B-1.pdfPlan Check # 05 5-6 4-- Date
Project Name/Address 1 Jul
Contact Person/Address Al2%,4
Department: Building Ef Engineering ❑ Planning ❑ T Fire ❑ Public Works ❑
Reviewer
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❑ Submit 2 sets of revised plans/documents to the Permit Coordinator.
❑ Corrections may be made by red lining plans/documents on file with the City.
DATE FAXED (Attach fax transmittal) PAGE —/— OF
Plan Check # J —J� Date 12 5 Jo
Project Name/Address
Contact Person/Address /V�-7A j�54-
Department: Building Engineering ❑ Planning ❑ Fire ❑ Public Works ❑
Reviewer
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❑ Submit 2 sets of revised plans/documents to the Permit Coordinator.
❑ Corrections may be made by red lining plans/documents on file with the City.
DATE FAXED (Attach fax transmittal) PAGE � OF Z
CITY OF EDMONDS
SPECIAL INSPECTION AND TESTING AGREEMENT
The project at 101La
/ L . W- issued under building permit
number requires special inspection and/or testing per IBC Chapter 17. The
complete list of special inspections is attached to this document.
BEFORE A PERMIT CAN BE ISSUED: The owner and contractor and special inspector shall complete
this agreement and the attached structural test(s) and inspections schedule including the required
acknowledgements.
APPROVAL OF SPECIAL INSPECTORS: Each special inspector shall be approved by the Building
Official prior to performing any duties or inspections. Each special inspector shall submit Statement of
Qualifications to the Building Official for review. Special inspectors shall display identification when
performing special inspections on site. Special inspection and testing shall meet the minimum requirements
of IBC Chapter 17 and the following:
A. Duties and Responsibilities of the Special Inspector
1. Observe Work
The special inspector shall observe the site work for conformance with the approved (stamped) plans
and specifications and applicable workmanship provisions of the IBC. Architect or Engineer
reviewed shop drawings may be used only as an aid to inspection. Special Inspections are to be
performed on a continuous basis —meaning that the special inspector is on site at all times observing
the work requiring special inspection. Periodic inspections, if any, must have prior approval by the
City based on a separate written plan reviewed and approved by the Building Official and the
engineer or architect of record.
2. Report Non -conforming Items
The special inspector shall bring non -conforming items to the immediate attention of the contractor
and note all such items in the daily field report. Any item not resolved in a timely manner shall be
immediate cause of the special inspector to notify the Building Official of the plan deviation., error,
change or omission. It shall also be the duty of the special inspector to promptly notify the engineer
or architect.
3. Complete Daily Reports
Each special inspector shall complete and sign both the special inspection record and the daily report
form for each day's inspection. These records shall remain at the jobsite with the contractor for
review by the City Building Inspector.
4. Furnish Weekly Reports
The special inspector or inspection agency shall furnish the City with weekly reports of tests and
inspections. The project engineer or architect, and others as designated shall also be copied on
reports. Weekly reports must include the following:
• Description of daily inspections and tests made with applicable Iocations
• List of all non -conforming items
Report on status of non -conforming items (resolved or unresolved)
Itemized changes authorized by the Architect, Engineer and City if not included in non-
conformance items.
S. Furnish Final Construction Report
The special inspector or inspection agency shall submit a final signed report to the City stating that
all items requiring special inspection and testing were fulfilled and reported. And, to the best of
L:ITEMPIBUILDINGISpeciallmpectionAgreementIBC.doe 7/04
SPECIAL INSPECTION AND TESTING SC' "-DULE
figivi(iy
PROIECr NAME BUa.AtNG PERMR N0.
�t'ROrECTADDREss TESI1NGWSPECMPJAGM4CYwSPE3AiwsPEC M
REINFORCED CONCRETE, GUNITE, GROUT AND MORTAR:
Concrete Gnufte Grout Mortar
Aggregate Tests
Reinforcing. Tests
Mix Resigns
Reinforcing Placement
Batch Plant Inspection
Inspect Piecing
Cast Samples
Pick up Samples
Compression Tests
PRECAST/PRESTRESSED CONCRETE:
rues rust -lens rr1e-le23
Aggregatc7csts
Reinforcing Tests
Tendon Tests
Mix Dcsi¢ns
Reinforcing Placement
insert Placement
Concrete Batching
Concrete Placement,
Installation Inspection
Cast Samples
MASONRY:
— Special Inspection Stresses Used
— Preliminary Acceptance Tests (Masonry Units, Wall Prisms)
— Subsequent Tests (Mortar•. Grout, Field WaA Prisms)
— Placement Inspection of Units
Tests
STRUCTURAL STEEUWELDING:
— Sample and Test (list specific members below)
— Shop Material Identification
— Welding Inspection 0 Shop 0 Feld
— Ultrasonic lnV-- ion ❑ Shop O Field
_ High -strength Bolting
Inspection O Shop O Feld
DA325 ON ❑X OF
O A490
Metal Deck Welding Inspection
— Reinforcing Steel Welding Inspection 1
— Metal Stud Welding Inspection
— Concrete Insert Welding Inspection
FIREPROOFING:
— I twernent Inspection
Density Tests
.� Thickness Tests
Inspect Batching
INSULATING CONCRETE:
— Sample and Test
— Placement Inspection
— Unit Weights
FILL MATERIAL:
— Acceptance Tests
_ Placement Inspection
T Field Density
STRUCTURAL WOOD:
— Shear Wail Nailing Inspection
— Inspection of Glu4am Fab.
