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CITYOF GLENDALE - -
' men PLANNING&DEVELOPMENT SERVICES .
41:„ 5850 W.GLENDALE AVE.,2ND FLOOR . .
GLENDALE,AZ 85301 'N
(Glendale 823:930.2800 SPECIAL INSPECTION CERTIFICATE
0 1 o t./ :," .www,GiendaleAZ.com ' STRUCTURAL
OWNER'S N0.'CIFICATIQAI PFSPECIAI IIVSPECTIQN
To be completed and signed by-the Ownerbelorera building permit Is Issued
In accordance With Sections.1704 and 1705 of the 20 t8:Intematlonal Building Codp;whi�h requires )*q rt I.cgJ1S Ucttgrfwork-.be placed under inspection
of a registered design professional.I,as owner/legal agent,do hereby certify that I'have eetalhed� 1{ (' � � j G ull-•U(;to.be
• .responsible forte special inspections on this•prri)egt, -,(e`e jite bo pa4)gii Ptbfosllonat/FU&=>Zieasa pddi?
Owner's name:. • -Owner'sSignature: Date: • ..
PROJECT NAME; . ' ' •.REGISTEREDJDESIGN PRRFESSIONAL/FIRM NAME: -
/� C11fr
[= lyoY�_ , ...:. f�- bwho� •.� hDeniXT�Si�n��-.1n5 ►-G
'PROJECT ADDRESS:. -- ' REGISTERED DESIGN.PROFESSIONAL/FIRM ADDRESS;
_` E-� . ti_._ , ,..„, ,,,�,,,,,a f_ . • i 31D5 5. j rd enue ?hoeh x1 ;1Z S50b9
. COG PROJECT NUMBER: - Y__. COG;PERMITNUMBER:
CERTIFICATE OF RESPONSIBILITY - - CERTIFICATE OF COMPLIANCE '
•
To be filled In and signed bythe professlonal.in charge of Special Iris}iections i 'Toie filled In and signed-bq the professional in charge of Special Inspections
before a building permit Is issued. , :before:a certificate of occupancy is issued.
As registereddeslgn professional In ' . '—� I certify that,to the best of my OrieSSlaf1e/
. change of special Inspections of the op e;�S'� n--1, � knovrledge,the requlrements.Of the Qt FO
above named project,I eartWthat I a •
�f I CA T 4 018 intemational Building Code iwa ��F I�'�TF 9�0
am farrilllar with the design df the - �� and the approved plans and 4, 3667� �' ��^
project arid hereby assume.full (4 36871 ,tJ n .;speoiflcatloM have been compiled 'sin O Q 0.
resgonstbllltyforcarryingoutthe with:insofar astha ortionofthe °� ROBERT N.m ROBERT N. ' < p - Z.
required special Inspections In C4 POCANO , .7 ; work.coring speeiai Inspection a POC NO .':
•accordance with Sections 1704 and ` . �ti under Section 1704 and 170 I dry �•
1705 of the 2018 international \ •% 4 ` concerned A?guarantee that the �� �o'i� .
Building Code, q ��nod% contraetonnecessanly constructed , \•G j N.
Rii«?NA 'c''� I. the building,in full accordance with 'tb BONA U.S'' L� .
�p%rp Q2 f(ie plans acid speeificatlons is reS yz •
neither Intended nor implied.
•
(Seal,Signature,and Date) . (Seal,Signature,and Date) .
SPECIAL INSPECTOR QUALIFICATIONS APPROVAL BY BUILDING OFFICIAL/PLANS EXAMINER(1704.2.1): . -__ .... DATE.
WORK WHICH REQUIRES SPECIAL INSPECTION: -:QUALIFIED SPECIAL INSPECTOR INDIVIDUAL OR FIRM
CONCRETE CONST•RUC•TION/R•EINF•ORQIN•G•ST•EEL• (170•5.3) PT
❑MASONRY CONSTRUCTION(1705,4)
_
•
WOOD PONSTi2UCTION.(1705,5)
.
❑ STEEL CONSTRUCTION(1705.2&AISC 360)
. pi SOILS.(1700.6) ' 'r" r
FOUNDATIONS(1705,T. 1705:8&1705,9) .
Ai SPECIAL POST-INSTALI.ED'(SPDXY/EXPANSION)ANCHORS:(1705.�..1):; :,"f 4 ;:', .
• ❑;EISMIO RESISTANCE(_1,705.12) •
0 SPRAYED FIRE-RESISTANT MATERIALS(1705,14) •
• .❑E)G ERiOR INSULATION AND FINISH SYSTEMS(EI.FS)(1705:16)
.❑ STORAGE RACKS(1705.12.7) ••
•
'❑ OTHER:. .
