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SPECIAL INSPECTION AND TESTING AGREEMENT
- 81 -be 2019-- a
Permit #•• a /77 -01.79 OY!7$ 017
I"1 911 Project: 'lvm r i+-4
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
re t o r ntl S eel Ins a tors.
The Special Inspection firm of�' �tll will perform special
inspection for the following types ttf work (separate forms must be submitted if more than one firm is to be
employed):
M Window Water Penetration Resistance Test n
per RCW` 64.55.050(l)(a) per RCW 64.55
All individual inspectors to be employed on this project must have substantial and verifiable training and
experience in building enclosure design and construction. The qualified inspector shall be free from improper
interference or influence relating to the inspection . Verification 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 may
be requested.
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 final report shall be submitted to the building department prior to the Certificate of Occupancy being
issued. The signed letter will certify that the building enclosure has been inspected during the course of
construction or rehabilitative construction and that it has been constructed or reconstructed in substantial
compliance with the building enclosure design documents, as update pursuant to RCW 64.55.020. Any
unresolved discrepancies must be detailed in the final report.
Cttnt tett ,e,
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.
1\EDMSVR-DEPTPS\13uilding\i-[audouls Information by Chuck\in9peu1ons\spec1h1 idspection and testing agreement RCW64.55
COE.docg/6/2015
I I I Il d I I Ile'1i rttnantµ
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.
Veda' I'r l" ssl nls"
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 fitmm to perform in keeping with the requirements of RCW 64.55, the WC,
the approved ',plants, and this document, may void this agreement and the Building Official's approval of the
special inspector. in such a case a stow special inspector and/or firm would need to be ,proposed for approval. A
failure of 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 ine"L
Owner. c ors rX 1l2 LGL Signature ° , Date �o�o�6
Contractor: Date:
Arch.lEng:Signature _ Date Y-1121-6
Special Inap• � K „y._ igitaturr� Date: 3t, IlY
Speciallnsp.Agency, _�.. . ti�, �4�(� T6T77/V4
µ e_
Date
ACtr,Lir"1" Opt THE CITY 0 EDMONDS BUILDING DEPT. 74
WiDMSVR-DUffFS0ui1dinsV1sndout9 Informslion by ChucMinspeciionsUpcoial inspection and tcsling ag/ecmcnt RCW64.55
WrAwV612015
SPECIAL INSPECTION AND TESTING AGREEMENT
z.
,.
Permit #• SLN 2019— 0/77 --0179 --'0179
Project: Hyl PAW
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 sAnd Special Ins aeetoa: •.,
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):
I1 ,11 M-rre—sr a Building Enclosure
per RCW 64.55.050(1)(a) per RCW 64.55
All individual inspectors to be employed on this project must have substantial and verifiable training and
experience in building enclosure design and construction. The qualified inspector shall be free from improper
interference or influence relating to the inspection . Verification 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 may
be requested.
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 final report shall be submitted to the building department prior to the Certificate of Occupancy being
issued. The signed letter will certify that the building enclosure has been inspected during the course of
construction or rehabilitative construction and that it has been constructed or reconstructed in substantial
compliance with the building enclosure design documents, as update pursuant to RCW 64.55.020. Any
unresolved discrepancies must be detailed in the final report.
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.
11EDMSVR•DEPTTS1Ruilding\Handouts Information by ChucMinspectionslspecial inspection and testing agreement RCW64.55
COE.doc8/6!2015
IluiI -dim Phu); I r I -%,", " I -
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.
Ita�si n I'"l°atd"��a;sa:ar�atis
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 r ject 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 RCW 64.55, 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 ofthis. j,.;;on nt
Owner G / "M412 LLC_ Signature �� .. „�� Date -3 IP -2016
Contractor:
Arch./Eng:
41�„°Vno�QRl6 h`
Date:
a
Date,
Special hf,wp Zach Pritchett _ Sna°omsuuuut� � -� �'u-t-�� Date: 3/16/16
_-
Special Insp. Agency��
ACCLI�r` I ta'E 'f 11 E 4 I"I t' OF EDMONDS BUILDING DEPT
4,1-16
By: � Date: .............w._u.—_....
UrDMSVR-DEPTFSOuildingVlandouts lnfmmalion by Chuck\inspeclionslspecial inspection and tesling agreement RCW64.55
COEAoc8/6l2015
a SPECIAL INSPECTION AND TESTING AGREEMENT
� Permit #:
��s Zfli� o� —or7g --or79
I IV�il
Project: �YDF � F
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
S moill Ins wcolotw III wo s wwNeial Itts mem cta�rs: 5O 4r paclo f.G C—
The Special Inspection firm . ..... will perform special
inspection for the following types of work (separate forms must be sobmittt:d if m, e than one firm is to be
employed):
■ Window Water Penetration Resistance Test a Building Enclosure
per RCW 64.55.050(1)(a) per RCW 64.55
All individual inspectors to be employed on this project must have substantial and verifiable training and
experience in building enclosure design and construction. The qualified inspector shall be free from improper
interference or influence relating to the inspection . Verification 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 may
be requested.
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 final report shall be submitted to the building department prior to the Certificate of Occupancy being
issued. The signed letter will certify that the building enclosure has been inspected during the course of
construction or rehabilitative construction and that it has been constructed or reconstructed in substantial
compliance with the building enclosure design documents, as update pursuant to RCW 64.55.020. Any
unresolved discrepancies must be detailed in the final report.
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.
\\EDMSVR-DEPTPS\Building\Handouts Information by ChucMinspections\special inspection and testing agreement RCW64.55
COE.doc8/6/2015
litlildin s lIc );'irfulent:
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.
llc!I:Ott Proressiollals:.
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 RCW 64.55, 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 anew special inspector and/ter linin would need to be proposed for approval. A
failure of the design and/or construction parties to perform arm in accordance with t is ,agreement: may result in a
STOP WORK notice being posted on the project until nonconlbrmi:ng items have been resolved.
ACKNOWLEDGMENTS
I have read and agree to comply with the terms and conditions of this a g •eemelit.
Owner: �� / L ! Si nature I:a'le
Contractor: _ OGT..m _.: a�igt t�nre.._ m_ . _ .... l at ..
_�._ �.
Arch./Eng:
Special Insp.
Special Insp. Agency
Signature,
AC C l JYJ 1'l, 'C l THE CITY " EDMONDS BUILDING DEPT.
Date:
Date:
Date:
\\EDMSVR-DEPTFS\Building\Handouts Information by Chuck\inspections\special inspection and testing agreement RCW64.55
COE.doc8/6/2015