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Home My WebLink About0000011 CITY OF GLENDALE,ARIZONA BUILDING SAFETY DEPARTMENT-COMMUNITY DEVELOPMENT GROUP - • Illti GLENI SPECIAL INSPECTION CERTIFICATE Project Name Date Csjcf- N CkseDAN. 12-2-3-c Project Address Permit Number DSC Number —703% 1v (D111A lie- J 1(1 y 0 CERTIFICATE OF SPECIAL INSPECTION BY OWNER (To be filled in and signed by owner before permit is issued) In accordance with the 2006 International Bulking Codes,which requires that the execution of certain construction work be placed under the inspection of the architect,engineer,or special inspector employed by me,I certify that the construction of the above-described building project will receive special inspection. • Name ofArchffect Contractor Name of Structural Engineer Signature of Owner or Legal Agent SPECIAL INSPECTION RESPONSIBILITY CERTIFICATE (To be filled in and sealed before building permit is issued.) I certify that I am famltarwith the structural design of the above-named project and,in accordance with the 20D6 International Building Codes,I hereby assume full responsbility for carrying out the required special inspections. Inspection reports will be filed with the Building Safety Department,as required by the 2006 International Building Codes. The following individual(s)will be special field inspector(s)under my direct �� r.�., supervision and are to be on the job site to render full,complete and competent inspection. gyp- : ,:,,:(I,r�� 07xs,r r , ,\ The special field inspector(s)are to be named below before work under their area of duty commences. �t/L�, 7• • IA • Architect or Engineer Responsible for Special Inspection(7ype or print) P. �`� PAUL G. CC S1 So T -1� e estfi d. SC 'rt f* Name of Inspector(Structural Meson, Name of Inspector(Steel) s 3j°��' Rabat gat._1 ��r Flit Name of Inspector(Concrete) Name of inspector(Welding)/IONA,U 1p. a ', .. EXPIRES 08-30-1 G Name of Inspector(Specify Type) E p x,j Name of Inspector(Specify Type) SPECIAL INSPECTOR QUALIFICATIONS[IBC 1703]ARE APPROVED. �nig'bnx:r- !"a f2 ,Q El CERTIFICATE OF COMPLIANCE AND APPLICATION FOR CERTIFICATE OF OCCUPANC' (To be filled in and sealed before certificate of occupancy is issued.) The construction of the above named project Is substantially complete and request is hereby made for • Issuance of the certificate of occupancy per the 2006 International Building Codes. • I certify that,to the best of my knowidege,the requirements of the approved plans for which special inspection is required and the 2006 International Building Codes have been complied with. A guarantee that the contractor has necessarily fulfilled the obligations of his contract is neither intended or implied. Architect of Engineer Responsible for Special Inspection(Type or Print) RETURN TO THE BUILDING SAFETY DEPT.FOR APPROVAL AND DISTRIBUTION TO THE FOLLOWING: ❑ BUILDING SAFETY DEPT. ❑ BUILDING INSPECTOR 0 ARCHITECT OR ENGINEER 0 JOB COPY E:\Forms\Copy of SPECIALINSPECTIONUpdatedwith20061Codes IP JLIL-29-20Ei9 17 t 43 SPEED I E AND ASSOCIATES 6029435508 P.l 2 CITY OF GLENDALE,ARiZONA ~ 1"4 BUILDING SAFETY DEPARTMENT-COMMUNITY DEVELOPMENT GROUP Till SPECIAL INSPECTION CERTIFICATE GLEN3>*E Date Project Name 0712912409 QUICK N CLEAN r.ARUtlASH _ 1—Permit Number Projca Narnher project ACdrPss Q$"1�4 7Q 3N67THAVE - ❑ CERTIFICATE OF SPECIAL.INSPECTION BY OWNER (To be filled In and signed by owner before permit is issued) In accordance with vie 2000 international Building Codes,which requlret that the execution of certain onstruaEIon work ba placed under the inspection of tho nrohltacf,englnoer,or speelal Inspeetor employed by me,i cattily that the construction of rho above-described.building proled will recelvo special Inspection. Nam of,4n hireot Contractor . Name of Strucfuni EngIcecr ' Signature of Owner or Loga1 Rgent J 0 SPECIAL INSPECTION RESPONSIBILITY CERTIFICATE (To be filled in and sealed before building permit is Issued) I certify that I am familiar with the atntotural design of the above-need project end,In accordance with the 28O0 Internsticnal Bu11ding Codes,I hereby *sauna full responsibility for carrying cut the required spacial lnspectlons. Inspection reports will Ise flied rein the Building Safety Department,as requiters by the 2000 intetnstlonal Building Codee. The following Indlvidual(s)will be spacial field Inspectors)under my direct Supeni bn end re is bO on the Job ,Ire to rend c r full,comploto and comment Inspection. -special field Irtapector(c)are to be named below before work under their area of duty commences. - 'fc Ito "or Engineer Responsible for Specie/InsPoctfon ftYPa arprlrrt) «' t C '� �--.._ 14 mete rnspector a /, p A 7`- re ing&Excavation msoodor di o`' f`q -re, ' tc1 a� 1w.1 i .A by 37693 — ,offs rrt concretI Inc Orr r3elnfareing sr e1 tnspsctar ~ cc JASON C. .JmJ A T 4- d„ Wl• 9 id ` Epoxy,&pa fen.ParAncho Inspector Stttr1crurer Vv Ir>imPacter S/Snnp....:..:�"P- A-1 d !u J ��1 CNA 11 5irucruraiMas ryinspector ..,^ Ares o9►3041 M Nh-I SPECIAL INSPECTOR QUALIFICATION [ISO 1703)A E APPROVE r 7 3 ii 0_ __ _ __ "__CERTIFICATP OF COMPLIANCEANID APPLICATION FOR CER - - ' E - OCCUPANCY (To be filled in and sealed before certificate of occupancy is Issued) The construction of the sbove-named profit Is oarbatantisily gomplrtr•end request Is hereby made for Issuance of the certificate of occupancy per the 2000 Intenationai Eullding Codes. I certify that,to the best of my knowledge,the requirements of the approved pions for which spec lel inspection Is tequiree and the 200,0 Intamctionsl Building Codes have been complied with. A gtuaranree that the contractor has nacasaertly fulfilled the obligations of this contract Is neither Intended nor implied, Architect or a-nolneer AesponeIblo flee Special lnspecrlon(lypc or prme RETURN TO THE BUII-Ott4G SAFETY DEPARTMENT POP APPROVAL AND DISTRIBUTION TO THE FOLLOWING: 7 BUILDING SAFETY DEPT. ❑ BUILDING INSPECTOR 0 ARCHITECT OR ENCsINGR 0 JOB COPY TOTAL P.02