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Home My WebLink About147203 r DocuSign Envelope ID:E6739533-1553-4850-BBD0-53C45F0EA7C3 LiirUrlLenuALt C\q7 PLANNING&DEVELOPMENT SERVICES 5850 W.GLENDALEAVE.,2ND FLOOR G2NDAL2tZ85301 Glendale 623.930.2800 SPECIAL INSPECTION CERTIFICATE A R I Z 0 N A www.GlendaleAZ.00m STRUCTURAL • OWNER'S 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 construe on work be pla und er Ins ection of a registered design professional.I,as owner/legal agent,do hereby certify that I have retained 66AriN M 6D "°Peif/("o/'i•Te r-0.s' responsible for the special Inspections on this project. Doeuglencd by;(Registered Design Professional/firm-peas D li L/8/2024 1 2'27 PM P Rajkumar sugumaran Owner's name: Owner's Signature: 1,/t_ Date: PROJECT NAME: REGI`E gram PROFESSIONAL/FIRM NAME: Phoenix Testing & Inspections, LLC Apex Heart & Vascular Center PROJECT ADDRESS: REGISTERED DESIGN PROFESSIONAL/FIRM ADDRESS: 21360 N 75th Ave., Glendale, AZ 85308 3635 South 43rd Ave, Phoenix, AZ 85009 COG PROJECT NUMBER: 220482 COG PERMIT NUMBER: 147203 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 r • I certify that,to the best of my egsi0na/ knowledge,the requirements of the kessi0na/ . charge of special Inspections of the p F g to 7 above named project,I certify that I �Ql \F 1 CA j 7 2018 international Building Code F 1 C A T 94 am familiar with the design of the R y °� and the approved plans and `¢' �� F y mew project and hereby assume full y 36871 O specifications have been compiled ,;- t,-36671— -O �-responsibility for for carrying out the t, with,insofar as the portion of the - n required special inspections In ROBERT N. <_ work requiring special Inspection ' +r ROUEFiT N. <. I accordance with Sections 1704 and POCANO under Section 1704 and 1705 is 1='UCANO di �'� concerned.A guarantee that the t '�, `/ 1705 of the 2018 International es 'L• >, L- BufldingCode. r nod. contractor necessarily constructed ��o:,,fined a' - " 4 f /BONA 5' the building In full accordance with r. pjres _ the plans and specifications Is , ��U;`lr�.U'3' neither Intended nor Impiied. / ,O/rtr S y (Seal,signature,end Date) Seal,signature,and Date) SPECIAL INSPECTOR QUALIFICATIONS APPROVAL BY BUILDING OFFICIAL/PLANS EXAMINER(1704.2.1): (14 k - DATE: 2/14/24 WORK WHICH REQUIRES SPECIAL INSPECTION QUALIFIED SPECIAL INSPECTOR INDIVIDUAL OR FIRM ❑CONCRETE CONSTRUCTION/REINFORCING STEEL(1705.3) ❑MASONRY CONSTRUCTION(1705.4) ❑WOOD CONSTRUCTION(1705.5) ❑STEEL CONSTRUCTION(1705.2&AISC 360) ®SOILS(1705.6) Phoenix Testing & Inspections, LLC ❑FOUNDATIONS(1705.7,1705.8&1705.9) ❑SPECIAL CASES:POST-INSTALLED(EPDXY/EXPANSION)ANCHORS(1705.1.1) ❑SEISMIC RESISTANCE(1705.12) ❑SPRAYED FIRE-RESISTANT MATERIALS(1705.14) ❑EXTERIOR INSULATION AND FINISH SYSTEMS(EIFS)(1705.16) 0 STORAGE RACKS(1705.12.7) ❑OTHER: I FORM EFFECTIVE 04/20/2019 POST ATJOB SiTE WiTH PERMIT 1 i I I s C CITY OF GLENDALE PLANNING&DEVELOPMENT SERVICES 5850 W.GLENDALE AVE.,2ND FLOOR GLENDALE,AZ 85301 egg' a.:ale 623.930,2800 SPECIAL INSPECTION CERTIFICATE k I Z o N „ www.GlendaleAZ.com STRUCTURAL OWNER'S 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 require_that certain construction work.be_placed_unde Inspection of a registered design professional.I,as owner/legal agent,do hereby certify that I have retained tAi'r� -`414 � bef7 responsible for the special inspections on this project. (Registered Design ProfesslonaVRnn-please print) Owner's name: Owner's Signature: Date: PROJECT NA_Ew _ REGISTERED DESIGN PROFESSIONAL/FIRM NAME: 1 A X-tit T1' D___VA _111-4 G l /114 ,i d''LIL fr 'Zil 5 Th/1 At_ z LtiG 2t N16. PROJECT ADDRESS: REGISTERED DESIGN PROFESSIONAL/FIRM ADDRESS: 14P0J r,11,1c-77oh1, AZ 05170 COG PROJECT NUMBER: 220482 COG PERMIT NUMBER: 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 knowledge,the requirements of the above named project,I certify that I `O�gS al Ei,,, 2018International Building Code �esslOnal En•i0 am familiar with the design of the •/ �E I , W and the approved plans and /�E t T�e project and hereby assume full �� specifications have been complied / /1► r` O •,G responsibility for carrying out the `c ,y/V 34630 • O� with,Insofar as the portion ofthe c� 34630 • ___ - .required speciaunspections in __ __.