APPROVED SI AGREEMENTOF EDAf
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SPECIAL INSPECTION AND TESTING AGREEMENT
Permit #:
Project:
_BLD2021-1100
Foundation Stabilization
Prior to issuance of a permit, this form must be completed in its entirety and returned to the City for
approval. The completed form must have signatures of acknowledgment by all parties.
DUTIES AND RESPONSIBILITIES
Special Inspection Firm and Special Inspectors:
The Special Inspection firm of Krazan
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 Steel/Welding
High Strength Bolting
_Spray applied Fireproofing
_Smoke Control Systems
Lateral Wood
Structural Observation by design professional
X C-Channel Installation
X Helical Pile Installation
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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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 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 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.
Building Department:
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 be responsible for approving
various stages of construction to be covered and for work to proceed.
Design Professionals:
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:
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 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 posted on the project until
nonconforming items have been resolved.
ACKNOWLEDGMENTS
I have read and agree to comply with the terms and conditions of this agreement.
Owner: Rusel Hause
Signature Rgid 1fagse Date 12/03/2021
Contractor: R&R Foundation Specialist Signature 3��,,-Z, Date: 12/06/2021
Arch./Eng: Longitude One Twenty_
Special Insp. Krazan
Special Insp. Agency
Krazan
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Slgnaturvef(rey S Mer er (Dec 6, 202110:39 PST)
ACCEPTED FOR THE CITY OF EDMONDS BUILDING DIVISION
B . Date:
Date:
Feb 3, 2022
Date:
Dec 6, 2021
\\edmsvr-deptfs\ADDRESS_FILESWIpha\DAYTON ST\814\BI,D2021-1100 FOUNDATION\BLD2021-1100 Si Agreement (unsigned).doc8/19/2021