HomeMy WebLinkAbout150191 ,
CIiY OF GLENDALE
•( PLANNING&DEVELOPMENT SERVICES
5850 W.GLENDALE AVE,2ND FLOOR
GLENDALE,AZ 85301
Glendale 623.9302800 SPECIAL INSPECTION CERTIFICATE
ARIZONA www.GlendaleAZ.aom 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 end 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 Si ec die&Asscosites to be
responsible for the special inspections on this project. (Rel3e:terd Design Pr°reslaregF m-pleaseptrm
Owner's name: Owner's Signature: Dam
_PROJECT NAME:- REGISTERED DESIGN PROFESSIONAL/FIRM NAME:
Francisend Sons RernodePtif Jason C.Weils,P.EiSpeedie&Assocites
PROJECT ADDRESS: REGISTERED DESIGN PROFESSIONAL/FIRM ADDRESS:
7221W;BeI Road '
COG PROJECT NUMBER:"):,-„,:,2213O5_ ": COG PERMIT NUMBER: /S 6/ 9/
CERTIFICATE OF RESPONSIBILITY CERTIFICATE OF COMPLIANCE • • •
To be tided in and signed by the professional in charge of Special Inspections To be filled in and signed by the professional in charge of Special inspectIbr '
before a building permit is issued. before a certificate of occupancy Is issued.
As registered design professional In I certify that.tet te best of my
charge of special Inspections of the knowledge,the requirements of the
above named project,I certify that I 2018 International Building Code
am familiar with the design of the An3L pir• and the approved plans and per.�1-. ,
S � fj., rl '1rh
project and hereby assume full ✓�E . specifications have been compiled . �� 7 etss
responsibility for carrying out the •'. with,insofar as the portion of the
Cr':�'
required special Inspections in i,.� •< 3 • work requiringspecial inspection y 37893 {
accordance with Sections 1704 and �' ti 3 �G• under Section 1704 and 1705 is g J5CN C. '-
1705 of the 2018 International .� C I concerned.A guarantee that theI
Building Code. contractor necessarily constructed o WELLS
dam . the building in full accordance with °�a ��
Oete Sight the.plans and specifications is 4,e� 9ne p
RR(ZON?i neither Intended nor implied. IZONA. '
(Seal,Sfgnature, 1n0 t.- (Seal,Signature,and Date)
SPECIAL INSPECTOR QUALIFICATIONS APPROVAL BY BUILDING OFFICIAL/PLANS EXAMINER(1704.2.1): Askr_LJ - DATE:02/13/2024
WORK WHICH REQUIRES SPECIAL INSPECTION QUAUFIED SPECIAL INSPECTOR INDIVIDUAL OR FIRM
CONCRETE CONSTRUCTION/REINFORCING brat_(1705.3) Speedie&Associates
0 MASONRY CONSTRUCTION(1705.4) Speedie&Associates
o WOOD CONSTRUCTION(1705.5)
Q STEEL CONSTRUCTION(1705.2&AiSC 360) Speedie&Associates
❑FOUNDATIONS(1705.7,1705.8&1705.9)
SPECIAL CASES:POST-INSTALLED(EPDXY/EXPANSION)ANCHORS(1705.1.1)
❑ SEISMIC RESISTANCE(1705.12)
0 SPRAYED FIRE-RESISTANT MATERIALS(1705.14)
0 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