HomeMy WebLinkAboutSpecial Inspection Miscellaneous 2009-8-17
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City of Springfield
Community Services Division
225 Fifth Street
Springfield, OR 97477
Telephone: (541) 726-3759
Fax: (541) 726-3689
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Project Address
Special Inspection and Testing
. To applicants of projects requiring special inspection or testing as per Section 1704 of the Oregon Structural Specialty Code. Please review the information below. Whenyouhave
finished, acknowledge an understanding of the information by signing below, and return this form to the City. .
BEFORE A PERMIT CAN BE ISSUED: The owner or mvner's representative, 0," theadvice,ofthe responsible Project Engineer or Architect; shall complete; sign. and submit to the
City for review and approval this fann completed, on both the front and ,back. .
The owner and General Contractor, where applicable, shall also acknowledge the following conditions applicable to'Special Inspection and/or Testing.
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1_ Contractor is responsible for proper notification for the Inspection o[ Testing-of items listed.
2. Testing laboratory shall take appropriate samples and transport them to their laboratory for proper eva.luation or testing.
.. Copies of all laboratory reports and inspections are to be sent to the City by the Testing- Agency.
.3. Special Inspection Agency ista submit-names and qualifications'ofon-site Speci!ll Inspectors to the City for approval.
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4. Special Inspector shall provide inspection reports to the building official of all inspection activities.
5. Contractor is responsible to review the City approved plans for additional inspection or testing, requirements that may be.noted.
BEFORE A CERTIFICA TEOF OCCUPANCY WILL BE ISSUED: The Special Inspection Agency shall submit to the Building Official a statement that all items requiring
inspection have been fulfilled and reported and were to the best of the inspector's knowledge, in conformance with the approved plans, specifications an~ applicable workmanship
provisions. Those items not tested.andJodnspected shall be noted in the statement. The report is to be submitted to the City prior to a r~quest for final insp~ctions.
ACKNOWLEDGEMENTS
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Owner Name (Printed) (}qw' er ignature, -^ ~ /J
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Engineer or Architect Firm (pr,nted) 'ee or ArC:"ite~~
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Testmg Laboratory Name (Printed) es mg Laborlltory Rep, Signature
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Gen, Contractor Firm Name (Printed)
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Speciallnspe_!;un A5unJ~ame (Printed)
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!sUllomg Official Name (Printed)
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Building Om-cial SIgnature
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Reinforced Concrete, Gu tite, Grout and Mortar:
Concrete Gunite Grout Mortar
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Precast/Pre-stressed Concrete:
Piles Post-Tens Pre-Tens
Cladding
SMOKE CONTROL:
. Leakage testiiig
.Control Verification
ROOFING:
.Insulation installation/R-Value*
.Test strips/seams
SPECIAL INSPECTION AND TESTING SCHEDULE
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GRADING, EXCA V A TION, AND FILL
Acceptance tests * PSF
EStablish final grade
Fill placement inspection/continuous
Soil Density
STRUCTURAL STEELIWELDING:
Sample and test (list specific members below)
Shop material identitica;(n (mill cert)
Weld inspection Shop ~Field
Ultrasonic inspection ~Shop--=-Field
High Strength Bolting_Shop _Field,
A325 _N _X _F
A490 _N _X _F
Metal deck welding inspection
Reinforcing Steel welding inspection
Reinforcing steel mill cel1iticate
Metal stud welding inspection
Concrete insert welding inspection
Moment resisting steel frames
A'l!!:regate Test of Mix Design
Reinforcing Test
Mix Design.Weighmaster Cert.*
Reinforcing Placement
Continuous Batch Phmt Inspect.
Inspect Placing
Cast Same.les
Samples (PickuplDelivered)
Compression.Test*
Ag.gi'egate Tests
Reinforcing Tests
Tendon Test
Mix Designs*
Reinforcing Placement
Insert Placement
Concrete Batching
Concrete Placement
Installation Inspection
Cast Samples
Pick-up Samples
Compression Tests
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STRUCTURAL WOOD:
Shear wall nailing inspectjon .
Shear wall anchors
'Inspection ofGlu-lam fab, . TIC psi
Inspection of truss joist fab.
Sample and test components
Fabrication welding of steel accessories
FIREPROOFING:
Placement inspection
Density tests
Thickness tests
Inspect batching
MASONRY
SpeCial inspection stresses lIsed* fm f'g
Preliminary acceptance tests (masoOlY units, wall prisms)
Subseque~t tesls (mortar, grout, tield \\'all prisms)
Placeinent inspection of units, and reinforcement'
Masonry, mortar"grout, and reinforcing steel cer~ificates
ADDITIONAL INSRUCTlONS, OTHER TEST, & INSPECTIONS:
Fonn Completed by:
DatI'"
'PROVIDE STRENGTH REQUIRED BY ARCHITECT OR ENGINEER OR CONTRACT DOCUMENT LOCATION OF VALUES