Inspection of Truss Joist Fab.
ADDITIONAL INSTRUCTIONS OR OTHER TESTS Sample and Test Components
AND INSPECTIONS:
As required by Ordinance #2661 the geotechnical engineer of record shall monitor this site during
cos a ort includin : site excavation,
shoring, soil support for foundation including piles, soil bearing capacity, subdrainage installation, sot
compactions, and other ge—otechnical aspec i
'cal report must be im lemen0d by the owner. The geotechnical engineer shall make
written, dated reports on the progress of the construction and submit a repUrt to the Building Official an a
vvve* b.sis'unfil fill site grading, drainage, foundation and associated groundwork is complete. Omissions or
deviations from the approved geotechnical report and/or approved plans or specifications shall be tg e g
an imme toe su rrtt 'tin of
work sg2ypages of more than one week In addition to the geotechnical monitoring, special inspections based,
om the provisions ofXBC Section - are requirea when specinet! on the approved plans. her Spec -a'
FormcompiCIN eetiens_tnaj�also hp rni„ited by tiie-geotechnical engineer, arelfiWt, or structural engineer (refer to
Telephone No approved plan set). At the completion of final site grading and all permitted structures, a final geo ec n
icat
"repo , pr itw his report shall
contain a 'statement that, based upon his/her professional opinion, site observations, and testing during the
monitoring of the construction, the completed development substantially compiles with the recommendations
in the geotechnical report and with all geotechnical related permit requirements. Any deviations or omissions
in the report, plans, or specifications that occurred during construction shall be addressed separately.
Occupancy, final approval or release of the bond for the project shall not be granted until the report has'been
reviewed and accepted by the Building Official.
his/her knowledge the project is in conformance With the approved plans and specifications,
approved change orders and the applicable workmanship provisions of the IBC. Items not in
conformance or unresolved items or any discrepancies in inspection coverage, (i.e., missed
inspections, periodic inspection when continuous inspections were required, etc.) shall be specifically
itemized in this report.
B. Contractor Responsibilities
1. Notify the Special Inspector
It is the duty of the contractor to notify the special inspector when work is ready for special
inspection. Note, the items listed on the attached schedule and as noted on the approved plans and
specifications are required to have special inspections. Adequate notice shall be provided by the
contractor so that the special inspector has time to become familiar with the project.
2. Provide Access to Approved Plans
The contractor is responsible for providing the special inspector access to approved plans at the
jobsite.
3. Retain Special Inspection Records
The contractor is responsible to retain at the jobsite all special inspection records submitted by the
special inspector. These records are to be provided to the City building inspector upon request.
C. City of Edmonds Building Department Responsibilities
Approve special inspectors or inspection agencies
The building department shall approve all special inspectors and special inspection requirements.
2. Monitor special inspection and approve weekly reports
Work requiring special inspection and the performance of special inspectors shall be monitored by
the City Building Inspector. His/Her approval must be obtained prior to placement of concrete or
other similar activities in addition to that of the special inspector.
3. Issue Certificate of Occupancy
The Building Official may issue a Certificate of Occupancy after all weekly special inspection reports
including the final report have been submitted and accepted.
D. Owner Responsibilities
The project owner or the engineer or architect of record acting as the owner's agent shall fund
special inspection services.
E. Engineer or Architect of Record Responsibilities
The engineer or architect of record shall include special inspection requirements on the plans and
specifications.
Owner
ACKNOWLEDGEMENTS
I have read and agree to comply with the terms and conditions of this agreement.
Date
Special Inspector Date
General Contractor
City Building Official
Date
Date
L:ITEMPIBUILDINGISpecialInspectionAgreementIBC.doe 7104