HomeMy WebLinkAbout0000 (14) rink, CITY OF GLENDALE,ARIZONA
dubBUILDING SAFETY DEPARTMENT-COMMUNITY DEVELOPMENT GROUP
SPECIAL INSPECTION CERTIFICATE
GLENDfE
'Project Name Date
C. �_ 4. ( &I a Ze PL_cC- v 't -vV I z =, f
Project Address A Permit Number DSC Number
�I CERTIFICATE OF SPECIAL INSPECTION BY OWNER
I I (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 (j Contractor
j\
Name of Structural Engineer [--\ A( 1 j0 1�AC1,L. 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 inspections. Inspection reports will be filed with the Building
Safety Department,as required by Section 306(c). The following individual(s)will be special field inspedors(s)
a under my direct supervision and are to be on the job site to render full,complete and competent inspection.
•
fi The special field inspector(s)are to be named below before work under their area of duty commences.
I f s .4tchitector.Engineer Responsible for Special Inspection(type or print) p (-4,-N-[c.
f tA,ArZvL_t� .. I-4 l��-�- F? l t '�� G ,- t__.
1.
I° , ` 1t Name of Inspector(Structural Mason, Name of Inspector(Steel)
f ki a1i� t l 205 7— SA PO Ni
y�Y 1 Name of Inspector(Concrete) Name of Inspector(Welding)
t o,S'ei ens - PO I`1 ZO 5 -1 b is4
(if r1, t'.. " ••';Name of Inspector(Specify Type) Name of Inspector(Specify Type)
t. �� z�
SPECIAL INSPECTOR QUALIFICATIONS [UAC SEC 306(B)]ARE APPROVED. / �� �' u �'��
tfurl rng U aai ate
CERTIFICATE OF COMPLIANCE AND APPLICATION FOR CERTIFICATE OF OCCUPANC
(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
issuance of the certificate of occupancy per Section 309 of the Uniform Administrative Code of the
City of Glendale 1997 edition.
I certify that,to the best of my knowldege,the requirements of the approved plans for which special inspection
is required and Section 306 of the Uniform Administrative Code have been complied with. A guarantee that
the contractor has necessarily fulfilled the obligations of his contract is neither intended or implied.
Architect of Engineer Responsible for Special Inspection(Type or Print)
RETURN TO THE BUILDING SAFETY DEPT.FOR APPROVAL AND DISTRIBUTION TO THE FOLLOWING:
❑ BUILDING SAFETY DEPT. El BUILDING INSPECTOR ❑ ARCHITECT OR ENGINEER ❑ JOB COPY
VilaP CITY OF GLENDALE.ARIZONA
BUILDING SAFETY DEPARTMENT-COMMUNITY DEVELOPMENT GROUP
SPECIAL INSPECTION CERTIFICATE
G�
Project Name Date
67. IM-Z M c) IVY F A) T
Project Address,' Permit Number DSC Number
4.3 vs.G' ¢ / 2‘..,e,,,ortc,<-2-. ie D 0 0 p1-
I I CERTIFICATE OF SPECIAL INSPECTION BY OWNER
I I (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 `-\ A t2o L ,Lc__ Signature of Owner or Legal Agent
M,C) -EA- .LA-- 1,1 Cs,
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 inspections. Inspection reports will be filed with the Building
Safety Department,as required by Section 306(c). The following individual(s)will be special field inspectrs(s)
under my direct supervision and are to be on the job site to render full,complete and competent inspection.
The special field inspector(s)are to be named below before work under their area of duty commences.
igF>i
e zhi'^ct^"Engineer Responsible for Special Inspection(type or pant) jr \ t _ 14 a,(,L
( ' { ��� l�A o(._D E_ N AL-L- 1 P . €u 4 r r�c.
11361
Name of Inspector(Structural Masora Name of Inspector(Steel)
HAIOLD El1GEN
Fib EAl/4/
N/� s '� SA POName of Inspector(Concrete) Name of Inspector(Welding)
S! ned.:.: P Z•ns- 1AP6 Ni Zo S T S.4eo Nam!
s <f0NA 13 Name of Inspector(Specify Type)
( pec'y. Name of Inspector(Specify Typel
/J//1. N r!4
SPECIAL INSPECTOR QUALIFICATIONS [UAC SEC 306(B)]ARE APPROVED.
Building UrAaal 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
issuance of the certificate of occupancy per Section 309 of the Uniform Administrative Code of the
City of Glendale 1997 edition.
I certify that,to the best of my knowldege,the requirements of the approved plans for which special inspection
is required and Section 306 of the Uniform Administrative Code have been complied with. A guarantee that
the contractor has necessarily fulfilled the obligations of his contract is neither intended or implied.
Architect of Engineer Responsible for Special Inspection(Type or Print)
RETURN TO THE BUILDING SAFETY DEPT.FOR APPROVAL AND DISTRIBUTION TO THE FOLLOWING:
❑ BUILDING SAFETY DEPT. ❑ BUILDING INSPECTOR ❑ ARCHITECT OR ENGINEER ❑ JOB COPY