HomeMy WebLinkAboutSpecial Inspection Building 2009-10-19
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City of Springfield
Community Services Division
225 Fifth Street
Springfield, OR 97477
Telephone: (54t) 726-3759
Fax: (541) 726-3689
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Building Penn it # Date
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ProjeCt Title
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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. When you have
finished, acknowledge an unders!anding of the information by signing below, and retum this foml to the City.
BEFORE A PERMIT CANBR ISSUED: The owner or owner's representative, on the advice.ofthe responsible Project Engineer or Architect, shall complete; sign. and submit to the
City for review and approval this form completed on both the front and back. " ,
~e owner and General Contractor, where applicable, shall also acknowledge the following conditions applicable to Special Inspection and/or Testing.
I. Contractor is responsible for proper notification for the Inspection or Testing-of items Iiste~:
2. Testing Jaboratory shall take appropriate sampJes and transport'them to their laboratory for proper evaluation or testing.
. Copies of all laboratory reports and inspections are to be sent to the City by theTesting. Agency.
3. Special Inspection Agency'is to submit names and qualifications of on-site Special Inspectors to the City for approval.
4. Spectallnspector shaJJ 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 CERTIFICATE OF 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 and applicable workmanship
provisions. Those items not tested and/or inspected shaH be rioted jn the statement The report is to be submitted to the City prior to a request f&~ti~al inspections.
ACKNOWLEDGEMENTS ,( /J '. /7-L-
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t:::e ~~) ~,i; <:.10: Gpn~~ntractor Firm Name (Printed).l / I~ral COrifra,ct\Sign~u "
~r or .....1,' Finn (Printed) ~eer '::.Jt -:gnf~e._ <~.e;.~nsp~n Agen~'e (printed)~iaI3P' Jl.ienCY-Rt!!> Si'gn,
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Testing Laboratory Name (Printed) Testing Labo}"tory Rep. Signature BUtl1lmg 15 Icial Name (printedf . Building Official Signature
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Reinforced Concrete, Gunite. Grout and Mortar;
Concrete Gunite Grout Mortar
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.1 Precast/Pre-stressed Concrete:
-I Piles Post-Tens Pre-Tens
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Cladding
SMOKE CONTROL:
Leakage testing
Control Verification
ROOFING:
Insulation installationlR-Value.
Test strips/seams
SPECIAL INSPECTION AND TESTING SCHEDULE
Aggregate Test of Mix Design
Reinforcing Test
Mix Design-Weighmaster Celt..
Reinforcing Placement
Continuous Batch Plant Inspect.
Inspect Placing
Cast Sam~les
Samples (PickuplDelivered)
Compression Test*
GRADING, EXCA VA 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 identification (mill cert)
Weld inspection _Shop _Field
Ultrasonic inspection _Shop _Field
High Strength Bolting_Shop _Field
A325 _N _X
A490 -Y1 _X
Metal deck welding inspection
Reinforcing Steel welding inspection
Reinforcing steel mill certificate
Metal 'stud welding inspection
Concrete. insert welding inspection
Moment resisting steel frames
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A~mgate Tests
Reinforcing Tests
Tendon Test
Mix Designs.
Reinforcing Placement
Insert Placement
Concrete.Batching
Concrete Placement
Installation Inspection
Cast Sa.moles
Pick-up Samoles
Compression Tests
STRUCTURAL WOOD:
Shear wall nailing inspection
Shear wall anchors
. Inspection ofGlu-lam fab. ... .T/C psi
I nspection of truss joist fab.
Sample and test components
Fabrication welding of steel accessories
FIREPROOFING:
Placement inspection
Density tests
Thickness tests
Inspect batching
MASONRY
'wi"'" SpeCial inspection stresses used.I?(J~ fm Ze>oo f'g
Preliminary acceptance tests (masonry units, wall. prisms)
Subsequent tests (mortar, grout, field wall prisms)
V'I' Placement inspection ofunits~ and reinforcement
Masonry, mortar, grout, and reinforcing steel certificates
ADDITIONAL INSRUCTIONS, OTHER TEST, & INSPECTIONS,
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~orm Completed by:
Date
'PROVIDE STRENGTH REQUIRED BY ARCHITECT OR ENGINEER OR CONTRACT DOCUMENT LOCATION OF VALUES