HomeMy WebLinkAbout32139 CITY OF GLENDALE,ARIZONA - i `,
,. '�LE - - . BUILDING SAFETY DEPARTMENT-COMMUNITY DEVELOPMENT GROUP
G ` SPECIAL ELECTRICAL INSPECTION CERTIFICATE •
•
Project Name - Date
1-23'4 s4 ,—I &LeaLDALe i • /0- 0(0 . 0(..; •
• Project Address Permit Number DSC Number
1040q. N. Ll3- A✓ . GGLfNn4ci 353vz 0626 ` 1
2 CERTIFICATEfOF SPECIAL INSPECTION BY OWNER
(To be filled in and signed by owner before permit is issued)
In accordance with the City of Glendale amendments to Section 306 of the Uniform Administrative Code of the City of Glendale 1997 edition,which requires that the
execution of certain electrical construction work be placed under the inspection of the engineer,or special inspector employed by me,I certify that the electrical portion of
construction of the above-described building project will receive special inspection.
•
Name of Architect of record - Contractor
ThILkY Cr. we6Kg_n1 ADoLFsOM £ Pe-iason)
Name of Electrical Engineer Signature •.•-j-:•at 4n-nt **Orr r AA. t2-�' .va
&ben a ' 0i5e9t) 73 q Z1 va)74/
tgr SPECIAL INSPECTION RESPONSIBILITY CERTIFICATE • -
�J (To be filled in and sealed before building permit is issued.)
I certify that I am familiar with the electrical design of the above-named project and,in accordance with the City of Glendale
amendments to Section 306 of the Uniform Administrative Code of the Ci of Glendale 1997 edition,I hereby assume full
Ointtf
responsibility for carrying out the required special m reports will be filed with the Building
Safety Department,as required by Section 306.3. The following individual(s)will be special field b'peatere ObSCMec
under my direct supervision and are to be on the job site to render full,complete and competent ineineetieer.sksion .
9. c+,'fir. > The special field inspector(s)are to be named below before work under their area of duty commences.
eke - 9rp
lr(-'.%S F i C A rF et, Engineer Responsible for Special Inspection(type or print) •
!/_'"c" ?4210 0 ,
(
T' RUr FRT D. I- Name of Inspector(Ground Fault Protection) Name of Inspector(Other,Specify)
o
0 ./ _
6;..1O Name ofQ1�IM(EquipmentSeen(
JWOO amps or more) •
,' rrned.. ' P- ..O9 SSBR. /1 e Q 0/soh
Name of brepeeter(Emergency and Stand-by Systems) •
eller er•-.V0Ae4 % /51c017 n`//���
SPECIAL INSPECTOR QUALIFICATIONS [UAC.SEC 306.2]ARE APPROVED. 4N' mob' Io-Z,p•( Xo
Building Official DatrF
• ' n CERTIFICATE OF COMPLIANCE •
I (To be filled in and sealed before certificate of occupancy is issued.)
The construction of the above named project is substantially complete.
I certify that,to the best of my knowledge,the requirements of the approved plans for which special inspection
is required and Section 306 of the Uniform Administrative Code have been complied with. A guarantee that
the contractor has necessarily fulfilled the obligations of his contract is neither intended or implied.
Engineer Responsible for Special Inspection(Type or Print)
RETURN TO THE BUILDING SAFETY DEPT.FOR APPROVAL AND DISTRIBUTION TO THE FOLLOWING:
0 BUILDING SAFETY DEPT. 0 BUILDING INSPECTOR 0 ARCHITECT OR ENGINEER ❑-JOB COPY