HomeMy WebLinkAbout32390 ... CITY.OF GLENDALE,ARIZONA
BUILDING SAFETY DEPARTMENT-COMMUNITY'.DEVELOPMENT GROUP
SPECIAL INSPECTION CERTIFICATE
GLIENDfE
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Praiect Adams . . Date
rThriact Ai:Hans Permit Nun-abet DSC Alugabet
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---- CERTIFICATE OF SPECIAL INSPECTION BY OWNER
(To be NIOd in and signed by Oieter before permit ia iasuecl)
In accorderme with Section 3116 ofibe Uniforin Arferfnlialretiva Code of the Trty of Glendele•1937+Article,whiell requires that the execution of cerlairt
construction wort be placed under the inspect*of the architect enaifter,or epeeel 6WXcArg employed by rne.I cenify that file constmotiori of the
above-dowel:or/buBding projactwi morihre speceat"respet.lien.
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Cnotractor -- -- -,-,
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'fiterna OSA/se/War 6,09itroat• Signature•ofOwner Legal of
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ID SPECIAL INSPECTION RESPONSIBILITY CERTIFICATE
(To be filled iii and sealed before building Oerfnit is issued.).
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J certify that lam famainriyillt the structural design Of the above..namedProject and,iriaccoidemowilh
Seellen aria ofillplAipirilAdmielstrelfve Code of the City of Glendale l'asi edition,I hebehy assume fad
rr.,ttotaiitty fOrcartyino Gilt the Mr:Wired Special Inspections.:Inspection reports wit Peeled with the BuildieS
Selety:pepartreent,es required by Section 308(4 The followlog indilvklyel(s)will pa special field isspectorge)
under-n-40nd aupeniJalen=dere to he an the jab site to render eel,complete slut competent inspection,
The efiecisl field inspecterle)ary to be named below beforework tinder their area a duty oororean000.
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' d$41, • ' ' . k- Arrinisd or Er4r*Itte Rea-pain-Warm Speciaf Irtspe.c6on foe orprinf)
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Name ief Inspecto!:(Sted)
:Mem of lespenterNifelquo)
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22.,.. 4":4,/,:cligttit.el...1,A,744..7c:.'1.:..':./,..0•.4-1.}: .Name of iftiiRtael.co:a41.0
. 'sc..; 0 CUR'4 .,/,a•;- eff \''\c'eA,V-. L' ... s,j,i. :_c_f.,..ff t\I\Uoot_:e-.11\ -v_e_e_
2 - 9,t15:24 N.1.•'• 11 R....-A 1 :ame eme42:riffilitesP:Petlf:STeeiMYctiffa:71,111.3P o)s'al" Mame a pector(Specity Type)
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——-SPECIAL-INSPECTOR-QUALIFICATIONS EUAC SEC-306(5)j-ARE APPROVED. . . _ .
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tackling Official Oats
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ii CERTIFICATE OF..COMPLIANCEND APPLICATION FOR CERTIFICATE OF OCCUPANCY
' (To.be filled in and seared before eeffificate of Occupancy is issued.) .
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.......-4,- ,,, .. . The cicingtuctkin crane above named project is setislonilelly.aentpleteetid.request Is he-fei roAde for
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./ . -./v..--..„.A . Issuance oldie Ceilifidate of occupancy per Section Sea of the thifforin Administrative Code of the
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City of Glendale 199T ediflon.
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,,,.- - - .„ I certify that.to the bhtt alley teen-Riese,the reqwmillents Of the approved plans for which special inspbctiell •....
- . 41 ' NV 1141 AM ,'
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' — coif zr , is required and Becton ma of the Uniform 0..,,droinistrative Coda have been cemalied with,A gitatordee Intl
i :--. ' • the'content:if has tWW.4610%Rifled ale obiloallOr of h.13 contract Is neither intended or implied.
' . -...tik,,.,• - Afthfk.1 of Engenovr.P .ponsliale 6,1..SpodaLL'Ittpccrit,n(Type cv-P&it)
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RETURN TO THE SIIII.DIIIG SAFETY OEPT.FORAPPROVAL ANC DISTRIBUTION TO THE FOLLOWING:
Li BUILD DIG SAFETY PET.. 0 BUILDING INSPECTOR 0 ARCHITECT OR ENCJIHR 0 JOB COPY
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