflíes,
DTTTIES AIìTD RESPONSIBILITIES
Sncçial Inspection Film rnd,Special h¡snectors:
The Special lnspcction firm of
will perform special inspection
one fi¡m is to be employcd):
for thc following types of wor{c (separaæ forms rm¡st be
NE
if more
-ReinforcÊd
Concrste
Bolting in Concrete
_Prestressed Concretc
Shotcrcte
Struch¡ral Masonry
_Structural Stæl^Yelding
_High Stnength Bolting
, Spray appltd Fireproofing
_Smoke Control Systems
L¡teral Wood
-X-Stn¡ctural Observation by design professional
_Grading/soils
_X_Other -Pipe Piling Instsllation
Other
All individual inspcctors to be employcd on this projcct will be ïùABO cctificd for the type ofwork they are to
inspect. If inspection is forwork that is not covered by the WABO categorics, orthe inspcctor is not WABO
certified, a detailed resume of the inspector and firm must be Bubmitted. The !ìesume 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 inspecæd for conformance with the plans and specifications approved by tfte City. Revisions
and addenda sheens will not be used for inspection, unless they have been approved by the City. Inspection
records shall include;
r A daily record to be maintained on site, itemizing thc inspections performed. Any nonconforming work
shall be brought to the immediate attention ofthe contractor for resolution.
r A weekly report shall be submitted to the Cþ; detailing the inspections and testing performed, listing any
nonconforming work and resolution of nonconforming items.
o A final report shall be submitted to the building department prior to the Certifìc¡te of Occupancy being
issued. This report will indicate that inspection and testing was completed in conformance with the
\\EDMSvR-DEPITS\B$ildirUlH¡ndor¡E Inbrma$on by Ctuc*þan rcvicr'Âoomnents- Build¡ngDvirion rcvicrvs\2018-0946 Spæiol
Inspection AgrcementdocTl26¿01 I
approvd plans, specificat¡ons and approved revisions or addenda. Any unresolved discrepancies must be
deùailcd in the final rcport.
Contreetor:
The contractor shall provide the special inspector or agsncy adequaûe norification of work re.quiring inspection.
The City approved plan and spociffcations must bG rnade available, at the jobsite for the use of úe special
inspector and the City inspector, The conbactor shall maintain all daily inspection reFoß, on sitc, for review by
all parties.
The special inspection fi¡nctions are considcred ûo bc in addition to the normal inspections pcrformed by the City
and the contaaotor is responsible for contacting the City to schedule regular inspeotions. No conc¡cte shall be
poured or other work covered until appmval is given by the Cþ inspecor.
Buildi¡¡ Dcnartmcnt:
The building departnent shall review any revisions and addenda The City inspector will monitor the special
inspection ñ¡nctions for compliance with the agreement and thc approved plans. The City inspector shatl bc
responsible for approving various stages ofconstuction to be covered and for work to proceed.
Deeiqn ProfÊsslon¡ls:
The architect and/or engineer will clearly indicate on tlre 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 ensurc that all required City approvats are
obtained, prior to work shown on thc rwisions being performed in the field.
Orvncr:
Thc project owrer, or the architect or cnginecr acting as the ownerc agcnt, shall employ the special inspoctor or
agency.
EI{FORCEMENT
A failure of the special inspector or firm to perform in keeping with the requirements of the IBC, the approved
plans and this dosument, may void this agrccment and the Building Official's approval of ttrc special inspector.
In such a ca¡te a new special inspector and/or fïrm would need to be proposed for approval. A failure of thc
design and/or construction pa¡ties to pcrform in accordance with this agrcement may result in a STOP 1VORK
notice being posted on the project until nonconforming items have been resolved.
ACKNOWLEDCMENTS
I h¿ve read and agree to comply with the terms and conditions of this agreement,
Owner:
Confactor:
Wtç¡té l-- W¡/
-s¡snature
Date
Date:
@ar
Date:
Special
Special Insp.
ACCEPTED FOR TI{E CITY OF EDMOI{DS BI.'ILDING DIVISION
By: Date: _
\\EDf¡¡¡VR-DEPTFS\Building\llardouclnfomrdion þ Chtrckþhn rcvicrilcommørtc- Building Divisioo r€vicrilsE0lS$gló Sæc¡¡l
Inrpcction AgrurmcntdocT/2620 1 I
Date:k- Ç- LE
SPECIAL INSPECTION AND TESTING AGREEMENT
Permit #: BLD2O1 8-0946
Project: SternDeckAddition
Prìor to íssuance of a permit, thís form must be completed ín íts entírely and retarned to the Cíty for
approval. The completedform must have sígnalures of øclcnowledgment by øll pørties.
