HomeMy WebLinkAbout991265 ANC -u, UUir(II IL: l LVAIVJ, nunlr ix AMU. ILL:bUZ 146 91J6 V. 004
13g) CITY OF GLENDALE,ARIZONA
U BUILDING SAFETY DEPARTMENT-COMMUNITY DEVELOPMENT GROUP
GLENE SPECIAL INSPECTION CERTIFICATE
talkie m • Date r OPD
Project rest Pe Nu er DSC Number
/7� )0 N, 75 41)4-- �'1 & 6 OD -ase
CERTIFICATE OF SPECIAL INSPECTION'BY OWNER
L—! (To be filled in and signed by owner before permit is issued.)
In accordance with Section 306 of the Uniform Administrative Code of the City of Glendale,^edition,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 win receive special inspection.
Name of Architect Contractor
Cens[..ee L' /PAA/ Br1l2A/N4M Cyetisy 2acnov C'o, XV0A Aenev
Name al&meant Engineer Signature of Owner or Legal Agent
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SPECIAL INSPECTION RESPONSIBILITYCERTIFICATE
(To be filled in and sealed before building permit is issued.)
I certify that I am familiar with the structural design of the above-named project and,in accordance with
Section 306 of the Uniform Administrative Code of the City of Glendale,_edition,I hereby assume full
responsibility for carrying out the required special inspection.Inspection reports will be filed with the Building
Safety Department.as required by Section 306(c).The following individual(s)will be special field inspector(s)
wider my direct supervision and are to be on the job site to render full,complete and competent inspection.
CThe special field inspector(s)are to be named below before work under their area of duty commences.
'. Architect orEngneerRespontfb4forSpeeiu(Lnpeclion (Te or Mn)
Name of inspectar(Savtsvra&Masonry) Name eJupe<sne(Ste<UQetc z,rur li1- 1d =nGpccfewLS (Ar Ia /'L'). ' Name of kupecsar(Covnne) Name._of1hurst°rfWeMin )
pay ¢.t C Z%Ttr fliie,ncl Zns_pecLc s(Aya,17
11111
\:'g� , Name of)nspectar(Spect/y TYPv Name af)aryeetor(Specify 7)pe) J Bar-int
)are Row -•o'tt and
Signature Date '
SPECIAL INSPECTOR QUALIFICATIONS [UAC SEC 306(B)) ARE APPROVED. L.�i%�I rJ� g1
Building Official Dare
CERTIFICATE OF COMPLIANCE AND APPLICATION FOR CERTIFICATE OF OCCUPANCY
(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 Section 30B of the Uniform Administrative Code of the
City of Glendale, edition.
I certify that,to the best of my knowledge,the requirements of the approved plans for which special inspection
is required and Section 306 of the Uniform Administrative Code have been complied with.A guarantee that
the contractor has necessarily fulfilled the obligations of his contract is nigher intended nor implied.
•
Architect or Engineer Reapnnsiblefor Special aupecdon rlypeor Priv)
Place Regiuratlen Seurand
Signature Date
RETURN TO BUILDING SAFETY DEPT.FOR APPROVAL AND DISTRIBUTION TO TfiE FOLLOWING:
❑
-BUILDING SAFETY DEPARTMENT
O •BOLDING INSPECTOR
0•ARCHITECT OR ENGINEER
Q.TOB COPY Fro BB art ntnreoTO THE BUDDING OFFICIAL WREN YOUR INSPECTION IS COMPLETE AND BEFORE A CERTIFICATE OF OCCUPANCY IS REQUESTEDJ
i\T-07/45