•
FORM EFFECTIVE 04/26/201.9 POST AT JOB SITE WITH PERMIT
a M ;, CITY OF GLENDALE
t `41 PLANNING&DEVELOPMENT SERVICES
%.,. 5850.W;GLENDALE AVE.,2ND FLOOR.
GLENDALE,
(;��Sent �a'+�` fi23.t33O.2800 SPECIAL INSPECTION/VERIFICATION CERTIFICATE
A R r z. c N A www.GlendaleAZ.com ARCHITECTURAL ENERGY CODE COMPLIANCE
OWNERS NOTIFICATION OF SPECIAL INSPECTION
To be completed and signed by the Owner before a building permit Is Issued
in accordance with the Glendale City Code,Chapter p,I,as owner/legal agent,do hereby certify thetthe construction of the below described building projectwill
receive:Special ingpecUon or Third Pertyyeriltsatiodfor compilenco With the City of Giendato'a current adopted Energy Cede.
Tha Architect may also eartitk this pro)oet for Energy Code compliance. ,
FP%1-,9: to,<t:,,aoxst.t1'na/ 1��� /
Ownsr!s:name; �,+ �'% V.56 Owner'sSignaiute, C".�. Date: { iq
PROJECT NAME: REGISTEREDDESi PROFESSIONAL/FIRM NAME:
mil. F/Z04 D p Energy Inspectors JC
PROJECT ADDRESS: 7928 W.Orange Dr, Lot 109 REGISTERED DESIGN PIROFESSIONAL/FIRMADDRESS:
� / Miller Lane
�F. A w 7® Ai, 7qr f.Av Las Vegas,NV 89117
-
COG PROJECT NUMBER: 1�9`1'530 h COG PERMIT NUMBER: \r.-1 7.).�)'\ LS
i
t SPECIAL INSPECTION/VERIFICATION RESPONSIBILITY CERTIFICATE CERTIFICATE OF COMPLIANCE&APPLICATION FOR CERTIFICATE OF OCCUPANCY
To be filled In and signed by the Architect,Special Inspector,Contractor or Third To be filled In and signed by the Archltect,Special Inspector,Contractor or Third
• PartyResponsIble foiverlfcation. Party Responsible for verification,
I certify that I am famiflar with the The construction of the above
energy code compliance. named project Is complete and
requirements of the above named meets or exceeds the requirements
project and energy conservation.I of the City of Glendale's currently
hereby assume full responsibility to adopted Energy Code.Request Is
carrying out the required special hereby made for Issuance of the Ofb/f/f 0jOc//Q1(
inspections and verifications. certificate of occupancy. o0
I certify that,to the best of my •
knowledge,the requirements of the
approved plans for which Special
Inspection or.Third Party Verification
Is required have been met:
• (Architect's Seel,Signature,and Data•If. !Architects Seal,Signature,sad Dole•g
i applicable). , *r ``` septtcaote) j
SPECIAL INSPECTOR QUALIFICATIONS APPROVAL BY BUILDING OFFICIAL/PLANS EXAMINER: ".Jr DATE:1p17'I/> Iq
Instruction/intormetion about line form:
1, A Special inspection Is not"Required..
2 The person signing in the area that stales that roject will ccn(orrn to the Currently adopted Energy Code does not have to be the same pet son Thai verifies
those requirements.
3. The City oi Glendale,Arizona.only needs Ills lot in convened and•raturned;we do not need any supporting documentation in caner to Issue a Certificate of
Occupancy. •
AV f 1q. I
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FORM EFFECTIVE 04/2e/20t9 POST AT JOB SITE WITH PERMIT
I '
• .• plir
Phoeniix,�Testiing & Inspectilon LLC
• • • 3635 S.43b Avenue• Phoenix.AZ.85009 • Phone(602)272-2688 • Fax(602)272-0804
Drainage Inspection
Inspection Date 9/30/21 Inspector 0.196',
Community El P r(tao Address 792& W, Orao e f.ot# 1 Q/
Builder Tayl 0 r ►-l O V e i 5 Q n Model&Elevation ✓ Permit# /30766
Concrete Contractor iNotes
Grading Contractor •Structural Engineer
Lot Landscaped YES ❑ NO kl Home Occupied YES 0 NO 21
Diagram-
10a 5 5 1 o o. 56 l oo. 54"
00.52.
1007 I4, 9 -7 '00076
lz.
18.0
9. 7
l°61111 . 16•2 oa, 75
148•
1
1ao, 12
100, 31
6-F 19,z 20.9 --95
jQD33
)00,2o
100.00 )00.H.-
Comments Drainage Inspection Results
(please circle one of the following)
Meets Builder oes Not Meet
Requirements Builder
Requirements
Updated 0er17168