SIGNED-RESUB1 BLD2022-0871+SI FORM+11.8.2022_11.08.32_AM+3209060v r�
1
SPECIAL INSPECTION AND TESTING AGREEMENT
Pcrnsit �umher: 13LD2022-Mi
Project: SAMUEL- REMODEL 6 AMT.10N
Prior to iaua.#t+-r of a 1wrmit. this forth mw,,r be compteled in its entirrh' and returned to the ('in- fo►
u/y+ro►al 1 hr i otwplrrrJ forsw ara+t ties �i�nata►ts of ac�na►.-kdgment hr all parti-m
DUTIES AND RE:SPONSIBR ITIE S
Sotcisl In•pcdtr-n i irwt Md SIR" 1 n.pxtlM
the Spm,al lsupvcu�m tirnn of
w sh petfogrn spoeial umpc►c "fix the fdlawlaQ typo of vrork (a¢9arate foetus tttivat he sarl+rnttted tf moec than ooc
fum is to be ctq►by+cd)
0 Reinforced Concrete
8 DcJting %n Concrctc (EPDXY ANCHOR DOLTS)
O Prmtrt:w d Coexrc e
O Shdcrctc
Struaund Slauwy
0 Stwctural Stm+`Weidmg
O 1110 Stm gth WAtins
:3 Spray appbod Fimyrooftng
O Smote Ccrmml Systems
C] Lateral Wood
C Strtwwmi Observstioo by design profcwssoesal
� (itsbe>Qp'x+ilt
C Rctamaag Wall Hiock InstaIlatncv
C Rcwtung Wall Footings
All indoldual ►mpoctors to ht e=npiaytd on this pt'olcct ntll be wABO cetifed (cc the type of work they asc to
&nVmt If mspatom is 1.Y M.mt that is toot eos'ernd by the WABO catq pnc!L. or the tnsp ctor is not WAHO ccnlf d,
a 6etailed resume of the trnl+tctar and firm must be submitted The tt=rm trust stet) -.that the umpe ctor aced the fum
are "lsiscd by odesmboi t and c%pernaxv to pafocm the v►ork and textrng rtquucd by tht prgext desert
%gw1f"xxss.
The rrrk shall be mqc,-+cd fn axtfocm C wah the plant and Tmlf"iom appeased by the Caty- Resiwwu and
addends slates wiU not k 6ud for irtspa Kwi, w%kss thc}' hase been appe'os'td by the City, LwP0C aan rVCVCdi ,W1
sncls+dc d
• A dwly roomd to be nuintatnad on scc Kmutttg the mFoW,,L m peened. Anyrwinctefornung -A-oei shall
be bmu& to the smmed►ate attention of the corxractor foe fcwl%oxn
• A weekly rgmn almll he subrratted to the City, ddarlutt the easpMKw and tccsttatg perfcwnwd. Issitrg any
awtomfomog work and resoMion of nonconfcxttttctg ►terra.
• A final rcpoet shay be aubn amcd to the bsukhng departrTWN P to the CeYtift►aac of Q an:y bang
►»iW 'Ms rcpoet wiU indicate that inspection and IcstirV was event cgcd m mafcx umm Sit!► the spprmod
plaru. sgwificatsooa and appemsod rrsimcmu or oddtrds Any untrC"vvd dncrqsmics mat be d"Icd to
the final rcpon.
iri ADMt3,% /1tI1 w.enr -OTH A1.1 W 1 W?8t==41171 RIBA[ XX I : - rxxA Ili -m Kila =a71 SI
I l 1S1[,�t Dl inn • 1� b:.'
The
The voearsc sl�sll pto+idc tht tsQacsal °� Y c for &C t d ft �W twpcc-orc and
Cm sWo'Od plan and $Pmficano�a WAN be osadc a�mbDk. stw �°�'Om tarrvpcm o0 jwr. for t+c.ww by all poR1cs
the Csy wWecwo The ooac wuv d" m mm all � 1O�°C:
b the a wmal mrp mum Wfog fOd b7 dw C dy and
The spe csal ,sap�oaa-a fummm arc a+aa�dercd a be >a addMsoa `o ccacmw shall be potnvd or
the ooeR.-scw is rcpaaasbk W tee CRY to schoadc reprlr
otje a Mort mvend 1n1 wpm -a' Is pv w by tdc Cey ww@CM
aetj4m pf"nw city"I ctsonrtcx the spocul
i Ix t+ss;3a awl re.xi sry rt;+ and a� aWv%vd lem The City tmpecsm hall be
utg+aam fiatarcm for oorwouce W th tlx aQoemtt
� �„� •ar+a�us � art oc+wo�n� to be cocr+od and for tsoelr a prv000d
The ardlrloa and'a atmm u U ckwiy mdscart cc the piaan and � boW snd cc cc d
�pmbm ragtaa�od uld sldl =I m& a u>lodtslt jot mspo�'O° as>d C vals me cbtaanod.
�u t�c,�saloet sd addads ptvctas to such a" a to c>m=rr chart a/ toq�+ud �h' aDDce
prior w Mat tdOwo as the mvnx= Dccg pafoet wd m the feta
n"MU ss �,c r•Aas aprt. ttisrdl s'mP�' acspctsar or
The plo�act owsIor. a the 21chL -W a aepaca aa>
cg agewy•
ENF ORC t_%I F �T � &c��s of ft 18C. the apprv. cd pbm
A ful�c of the specud tnvoc'w ct fins W petfoes r:mp�
sad tl�i. doc-aeaeM MY avid tbn apoed mid de 8 - it I' t6 pffiaal's appitv+ai ottdlc >n+Poct°e. in siacA a
WMW mWeem an
Caw s acw dar fins waald need b be pwpaod for appww@L A (alum of the Amsm and cc
wa I� so pafmm a aoaardroae r+awlt to s STOP M C)R)C naxc bcuq Pusrc+d
comstrwort the psu'ma tlettl NNwty onw" iwms bores bow toohv&
.( kl%o%%l I IK.%It '% I
i ba--c rad said &V= w oaapiY u"O tscra 'c-am "adsb' ad t11-- -�"".."'
Dula Samuel S
i
Caaracsoc
AmhUgr Se�:>,sRss
SPOCIA tw- — Smarr
Specud I"eCttrvo Ap=)-. -
ACCEIPTE:D FOR THE CtTI 00 t-DMO%D% Bl It -DING DI% MON
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11/6/2022
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