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BUN.DING SAFETY DEPARTMENT-COMMUNITY DEVELOPMENT GROUP
GLENE SPECIAL INSPECTION CERTIFICATE
Prsanieree Dam
BROOKWOOD DIALYSIS CENTER TI 09/08/2d08
Project Address Penne Number Puha Nuretor
8910 N 43RD AVE 080667
CERTIFICATE OF SPECIAL INSPECTION BY OWNER
(To be flied In and signed by weer before permit Is Issued)
M aaoadanoa with the 2088 international Budding Codes. which rowans Nal the execution of certain aawtecte n an be placed under the
iapealka 01 the=hatch owner,or spaced inspector employed by me.I teary that ON ansuudtn at the above-descdbad building project whi
MOO"end mspecean.
NameroArambor Corfecbr
fearer, Robbins & Stephens, inc. Envision Construction & Design
Naha ofStrUctUndEngineer Sense of Onverata alAga,f
Caruso Turley Scott, INc.
SPECIAL INSPECTION RESPONSIBILITY CERTIFICATE
(To be tied in and sealed before bull@rg permit Is issued)
I certify that I we bream with . - sNkhad deste of the above-named paled and,in em tiara with the 2008 fntomaVenal&ddM Codes.I hint,
eaarnra lullisaporMhlley for —aria; the required special Inspections Inspection reports will be Bled with the Building Wary Deponent sequins regui
by t he 2OOR y+e1I: B "�.r The logesdng MwJ iduegs)wa be special Bald Inspeaotls)under my dratd supervision and me to be on the Jot
aisle .:.j�� Tnal P,::rJ. .cam InM,ecfon.
CerThe special held Inspector(s) tce
or(a)ere to be named below before work under Net mon of duty comma a
/ v/V( "vl7ca - Anted aEnstimer Raspmemle Aw r Spo Inspaden(typo ran
23288 4, `" {/�Rt-u 'Tu
5o na SC&
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C.J. r�pap:Egemaa�t,ParAnanra> II
smaftrg ftaat wak /rupee/or
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ositafele Rr4E,z f f&4GEt
10MA.ut 743014 Vehl Qg1JSEW
EXPIRES 03-31-11 p d9
SPECIAL INSPECTOR QUALIFICATIONS(IBC 17031 ARE APPROVED. s 9../ pg
nemmdmirm
CERTIFICATE OF COMPLIANCE AND APPLICATION FOR CERTIFICATE OF OCCUP
(To be filled In and seated before certificate of omupancy Is Issued)
The construction of the son-earn project la substantially nano and inquest B hereby made fa khmtanee e
the nits of occupancy per the 2006 International Building Codes.
I teddy theta to Its best of my Mev4odge,Ue nequkmeoms of Ne appnovmd pin for attach spade!Inepedkn b
required and the 2008 International Building Codes have been consoled wnh. A gun nntee that the contracts hat
necessarily Milled the obligations of this caroaot is nether intend mar Mepiled.
AMOS aWigvaor Responsible for SpaBderapadfsi awe awful)
RETURN 10 THE EtuttOiNG SAFETY DEPARTMENT FOR APPROVAL AND DISTRIBUTION TO THE FOLLOWING:
❑ BUILDING SAFETY DEPT. 0 BUILDING INSPECTOR ❑ ARCHITECT OR ENGINEER ❑ JOB COPY
C'C le- 21/42-*l