2019-0935 Special Inspection Form (Unsigned).pdfof ED�,o SPECIAL INSPECTION AND TESTING AGREEMENT
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Permit #: BLD2019-0935
Project: 16216 N. Meadowdale Beach RD. Retaining Wall
Prior to issuance of a permit, this form must be completed in its entirety and returned to the City for
approval. The completed form must have signatures of acknowledgment by all parties.
DUTIES AND RESPONSIBILITIES
Special Inspection 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 firm 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
Soils Evaluation
_X_ Retaining Wall Installation
_X_ Retaining Wall Drainage Installation
_Other
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 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 perform the work and testing required by the
project design and specifications.
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 Certificate of Occupancy being
issued. This report will indicate that inspection and testing was completed in conformance with the
LABUILDING DIVISION FILES\Building Division Comment Letters\comments - Building Division reviews\2019-0935 Special Inspection
Form (Unsigned).doc10/16/2019
approved plans, specifications and approved revisions or addenda. Any unresolved discrepancies must
be detailed in the final report.
Contractor:
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.
Building 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 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.
ENFORCEMENT
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:
Date
Contractor: Signature Date:
Arch
Date:
Special Insp. Signature Date:
Special Insp. Agency.
ACCEPTED FOR THE CITY OF EDMONDS BUILDING DIVISION
LABUILDING DIVISION FILES\Building Division Comment Letters\comments - Building Division reviews\2019-0935 Special Inspection
Form (Unsigned).doc10/16/2019
Date:
LABUILDING DIVISION FILES\Building Division Comment Letters\comments - Building Division reviews\2019-0935 Special Inspection
Form (Unsigned).doc10/16/2019