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HomeMy WebLinkAbout11349 13 cr CITY OF GLENDALE,ARIZONA !Alb BUILDING SAFETY DEPARTMENT-COMMUNITY DEVELOPMENT GROUP GLENDf,E SPECIAL INSPECTION CERTIFICATE • Project Name Date 9rrei_h1/414 DP I ic-A l_ - -0 4-- Project Address / Permit Number �J DSC Number 7700 6,2 Arra&ad !ten s 4-//4,3 11? < 64 be) ( CER 11F1CATE 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 me,I certify that the construction of the above-described building project will receive special inspection. Name of Architect Contractor • Name of Structural Engineer .. Signature of Owner or Legal Agent --- — SPECIAL INSPECTION RESPONSIBILITY CERTIFICATE (To be filled in and sealed before building permit is issued.) • I certify that I 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) under my direct supervision and are to be on the job site to render full,complete and competent inspection. � � . T e special field inspector(s)are to be named below before work under their area of dutycommences. •� � / ,� et. P l - 0„ .4reh:"`�'Engineer Responsible forSpecialInspection (Type or Print) - .« 21852 CHARLESH. < CH�e�..�s 1�- A-T r�w — c[ ATKINSON p Name of Inspector(Structural Masonry) Name of Inspector(Steel) % K� Name of Inspector(Concrete) Name of Inspector(Welding) • /ZONAU A' N��Q��L•L13_6 ! Name of Inspector(Specify Type) Name of Inspector(Specify Type) Place Registration Seal and Signature Date 7,SPECIAL INSPECTOR QUALIFICATIONS [UAC SEC 302.5] ARE APPROVED.\-P G( /J fi7-5'0`/// Building Officia() Date CERTIFICATE 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 ICJivance of the certificate of occupancy per Section 309 of the Uniform Administrative Code of the er .t4 j1 •ity of Glendale,1997 edition. ..4k( +0 (9-* 21 852 5.7. I certify that,to the best of my knowledge,the requirements of the approved plans for which special inspection CD CHARLES H. is required and Section 306 of the Uniform Administrative Code have been complied with.A guarantee that CC ATKINS©N the contractor has necessarily fulfilled the obligations of his contract is neigher intended nor implied. 11, R/z®ry r Architect or Engineer Responsible for Special Inspection (Type or Print) Place • - �' al and Signature Date RETURN TO BUILDING SAFETY DEPT.FOR APPROVAL AND DISTRIBUTION TO THE FOLLOWING: -BUILDING SAFETY DEPARTMENT % 1] -BUILDING INSPECTOR -ARCHITECT OR ENGINEER 0 -JOB COPY(TO BE RETURNED TO THE BUILDING OFFICIAL WHEN YOUR INSPECTION IS COMPLETE AND BEFORE A CERTIFICATE OF OCCUPANCY IS REQUESTED.) Au-001-07/00 -