Signed Special Inspection Agreement.pdfSPECIAL INSPECTION AND TESTING AGREELMEAT
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a Permit #: �,..� ,���m,m,� �a����� RESuB
YProject:A U6 0 1 20 1'
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Prior to bsuaner of a µemail, this form Ym ct be completed In its �►rtirfitl� aa� return.t � �a ��
approval. Thr romplezed form inust have sIg►eaxtures of acknowledgment ky all parties.
qUMNS AND I FSP<INSIBILl7'IES
Z'lic S,cial tnspccttc)n Wni c,f lk+`-�z L;� -N_ _gTze)- I'r_ II HJC-'�L,►- /I will lkrt'.aln slYVi:i;dl
inspection foi tlic follilv,,irr:g Igws of �.vurk tsrp;trate farms ❑auU he iAniatcd it n-Klry 111all Ilnl' firm in to bbe
empl(lye'dl
Cieneiakiw rrallnitku-ing
'I'cmprorary ero%inri coriliol
F( taitlink; Nall loo(ing dram
r Placelncial lo-ffill & ermt1l;w(l n
Fxcjxat;oq, gracfin & sav preparation
Sod bcuri.ng ver kadmi
Rc,,xsning v;311 ,:motrtiction
Final ;:ror4on control
All ancfividual inspectors to he emphlycil tin this p"Ico wtH b 'NoW( certttied f,,.-r the type rif i4oi ' they att rat
inspect. if in-gvcnom is Air %ilrk tllul is M covered by the WAF3O cmeLill e4 or Te Agitmi is nat T4'XhHO
corlifiod, a ilk -tailed rctiume of the inspector and iilm must l+e s binim!J, Thv rvsumv rnd!,t shllw that the
inspeckir and the firm are qualified by ctl wwAln i0d eMw irn.e H) perfllrm t'tc -Aof� . and ce ling requited hy lhs
ripptt design and zl'►ad ications
I'lir t+'trrk shall be insptLlcd fnt 1-onlotirwnt-c ~%'ilh Vic plaits and specif'icaulans ag ro ed by the Lily_ !ZPA ralllk
and addenda shem vvill n<A 1u slwd for inspeclion, unless they have hecn apple ved by Flit' 01i 1 lttcptN.- uon
tc olyds shall indade.;
A daily record to he maintained lln srtr, ilr►rliring the rn,pections pertormncd. Any ntmetinformiog, m 14
Nitall he baxighr io t1w irnrticdiatc attention at the ci.mtra0c)r for remiluiillrl.
sk 1weekly relxitr shAl he 8uhtruunj u) the Chy dctallws the inkrieLtl4S x arid tLtsihig pti`rlllriatc'd, 114ting
Erns' n(rm:mi:l`k rnlin,,g ti,vork and rCsA)tutiOn of nti'nconfolllllli.K 11trV1N
A final repon shall he submitted to the huildinl., depirll►k:1nt I16a1 I+1 ilt,� C cruflcalc 0 01cup ancY being
iesucd. This reTOrt will inliiCUI tll;rl and woing -Aiars completed to c0nf-.W nilrlce t ith tfl��
approved plan,, sllt-t ilit:ctti<,rts and approved re idons or addenda. Anti u(lrcs;)IYcd diwIt-palK iCs mast
lW rlL-t;rile-ll ;n the. linal rep<)n
mo I rm'1r°,tVlh",
The: Atratl-t n Shall provide Ibc--,Pechl II)wlll'oul ill agclwt ;Vjvgllmv 11ou'lik'1i6nln tit %-ork requiring nspeci.on.
11c C'ity appru�cd Ulan algal , wt-iflt:s 1Ams must be inade avaHaNe., at the ji bshe fern 11he Use of tltc Well
inspector and il)e City instx,ctllc, Tow cclntratnot' shall maintain all daily 1:'lx+lts, alrl silt•, Ilir review by
all fvtigrhti
The. special inspection functions are considered to be in addition to the normal inspections perl'orttled by the City
and the contractor is responsible fur contacting the city to schedule regular inspections. No concrete shall he
poured or other work covered until approval is given by the City inspector.
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 he
responsible for approving various stages of construction to be covered and for work to proceed.
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:
e 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 pasted on the project until nonconforming items have been retiolved,
ACKNOWLEDGMENTS
1 have read and agree to comply with the terms and conditions of this agreement.
Owner:"Jl.x?�� fVJc'j� i/ Signatures Date
Contractor: � ��_ .9� - s _ Signfl lure
ArchJEng, f .. aL ., _ v.ea �.i i' hd",� +� �' Sl ll�llur�. .Y c m;
�„ V iel`.� ! m�,.��,�Y'�'i i�' �.,) d" 1' J� _�". �'✓�1 '�A,_ �r,i. �1;:IdiV41 - pJ„�t°r� l,d ���' �m� Aa�
a (lu 1.; ttb 11q N� L'df l'nl,'i�,.. .�o °",`
p "t 1 1 11; I lw THE ClTY,i: EDMONDS BUILDING DEFT,
By: Date::
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