HomeMy WebLinkAbout151594 CiTY OF GLENDALE
PLANNING&DEVELOPMENT SERVICES
5850 W.GLENDALE AVE.,2ND FLOOR
GLENDALE,AZ 85301
QeC'o_ a{} 623.930.2800 SPECIAL INSPECTION CERTIFICATE
A . I z o 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 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 Steve Slonaker PK Associates to be
responsible for the special Inspections on this project. (Registered Design Professional/Finn please print)
Owner'sname:5-t)i? 60.0144— cev Owner's Signature: Date: )
PROJECT NAME REGISTERED DESIGN PROFESSIONAL/FIRM NAME:
[Abfazo-Arrowhead NICLY:Expansian Steve Slonaker Calyx Harrell/
Professional Service Industries, Inc.
PROJECT ADDRESS: t 870,1:-N.-67th:Ave - _ REGISTERED DESIGN PROFESSIONAL/FIRM ADDRESS:
Glendale, AZ 85308 PK Associates4050 East Cotton Cente'Blvd.
#59 Phoenix, AZ 85040
COG PROJECT NUMBER: 222095 ! COG PERMIT NUMBER: 151594
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 theE ._.. I.)
tenel f knowledge,the requirements of the
above named project,I certifythat I tFICAT22018International Building Codeam familiar with the design of the and the approved plans andproject and hereby assume full 4635 specifications have been compliedresponsibility for carrying out theEVEN with,Insofar as the portion of the rr 6265required special inspections in -- -- work-requiring specialInspection CALYXIiAaccordance with Sections 1704 and /3D/2 under Section 1704 and 1705 is
1705 of the 2018 International S Oconcerned.A guarantee that the2023-1Building Code. contractor necessarily constructedbGNED
the building in full accordance with
the plans and specifications is2O —•
P
neither intended nor implied.
I ea, i Mule,and Date) (Seal.9 a ure,and Date)
SPECIAL INSPECTOR QUALIFICATIONS APPROVAL BY BUILDING OFFICIAL/PLANS EXAMINER(1704.2.1): . . __&' —i" DATE: 10/21/2022
WORK WHICH REQUIRES SPECIAL INSPECTION QUALIFIED SPECIAL INSPECTOR INDIVIDUAL OR FIRM
® CONCRETE CONSTRUCTION/REINFORCING STEEL/POST-TENSION(1705.3) PK Associates Professional Service Industries,Inc.
® MASONRY CONSTRUCTION(1705.4) PK Associates
❑ WOOD CONSTRUCTION(1705.5)
ill STEEL CONSTRUCTION(1705.2&AISC 360) PK Associates Professional Service Industries,Inc.
❑ SOILS(1705.6)
® FOUNDATIONS(1705.7,1705.8&1705.9) PK Associates
IXI SPECIAL CASES:POST-INSTALLED(EPDXY/EXPANSION)ANCHORS(1705.1.1) PK Associates Professional Service Industries,Inc.
❑SEISMIC RESISTANCE(1705.12)
IBI SPRAYED F1RE-RESISTANT MATERIALS(1705.14) Professional Service Industries,Inc.
❑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