2892_001.pdf0
SPECIAL INSPECTION AND TESTING AGREEMENT
Permit BLD2019- 1094
Project: 8503 216TI-I ST SW
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 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
Pre stressed Concrete
Shotcrete
Structural Masonry
Structural Epoxy
— High Strength Bolting
— Spray applied Fireproofing
Smoke Control Systems
Lateral Wood
Structural Observation by design professional
X Soils
X Piles and Lifting Assembly
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
approved plans, specifications and approved revisions or addenda. Any unresolved discrepancies must
be detailed in the final report.
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The City approved plan and specifications must he 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 he in addition to the normal inspections performed by the City
arid the contractor is responsible foi contacting the City to schedule regular inspections. No concrete shall lie
poured or other work covered until approval is give-n_,b)LIhe City inspector.
Building Department:
The building department shall review any revisions arid addenda. I -lie City inspector will monitor the special
insvection 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 Avork to proceed.
Desian Professionals:
The architect and/or engineer will clearly indicate oil the plans and specifications the specific types ofspecial
inspection required and shall include a schedule for inspection and testing. The architect andlor engineer will
coordinate (heir revision and addenda process in such a way as to ensure that all required City approvals are
obtained, prior to work sho-wrl on the revisions being performed ill (lie field.
Owner:
The proJect owner, or the architect or engineei acting as the owners agent, shall employ the special inspector or
agency.
ENFORCEMENT
A failure ofthe 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 Orficial'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 ma) result in a STOP WORK
notice being posted on the proJect until nonconforming itenis have been resolved.
ACKNOWLEDGMENTS
I have read and agree to comply,%vith (lie terms and conditions of this agreement.
Date
Owner:0-pokw -c(-
Signatm - imm
Contractor: Kveu Y'J", --Signature_ Date:
Arch./Eng: iture Date:
J&J-T v�m -Sign;
Sig,
Special Insp. A -6) iature Date:
Special lnsp.Agency__W-T,�t�
ACCEPTED FOR HIE CITY OF EDMO-NDS BUILDING DIVISION
By 7 Date:/./— / —3' —1