HomeMy WebLinkAboutPermit Field Test & Inspection Report 2008-4-23
SPRINGFIELD
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City of Sprmgfield
Community ScrviCl:s DivIsion
225 Fifth Street
Springfield, OR 97477
Telephone' (541) 726-3759
Fax: (541) 726-3689
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Building PClmit:1
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Project Title
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Project AlMlcss U
Date
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Special Inspectioll aml Testing
To applicants of projects requiring spccml inspection or testlllg as per Sechon 1704 of the Oregon Structural Specmlty Code. Please reView the lIlfonnatlon below. When you have
finIshed. acknowledge an understanding of the IIlformatlOn by SlgllLllg below, and return this form to the City
BEfORE A l'ERJ\'IIT CAN BE ISSUED: The owner or owner's representative, on the advice of the responsible Project Engineer or Architect, shall complete, sign, and submIt to the
Clt)' for rCHew nnd approval tillS form completcd on both the front and back
The owner and General Contractor, where applicable, shall also acknowledge the followmg conditIons applicable to Special Inspection andlor Testlllg.
I. Contractor IS responSible for proper notification for the Inspection or Testing of Items listed
2 '1 estlllg laboratory shall take appropnate samples and transport them to their laboratory for proper evaluatIOn or tcstmg.
· Copies of all laboratory rcports and mSpCCtlOllS are to be sent to the CIty by the Testmg Agency
3 Special InspectIOn Agency is to submit names and quabfications of on-site Special Inspectors to the CIty for approval
4. Spccmllnspector shall provide lnSpecllOn reports to the buildmg offielol of all inspection actiVIties
5 Contractor IS responSIble to review the CIty approved plans for additJonal Inspection or tcstmg reqUIrements that may be noted
BEFORE A CERTlFICA1 E OF occur ANCY WILL BE ISSUED: The Special Inspection Agency shall submIt to the BUIlding OffiCIal a statement that all Items reqUiring
inspcctlon have been fulfilled and reported and were to the best of the mspector's knowledge, in conformance With the approved plans, speCifications and apphcable workmanship
proYI~ions Tho~e item~ not tested andlor inspected shall be noted in the statement. The report is to be submitted to the City prior to a request for linal Inspectlons.
ACKNOWLEDGEMENTS
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Owner Ndme (Printed)
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Engineer or Architect Finn (Prlntcd)
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Te~ling LaboHltor) N<lmc (Printed)
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En~Chchitect Signature
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Gcncral Contractor Signatllre
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Building Official Sl~re ~
SPECIAL INSPECTION AND TESTING SCHEDULE
I Rl:mforccrJ Com.rdC, Gumte, Grout and Mortur.
Concrctc Gumtc Grout Mortur
~
A!!C!rel!:ltc Test ofMI''' Dcsll:~lI
RClllforcllll!. Te~t
MIx Design-WeH!,hmaster Cert ..
RClllforclllg Placcment
Continuous Batch Pl,lntlllspcct
Inspect Placin,g
Cast Sanlples
I Samples (PIckup/Delivered)
I CompresslOll Test*
t.{ ~oo
PrccastIPre-stressed Concrete
Pilc~ Po~t-Tcns I Pre-Tens
I
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Cladding
Agglegate Tests
RemforcmJ!; Tests
Tendon Test
MIX De~il!.ns.
Remforcmg Placement
Insert Placement
Concrete Batching
Concrete Placement
Installation [nspecl1on
Cast Samples
Pick-UD Samples
CompressIOn Tests
SMOKE CONTROL:
FIREPROOFI~G:
Leakage testmg
Control VerificatIOn
Placement inspection
Density tests
Thtckne~s tcst~
Inspect batchmg
ROOfiNG:
Insulation installationlR- Valuc*
Test stllps/scams
ADDI nONAL INSRUCTIONS, OTHER TEST, & IN5PECTJONS:
GRADING, EXCAVATION. AND FILL
Acceptance tests · PSf
Establish tinal grade
fill placement Illspechon/continnolls
Soil Dcnsity
STRUCTURAL STEEL/WELDING:
Samplc and test (list speCIfic mcmbcrs below)
Shop materlalldentIticatlon (mIll cert)
Weld mspectlon Shop
Ultra\olllc lnspeclton Shop
High Strength Boltmg Shop
A32) _N _X
A490 N_X
Metal deck weldlllg IIlSpectlon
Reinforcmg Steel welding inspectIon
Reinforcmg steel mill certificate
Metal stud weldmg inspectIon
Concrete msert welding IIlspectlnn
Moment reslstlllg sleel framcs
field
Field
FIeld
F
_F
STRUCTURAL ""OOD:
Shear wall naIling inspection
Shear wall anchors
Inspection of Glu-Iam fab * TIC pSI
Inspection of lru~s Joist fab
Sample and test component~
Falmcdtion weldmg of <;tcel nccc~soTlCS
MASONRY
SpeCial mspectton stresses used. Pm Pg
Prchl1ll11ury acceplance tests (l1l.lsonry UntIS, wall pn~ms)
Subsequent tests (mortar, grout, field wall prIsms)
Placement mspectlO/\ ofumts, and remforcement
Masonry, mortar, groul, and remlorcing steel certllicates
Form Completed by.
Date
".'IW\'IDE S nn~NGTII REQUIRED BY .\RCIIITECT OR ENGINEER OR CONTRACT DOCUMENT LOCATION OF VALUES