3163_00101� ED"�/o
SPECIAL INSPECTION AND TESTING AGREEMENT
Permit#: BLD2019-1476
Project: Cottle, 7821 203rl Street SW
Prior to issuance of a permit, thisform must be completed in its entirety and returned to the Cilyfor
approval. The completedform must have signatures of acknowledgment by allparties.
DUTIES AND RESPONSIBILITIES
Special hisl)ectioii Firiiiaiid Sl)ecial 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 Epoxy
— High Strength Bolting
— Spray applied Fireproofing
Smoke Control Systems
Lateral Wood
Structural Observation by design professional
X Soils/Helical pile/type (A&B) bracket
installation
___Expansion Bolts/Threaded Expansion Inserts
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.
LABTALDINCT DfVISION FILESTorms\Special inspection form-old.docl 1/26/2019
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 thejobsite for the use of the special
inspector and the City inspector. T'he 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.
[Juildim! Devairtinviii:
The building department shall review any revisions and addenda. The City inspector will monitor the special
inspection furictions for compliance with the agiecmeni and the approved plans. The City inspector shall be
responsible for approving various stages of construction to be covered and for work to proceed.
Desiell I'l-ofe."imulls:
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.
0%% ner:
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 finn to perform in keeping with the requirements of the I 13C. the approved
plans mid this domnent, may void this agreement and the Building Official's approval of the special inspcctui
In such a case a new special inspector and/or fm would need to be proposed for approval. A failure of the
design and/or construction parties to perfom in accordance with this agreement may result in a STOP WORK
notice being posted on the project until nonconforming item have been resolved.
ACKNOWLEDGMENTS
I have read and agree to comply with the terms and conditions of this agreement.
Owner: t Signature
Airch.lEng: _S Lark Foundations
FI
A
Date
Date: iq 5
-Signature j- Date: 12/10/19
Special Insp _ Stark Foundations . SigFullure Date: 12/10/19
Special Insp. Agency__ --_____--_-
ACCEPTED FORTHE CITY 01- EDMONDS BUI1.13ING DIVISION
L Of if] DINO DI'VISION R11-N-TomiQ%1w%1 I I i26;2M9