DUTIES ANID RESPONSIBILITIES
Snecial Insnection Firm and Special Inspectors:
The Special Inspection firm of
will perform special inspection for the following types of work (separate forms must be submitted if more than
one fìrm is to be employed):
_Reinforced Concrete
Bolting in Concrete
Prestressed Concrete
_Shotcrete
_Structural Masonry
Structural Steel/Welding
_High Strength Bolting
_Spray applied Fireproofing
_Smoke Control Systems
Lateral Wood
_X_Structural Observati on by desi gn professional
_Grading/soils
_X_Other _Pipe Piling Installation
Other
All individual inspectors to be employed on this project will be V/ABO certified for the type of work they are to
inspect. If inspection is for work that is not covered by the $/ABO 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 perform the work and testing required by the project
design and specifi cations.
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 shall include:
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.
A final report shall be submitted to the building department prior to the Certifîcate of Occupancy being
issued. This report will indicate that inspection and testing was completed in conformance with the
\\EDMSVR-DEPTFS\Building\Handouts Information by Chuck\plan revíew\comments - Building Division reviewsV0l3-0946 Special
Inspection Agreement.docT /26/201 I
a
a
a
åpprovÊd plans, specificalions and approved revisions or addend¿. Any unrcsolved discrepancies must be
de¡ailed in the final rcport.
Contr¡ctorr
lhe conractor shall provide the special inspector or agency adequarc norificariön ofwork requiring inspecrion.
The Ciry approved plan and specifications must be made available. at rhe jobsite for thc ur. of th" Ipecial
inspector and the City inspector. The conffaç¡or shatl maintain all daily inspecrion repons, on site, ibr review by
all partics.
The special inspection functions are considered to be in addition rÕ the normal inspections performed by the Ciç
and lhe contractör is responsible for conncting the Ciry to schedule regular inspections. Nà concrete shall be
poured or other work covered unril approvâl is given b} rhe ciç, inspector.
Bulldins Dcn¡rtment:
The building deparrment shall rcview any revisions and adcienda. The City inspector rvill monitor the special
inspection ñ¡nctions for compliance rvith the agrcement and the approved plans. The Cí1v inspeetor shall be
responsible for approving various stages of construcrion to be covered ¡nd for work to pror"oà.
Deslqn Profe¡sion¡ls:
The architect andlor engincer rvill clearl,v indicare on rhc plsns and specifications rhe speciiìc rypes of special
inspection required and shall include a schedule t-or inspectron and resting. The architect and/órengineer will
coordinate their revision and addenda process in such a $råy ås ro ensure rhat all required City apprãvals are
obtained, pnor t0 work shown an rhe revisions b€inß performcd in rhe field.
Owner:
Thc project o\!nsr. or thc architect or engincer rcting as the owners agenr. shali employ the special inspeetor or
agencli.
ENFORCEMENT
A täilure of the spccial inspector or fìnn to perform in keeping rvith the requiremenæ of the lBC. rhc approved
plans and this document may void this agreement and the Building OfTcial's approvalof the special inipceror.
In such a çase a nerv special inspector and/or firm rvould necd to be proposcd for approvol. A failure ofthe
design anÜor construction parties to perfbrm in accordance *irh rhis agrcemcnt may result in a STOp TfORK
notice being posted on the çrroject until noncnnforming items have been resolved.
ACKNOWLEDGMENTS
í have read and agree to comply with the ¡enns and conditions of this agæement
owner: î¡ ^ L çN t l-- W,¡rl signature
Conrractor:
Datc @nr
s D.,". Ç r /i¡*
LT
^rch.nn1:el& A{Ailæ,N:é signature Date:
Speciar t n,p. Å) &6ó tt &Íftll tJ lt,Hs;Dete
Special Insp. Agencv
ACCEFTED FOR THË'CITY OF EDMONDS BIJIT,DTNG DIVIS¡ON
Br', Daæ:
r'ÈLlL{SVR-DEPTFS'.Êrtilding\Handouts lnr'nn¡slron iry Chr}ckþlan rtrraì}\co$mcnt6 - Buil<irng Divi¡ron rrytcçs,2018,û9¡16 Spccia
lnrpoctron À grcffsni docT,€6/?O I I