SIGNED SPECIAL INSPECTION AGREEMENTSPECIAL INSPECTION AND TESTING AGREEMENT
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Permit #: BLD2019-1203
Project: 201 Alain Street Canopy/Trellis
Prior to issuance of a permit, this form must he completed i►t its entirely and retur►ted to the City fur
approval. The completed form must have signatures of ackrro» Iledgment liv all parties.
DUTIES .AND RESPONSIBILITIES
Special Inspection firm and Sneeiaall Inspectors: A
M
The Special Inspection firm of K U kA_ � �(
will perform special inspection for the lolluwing types of work (separate forms must be submitted if more than
one firm is to be employed I:
_Reinforced Concrete
_X_Bolting in Concrete
_Prestressed Concrete
Shntcretc
__Structural Masonry
_X_Structural Steel/Welding
_High Strength Bolting
__Spray applied hireprooling
—Smoke Control SNstems
Lateral Wood
Other
All individual inspectors to he employed on this project "Ill he WABO certified tier the type of work the% are tl
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 impeclor and fu•In must be submitted. The resume must show that the
inspector and the firm are qualified by education and experience to perform the cork and testing required by the
project design and specifications
The work shall be inspected for confol stance a ith the plans and specifications approved by the City. Revisions
and addenda sheets will not be used for inspection. unless they have been apprtmed by the City. Inspection
records shall include:
A daily record to he maintained on site. itemizing the inspections performed. Any noneon forming work
shall he brought to the immediate attention of the contractor for resolution.
A weekly report shall he submitted to the C'it\; detailing the inspections and testing performed, listing
any nonconforming work and resolution of nonconforming items.
A final report shall he submitted to the building department prior to the Certificate ol'Oecupancy being
issued. This report will indicate that inspection and testing was completed in conformance with the
approved plans. specilicwtions and approved revisions or addenda. Any Unresolved discrepancies must
he detailed in the linal report.
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Contractor:
The connot: shall pl-m Itic IIle spei ml Ill%lk.clor III agelx% adequate 1luliIIcalit-ill of %%ork miLliI lllg II1Sl)eClloll.
1•he City apprt)ted 1)1a11 and .l)eiilicatit,n. opts' he made atailahle. aI the it t+sile IIn the use of the %pecial
Impectnl and the City insllectol. The ionllactol shall maintain all daily inspection reports. on site. loll retiett ht
all parties
The sl)eclal Ill%pii11t111 Itinctlltll, ,!IV 04111dCICtl ttl he ill addltll►1111►tile Illtrmal inspection, performed ht tilt• cm
and the contractor is responsihle loll conulctin,. the Cilt to whedule regul:u impectioms. Not couerete •hall h:
Poured Ill ()tile' t'l, co-Icd until approval I% vItcn M the City inspector.
Building Deaartment:
The building department .hall tcvie%% an\ rcti%illn> and addenda The ( Itt rllspectiu tt III nuaul(v the %llet:1al
inspection lilnelin11% lilt Compliance %%ith tile:lgreemem and thr appi tcd p611s. -Ille (',:y ul,pector shall he
lesponslhie lol approtnlg taritals %tape%ol.omp'urluat (rl he entered and for work to l,ruceed
Design Professionals:
The architect and/or engineer tt ill clearly indicate tin the plans and specilicalirnls the specific types ol, special
inspection required ant! shall include :, schedule lot nlspeclion and leering. The aochhecl and/or engineer will
coordinate their 1 ev ision and addenda process in sl,ch a tt at as to ensure that all rcyun'ed Cily approvals are
obtained. prior to tt ark ,hurt it on the ret isions being performed in the field.
Owner:
The project owner, or the arclikee( or engineer acting as the owners agent. ~hall employ (Ile special inspector or
aaenct.
ENFORCEMENT
A failure ol'the special inspector or firm to perform in keeping ttilh Ute requirements of the IBC. the approved
plans and this doC(Illlellt. nluy %'old this agreement and the Building OI I'ic ial's apprm:Il of the special inspector
In such a case a nett special inspector and/or Ilan would need to he Proposed for apprm al. A failure of the
design and/or construction parties to perform in accordance ttilh this agreement may result in a STOP WORK
notice heing posted tin (he project until nonconlorrning items haVPJWXJl-f4eNol,t•ed.
ACKNOWLEDGM
1 have read and to w collipl� ith the lerm, and conditions o
Owner. ?_r41 %•C i L r. X 'Zb 2 U tit
- -- Signature
Contractor: --- - -- Signature
Special Insp %V L-7LLc>t_ Slgllallll'l'
Special Insp Agcniy_ _71,4N
ACCEPTED FOR TIIE CITY OP FDNIONDS BUILDING DIVISION
By 7 Dale:
) /, f 4
Date
i
j a �1Date. %
Dane: to/m
Date: UA I
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