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APPROVED SI FORM BLD2023-0028BLD2023-0028 SPECIAL INSPECTION AND TESTING AGREEMENT Permit Number: BLD2023-0028 May 18 2023 Project: Jospeh, 8023 215t' Place SW CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT Prior to issuance of a permit, this form mucst be completed in its entirety and returned to the Cityfor approval. The completed forma must have signatures of acknowledgment by all parties. DUTIES AND RESPONSIBILITIES Special Inspection Firm and Special Inspectors The Special Inspection firm of Krazan & Associates will perform special inspection for the following types of work (separate forms must be submitted if more than one finn is to be employed). M Structural Epoxy ® 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 ❑ Water -Resistive Barrier coating and cladding ❑ Retaining Wall Block Installation ❑ Retaining Wall Footings 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. \\edmsvr-userfs\userpro Wd akau\Desktop\DON 0 VANS Comments Letters and Special Inspection forms 2019\Special Inspection forms\SI 2023-0028 Joseph.docx 5/1/2023 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 Dcpartmcnt 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 teens and conditions of this agreement. Owner: Ton J6) 27 i, Signature Date L Contractor: Signature Date 12q Arch/Engr: M ( K:'�_ M*&UW Signature Date .6ZS Special Insp: Jeff Mercer Special Inspection Agency: Krazarl $ Associates Signature Date Jeffrey S =-Jemw3 r .C'J5' Date 5/15/23 MereerSignature ewvaeiA ' Oat 403 O&IS 11V¢61-MO' ACCEPTED FOR THE CITY OF EDMONDS BUILDING DIVISION LZA Date \\edmsvr-userfs\userprof$\dakau\Desktop\DONOVANS Comments Letters and Special Inspection forms 2019\Special Inspection fomis\SI 2023-0028 Joseph.docx 5/l/2023