HomeMy WebLinkAbout157302 EF LA -
C
CITY OF GLENDALE
PLANNING&DEVELOPMENT SERVICES
5850 W.GLENDALE AVE.,2ND FLOOR
GLENDALE, Z 85301
Glendale 623.930.2800
SPECIAL INSPECTION CERTIFICATE
ARIZONA 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 Meyer Borgman Johnson to be
responsible for the special Inspections on this project. l)(Pest eyed Design Professlonel/Flrm-please print)
Owner's name: Banner Health Owner's Signature: Debbie Olgui r.-s a— Date: 1/2/2024
PROJECT NAME: REGISTERED DESIGN PROFESSIONAL/FIRM NAME:
Baiinei-Thunderfjird-Medical=Center-EPi.Lab James Newall, PE, SE/Meyer Borgman Johnson
PROJECT ADDRESS: REGISTERED DESIGN PROFESSIONAL/FIRM ADDRESS:
5555 W. Thunderbird Road, Glendale, AZ 85306 116 E. University Drive,Suite 500, Tempe, AZ 85281
COG PROJECT NUMBER: 230753. COG PERMIT NUMBER: 157302
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 s‘onal knowledge,the requirements of the clonal
above named project,I certify that I QcoN�'\F ICAT ///0, 2018 international Building Code Qc°/��f ICAT,/n�^
am familiar with the design of the �� F,� ,no � and the approved plans and 46 Fy LP
project and hereby assume full D c,, specifications have been complied e� c,�' . c
62677 62677
responsibility for carrying out the `� with,insofar as the portion of the •`= c
JAMES P. JAMES P. c
required special Inspections in o work requiring special inspection i NEWHALL 2a --
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accordance with Sections 1704 and o p\`ti,: under Section 1704 and 1705 is o g� ,:
1705 of the 2018 International fm 41' ' concerned.A guarantee that the fe '���
BuildingCode. 1, S/gnecP'. -y SfgnecP''. •
,o P' contractor necessarily constructed 'Qj P
the building in full accordance with \2� l ' r /J
the plans and specifications is —� � --���
neither intended nor implied.
(Seal,Signature,and Date) (Seal,Signature,and Date)
SPECIAL INSPECTOR QUALIFICATIONS APPROVAL BY BUILDING OFFICIAL/PLANS EXAMINER(1704.2.1): rA lc
DATE: 3/29/23
WORK WHICH REQUIRES SPECIAL INSPECTION QUALIFIED SPECIAL INSPECTOR INDIVIDUAL OR FIRM
❑ CONCRETE CONSTRUCTION/REINFORCING STEEL(1705.3)
❑ MASONRY CONSTRUCTION(1705.4)
O WOOD CONSTRUCTION(1705.5)
/Q/STEEL CONSTRUCTION(1705.2&AISC 360) Meyer Borgman Johnson
❑ SOILS(1705.6)
❑/FOUNDATIONS(1705.7,1705.8&1705.9)
$SPECIAL CASES:POST-INSTALLED(EPDXY/EXPANSION)ANCHORS(1705.1.1) Meyer Borgman Johnson
o 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