— m -work-requiring special Inspection d —ALLEN R. m accordance with Sections 1704 and D: ALLEN R. under Section 1704 and 1705 is Dv 1705 of the 2018 International C MILLER concerned.A guarantee that the o MILLER Building Code. .74 2 A 19/7 contractor necessarily constructed 9TF VZ 4E6.sb.„.. the building in full accordance with ,9 Sin �� Z S D P' the plans and specifications is 'Q/ZONA U 5 P" ONA U• neither intended nor implied. (Seal.Signature,and Date) f Seal,Signature,and Date) SPECIAL INSPECTOR QUALIFICATIONS APPROVAL BY BUILDING OFFICIAL/PLANS EXAMINER(1704.2,1): (a{ }(IC DATE: 3/28/22 WORK WHICH REQUIRES SPECIAL INSPECTION QUALIFIED SPECIAL INSPECTORy INDIVIDUAL OR FIRM yr CONCRETE CONSTRUCTION/REINFORCING STEEL(1705.3) f'qq J4 /`flLL � E/L ' ; 1414—?• y41_ Fi dI airriv R, yr MASONRY CONSTRUCTION(1705.4) /4u�r,� r u.F-/L � 2 -, . " i- - ❑ WOOD CONSTRUCTION(1705.5) STEEL CONSTRUCTION(1705.2&AISC 360) L/t � ►�o,�� h . � _ ❑ SOILS(1705.6) /'� ❑ FOUNDATIONS(1705.7,1705.8&1705.9) SPECIAL CASES:POST-INSTALLED(EPDXY/EXPANSION)ANCHORS(1705.1.1) Al I J A pt ,d � 5 mJGr, • ❑ SEISMIC RESISTANCE(1705.12) !� ❑ SPRAYED FIRE-RESISTANT MATERIALS(1705.14) ❑EXTERIOR INSULATION AND FINISH SYSTEMS(EIFS)(1705.16) ❑ STORAGE RACKS(1705.12.7) ❑ OTHER: FORM EFFECTIVE 04/26/2019 POST AT JOB SITE WITH PERMIT CITY OF GLENDALE PLANNING&DEVELOPMENT SERVICES 5850 W.GLENDALE AVE.,2ND FLOOR GLENDALE,AZ85301 SPECIAL INSPECTION/VERIFICATION CERTIFICATE Glendale 623.930.2800 ARIZONA www.GlendaleAZ.com ARCHITECTURAL ENERGY CODE COMPLIANCE OWNER'S NOTIFICATION OF SPECIAL INSPECTION To be completed and signed by the Owner before a building permit Is Issued In accordance with the Glendale City Code,Chapter 9,I,as owner/legal agent,do hereby certify that the construction of the below described building project will receive Special Inspection or Third Party Verification for compliance with the City of Glendale's current adopted Energy Code. The Architect may also certify this project for Energy Code compliance. Owner's name: kC✓f ktialltr JUC/,//f?(,11G1i Owner's Signature: Date: 5/27/2y PROJECT NAME: J REGISTERED DESIGN PROFESSIONAL/FIRM NAME: Apex Heart and Vascular Center Marwan Tamimi/SCSA Healthcare Architecture&Planning PROJECT ADDRESS: REGISTERED DESIGN PROFESSIONAL/FIRM ADDRESS: 21360 N 75th ave. Glendale, AZ 85308 2942 N Greenfield COG PROJECT NUMBER: 220482 COG PERMIT NUMBER: L47203_ SPECIAL INSPECTION/VERIFICATION RESPONSIBILITY CERTIFICATE CERTIFICATE OF COMPLIANCE&APPLICATION FOR CERTIFICATE OF OCCUPANCY To be filled In and signed by the Architect,Special Inspector,Contractor or Third To be filled in and signed by the Architect,Special Inspector,Contractor or Third Party Responsible for verification before the permit can be issued. Party Responsible for verification when construction is complete. I certify that I am familiar with the The construction of the above energy code compliance named project is complete and • requirements of the above named meets or exceeds the requirements I. I , project and energy conservation.I of the City of Glendale's currently { herebyassume full responsibility to �� c - - - p y 4s„ h adopted Ene?gy Code.Request Is ��E 'cy� carrying out the required special u° �0 4+ hereby made for Issuance of the / ', 'v `y inspections and verifications. rc 36801 certificate of occupancy. ¢�° 36901 c2; MARWAN S I certify that,to the best of my MARWAN S MUJAHED o n.a �ya �. knowledge,the requirements of the n MWAHED 'q r g• approved plans for which Special • 'S ? qOs �jl.. Inspection or Third Party Verification ��20` - s• is required have been meL �kp`RENA - s_ (Architect's Seal.Signature,and Date-If (Architect's Seal,Signature,and Date-If applicable) applicable) SPECIAL INSPECTOR QUALIFICATIONS APPROVAL BY BUILDING OFFICIAL/PLANS EXAMINER: �t �a.w.E DATE: -••ar•7de.=sessocp instruction/Information about this form: 1. The person signing in the area that states that project will conform to the currently adopted Energy Code in the left box,does not have to be the same person that verifies those requirements and Is signing in the right box. 2. The City of Glendale,Arizona,only needs this form to be completed and returned;we do not need any supporting documentation in order to issue a Certificate of Occupancy. • } FORM EFFECTIVE 10/28/2020 POST AT JOB SITE WITH PERMIT I 4