HomeMy WebLinkAbout00000 r CITY OF GLENDALE,ARIZONA . •
BUILDING SAFETY DEPARTMENT-COMMUNITY DEVELOPMENT GROUP
Mk SPECIAL ELECTRICAL INSPECTION CERTIFICATE
GLENDfE
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Project Name e : Dat��f �g )
Mitizo t.A.A.;$ i.
Project Address Permit Number DSC Number i
7410 t.I. ZANUEno tuit> 042161- 5
CERTIFICATE OF SPECIAL INSPECTION BY OWNER
(To be lilted In and signed by owner before permit Is issued) i
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In accordance with the City of Glendale amendments to Article 90.2(A)of the 2005 National Electrical Code,which requires that the execution of certain `
electrical construction work be placed under the inspection of the Engineer,or Spacial Inspector employed by me,I certify that the electrical portion of t
construction of the ahovs-described hufdioo orvinct will receNe SI)Fn',,I inspection t
Name 0/./tit/led of re ord Contractor i
� aL�{L II AS CQ� � �C -�\ L. c'� 1
t ( AyCS(CgC , �c
Name of Electrical Engineer VVV1 Signature of Owner or Leg gent i
DA14tAY 3 . StMPSoN (`Y i
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SPECIAL INSPECTION RESPONSIBILITY CERTIFICATE I
— (To be filled In end sealed before building permit Is issued.)
I certify that I am familiar with the electrical design of the above named project and,In accordance with tha City of Glendale
amendments to Article 90.2(A)of the 2005 National Electrical Code,I hereby assume lull responsibiltly for
carrying out ire required special inspections. Inspection reports will be filed with the Building Safely Department, I
as required by 2003 International Building Code Section 109,3.9.1. The following Individual(s)will be special field Inspectors
under my direct supervision and ere to be on the job silo to render full,complete and competent inspection.
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The special field inspector(s)are to be named below before work under their area of duly commences. j
��‘i.t C A TF Dee„ Engineer Responsible(or Special inspection(type Cr print) I
m U 35945 O g j>ANt4'( J . J 1 NAQ50 0 I
ti DANNY J. Name of Inspector(Ground Fault Protection) Name of Inspector(Other,Specify) 1
a SIMPSONO�/ f
ae'r/ 1b /T�/ Name of Inspector(Equipment 100D amps or more)
4RICNAUSP ? or2 �[�I �/.�E. 1 t
�r Name of inspector(Emergency and Standby Systems)
pies 03)3' i-
SPECIAL INSPECTOR QUALIFICATIONS[IBC SEC 109.3.9.1]ARE APPROVED.... Q, _ 9_4 "Oa
Building Official Dare
CERTIFICATE OF COMPLIANCE
— (To be filled In and sealed before certificate of occupancy is Issued.)
The construction of the above named project is substantially complete.
I certify that,to the best of my knowledge,the requirements of the approved plans for which special inspection
Is required and 2006 International Building Code Section 109.3.9.1 have been complied with. A guarantee that
the Contractor has necessarily fulfilled the obligations of his contract is neither Intended or implied.
Engineer Responsible for Special inspection(Type or Prim)
RETURN TO THE BUILDING SAFETY DEPT,FOR APPROVAL AND DISTRIBUTION TO THE FOLLOWING:
❑ BUILDING SAFETY DEPT. ❑ BUILDING INSPECTOR El ARCHITECT OH ENGINEER ❑ JOB COPY
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