HomeMy WebLinkAboutSpecial Inspection Building 2009-9-17
'.
~
\(1'...
l'. INGFIELD '-.~ -'j!I;.;-n,
..~
City of Springfield
Community Services Division
225 Fifth Street
Springfield, OR 97477
Telephone: (541) 726-3759
Fax: (541) 726-3689
C2mA:::tJ '7 -01.2:5- ~
Building Penllilll
SV\. tV {I!.a 0 ,-:.
?/lya7
Dale
qy 3'3
i 1/ "7
A..Q 0; 110IV
Project Title
,Sf"". Sf'J:2.1 rJ<; FllSl.-D
Project Address
6~
'" ~-
Special IlIspeetionnnd ,Testing
:Hnts ofprojecls re,quiring special inspection or testing lIS per Section 1704 of the Oregon Stntctul'lll Specialty Code. Please review the information below, When you have
acknowledge an understanding of the inTormation by signing below, and return this form 10 the City,
. ~ ".,
E A PERMIT CAN .BE ISSUED: The owner or owner's representative, on the advice nfthe responsible Project Enginec.' or Architect, shaWcompletc, sign, and submilto the
review and app10valthis form 'completed on both the front and back, .
er and Geneml Contractor, where applicable, shall also acknowledge the following conditions applicable to Special Inspection and/or Testing.
-.' - - . - ,
. .
tractor is responsible for proper notilication for the Inspcction or Testing ofitems listed,
:i~g laboratory shall take appropriate samp.les and trans porI them to their laboratory for proper evaluation or Icsting,
. . .,
. Copies of all laboratory reports and inspections are to be sent to the City by thc Testing Agcncy.
ciaHnspection Agency is to sobmit names and qualifications of on-site Special Inspectors to the City for approval.
. ,
ciollnspector shall.provide inspection rcports to the building officiafofall inspection activities,
, .
,tractor is responsible 10 review the City approved plans for additional inspection or testing requirements that may be noted,
. ... I. .
-iE-A-CERTIFICA'f.E.OF-OCCUP.ANCY_WILL.BEJSSUED:_The.SpeciaUnspey!i.ollAgencv shall submit to the. Building Ofticiillu slatementthat all items requiring .
)n have been fulfilled and reported and were to U,e beSt of the inspector's knowledge, in eonfommnee with the approved plans, specijiCiiiiolls and appliCiiolewarKmansnip
ns. .n,ose items not tested and/or inspccted.shall be noted in the statement. The repon is to be submitted to lhe City prior to a request for linal inspections,
IOWLEDGEMENTS' n
\ -\- ,"-\01'\'\ e.. (O,,,+r-,,, fo<<.J" Gro.- ~ ~
Name (Printed) ow~i:;iJl6fure. ~ -
rIOI.J~k-~\-l~ J( ;lL ~
er o.r Architect Finn (Printed) - c1~Sig~l~e
(.'ifSI::- ~ ~ ill
(ia~oratory Name (Printed) islory Rep:Signature
pAt \-\oM~ (-o"rhA+O\t. S-
Gen, C~raetor Firm Name (Printed) .
tJ t>5..}, .' '
Spceisllnspe<llioo-A-gel'lGy_hlamc (Printed),
_~ . ~~.. ~..'o
Buildmlr'Elffieial Name (Printed)
~ 1 i:nalllli~
Slleeiallnsp. ~cy-Rep~n.
,,\ . ~., \it \ ,,-. ,..---.
Bwlilmg uliieial Signature -
-Q-
.. .....
i,~\
-..
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
~- ',~
SPECIAL INSPECTION AND TESTING SCHEDULE
Reinforced Concrele, Gunite, Grout and Mortar:
Concrete I Gunite Grout Mortar
I
GRADING, EXCA V A TlON, AND FILL
Acceptance tests *. PSF
Establish final grade
Fill placement inspection/continuous
Soil Density
A~gregate Test of Mix Design-
Reinforcing Test
Mix Design-Weighmaster Cert.*
Reinforcing Placement
Continuous Batch Plant Inspect.
Inspect Placing
Cast SamQles
I Samples (Pickup/Delivered)
I Compression Test*
STRUCTURALSTEELAVELDING:
Sample a11d test (list specific members below)
Shop material identitication (miB cert)
Weld.inspection ~Shop _Field
Ultrasonic inspection _Shop _Field
High Strength Bolting_Shop _Field
A325 _N _X
A490 _N _X
Metal deck.welding inspection
Reinforcing Steel welding inspection
Reinforcing steelll1ill certiticate
Metal s.tud welding inspection
Concrete insert welding inspection
Moment resisting steel hames
I
I
I
I I
Precast/Pre-stressed Concrete:
Piles I Post-Tens I Pre-Tens
I I
_F
_F
Cladding
I
I A~gregate Tests
I Reinforcing Tests
Tendon Test
Mix Dcsigns*
Reintorcing Placement
I Insert Placement
I Concrete Batching
Concrete Placement
Installation Inspection
Cast Samples
Pick-:uIJ Samples
Compression Tests
STRUCTURAL WOOD:
Shear wal1nailing inspection
Shear wall anchors
Inspection ofGlu"-lam rab. * T/Cpsi
Inspection of truss joist fab.
Sample and'test components
Fabrication welding of steel accessories
SMOKE CONTROL:
FIREPROOFING:
Leakage testing
Control Verification
Placement inspection
Density tests
Thickness tests
Inspect batching
MASONRY.
Special inspection stresses used*_ fm fg
Preliminary acceptance tests (masonry units, wall prisms)
Subsequent tests (mortar, grout, field wall prisms)
Placement inspection of units, and reinforcement
Masonry, mortar, 'grout, and reinforcing steel ,certificates
ROOFING:
Insulation installation/R-Value*
Test strips/seams
ADDITIONAL INSRUCTTONS, OTHER TEST, & INSPECTIONS:
b- :Pl?)( '/ - SEr AA/iH-D"", :&"a.<...J:J,
Form Completed by: ~
Date ~::2;J2;;
'PROVIDE STRENGTH REQUIRED BY ARCHITECT OR ENGINEER OR CONTRACT DOCUMENT LOCATION OF VALUES