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�� 5850NL GLENDALE AVE,2NDFLOOR
a. GLFiw.E,DB53D1 SPECIAL INSPECTION/VERiFICATION CERTIFICATE
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ARCHITECTURAL ENERGY CODE COMPLIANCE
OWNERS NOTIFICATION OF SPECIAL INSPECTION
To be compteled end signed by the Owner before a building permit is lamed
In accordance with lheGlendele City Code,Chapter 9.1,as owner/legal agent do hereby certify that the construction of the below described bulldog protect will
receive Special inspection or Third Party Vert Ream for compliance with the City of t;tendele's current adopted Enerre Code.
The Architect may also aerrtlfythla project for Enure/Coda compliance.Owner's name: gr'ir-- Gir;V+r:wg1!_ OwaeYsStgnelare: l�v!� Date: E/A
PROJECT NAME: p REGISTERED DESIGN PROFESSIONAL/FIRM NAME
Cadence at Westgate Village u k I Energy Inspectors -JC
'PROJECT ADDRESS: REGiSTERED DESIGN PROFESSiON WFIRM ADDRESS:
2570•S Miller Lane
�/ -' •e Las Vegas, NV B9117
CO&PROJECT NUMBER: I ct t i 7 3 COG PERMIT NUMBER:
SPECIALINSPECUUON/VEBIFICATIN RESPONSiBLLITYCERiIRCATE CERTiFICA1EOF COMPLIANCE&APPLICATION FORCERTIFlCATE OFOCCUPANCt
To be Aged in and signed by the Architect,Speclet Inspector,Contreclot or Third To be filled In end signed by the Ara Meet.Special inspector,Contractor or Third
Patty Remormible for year:Wort. Party Responsible for verification.
I Colby that f am familiar Mitt the The construction of the aboveenergy code compilance named proJeatis complete end
requhetnents of the above named meets or exceeds the requirements
project and energy consetvatlop.I of the Cigr of GIendale's currently
hereby assumettllt responalbaYto adopted Energ Code.Request Is
canytng out the required spectral hereby nmdefor Issuance of theA t
Inspections and verlficatIons. certificate of occupancy.
I cerUfythat,to the best of my
knowledge,the requirements of the J.Lf i{itz-a
approved plans for Which Spodal !!
Inspection or Third Party Verification
Is required have been met
(ArehtiectsSeaf,signature,and Date-rr fluchrtectYseal slgtature,andpate•tr
aValoaYte) applicable] t
SPECIAL INSPECTOR QUAi IFICATIONS APPROVAL EY BLAMING OFFICIAL/MANS E SA AIRER.vier DATA 0112 i114
instrucbr•/information abort this form:- ff
1 A Spacial Inspection is not'Regtired%
2. The person•slgiunC in the area that states that project will conform to MS currently adopted Ettergy Code does not hare to he the same person that verities
those requrremen s.
3. The City of Glendale,Arizona,onif needs this form completed and lcharted;we do not need any strpporung documentation ht order to¢sue a Certificate of
Occupancy.
JOB SITE COPY
THESE PLANS SHALL BE KEPT AT THE
JOBSITE AND BE AVAILABLE TO CITY
OF GLENDALE INSPECTORS DURING
WORKING HOURS. PLANS SHALL NOT
BE ALTERED WITHOUT BUILDING
OFFICIALS APPROVAL.
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FORM EFFECTIVE 04/26/2019 ' POST ATJOB SFTE WITH PERMIT
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