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APPROVED BLD RESUB1 BLD2023-0640+BLDG SPECIAL INSPECTION+12.22.2023_10.36.37_PM+3969483BLD2023-0640 OF EDAI O U v Est. 1 S90 RESUB Dec 27 2023 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT SPECIAL INSPECTION AND TESTING AGREEMENT Permit Number: BLD2023-0640 Project: Hartanah KL LLC, 15604 7511 Place West 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 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 ® Auger Cast Concrete Piles ® High Strength Concrete © Soils ❑ 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 SPECIAL INSPECTIONS OF CAST —IN —PLACE DEEP FOUNDATIONS VERIFICATION AND CONTINUOUS PERIODIC REFERENCE IBC INSPECTION DURING TASK DURING TASK STANDARD REFERENCE INSPECT DRILLING OPERATIONS AND MAINTAIN COMPLETE AND ACCURATE X RECORDS FOR EACH ELEMENT. VERIFY PLACEMENT LOCATIONS AND PLUMBNESS, CONFIRM ELEMENT DIAMETERS, BELL DIAMETERS (IF APPLICABLE), LENGTHS, EMBEDMENT INTO BEDROCK (IF APPLICABLE) AND ADEQUATE END -BEARING STRATA CAPACITY. RECORD CONCRETE OR GROUT VOLUMES. FOR CONCRETE ELEMENTS, PERFORM TESTS IBC 1705.3. AND ADD TIONAL SPECIAL INSPECTIONS. IN ACCORDANCE WITH SECTION 1705.3. NOTE: APPROVED SPECIAL INSPECTION AGENCIES SHALL KEEP RECORDS OF SPECIAL INSPECTIONS AND TESTS. THE APPROVED AGENCY SHALL SUBMIT REPORTS OF SPECIAL INSPECTIONS AND TESTS TO THE BUILDING OFFICIAL AND TO THE REGISTERED DESIGN PROFESSIONAL IN RESPONSIBLE CHARGE. \\edmsvr-userfs\userprof$\dakau\Desktop\DONOVANS Comments Letters and Special Inspection forms 2019\Special Inspection forms\SI 2023-0640 Hartanah KL LLC.docx 10/30/2023 Doc ID: 7fOe423150df5f7aea613a831215e91ca96dadfc All individual inspectors to be employed on this project will be WABO certified for the type of work they are to inspect. If inspection is for work that is not covered by the WABO categories, or the inspector is not WABO certified, a detailed resume of the inspector and firm must be submitted. The resume must show that the inspector and the firm are qualified by education and experience to perform the work and testing required by the project design and specifications. The work shall be inspected for conformance with the plans and specifications approved by the City. Revisions and addenda sheets will not be used for inspection, unless they have been approved by the City. Inspection records shall include: A daily record to be maintained on site, itemizing the inspections performed. Any nonconforming work shall be brought to the immediate attention of the contractor for resolution. A weekly report shall be submitted to the City; detailing the inspections and testing performed, listing any nonconforming work and resolution of nonconforming items. A final report shall be submitted to the building department prior to the Certificate of Occupancy being issued. This report will indicate that inspection and testing was completed in conformance with the approved plans, specifications and approved revisions or addenda. Any unresolved discrepancies must be detailed in the final report. \\edmsvr-userfs\userprof$\dakau\Desktop\DONOVANS Comments Letters and Special Inspection forms 2019\Special Inspection forms\SI 2023-0640 Hartanah KL LLC.docx 10/30/2023 Doc ID: 7fOe423150df5f7aea613a831215e91ca96dadfc 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: Hartanah KL LLC Signature � � 4-04 Date 11 / 21 / 2023 Contractor: DLH Inc Signature l Date 11 / 07 / 2023 Arch/Engr: Motionspace Architecture Signature Date 11/7/2023 Special Insp: Otto Rosenau & Associates. Inc. Signature Date 11 /1 /2023 Special Inspection Agency: Otto Rosenau & Associates, Inc. Signature Date 11 /1 /2023 Geotechnical Inspections: Nelson Geotechnical Associates Signature l Ui 66 Date 11 / 21 / 2023 ACCEPTED FOR THE CITY OF EDMONDS BUILDING DIVISION By: W. X Date 2/05/2024 \\edmsvr-userfs\userprof$\dakau\Desktop\DONOVANS Comments Letters and Special Inspection forms 2019\Special Inspection forms\SI 2023-0640 Hartanah KL LLC.docx 10/30/2023 Doc ID: 7fOe423150df5f7aea613a831215e91ca96dadfc X Dropbox Sign Audit trail Title 20231107 - Koh - Special Inspections Form File name 20231107 - Koh - ...pections Form.pdf Document ID 7fOe423150df5f7aea613a831215e91 ca96dadfc Audit trail date format MM / DID / YYYY Status Signed Gcocirre-it �-:'Yficr•, 11 / 08 / 2023 Sent for signature to Michael Koh 00:07:32 UTC (michael.yvette@gmail.com), Jason Holub (Jason@dlhinc.com) and Alex Rinaldi (alexr@nelsongeotech.com) from nazim@motion-space.com IP: 162.125.63.9 v 11 / 08 / 2023 Viewed by Jason Holub (Jason@dlhinc.com) =� 00:22:26 UTC IP: 172.56.105.218 11 / 08 / 2023 Signed by Jason Holub (Jason@dlhinc.com) 00:24:10 UTC IP: 172.56.105.218 11 / 21 / 2023 Viewed by Michael Koh (michael.yvette@gmail.com) 08:17:12 UTC IP: 115.132.10.84 11 / 21 / 2023 Signed by Michael Koh (michael.yvette@gmail.com) ti 08:18:35 UTC IP: 115.132.10.84 Powered by X Dropbox Sign X Dropbox Sign Title 20231107 - Koh - Special Inspections Form File name 20231107 - Koh - ...pections Form.pdf Document ID 7fOe423150df5f7aea613a831215e91 ca96dadfc Audit trail date format MM / DID / YYYY Status Signed Gcocirre-it Y}�r C 11 / 21 / 2023 Viewed by Alex Rinaldi (alexr@nelsongeotech.com) =� 15:21:26 UTC I P: 50.47.55.49 11 / 21 / 2023 Signed by Alex Rinaldi (alexr@nelsongeotech.com) sicE� 15:24:35 UTC IP: 50.47.55.49 11 / 21 / 2023 The document has been completed. 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