HomeMy WebLinkAbout157119 CITY OF GLENDALE
PLANNING&DEVELOPMENT SERVICES
5850 W.GLENDALE AVE.,2ND FLOOR
GLENDALE,AZ 85301 Glendale 623.930.2800 SPECIAL INSPECTION CERTIFICATE
-- R I z 0 N A 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 t apertain c nstru I rk be placed under inspection
of a registered design professional.I,as owner/legal agent,do hereby certify that I have retained IMatnan Kline/AV Schwan to be
responsible for the special inspections on this project. (Registered Design P.roressionai/,Finn piease print)
Ryan Field thrmayi5 Signature: 14 Imo. 02/28/23
IRROJECTINAMA fR EGISTERED]DESiGN F ROF.ESSIONMF■IRM NAME
OVER EASY TI Nathan Kline/AV Schwan
RROJEGIT(ADDRESS1 REGISTERED DESIGN PROFESSIONALS/FIRM ADDRESS:
6728 W. DEER VALLEY RD STE 101 6000 omas #1
Scottsdale, AZ 85251
COG PROJECT NUMBER: 230457 COG PERMIT NUMBER: 157119
tCF,ERITIIFC,iTQF�RESP'pNSIBI'LIT1Y 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 E
' _+`:'(� 2018 International Building Code .am familiar with the design of the I�rf�` and the approved plans andproject and hereby assume full ti� specifications have been complied /ponsibiIity for caring out the 4109 with,insofar as the portion of the n 54109,juired special inspections inTHAN L. = work requiring special inspection NATHAN L... ordance with Sections 1704 andLINE under Section 1704 and 1705 is . KLINE 1705 of the 2018 International concerned.A guarantee that the2-27-202 " 202Building Code. C^' contractor necessarily constructed
V S the building in full accordance with 174Qj V SP
oNA, Zolvn,
the plans and specifications is
Expires 2/3f/2024 neither intended nor implied. Expires: 12/31/2024
Si: atu[e,andlDate)) (Seal,Signature,and Date)
SPECIAL INSPECTOR QUALIFICATIONS APPROVAL BY BUILDING OFFICIAL/PLANS EXAMINER(1704.2.1): 4....x+ DATE: 03/27/2023
WORK WHICH REQUIRES SPECIAL INSPECTION [QUALIFIEaP•.ECI'AL�INSPECyTtQR11ND'I,UID.UAL�O.R�FIRM�
D CONCRETE CONSTRUCTION/REINFORCING STEEL/POST-TENSION(1705.3)
❑ MASONRY CONSTRUCTION(1705.4)
❑ WOOD CONSTRUCTION(1705.5)
❑ STEEL CONSTRUCTION(1705.2&AISC 360)
❑ SOILS(1705.6)
❑ FOUNDATIONS(1705.7,1705.8&1705.9)
❑[SPECIAL GASES:POST-INSTALLEDTEP.OXYJE(PA`NSION)IANCHORSI(1�7�051�1�1 Nathan L. Kline, PE
❑ SEISMIC RESISTANCE(1705.12)
El SPRAYED FIRE-RESISTANT MATERIALS(1705.14)
_ EXTERIOR INSULATION AND FINISH SYSTEMS(EIFS)(1705.16) •
❑ STORAGE RACKS(1705.12.7)
O.OTHER:
Fr1pM FFFFr:TIVF(1AP)R/7119 0 Dr1CT AT Ir1R CITF WITH DFgMIT