HomeMy WebLinkAbout152184 •
C-.-44
"0 CITIOFGIENDALE PLANNING&DEVELOPMENT SERVICES
5850 W.GLENDALE AVE.,2ND FLOOR
GLENDALE.Ad85301 SPECIAL INSPECTION CERTIFICATE
���7;:agesza,s3oai�oo
A .; ; z n ii .•. wrNGiendaieALcem STRUCTURAL
OWNER'S NOTIFICATION OF SPECIAL INSPECTION
To be completed and signed by the Owner before a building permit is issued
. • In accordance with Sections 1704 and 1705 of the 2018 international Building Code which requires'that ce n conwuctioe work be pla it 4nde i i ction
of a registered design professionaL I,as owner/legal agent,do hereby certify that I have s tained t e..'►ykt ;LA i hee�s:r( �I rLIto be
responsible for the special Inspectio on this pro sot. /`�tt'l_gs,l«e�y sg"/Prote na!-gin"'.P? ep q
•
l lA \se- S► r0u ner's Si nature:; It ._ 0 : •• . •:Date:; -f r t 12-7,
s(,-_name :.., l
';PROJECT NAME? REGISTERED DESIGN PROFESSIONAL/FIRM NAME:,
ASPERA SENIOR LIVING F ) REPAIR icza. ;Y ( hs
i,PROJECTADDRESS:,' REGISTERED DESIGN PROFESSiONA1,/FtRv,VDDRESS:' Z414
2r12'40 N 78 i-I-i AVE
'2-1( 5 V�N. , s �l<aa t v Li.ct—T)c .
cos PROJECT NUMBER: 220S2a-1. COG PERMIT NUMBER: 152184
.CERTIFICATE OF.RESPONsiall,11Y; CERTIFICATE OF COMPLIANCE
To be filled In and signed by the professional in charge of Special Inspections • To be filled in and signed bythe professional in charge of Special Inspections
t before a building permit is issued. before a certificate of occupancy is issued.
}'.As registered design professional in • I certify that,to the best of my •
_
charge of special inspections of the 7-kessi0Rp/e knowledge,the requirements of the. otgssiortp/
above named project.I certify that I e-o. g1CA�\0 2018 International Building Code aQt — Fig
e Q� �a e, 1FICA\4
am familiar with the design of the • �0� 64' D m^ and the approved plans and ��� 4 f �eA
project and hereby assume full y i specifications have been complied y
responsibility for carrying out the 73319 with,insofar as the portion of the I 73319
required special Inspections in, DARIN work requiring'special Inspection cr
DARIN
accordance with Sections 1704 and WILLIS under Section 1704 and 1705 is WILUS
1.705 of the 2018 International gy n�N/j7 / concerned.A guarantee thatthe /)/frj17r` l
Buitding Code. asj�d.•,•-'' / contractor necessarily constructed \ �i/s� ' //
A'4 / the building In fun accordance with •/ ,_J
Ao.
�- the plans and specifications is J
// _CILIA' y neither Intended nor implied. / i,
(Sea,S g.tture,act Cste) • (Seal,Signature.and Date)
SPECIAL INSPECTOR Q APPROVAL BY BUILDING OFFICIAL/PLANS EXAMINER(1704.21): DATE
WORK WHICH REQUIRES SPECIAL INSPECTION QUALIFIED SPECIAL INSPECTOR INDIVIDUAL OR FIRM.,
❑ CONCRETE CONSTRUCTION/REINFORCING STEEL/POST-TENSION(1705.3)
❑MASONRY CONSTRUCTION(1705.4)
❑WOOD CONSTRUCTION(1705.5)
❑ STEEL CONSTRUCTION(1705.2&AISC 360) •
t ❑ SOILS(1705.6). •
i E'Fair:,EWTIONS(1705.7,1705.8&_`1705.9}, '+Gr► 1 t i Vvt�ii✓u- ✓i- SD'u^ to S
❑ SPECIAL CASES:POST-INSTALLED(EPDXY/EXPANSION)ANCHORS(1705.1.1) ,,r
• ❑ SEISMIC RESISTANCE(1705.12) . .
❑ SPRAYED FIRE-RESISTANT MATERIALS(1705.14)
• ❑EXTERIOR INSULATION AND FINISH SYSTEMS(EIFS)(1705.16)
❑ STORAGE RACKS(1705.12.7) .
0 OTHER: .
• FORM EFFECTIVE 04/26/2019 POST AT JOB SITE WITH PERMIT