HomeMy WebLinkAbout139161 Ci CITY OF GLENDALE
PLANNING&DEVELOPMENT SERVICES
5850 W.GLENDALE AVE.,2ND FLOOR
GLENDALE, Z 85301
Glendale 623.930.2800
SPECIAL INSPECTION CERTIFICATE
ARIZONA www.GlendaleAZ.com STRUCTURAL
OWNERS 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 certain construction work be placed under inspection
of a registered design professional.I,as owner/legal agent,do hereby certify that I have retained David A.Thomas,P.E./RAMM Engineering to be
responsible for the special inspections on this project. (Registered Design Professional/Firm-please print)
Owner's name: Owner's Signature: Date:
PROJECT NAME: REGISTERED DESIGN PROFESSIONAL/FIRM NAME:
Litchfield Easy Storage David A.Thomas, P.E./RAMM Engineering
PROJECT ADDRESS: REGISTERED DESIGN PROFESSIONAL/FIRM ADDRESS:
5960 N. Litchfield Road, Glendale,AZ 2105 S.Hardy Drive,Suite 13,Tempe,AZ 85282
COG PROJECT NUMBER: — COG PERMIT NUMBER: /3' '/Lip /3 / ,/ `3q/C1f
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 Inspections
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 �QSSIp knowledge,the requirements of the 0�
above named project,I certify that I �e<o tCAT�n�F 2018 International Building Code ��to�4�A�6-4. .
am familiar with the design of the �,� . N,. and the approved plans and to, ,��f TE vim
project and hereby assume full r•:? <✓ tip C� specifications have been complied 4.) F y
responsibility for carrying out the +or q 281 a2 withI‘r ,insofar as the portion of the G 28 $� O• 2�
required special inspections in I DA,JED A. work requiring special inspection crDAVID A
accordance with Sections 1704 and THC)MA'�S under Section 1704 and 1705 is TH�1MfiS
1705 of the 2018 International 7 concerned.A guarantee that the
Building Code. r Si Ep contractor necessarily constructed ��� �/y
the building In full accordan.: .th �.+1\4ke6 2
��+VA U the plans and specificatio • is %'�.h Z2INA ��'
neither intended nor impli-
(Seal,Signature,and Date) (Seal,Signature,and Date)
SPECIAL INSPECTOR QUALIFICATIONS APPROVAL BY BUILDING OFFICIAL/PLANS EXAMINER(1704.2.1): DATE:
WORK WHICH REQUIRES SPECIAL INSPECTION QUALIFIED SPECIAL INSPECTOR INDIVIDUAL OR FIRM
NI CONCRETE CONSTRUCTION/REINFORCING STEEL(1705.3) RAMM Engineering and Testing
J4I MASONRY CONSTRUCTION(1705.4) RAMM Engineering and Testing
❑ WOOD CONSTRUCTION(1705.5)
($i STEEL CONSTRUCTION(1705.2&AISC 360) Crosspoint Testing
($1 SOILS(1705.6) RAMM Engineering and Testing
❑ FOUNDATIONS(1705.7,1705.8&1705.9)
($I SPECIAL CASES:POST-INSTALLED(EPDXY/EXPANSION)ANCHORS(1705.1.1) Crosspoint Testing/RAMM Engineering and Testing
❑ SEISMIC RESISTANCE(1705.12)
❑ SPRAYED FIRE-RESISTANT MATERIALS(1705.14)
❑ EXTERIOR INSULATION AND FINISH SYSTEMS(EIFS)(1705.16)
❑ STORAGE RACKS(1705.12.7)
Cl OTHER:
FORM EFFECTIVE 04/26/2019 POST AT JOB SITE WITH PERMIT