APPROVED BLD BLD2023-0174+SI FORM +11.6.2023_9.35.24_AM+3882413RECEIVED
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CITY OF EDMONDS
DEVELOPMENT SEMI
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DEPARTMEW
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SPECIAL INSPECTION AND TESTING AGREEMENT
Permit Number:
Project:
BLD2023-0174
Raman, 1050 Walnut Street
Prior to issuance of a permit, this form must be completed in its entirety and returitetl to the City for
approval. The completeel form ntust have signatures of aeknowledgmeW by all parties
DUTIES AND RESPONSIBILITIES
Special InslRection Firm and S )eciial Ins ecitors
The Special Inspection firm of 4W
will perform special inspection for the foil
firm is to be employed). owing types o work (separate forms must be submitted if more than one
CK Soils to also include:
tiv ■ Monitor and test structural fill placement and soil compaction
Jos • Observe bearing capacity at foundation locations
M0 • Observe slab -on -grade preparation Pv+ p''O/OW
ice' a Verifj, infiltration system placement
Wo " Monitor foundation drainage placement Nwf- J)t--ptilj--d
v0 • Observe excavation stability -- rt,�,�r�j p ty'z
PAY
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 resuine ofthe inspector and firin must be submitted. The resume must show that the inspector and tiie firm
are qualified by edification and experiellec to perfm•m 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
nonconforining work and resolution of nonconforming items.
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• 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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