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SPECIAL INSPECTION pNTESTING AGREEEN
Permit #: BLD2013.0329
Project: MCDONALDS a STRUCTURAL
Prior to issitatice of a perinit, this form must be contpleted itt its entirety atad returned to the City for
approval. The completed forth must have signatures of ackitowledgntent by all parties.
DUTIES AND RESPONSIBIILITIES
Special Inspection Firm and Special Inspectors:
The Special Inspection firm of _ ` %� Cr .. _ .. �, will perform special
inspection for the following types of work (separate forms must be submitted if more than one firm is to be
employed):
X Reinforced Concrete
® Bolting in Concrete
® Prestressed Concrete
® Shotcrete
X Structural Masonry
X Structural Steel/Welding
X High Strength Bolting
El Spray applied Fireproofing
® Smoke Control Systems
11 lateral Wood
® Structural Observation by design professional
Grading/soils
® Other
® 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.
'file 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,
LABoildmg New I -older 2010T--ornWSpecial inspection form &0/21/2013
Contractor:
The contractor shall provide the special inspector magency adequate notification o[work requiring inspection.
The City approved plan and specifications must be made available, at the jobsite for the use or 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 arc considered to be in addition m(lie normal inspections performed bythe City
and the contractor ioresponsible for contacting the City /uschedule regular inspections. NuouocroteshuUbe
poured nrother work covered until approval iagiven hythe City inspector.
The building department shall review any revisions and addenda, The City inspector will monitor the special
inspom|uob/ncdonoforuompUuncuwkhthrogm:*meu\undthuuppmvedp\uns.7heCityinspoc(urahoUho
responsible for approving various stages of construction to be covered and for work to proceed,
The architect and/or engineer will clearly indicate on/he 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 \uwork shown vothe revisions being performed in the field.
The project owner, or the architect or engineer acting as the owners agent, shall employ the special inspector or
agency,
ENFORCEMENT
Afailure o[the special inopc mrmU/mmpoibnninkxupngwidhUmrequirom*omof the MC, the approved
plans and this document, may void this agreement and the Building Official's approval of the special inspector.
lnouohoouauunowope*iu|inapoo|ornnd/orDrmwou|do*edmbopmp000d[oruppmvai & failure o[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
lhave read and agree tncomply with the terms and conditions nf this agreement.
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Commo/m: iAomu Date:
Arch./Eng:|
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Special {wp, Agency