HomeMy WebLinkAbout158094 T i 5 90Q V .,
. CITY OF GLENDALE
PLANNING&DEVELOPMENT SERVICES
5850 W.GLENDALE AVE.,2ND FLOOR
6239328 o853D1 SPECIAL INSPECTION CERTIFICATE
www.GlendaleAZ.com 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 uir s t at certain construction work be placed under inspection
of a registered design professional.I,as owner/legal agent,do hereby certify that I have r fined )R:) INA C[=Lit to be
responsible for the special inspections on this project.11 (Registered Design Professional/Firm-please print))
Owner's name: 'EFF �Ci1 I Ki�S a\S Owner's Signature: nt
Date: /. 2-U . Zi2�
PROJECT NAME: REG ERED DESIGN PROFESSIONAL/FIRM NAME:
tl i)\J S Ca.I. -" S 1�1ail C K r_xA01 )\I ota --i
PROJECT ADDRESS: REGISTERED DESIGN PROFESSIONAL/FIRM ADDRESS:
I-7 Li. I N- lO)�T ►q-V2--- Z52-s E= . A-F-t2-CJA-V1/4 .-131`zmL),2-Gi GI a-. 44.t14
Gua ��, Az._ 36t, -Gvlx: 1 Al 85b1
COG PROJECT NUMBER: 231199 COG PERMIT NUMBER: /56 0 7
CERTIFICATE OF RESPONSIBILITY CERTIFICATE OF COMPLIANCE
To be filled in and signed by the professional in charge of Special Inspections To be filled in and signed by the professional in charge of Special In ons
before a building permit is issued. before a certificate of occupancy is issued. �.1j r w
As registered design professional in ' I certify that,to the best of my r' AT ticharge of special inspections of the ,;ap, ►'. ,,knowledge,the requirements of the above named project,I certify that I tcik . -r'.'41.'� 2018 International Building Codeam familiar with the design of the (/�aQ r ^ and the approved plans and J293i1project and hereby assume full 'a;t. �'0 specifications have been complied „7 FREDERICK J.
responsibility for carrying out the j . 29371 with,insofar as the portion of the ' 0 hl{jE(rK,E
required special inspections in Ili FREDERICK J. el work requiring special inspection srj� Z '
accordance with Sections 1704 and NOELKE under Section 1704 and 1705 is �.s 'r
1705 of the 2018 International �s� £, concerned.A guarantee that the 'ty,,ti,`EO Q�
Building Code. \4 S�NEp / contractor necessarily constructed *-O?VA t
"4/? �' the building in full accordance with
-'O A V the plans and specifications is
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
MI CONCRETE CONSTRUCTION/REINFORCING STEEL/POST-TENSION(1705.3) F.,10c:\u L. 1 •Qr�L�
❑ MASONRY CONSTRUCTION(1705.4)
❑ WOOD CONSTRUCTION(1705.5)
▪ STEEL CONSTRUCTION(1705.2&A1SC 360) P- l,tL. LA 1'+�' _l0
❑ SOILS(1705.6)
11111 FOUNDATIONS(1705.7,1705.8&1705.9) \2 4 u L_ L-A-1 i�)..l D •
❑ SPECIAL CASES:POST-INSTALLED(EPDXY/EXPANSION)ANCHORS(1705.1.1) t`-141.L),L- LA t i J,0
❑ SEISMIC RESISTANCE(1705.12)
❑ SPRAYED FIRE-RESISTANT MATERIALS(1705.14)
Cl EXTERIOR INSULATION AND FINISH SYSTEMS(EIFS)(1705.16)
❑ STORAGE RACKS(1705.12.7)
❑ OTHER:
FORM EFFECTIVE 04/26/2019 POST AT JOB SITE WITH PERMIT
1)( 58094 ,
P 0 R
bnDATE - JOB P.O.
, 2525 E.Arizona Biltmore Circle, D-240 S — L_J
bakkum noelke Phoenix, Arizona 85016 vnaECT
consulting Phone 602.955.9200 ° g/^1 SD p- G S/D F Jl1G r
structural engineers Fax 602.955.9201 LOOAnoI
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www . bakkumnoelke . com canTrtACTat owoe
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THE FOIlAMNG WAS NOTED
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29371
FREDERICK J. -•
o
NOELKE 3
GIs 5/23/23,
14 S/•ned••..� P.
ZONA, U r�
COPIES 10
SIGNED4 . w PC-1 t-ir
P15 �
v
'a FLJRo 0HT .
iiGATE .ICO no.
2525 E.Arizona Biltmore Circle,D-240 5 1 7 —
Phoenix,Arizona 85016 -PRoJEcT
bakkum noelke Phone 602.955.9200 %%4=:)&f f"J e:*)1J- P. „m.- i
consulting
structural engineers fax 602.955.9201 tocAnon
t 74--5 i t,.J.. a, 1 AV
www . bakkumnoelke . com CONTRACTOR OMER
WEATHER TOO • at AM
) 7 ) kJ+ ori' 4/j. _ • at PM
PRESENT AT SITE
c"$17 .:�1—tom, ,L__ / ,�-,p7 - 5S c)b �7 �`"�',. .._
THE FOLLOWING WAS NOTED
> _-✓IE u! '� F---0 L.)r,-.1 r-! at-! i ' C _co l
01 l-(14-1-ef r7 -'T"-E-0 3 -- 3) 3
r~ ; w T N.
/•'''" ti
,i G 9371 �
FRED2 J,
NOELKEERICK ,,.
\•9 GNpP ' . i ' -
oNa /
COPIES TO
SIGNED r=/ 06--- .