HomeMy WebLinkAbout070563 Q)w f CITY OF GLENDALE.ARIZONA
BUILDLNG SAFETY DEPARTMENT•COMMUNITY DEVELOPMENT GROUP
GLENDaE SPECIAL INSPECTION CERTIFICATE
'Pmleo Na Date
/'�u e `5 f$ tpunGto cat 2'f/07
Project Aadreu Permit N r DSC Number
67427 N 47' Ave- 070 re3
I 1 CERTIFICATE OF SPECIAL INSPECTION BY OWNER
(To be filled in and signed by owner before permit is issued.)
In accordance with Section 306 of the Uniform Administrative Code of the City of Glendale, 1997 edition,which requires
that the execution of certain construction work be placed under the inspection of the architect,engineer,or special inspector
employed by mc.I certify that the construction of the above-described building project will receive special inspection.
Name a Architect /�5 Cont
n,cmr
Name u/Sirn�uu1nl�Ertnn�e,r " //���' SI., w •• 'QM,"
6� �huclt-4Frlpereev5 r i1/'
ESPECIAL INSPECTION RESPONSIBILITY CERTIFICATE
(To be filled in and sealed before building permit is issued.)
I certify thut 1 am familiar with the structural design of the above-named project and.in accordance with
Section 306 of the Uniform Administrative Code of the City of Glendale, 1997 edition,I hereby assume full
• responsibility for carrying out the required special inspection.Inspection reports will be filed with the Building
Safety Department,as required by Section 306.3.The following individual(s)will be special field inspector(s)
.rte under my direct supervision and arc to be on the job site to render full.complete and competent inspection.
7• ; �' ei ";• e special field inspector(c)are to be named below before work under their arcs of duty commences.
i
Q Q1 y �
Arcb,uct urE,gineer Rrepunrihlefor Special Inspect (TYp or Print)
.ID: C) " fitt.hu.el t Cx wt.- 6e6 Srir'� t nem
30559
MICHAEL B.
6 OGO O . Namtof Wprcwr(StercwtWVary) , 1 Name of Inapttturgreet)
, y�y�/ry,� o W045+e� naS�I f
`rrOrfid...••' None of Inspector(Concrete) Name of)nrpremr(Welding)
f9/ZONA,U`SP
Name,1 tnrper nn lspech l>pe) 'Name fJetptoar(Sperih Type)
rP
Place Ree:n .. al and
Sianamn Date ,
SPECIAL INSPECTOR QUALIFICATIONS (UAC SEC 302,51 ARE APPROVEDY.ePI /8 ! f lig?
Building Official (� Da
nCERTIFICATE OF COMPLIANCE AND APPLICATION FOR CERTIFICATE OF OCCUPANCY
(To be filled in and sealed before certificate of occupancy is issued.)
The construction of the above.named project is substantially complete and request is hereby made for
issuance of the certificate of occupancy per Section 309 of the Uniform Administrative Code of the
City of Glendale. 1997 edition.
I certify that.to the ben 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 nigher intended nor implied.
•
Artb,met or Emmert Renpnurblejot Special lntpernW (Type ar?Nal)
Place Rector-pun Swot NW
BienniumDan
RETURN TO BUILDING SAFETY DEPT.FOR APPROVAL AND DISTRIBUTION TO THE FOLLOWING:
Q•BUILDING SAFETY DEPARTMENT
to-BUILDING INSPECTOR
❑•MCNRECT OR ENGINEER
O .tae COPY(Tose aENasEo TO THE WILDING OFFICIAL WHEN YOUR INSPECTION IS COMPLETE AND BEFORE A CERTIFICATE OF OCCUPANCY IS REQUESTED.)
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